National Forest Roadless Area Conservation Act

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

Mr. Speaker, this bill, H.R. 3962, does not represent good public policy. I rise to express my concerns about H.R. 3962, the Affordable Health Care for America Act.

This legislation is misnamed, as even the nonpartisan Congressional Budget Office says it will not be affordable for the American people and our nation as a whole.

The Congressional Budget Office says this legislation will cost $1.055 trillion over the next 10 years, raising taxes on American taxpayers and businesses by $729.5 billion. Of great concern to me, and the 138,647 Medicare beneficiaries I represent, is that it will also cut Medicare payments by $500 billion. There is no possible way you can cut such a significant amount of funding out of a program that is so vital to senior citizens without compromising the availability or quality of their care and without disrupting the relationship they have with their current doctors and medical providers.

Within the Medicare program, H.R. 3962 also cuts the reimbursement rate for seniors enrolled in Medicare Advantage programs. In the 10th Congressional District of Florida which I represent, more than one- third of the Medicare beneficiaries, or 47,729 seniors, are currently enrolled in Medicare Advantage plans. The Chief Actuary of the Centers for Medicare and Medicaid Services estimates that if enacted, the legislation we consider today would cut enrollment in Medicare Advantage by 64 percent over 4 years. This means that more than 30,500 of the seniors I represent will lose or have to give up the health care coverage they currently have and like. This violates the number one promise made by the sponsors of this legislation, who say that if you like your current health care coverage, you can keep it.

The Congressional Budget Office also notes that changes in this legislation to the Medicare Part D program will, in the end, drive up Part D premiums by as much as 20 percent. These are additional premiums that seniors living on fixed incomes will have to pay to keep their prescription drug coverage.

Finally, with regard to Medicare, this legislation does nothing to correct a 21 percent cut in physician reimbursement rates that is scheduled to take effect January 1st for doctors who provide care to our seniors. Having met with doctors I represent throughout the past year, I know that one of their major concerns about health care reform is that they will be asked to take larger and larger cuts in Medicare reimbursement rates. These cuts, they say, will make it more and more difficult for them to care for Medicare patients. In the end, many seniors could be forced to find new doctors.

In addition to the impact this legislation would have on senior citizens, I am concerned about the economic impact this legislation will have on those seniors, their children, their grandchildren, and their great grandchildren. H.R. 3962 creates a brand new federal entitlement program at a time when our nation is struggling to sustain those entitlement programs already on the books. While the Congressional Budget Office says that under a best case scenario the $500 billion in Medicare cuts and $729.5 billion in tax increases will pay for this legislation over its first 10 years if there are no unexpected costs, it is doubtful that this will keep the program from running up federal deficits after that and leaves no margin for error.

In fact, despite one of the goals of this legislation to make health insurance more available and affordable for uninsured Americans, we simply move an estimated 18 million people into the government Medicaid program. This is more than half of the 34 million uninsured

Americans who the Chief Actuary of the Centers for Medicare and Medicaid Services says will receive coverage under this legislation.

Of the 13 million uninsured Americans who will receive coverage under the Health Insurance Exchange program created in this legislation, the Chief Actuary estimates that 40 percent, or 5.2 million, will take advantage of the government subsidized public option created by H.R. 3962.

The creation of a government subsidized public option is another major concern of the large majority of my constituents who have called and written me in opposition to this legislation. We are concerned about the insertion of the federal government into the precious patient-doctor relationship. At last count, this 1,990 page bill creates more than 100 new boards, bureaucracies, commissions and programs. Among those created by the bill is the ``Health Benefits Advisory Committee,'' that would be chaired by the U.S. Surgeon General, to make recommendations on cost and coverage issues.

This 27-member government committee of unelected administrators will be in charge of advising other bureaucrats, who will then decide what procedures American citizens are allowed to have and what doctors you are allowed to see under your healthcare plan. This places another layer of bureaucracy between you and your doctor.

This committee is in addition to another newly created federal organization called the ``Health Choices Administration,'' which will be governed by a new Commissioner who will distribute billions of dollars of taxpayer-funded subsidies. Additionally, the Commissioner will have complete control over all insurance plans offered through the newly created Health Insurance Exchange.

Perhaps the toughest of the mandates handed down by the federal government under this legislation is that businesses must provide health care for their employees or pay an 8 percent payroll tax and that individuals must purchase health insurance or pay a 2.5 percent tax on their adjusted gross income. This is not the federal government providing incentives to individuals or employers. This is the federal government imposing its will on individuals and businesses, and penalizing those who do not comply.

This legislation further penalizes small businesses by imposing a 5.4 percent surtax on individuals earning more than $500,000. Half of these so-called ``high earners'' are small business owners. Just imagine how small business owners all across our nation will react to this $544 billion in new federal taxes they will pay over the next 10 years. With the unemployment rate nationally at 10.2 percent and 11.4 percent in Florida, Congress should not be making it harder for business owners to create new jobs.

Finally, at a time when we are trying to lower health care costs, this legislation imposes a new 2.5 percent excise tax on the cost of wheelchairs, portable oxygen systems, diabetes testing equipment, and a whole range of other medical devices. This tax will be paid by our constituents who have no choice but to purchase this medical equipment and who may already be stretched thin by other medical costs.

Mr. Speaker, I have discussed here some of my concerns about provisions in this bill; however there are glaring omissions to this legislation as well. The most significant provision that has been left out is medical liability reform. This is a top issue for doctors, hospitals and all medical providers, as it is one of the major drivers increasing the cost of health care. Tort reform would help reduce the filing of unwarranted lawsuits, decrease the number of duplicative tests that are a part of defensive medicine, and lower the cost of medical malpractice insurance rates, which would translate in lower medical costs.

Tort reform is one of the many areas that we can and should be able to agree upon to increase the availability and decrease the cost of health care. There are others I support, some in this bill, including requiring coverage for individuals with pre-existing conditions, preventing insurance companies from cancelling the policies of individuals when they become sick, providing for the availability of health insurance across state lines, ensuring that employees can retain access to health insurance when they change or lose their jobs, creating health insurance pools that small business owners and self- employed individuals can join to provide lower cost health insurance for their employees and themselves, and closing the so-called doughnut hole in the Medicare Part D prescription drug program.

Mr. Speaker, there is no doubt that our nation can and should do better to provide quality and affordable health care for the American people. Throughout my service in Congress, I have done all I could to expand health care opportunities nationally and throughout the 10th Congressional District, which I represent.

By establishing the National Marrow Donor Program in 1986, I sought to provide life-saving medical options to terminally ill patients suffering from leukemia and more than 60 otherwise fatal blood disorders. Today the national registry has more than 7 million volunteers available to donate the life-saving bone marrow.

During the time that I worked to establish the national registry and as we began to find matched marrow donors for patients, I met with family after family who needed help convincing health insurance companies to cover the marrow transplant procedure. From this experience, I witnessed first-hand the tragedy of families losing their health insurance coverage at their time of greatest need and of being denied coverage for a life-saving procedure.

In a similar manner, I have identified other national and local health care needs and have done something to solve the problems that include increasing the vaccination rates for our nation's children; ensuring the availability of specialized services, facilities and equipment at our nation's hospital emergency rooms to meet the needs of children; expanding the funding for graduate medical education programs to increase the number of doctors who receive the next step of their training; increasing the Inspector General force at federal agencies to uncover waste, fraud and abuse which threaten the safety of seniors and veterans, and divert limited federal health care resources; improving the quality of health care through our investment in biomedical research by doubling the budget for the National Institutes of Health during my 6 years as Chairman of the Appropriations Committee; expanding other research opportunities through the Department of Defense in the areas of breast cancer, prostate cancer, Parkinson's Disease, ALS, multiple sclerosis and diabetes; and expanding the number of community health centers throughout Florida and Pinellas County.

Mr. Speaker, I take a back seat to no one when it comes to my work to improve and expand the quality and availability of health care for the American people and the people I represent. I supported the creation and expansion of the State Children's Insurance Program, which increases access to health care for our nation's youth, and likewise the Family and Medical Leave Act, allowing employees to take time off from work to care for a sick and recovering family member.

However, I cannot support legislation that would threaten the sanctity of the patient-doctor relationship, that would establish new federal bureaucracies that would insert themselves into the health care programs of individuals and employers, that creates a new and financially unsustainable federal entitlement program, that threatens the availability of health care for our nation's seniors, that raises taxes substantially and threatens the viability of many small businesses at a time when we are trying to get our nation's economy back on track, and that ultimately will not make health care insurance more affordable for the American people.

We have all heard from the American people we represent over the past few months that this legislation has been under consideration. We have heard that they are closely following its progress. We have heard that they have many concerns about this legislation before us. And we have heard that they want us to work together in a bipartisan manner to bring down the cost and expand the availability of health care coverage.

Today, we have a historic opportunity to tell the American people we hear their voices. We can commit to them that, on this issue which will affect every single household and business in our nation, we will go back to our respective committees and work together--as Republicans and Democrats; conservatives, moderates and liberals; Blue Dogs and Progressives--to come up with a solution that the American people can support and, most importantly, have confidence knowing it will do the job without bankrupting our nation, jeopardizing our economic recovery and violating the free market principles upon which our nation was founded.

Mr. Speaker, I yield myself 2 minutes.

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

Mr. Speaker, I first want to apologize to my wife, Terry. Back in September for my 60th birthday, she gave me a birthday present of a weekend in Las Vegas today. I obviously can't be there because I have to be here doing my duty for the 6th District of Texas. But like many of us, we wear two hats. So to my wife and all the families that had things planned this weekend, I do want to apologize.

I would also point out that my wife works for a public hospital in Fort Worth, Texas; and this is something that's very, very dear to her heart.

Mr. Speaker, there are many reasons to oppose the bill before us, H.R. 3962. There are numerous policy reasons. It's going to cost over $1.2 trillion over 10 years if you include the physician reimbursement fix in the separate bill. When fully implemented, it's my opinion that two-thirds to three-fourths of every dollar spent on health care in America is going to be spent by the Federal Government in some shape, form, or fashion. It's going to create, in my opinion, Mr. Speaker, a two-tiered health care system: the public system for most of us and then a private system for the elites of the country that can afford to go outside the public system.

It's a bad deal for average Americans. The average person today who works and has a health care plan through their employer, the average plan costs about $10,000 a year. The employee pays $3,500; the employer pays $6,500. Since there's an 8 percent payroll tax, on the average of $40,000, that would be about $3,200. Most employers, when this plan is implemented, can pay the 8 percent tax, which is $3,200, or the $6,500 premium that they pay for their employees.

They're going to stop providing health care through the employment and they're just going to put them in the public option. The employee is going to take that $3,500 that he or she was paying for their premium for a $10,000 plan and they're going to find out that when they go into the health care exchange, their $3,500 doesn't buy a $10,000 policy. It buys a $3,500 policy. It's a bad deal.

Mr. Speaker, I yield myself 1 more minute.

So there are lots of policy reasons.

But the real reason, Mr. Speaker, is that I just don't think it's right, in the guise of helping Americans, to mandate what they have to do. I don't think it's right to mandate that you have to have health insurance or you might go to jail. I don't think it's right that you mandate an employer to provide health care insurance or they're going to pay all these penalties. I don't think it's right that we set up a health choice administration that sets what the health care plans have to be. I don't think it's right that you say that 70 to 90 percent of those premiums of the benefit package that is mandated has to be paid by the employer.

I just don't think mandating to Americans is a good idea, except in a few cases. To protect the country in times of war, we have on occasion had to mandate our young men, and now our young women, to have to serve. We mandate we have to pay our taxes. But we don't have to mandate that you need health insurance.

Vote ``no'' on the bill and ``yes'' on the Republican substitute.

Mr. Speaker, I yield 1 minute to a member of the committee, the gentleman from Illinois (Mr. Shimkus).

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

Mr. Speaker, I would like to yield 1 minute to the gentlewoman from California (Mrs. Bono Mack), a member of the committee.

Mr. Speaker, I yield 2 minutes to the gentleman from Georgia (Mr. Deal), a subcommittee ranking member.

Mr. Speaker, I would like to yield 1 minute to another member of the committee, Congresswoman Marsha Blackburn of Nashville, Tennessee.

Mr. Speaker, I yield for a unanimous consent request to the former chairman of the Appropriations Committee, Mr. Bill Young of Florida.

(Mr. YOUNG of Florida asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I yield a clock 3 minutes to the minority leader, Mr. Boehner. This is not his leadership imperial minute. It is the clock 3 minutes.

I yield 2 minutes to a member of the Republican leadership, Mr. McCarthy of California.

Mr. Speaker, I yield 1 minute to the distinguished ranking member of the Science Committee and a member of the Energy and Commerce Committee, the gentleman from Rockwall, Texas, Congressman Ralph Hall.

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

Mr. Speaker, I yield 1 minute to a distinguished member of the Energy and Commerce Committee, one of our ranking members of the subcommittee, the gentleman from Michigan (Mr. Upton).

Mr. Speaker, I yield 1 minute to the distinguished former mayor of Fort Worth, Texas, the Honorable Kay Granger.

Mr. Speaker, I yield 1 minute to one of the distinguished ranking members of the Energy and Commerce Committee, the gentleman from Florida (Mr. Cliff Stearns).

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

I yield 1 minute to another of my distinguished ranking members on the Energy and Commerce Committee, the gentleman from the Bluegrass State of Kentucky (Mr. Whitfield).

I would like to yield 1 minute to the gentlelady who has the privilege of representing Key West, Florida, the Honorable Ileana Ros-Lehtinen.

Mr. Speaker, I would like to yield 2 minutes now to the leader of the Republican Health Care Task Force and a member of our committee, the deputy ranking member, Mr. Roy Blunt.

Mr. Speaker, I see that we have changed from the Jets and the Giants to the Green Bay Packers in the chair.

I would like to yield 1 minute to a Ramblin' Wreck from Georgia Tech, a member of the Committee on Energy and Commerce, Dr. Gingrey.

Mr. Speaker, I yield 1 minute to the gentlewoman from Missouri, who represents the hometown of Rush Limbaugh, Cape Girardeau, Missouri, Congresswoman Jo Ann Emerson.

Mr. Speaker, I recognize one of my ranking subcommittee members, Mr. Radanovich, who represents Fresno, California, for 1 minute.

Mr. Speaker, I am proud to yield 1 minute to the honorable gentlewoman from North Carolina (Mrs. Myrick), a cancer survivor.

Mr. Speaker, I am proud to yield 1 minute to the sixth Frelinghuysen to represent a district from the Garden State of New Jersey, the Honorable Rodney Frelinghuysen.

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

Mr. Speaker, I am proud to yield 1 minute to the honorable gentleman from Pennsylvania (Mr. Pitts), one of the strong pro-life leaders in the U.S. Congress, a combat veteran of Vietnam, and a member of the Energy and Commerce Committee.

Mr. Speaker, I yield 1 minute to the gentlewoman from Wyoming (Mrs. Lummis), who represents the entire State.

Mr. Speaker, I yield 1 minute to the gentleman from Nebraska (Mr. Terry), who represents Omaha, Nebraska, the home of the College World Series.

I would like to recognize the gentleman from Virginia, Congressman Frank Wolf, for a unanimous consent request.

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

Mr. Speaker, I yield 1 minute to the former FBI man from the great State of Michigan (Mr. Rogers), a member of the committee.

Mr. Speaker, I yield 1 minute to the gentleman from the Pelican State, Congressman Scalise from New Orleans, a member of the committee.

Mr. Speaker, could I ask how much time. You said it a minute ago, but I was not listening.

Thank you, Mr. Speaker. I was listening to my distinguished friends on the majority raptly.

I now yield 1 minute to one of our doctors, physicians, the gentleman from Lewisville, Texas, the Honorable Michael Burgess, also a member of the committee.

Mr. Speaker, I yield 1 minute to the gentleman from Phoenix, Arizona, Congressman John Shadegg, a member of the committee.

Mr. Speaker, I am proud to yield 1 minute to the gentleman from the Hoosier State of Indiana, Mr. Steve Buyer, another member of the Energy and Commerce Committee, and the ranking member on the Veterans' Affairs Committee.

Mr. Speaker, I will yield 1 minute to the gentleman, if that's allowed.

Mr. Speaker, I yield 1 minute to the distinguished ranking member of the Financial Services Committee from the great State of Alabama, Mr. Spencer Bachus.

Mr. Speaker, it is my privilege to yield 1 minute to Congressman Fortenberry of Lincoln, Nebraska, which today, since Oklahoma is playing Nebraska at Lincoln, is the largest city in Nebraska.

Mr. Speaker, I yield 1 minute to the gentleman from Lubbock, Texas, a recent beneficiary of the best health care system in the world, Congressman Randy Neugebauer.

Parliamentary inquiry, Mr. Speaker.

We respect the ruling and the admonition about members of the gallery, but is it acceptable under the rules for the Members of Congress to show approval or disapproval of a speech on the floor?

Thank you, Mr. Speaker. We approve the Speaker's ruling.

Mr. Speaker, it is now my privilege to yield 1 minute to the gentleman from the State of Oklahoma (Mr. Cole), and it is with great pleasure that I announce that the entire Oklahoma and Nebraskan delegation who disagree on the outcome of the football game are all in agreement in opposing this bill.

Mr. Speaker, I yield 1 minute to one of our pro- life leaders, the Honorable Chris Smith of New Jersey.

Mr. Speaker, I have a parliamentary inquiry.

Who has the right to close this part of the debate? Does Chairman Waxman have the right to close or does the ranking minority member have the right to close?

Mr. Speaker, I yield 1 minute to Congressman Jeb Hensarling from the great State of Texas for 1 minute.

Mr. Speaker, I would like to recognize a Member from the great State of Georgia (Mr. Kingston) for 1 minute.

Mr. Speaker, I yield myself the balance of the Energy and Commerce time.

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

Mr. Speaker, first of all, let me tell you how proud I am of the members of the Energy and Commerce Committee on both sides of the aisle who have participated in this debate since January, and who have participated on the floor debate today. It makes me proud to be a member of that committee.

Mr. Speaker, we have heard all of the policy arguments pro and con for this bill. I am going to end the Republican side of the Energy and Commerce debate simply by saying that I think this bill should be defeated because it is an imposition on personal freedom here in America. I just simply don't think that it is right to tell people that they have to have insurance, tells employers they have to provide insurance, to set up a bureaucracy that advises a bureaucracy what that insurance should be, that then determines what the insurance itself should be, what the minimum premium should be, what has to be covered, what shouldn't be covered, and then over time almost guarantees that everybody, except the richest people in America, are in some version of the public option.

I just think that is wrong in America, Mr. Speaker, and for that reason alone I am against this bill.

There is an alternative. The Republican alternative covers many of the things that my friends on the majority side say they are for. We simply do it without mandating and imposing government will on the American people. Please vote ``no'' on the majority bill, and vote ``yes'' on the minority substitute.

Mr. Speaker, pursuant to House Resolution 903, I call up the bill (H.R. 3962) to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes, and ask for its immediate consideration in the House.

Mr. Speaker, I am pleased to start off the debate by recognizing our very distinguished majority leader, Steny Hoyer from the State of Maryland, for 1 minute.

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

Mr. Speaker, I am pleased at this time to yield 3 minutes to the majority whip of the House of Representatives, Mr. Clyburn.

Mr. Speaker, at this time I am very pleased to recognize and to yield 1 minute to the gentlewoman from Connecticut (Ms. DeLauro).

Mr. Speaker, I am pleased now to yield 2 minutes to the gentleman from Connecticut (Mr. Larson), the chairman of the Democratic Caucus.

Mr. Speaker, I am pleased at this time to yield 2 minutes to the gentleman from the State of Maryland, Mr. Chris Van Hollen.

Mr. Speaker, I yield myself 3 minutes.

Today, we have a historic opportunity. Sixty-five years after Franklin Roosevelt and Social Security and 35 years after Medicare, we have an opportunity, under the leadership of President Obama and Speaker Pelosi, to reform our health care system and at last provide coverage to all Americans.

We know that health insurance today is failing our families and our economy. If we do nothing, the system will go bankrupt, premiums will keep skyrocketing, benefits will be slashed, what you get will cost more, and the deficit will increase by billions of dollars.

Today, Americans with health insurance know that they are one serious illness away from debt and bankruptcy, and millions of Americans have no insurance at all. With this legislation, we can fix these problems.

First and foremost, this bill provides health insurance security for all Americans. If you have health insurance today, you can keep it; you keep your doctor and your other health providers. But if you lose your job, you will not lose your health insurance. If you have a preexisting medical condition, you cannot be denied health insurance. If you have a serious illness, we remove the cap insurance companies have imposed on paying for treatments over your lifetime. Effective immediately, it will be illegal for insurance companies to put lifetime caps on your coverage. And children all the way up to age 27 can continue on their parents' policies.

Our bill has historic reforms. It expands coverage and reduces costs. It trains doctors and supports community health centers. It provides a public health insurance option that will give Americans more choice and competition.

Our legislation strengthens Medicare. We will eliminate copayments for preventive services. We close and then eliminate the doughnut hole that makes prescription drugs unaffordable for so many of our seniors.

And this legislation is affordable. The only thing not affordable is to do nothing. The legislation is fully paid for. It will not add to the deficit over the next two decades.

Today, we have the chance of a lifetime to do something great and momentous for the American people. By passing this bill, we can reform health insurance in America and provide all Americans with the security of knowing that when they get sick, care will be available and affordable.

I urge all my colleagues to support this bill.

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

If the gentleman would yield.

As the gentleman well knows, the decision is not up to one person; it will be up to the conferees. The conferees will have to be meeting with the Senate conferees and going over a number of positions.

If this amendment is adopted by the House, it will be the House position as we go into conference. We will have to discuss it further, and then we will see what will be the result. But no guarantee can be made by me or any other Member at this time.

There will be an opportunity, as you know, to instruct the conferees, which reinforces, of course, a particular part of the House bill.

Mr. Speaker, at this time, I am honored to yield 2 minutes to the gentleman from New Jersey (Mr. Pallone), the chairman of the Health Subcommittee of the Energy and Commerce Committee.

Mr. Speaker, this bill reflects the input and the inspiration of two Kennedys in the Congress of the United States, certainly Senator Ted Kennedy, but also Patrick Kennedy, who has been such a leader in the areas of mental health and addiction.

I yield to the gentleman from Rhode Island for a unanimous consent request.

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

Mr. Speaker, I ask unanimous consent that Members have 5 legislative days in which to revise and extend their remarks on H.R. 3962 and include extraneous material in the Record.

Mr. Speaker, at this point, I am greatly honored to yield 3 minutes to the chairman of the Ways and Means Committee, one of the crafters of this bill and one of the great leaders in health care as well as other policy areas, the gentleman from New York (Mr. Rangel).

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

Mr. Speaker, I yield 1 minute to the gentlewoman from California, Anna Eshoo.

Mr. Speaker, I yield 1 minute to a member of our committee, the gentleman from New York, Eliot Engel.

Mr. Speaker, I yield 1 minute to a member of our committee, the gentleman from Texas, Gene Green.

Mr. Speaker, I yield 1 minute to a very active and important member of the Health Subcommittee and of the full Energy and Commerce Committee, my colleague from California, Lois Capps.

Mr. Speaker, I yield 1 minute to the gentleman from Pennsylvania (Mr. Doyle).

Mr. Speaker, I yield 1 minute to the gentleman from the

State of Washington, a very important member of the Energy and Commerce Committee, Mr. Inslee.

Congressman Inslee, you are correct. It's our intent that the patient would not be switched from a referenced product to a non- interchangeable biosimilar without approval from the doctor.

I yield the gentleman an additional 30 seconds.

Our intent is also that a patient could not be financially induced by their plan to switch to a non-interchangeable biosimilar without the consent of their doctor, and I am happy to work with the gentleman to clarify the language in conference.

Mr. Speaker, at this time I yield 1 minute to the gentleman from the State of North Carolina, an important member of our committee, Mr. Butterfield.

Mr. Speaker, I yield for the purpose of a colloquy to the chairman of the subcommittee, Mr. Pallone, 1 minute.

I want to thank the gentleman from New Jersey for his leadership on the bill before us today and for his tireless efforts on behalf of low-income Americans who need long-term care. I support the elimination of barriers to the provision of home and community-based services under Medicaid, a result that the gentleman's Empowered at Home Act would achieve.

I yield the gentleman an additional 30 seconds.

I will continue to work with you and other Members to enact legislation that gives State Medicaid programs a robust option for offering low-income Americans the choice of receiving long-term care services in the community rather than in a nursing home.

Mr. Speaker, I am pleased to yield 1 minute to a very important member of our committee, the gentlewoman from the Virgin Islands (Mrs. Christensen).

Mr. Speaker, I yield 1 minute to the gentlewoman from Illinois (Ms. Schakowsky), a senior member of the Energy and Commerce Committee.

Mr. Speaker, can I inquire how much time is available on each side?

Mr. Speaker, I yield 1 minute to the gentlewoman from Wisconsin (Ms. Baldwin).

Mr. Speaker, at this time I yield 1 minute to the gentleman from Massachusetts (Mr. Frank) for the purpose of a colloquy.

The answer is yes.

Yes. The bill ensures the commissioner will work with the Small Business Administration.

Mr. Speaker, I yield 1 minute to the gentlewoman from Florida (Ms. Castor), a member of our committee.

Mr. Speaker, I am pleased to yield 1 minute to the gentleman from Pennsylvania (Mr. Patrick J. Murphy), who has been a leader in our efforts to lower growth in premiums through measures such as immediate review and justification of insurance rate increases.

Mr. Speaker, I yield the gentleman an additional 10 seconds.

If the gentleman would permit, I want to thank you for your leadership, and assure you we are going to continue to work in conference to do everything we can to make coverage affordable for the American people.

Mr. Speaker, I yield 1 minute to the gentleman from Connecticut (Mr. Murphy).

Mr. Speaker, I yield 1 minute to the gentleman from Colorado (Mr. Salazar).

Mr. Speaker, I yield 1 minute to the gentlewoman from Ohio, Betty Sutton, a member of our committee.

Mr. Speaker, for a unanimous consent request, I yield to the gentleman from Iowa (Mr. Boswell).

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

Mr. Speaker, I yield 1 minute to the gentleman from Virginia (Mr. Perriello) for the purpose of a colloquy.

If the gentleman will yield, yes, it is. That is a correct statement.

The gentleman is correct in that statement.

Mr. Speaker, that was a remarkable child and a great ventriloquist.

I would like to yield for a unanimous consent request to the gentleman from Virginia (Mr. Boucher).

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

At this time, I yield 1 minute to the gentleman from the State of Maryland (Mr. Sarbanes), a member of our committee.

Mr. Speaker, I yield myself 1 minute.

Before I yield to another very important member of our committee, I just want to set the record straight. We keep faith with the veterans in this bill. We allow them to keep their veterans benefits. We allow them to keep their benefits. They may, if they choose to, go into the exchange; but if they don't, they keep their benefits.

I yield 1 minute to the gentleman from Iowa (Mr. Braley), a member of the Energy and Commerce Committee.

Mr. Speaker, I yield 1 minute to the gentlewoman from the State of California (Mrs. Davis) for the purposes of a colloquy.

If the gentlewoman would yield, I thank you and I'm encouraged you and your staff have committed to further working on these provisions and not allowing health insurers to find loopholes in State laws.

Mr. Speaker, I yield 1 minute to the gentleman from Maryland (Mr. Cummings).

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

Parliamentary Inquiry

Mr. Speaker, 37 million Americans do not have health insurance because they can't afford it, their employers do not offer it to them, or they have a preexisting condition and the insurance companies deny it to them. We want them to buy the same policies that our Republican Members have talked about in such glowing terms, available to them and their families. Don't say ``no'' to 37 million Americans and tell them they have freedom. They don't have freedom to go without. In a country where people should not be forced into bankruptcy when they get sick, let's let people buy private insurance or a public option and get coverage.

I rise in strong opposition to the bill because our Nation is going broke.

I rise in opposition to this bill.

We must carefully weigh the implications of a costly new government spending program at a time when the country already owes more than $56 trillion in entitlement obligations.

I am also deeply concerned about the national debt, which has doubled since 2000 and is nearing $12 trillion for the first time in our history.

Any plan put forward must control costs, not add billions of dollars to an already ballooning deficit.

America is going broke. Is this the legacy this Congress wants to leave our children and grandchildren?

News Release

``Health care is a very personal issue and there are very

real consequences to what Congress does on this issue.

Congress must be committed to offering affordable,

accessible, and portable health care choices with the goal of

fixing what's broken and keeping what works. I know there are

good and reasonable people with deeply held views on every

side of the health care reform issue. That's why I believe

all sides need an opportunity to be heard and offer ideas so

that a bipartisan consensus can be reached.

``I believe every fair-minded person would agree that

Congress needs to find a way for the millions of Americans

without health insurance to be assured of quality, affordable

health care when they need it and to address the concerns of

those who are paying for a plan they believe falls short of

the coverage they need. Part and parcel of that discussion, I

believe, also must be the recognition that there are many

folks are paying for a health insurance plan that they like

and want to keep and they don't want the government involved

in their health care decisions.

``I am very concerned, however, about the health care

reform process under way in Congress. House Democrats on

October 29 unveiled a 1,990-page health reform bill--H.R.

3962--which is estimated to cost just under $900 billion over

10 years. Especially troubling is the majority leadership's

intention to fast track the legislation for House

consideration within days of its introduction.

``Congress needs to listen to the American people, take its

time and get health care reform legislation right. This is

too important an issue to rush through under some artificial

timeline. It is for this reason that I am cosponsoring a

resolution calling for any health care reform legislation

considered by Congress to be made available online in its

final form 30 days prior to being voted on in the House. I

believe that every American must have the opportunity to read

and understand what Congress is considering. Now with the

latest bill covering nearly 2,000 pages, that is more

important than ever. A copy of H.R. 3962 is available on my

Web page, www.wolf.house.gov. ``I opposed the first version of the Democrats' health

reform legislation (H.R. 3200) that was introduced this

summer, and nothing that I have read so far in the newest

version introduced on October 29 changes my view. This

legislation would set up a government insurance option with

rates to be negotiated between providers and federal health

officials. It has mandates for every American to have

insurance and for employers to provide insurance. It would

expand Medicaid to historic levels adding new mandates on

states. The revenue sources identified include a surcharge

on wealthy taxpayers and changes to Medicaid and Medicare

which would translate to about $500 billion in cost

savings over 10 years, according to the Congressional

Budget Office.

``When President Obama earlier this year directed Congress

to come up with a health reform plan, I had hoped that both

Republicans and Democrats could work together on this issue

of such complexity in a bipartisan way and reach consensus on

a plan to address the needs of uninsured Americans, protect

those with insurance plans they like, and keep a lid on

deficit spending at a time when our economy is reeling from

recession and spiking unemployment. What we have seen,

however, is the opposite. The speaker and House majority

worked alone on H.R. 3200 that initially was to be voted on

by the House in early August. They have continued to work

behind closed doors to refine that plan, and the latest bill,

H.R. 3962, was drafted solely by the majority.

``I don't believe that is the right way to develop public

policy on an issue of such importance and far-reaching

consequence to every American. This is a complex issue to

legislate, and there are legitimate questions that Congress

must answer. Among the many questions to be resolved are how

to make sure health care decisions are patient-centered and

remain between physicians and patients and not prescribed by

some government formula; how to provide for Americans who

don't have health insurance and ensure those with pre-

existing conditions can get insurance; how to protect those

who have health insurance and don't want to be forced to give

up their plans or pay more for them; how to control health

care costs and pay for health care reform without increasing

the

deficit; how to ensure that U.S. taxpayers are not

subsidizing health insurance for those illegally in our

country; how to ensure that the self-employed and small

business owners can afford insurance, and how to ensure that

young adults can continue to be carried under their parents'

health plan until they reach age 25.

``I have concerns about a government-run insurance option

and what that will mean in the way of costly mandates for

small businesses and other employers during a time when

unemployment is teetering near 10 percent. I am also

concerned about how Americans will pay for a $900 billion

plan as our country tries to work its way out of an economic

recession and faces trillions of dollars in debt and a

growing annual deficit that could be near $2 trillion. I also

have questions about finding a half trillion dollars in

savings in Medicare and Medicaid costs. What will that mean

for senior citizens today?

``We must carefully weigh the implications of a costly new

government spending program at a time when the country

already owes more than $56 trillion in promised entitlement

obligations through Medicare and Social Security. I'm also

concerned about the national debt, which has doubled since

2000 and is nearing $12 trillion for the first time in our

history, and unprecedented federal deficits, which could

result in increased interest rates for consumers if we

continue to finance government by borrowing from foreign

lenders. I have the leading bill in the House to establish a

bipartisan commission to review entitlement spending with tax

policy on the table to ensure that Congress addresses these

spending issues, which if left unchecked, will be disastrous

for future generations. (For more information about the SAFE

commission, go to www.wolf .house.gov/SAFE.)

``I again want to emphasize: it is important for Congress

to fix what's broken with our nation's health insurance

system. But we have to do it the right way without changing

what is working. We need a plan that controls costs without

adding billions of dollars to an already ballooning deficit;

ensures competition and choice; provides that patients and

their doctors make the decisions on medical care rather than

a government-run agency, and addresses skyrocketing medical

liability costs and tort reform.

``I believe that the legislation in the House falls short

of those goals and that Congress has a lot more work to do to

provide the kind of health reforms Americans want and need.''

I thank Mr. Waxman for yielding.

Our rule was chaired by John Dingell, himself a historic figure on a historic day.

I want to congratulate all of those who have participated in the accomplishment of the product that we consider this day: Mr. Waxman, one of our senior Members in the House; Mr. Rangel, one of our senior Members in the House; and Mr. Miller.

I want to thank too the Republicans who engaged in this discussion, in this debate, because it is historic, and all of us who sit in this Chamber know that it will have a great effect on our people. Some perceive that effect as not positive. More, I believe, think it is positive. In any event, none of us believe that it is not extraordinarily important.

Soon each one of us is going to look into his or her conscience and vote on this bill. And when the time comes, I don't know if any words of mine will sway any of you. But I know that the most powerful arguments for the bill won't be spoken on this floor. They are being lived right now in our country in every one of our districts, in every one of our towns and counties and municipalities.

In the anxiety of the family that finds itself paying more and more each year for health insurance that grows weaker and weaker.

In the frustration of the small business owner weighing the choices of dropping her employees' coverage against the threat of being driven out of business by her competitors.

And in the fury of the patient who learns that an insurance company bureaucrat has deemed him too sick for the coverage he paid for.

They are our families, our neighbors, our fellow citizens. They are waiting for health insurance reform that is more affordable, more secure, more just. Their stories will be with me and I know with each of us when we cast our vote.

Because I want to say to every American facing down illness: never again, never again will you be denied coverage because you have diabetes or asthma or some other disease or because you're pregnant or because you have anything else your insurer decides is a preexisting condition. Never again will your coverage run out. Nor will you find the coverage you thought you had paid for was actually not there at all. And never again can insurance companies drive out competition and set premiums as high as they like, because there will be a public insurance option and a transparent marketplace to keep them honest, to keep them competitive, to bring prices down.

I want to say to our middle class families, the backbone of our country: you will have coverage that you can depend upon. Even if you change your job or lose your job or decide to start a business, you will be able to find affordable coverage in a competitive marketplace, an insurance exchange that offers you a choice of good policies at fair rates. In fact, according to an MIT analysis, buying coverage on the exchange will bring your premiums down by a great deal, even without the affordability credits.

If your family makes $90,000 or more, you'll save more than 1,200 bucks. If your family makes $60,000, you'll save more than $5,000. And if your family is making $38,000, you'll save more than $9,000. That's the kind of tax cut that America needs to secure its medical future.

I want to say to our seniors: you can count on Medicare, on a Federal program, for dignity and peace of mind in your golden years. And that will not change. Today we will vote to protect your access to your doctor, to encourage Medicare physicians to cooperate on higher quality care, to keep your Medicare solvent for longer, and to bring an end to the doughnut hole that leaves prescription drugs unaffordable for so many.

I want to say to our small businessmen and women: I know your premiums keep going up and that each year they make it harder to stay in business, to compete with Big Business and with foreign firms. You deserve a fair playing field; and in the insurance exchange marketplace, you'll be able to buy coverage at the low group rates you're now being denied.

I want to say to the 35 million Americans without insurance, who are forced to skip checkups and preventative care, who are forced to turn to the ER as the first and only line of defense, who live sicker and shorter lives: you will have what every man, woman, and child has in every other industrialized country in the world: health coverage you can afford and that you can count on.

And every American who is rightly worried about our mounting deficits and debt, I can tell you this: this bill does not add to the deficit over the next 10 years or the 10 years thereafter. This bill means health care that is more fiscally sustainable for years to come.

That is what this bill, the Affordable Health Care for America Act, can achieve for our country and for our people. It isn't a simple bill. It isn't a perfect bill, but it is the product of months and months of careful debate, sometimes animated debate, yes, even angry debate, careful scrutiny, hard work, and citizen input. And it's the right response to this time of economic insecurity in which we have been called to lead.

If we miss this chance, or if we vote for a Republican plan that does very little to expand coverage, weakens insurance, frankly, for millions who have it, and continues to allow millions of Americans to be denied affordable coverage, we'll find ourselves back here again.

But by then, premiums will eat up even more of our families' budgets; health care will consume even more of our economy; and even more Americans will have died for the lack of health care.

If we miss this chance, if we miss this challenge of nearly a century's duration, when Teddy Roosevelt, one of the great Presidents of this country, a Republican President of this country, said a hundred years ago we need to have health care coverage for all Americans--this is not a new idea, but it is

an idea whose time has surely come--the years between this chance and our next one will be filled with stories that are unworthy of America at its best.

Stories like Linda's, who wrote to The New York Times of the anguish she felt suffering from abdominal cancer and standing in the hospital just feet away from the drugs that could help save her life, drugs her insurance company was denying her.

Stories like Deamonte Driver's from Prince George's County, just a few miles down the road, who died at the age of 12 from a toothache, a toothache that was not treated by a dentist; and, as a result, it became infected. That infection went into his brain. He was in the hospital for 30 days at a cost of $250,000. Why? Because he didn't have $80 to get that tooth filled.

This bill will change that. We can be better than that. America is better than that. We must be.

Americans rightly want to know what's in this bill for them and for their families, but there's also something important in this bill for us as a people: a system worthy of the values we profess and the principles we hold dear. We will vote for a healthier America. We will vote to give our fellow citizens a greater sense of security. We will vote to make Medicare stronger for our seniors. We will vote for a healthier economy, for affordable coverage for individuals and small business. We will vote to begin containing costs, which will otherwise be unsustainable for our children and for our grandchildren.

We will, in sum, my colleagues, on this historic day, vote for a more perfect Union of which our Founders dreamed.