Raising a question of the privileges of the House.

Madam Speaker, let me first extend my appreciation to my good friend from Rochester, New York, Ms. Slaughter, for yielding me the customary 30 minutes, and I yield myself such time as I may consume.

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

Madam Speaker, last Sunday when we opened debate here on the rule, I opened by condemning the attacks that have been made on Members of this institution, their families and their staffs. Unfortunately, it is something which all of us who have been privileged to serve in elective office and as Members of Congress in particular have had to face for many years. I will reiterate, Madam Speaker, violence or the threat of violence is simply unconscionable, and we all join together in calling for an immediate end to these types of utterly unacceptable acts.

Madam Speaker, last Sunday I also predicted that we would be back here voting once again on the reconciliation bill. And here we are.

The need for another vote is further demonstration of just how flawed the tactics of the Democrats in charge of Congress have been. It shouldn't surprise anyone, Madam Speaker, that the reconciliation bill was found to violate Senate rules, as traditionally has been the case with the only exception in 1983. No legislation of this magnitude can be slapped together at the last minute and then withstand scrutiny. Our revote today is just further evidence of the perils of the refusal of the Democrats in charge to act in a bipartisan and open way.

We have been debating the issue of health care reform in the Congress for a long period of time. As a Nation, we have been struggling with the very serious issue of increasing access to quality care for many, many, many years. We all want to expand coverage and improve quality for the American people. There are a number of key reforms that enjoy broad bipartisan support that would bring us much, much closer to that goal.

Yet, despite these opportunities for bipartisanship, Madam Speaker, the Democrats in charge insisted on forcing through the most partisan and costly bill possible. And despite all the time that has been spent on this issue, they insisted on forcing through a reconciliation bill that was largely written the night before we voted on it. Again, Madam Speaker, this was written in large part the night before we voted on it. That is why it should be no surprise, and there were those of us last Sunday who predicted that we would be back here.

Less than a week after that vote, serious mistakes in the legislative package have already been discovered, as I have said. Today's underlying package, as I said at the outset, has been returned to the House because it contained provisions that violated Senate rules.

Far more significant, however, are the mistakes that have been uncovered relating to a key provision in the Senate health care bill that is now law, mistakes that will not be fixed today; and I underscore, mistakes that will not be fixed today. One of the centerpieces of that legislation was a provision to ensure that no child is denied coverage for a preexisting condition. This is an issue that again enjoys overwhelming bipartisan support. I believe very passionately in the need to ensure that no one is denied coverage for preexisting conditions.

Madam Speaker, had we taken a responsible, step-by-step approach to reform, this provision dealing with preexisting conditions could have been signed into law months ago; but because the Democrats in charge shunned bipartisan cooperation and an open, transparent process, forcing through a hyper-partisan bill with no opportunity for open debate or any amendment, their $1 trillion bill passed Congress without any real accountability.

The result? They botched the language on preexisting conditions and we now know, Madam Speaker, that children will not get the coverage that they were promised. This is the inevitable result of a closed, partisan process.

Even the good ideas that are put out there that both Democrats and Republicans alike can come to an agreement on are undermined by a lack of scrutiny and transparency. Their bill was certainly filled with a lot of terrible ideas. Spending $1 trillion we don't have and hiring tens of thousands of new IRS agents to investigate hardworking Americans ranks at the very top of that list. But even the provisions like preexisting conditions that had bipartisan support are being undermined by shoddy work.

While the legal experts sort out the mess that was made of the legislative language, job creators are assessing just how much damage has been done to them. Today, The Wall Street Journal pointed out that companies large and small are taking stock of the new taxes that have been imposed and what the impact will be.

Now, we had an exchange upstairs about the fact that we have seen the stock market go up, and we all know that the stock market has gone up. But that does not belie the fact that Caterpillar will face $100 million in new taxes in the first year alone. The medical device company Medtronic fears it may have to lay off 1,000 workers in order to pay the new taxes.

Madam Speaker, with the national unemployment rate as we all know hovering just under 10 percent, this could not be a worse time to impose job-killing tax increases. The prospect of crippling new taxes and further job losses is not acceptable. We should focus on creating, not losing, good private sector jobs.

The process of reforming the so-called reform bill and undoing the damage that has been done will take years, wasting untold taxpayer dollars we cannot afford. Wasting precious time while the American people wait for real reform that actually improves access to quality health care is a waste. It shouldn't be done, and this is a tragically missed opportunity.

To the many Americans who are outraged by this bill and the process by which it was considered, and by the way, we are here under what is known as martial law rule. We just completed our meeting in the Rules Committee a few minutes ago, and without any consideration we have come right down to the House floor. People are outraged with this process. That has played a role in creating the anger that is there. I can only say there are still some Members of Congress, and I am one of them, who believe in bipartisan cooperation--in bipartisan cooperation, and we believe, as was promised in a new direction for America that then- Minority Leader Pelosi put forth for the American people and said she

would have when she took the oath in January of 2007, an open, transparent process. To many Americans who had high hopes for a true reform bill, I will say there are still some Members of Congress who will fight for real reform even if the Democrats in charge will not do that.

We will fight to ensure that all Americans have effective guarantees of coverage despite preexisting conditions. We will fight for meaningful lawsuit abuse reform, and we will work to allow small businesses and States to band together to offer better and more affordable coverage.

We will work to ensure that government bureaucrats never come between patients and doctors. We will make sure that no one will be forced to give up their current coverage if they do not so choose, and that those who have diligently saved in their health savings accounts are not in any way punished.

If we can abandon the failed tactics that the Democrats in charge have put forward and work in an bipartisan and open fashion, these are the kind of real reforms that can be enacted so all Americans will have access to quality, affordable health insurance.

I reserve the balance of my time.

Announcement by the Speaker Pro Tempore

Madam Speaker, at this time, I'm happy to yield 2 minutes to a very hardworking new Member who's an expert on TennCare, an obstetrician from Johnson City, Tennessee (Mr. Roe).

Madam Speaker, I yield myself such time as I might consume, and I would like to engage in a discussion, if I might, with my good friend from Johnson City, Tennessee, who, as we say, appears to be the only medical doctor here on the House floor at the moment.

He was just discussing his role and many years he's served, worked as an obstetrician, and one of the things that we have found, reports are--and this is before this bill was even considered--that there are many people who are in a position where they are being told, people who are under Medicare, that they are being refused an opportunity to have the kind of physician choice that they want.

We regularly have heard throughout this debate that you'll be able to choose your own doctor. But, Madam Speaker, I ask the question: Will your doctor choose you? What kind of incentive do we have at this juncture for people to get into the medical profession?

And I'd like to yield, if I might, to my friend from Johnson City, if he might respond to this notion of, well, you may be able to choose your doctor, but will your doctor choose you. And I am happy to yield to my friend.

I thank my friend for his remarks. And let me just say, this notion of you may choose your doctor but your doctor may not choose you, is that a fair assessment?

I'm happy to further yield to my friend.

And that's why I was arguing that it is really difficult to imagine why it is that people will pursue the medical profession, as the gentleman has done so ably over the years.

And I am happy to further yield to my friend.

I thank my friend.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I yield myself such time as I might consume, and I would like to engage in a discussion, if I might, with my friend and argue that I totally concur. We totally concur with the need to work on this issue of preexisting conditions.

The problem, Madam Speaker, has been that while this was extraordinarily well-intentioned, we've already found that this shoddily put together bill has denied the addressing of preexisting conditions. There are people out there who unfortunately believe, Madam Speaker, that the issue of preexisting conditions has been taken care of. One needs to look at the news reports right now of the problems that exist with our shared bipartisan goal of addressing that issue.

I reserve the balance of my time.

May I inquire of the Chair how much time is remaining on each side?

I will reserve the balance of my time, Madam Speaker.

Madam Speaker, at this time I am happy to yield 1\1/2\ minutes to a very hardworking member of the Committee on Rules, the latest recipient of the Ronald Reagan award, our friend from Grandfather Community, North Carolina (Ms. Foxx).

Mr. Speaker, it's nice to see you, but I should say for the record I did enjoy seeing Ms. Edwards in the chair more than I am enjoying seeing you here. But it's always good to see you.

With that, I would like to yield 1\1/2\ minutes to our very hardworking colleague from Bainbridge Township, Ohio (Mr. LaTourette).

I yield my friend an additional 15 seconds.

Mr. Speaker, at this time, I am happy to yield 2 minutes to the gentleman from Ennis, Texas (Mr. Barton), the hardworking ranking minority member on the Committee of Energy and Commerce.

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

Mr. Speaker, at this time I am happy to yield 1 minute to our hardworking colleague from Indianapolis, Indiana (Mr. Burton).

Mr. Speaker, I yield 1 minute to the gentleman from Athens, Georgia (Mr. Broun), another one of our very able medical doctors.

Mr. Speaker, I yield 1 minute to our friend from Goddard, Kansas (Mr. Tiahrt).

Mr. Speaker, may I inquire of my friend how many speakers she has remaining?

We don't have that many.

I reserve the balance of my time.

Mr. Speaker, at this time I yield 3 minutes to my very good friend, another medical doctor who is with us here, the gentleman from Lewisville, Texas (Mr. Burgess).

Mr. Speaker, may I inquire how much time is remaining on each side.

May I inquire of the distinguished Chair of the Committee on Rules how many speakers she has remaining.

And then you plan to close?

So then no more speakers other than your close. Is that it?

Mr. Speaker, now may I inquire of the distinguished Chair of the Committee on Rules if she has three or four more speakers? I don't know, Mr. Speaker, if the distinguished Chair on the Committee on Rules has anymore speakers.

I just wanted to clarify that.

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

Mr. Speaker, I am going to close the debate as I had begun, by denouncing the charges and smears that we have seen over the past several weeks. Tragically, those of us who serve as Members of Congress for years have dealt with that. It is unacceptable and outrageous, and we all join together in decrying the things that we have seen.

Mr. Speaker, there is a high level of frustration over the process through which we have gone, and there is an understandable outrage from people all across this country for the final work product that we have.

The process has been, at very best--I am trying to be generous-- unorthodox. The notion of utilizing reconciliation, which is designed to reconcile budget discrepancies, for this, is not the right thing to do. And it has never, ever, since passage of the 1974 Budget Entitlement Act, been used for such a monumental piece of legislation.

We have tried desperately to work in a bipartisan way, and everyone talks about this. But, Mr. Speaker, we have reached out, as Mr. Burgess said, time and time again, and we have been rebuffed. The only thing bipartisan about this legislation and the vote that we will see tonight, Mr. Speaker, is not the support for it but the opposition to it.

Our colleagues on the other side of the aisle have a 70-seat majority, and yet many of their Members will be joining us, as they did last Sunday night, in opposing this. Why? Because they know that this is badly flawed legislation. It's badly flawed legislation, because, as we listened to so many medical doctors point out, we are told that you can choose your own doctor. We constantly hear that refrain from the President and others. But the question is, With the decrease in the numbers of doctors out there, will your doctor choose you?

And then, Mr. Speaker, we get to the question of, Will we or will we not be able to pay for this? Well, $1 trillion, 569.2 billion in tax increases, and tremendous uncertainty is not going to adequately address the challenges that we have.

We all want to ensure that no one is denied access to health care because of preexisting conditions. We can do that in a bipartisan way. But, Mr. Speaker, unfortunately, this bill doesn't do that.

There are people out there who today believe that they will not be denied access to insurance because of preexisting conditions. But, guess what? Because this bill was so poorly put together, right now they are denied access. We want to make sure, and we are happy to work in a bipartisan way, to address that concern.

As we look at the fact that we are back here tonight because of those two amendments that were problems in the Senate, the fact that we already have announced problems with the goal of ensuring that everyone has access, is not denied access because of preexisting conditions, and when we look at the challenges that have been put forward time and time again, we simply ask our colleagues: When we work to clean this up, Mr. Speaker, I hope very much we will be able to work in a bipartisan way.

I urge a ``no'' vote.

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

Madam Speaker, by direction of the Committee on Rules, I call up House Resolution 1225 and ask for its immediate consideration.

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

General Leave

I ask unanimous consent that all Members have 5 legislative days within which to revise and extend their remarks and insert extraneous materials into the Record.

I yield myself such time as I may consume.

Madam Speaker, the rule provides for consideration of the Senate amendments to H.R. 4872. It shall be in order to take from the Speaker's table H.R. 4872, with the Senate amendments thereto, and to consider in the House, without intervention of any point of order except those arising under clause 10 of rule XXI, a single motion offered by the Chair of the Education Committee that the House concur in the Senate amendments. The Senate amendments and the motion shall be considered as read. The rule provides 10 minutes of debate equally divided and controlled by the Chair and the ranking minority member of the Committee on Education and Labor. Finally, the previous question shall be considered as ordered on the motion to final adoption without intervening motion or demand for division of the question.

Madam Speaker, the disturbing atmosphere that we've seen around the Capitol recently is alarming. The rash of ominous threats, voice mails, letters, brick throwing, and other sordid acts of protests is downright despicable and marks a low point in the Nation's history. I say this in part from firsthand experience. As many of you know, my Niagara Falls office was the target of attack last week when someone hurled a brick through the window in the dark of night. Separately, I received a phone call on my campaign office phone line that referenced 16 sniper teams and an attempt that would be made to target the children of Members of Congress who voted for the health care legislation.

Each day my four offices give me a careful log of phone calls and emails from people who have taken the time to share their opinions with me, and I read each of those comments because I value that input and want to hear from everyone, not just the people who agree with me. I daresay there isn't a single elected official in the country who has not had a heated run-in with someone who felt strongly that they had voted the wrong way on an issue. In fact, it is part of this country's great tradition that we not only tolerate dissent but we encourage it.

To speak up and to take part in democracy is a noble and treasured part of the American way. But all that changed last year when suddenly town hall meetings across the country turned into vicious shouting matches. Persons who had taken the time to go to the town meeting to learn about the health care bill were oftentimes harassed and frightened and unable to learn anything except that they felt somewhat under siege. I remember that someone arrived at a meeting with a handgun holstered to his leg, and he could not have been more than 50 yards away from the President of the United States.

Spirited debate has become negative. All of us have noticed that in our offices. As I mentioned, I have four offices. The calls that came in--I thank my staff, and I'm sure all of you do, too, for simply tolerating it. It was all day. One day the calls came in so quickly that not another piece of work could be done in all my offices. We were threatened. We were cajoled. We were told--mostly by people from Texas and Oklahoma--that they would never vote for me again, which would be very unlikely in New York anyway.

But I am happy to tell you that as of Sunday night and the passage of this bill, all of those calls are gone. We were getting up to--I would say totaling in the four offices nearly 100 a day. It's all gone now, and the people who call express sorrow for the trouble that has been put upon me, saying that their America does not do that to anyone, particularly someone that they have put their trust in.

But this week, the leader of the national Republican Party said that Speaker Pelosi should be put ``on the firing line.'' Another Republican leader and former national party candidate placed rifle site targets on a national map showing congressional districts of Democrats who supported health care for all Americans, and that same leader urged her supporters, ``Don't retreat, reload.'' And even worse were the remarks made here by the minority leader, who recently said that one of my colleagues who backed the legislation was politically a ``dead man'' back home. Taken together with the incidents around the country, these episodes might prompt a quick and forceful repudiation of comments that would endorse violence, but instead, we get just the opposite.

When Republican Members went out onto the balcony off the Speaker's lobby Sunday to shout to and encourage rowdy protesters, they were implicitly encouraging a discourse that had already soured. In fact, I was dismayed to learn--not dismayed, dismayed doesn't cover it--I was angry. I was concerned. It terrified me, the thought that we would have to live through any of that again. When I found out that some of my colleagues were the victims of racial epithets, spitting, homophobic slurs, this sort of display is shocking even to someone who has seen some pretty terrible things over the years.

Despite all this, Democrats move forward with hope and optimism. It is my sense that as more Americans learn about the provisions of the health care reform legislation, they will in increasing numbers support the vote over the weekend, and the polls show this already happening.

It is a surprise to me today that with the passage of reconciliation by a 56-43 margin in the Senate, that the other side would continue to try to throw up petty roadblocks or complain that they haven't had time to read the bill.

Do you want to know what we are debating here today? We are debating two sentences. That's it, two sentences. Does it make sense to anyone that the other side is demonizing a bill that has already been approved by both the House and Senate and signed into law? No, instead we should celebrate the incredible accomplishment of finally passing this legislation after a struggle of more than a hundred years.

I won't even bother reciting all of the ways in which ordinary Americans will gain as we shift the balance of power away from insurance companies and back to patients, because they will know very shortly. I have already spoken at length about how under our bill families will no longer feel trapped by their coverage or fearful about children with preexisting conditions. Health care reform, I am happy to say, is now the law of the land. I encourage my colleagues to join me today in quickly adopting these small technical fixes to the legislation so we may move on to more pressing challenges.

I reserve the balance of my time.

Parliamentary Inquiry

Madam Speaker, I yield 3 minutes to the gentleman from Massachusetts (Mr. McGovern), a member of the Rules Committee.

Madam Speaker, I am pleased to yield 2 minutes to the gentlewoman from California (Ms. Matsui), a member of the Rules Committee.

Madam Speaker, I feel I need to introduce Dr. Donna Christensen, who is a medical doctor from the Virgin Islands, for 15 seconds.

Madam Speaker, I yield 2 minutes to the gentleman from Colorado (Mr. Perlmutter), a member of the Rules Committee.

Madam Speaker, I yield 2 minutes to the gentleman from California (Mr. Stark).

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

I yield 2 minutes to the gentleman from New Jersey (Mr. Pallone).

Mr. Speaker, I yield 3 minutes to the gentleman from California (Mr. Waxman).

I cannot yield for that purpose.

I cannot.

I am happy to yield 3 minutes to the gentleman from South Carolina (Mr. Spratt).

I yield 1 minute to the gentleman from New York (Mr. Bishop).

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

Mr. Speaker, I yield 1 minute to the gentleman from New York (Mr. Hall).

Mr. Speaker, may I inquire as to the time remaining?

Yes, I have three.

Mr. Speaker, I yield 1 minute to the gentleman from Texas (Mr. Hinojosa).

Mr. Speaker, I yield 1 minute to the gentlewoman from Texas (Ms. Jackson Lee).

I have one more speaker.

As soon as you have.

I have one more speaker, then I hope that you will close and then I will close.

I am pleased to yield 2 minutes to the gentleman from New Jersey (Mr. Andrews).

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

I did misspeak. Mr. Rangel has come in, and I would like to give him 1\1/2\ minutes.

Let me yield 1 minute to Mr. Rangel, the gentleman from New York.

I have no further speakers.

Mr. Speaker, let me just remind us that we have been all this time debating about three lines in the bill. If you want to take the nastiness out of the Senate bill, this is the bill you have to vote for.

I ask a ``yes'' vote from all my colleagues on both the previous question and on the rule.

I move the previous question and the resolution.

The previous question was ordered.

Mr. Speaker, earlier this week history was made with the enactment into law of the comprehensive access to quality affordable health insurance for all Americans. Tonight we complete action on this legislation and cement for all Americans their sense of security that they will always be able to afford and access health care for themselves and their families.

Since our passage of the underlying legislation last weekend, the American people are beginning to fully appreciate the benefits that we have written into law. When fully implemented, reform will bring 32 million uninsured Americans into the health insurance system, seniors will see immediate help with the cost of their prescription drugs, and people who have preexisting medical conditions will not be denied health insurance or charged more for that insurance. If you lose your job, you will not lose access to health care.

Our vote tonight improves on what President Obama signed into law on Tuesday. This includes closing the gap in Medicare prescription drug coverage, including the rebate this year to eligible seniors; improving affordability for those with income up to 400 percent of the poverty level; eliminating the special Medicaid deal for Nebraska; and increasing matching rates to States for the costs of services to newly eligible individuals to 100 percent for the first 3 years of coverage expansions.

Increasing Medicaid payments. The rates will be increased for primary care physicians so that new Medicaid beneficiaries will have access to primary

care and a greater investment into community health centers. These initiatives are fully funded and paid for.

The reconciliation bill reduces the deficit by more than $1 trillion over the next two decades.

Health security is a fundamental right for every American, and we remain faithfully committed to that objective.

I want to use my time here to give special thanks to our health team on our staff. First of all I want to single out Karen Nelsen, who has been director of the health staff going back to the time I was chairman of the Health and Environment Subcommittee and during the time we were over at the Oversight and Government Reform Committee. With her able assistance, we have Jack Ebeler, Tim Gronniger, Andy Schneider, Purvee Kempf, Brian Cohen, Ruth Katz, Anne Morris, Tim Westmoreland, Stephen Cha, Virgil Miller, Katie Campbell, Bobbie Clark, Sarah Dupres and Naomi Seiler.

I want to just close by saying I wish the Republicans would have worked with us instead of fighting this bill every step of the way. They're complaining now they didn't get amendments, but when we called on them to help us, they said no. They wouldn't work with us on the stimulus bill, they wouldn't work with us on the energy bill, they wouldn't work with us on the health bill, but we got it done anyway.

Mr. Speaker, the bill is to be commended as a model of cooperative federalism. Under the new law, ``a State is free to establish a health insurance exchange if it so chooses. But if it declines, the Secretary will establish an exchange.'' This is a strong example of what the Supreme Court has recognized as an appropriate exercise of federal power to encourage State participation in important federal programs. ``[W]here Congress has the authority to regulate private activity under the Commerce Clause, we have recognized Congress' power to offer States the choice of regulating that activity according to federal standards or having state law pre-empted by federal regulation. Hodel v. Virginia Surface Mining & Reclamation Assn., Inc., supra, 452 U.S., at 288, 101 S.Ct., at 2366. See also FERC v. Mississippi, supra, 456 U.S., at 764- 765, 102 S.Ct., at 2140. This arrangement, which has been termed ``a program of cooperative federalism,'' Hodel, supra, 452 U.S., at 289, 101 S.Ct., at 2366, is replicated in numerous federal statutory schemes.'' New York v. United States, 505 U.S. 144, 165 (1992).

Individual Responsibility

The individual responsibility requirement requires individuals to pay a tax on their individual tax filings or provide information documenting they fulfill the requirements for having essential minimum coverage over the past year. Congress makes the following findings to support this requirement, these are in addition to those made on Sunday, March 21, 2010:

(1) The requirement is necessary to achieve near-universal coverage while maintaining the current private-public system. It builds upon and strengthens private employer-based health insurance, which covers 176,000,000 Americans nationwide. In Massachusetts, a similar requirement has strengthened employer-based coverage: despite the economic downturn, the number of workers offered employer-based coverage has actually increased. Sharon K. Long and Karen Stockley, Massachusetts Health Reform: Employer Coverage from Employees' Perspective, Health Affairs, October 1, 2009.

(2) Under the Patient Protection and Affordable Care Act, if there were no requirement, many individuals would wait to purchase health insurance until they needed care. Those individuals would then get the benefit of the lower premiums that are a direct result of the Act's reforms, even though those lower premiums result in part from the fact that other younger and healthier people bought insurance at an earlier point. Higher-risk individuals would be more likely to enroll in coverage, increasing premiums and costs to the government. The Urban Institute, January 2008. The requirement will broaden the private health insurance risk pool to include healthy individuals, which will spread risk, stabilize the market, and lower premiums. Congressional Budget Office, An Analysis of Health Insurance Premiums Under the Patient Protection and Affordable Care Act, November 30, 2009. It is necessary to create effective private health insurance markets throughout the country in which improved health insurance products that are guaranteed issue and do not exclude coverage of pre-existing conditions can be sold.

(3) Administrative costs for private health insurance, which were $90,000,000,000 in 2006, are 26 to 30 percent of premiums in the current individual and small group markets. Congressional Budget Office, December 2008. The requirement is necessary to create effective private health insurance markets throughout the country that do not require underwriting, eliminating its associated administrative costs. By significantly increasing health insurance coverage and the size of purchasing pools, which will increase economies of scale, the requirement, together with the other provisions of the Patient Protection and Affordable Care Act, will significantly reduce administrative costs and lower health insurance premiums.

(4) Health insurance and health care services are a substantial part of the national economy. National health spending is projected to increase from $2,500,000,000,000, or 17.6 percent of the economy, in 2009 to $4,700,000,000,000 in 2019. Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Expenditure Projections, 2008-2018. Private health insurance spending is projected to be $854,000,000,000 in 2009, and pays for medical supplies, drugs, and equipment that are shipped in interstate commerce. Centers for Medicare & Medicaid Services, Office of the Actuary. Since most health insurance is sold by national or regional health insurance companies, health insurance is sold in interstate commerce and claims payments flow through interstate commerce.

(5) The requirement, together with the other provisions of the Patient Protection and Affordable Care Act, will add more than 30,000,000 consumers to the health insurance market. Congressional Budget Office, Patient Protection and Affordable Care Act, Incorporating the Manager's Amendment, December 19, 2009. In doing so, it will increase the demand for, and the supply of, health care services. According to one estimate, the use of health care by the currently uninsured could increase by 25 to 60 percent. Congressional Budget Office, December 2008.

(6) Under the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Patient Protection and Affordable Care Act, the Federal Government has a significant role in regulating health insurance. The requirement is an essential part of this larger regulation of economic activity, and the absence of the requirement would undercut Federal regulation of the health insurance market.

(7) Payments collected from individuals who fail to maintain minimum essential coverage will contribute revenue that will help the Federal government finance a reformed health insurance system that ensures the availability of health insurance to all Americans.

The preceding 7 points cite numerous studies and papers which illustrate the extensive evidence that the Patient Protection and Affordable Care Act, as amended by Section 1002 of the Health Care and Education Reconciliation Act, substantially affects interstate commerce. These citations are included as hyperlinks or in their written entirety for the record.

Madam Speaker, I rise along with my colleague Congressman Bonner to provide, pursuant to

Rule 7(g) of the Rules of the Committee on Standards of Official Conduct, a statement of the Chair and Ranking Republican Member regarding H. Res. 1193, H. Res. 1220, H. Res. 1255, and H. Res. 1287.

The House has referred H. Res. 1193, H. Res. 1220, H. Res. 1255, and H. Res. 1287 to the Committee for its consideration. We acknowledge the referral of those resolutions. If adopted, the resolutions would have required the Committee to report to the House regarding aspects of its investigation ``In the Matter of Allegations Relating to the Lobbying Activities of Paul Magliocchetti and Associates Group, Inc. (PMA).'' Although the resolutions were not adopted, we are responding to expand further upon the Committee's previous public statements regarding its investigation in this matter.

The outside Office of Congressional Ethics, OCE, after investigation, concluded that matters for five Members regarding the PMA matter should be dismissed. After review, the Committee concurred with the outside ethics office. The Committee concluded that the matters of two other Members should also be dismissed because the facts regarding those Members' actions were not different from those of the five Members for whom both the Committee and OCE concluded dismissal was appropriate. The Committee's action to date does not preclude future Committee action related to these matters should new information warranting action become available.

The Committee publicly released a 305-page report that discusses the scope of the Committee's work in the PMA matter, as well as the basis for the Committee's bipartisan and unanimous conclusions. This report is available to the House and the public on the Committee's Web site, at http://ethics.house.gov/. As noted in that report, the Committee's investigation during a nine-month period included extensive document reviews and interviews with numerous witnesses. As a result of its own investigation and OCE's seven separate reports and findings, the Committee--whose Members include equal numbers of Democrats and Republicans--unanimously determined that the evidence presently before the Committee merited dismissal of all seven matters.

The information reviewed by the Committee included statements from all seven Members. Summaries of interviews with five Members were included in OCE's findings, which the Committee chose to publish. Since the Committee agreed with OCE's recommendation that those five matters should be dismissed, the Committee was not required to publish any statement or OCE's reports and findings in those matters, but did so because of the unique circumstances of this matter and in the interests of public disclosure and transparency.

In addition, the Committee sought statements from Representatives Tiahrt and Visclosky to respond specifically to allegations about their conduct. Both Members provided the Committee with statements through counsel, and the Members certified under penalty of perjury to the truth of those statements. Both statements are available, in their entirety, in the Committee's public report. Based in part on those statements, the Committee found no evidence to conclude that the facts regarding Representatives Tiahrt and Visclosky differed substantially from the facts regarding the other five Members--for whom both the Committee and OCE recommended dismissal. Accordingly, the Committee concluded that the matters of the two other Members should also be dismissed.

In reaching its unanimous conclusion, the Committee relied not only on the findings provided by OCE, but its own investigation. During the course of its investigation in this matter, the Committee's staff reviewed close to one-quarter of a million pages of documents. The Committee investigation covered more than 40 companies with ties to PMA. OCE's findings included summaries of interviews with five Members' offices. The Committee investigation included interviews with 33 Members' offices. The Committee investigation involved interviews with chiefs of staff, military legislative aides, other Members' staff, and Appropriations Committee staff. In reaching its conclusions, the Committee relied on the totality of this large magnitude of information.

As in other investigations, although the Committee has discussed in general terms the scope of its investigation, it did not address more specific details of various investigative steps taken by the Committee. To do so would compromise the investigative capabilities of the Committee in this and future matters by chilling voluntary cooperation. Requiring the disclosure of the details of any investigative body's activities would damage its ability to conduct its activities. Ethics investigations, in particular, rely not only upon subpoenas, but upon voluntary cooperation. Success in such an investigation usually comes because people connected to the matter choose to cooperate with the investigators and volunteer information. In many cases, their decision to cooperate is based, in part, on their belief that their identity or the details of their cooperation will not be publicly disclosed.

Moreover, disclosing specific investigative steps taken in the PMA matter could compromise any ongoing criminal investigations; harm the ability of the Committee to investigate any additional allegations of wrongdoing in this or related matters; discourage those who might bring credible allegations to the Committee in the future from doing so; and chill the voluntary cooperation of those called before the Committee in various investigations.

Prior to the House referral of the resolutions to the Committee, on February 26, 2010, the Committee unanimously voted to release a public report in the PMA matter. By a unanimous and bipartisan vote, the Committee concluded that, based upon the totality of current information gathered during a nine-month investigation, no House Member or employee violated provisions of the Code of Official Conduct or laws, rules, regulations, or other standards of conduct applicable to his or her conduct in the performance of his or her duties or the discharge of his or her responsibilities relating to proposed appropriations requests and activities of PMA.

In addition, we note that policy decisions--whether about the current appropriations process, including earmarks, or about the campaign finance system--are not within the jurisdiction of the Committee. Whether these policies should be changed is a subject that should be taken up in the appropriate venue.

The task before the Committee in the PMA matter was to determine whether House Members and staff complied with the current law and House rules. In a unanimous and bipartisan manner, the Committee concluded the evidence presently before the Committee merited dismissal of all seven matters. The Committee's action to date does not preclude future Committee action related to these matters should new information warranting action become available.

I think it's time for us to take a deep breath, take a timeout and go home and listen, Mr. Speaker. So I asked the Rules Committee this evening to not move this package tonight, but let us go home for the next 2 weeks and then come back week after next or week after 2 weeks and actually fix what needs to be fixed.

I listened when my chairman, Mr. Waxman of California, talked about the reconciliation package before us fixes the Nebraska problem. Well, the way they fix it, Mr. Speaker, is by giving every other State the same sweet deal they gave to Nebraska but only for 4 years.

After 2014, that deal goes away for Nebraska and every other State. I don't think that's much of a fix.

No one on the majority side, Mr. Speaker, has talked about the Medicaid trap. When this fully kicks in in 2014, everybody that's eligible for Medicaid in the country, that is below 133 percent of poverty, has to be in Medicaid and that's their only choice. They cannot be in a private sector plan. And obviously we all know they don't have the option of not taking the coverage.

Some of us think that that may be unconstitutional. Even if it's not unconstitutional, I don't think it's fair to our low-income Americans to say that the only health insurance plan you can have is Medicaid.

We have talked about the preexisting conditions, Mr. Speaker. This bill does require that preexisting conditions be covered. That's a good thing, not a bad thing. But it's not funded. They have only got $5 billion in this bill for 4 years. That's a little over a billion dollars a year. You can't cover 8 to 10 million Americans that have preexisting conditions and no insurance today for $1.25 billion a year. I call that the preexisting short sheet.

And, finally, this reconciliation package doesn't do anything to prevent the requirement in the original Senate bill that's now the law that elective funding of abortion be offered in at least one plan in each State. I really believe if there was an up-or-down vote on that again in this body, that that would be voted down.

Please vote against this reconciliation package rule. Let us go home and listen to our constituents.

``Unorthodox Process'': My friend from California Mr. Dreier coined the process and procedure that has been forced upon as ``at best, unorthodox.'' But it doesn't have to be that way, Mr. Speaker. There is no deadline that says we need to push this through tonight. Let's do it right.

Hoping for similar luck to have I had last Saturday when I asked that Rules drop the ``deem and pass'' scheme and they did, I asked this afternoon in the Rules Committee for an extension on this reconciliation vote until after the two-week recess. We could talk to our constituents, hear their thoughts. We could look for more issues that will need fixing and then fix them. There is no deadline that says we need to push this through tonight. Let's do it right.

The new version of the reconciliation package that we vote on today reflects two relatively minor changes made by the Senate to education program provisions in the bill. We had to strike these provisions because they violated the Byrd Rule that governs budget reconciliation bills in the Senate. But that's the point, Mr. Speaker. We rushed, rushed, rushed and made mistakes. I shudder at the thought of the additional mistakes we'll need to fix as we finally have time to digest this massive law.

My Democrat colleagues insist that the Senate bill is law, signed by the President, and that there should be no more debate on the policy. But just because it received an entirely partisan majority, and just because it was signed by the President, doesn't mean it's good law. This was a partisan process, a partisan bill, with bipartisan opposition.

This Act increases the penalty on individuals who fail to comply with the new requirement to maintain Washington-bureaucrat-approved insurance coverage:

Modifies the individual mandate penalty in three ways: (1) exempts income below the filing threshold from the calculation of the penalty, (2) lowers the flat dollar penalty from $495 to $325 in 2015, and from $750 to $695 in 2016, and (3) for individuals paying a penalty based on family income, changes the penalty from 0.5% to 1.0% of family income in 2014, from 1.0% to 2.0% of family income in 2015, and from 2.0% to 2.5% of family income for 2016 and later years.

This Act increases the penalty on employers who fail to comply with the new requirement to buy their employees Washington-bureaucrat- approved insurance coverage:

Increases the annual per-employer penalty from $750 per employee to $2,000 per employee, and subtracts 30 full-time employees from the penalty calculation (e.g., a firm with 100 employees would have to pay