Providing for consideration of the bill (H.R. 2) to amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes.

Madam Speaker, I want to thank the gentleman from Florida as we begin a new year and a new Congress with an opportunity to work not only with the gentleman, but also my colleagues from the Rules Committee, and you, Madam Speaker, during this new Congress. And I thank the gentleman for yielding me the time that he has done.

Madam Speaker, I rise today in strong opposition to this rule and to the ill-conceived underlying legislation. I think the premise that I have heard my friends on the other side of the aisle talk about today of making sure that we just expand this program to meet every single need of every single child is not what this program was designed for, and a $35 billion expansion of the program will help bankrupt this country and the States that try and provide the services also.

I do not support this bill or the way it has been brought to the floor either. My Democrat colleagues on the other side of the aisle who promised to be the most open and honest ethical Congress have once again given Republicans absolutely no say in the process, and they are completely disregarding President-elect Obama's promises to work together to solve the problems of this country.

Today, House Democrats have once again chosen to force their own legislation through a biased rule that we are here debating on the floor of the House right now. This bill has been brought to the floor today without one committee hearing or markup. The current SCHIP program expires on March 31, and so I would ask my colleagues, why aren't we having hearings? Why aren't we having input from House Members? Why aren't we consulting Republicans in this process? In fact, Republicans only received the text yesterday morning. And today's rule once again limits the Republican opportunities for any chance of reform or ideas, confirming the Democrats' plans to govern this House without any input from Republicans.

Democrats over the past few years have demonized me and my Republican colleagues for not expanding the current State Children's Health Insurance Program to unprecedented levels, and they continue to cry out that Republicans are anti-children. I would like to remind them that it was a Republican Congress that initiated this program over a decade ago. It was begun to make sure that children that had no health coverage could gain that coverage.

However, my colleagues and I recognized the need for SCHIP, and we see that we need to help low-income, uninsured children whose families earn too much to qualify for Medicaid but not enough to buy private coverage. For that reason SCHIP was created and today covers about 6.7 million children in our country.

However, today we find that the Democrats' proposed $35 billion expansion of a program that has not yet accomplished its original intent is now being taken to unprecedented levels by my friends on the other side of the aisle. My Democrat friends want to continue to push their government-run health care agenda even though this legislation moves some 2.4 million children who are currently on private health insurance to an inferior public program with less access.

I'll repeat that. The numbers that my friends have been talking about of expanding this to children across this country, 2.4 million of them already have private insurance.

That's a mistake. It's a mistake. So now what we're looking at is that Medicaid programs facing extreme shortfalls and physicians who are scaling back on Medicaid and SCHIP patients due to extremely low reimbursement rates will now take on these additional children.

Why would we want to subject 4 to 6 million more children to this kind of care? Madam Speaker, it seems like my Democrat colleagues are putting their agenda first, not our American children.

This legislation turns an innovative idea on its head by increasing government spending exponentially, leaving taxpayers to foot the bill when their budget gimmicks fail to create the necessary ability to fund properly these programs. This bill has no income limits for eligibility. None. And it allows coverage for families making up to $83,000 a year and has no annual authorization limit and allows States to decide who qualifies, leaving adults and illegal immigrants to compete against low-income American children.

Madam Speaker, it should be important that we should meet the current goals of the program and expectations before we expand that program. For that reason some of my Republican colleagues and I sent a letter to our new President-elect, President Obama, and Speaker Pelosi outlining what we think Republicans would like our Democrat colleagues to understand and consider before expanding the current SCHIP program. I would like to include this as part of our deliberations today.

Congress of the United States,

Washington, DC, January 12, 2009.

President-elect Barack Obama,

Presidential Transition Office,

Washington, DC.

Hon. Nancy Pelosi,

Speaker, U.S. Capitol,

Washington, DC.

Dear President-elect Obama and Speaker Pelosi: Thank you

for expressing your desire to work with us to address the

needs of the American people. We recognize that reauthorizing

the State Children's Health Insurance Program (SCHIP) is an

early legislative priority, and we hope that you will

consider this legislation to be one of the first

opportunities for bipartisan cooperation.

During the last Congress, significant efforts were made in

an attempt to address concerns raised by House Republicans

about how the underlying bills would impact uninsured

children. Despite the progress that was made, there are still

a few outstanding issues that we hope you agree should be

addressed when we work to reauthorize the program this year:

Serving Eligible Low-income Children First

SCHIP is intended to serve those that are neediest first.

As low-income families continue to face more economic

insecurity, providing access to affordable health care

coverage, regardless of any job change or displacement,

should be our first priority. The legislation should demand

success from the states in enrolling poor and low-income

children below 200 percent of the federal poverty level,

especially those who are currently eligible for Medicaid and/

or SCHIP, but are not yet enrolled. Demanding success from

the states could be as simple as requiring that states meet a

threshold of enrollment before further expansions. Nearly all

the states have demonstrated over the past year to the

Centers for Medicare and Medicaid Services that meeting this

standard is indeed possible.

Furthermore, in the current economic environment, several

states have indicated that they will be experiencing

shortfalls that could impact their ability to provide

Medicaid benefits and services. Asking states to expand their

SCHIP program before they are able to finance their existing

Medicaid program would be a mistake. Expanding SCHIP to

higher income families will only exacerbate the real access

to care problem in the Medicaid program.

Citizenship Status

We believe that only U.S. citizens and certain legal

residents should be permitted to benefit from a program like

SCHIP. We also think it is fair to say that both parties

believe that our immigration system is broken. That is why it

is so important that the legislation include stronger

provisions to prevent fraud by including citizenship

verification standards to ensure that only eligible U.S.

citizens and certain legal residents are enrolled in the

program.

Protecting Private Insurance Options

We agree that those with private coverage should not be

forced into a government-run plan. SCHIP legislation should

focus expansion efforts on children who are currently

uninsured instead of moving children who have private health

insurance options into government-run health insurance.

Moving a child from private health insurance to government-

run health insurance should not be part of your stated goal

of providing SCHIP for 10 million children, a number we

assume to be targeted towards low-income uninsured children.

Stable Funding Source

In order to guarantee access to the program and long term

stability, SCHIP should be funded through a stable funding

source, not budget gimmicks. Further, the legislation should

not include extraneous provisions unrelated to SCHIP that

limit patient choice or prohibit access to quality medical

care. Our nation's Governors need a stable SCHIP program so

they may properly budget. Every American faces the crushing

burden of a declining economy. This should not be a time

Congress raises taxes, especially on the poorest Americans,

to finance program expansions as part of the SCHIP

reauthorization bill.

We believe these to be critical elements to improve this

vital program that if fully incorporated would dramatically

increase bipartisan support for the legislation. Thank you

for the consideration of this request. We look forward

hearing from you and working with you towards a bipartisan

agreement.

Sincerely,

Robert Aderholt, Steve Austria, Michele Bachmann, Spencer

Bachus, Gresham Barrett, Roscoe Bartlett, Joe Barton,

Judy Biggert, Gus Bilirakis, Rob Bishop, Marsha

Blackburn, Roy Blunt, John Boehner, Mary Bono Mack,

John Boozman, Charles Boustany, Kevin Brady, Paul

Broun, Henry Brown, Ginny Brown-Waite, Michael Burgess,

Dan Burton, Steve Buyer, Ken Calvert, Dave Camp, Eric

Cantor, John Carter, Bill Cassidy, Jason Chaffetz,

Howard Coble, Mike Coffman, Tom Cole, Michael Conaway,

Ander Crenshaw, John Culberson, Geoff Davis, Nathan

Deal, David Dreier, Mary Fallin, Jeff Flake, John

Fleming, Randy Forbes, Jeff Fortenberry, Virginia Foxx,

Trent Franks, Rodney Frelinghuysen, Phil Gingrey, Louie

Gohmert, Bob Goodlatte, Kay Granger, Sam Graves, Ralph

Hall, Doc Hastings, Dean Heller, Jeb Hensarling, Wally

Herger, Peter Hoekstra, Duncan Hunter, Bob Inglis,

Darrell Issa, Lynn Jenkins, Sam Johnson, Walter Jones,

Jim Jordan, Steve King, Jack Kingston, Mark Kirk, John

Kline

Doug Lamborn, Christopher Lee, Jerry Lewis, Blaine

Luetkemeyer, Cynthia Lummis, Daniel Lungren, Don

Manzullo, Kevin McCarthy, Thaddeus McCotter, Patrick

McHenry, John McHugh, Cathy McMorris Rodgers, Jeff

Miller, Sue Myrick, Devin Nunes, Pete Olson, Erik

Paulsen, Mike Pence, Joe Pitts, Todd Platts, Ted Poe,

Bill Posey, Tom Price, Adam Putnam, George Radanovich,

Hal Rogers, Mike Rogers, Thomas Rooney, Peter Roskam,

Paul Ryan, Steve Scalise, Jean Schmidt, Aaron Schock,

James Sensenbrenner, Pete Sessions, John Shadegg, John

Shimkus, Bill Shuster, Michael Simpson, Adrian Smith,

Lamar Smith, Cliff Stearns, John Sullivan, Lee Terry,

Glenn Thompson, Patrick Tiberi, Fred Upton, Greg

Walden, Zach Wamp, Lynn Westmoreland, Ed Whitfield, Joe

Wilson, Robert Wittman

The first priority should be to make our Nation's poorest, uninsured children covered. This is the intent of the program, and we should fulfill that program and that goal. Currently, at least two-thirds of children who do not have health insurance are already eligible for Federal help through either SCHIP or Medicaid. We should enroll these children first before expanding to higher income brackets.

The second priority is to ensure that SCHIP does not replace or significantly impact those who already have private health insurance with a government-run program. Last year Hawaii created a new government-financed program to fill the gap between private and public insurance in an effort to provide universal coverage for children. But State officials soon found that families were dropping private coverage to enroll their children in the government plan. The Governor of Hawaii terminated the plan when she realized Hawaii could not and should not subsidize the cost for children already receiving private health insurance.

Madam Speaker, should this legislation pass, we know that 2.4 million more children will be ``crowded out'' from their private insurance plan and moved to SCHIP. In days where Congress is faced with a second $350 billion bailout plan and a possible $1.3 trillion stimulus package, is the Federal Government in any financial shape to be financing health care costs for children who are already receiving private health insurance?

Lastly, a citizenship verification standard is critical to ensuring that only U.S. citizens and certain legal immigrants are allowed to access the taxpayer-funded benefits, not illegal immigrants. The underlying legislation offers no safeguards to ensure American children come before illegal immigrants.

Republicans understand how important and personal health care decisions are for individuals and families. We believe in freedom of choice, and allowing patients and doctors to make health care decisions, not government bureaucrats, is the direction we should go. Allowing for a tax credit or tax deduction for the purchase of health care insurance would give an individual or a family the choice of an affordable health care plan that fits their needs.

Said another way, a family and their children should be able to choose their own doctor and go to that doctor day in and day out, not simply to have to shop to find what is then available through a government-run program. This would bring the ownership and control back to the individual and the family.

Madam Speaker, additionally, if we allow individuals to purchase health insurance across State lines and let businesses and associations band together to purchase insurance, we guarantee choice, portability, and flexibility for families and employees. Rather than limiting choice like my Democrat colleagues, Republicans strive for quality, affordable health care for every single American.

Madam Speaker, another fatal flaw with this huge government expansion is how our Democrat colleagues are going to pay for this plan. The proposed budget uses gimmicks to comply with PAYGO rules, masking the true cost of the expansion. Democrats will increase taxes on cigarette packs by 61 cents to $1 and included taxes on cigars of up to $3 to come up with the majority of the $35 billion expansion. The problem is that this tobacco tax disproportionately burdens low-income Americans because the majority of smokers are young adults and individuals and families making less than 300 percent of the Federal poverty level. To produce the revenues that Congress needs to fund the $35 billion SCHIP expansion would require a tax for 22.4 million new smokers by 2017 or 80 percent of the beneficiaries would lose coverage in 5 years. That means that we are going to tax these users and rely on that stream of revenue that will be diminishing very quickly. That is not a responsible way to fund the program.

Eliminating physician ownership and health care practices is another way that the Democrats plan to pay for expansion. The current state of our community hospitals is in disarray. Community hospitals are overcrowded and understaffed. Physician-owned hospitals run more efficiently, have higher patient satisfaction and higher quality outcomes than their community counterparts. Yet my friends on the other side of the aisle want to eliminate that option for individuals. So while dumping children in a government-run health care plan, they also want to limit health care choices for everyone by eliminating physician-owned facilities.

Rather than limiting choices, Congress should be in the business of creating more avenues and opportunities for individuals and families to find affordable insurance for their choices that provides them and leads them to quality care. This legislation does the opposite.

I encourage my colleagues to oppose this rule and the underlying legislation.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, at this time I would like to yield 2 minutes to the ranking member of the Rules Committee, the gentleman from San Dimas, California (Mr. Dreier).

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

Madam Speaker, you know, it's pretty incredible. A number of speakers that we've had here today sat through the hearing yesterday and understood that this bill is not going to become law anytime soon. Yet we are down on the floor of the House of Representatives touting how this will be the first bill that our new President, President Barack Obama, will sign; and yet, testimony in the Rules Committee yesterday, a full admittance that we don't know whether this is all going to make it or not. It will be interesting to see.

Madam Speaker, at this time I would like to yield 2 minutes to the gentlewoman from Energy and Commerce, Mrs. Blackburn.

Madam Speaker, at this time I would like to yield 3 minutes to the gentleman from the Energy and Commerce Committee, Dr. Gingrey.

Madam Speaker, at this time I would like to yield 1\1/ 2\ minutes to the gentlewoman from Illinois (Mrs. Biggert).

Madam Speaker, at this time I would like to yield 1\1/ 2\ minutes to the distinguished gentleman from Miami, Florida (Mr. Lincoln Diaz-Balart).

Madam Speaker, we believe we are in agreement with the gentleman from Florida (Mr. Hastings) that we will allow their side to catch up at this time.

We continue to reserve.

Madam Speaker, I yield 1 minute to the gentleman from Lewisville, Texas (Mr. Burgess).

Madam Speaker, at this time I would like to yield 2 minutes to the gentleman from Lincoln, Nebraska (Mr. Fortenberry).

Madam Speaker, at this time I would like to yield 2 minutes to the gentleman from Louisiana (Mr. Scalise).

Madam Speaker, the gentleman, the majority leader, indicated he had not had an opportunity to see the Congressional Budget Office report to the gentleman Mr. Waxman, dated January 13. I would like to insert this into the transcript of today's debate.

Congressional Budget Office Cost Estimate

H.R. 2--Children's Health Insurance Program Reauthorization

Act of 2009

Summary: The legislation would authorize the Children's

Health Insurance Program (CHIP) through fiscal year 2013 and

increase federal funding for the program above current

levels. The bill would provide performance bonus payments to

states for enrollment costs resulting from specified

enrollment and retention efforts. H.R. 2 would establish a

child enrollment contingency fund to cover state CHIP

expenditures beyond the amount allotted in statute for the

2009-2013 reauthorization period. The bill also would add an

additional state option to use CHIP funding to provide a

premium assistance subsidy for children enrolled in a

qualified health insurance plan, provide additional funding

for outreach grants, and improve access to dental benefits

and mental health parity in CHIP plans.

H.R. 2 includes other provisions related to the Medicaid

program and CHIP. These provisions include ones that would

allow states the authority to waive the restriction on

providing Medicaid and CHIP coverage to certain legal

immigrants before five years of

residency, provide an alternative citizenship verification

process for states when determining Medicaid eligibility, and

provide grants for increased outreach and enrollment

activities. Finally, the bill would increase the federal

excise tax on tobacco products.

The effects on direct spending and revenues over the 2009-

2013 and 2009-2018 periods are relevant for enforcing pay-as-

you-go rules under the current budget resolution. CBO

estimates that enacting H.R. 2 would increase direct spending

by approximately $32.3 billion over the 2009-2013 period, and

by $65.4 billion over the 2009-2018 period. In addition, the

Joint Committee on Taxation (JCT) estimates that certain

provisions of the bill would increase federal revenues by

$31.3 billion over the 2009-2013 period and $64.7 billion

over the 2009-2018 period. Accounting for those effects and

other revenue effects stemming from provisions in H.R. 2, CBO

estimates that enacting the legislation would reduce deficits

by $1.1 billion over the 2009-2013 period and by $1.7 billion

over the 2009-2018 period.

CBO has reviewed the nontax provisions of the bill (Title I

through Title VI, excluding section 311(a)) and determined

that they contain no intergovernmental mandates as defined in

the Unfunded Mandates Reform Act (UMRA). CBO has determined

that those provisions contain private-sector mandates on

group health plans and issuers of group health insurance. In

aggregate, the costs of the mandates on private entities in

the nontax provisions of the bill would not exceed the annual

threshold established by UMRA for private-sector mandates

($139 million in 2009, adjusted annually for inflation).

Estimated cost to the Federal Government: CBO's estimate of

the impact of H.R. 2 on direct spending and revenues is shown

in the following table. The costs of this legislation fall

within budget function 550 (health).

--------------------------------------------------------------------------------------------------------------------------------------------------------

By fiscal year in billions of dollars--

Madam Speaker, we reserve our time.

Madam Speaker, we continue to reserve our time.

Madam Speaker, we will continue to reserve our time.

I thank the gentleman. I have no further speakers and would yield myself the balance of my time to close.

Madam Speaker, I will be asking for a recorded vote on this closed rule.

With the current program not expiring until March 31 of this year, we have seen enough Members question the underlying legislation, and I think we deserve an open and honest debate in the committees of jurisdiction before we take a vote on such a large expansion--$35 billion more of government programs.

This legislation spends billions of dollars to substitute private health insurance with government-run coverage. It enables illegal aliens to fraudulently enroll in Medicaid and in SCHIP. The bill creates the most regressive tax increase in American history, using funding gained from taxing the poor to pay for expanding SCHIP eligibility to higher income families. This legislation increases the number of adults on SCHIP, allowing even more resources to be taken away from the low-income, uninsured children who need it the most.

Madam Speaker, this legislation moves us closer and closer to a government-run program and further and further away to access for quality health care of our choice.

I encourage all of my colleagues to vote ``no'' on the rule and to vote ``no'' on the underlying legislation. We should ensure that SCHIP meets its original intent and that it covers the poorest children first.

We have been very clear about saying that the Republicans in this body have asked for the opportunity to have regular order to discuss this issue in committee and have asked for the opportunity to have Republicans and Democrats present their ideas and hear them accepted for amendments before the Rules Committee. We object to the way that this Rules Committee has handled this issue.

I yield back the balance of my time.

Madam Speaker, I demand a recorded vote.

Madam Speaker, by direction of the Committee on Rules, I call up House Resolution 52 and ask for its immediate consideration.

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

General Leave

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

I yield myself such time as I may consume.

Madam Speaker, H. Res. 52 provides a closed rule for consideration of H.R. 2, the Children's Health Insurance Program Reauthorization Act of 2009.

I really am honored and privileged to have the opportunity to present this rule to the body. The rule provides 1 hour of debate, equally divided among and controlled by the chairperson and ranking minority member of the Committee on Energy and Commerce and the chairperson and ranking minority member of the Committee on Ways and Means.

Madam Speaker, the SCHIP reauthorization bill of 2009 is a fiscally responsible way to revive our commitment to providing America's low- income children with the quality health care they need and deserve. The bill authorizes $32.3 billion over 4\1/2\ years to cover the seven million children who currently rely on SCHIP, and extends coverage to more than four million low-income children who are currently living without health care. The bill offers comprehensive and wide-ranging care that includes mental, dental, prenatal, and maternal health services.

The underlying bill also supports a multifaceted approach to increasing health insurance enrollment. It provides States with incentives to lower

the number of uninsured children and authorizes $100 million in grants for new outreach programs in schools and community-based organizations.

Additionally, the bill fights geographical health disparities by offering additional support to underfunded States that meet these enrollment goals, and improves reporting on State health conditions.

Lastly, this bill has provisions that ensure that SCHIP prioritizes children who legally reside in the United States. The bill prohibits new waivers that would cover parents, phases out SCHIP coverage for parents and childless adults, and includes measures that prevent payments to unlawful immigrants.

Madam Speaker, when all 50 States, the District of Columbia and five territories--and perhaps the sixth, the Northern Marianas, now that they're included--gave children health care under SCHIP, our government exemplified our Nation's commitment to equal opportunity. SCHIP has prevented millions of low-income children from suffering under our country's flawed health care system for over 10 years. And adequately supporting and expanding this valuable program is even more imperative during these hard economic times.

Madam Speaker, the '08 financial crisis exacerbated our longstanding health care crisis. Last year, skyrocketing gas and food prices and the plummeting job market made it difficult for lower and middle income-- indeed, for all Americans--to finance their everyday needs, importantly, including health care.

In a country where a large portion of people receive health care insurance through their employer, it comes as no surprise that when the economy and job markets plunge, the number of uninsured Americans soars, and children frequently pay the highest price. Even prior to last year's economic crisis, the number of children who depended on SCHIP and Medicaid was increasing.

Madam Speaker, the facts are clear: One in nine American children are uninsured. And this issue hits close to home. Florida was ranked 45th in the Nation in terms of overall health. Like other low-ranking States, Florida has a large uninsured population and a high rate of child poverty. In fact, Florida has the second largest number of uninsured children in the country.

Although these statistics are inexcusable, our current President's failure to address the alarming number of uninsured children in this country was and is an outrage. The President committed an egregious action, in my opinion, against our children when he repeatedly vetoed the bipartisan SCHIP Reauthorization Act of 2007. For many States, the annual funds allotted to State SCHIP programs were on the verge of depletion, and the welfare of millions of children depended on whether Congress and the President would agree to adequately finance SCHIP. President Bush's action sent a devastating message. The leader of the free world was willing to put the lives and welfare of millions of American children at risk.

Now, in this new Congress, and with a new administration, we have the power, the political will, and the opportunity to make a different choice. Like-minded Democrats and Republicans and independents understand that fighting the epidemic of uninsured people in this country is a fundamental component of restoring our economy. We know that SCHIP and other health care programs decrease costly emergency room visits and invasive medical procedures. We know that extending health care insurance helps to combat the social, economic and health disparities that continue to divide our Nation and hinder our progress. And we know that healthy children are better equipped to compete in school and help America compete in the global market.

Simply put, we cannot have a healthy economy without healthy people. And this must begin with our children. I urge adoption of this rule and passage of the underlying legislation.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I am very pleased to yield 3 minutes to the distinguished gentlewoman from California, my colleague and good friend on the Rules Committee, Ms. Matsui.

Madam Speaker, I am very pleased to yield 1 minute to the distinguished gentlewoman from Florida, my colleague on the Rules Committee, who is also going to be on the committee of jurisdiction real soon, and we are going to miss her on the Rules Committee, Ms. Castor.

I yield the gentlelady an additional 15 seconds.

Madam Speaker, I am very pleased to yield 2 minutes to my good friend from Ohio, the distinguished gentlewoman, Ms. Sutton, a member of the Rules Committee, also soon to be a member of the Commerce Committee and will be sorely missed on our Rules Committee.

Madam Speaker, would you be so kind as to inform both sides as to the remaining amount of time.

Madam Speaker, I am very pleased to yield for his first floor speech to a gentleman that is going to be on the Rules Committee real soon, the distinguished gentleman from Colorado (Mr. Polis), for 1 minute.

Madam Speaker, I am very pleased to yield 2 minutes to my good friend, the distinguished gentleman from Texas (Mr. Edwards) who, when this program had its inception in 1997, was an original cosponsor of this legislation.

Madam Speaker, I am pleased to yield 2 minutes to my classmate and good friend,

the distinguished gentleman from Michigan (Mr. Stupak), a member of the Energy and Commerce Committee.

Madam Speaker, can you tell me again how much time each of us has?

Madam Speaker, I am pleased to yield 1 minute to a new Member, the distinguished gentlewoman from the State of Ohio (Ms. Kilroy).

Madam Speaker, I am very pleased to yield 1\1/2\ minutes to yet another of our new Members on the Democratic side, the distinguished gentleman from North Carolina (Mr. Kissell).

Madam Speaker, at this time I am very pleased to yield 1 minute to my classmate and good friend, the distinguished gentleman from Texas (Mr. Doggett), a member of the Ways and Means Committee.

Madam Speaker, I yield 1 minute to the distinguished gentleman from Georgia (Mr. Scott), my good friend who along with his fellows in the area of Georgia have been champions for children's health insurance.

Madam Speaker, I am very pleased at this time to yield 1 minute to the distinguished gentlewoman from the District of Columbia (Ms. Norton) who knows this issue extremely well.

Madam Speaker, I am very pleased to yield 1 minute to one of the original sponsors of the original SCHIP legislation, the distinguished gentlewoman from Connecticut, my good friend, Rosa DeLauro.

Madam Speaker, I am very pleased at this time to yield 1 minute to the distinguished majority leader of the Democratic Caucus, Mr. Hoyer, my good friend.

Madam Speaker, may I indulge you again to give us the remaining amount of time.

Madam Speaker, at this time, I am very pleased to yield 1 minute to the distinguished gentlewoman from Pennsylvania, yet another of our new Members, providing new dynamics and new direction, Mrs. Dahlkemper.

Madam Speaker, I am very pleased at this time to yield 1 minute to my good friend, the distinguished gentlewoman from Texas (Ms. Jackson-Lee).

Madam Speaker, I am very pleased to yield at this time 1 minute to a distinguished new Member who represents those 10 miles from my home, Orlando, Florida (Mr. Grayson).

Madam Speaker, I am very pleased at this time to yield 1 minute to the distinguished gentleman, my friend from Oregon, a member of the Ways and Means Committee, Mr. Blumenauer.

Madam Speaker, at this time, I inquire of the gentleman whether or not he is their last speaker. I am prepared to close, and I will be our last speaker.

Madam Speaker, when I hear my good friend from Texas speak of regular order on this particular measure, it would presume, among other things, I guess, that

no one in this body knows that there is a significant number of children who are uninsured and that this measure, once offered in 1997, did begin the process that today we wish to continue and that still does not complete the task that most of us feel is necessary in order to insure all of the children in this country.

Madam Speaker, this is a good rule for a critically important bill. Although this bill cannot repair all of the flaws that are intrinsic in America's health care system, it undoubtedly serves as a strong and honorable prelude to facilitating comprehensive health care reform.

Mahatma Gandhi, among many things, said that you can learn about a country's condition by looking at its most weak and vulnerable people. The alarming rate of uninsured and poverty-stricken children in this country tells us that the richest country on Earth is in poor condition.

I urge my colleagues to vote in favor of this rule so that we may support a bill that will give millions of children the basic right to health so that they can become leaders and productive citizens.

I urge a ``yes'' vote on the previous question and on the rule.

I yield back the balance of my time, and I move the previous question on the resolution.

The previous question was ordered.

I must say, following the last speaker, I think the last speaker is absolutely wrong. I think he misrepresented very substantially the facts of this bill, which strengthens verification.

This administration, the Bush administration, will tell you that, and the governors will tell you that the current verification system is not working, and that, in fact, we strengthen, in this bill, the verification. And of course, although he made it clear that illegal immigrants are not included and are very specifically not included, this bill will make it easier and more facilitate ensuring that objective than the present law.

Very briefly.

If, in fact, in other sections the verification process has not been strengthened, that may be accurate. I haven't seen the CBO report to which you refer. However, the strengthening will preclude that objective from happening, in my opinion.

Madam Speaker, I want you to hear the story of Deamonte Driver. This is from the Washington Post from February 28, 2007.

``12-year-old Deamonte Driver died today of a toothache.'' 12 years of age. ``A routine $80 tooth extraction might have saved him. But by the time Deamonte's own aching tooth got any attention, the bacteria from the abscess had spread to his brain, doctors said. After two operations and more than 6 weeks of hospital care, the Prince George's County 12-year-old died.''

If you want a picture of American health care, in all its excellence and in its failures, there it is: The best doctors, the latest technology, 6 weeks of hospital care for a sick boy, at the cost of $250,000, in a country that can't find $80 to fix a toothache.

To paraphrase Adlai Stevenson, American health care swallows tigers whole, but it can choke to death on a gnat. We couldn't find $80, and in the end it cost us a quarter of a million dollars. More importantly, it cost us the life of a young man. A system that makes such errors on a regular basis is both financially foolhardy and morally insupportable.

Yes, on a regular basis, Deamonte Driver's case may be extreme, but it was hardly unique. Every day, uninsured parents are foregoing much cheaper preventive care and using the emergency room as the first line of defense for their children's health. Ironically, the President of the United States, when he vetoed this bill, said that's exactly what they could do, intervene in the most expensive, last ditch intervention in health care. We're all paying for that. We are subsidizing those ER visits, we are dealing with the overburdened hospitals, and we are creating a sicker, less productive work force.

Fixing American health care will take much longer than an afternoon, but if I could pass just one bill today, if I could find the most efficient use of our health care dollars, I'd ensure more children. I think 80 percent of Americans agree with us on that.

One of the previous speakers, a physician on the other side of the aisle, was recognized to speak. I spent, Mr. Dingell spent, Mr. Bachus spent, Mr. Rockefeller spent, Mr. Grassley spent some 30 hours in meetings with that doctor trying to reach a compromise. There were a number of other people in that room. Ultimately, there was no, notwithstanding the changes we made in the bill, there was no willingness to compromise to ensure the children.

There's no more medically pivotal time in life than that of a child. Make it through childhood without checkups, without a doctor's care, and you're still facing a lifetime of endangered health. Every other developed nation in the world seems to get that. Every other developed nation in the world provides its children with health care. Every developed nation makes sure all of its children are covered, with the exception of the United States of America.

This bill brings into the State Children's Health Insurance Program 4 million children not covered today because the President vetoed the CHIP bill, and we could not get 15 additional people in this body to override the veto. We got 45 on the Republican side of the aisle, and all the Democrats, but we couldn't get those extra 15. This bill brings in those 4 million children. It does what President Bush promised to do when he ran for re-election in 2004.

Accepting the Republican nomination in 2004, President Bush said this: ``In a new term, we will lead an aggressive effort to enroll millions of poor children who are eligible but not signed up for government health insurance programs.'' That's what he promised.

That's what the House and Senate have been pushing to do, what we passed legislation to do, and what the overwhelming majority of Americans have wanted to do for years.

Madam Speaker, we've tried. President Bush vetoed similar bills twice. But we are confident that President-elect Obama sees the issue differently. The American people saw the issue differently. They wanted change. This bill is going to reflect their desire for and vote for change.

This bill gives States permission to waive an arbitrary waiting period of 5 years to enroll immigrant children who are here legally.

Is there anyone here who wants to check on a sick child and say, we know you're here legally, but you've got to wait 5 years? A 1-year-old or a 2-year-old, that's two or three times their lifetime. It doesn't make moral sense to deny those children health services when their parents already pay payroll taxes. It doesn't make public health sense to keep those kids from getting the basic care they need.

As a parent, as a grandfather, and as a great grandfather, very frankly, I want my child in school with healthy children, from wherever they come. And it doesn't make economic sense to subsidize unnecessary emergency room visits.

Madam Speaker, we all know that we're in a severe recession, and it makes this bill more vital than ever, because when we considered this bill last year, we hadn't lost millions of jobs. Millions of parents had not yet lost their health insurance. This legislation is more necessary than ever. More and more Americans are out of work.

More and more family budgets are strained to the breaking point. Today, health coverage for kids could make the difference between a family's economic ruin and economic stability.

As Yale University's Jacob S. Hacker writes, ``access to affordable health care could be an immediate lifeline for working families.''

It is in our power to throw that lifeline today. It's the right thing to do. It's the right thing to do for our children. It's the right thing to do for our families. It's the right thing to do for our economy, and it is the morally correct thing to do.

Pass this rule, pass this bill, let us send it to President Obama, and he will add the 4 million children, with our help, to health care in the richest land on the face of the Earth.

Madam Speaker, pursuant to House Resolution 52, I call up the bill (H.R. 2) to amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes, and ask for its immediate consideration in the House.

Madam Speaker, I ask unanimous consent that every Member have 5 legislative days in which to revise and extend their remarks and include extraneous material on the legislation now before us.

Madam Speaker, I yield myself 1 minute.

Madam Speaker, we have been working to reauthorize the Children's Health Insurance Program for the past 2 years. In the last Congress, we passed legislation that enjoyed bipartisan support in both the House and Senate as well as the support of the American people. Unfortunately, it did not enjoy the support of the President, who vetoed our bill not once, but twice, and went on to proclaim that uninsured children can simply go to the emergency room to have their medical needs met.

But this is a new day in Washington. Soon we will have a new President who has committed himself to reforming our Nation's health care system so every American can access affordable and quality health care. The bill we are considering today makes a down payment on that promise by putting the health and well-being of our children first.

Madam Speaker, this bill will make critical improvements to CHIP. There will be more resources for States to enroll eligible children. There will be better benefits. As a result, there will be 11 million children who will have access to the quality health coverage they need and deserve.

Madam Speaker, I yield myself another 15 seconds.

After 2 years of trying to get this bill enacted, we are now nearing the finish line and with not a moment to spare. As the Nation moves deeper into a recession and unemployment rates continue to rise, millions of Americans are joining the ranks of the uninsured, many of whom are children. We can't delay. We must enact this legislation now.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I yield 1 minute to the gentleman from California, the chairman of the Energy and Commerce Committee (Mr. Waxman).

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

Madam Speaker, I yield 1 minute to the gentleman from Michigan, the chairman emeritus of the Energy and Commerce Committee (Mr. Dingell).

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

Madam Speaker, I yield 1 minute to the gentlewoman from Colorado, the vice chair of our committee, Ms. DeGette.

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

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

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

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

Madam Speaker, I yield to the gentlewoman from New York (Mrs. Maloney) for the purpose of a unanimous consent request.

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

Madam Speaker, I yield 1 minute to the gentleman from Georgia (Mr. Barrow).

Madam Speaker, I yield 30 seconds to the gentlewoman from California (Mrs. Capps).

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

Madam Speaker, I yield 30 seconds to the gentlewoman from the Virgin Islands (Mrs. Christensen).

Madam Speaker, I yield 1 minute to the gentleman from Illinois (Mr. Foster).

Madam Speaker, I would yield 30 seconds to the gentlewoman from New Hampshire (Ms. Shea-Porter).

Madam Speaker, we inquire of the time that is remaining.

Madam Speaker, at this time, I would yield 30 seconds to the gentleman from New York (Mr. Massa).

Madam Speaker, I have some additional speakers, though.

I yield 30 seconds to the gentleman from Virginia (Mr. Connolly).

Madam Speaker, I would yield 30 seconds to the gentleman from Iowa (Mr. Loebsack).

I do not, but I was going to ask how much time remains.

Madam Speaker, I would yield myself a minute and a half.

I just want to stress how important this bill is and also that it is, essentially, the same bill that we passed in the last Congress. It was bipartisan. It was passed in both houses with a fairly large margin. The only thing that stood in the way was President Bush's veto.

Now we do have a new President. We know that he has supported the legislation. It is so crucial for the children of this country, for the 4 million or so now who are eligible but for whom there is no funding, who will be covered by this legislation. It is fully paid for.

Particularly now, when we have a recession and when we know that so many people are losing their jobs and, as a consequence, their health insurance for themselves and for their families, what could be more important than making sure that those families' children are covered by this legislation?

I must say I'm very proud of the fact that we are here in the first week, essentially, of this new Congress passing this bill. I know the other body is about to pass it as well and that we will be able to send it to the President and have it be one of the first accomplishments of his Presidency and of this Congress.

I know Mr. Stark already thanked the various staff members, so I won't thank them again. But I do want to pay particular attention to Bridgett Taylor because I know that she worked on this legislation for 2 years or more and was even there when we first passed the SCHIP bill 10 years before that. And it has always been one of the things that she cares so much about. But I want to thank all of the staff people and all of my colleagues for all of the work that they've done on this legislation.

Madam Speaker, today is the beginning of a new Congress. Our new President hasn't even taken the oath of office and we are throwing fiscal discipline out the door. This whole idea of PAYGO is gone. It doesn't exist. It is a charade.

Let's take a look at what this bill actually does. This bill proposes to add all these new kids on the SCHIP program, and then in the out- years it shoves them off a cliff, taking 7 million children off of the SCHIP program. They do this only to carve and jam this bill into compliance with PAYGO.

I received a letter from the CBO just this morning that if this bill was actually carried through, if you didn't kick all of these children off of this program, it would cost $42 billion more. This bill has a $42 billion deficit hole in it. The spending increase in SCHIP in this bill increases on average 23 percent a year. Madam Speaker, Medicare is going bankrupt according to the trustees, and that increases at 6.5 percent a year.

We are being deprived of a bipartisan opportunity to extend the current SCHIP program, which would have an enormous vote here if you brought a bipartisan bill to the table. That is not what is happening. Budget gimmicks, fiscal irresponsibility, a $42 billion deficit, and the creation of a brand new entitlement program. And what is worse, we are committing our taxpayer dollars, which are so precious in this difficult economic time, to pay for insurance that people already have. 2.4 million people who already have private health insurance are going to get kicked off of their private health insurance and the taxpayers are going to pick up the tab. That is not fiscal responsibility.

Let's solve the uninsured problem. Let's come together and fix the health care problems in America. Let's not bankrupt the country. Let's not play budget gimmicks. Let's not throw PAYGO out the window. And let's not take away the health insurance that people already have and make them have government-sponsored health insurance. We should reject this bill.

U.S. Congress,

Congressional Budget Office,

Washington, DC, January 14, 2009.

Hon. Paul Ryan,

Ranking Member, Committee on the Budget, House of

Representatives, Washington, DC.

Dear Congressman: As you requested, the Congressional

Budget Office (CBO) has estimated the budgetary effects of

modifying H.R. 2, the Children's Health Insurance Program

Reauthorization Act of 2009, to extend the program's

authorization through 2019 in a manner that would provide

sufficient funding to allow states to meet demand for

increasing enrollment within the program's parameters. If

H.R. 2 were changed to authorize the Children's Health

Insurance Program (CHIP) through 2019 and to provide

sufficient funding for such increasing enrollment throughout

that period, CBO estimates that enacting that alternative

version of the bill would increase deficits by $41.6 billion

over the 2009-2019 period. In contrast, CBO estimates that

the version of H.R. 2 introduced in the House of

Representatives on January 13, 2009, would result in a net

reduction in deficits of $0.4 billion over that 11-year

period.

The introduced version of H.R. 2 would authorize CHIP

through 2013 and would provide significant funding increases

over the next few years, leading up to a total funding level

of $17.4 billion in 2013. The program's funding for the

second half of fiscal year 2013 would be $3 billion. Under

baseline rules, that amount annualized--$6 billion--would be

projected for each subsequent year. The estimated cost of the

bill assumes that funding level for CHIP for fiscal years

2014 through 2019. On that basis, CBO estimates that the

introduced version of H.R. 2 would increase federal direct

spending by $73.3 billion through 2019, including the costs

of other provisions in the bill. (That spending would be

offset by increases in federal tax revenues totaling $73.6

billion over the same period, primarily from increases in the

excise taxes levied on tobacco products.)

As an alternative to the introduced version of H.R. 2, you

requested that CBO assume the CHIP rules and structure as

currently delineated in H.R. 2 would remain unchanged through

2019 and that sufficient funding would be made available

after 2013 to accommodate projected enrollment growth. The

projected enrollment growth is based on expected growth in

the total population, as well as changes in the health

insurance market and the economy as a whole. Under those

assumptions, CBO estimates that average monthly enrollment in

CHIP would rise from about 9 million in 2013 to about 12

million in 2019.

Based on the assumptions you specified, CBO estimates total

changes in direct spending of $115.2 billion, as compared

with the $73.3 billion increase we estimate for the

introduced version of H.R. 2. (Revenue increases would remain

unchanged.) Thus, the net budget impact of a modified version

of H.R. 2, as you specified, would be an increase in deficits

totaling $41.6 billion over the 2009-2019 period.

If you wish further details on this estimate, we will be

pleased to provide them. The CBO staff contacts are Robert

Stewart and Sean Dunbar.

Sincerely,

Robert A. Sunshine,

Acting Director.