To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges.

Mr. Chairman, I would just remind the gentleman, the ranking member from New Jersey, in our committee hearing earlier this year we heard from the Governor of Utah who had been setting up a state exchange prior to the passage of the Patient Protection and Affordable Care Act, and now was left with an uncomfortable situation where it has been ruled unconstitutional by two district courts. He's waiting for whatever happens in the court system. But as he told us in committee, ``I'm walking on shifting sands. I no longer know where to go. Passage of the Patient Protection and Affordable Care Act has made my life infinitely harder.''

I would now yield 2 minutes to the gentleman from New Jersey (Mr. Lance).

Mr. Chairman, I yield 2 minutes to the subcommittee chairman of the Oversight and Investigations Subcommittee, the gentleman from Florida (Mr. Stearns).

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

Mr. Chairman, I yield 2 minutes to the gentlelady from Tennessee (Mrs. Blackburn).

Mr. Chairman, I yield 2 minutes to a valuable member of the committee, the gentleman from Kansas (Mr. Pompeo).

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

Mr. Chairman, I would just point out that this bill only rescinds monies that have not been obligated. Monies that have been obligated would not be rescinded.

I now yield 2 minutes to the gentleman from Iowa, Steve King.

I yield the gentleman an additional 30 seconds.

Mr. Chairman, I yield myself 1 minute.

How many times did we hear over the runup to the passage of the Patient Protection and Affordable Care Act, If you like what you have, you can keep it? It turns out nothing could be further from the truth. In fact, the real truth is they don't want you to keep your current insurance.

We have heard Members on the other side of the aisle claim that 2 million fewer people will be enrolled in the exchange and that the bill will increase costs to the employers. So here is some shocking news: These assertions that during the health care debate many people said repeatedly that under the bill you will not be able to keep your health insurance you like, in spite of promises made by the Democrats, people were concerned that the new law would encourage employers to drop health care coverage for workers.

In fact, we received some memos to that effect as part of an investigation that then-Chairman Waxman actually initiated right after the passage of the bill. But then when trying to pass the bill, the Democrats repeatedly denied those claims. Now they seem to relish the fact that employers will drop coverage, and they actually see it as a negative that 1 million people will continue to have employer-sponsored insurance, the coverage that they precisely wanted to keep.

I reserve the balance of my time.

I yield myself 3 minutes.

Mr. Chairman, States are coming to the realization that there is no flexibility in these grants. They are coming to understand that the mere words that a State gets to develop an exchange that fits their individual needs, in fact, just rings hollow.

The other side has used the word ``flexibility'' as a big bait-and- switch, just similar to the words ``if you like what you have, you can keep it.'' The authors of the bill praised these words, but they are simply not true. The law clearly puts Washington in control, in firm control, in absolute control, of these exchanges.

For example, section 1302, the Secretary will choose the essential benefits that must be paid for by individuals and families in the State exchange.

Section 1302 (d)(2), the Secretary will control whether an HSA can be offered.

Section 1311(h), the Secretary can by regulation select the doctors and other health professionals that are allowed to provide care in the exchange plans. As a physician, I find this one of the more chilling provisions in this legislation.

Section 1311(i), the Secretary--the Secretary--decides whether a plan provides linguistically appropriate and culturally sensitive information. If they do not meet the Secretary's approval, they cannot have that plan.

Section 1311(c)(1) and section 1311(e), the Secretary--the Secretary--determines the process and requirements for certifying whether a plan can be sold in the exchange.

Section 1311(c)(1)(I)(6), the Secretary can decide when individuals can enroll in the exchange plan.

Section 1311(d)(4), the Secretary will judge the adequacy of an exchange Internet Web site.

Section 1311(k), the Secretary will determine whether an exchange establishes rules that conflict with or prevent the application of regulations promulgated by the Secretary. In other words, not only do they get to make the rules; they get to be the referee.

Concerns were raised prior to the passage of the Patient Protection Affordable Care Act that the law was designed, designed, for employers to drop coverage so Washington would control health care through ObamaCare exchanges. Now the other side protests when 1 million people will keep their employer-sponsored insurance because they would rather have them under the direct and absolute control of Washington, D.C., rather than their State capitals.

I reserve the balance of my time.

I yield myself 1 minute, Mr. Chairman.

I would remind my colleagues on the other side of the aisle that the Governor of Utah coming to our committee hearing said that he was setting up exchanges prior to the passage of the Patient Protection and Affordable Care Act. The passage of the Patient Protection and Affordable Care Act has limited his ability to provide those exchanges. In fact, he went so far as to say now, with the nebulous future surrounding the Patient Protection and Affordable Care Act, because of activity in the courts--not in the United States House of Representatives, but in the courts--remember them, the third branch of government that gets to decide if something is constitutional or not-- because of the ambiguity surrounding the cases in the courts, the Governor of Utah felt that he could not go forward with the plan that he was implementing, and he worried that the money he had already spent, his own State's money on developing State exchanges, would now be for naught. He does not know what the rules will be going forward if the Patient Protection and Affordable Care Act is allowed to stand because those rules have yet to be written. Those rules have yet to be interpreted.

So in a very perverse way, we have made it harder for a State to provide exchanges by passing the Patient Protection and Affordable Care Act.

I reserve the balance of my time.

I yield myself such time as I may consume.

Mr. Chairman, I would not presume to put words into the mouth of the Governor of Georgia, but I do know from a long association with him that he was very abhorrent of any mandates that were placed on the States. So I do not doubt the fact that he said the worst of all possible worlds would be to get the mandate and not get anything else to help him back that mandate. But to be very clear, the mandates themselves are the anathema.

Why would those mandates be a problem for the Governor of Georgia or the Governor of any other State? Because now the decisionmaking does not rest with the State. The State is mandated. The State is mandated to set up these changes. And yet the Health and Human Services Secretary will choose the essential benefits that must be paid for by individuals and their families.

That's no longer a State decision. That's no longer a gubernatorial directive. That is now a directive from the Secretary of Health and Human Services. They would also decide whether their planned provider network is adequate, regardless of whether or not it covers the doctor that you use and you like. The Secretary--not the Governor, not the Governor's chief of staff, not someone in the State legislature--the Secretary of the Department of Health and Human Services, who has that now unprecedented power and is only limited by her own imagination.

The Secretary would impose price controls on health coverage. The Secretary would pick who gets a waiver from the annual limit requirements. The Secretary would establish cost-sharing requirements regardless of their effects on premiums, not a gubernatorial directive, not something established by the State Commission of Insurance, not something contributed to by the Governor's chief of staff, not something decided by any State legislature, but by the Secretary of the Department of Health and Human Service.

Again, Chairman Upton in his opening remarks said the spending would only be limited by the imagination, by the limits of the imagination of the Secretary of the Department of Health and Human Services. We know who that is this year. We don't know who that is next year. We certainly do not know who that is in 2 years' time.

It is the responsibility of this Congress to exercise the due oversight over these programs. We abnegated that authority by the forward funding of these programs. As Mr. King pointed out in his remarks, we abnegated that authority. It's now time for Congress to claim that back. That's not mindless. The mindlessness, I might remind the Chair, was when this bill was passed a year ago without due proper authorization and oversight.

I reserve the balance of my time.

Mr. Chairman, I will direct my remarks to the Chair and not to anyone in particular, which I believe is one of the habits of the House; and I yield myself 1 minute for this purpose.

I was always taught growing up that if you're going to tell a story, you ought to begin it with ``once upon a time.'' I think I should have heard a few ``once upon a times'' in that last tirade that was just leveled upon the House.

Their hypocrisy knows no bounds, Mr. Chairman. The other side claims that the health care law is about State flexibility, but they oppose H.R. 1213 because some States might assess a health plan fee to fund the operation of exchanges that the State wants to set up. If you're for flexibility, then eliminate complete control that the Secretary has over the State exchanges. Let States establish exchanges without onerous and costly Federal mandates and finance them according to how each State feels is appropriate.

Now, to talk about hypocrisy, what the other side fails to mention is that the Patient Protection and Affordable Care Act advocates taxing health care plans that sell insurance in the exchanges. Rather than being silent on how States should fund their exchanges once the grant money runs out, the Democrat health care bill actually spells out that the States should consider charging taxes on health insurance premiums for plans sold in the exchange.

I yield myself an additional 30 seconds.

The hypocrisy could be tolerable if it just simply ended there. However, the other side also fails to mention that the Patient Protection and Affordable Care Act directly charges a $60 billion tax on Americans' health insurance premiums, in section 9010, or that imposes tens of billions of dollars in direct taxes on medical devices and drugs that people will use that will increase their health care premiums, according to the CMS actuary.

I reserve the balance of my time.

Mr. Chairman, I yield myself 1 minute.

Although the issue of Medicare is not the subject of this debate today, I can recall a time about 20 years ago when Paul Tsongas, a former Senator, came to Dallas to talk to a group called the Dallas Business Group on Health. It was the day after President Clinton had come to this House and addressed a joint session of the House and Senate and unveiled his health care plan in September of 1993. Senator Tsongas came to talk to us in Dallas, and he said, ``It was a beautiful speech. There wasn't a dry eye in the house. The only problem was that the President proposed five new entitlement programs, and we cannot pay for the ones that we have.''

Former Senator Tsongas then went on to articulate how the rate of rise of entitlement spending was going to cripple this country in the future such that by at some point between 2015 and 2020 this country would see intergenerational conflict the likes of which it had never seen before.

Yes, it is incumbent upon us to recognize that train wreck that is coming and deal with it. Representative Ryan put forward a very thoughtful plan 2 weeks ago. Let's see the plan from the other side. So far that's been lacking.

I reserve the balance of my time.

Mr. Chairman, at this point, I would like to yield 4 minutes to the chairman emeritus of the full committee, the gentleman from Texas (Mr. Barton).

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

I urge an ``aye'' vote on the measure.

I yield back the balance of my time.

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

I supported a seemingly similar amendment 3 weeks ago when the House considered H.R. 1217, a bill related to the public health slush fund in the Patient Protection and Affordable Care Act. However, I have to oppose this amendment because, despite the seeming similarity of the two amendments, this really is an apples-to-oranges comparison. The public health slush fund considered under H.R. 1217 provided a specified amount in mandatory funding for the Secretary in fiscal year 2011 and each year thereafter. In Ms. Jackson Lee's amendment 3 weeks ago, it would be possible to determine the amount of funds that would be rescinded in fiscal year 2011 if H.R. 1217 had been enacted into law. But the amendment offered today by Ms. Jackson Lee actually strengthens the arguments in favor of passing H.R. 1213, the bill before us today.

Section 1311 of the Patient Protection and Affordable Care Act provided the Secretary with an unlimited amount of money with virtually limitless discretion to spend on establishing exchanges or what activities could facilitate enrollment in what are known as qualified health plans. Giving the Secretary a blank check to spend is an abdication of our responsibility here in the House of Representatives. This blank check also makes it impossible to implement the Jackson Lee amendment. There is no dollar figure for how much the Secretary can spend on this program. It is simply an unknown unknown. The Secretary could decide tomorrow to spend another $100 million or another $100 billion. In 2013 the Secretary could take the advice of CMS and funnel money into any amount of activities. Congress and, for that matter, the general public won't know that until the money is spent.

I think the gentlelady from Texas has good intentions with her amendment. Unfortunately, because Congress decided to leave it entirely up to the Secretary of Health and Human Services and the Secretary alone to determine the amounts of money that can be spent, the amendment does not work in this circumstance. I urge my colleagues to oppose the amendment.

Again, I would just simply point out that the gentlelady's amendment under the legislation that was considered previously was appropriate because there were actually funding levels that were mentioned in the legislation.

Now, reading from the Patient Protection and Affordable Care Act here in section 4002, under the Prevention and Public Health Fund, in paragraph B, which discusses funding: There are hereby authorized to be appropriated and appropriated to the fund out of any moneys in the Treasury not otherwise appropriated, one, for fiscal year 2010 $500 million; two, for fiscal year 2011 $750,000, and so on and so forth. In other words, the funding is explicit under the previously considered legislation.

Under the legislation today, which is the health benefits exchange, here is how the funding language reads: For each fiscal year, the Secretary shall determine the total amount that the Secretary will make available for each State for grants under this subsection. Well, we have no earthly idea. Is that $10, $100, $100 million, $100 billion, $13 trillion? We have no earthly idea.

So while the intent of this amendment in previous legislation was one which the majority could accept, in this case, it actually becomes meaningless because there is no dollar figure

specified as the upper limit as to what the Secretary can spend.

I reserve the balance of my time.

Mr. Chairman, the real travesty here is the fact that there is no upper limit on what the Secretary of Health and Human Services can spend on the exchanges. It is pointless to put up on the Web site how much money has been saved when the actual amount of money to be spent equals infinity.

We are borrowing 42 cents out of every dollar that we spend at the Federal level from the Chinese and handing the bill to our children and grandchildren. That has to stop. That's what this legislation is about today. That is why I urge my colleagues to vote against the Jackson Lee amendment and vote for the underlying bill.

I yield back the balance of my time.

I stand in opposition to the Waters amendment because it does perpetuate the fallacy that the Patient Protection and Affordable Care Act will actually provide affordable health care options.

We've had this debate for some time, and my colleagues on the other side of the aisle have argued that the way to provide an affordable coverage option to the uninsured is through a massive 2,700-page law authorizing thousands of pages of new regulations. Yet we've learned that merely one costly requirement of the many contained in the Patient Protection Affordable Care Act has forced the Secretary to issue over 1,200 waivers.

Now, Mr. Chairman, I want you to take a minute with me and to envision in your mind's eye, I want you to visualize a central planner, maybe a very benevolent central planner, but a central planner nevertheless, moving data points around on a spreadsheet. That's what we're going to have under this.

Washington will literally impose thousands of new requirements on plans that kindly bureaucrats are kind enough to allow poor Americans to buy in the Patient Protection and Affordable Care Act's exchanges. The only way to make these federally controlled health plans affordable is through the massive subsidy contained in the Patient Protection and Affordable Care Act. Yet every Member of this body should know that we can no longer afford the ``business as usual'' spending binge to which my Democrat friends are clearly affixed.

I also reject the premise of this amendment. Remember, a few moments ago when debating the baseline bill, I said, you know, we've given the Secretary of Health and Human Services the ability to write all the rules of the game and then to function as the referee to interpret the rules. That's what we're furthering with this amendment.

The underlying assumption of this amendment is that the Secretary of Health and Human Services should issue a report to judge the benefits of the regulations. Oh, by the way, regulations that her own department writes. Given the politically charged reports being issued by the Department of Health and Human Services since the passage of the Patient Protection and Affordable Care Act, we shouldn't pay for another taxpayer-financed advertisement for their health care law.

I urge my colleagues to oppose the Waters amendment.

I yield back the balance of my time.

Mr. Chairman, I rise in opposition to the Ellison amendment.

Mr. Chairman, I do feel obligated to point out that the insurance companies of this country love the Patient Protection and Affordable Care Act. Look what happened to their stock on March 24 of 2010. It went through the roof. The reason is that they got individual mandates, not supported by any Republican I'm aware of. They got individual mandates that every man, woman and child in this country now has to purchase their products. They were suddenly released from creating products that people might actually want, and now you have to buy their products because the Federal Government tells you you must, and the Internal Revenue Service is going to be the enforcer; but let's confine our remarks to the business at hand, which is the Ellison amendment.

The amendment would require the Secretary of Health and Human Services to submit a report on the possible delays and potential enrollment reductions in health benefit exchanges. Now, here is a bit of irony. The reason we need this bill is that the authors were either inadvertently providing the Secretary of HHS an unprecedented unlimited tap on the Federal Treasury for these grants or they meant to provide this blank check to the Secretary. Now the amendment would ask the same Secretary to evaluate the impact of taking away their authority to spend unlimited money.

I wonder how they're going to rule on that?

Not one amendment has been offered this afternoon that would actually ask the Secretary to report on how the Secretary is going to spend these funds or provide information regarding how much money the Secretary actually intends to spend in this section. People should be aware that the amendment does not ask for a report on the benefit of health insurance exchanges. Rather, the amendment asks the Secretary to evaluate only the exchanges contemplated under the Patient Protection and Affordable Care Act, which gives the Secretary the authority to determine what plans can be sold and what benefits must be offered.

The Secretary is even given the authority to limit your choices of doctors. That's not rhetoric. That's in section 1311(h) of the Patient Protection and Affordable Care Act. Some States may want to create exchanges that look nothing like the centrally controlled exchanges called for in PPACA. Yet this amendment only wants the Secretary to report on exchanges that the Secretary is charged with creating. Some States may want to create exchanges that actually provide people real choices and that actually let people keep their doctors. Some States may feel that reforms other than exchanges fit their States better.

I also oppose the amendment because it is a conflict of interest to ask the Secretary to report on whether the Secretary believes that unlimited funding and numerous authorities to control the exchanges are a bad or a good thing. I also reject the notion that only an exchange designed and controlled by Washington, D.C., can reduce the number of uninsured.

I reserve the balance of my time.

Mr. Chairman, I will direct my remarks to you and will try not to make them personal, but I am offended that the previous speaker would say that I am attacking the Secretary of Health and Human Services. Nothing could be further from the truth.

The fact of the matter is, Mr. Chairman, that the Patient Protection and Affordable Care Act that was pushed through this Congress by then- Speaker Pelosi and members of the Democratic Caucus gave the Secretary of Health and Human Services unprecedented power. With regard to every man, woman and child in this country, the most intimate aspects of their lives are now controlled by the Secretary of

Health and Human Services. Further, every time in this law where it reads ``and the Secretary shall--'' and I believe there are almost 2,000 of those phrases--there is a new episode of a Federal rulemaking. There are thousands of pages that go in the Federal Register.

Now, I know most people spend part of their nights reading the Federal Register every evening; but for those who don't, these regulations are coming at you at an alarming rate.

Let's be honest about the insurance companies. The insurance companies love this bill. They get an individual mandate: you've got to buy their product. You have no choice. It is a mandate enforced by the Secretary and, oh, by the way, by the Internal Revenue Service.

Look, this is a bad amendment. Let us defeat this amendment. Support the underlying bill.

I yield back the balance of my time.

Mr. Chairman, I rise in opposition to the Pallone amendment.

Mr. Chairman, I yield myself 4 minutes.

The description provided by the author to the Rules Committee states that the amendment ``would require the Government Accountability Office to report on benefits of funding in setting up State-run exchanges that reflect the State's marketplace, as opposed to State exchanges established and operated by the Federal Government.''

That description sounds appealing enough in its own right; but sort of like the health care reform law of last year, you have to read the amendment to find out what is in it.

The amendment does not ask the Government Accountability Office to examine the benefits of State-run health insurance exchanges. Rather, the amendment asks the GAO to report only the exchanges called for in the Patient Protection Affordable Care Act, whose rules and structure are dominated by Washington rather than States or individuals.

The amendment description speaks to ``setting up State-run exchanges that reflect the State's marketplace.'' However, talk about State flexibility in the Patient Protection and Affordable Care Act is just that: it is merely talk.

I would remind my colleagues about the Golden Rule: He with the gold makes the rules.

So let's once again look at just a few areas where Washington will dictate operation and structures of the exchanges.

For the purposes of comparison, let me use Washington versus Austin, the capital of my State.

So will Washington or Austin choose the essential benefits that must be paid for by the individuals and families? Section 1302 of the Patient Protection Affordable Care Act says that responsibility is Washington's.

Will Washington or Austin control whether health savings accounts and other consumer-driven plans can be offered? Section 1302(d)(2) says Washington wins that round.

What about, will it be Washington or Austin that will select the doctors and other health care professionals that are allowed to provide care in the exchange plans? Well, section 1311(h) gives that authority to Washington, not Austin.

Washington or Austin to decide if your plan's provider network is adequate regardless of whether or not it covers your doctor? Section 1311(c)(1)(B) gives that authority to Washington, DC.

Will it be Washington or Austin to decide whether a plan provides linguistically appropriate and culturally sensitive information? Section 1311(i) gives the nod to Washington.

Will it be Washington or Austin that determines whether a State plan is properly accredited? Well, once again, section 1311(c)(1)(B), Washington wins that round also.

Washington or Austin, who do you think is going to win this one, can decide when individuals can enroll in an exchange plan? Section 1113(c)(1)(I)(6), Washington, DC wins that one.

Washington or Austin, impose certification and decertification plan requirements written by the Department of Health and Human Services? Well, that's hardly fair because HHS is in Washington, and, you guessed it, Washington wins that round.

Washington or Austin, who do you think is going to win this one: judge the adequacy of an exchange Internet Web site? That's something that the States should be able to decide. After all, who knows the residents of the State better than Austin in the State of Texas? Well, Washington actually wins that round.

How about this one: Washington or Austin, force State government to pay for existing benefit requirements? Well, guess what, Washington, not the State. Washington will be the one making that determination.

Then under section 1321, If the Secretary determines a State has not taken the necessary steps, as determined by the Secretary, to meet all the requirements set forth by the Secretary, then the Secretary will take over the State exchange.

I think, Mr. Chair, you begin to get the impression that this is not State flexibility; this is of and run by Washington, DC.

I reserve the balance of my time.

I yield myself the balance of my time.

The Patient Protection and Affordable Care Act, as seductive as the title sounds, does not empower the States. In fact, it does just the opposite.

Some States have created or are in the process of creating State exchanges that would not meet the requirements set forth by Washington. For these and other States that don't believe that Washington knows best, I oppose this amendment. I urge my colleagues to oppose the amendment. I urge my colleagues to support the underlying bill.

I yield back the balance of my time.

I yield myself 4 minutes.

My colleagues on the other side of the aisle have argued that these grants encourage flexibility by promoting State control of the exchanges. Yet this argument is based on the premise that States can actually design the right health care plan for their citizens under the Patient Protection and Affordable Care Act. But when you look at the law, you understand that this concept is actually not true.

In reality, the relationship between the States and Washington, the States are the servant, not a partner of Washington under this health care law. The Secretary of Health and Human Services will control what benefits must be bought, must be bought, in an exchange.

A benevolent central planner, and I underscore the word ``benevolent,'' but a benevolent central planner will decide whether you, your doctor, your nurse, your clinic, your hospital can provide care to you through an exchange plan. A regulation writer at the Department of Health and Human Services will decide whether or not your health savings account complies with their rules.

Rather than promote local control, the Patient Protection and Affordable Care Act's exchanges have only the veneer of providing States flexibility, and they certainly rob an individual and they rob families of health care choice, even if they are happy with the coverage that they currently have.

The Welch amendment does not authorize a grant program for States to establish exchanges, that is exchanges written with a lower case E, but, rather, Health Benefit Exchanges, all caps, that are contemplated in the Patient Protection and Affordable Care Act.

Section 1321 of the bill has the title ``State Flexibility in Operation and Enforcement of Exchanges,'' but a reading of that section shows the title could not be anymore misleading. The section is littered with phrases such as ``other requirements the Secretary determines appropriate,'' or words such as ``the Secretary determines that an electing State has not taken the actions the Secretary determines necessary.''

Section 1311(k), I have referenced that previously, section 1311(k) states that ``an exchange may not establish rules that conflict with or prevent the application of regulations issued by the Secretary.''

Mr. Chairman, I am encouraged that the supporter of the amendment believes that we should not provide the Secretary with a blank check. However, I oppose this amendment because it perpetuates the idea that the Federal Government should dictate how States establish exchanges.

Last year, we were told we need to read the bill to know what is in it. Today, I ask those here in this body to ignore the rhetoric and actually read the bill. Those who do will clearly see that any suggestion that the Patient Protection and Affordable Care Act provides States flexibility does not hold up to the words in this 2,700-page bill.

I reserve the balance of my time.

I thank the chairman.

I would just say, once again, the flexibility does not exist. It's a veneer, it's a falsehood that under this plan the States would maintain flexibility. The Secretary determines whether or not the States are complying. The Secretary determines whether or not the plans are in compliance with what the Secretary thinks is a reasonable plan to be offered. If we want to talk about the ability of people to buy insurance across State lines, that's an argument that we can and should have. I don't

know why your side rejected that in the debates over the Patient Protection and Affordable Care Act. The fact of the matter is, they didn't. We are where are. Let's defeat this amendment and support the underlying bill.

I yield back the balance of my time.

Mr. Chairman, I move that the Committee do now rise.

Mr. Speaker, what we are going to do here for the next hour is talk about why we feel so strongly the need to repeal, and if not successful, to defund so many provisions of the Patient Protection and Affordable Care Act.

But, Mr. Speaker, before I get started in the subject at hand, I do want to join my colleagues, particularly my colleagues on the Democratic side of the aisle, in remembering our colleague John Adler. I didn't realize that John had been sick. I didn't realize that John had had surgery. I didn't realize until just moments ago that our colleague from New Jersey had died. As I sat here listening to the New Jersey delegation on both sides of the aisle talk about John, it helped me understand a little bit better about him.

All I know about John is that he was a great guy and a really, really nice Member of this body and someone that I respected. I got to know him, Mr. Speaker, in the House gym at 6 o'clock in the morning usually. He would be working out, and I would be working out--I am 15 years older than John was--and we just struck up a good friendship. I truly will miss him, as well as my other colleagues, as they express their sympathy to his wife and his four sons. But truly a great Member.

It reminds me too, Mr. Speaker, that as we do our work, as we do our work with 1-minutes, and we do our work with 5-minute Special Orders, and now this leadership hour talking about a very important issue that our colleagues on the other side of the aisle for the most part, almost 100 percent of them feel very differently about this issue, we differ on a lot of things, and we will continue to do that. It has gone on forever.

But the point I would like to make, and I will conclude with this, is that there are 435 people in this House of Representatives. And sometimes we Republicans are in the majority and sometimes the Democrats are in the majority, and the worm turns, and nothing is forever.

But we have good, decent men and women serving here representing their districts and doing the work of the people. And God bless them. God bless each and every one of them. God bless a Member like John Adler, who died much too young, as my colleagues have said already.

But we want to always keep in mind that as we argue and debate and make points and feel very strongly about an issue, that doesn't mean we don't love one another. And we do. And I loved John Adler. He was a great Member of this body.

Mr. Speaker, again here we are, though, getting right back into the business at hand. And this is a hugely important week, a hugely important week as we try to come to some conclusion in regard to how much money we need to cut out of, not this fiscal year we are in right now, but the last fiscal year, which started--well, actually we are in the fiscal year, but it started on October 1 of 2010.

Here we are, what is it, the 4th of April, 2011, so half of the fiscal year has already expired and we have not funded the government except in this piecemeal fashion.

We didn't have a budget, we didn't have spending bills, and we put these little 2-week Band-Aids, 2, 3 weeks, a little bit of cutting, but from my perspective and from my side of the aisle and our leadership not nearly, nearly enough. And we are faced with this tremendous issue of trying to reach a compromise and an agreement to lower spending.

The American people certainly gave a mandate, I think, to 87 new Republicans and 9 new Democrats to come up here and quit all this spending. Let's not have $1.5 trillion deficits year after year after year. That's how you get to $14 trillion worth of debt, and that's what we are facing right now; and, indeed, in a month or so, we are going to be asked to even raise that debt ceiling statutorily to say, well, we will continue to borrow and kick the can down the road.

Obviously, Mr. Speaker, these are times that try men and women's souls, and we all feel very strongly about our position. But I know my leadership and Members on this side of the aisle, and I hope our Democrat colleagues, feel the same way. We hope and pray that we can do the people's work and cut this spending and get this country back on a sound fiscal footing so that as we go forward to the 2012 budget, which we will hear about tomorrow, that we will continue to work hard to finally balance this budget and get our country out of this significant debt.

Speaking of debt, Mr. Speaker, the reason I am here tonight, I represent the caucus on the Republican side of the aisle known as the House GOP Doctors Caucus. There are, I think, 21 of us now, doctors and nurses on this side of the aisle, with just years and years of clinical experience.

As an example, I spent 26 years practicing my specialty of obstetrics and gynecology. We have registered nurses that are part of the Doctors Caucus. We have specialists, general surgeons, cardiothoracic surgeons, family practitioners, gastroenterologists. I could go on and on, but some of them, hopefully, will be with me during this hour, will join me in a few minutes to talk a little bit more about our concerns, their concerns, Mr. Speaker, with the Patient Protection and Affordable Care Act of 2010.

This was a bill, a law, that was finally passed and signed by President Obama on March 23, 2010, after about a year and a half of debating the issue in both this Chamber and in the Senate Chamber; and when it finally came down to the reality that there weren't enough votes on the Senate side, it was passed by something called reconciliation which, to this day, I don't think the American people understand. But, Mr. Speaker, I will tell you this, what they do understand is they don't like it, they didn't like the process, and they don't like the policy.

Now, I have heard the President say, and I have heard the Democratic leadership in the 111th Congress, when this bill was passed, talk about how Congress and particularly the Democratic Members have been trying to pass a comprehensive massive health care reform law for almost 100 years. They talked about Franklin Delano Roosevelt, and they talked about John Fitzgerald Kennedy and they talked about, of course, President Bill Clinton and saying, you know, we finally got there, we finally did it, we finally accomplished what we were trying to do for almost 100 years.

Well, they missed the point, Mr. Speaker, because the reason why that type of legislation was not passed in 100 years is because the American people back then didn't want it anymore than they do today; and some 62 percent still say, very loudly and very clearly, in poll after poll after poll, we don't want the Federal Government taking over health care, one-sixth of our economy, lock, stock and barrel. We don't want that.

We want improvement in our health care; and no matter how good something might be, there is always room for improvement and, clearly, our health care system is too expensive. We agree with that. I think Members on both sides of the aisle can reach that conclusion pretty clearly.

So there is agreement to try to do everything we can to continue to provide the best health care in the world. It's not true when people say our health care system is like that of a Third World country. Nothing could be further from the truth. We have the greatest health care system in the world, and some of the doctors in the House GOP caucus will be with me tonight to talk about that.

You know the old expression, don't throw the baby out with the bath water, I think that's what we have tended to do here. We have enacted into law--on March 23 of last year, it's already had its 1-year anniversary a couple of weeks ago--we have done something that I think is not only opposed to what the American people want, you should never do that, but it's bad, it's bad medicine.

It's bad for consumers, it's bad for patients, it's certainly bad for corporate America. And it's absolutely bad for the taxpayer. It's a top-down sort of system where a bureaucracy comes between literally and figuratively a doctor and his or her patient. That's not a prescription for improving our health care system.

I have got a couple of posters here with me, and I wanted to reference these to my colleagues. In fact, I will have several more, but I am going to keep this one up on my far left, that one that shows the picture, I forget what his name is. Maybe one of my colleagues will remember.

Well, I remember Boss Hogg, but I was trying to remember what the actor's name is; I don't think he is still living. But I think most of my colleagues do remember Boss Hogg from that old series ``The Dukes of Hazzard.'' It was one of my favorites, kind of like poking fun at ourselves, really; sort of like Archie Bunker and ``All in the Family'' and things like that that those of us who have been around awhile can look back on and laugh and get a chuckle out of it.

But Boss Hogg sort of represents the boss, the bureaucracy, if you will, of the government, Big Government, running health care. Under old Boss Hogg's picture, there he is with that cigar in his hand: you can have whatever you like as long as the boss approves it.

And that's really the way it has turned out, what we talked about in the House. I think it was H.R., House of Representatives, bill No. 3200. It was Senate bill 3590 or H.R. 3590, a shell bill that came over from the Senate and finally was passed into law and became known as the Patient Protection and Affordable Care Act.

But that law has so much bureaucracy, and I will get into some of the numbers on that in regard to all of the new folks in the government that would control health care, but all under this giant government takeover, and Boss Hogg sort of represents that to me as a way of communicating with the public.

But in any regard, before I continue with some of the statistics on the bill, I see that I am joined by my colleague from Georgia, a fellow physician and a member of the House GOP Doctors Caucus, who is a family practice physician from the Athens area where the great University of Georgia is located. Dr. Paul Broun is actually a doctor who makes house calls, which is really unique and refreshing. He has been a welcome addition to not only our Georgia delegation but this body.

I yield to the gentleman from Athens and Augusta and my hometown, Dr. Paul Broun.

Mr. Speaker, I thank the gentleman for his contribution and for being with us this evening. I realize there are conflicting things going on on Capitol Hill this

evening, very important things. But I really appreciate Dr. Broun being with us.

We have also been joined by another member of the Doctors Caucus, that is our good friend and new Member, freshman Member from the great, great State of New York, where my daughter and son-in-law reside. Ann Marie Buerkle is a registered nurse, Mr. Speaker, by profession and certainly knows of what she speaks in regard to health care, representing the Angels of Mercy, if you will.

She is concerned, Mr. Speaker, about the health insurance industry and the complexity of such, and maybe even wants to discuss some ways that we could change and improve, certainly improvement is called for, and it doesn't have to be within a 2,400-page bill, as Dr. Broun was mentioning ObamaCare entails.

So at this time, I'm proud to yield to Representative Ann Marie Buerkle.

Mr. Speaker, I thank the gentlewoman from New York for sharing her thoughts. Certainly, I agree completely with her. She clearly knows of what she speaks.

This law, it is no longer a bill, it is now the law. Patient Protection Affordable Care Act, it has been the law for a little more than a year, as I said earlier. Of course, the Congressional Budget Office that estimates the cost of laws that we put into effect, they give us an estimate when it is in the bill form so Members can decide whether or not what we are about to do is something that is affordable. And the estimate of this law costing $900 billion, Mr. Speaker, the true cost over the next 20 years is probably in the neighborhood of $3 trillion, not $900 billion.

But I do want to just talk about that number and remind my colleagues

about the pay-for provision that the Democratic Party, the former majority party in the 111th Congress, had in place at the time this bill was passed. Everything had to be paid for, so you had to figure out a way to come up with the money.

In passing this bill and paying for it, Mr. Speaker, some $570 billion was taken out of the current Medicare program. The Medicare program, which serves something like 47 million of our seniors, 5 or 6 million of them are younger people who are on disability that are covered under Medicare. And we literally, to help pay for this new entitlement, this new entitlement which has very little to do with Medicare except that half of the money, half of the pay-for in this $900 billion was taken from a program, Medicare, servicing our disabled and our elderly, providing them health care, half of the money was taken out of that system. The actuaries and the Medicare trustees tell us that over the next 75 years, the unfunded liability, Mr. Speaker, of Medicare is something like $35 trillion, with a ``t,'' $35 trillion. And yet we took the money by cutting Medicare Advantage something like $120 billion. We cut money out of hospice. We cut money out of long- term care, skilled nursing homes.

We cut money out of home health care. We taxed everything that even looked like it had anything to do with health care: durable medical equipment, supplying oxygen for people who were and are continuing to struggle from chronic obstructive pulmonary disease. ``Emphysema'' is a term we use a lot, and I think most people would recognize that.

Finally, we came up and said, okay, we've paid for this; but at the same time, Mr. Speaker, we did absolutely nothing in regard to medical liability reform, something that probably if we enacted it--and if there were something in this bill, ObamaCare, as the President did promise that there would be--could save $200 billion a year, according to the RAND Corporation and other think tanks, from the overall cost of health care, which is one-sixth of our entire economy, of our gross domestic product in a year. That's how big this industry is. So there is essentially nothing in the bill about medical liability reform.

Why do I say that, Mr. Speaker?

My colleagues, I think you understand that it's not about the high insurance premiums that doctors have to pay on an annual basis so that they can practice and be protected from liability if something goes wrong. Obviously, they need that protection and those health insurance premiums for the high-risk specialties like the one that I enjoyed for 26 years, OB/GYN, and neurosurgery.

Mr. Speaker, think about that doctor at the Tucson Medical Center who was there in that emergency room when our colleague, Representative Gabrielle Giffords, was taken there literally near death. I think Dr. Rhee was his name, R-H-E-E. In fact, Dr. Rhee, I learned later, was a graduate of the great school that I went to, Georgia Tech, the Georgia Institute of Technology. Dr. Rhee spent his career in the military after completing medical school. He served his country for something like 22, 23 years, and he happened to be in that emergency room as head of the trauma center and had had all that specialty training and all those years of treating our wounded warriors in many conflicts--I'm sure in Afghanistan and Iraq.

If he had not been there for our colleague Gabrielle Giffords--God bless her--we would be talking about her today as we were talking earlier about John Adler, our former colleague from the great State of New Jersey who died today. But that doctor was there. He was there.

I fear, as I talk about this new health care law, there is hardly any provision in there that would provide for doctors, even for primary care physicians. There is some attempt, but when you take all the additional Medicaid-eligible patients, increasing the minimum eligibility at 138 percent of the Federal poverty level, you add just millions of additional patients to be seen and literally hundreds of billions of dollars of additional cost onto the backs of our States that have to have balanced budgets, unlike here in the Federal Government where we just keep borrowing money and where we're now up to $14 trillion worth of debt.

So we have a huge problem in regard to this law that the CBO says costs $900 billion over 10 years. I say--and this poster points it out--the true cost, which is the last bullet point with the red dot, is $2.2 trillion and counting; but as Ms. Pelosi said--and I quote her in the third bullet point here--``we have to pass the bill to find out what's in it.'' That was before the bill passed. Clearly, we are finding out now, unfortunately, what the true cost is.

Mr. Speaker, I want to yield additional time to my colleague from New York.

Mr. Speaker, the gentlewoman is absolutely right.

As I pointed out in that $500 billion-plus cut-out of the Medicare program to help pay for this new entitlement of the Patient Protection and Affordable Care Act, $120 billion of the $500 billion-plus was taken from the Medicare Advantage program. The Medicare Advantage program enrolls about 20 to 25 percent of our Medicare beneficiaries.

Why so many?

We are talking about, maybe, 11 million or 12 million who sign up and decide that, rather than the traditional fee-for-service and just pick a doctor out of the Yellow Pages who accepts Medicare, it's more like a health maintenance organization that emphasizes wellness, that emphasizes prevention, tests that are not typically covered under traditional fee-for-service Medicare, like colon cancer screening, breast cancer screening, mammograms for women, especially between the ages of 40 and 60, prostate cancer screening for men, annual physical examinations, follow-ups from a nurse practitioner within the doctor's office, maybe even on a monthly basis to make sure that the senior is taking the medication that was prescribed by the primary care doctor.

All of these things are included with Medicare Advantage. That's why it's called Medicare Advantage. It is an advantage with very little additional cost. In fact, people who are under those programs typically don't have to buy supplemental insurance to cover co-pays and deductibles and hospital care after they've exhausted their benefits. So that's why so many choose that.

Yet what we have done is we've stripped--we've gutted--that program so badly that, of those 12 million, it's estimated 7 million of them will lose that coverage under Medicare Advantage. They'll have to get it under the traditional Medicare, and they'll have to pay $130 a month extra for that supplemental whether they get it through a plan that's endorsed by the American Association of Retired Persons or through some health insurance company, but the average cost is going to be an additional $130 a month for those folks.

So as we talk about the cost, I do want to shift, Mr. Speaker, to the cost

to employers. In this next slide, where the title says, ``ObamaCare Hurts Workers, Increases Costs,'' the majority of employers anticipate health care reform will increase health costs. And most say they plan to pass the increases on to their employees--88 percent plan to do that--or reduce health benefits and programs, 74 percent.

This idea of setting up these exchanges throughout the 50 States and territories and that only 6 million people who have employer-provided health insurance can keep it, they won't need to be on the exchanges, Mr. Speaker, that is absolute poppycock. It's probably going to end up being about 130 million people who get their health care provided today by their employer will end up in those exchanges. And that's why I say this cost that was estimated by the CBO of $900 billion will be in the trillions, because when all of these people morph out of the employer- provided health care onto these exchanges, think how many of them will be eligible for a Federal subsidy to help them pay for that insurance. Because the law says, the so-called ``Affordable Care Act,'' that anybody with an income of less than 400 percent--not 100 percent, not 200 percent, not 300--400 percent of the Federal poverty level--which is getting close to $90,000 for a family of four--I think of my four children and their families of two and three and four, and I know what their incomes are--the Federal Government will be subsidizing so many people that the cost, the true cost will be astronomical, and it is something that we cannot afford. That's why our representative from New York and our other representative from Georgia spoke earlier about we can't do this, we can't afford to do this. We need to repeal this law. It is a bad law.

I've said before, Mr. Speaker, that in my humble opinion I think it's the worst law that has ever been passed in this Congress. There have been some folks on the other side of the aisle--well, not on the other side of the aisle, but the more liberal media who took me to task for saying that, but I truly believe it. I truly believe it's one of the worst laws that was ever passed. And we have made every effort to repeal it.

One of the first things we did in the 112th Congress was pass H.R. 2 to repeal ObamaCare. We sent it over to the Senate, and the Senate-- which is controlled by the Democratic majority and led by the Senator from Nevada, Harry Reid--just simply, I guess, put that in file 13, and H.R. 2 is sort of dead in the water over on the Senate side.

So what we are doing now, it is our obligation because of what the American people have told us: Over 60 percent of them a year after passage of the bill, despite the fact that Ms. Pelosi said, once we pass it and you find out what's in it, you'll like it. No, they don't. They don't like it. They don't like it one darn bit better, and they wanted us to repeal. We made every effort at repeal.

And now we're into Plan B, Mr. Speaker. Plan B, of course, is to try to defund especially the parts of the bill that are on automatic pilot, that we have no control over. And when I say ``we,'' I don't mean the new Republican majority in the House of Representatives; I mean every Member of Congress--100 Senators, 435 Members of the House, both sides of the aisle. For goodness sakes, we ought to have control over the spending.

This is not a poster. I don't have a poster on this one. But tomorrow, in the Energy and Commerce Committee, Mr. Speaker, the committee on which I am proud to serve, along with several of our other House GOP doctor members, we are going to have a markup on several bills to change this automatic pilot spending under ObamaCare and put it into the more typical discretionary spending where Members of Congress can say, do we want to spend that money? And if we do want to spend the money, how much do we want to spend? And that we have oversight and we can make sure every year that we look at the program, and if it's not working then defund it.

And these bills--and I'll just mention them real quickly--H.R. 1217, a bill to repeal the prevention and public health fund, $17.5 billion that the Secretary of Health and Human Services has control over, a fund of money that she can spend in any way she wants to. You think back to the ads that we saw with Andy Griffith as the pitchman on television last year about the great value of this new law and how it's going to strengthen and improve Medicare. How you do that by cutting $500 billion out of a program is beyond me. But that money, that $17.5 billion in this prevention and public health fund, can be spent indiscriminately by a decision made by whoever the Secretary of Health and Human Services might be. H.R. 1216, H.R. 1215, H.R. 1214 and H.R. 1213, in the aggregate, this is over $18 billion worth of spending that we Members of Congress have no control over. We're going to get control over it, though, and we're going to defund anywhere we feel that it is wasted, duplicative spending that the American people can ill afford.

I want to go ahead and point out a few other things that are on the slides, Mr. Speaker. I mentioned, of course, the $575 billion in cuts from the Medicare program. I mentioned the 7.4 million people who will lose that coverage under Medicare Advantage because of that $126 billion pay-for. I didn't mention, though, on this slide the third bullet point.

Many physicians may stop taking Medicare patients because reimbursements will be below the cost of providing the care. Now, is that Representative Phil Gingrey from the 11th of Georgia, is that a statement that I've made? Well, maybe I have made it. But I'm quoting the Actuary of Medicare, Richard Foster, who we had last week as a witness before the Energy and Commerce Committee talking about some of these things. This bears repeating, Mr. Speaker; ``Many physicians may stop taking Medicare patients because reimbursements will be below the cost of providing the care'' Richard Foster, Committee on Medicare and Medicaid Services, Chief Actuary.

Today, doctors are reimbursed under the Medicare program by a formula, an arcane, very difficult--you talk about calculus being difficult; understanding the sustainable growth rate formula to determine how doctors are reimbursed for providing their service, whether it's their brain power or their surgical skills, is beyond anybody's comprehension. And every year, for the last 6 or 7 years, when you apply that formula to the next year's reimbursement level, there is a cut from the last year's reimbursement--2 percent, 3 percent, 4 percent--to the point now, Mr. Speaker, what we have done, of course, we here in the Congress have mitigated those cuts and said we're not going to enact those cuts because these doctors will not be able to provide the care, just as Mr. Foster, the Actuary, said. And if we don't put a bandaid on these cuts and mitigate them, then the doctors will just drop out of the program. And I don't care how much you expand access and hand out more insurance cards, if there are no doctors there to see you, you're not going to have care. You do not have decent care--you don't have any care.

So in this bill, in this new law, not only is that formula still there, and the doctors are facing a 31-percent cut in their reimbursement if we don't mitigate it once again come December 31 of this year, not only is that on their backs, but in ObamaCare, there's this new provision called IPAB, this new bureaucracy--Independent Payment Advisory Board--that's going to actually cut the doctors even more. The Actuary is right: We're not going to have doctors providing the care.

And that's because we've taken money out of this program and put it into an entirely new entitlement program for the most part for young people. Some entitlement, when you force them to buy health insurance in many instances when they don't need it and they don't want it.

Mr. Speaker, I see we've been joined by the cochairman, along with myself, the cochairman of the House GOP Doctors Caucus, my classmate from the 108th Congress, the Member from Pennsylvania, my friend and colleague, Dr. Tim Murphy.

I yield to the gentleman from Pennsylvania.

I want to thank you, Dr. Murphy, and I appreciate you coming.

Mr. Speaker, I thank you for the time. I know our time is up.

I just refer to our last poster in conclusion: Repeal and Replace ObamaCare.

I yield myself 3 minutes.

Mr. Chairman, this is just another in the Republican series of efforts to try to repeal the Affordable Care Act. I don't need to say, but I will say over and over again how effective the Affordable Care Act has been.

We have already put in place most of the anti-discriminatory aspects of the Affordable Care Act so that people now can have their children up to 26 on their insurance policy. They don't have lifetime or annual limits on care. We've ended arbitrary rescissions. We're giving patients access to preventive services without cost. We've begun the process of filling up the doughnut hole by giving seniors a $250 rebate last year, and now a 50 percent discount on the drugs. The list goes on and on. People are starting to see the benefits of the Affordable Care Act.

But as you know, over the next few years, until 2014, one of the major benefits of it is that we will now cover almost every American; 32 more million Americans that have no insurance now, with a guaranteed good benefits package, lower costs, and help in paying their premiums.

The fact of the matter is, the Republicans want to eliminate all this. And when they talk today about bringing up a bill that would eliminate the grants or the funding for the state exchanges, this is at the core of the Affordable Care Act because, without effective state exchanges, robust state exchanges that are actually tailored, if you will, to individual States, it will be more difficult to do the things that I mentioned that are the commitment and the promise of the Affordable Care Act.

Now, what I don't understand though is that my colleagues on the other side of the aisle have always been advocates for States' rights. The consequence of their legislation today if it were to become law would mean that States, and 49 States and most of the territories have asked for these grants, would be denied these grants to set up the State exchanges. Most likely, what will happen then is that, rather than have a State exchange which is tailored to their own State and their own constituents, they will end up having a Federal or national exchange.

Now frankly, I don't have a problem with that. But if you're a States rights advocate, which is what a lot of the Republicans have been saying all along, why would you want to force the States to not have their own flexibility, not set up their own State exchanges and instead set up a Federal exchange?

The exchanges aren't going to go away with this legislation. It's simply going to mean that the States can't do a good job, or that they're going to yield that power to the Federal Government and you're going to have a national exchange.

This is the worst time to do this. As we know, States are hurting. They don't have money. Most of them have a crisis in terms of balancing their budget. Why would you want to deny them the money to set up the exchange?

I'll give you an example in my own State. My own State has applied for some of these grants. They are using it to do demographics to find out what kind of people they have, what their health care needs are, so they can tailor the State exchange in a way that's most effective to cover the most Americans and provide them good quality health care at a low cost. That's what this is all about.

And for the Republicans today to bring this bill up in their effort to try to repeal the whole package, it absolutely makes no sense whatsoever. I just don't understand it.

They talk about mandatory funding. Well, we have mandatory funding for Medicare, for Medicaid, for all kind of things in this Congress. All they're going to do with this is make it more difficult for the States to establish their own exchange.

I reserve the balance of my time.

Mr. Chairman, I yield 4 minutes to the ranking member of our full Energy and Commerce Committee, the gentleman from California (Mr. Waxman).

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

Mr. Chairman, I yield myself 15 seconds.

I hold the gentlewoman in a lot of respect, but it bothers me that you say we are going to come back and keep voting and voting again on repeal, repeal, repeal. We know this isn't going to pass the Senate.

When I went home the last 2 weeks, all I heard was: What are you doing to create jobs? Deal with the economy.

When we deal with this and keep doing the same thing over and over again, we don't deal with jobs.

I yield now 1\1/2\ minutes to the gentlewoman from California (Mrs. Capps).

Mr. Chairman, I yield 1\1/2\ minutes to the gentlewoman from Wisconsin (Ms. Baldwin).

Mr. Chairman, I yield myself 30 seconds.

I would just like to point out to the gentleman, 49 States and the District of Columbia, along with 4 territories, have been awarded $54 million in planning grants. So all you are doing here--these exchanges are still going to exist even if this bill passed and became law. All you are doing is taking away the money, in almost every case, from your own State to try to set up these exchanges and not have it become a national exchange.

So the gentleman can talk all he wants about the funding, but the fact of the matter is it is most likely his own State is asking for this funding so they can get these exchanges established. Why do the Republicans want to take money away from their own State?

I yield now 1\1/2\ minutes to the gentlewoman from the Virgin Islands (Mrs. Christensen).

Mr. Chairman, can I inquire how much time remains on both sides?

I yield now 2 minutes to the gentleman from Texas (Mr. Green).

Mr. Chairman, I yield myself 30 seconds.

Again, I don't understand what Dr. Burgess is trying to say, the point he is trying to make. If we don't have this funding under this bill, States are not going to be able to choose the type of marketplace that is best for their families and businesses. By passing this bill, you take away ultimately the States' right to make the decisions about what kind of plans they have and how they want to tailor these plans.

All he is doing with this bill is handing it over to the Federal Government, exactly the opposite of what he is saying. What he is reading is essentially what is going to happen if there is no State exchange and there is a Federal exchange. So why deny the States the money, when they can tailor the exchange with those grants?

I yield now 2 minutes to the gentlewoman from Connecticut (Ms. DeLauro), the ranking member on the Labor-HHS appropriations subcommittee.

Mr. Chairman, I yield myself 1 minute.

I have heard Dr. Burgess talk about Governors. I just want to give you some quotes from some Governors--Republican Governors. Nathan Deal, a former member of the Energy and Commerce Committee, former chairman of the Health Subcommittee, this is what he said with regard to the State exchanges and the grants. He says: ``One of the real problems that some of us as Governors foresee is if the mandates on States remain in place, the funding from the Federal level to carry out those mandates is withheld. That's the worst possible condition that States could be left in.''

That is exactly what my colleague from Texas is proposing. The States will continue to have the mandate to set up the exchange or, without money and therefore not be able to tailor to exchange to the State or alternatively letting it go to the Federal Government, having the Federal Government run a Federal exchange.

Nathan Deal, one of our own Members, chairman of the subcommittee, said, Worst possible scenario. I don't understand. Again, I keep saying the same thing, but I have to repeat it, Mr. Chairman. To say that we're going to have State exchanges without having

the funding means the State exchange will either be lousy, or it simply won't exist and the Federal Government takes over.

I yield now 2 minutes to the gentleman from Michigan (Mr. Levin), the ranking member on the Ways and Means Committee.

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

Mr. Chairman, I yield myself 1 minute.

Again, I listened to the gentlewoman from Tennessee (Mrs. Blackburn) before, and basically she said we're just going to keep repealing and repealing and repealing. I understand that you want to get rid of the whole bill. But why do you bring up legislation today that, again, I guess you're doing it because you don't want to keep repealing the whole bill over and over again because it becomes ludicrous. So instead you take pieces out--in this case, the State exchanges--and you say we're not going to give States the grants to actually follow up.

It's obvious, when we talked about Nathan Deal, he doesn't like the law. He'd like to see it repealed. But he's saying if you're not going to repeal it, then don't defund it because then the States can't carry out their functions in an effective way.

So all I'm saying to my colleague from Texas is if you just want to keep repealing and repealing, like Mrs. Blackburn said, go ahead and do it. We'll waste time, which doesn't make sense. But if you're going to then take pieces out, then don't say to the States, We're going to defund you and not allow you to do what you're already required to do or set this over to the Federal Government.

You see, this is the absurdity of what the other side of the aisle is trying to do. It's just a complete waste of time.

I yield now 2 minutes to the gentleman from California (Mr. Miller).

I yield the gentleman an additional 30 seconds.

Mr. Chairman, I yield 3 minutes to the gentleman from California (Mr. Garamendi).

Mr. Chairman, may I inquire how much time is remaining?

I yield myself the balance of my time.

Mr. Chairman, I am pleased that my colleague on the other side, Dr. Burgess, got up and talked about the Ryan budget, or the Republican budget, I should say, because as far as I know every Republican voted for it, and most Democrats voted against it, and he also mentioned, I think, President Clinton's efforts to achieve health care reform.

The Democrats over the years--Harry Truman, President Clinton, President Obama--have all been reaching out to try to achieve health care reform and find a low-cost way of providing a good benefit package to all Americans, and it's sad to think that on the other side of the aisle, when they became the majority, the first thing they did was to pass this Republican budget that actually puts an end to Medicare and really jeopardizes the future of Medicaid as well.

I think it says a lot about the fact that the Democrats are trying to expand health care choices and options

and provide low-cost health care with a good benefit package. The Republicans are taking the plans that exist now like Medicare and Medicaid and either ending them in the case of Medicare or in the case of Medicaid really making it so it's going to be very difficult for Medicaid to continue.

We already have in place, as I mentioned in the beginning of this debate, many of the positive aspects of the Affordable Care Act, all those things that eliminate discrimination, let you put your children on your policy, start to plug up the donut hole for prescription drugs for seniors. This is working. This is legislation that's working and making a difference for the American people and making it possible now with these State exchanges, once they're up and running with the tax credits that are available, for even those other 32 or 30 to 40 million Americans who don't have health insurance insurance now to finally have it.

Now, why do the Republicans want to eliminate this? I listened to Dr. Burgess. He says it costs too much. The fact of the matter is the CBO said the Affordable Care Act was going to save money, reduce the deficit over 10 years. I know they only like to look at the CBO numbers when they think they're beneficial to their point of view, but the fact of the matter is the CBO is a nonpartisan arm of this Congress and they say that the Affordable Care Act reduces the deficit over 10 years. At the same time, we're covering everyone and we're providing a good benefit package just like, say, Blue Cross or Blue Shield does today.

What this bill does is to eliminate choices, because if the States are allowed to tailor a program in exchange for their own constituents in their State, I believe it will be more robust, it will be a better plan tailored to those people from New Jersey, in my case, or Texas, in the case of Dr. Burgess. By taking away the money for the exchanges, all you're going to do is make that more and more difficult. States will still have to do it, but they won't have a good plan. They may limit their choices. They may not have a lot of choices which they would have if they have some money to plan and be rational about how this works.

Of course, the more likely scenario is that we will simply have a Federal exchange and a lot of States will opt out and not even have their own State exchange. I think that would be a mistake to do. I really do. As much as I'd rather have a Federal exchange than no exchange, I do think it makes sense to have State exchanges.

So, again, I think that what the Republicans are doing now, and I think that Mrs. Blackburn said it earlier--she said we're just going to repeal this, and we're going to take a piece of it and repeal something else until we get rid of the whole thing. Well, don't waste the time of the Congress on doing the same thing over and over again. I was home for the last 2 weeks. We all had a break. We're at home for 2 weeks. All I heard, I didn't hear about health care. I heard about jobs and how the economy was starting to sputter again.

You know, the last quarter was not as good as it could have been, and the fact of the matter is that since the Republicans have come into the majority here they're not doing anything to create jobs. We don't have a bill to create jobs. We keep doing the same thing every day. Today, it's going to be defund health care; tomorrow it's going to be abortion again. I don't know how many times we're going to have these same bills that come out of our Health Subcommittee and the Energy and Commerce Committee.

It is unfortunate. I urge my colleagues to vote ``no'' on this bill.

Mr. Chairman, I have an amendment at the desk.

I yield myself 3 minutes.

Mr. Chairman, my amendment requires the Comptroller General of the Government Accountability Office to study the impacts of the exchange grants on allowing States to set up State-run exchanges, as opposed to having the Federal Government establish and operate the States' exchanges.

Dr. Burgess and I have had a colloquy on this back and forth all afternoon, and I know he just mentioned it again. My whole point today has been that if we are going to have exchanges, which I know many of my Republican colleagues would not want to do, but they are not repealing the State exchanges. They are simply saying that they are not going to give them any money to proceed.

I think that is a very shortsighted plan because the fact of the matter is that the State exchanges would work best if they had the flexibility and they had the money so that they could figure out what was the best way to tailor the health care exchange program to their needs in their State. My view is that by denying them that money through the State grants, we are simply letting the Federal Government come in and essentially run the exchange.

My colleague Mr. Burgess keeps mentioning over and over again, well, the Health and Human Services Secretary is going to do this and is going to do that. Well, if he doesn't like that, then why in the world would he let her do it by saying they are not giving the States the money to do their own thing? I mean, if you believe in States' rights, if you don't want the Health and Human Services Secretary to control the process, then let the States do their thing, and the only way they are going to be able to do that is if they get some money to accomplish that goal.

I mentioned my home State of New Jersey has already received some money through these grants. They are doing demographic surveys. They are trying to find out who the clientele are, what the health concerns are of the clientele so that they can make decisions about what kinds of plans they would have on the exchanges, what they would offer on the exchanges. This is the type of thing that is allowed and encouraged if you have State grants. Without the State grants, that won't be possible.

All I'm saying with my amendment is to let us see what the GAO says would happen if the Federal Government comes in and runs these exchanges rather than the States. I don't think it is going to be a good thing by comparison, but I would like the GAO to certainly study it.

I would point out, 49 States, the District of Columbia, and four territories have gotten beyond the ideology and have applied for these exchange grants. There is almost nobody on either side of the aisle that doesn't have their State applying for these grants, because the States know that if they are going to set up these exchanges, they might as well have the money so they can have the flexibility to do it the right way. So all you are doing by repealing these grants is pulling the rug out from the States, your own State in almost every case, whether you are a Democrat or a Republican.

I don't want to repeat what Mr. Deal said, now the Governor of Georgia, but my colleague from Texas often mentions the Governor of Utah, and I just wanted to read a quote from the Governor of Utah.

I yield myself an additional 30 seconds, Mr. Chairman.

Governor Herbert of Utah stated at a recent hearing in the Energy and Commerce Committee on March 1--and he was commenting on Governor Barbour, who also appeared before the committee--he said: I am not saying it is the approach. It is an approach. And I would just echo what Governor Barbour said. You know, all States ought to have the opportunities to find the solutions to the problem.

So again, even the Governor of Utah, which Dr. Burgess has mentioned many times, has said: I may not like the Affordable Care Act; I may not even like exchanges. But if you are going to have exchanges, it certainly makes sense for States to operate them and have the money to do it in a right way.

That is what this bill would stop. That is why we need the GAO report.

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

My colleague on the other side, I don't understand. You are saying that you want Austin to do it, you want Austin to have the flexibility to frame a program that is done best because you think that Austin and the State are going to do it best. Well, if that is the case, why in the world are you putting this bill on the floor? Because my whole point in this amendment is that, by passing this bill, you are simply abdicating the right of the State to make a decision and to have the flexibility to set up a good program that is tailored to the State. It is the exact opposite of what you are saying you want to do.

If you believe that the Secretary of Health and Human Services in Washington is going to make the wrong decision, I don't think she would, but if you believe that, then you shouldn't be offering this bill, because this bill takes away the flexibility and the power of Austin or the States to make the right decisions. It is totally contrary to the purpose of what you are trying to accomplish. To me, it is mind-boggling.

Now, I think what you are really trying to do, of course, is just say let's forget about the exchanges, let's defund the exchanges, let's get rid of the whole Affordable Care Act. Obviously, that would be very unfortunate because so many more people are going to be covered at a low cost with a good benefit package and all the benefits and the antidiscriminatory practices that have already been in place would be gotten rid of.

I would say again, if you are totally opposed to the bill, that is one thing. But if you feel strongly that the State exchanges should be run by the States, then your legislation today is totally misplaced.

Mr. Speaker, I thank the gentleman from New York for giving me the customary 30 minutes, and I yield myself such time as I may consume.

It's my understanding this is his first rule that he is managing in his name on the floor of the House, and I congratulate him in that regard. In the 111th Congress, I had the opportunity to manage a number of rules, and I had a perfect record--I never lost a rule. This Congress as well, I too have a perfect record--I have never won a rule. I wish the gentleman from New York success in his efforts and congratulate him on his appointment to the Rules Committee and look forward to working with him throughout the 112th Congress.

Today, while millions of Americans remain unemployed and millions more await the chance to receive affordable health care, the Republicans are spending another week rehashing old debates instead of talking about creating jobs and, in fact, in this case, undermining Americans' access to quality health care.

This rule brings forth two bills. First, the majority brings forth, under this bill, legislation that will prevent Americans from accessing the exchanges which are competitive marketplaces in which to buy private insurance.

Now, there's a lot of subterfuge and misinformation in this debate. For instance, there is no ObamaCare option. There is no public insurance option that we are even discussing here. What is being discussed is a marketplace in which individuals, primarily those who work in small businesses or are self-employed, will have access to choose from the private policy of their choice.

According to the Congressional Budget Office, under this Republican proposal, 2 million fewer Americans will be enrolled in exchanges in 2015. The Congressional Budget Office also says that H.R. 1213 will result in higher premiums in the exchange. Again, a bill that is delivering higher premiums for American citizens--hardly, hardly the outcry that I have heard on the stump.

I had a chance to have public meetings in the last 2 weeks back in our district, as many Members of Congress have. My constituents, Mr. Speaker, did not request that we deliver higher health insurance premiums. They wanted us to deal with the deficit. They wanted us to deal with jobs and the economy. Not a single constituent of mine asked for higher health insurance premiums, which seems to be a priority of this Congress.

Now, there may be a talking point involved, and certainly both of these bills today were also included in H.R. 2, which was a repeal of health care reform, largely. Now we are looking at individual pieces. But this new marketplace has historically been an idea that has had strong bipartisan support: to have competitive health care exchanges; to keep in tact America's employment-based system while expanding access to tens of millions of people, including small businesses and people who are self-employed. Truly, the exchanges represent an opportunity for a more competitive and a more transparent marketplace that empowers consumers to make the choice between private insurers.

The other bill that is brought forth under this particular rule, after we have dispensed with denying health care to an estimated 2 million more Americans through the exchanges, we are also, in this next bill, eliminating funding for school-based health clinic construction, renovation, and equipment. That would particularly harm our Nation's health care services, especially for children, youth, and families and those with low incomes.

School-based health care clinics serve students whose access to health care is limited; and frequently, the scope of services is determined by school officials in partnership with parents and community-based health care initiatives. Services are designed to identify problems early, provide continuity of care, and improve academic participation. These programs save money by providing access to preventive care that frequently alludes many of the families affected.

And yet also, while we are denying basic preventive care to our Nation's youth, the passage of this bill will also deny job opportunities to Americans all across the country who are ready with shovel-ready projects to begin improving and building school-based health care clinics. So here we are with a bill: less jobs, less health care, less education--hardly the priorities that I think the voters wanted for the 112th Congress.

Democrats believe strongly that we need to make tough choices to end the deficit and end the climbing spiral of debt. But what we are left with with these two bills, as separate from H.R. 2, is actually the worst of both worlds. The Republicans leave in place the taxes that were used to pay for health care reform--they leave in place in these two bills the medical device tax; they leave in place the tax on unearned income--and yet they remove the benefits to the American people from these taxes.

Whenever the American people agree to any degree of taxes, they want to see a tangible result. But what is being done with these bills is leaving in place the taxes of health care reform and removing the benefits to the American people of health care reform. That's hardly a balanced and fair approach, and it's one that the House should reject.

I would remind my colleagues of House Resolution 9, which I supported on the floor of the House of Representatives. It dealt with 13 items out of the original jurisdiction of our Rules Committee before the gentleman from New York joined our Rules Committee. We instructed the House on replacing health care reform and what some areas for working on it would be.

I would like to submit to the Record in the context of this debate, Mr. Speaker, House Resolution 9, which was adopted by the House and, indeed, discusses changing existing health care law within the various committees of jurisdiction to foster economic growth and private sector job creation; to lower health care premiums, preserve a patient's ability to keep their health care plan, provide people with preexisting conditions affordable access to health care; and many, many other good ideas.

But rather than discussing any of these 13 points that were contained in House Resolution 9, the business of the committees of jurisdiction has apparently been not only to repeal health care reform generally but now to repeal each of the individual components while leaving the taxes in place. We would encourage these committees to comply with House Resolution 9. And I think by rejecting this bill before us today, we are sending a powerful message to the committees of jurisdiction that rather than talking about repeal, repeal, repeal, they need to also discuss replace.

What are we going to do if the exchanges don't exist or are handicapped to provide people with preexisting conditions access to affordable health care? Again, if we repeal the support for the exchanges, how are we fostering economic growth and private sector growth? How are we encouraging small businesses and self-employed people to have access to the same health care services at a similar cost that large employers already have?

I call upon my colleagues to reject this rule and both underlying bills and begin the discussions of how to improve and build upon health care reform, finding a common ground between Members of both parties and saving taxpayers money to help reduce the deficit.

H. Res. 9

In the House of Representatives, U.S., January 20, 2011.

Resolved, That the Committee on Education and the

Workforce, the Committee on Energy and Commerce, the

Committee on the Judiciary, and the Committee on Ways and

Means, shall each report to the House legislation proposing

changes to existing law within each committee's jurisdiction

with provisions that--

(1) foster economic growth and private sector job creation

by eliminating job-killing policies and regulations;

(2) lower health care premiums through increased

competition and choice;

(3) preserve a patient's ability to keep his or her health

plan if he or she likes it;

(4) provide people with pre-existing conditions access to

affordable health coverage;

(5) reform the medical liability system to reduce

unnecessary and wasteful health care spending;

(6) increase the number of insured Americans;

(7) protect the doctor-patient relationship;

(8) provide the States greater flexibility to administer

Medicaid programs;

(9) expand incentives to encourage personal responsibility

for health care coverage and costs;

(10) prohibit taxpayer funding of abortions and provide

conscience protections for health care providers;

(11) eliminate duplicative government programs and wasteful

spending;

(12) do not accelerate the insolvency of entitlement

programs or increase the tax burden on Americans; or

(13) enact a permanent fix to the flawed Medicare

sustainable growth rate formula used to determine physician

payments under title XVIII of the Social Security Act to

preserve health care for the nation's seniors and to provide

a stable environment for physicians.

I reserve the balance of my time.

Mr. Speaker, I yield myself 1 minute to respond before further yielding.

The gentleman from California again identified several areas where there are opportunities for both parties to work together: allowing the sale of insurance across State lines, something I certainly support; pooling for high-risk individuals; reforming the medical liability system.

Again, it really goes to a question of if we are, in fact, repealing in part or all various parts of the health care reform, what is replacing it. When we talk about pooling of high-risk individuals, if we can put together a way of doing that, that can effectively serve as a marketplace or as an exchange.

What this bill simply does is repeal the support for the exchanges, leaving many of these with preexisting conditions, particularly those who work for small businesses or are self-employed, entirely in the lurch. As we discuss how to improve health care for the American people, it's critical to actually have the solution to the policy problem that's been identified.

The gentleman talked about an inadequate selection process with regard to the use of funds, inadequate congressional oversight. Again, why not bring a bill forward that talks about setting the right process in place to allow for the correct oversight of the use of these funds? It's a question of making it work for the American people rather than throwing the baby out with the bath water.

With that, Mr. Speaker, I am proud to yield 2 minutes to my colleague, the gentlewoman from Maryland (Ms. Edwards).

I yield the gentlewoman an additional 30 seconds.

Mr. Speaker, I yield myself 30 seconds to respond really briefly.

In the minority report from the committee, it discusses the oversight of the exchanges. Specifically, the Government Accountability Office is required to review the operations and the administration of the exchanges. In addition, not one, not two, but three congressional committees--Energy and Commerce, Oversight and Government Reform, and other congressional committees--can provide the oversight of the implementation of the Affordable Health Care Act according to section 1311.

Again, if there is additional oversight, as the gentleman from California seeks, why are we not discussing a bill that provides additional oversight? We all want this money to be spent correctly and well.

With that, I am proud to yield 3 minutes to the gentlewoman from Texas (Ms. Jackson Lee).

I yield an additional 30 seconds.

I yield myself 15 seconds just to restate what my colleague, the gentlewoman from Maryland, stated: If the Republicans are against the public option, if they are against the private option in the form of the exchanges, the only option left is pay more insurance premium. That simply is not acceptable to the American people.

With that, Mr. Speaker, I yield 3\1/2\ minutes to the gentleman from California (Mr. Garamendi).

I will be happy to yield an additional 30 seconds to the gentleman from California.

I am happy to yield 2 minutes to the gentleman from California (Mr. Garamendi).

I yield myself the balance of my time.

Mr. Speaker, I want to further discuss the benefits of school-based health centers. A wide range of research and evaluations have demonstrated that school-based health centers are cost-effective investments in our Nation's health care safety net for children and adolescents and also help improve academic performance.

Now, each school-based health program is different, as they should be. Some of the services often include things like well-child and well- adolescent exams, immunizations, treatment for illness or injury, including management of chronic conditions, like obesity, diabetes and asthma; and they also frequently include services like mental health assessment and treatment, prevention programs to help reduce smoking, to help reduce teenage pregnancy rates, to help reduce violence. They frequently include substance abuse counseling and nutrition counseling, as well as dental cleaning.

These are services that prevent costly emergency services and hospitalizations later and help keep kids in school where they should be learning. Most importantly, stronger school-based health centers lead to stronger, more successful children and adolescents across the country. By bringing health care services to the children where they spend most of their day, at school, school-based health centers are a sensible and inexpensive way to deliver basic health care services to children all over the country.

This unwise legislation undermines our fiscal condition by wasting an opportunity to leverage local funding. Providing capital support to school-based health centers is a Federal investment that is a good deal for taxpayers. That is because when we provide modest Federal support to school capital projects, local and State funding, in partnership with nonprofits and community health clinics, is spent on operating activities, staffing and other equipment. What a great value for our Federal dollar.

Likewise, the value of this Federal investment is immense to local districts, many of whom are at their bonding capacity, who can't build school-based health centers on their own. However, many of these districts will benefit tremendously, and the students and families, from school-based health care clinics.

The research is clear, Mr. Speaker. Over a decade of studies consistently find positive benefits of school-based health centers. These benefits include better student academic achievement, increased school attendance and reduced tardiness among inner-city children who receive counseling in the school-based health center, fewer school discipline referrals for students who receive mental health services, and increased learning readiness and parental involvement.

As we discuss in this Congress reducing the learning gap, helping all students achieve, and ensuring that every American, regardless of where they live, has access to hope and opportunity through a quality education, school-based health care clinics are an important part of the solution.

In Colorado alone, there are 46 school-based health care clinics in 18 school districts, including one in the Summit County School District, which I represent, which is applying for funding under this program, and another applicant from Eagle County, Colorado. Eight other Colorado applications are going forward under this opportunity, as they are throughout the Nation.

This is the initiative, Mr. Speaker, that Republicans are seeking to eliminate. They say they want a fiscally responsible budget and more jobs, but what we see instead is their priority to stop programs that save money and create jobs and increase student achievement and learning, like school-based health care centers.

There can be no doubt about how the new majority is going about its business. There are no attempts to find common ground, like we have in House Resolution 9, and to work on ways to improve health care or to implement pooling mechanisms or to allow purchasing across State lines of insurance policies. Rather, we are dealing with press releases disguised as legislation that will neither pass the other body nor be signed into law.

That's not governance. That's immaturity. And the only Americans being

asked to sacrifice in the name of deficit reduction are those who have very little, if not nothing, left to lose and no real way to fight back. That's not leadership.

Mr. Speaker, we can and must do better. I urge my colleagues to oppose the rule and the underlying bill.

Mr. Speaker, if we defeat the previous question, I will offer an amendment to the rule to provide that immediately after the House adopts this rule, it will bring up H.R. 1366, the National Manufacturing Strategy Act of 2011. This bill, introduced by Mr. Lipinski of Illinois, will require the President to develop a national manufacturing strategy in order to boost traditional and high-tech manufacturing, spur American job growth, and strengthen the middle class.

This bill passed the House on a bipartisan vote of 379-38 in the 111th Congress. Manufacturing is a cornerstone of our Nation's economy. The U.S. Government, through its policies and programs, has major influence on our manufacturing base, and our national security, energy, and transportation systems rely on that base. We must unify government programs, leading to increased efficiency, and promote policies to promote our domestic manufacturing base to help our competitiveness in the global market.

Mr. Speaker, I ask unanimous consent to insert the text of the amendment in the Record along with extraneous material immediately prior to the vote on the previous question.

Mr. Speaker, I urge my colleagues to vote ``no'' and defeat the previous question so we can debate and pass jobs legislation today, rather than legislation to increase the health care premiums that Americans pay.

I urge a ``no'' vote on the rule and the underlying bill, and I yield back the balance of my time.

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

Mr. Speaker, I demand a recorded vote.

Mr. Chairman, I have an amendment at the desk.

Mr. Chairman, listening to the general debate, I would have to say that I am concerned and not supportive of this legislation and would hope that we would vote against the underlying bill.

But I have an amendment that I believe my colleagues on both sides of the aisle would appreciate, and it's very simple. This amendment will provide the public with important information about mandatory funding to States for health benefit exchanges that will no longer be available for the public and small businesses to use in order to obtain competitive health coverage for their necessary health care, post the moneys that are rescinded, and let the public judge for themselves: Good health care or not.

This particular amendment deals directly with the concern that we don't have the ability to move forward on health exchanges that will help the vast numbers of Americans. For example, the American health benefit exchanges make it easier for small businesses and the public to obtain competitive health insurance on the basis of price quality rather than to be subject to the abuses of insurance companies who would charge exorbitant, prohibitive rates. The health care exchange program is a key element of the Affordable Care Act, aimed at providing coverage to the uninsured.

There are 6.2 million residents in my home State of Texas that do not have health care insurance. Of the 26 percent of the Texas population that is uninsured, 18 percent are children. Insurance exchanges would also be available to small businesses with fewer than 100 employees. Texas is home to nearly 400,000 small businesses employing less than 500 people and nearly 2 million self-employed entrepreneurs. Letting everyone know that we are making a good dent in the deficit, which we can do in many, many other ways, will also show them why I don't have good health care. Meaning, why don't small businesses and farmers?

So at this time, Mr. Chairman, I would ask that my colleagues support an amendment that is transparent to let you know what the savings are. But what's the question? What's happening to the accelerating rate of health care and the sick people who are getting sicker?

With that, I reserve the balance of my time.

I thank the gentleman from Texas. But he well knows that we have had mandatory appropriations, and it is not difficult to indicate what money you are allegedly saving. So if the American public can juxtapose those so-called savings on the backs of the elderly, losing Medicare of course, on the backs of sick families and sick children, and to see how we can stop the normal primary medical care that you would get for children that are in need that these health exchanges would provide, and as well neonatal care for children who are born prematurely, this is what the Republicans would like us to do as we eliminate our health exchanges.

Frankly, he should look at what has already happened. Forty-nine States, including the State of Dr. Burgess and myself, the State of Texas, have applied for funding for health exchanges. And so to stop in the middle and suggest that you are now impacting the deficit--no, you are killing and losing and indicating that you want to close down the good health care that we are trying to promote. Insurance exchanges would also be available again to small businesses, and Texas is home to nearly 400,000 of them. The Kaiser Foundation says 23 percent of the Texas population lives in poverty. They would be able to participate in these exchanges. I would make the argument that it's good to put how much money you are allegedly saving so you can see how much you are losing by all the sick people who would not have care.

I reserve the balance of my time.

I thank my good friend from Texas, and he has made my argument because the Secretary of Health and Human Services can explicitly state the funding that might be used. In addition, isn't it interesting that this is being repealed on the basis of savings, and yet the Republicans can't explain whether there are going to be any savings or not.

At the same time, sick people are going to get sicker. And in my State, 444 people out of every 100,000 have cancer. Of the population, 9.3 percent are diabetic, 32 percent are overweight; and they will not be able to have the coverage. I am going to ask my colleagues to vote on a sensible amendment. Show us what you are going to save. Let it be put on the Web site. Let the American people see it. And explain why you would rather put these dollars on while you raise the cost in an unbelievable way. And because of the fact that people will not have insurance, they will get sicker and sicker and sicker and sicker. God forbid if we take out Medicare and all the seniors will wind up being sick and lose their lives as well.

I reserve the balance of my time.

Mr. Chairman, let me just say that, if H.R. 1213 passes, it will severely harm cash-strapped States who cannot afford to establish the health benefit exchanges which, by the way, will help people of all backgrounds, and particularly our small businesses, our farmers and, yes, the children that you've seen on these posters.

I ask my colleagues to support this important amendment. Show your cards. If we're saving money, let it be on the Web site, and let us compare those savings against the thousands and millions of individuals who will be blocked from having health exchange opportunities. While some of us will have savings accounts, others will have nothing, absolutely zero.

Vote for the Jackson Lee amendment to really show the cards of what happens when you cut out and repeal health care coverage for America.

Mr. Chairman, I would first like to state my clear position that I am adamantly opposed to H.R. 1213 and its Repeal of the Mandatory Funding Provided to States to Establish American Health Benefit Exchanges under the Affordable Care Act. The funding for American health benefit exchanges curbs insurance company abuses, saves lives and saves money.

If H.R. 1213 to Repeal Mandatory Funding Provided to States to Establish American Health Benefit Exchanges Provided under Section 1311(a) of the Patient Protection and Affordable Care Act is enacted into law:

i. what my amendment does is

Requires the Department of Health and Human Services to post public notice on its official website that the funds from Section 1311(a) of the Patient Protection and Affordable Care Act that will be rescinded including the amount of the funds rescinded.

This amendment will provide the public with important information about mandatory funding to States for health benefit exchanges that will no longer be available for the public and small businesses to use in order to obtain competitive health coverage for their necessary health care.

This amendment also assists my Republican colleagues by permitting them to easily and transparently show the American public that they are cutting government spending, by how much they are cutting spending, and where they are cutting government spending. So I expect that my Republican colleagues will fully support this amendment.

ii. purpose of the mandatory funding to states for American health

benefit exchanges created under the affordable care act (section

1311(a) of the affordable care act)

When Congress passed the Affordable Care Act in 2010 and the President signed it into law, the Department of Health and Human Services was mandated to provide funding by making Grants to States for the purpose of establishing ``American Health Benefit Exchanges,'' so to make it easier for small businesses and the public to obtain competitive health insurance on the basis of ``Price & Quality'' rather than be subject to the abuses of insurance companies who would charge exorbitant, prohibitive rates for coverage. This was already a cost cutting measure. This is sorely needed insurance reform.

The health insurance exchange program is a key element of the Affordable Care Act aimed at providing coverage to the uninsured. Six million two hundred thousand residents in my home state of Texas do not have health care coverage. Of the 26 percent of the Texan population that is uninsured, 18 percent are children.

Insurance exchanges would also be available to small businesses with fewer than 100 employees. Texas is home to nearly 400,000 small businesses employing less than 500 people, and nearly 2 million self- employed entrepreneurs who would certainly benefit from a health insurance exchange.

According to the Kaiser Family Foundation, 23 percent of Texas' population lives in poverty. Health insurance exchange programs would provide relief to those living at less than 133 percent of the poverty level, about $14,484 dollars annually, by making them eligible for Medicaid in all states. More than 30 percent of impoverished Texans would be eligible for Medicaid under this provision.

The Health Benefit Exchange Programs were championed as a means for people to get affordable health care and now they are opposing that very principle in H.R. 1213.

If H.R. 1213 passes, it will severely harm cash-strapped states who cannot afford to establish the health benefit exchanges on their own.

The Affordable Care Act requires all State Health Benefit Exchanges to be self-sustaining by Year 2015 and no further Federal grants will be made to states for health benefit exchanges after January 1, 2015. This sounds like the State's rights that my Republican colleagues have been championing on this Floor for a very long time in the course of debating health care reform. Now, they are opposed to the very State's rights contained in the Affordable Care Act that pertain to health benefit exchanges.

This bill takes away the ability of States to provide cost-saving health coverage through Health Benefit Exchanges.

This bill deals a severe blow to America's middle class and small businesses who simply seek to obtain affordable health insurance so they can do their part to help keep America healthy and contribute to our continued national economic growth.

I urge all of my colleagues to support my amendment to H.R. 1213 to facilitate transparency in government spending cuts and notice of funding that will no longer be available to them.

Mr. Chairman, I demand a recorded vote.