Personalize Your Care Act of 2013

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

Madam Speaker, today is a little like ``Groundhog Day.'' The Republican leadership has come out here and tried to decide what the weather is going to be, and they are going to get the same answer that they have gotten 49 times before. They can pass it from here, but it is not going to change anything. We have seen this poorly designed, sadly staged GOP political theater before--50 times. This is the 50th vote of this Tea Party, Koch brothers-led Congress to crash the Affordable Care Act.

It is a waste of time and resources, and ignores the facts. Americans want affordable health care, and ACA delivers it to them. ACA has saved lives and brought down our spending. New fraud measures, including new authorities imposing payment suspensions and more rigorous-provider enrollment procedures put into law by ACA, helped the Federal Government recover $4.3 billion in taxpayer money from individuals and companies that tried to defraud the health care programs. The ACA is delivering historic results for the American people, and yet the Republican leadership is hell-bent on a 50th stroke.

Regardless of the fact that our economic system remains stuck in neutral, nothing has been done about jobs, unemployment insurance, raising the minimum wage, and so forth.

If that was all that was going on here, this would still be insulting and absurd. The bill under consideration today, H.R. 4118, is virtually identical to H.R. 2668, a bill passed on the 17th of July, 2013. The Republicans have already passed this bill to delay the individual mandate, something the CBO knows will result in higher insurance premiums. So beyond wasting time and engaging in stunts designed to make the producers of FOX News happy, Republicans want to return Americans to the days before ACA, when a cancer victim couldn't get covered and seniors couldn't get their prescriptions; to the day when wage workers who had paid hundreds of dollars out of pocket went without; to the days of ever-changing lists of preexisting conditions when companies tried to drop coverage.

The real business of the Congress should be to stand up for those Americans and millions more like them. That is what the American people want. That is what the American people deserve. That is why they want us to vote ``no.''

Jim McCrery, in March, 2000, said in an article in Atlantic Monthly that an

employer mandate and an individual mandate was essential.

I can't understand the Republicans saying we don't want everybody to play. We don't want everybody according to their ability to be in. Why are you so eager to let people out the door because they are going to wind up in the emergency room? Have no doubt, they will be getting health care, but they won't be paying for it. You are saying: That's okay with us, we like people who are free riders. That is not America. We are all supposed to do our part, and that is why everyone here should vote ``no.''

I reserve the balance of my time.

Madam Speaker, I yield 3 minutes to the gentleman from Illinois (Mr. Danny K. Davis).

Madam Speaker, I yield 3 minutes to the gentleman from Oregon (Mr. Blumenauer).

I yield the gentleman an additional minute.

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

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

Is the gentlelady from Kansas ready to close?

Mr. Speaker, I have one Member who is in transit, but let me say a few things until he gets here.

I have been in Congress for 25 years, and I have listened to the Republicans talk about what we ought to do about health care. They have never brought a bill to the committee--a chairman's mark--for us to mark up and bring out on the floor.

Now, if you have a solution for the fact that health care costs are the biggest costs driving bankruptcy in this country, where is it since you don't like what we have here?

When I was younger, I lived through the implementation of Medicare. The American Medical Association--everybody--was just up and down, and it was the worst thing. If we put in Medicare, it was going to be the end of the world, and we would never have health care again in this country. We went on and on and on like that. They so poisoned the well that, when people went out to actually recruit people to get into the Medicare program, people said: I am not going to have any of that socialistic medicine in my house.

That is what it was called. That is what people were doing in 1964 and 1965. This is a rerun of that very same movie. The Republicans want to kill the idea and leave the American people out there on their own. It is probably the single best example of the difference between the Republicans and the Democrats.

The Democrats have put something out here, and we are trying to help all Americans. Is it perfect? There isn't anybody on my side who would say it is. If we had had some hearings in the Ways and Means Committee, the subcommittee could have done a whole bunch of things--there are all kinds of problems out there--but there haven't been any hearings on this bill, on how to fix it.

I talked to Bill Frist some months ago. He said: Jim, there is no reason to repeal it. You ought to fix it. Make it work. Make it work for the American people.

One of the interesting things that I hear over and over again--and it must be confusing to folks at home--is that the President said: If you like your health care, you can keep it. Now, implicit in that is that it will still exist. The President didn't say: I am going to tell the insurance companies you have got to keep those plans out there.

That wouldn't be the free enterprise system, what you have. You don't like the free enterprise system.

As soon as the President passed this bill, immediately, we had people in the insurance industry pulling down plans all over the country, sending out mailings, saying: You have lost your health care coverage.

I sometimes wonder if global warming--or climate change--is really not because of Obama's health care. I hear that it is the cause of every evil--of people losing jobs. I don't know. Whatever is going on in the country, it is because of ObamaCare. That is foolishness. When you are trying to change a program for 20 or 30 million people, you are bound to have some problems. We are having them, and we are working them out. It was awful at the beginning, and it is better now. It is better today than it was 3 months ago, and it will be. It will continue to improve because the American people need it. They absolutely need it even with the foolishness coming out of here, of trying again to convince the American people to get rid of this.

I had a woman in my district who was an opera singer. She went to Germany, and she got into the German health care system. Instantly, boom, you are in. Anybody who goes to Germany is in. Her daughter got leukemia. Her daughter was treated for leukemia, and she went into remission. The mother finished her contract and came home to the United States. She could not find an insurance company anyplace in this country that would give her insurance for her daughter--none.

Now, that is what you want to go back to. You want to go back to the time when a parent can't find an insurance company that will take care of his kid, and that is the kind of thing that we have been watching for as long as I have been in Congress and before that, and this bill has begun to stop that.

We had lifetime limits. Some cancers eat up a lot of money real quickly. Bone marrow transplants are $125,000 or more, and people wind up being unable to purchase the medication. All of that is covered by this bill, and you are saying to people: No, we want to go back to 1930. We like the Dust Bowl. We like the hard times of the thirties. We don't want any of this stuff.

In my view, this is a perfect place for Democrats to vote ``no,'' and Republicans, of course, will vote ``yes,'' and the American people will make a judgment in the next election.

I yield back the balance of my time.

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

Mr. Speaker, pursuant to House Resolution 497, I call up the bill (H.R. 4118) to amend the Internal Revenue Code of 1986 to delay the implementation of the penalty for failure to comply with the individual health insurance mandate, and ask for its immediate consideration.

Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days in which to revise and extend their remarks and to include extraneous materials on H.R. 4118.

Mr. Speaker, I yield such time as he may consume to the gentleman from Michigan (Mr. Camp), the illustrious chairman of the House Ways and Means Committee.

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

Madam Speaker, the enforcement of the individual mandate penalty tax is an important issue, an issue of basic fairness, and I look forward to debating this legislation on the House floor.

On February 10 of this year, the Department of the Treasury announced that it would delay enforcement of the employer mandate penalty tax for businesses with 51 to 100 employees until 2016. This delay in the President's health care law comes on the heels of a similar delay the administration announced last July, which exempted all large businesses from the employer mandate penalty until 2015.

Amidst all of these delays, it is easy to forget that the employer mandate, like the individual mandate, was required by the Affordable Care Act to be in effect right now. The President has now acted unilaterally on two separate occasions to give Big Business relief from this tax burden. However, he has not leveled the playing field for the millions of individuals and families who are forced to comply with the individual mandate tax.

Aside from the fact that it is fundamentally unfair to give businesses special treatment that is not extended to these individuals, American families have also been forced to deal with a botched rollout of healthcare.gov and a series of confusing administration delays of the law issued via blog post. This has led to confusion, frustration, and, ultimately, difficulty complying with the law.

Nowhere is this more evident than the fact that only 4 million Americans have enrolled in health coverage on the healthcare.gov Web site. This means that with less than a month to go in this initial open enrollment period, we are still 3 million enrollees short of the original CBO projection of 7 million enrollees--one that even the administration once touted as its goal. Enrollment is still 2 million enrollees short of CBO's new projection of 6 million enrollees.

These millions can be added to the tens of millions of other American individuals and families who will now likely be forced to pay the individual mandate penalty. In my State, Kansas, the latest census information estimates that 356,000 folks are uninsured. At the last count, only 22,000 of those individuals have enrolled on healthcare.gov.

Unlike businesses, the President has offered no relief for these individuals who do not or are unable to comply with the law's mandates. I believe that this is simply not fair and that the House must act to provide parity for these folks. That is why I have introduced this bill under consideration today.

H.R. 4118 would eliminate implementation of the individual mandate penalty by 1 year. This means that the individual mandate penalty would be zeroed out this year. It would rise to $95 or 1 percent of income in 2015, to $325 or 2 percent of income in 2016, and $695 or 2\1/2\ percent of income in 2017 and thereafter. I believe this is a simple concept, and considering the circumstances, I applaud this committee for taking up this legislation to provide fairness to all Americans under the President's health care law.

In closing, I would ask this: If the President can delay the employer mandate, where is the relief for everyone else? It is time to give relief to hardworking individuals and families and work toward a legislative solution to eliminate these tax penalties for everyone. Congress must pass this bill today and create simple fairness for all.

I reserve the balance of my time.

Madam Speaker, I yield 2 minutes to the gentleman from Texas, Chairman Kevin Brady, our chair of the Ways and Means Health Subcommittee.

Mr. Speaker, I yield 2 minutes to the gentleman from Ohio (Mr. Renacci), our colleague and friend on the House Ways and Means Committee.

Madam Speaker, I yield 2 minutes to the gentleman from Indiana (Mr. Young), our friend and colleague on the Ways and Means Committee.

Madam Speaker, I yield 2 minutes to the gentleman from Tennessee (Mr. Roe), my friend and colleague.

Mr. Speaker, I yield 1 minute to the gentleman from Virginia, Eric Cantor, our current Republican House majority leader.

Mr. Speaker, I yield 2 minutes to the gentleman from Louisiana, Steve Scalise, the chairman of the Republican Study Committee.

I see no other speakers, so I am prepared to close.

Mr. Speaker, in closing, this bill is about fairness and about providing relief to all hardworking Americans just as the administration keeps giving to businesses. It is about leveling the playing field for the millions of individuals and middle class families who are forced to comply with this health care law.

Just last week, a stunning poll found that only 6 percent of Americans claim ObamaCare is working and want it kept intact. Opposition to this law is at an all-time high, and even the President admitted that the launch of this law was fumbled. Add that to the millions of Americans who are losing their health insurance that they like, are losing access to the doctors they have always seen, are submitting their personal data to an unsecured system, are paying higher premiums they can't afford, and clearly, we have a law that is not working and is not fair to the American people.

The court of public opinion is a powerful thing. The House will listen, and it will continue to listen, and it will continue to provide relief and fairness to middle class families. I hope the Senate and the President will also do the right thing for the American people.

With that, Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, I reserve a point of order against the motion to recommit.

Mr. Speaker, I withdraw my point of order and seek time in opposition to the motion.

Mr. Speaker, once again, the Democrats are simply missing the point. The President is the one who has delayed the employer mandate, the President has said this law is not ready, and the President has declined to extend the same flexibility to individuals.

This is about basic fairness. It is only fair that hardworking taxpayers are given the same treatment as businesses.

Like so many other provisions of the law that have been delayed, repealed, or declared unworkable, this is just another example that, despite the administration's promises, ObamaCare is not working for the American people.

I reject this motion.

Please support H.R. 4118, and I yield back the balance of my time.

Mr. Speaker, I rise in opposition once again to an attempt by the majority to defeat the Affordable Care Act.

This begins the third year that the majority has attempted to put an end to affordable, available and accessible health care for all Americans.

They have ignored the law, a Supreme Court decision and a national presidential election that affirmed the establishment, legality, and popularity of the Affordable Care Act.

I oppose this bill for three reasons: there are much more pressing issues facing our nation, this bill is wrong on the facts, and the Affordable Care Act is working.

There are much more pressing issues facing our nation: unemployment, food security, housing security and access to job training that leads to employment.

We should be debating a bill to restore emergency supplemental unemployment benefits.

We should be restoring cuts the Supplemental Nutrition Assistance Program that was cut by nearly $20 billion dollars over several years.

We should be voting to raise the minimum wage to $10.10 an hour over several years and link future increases of the minimum wage to inflation.

We should be taking up the budget process with eagerness to avoid another government shutdown.

In 2013, we had a Federal government shutdown because we lost precious legislative time voting to repeal or seriously diminish the ability of the Affordable Care Act to do what it is currently doing-- providing health insurance to millions of Americans.

Every wasted vote--moves this Congress another step closer to another Federal government shutdown.

The budget process takes months of work by over a dozen committees to complete.

Each vote that stops our legislative work and bring us to the floor for a debate on legislation that will not go anywhere--is time taken away from our work to avoid another government shutdown.

The American people were unaware of the cost of over 40 votes to end Obamacare until millions of citizens were put out of work when the government shutdown last year.

They are watching what is happening in Congress very closely and the consequences will fall heaviest on those who were hurt by the last government shutdown.

The 113th Congress has 70 legislative working days left on the calendar before September 30, 2014--the end of the fiscal year for 2014 and the beginning of the fiscal year for 2015.

I call on my colleagues to bring to the floor bills like H.R. 3773, the Unemployment Jobhunters Protection and Assistance Act, a bill I introduced that would extend emergency unemployment compensation (EUC) payments for eligible individuals to weeks of employment ending on or before January 1, 2015.

This Congress would find a better use of its time if it would take up consideration of H.R. 3888, New Chance for a New Start in Life Act of 2014, that would authorize the Secretary of Labor to make grants to States, units of local government, and Indian tribes to carry out employment training programs to assist long-term unemployed job hunters to obtain the skills and training they need to reenter the workforce and fill jobs in high-growth sectors of the economy.

These are just two bills that would improve the lives of people who we all serve, but there are dozens of others introduced by members who came to the Congress to serve the will of the people and not their own will.

I oppose this bill because it is wrong on the facts.

Republicans are claiming that this bill is simply logical because the Administration has already delayed the employer responsibility provision for one year.

This claim is inaccurate and disingenuous.

Nonpartisan experts agree that there is no comparison between the impacts of a delay in the employer responsibility and individual responsibility provisions.

For example, in a report in July, the nonpartisan Urban Institute concluded, ``Delaying or eliminating the individual mandate would significantly decrease insurance coverage relative to the full Affordable Care Act's implementation, whereas delaying or eliminating the employer mandate will have essentially no effect on coverage.''

The Affordable Care Act is good for the American People

The Obamacare is popular and growing in greater popularity everyday as consumers get past the rhetoric and experience the reality of the peace of mind that health insurance for their families and themselves brings.

Thanks to the Affordable Care Act, in Texas:

5,198,000 individuals on private insurance have gained coverage for at least one free preventive health care service such as a mammogram, birth control, or an immunization in 2011 and 2012. In the first eleven months of 2013 alone, an additional 1,683,800 people with Medicare have received at least one preventive service at no out of pocket cost.

The up to 10,695,000 individuals with pre-existing conditions such as asthma, cancer, or diabetes--including up to 1,632,000 children--will no longer have to worry about being denied coverage or charged higher prices because of their health status or history.

Approximately 5,189,000 Texans have gained expanded mental health and substance use disorder benefits and/or federal parity protections.

4,889,000 uninsured Texans will have new health insurance options through Medicaid or private health plans in the Marketplace.

As a result of new policies that make sure premium dollars work for the consumer, not just the insurer, in the past year insurance companies have sent rebates averaging $95 per family to approximately 726,200 consumers.

In the first ten months of 2013, 233,100 seniors and people with disabilities have saved on average $866 on prescription medications as the health care law closes Medicare's so called ``donut hole.''

357,000 young adults have gained health insurance because they can now stay on their parents' health plans until age 26.

Individuals no longer have to worry about having their health benefits cut off after they reach a lifetime limit on benefits, and starting in January, 7,536,000 Texans will no longer have to worry about annual limits, either.

Health centers have received $293,038,000 to provide primary care, establish new sites, and renovate existing centers to expand access to quality health care. Texas has approximately 400 health center sites, which served about 1,079,000 individuals in 2012.

Every day more uninsured Americans are signing up for plans as the website gets faster and more people with insurance are benefiting from the law.

I ask my colleagues on the other side of the aisle to not spend any more precious legislative work on efforts to end the Affordable Care Act or ignoring the number of people continuing to vote in favor of the new law with their insurance enrollment dollars.

Mr. Speakers, I urge my colleagues to join me in voting against this bill.

Mr. Speaker, I have a motion to recommit at the desk.

I am in its current form.

Mr. Speaker, this is the final amendment to the bill, which will not kill the bill or send it back to committee. If adopted, the bill will immediately proceed to final passage, as amended.

This Republican bill represents the 50th attempt to undermine and repeal the Affordable Care Act. The Democratic motion to recommit lowers out-of-pocket costs, secures tax credits and rebates, and ensures no discrimination against those with preexisting conditions.

The bill would delay the individual responsibility provision of the Affordable Care Act to purchase health care by 1 year, which would directly impact the out-of-pocket costs of consumers and threaten the ability of millions of Americans with preexisting conditions to have health coverage.

The nonpartisan CBO estimates that the enactment of the Republican H.R. 4118 would increase the number of uninsured by 1 million in 2014, by 2 million in 2015, and by 1 million in 2016. That is 4 million Americans who would not have access to health insurance otherwise.

The White House pointed out this morning that the individual shared responsibility provision is essential to ensuring that 129 million Americans with preexisting conditions can get coverage without being charged more or losing coverage when they get sick.

Mr. Speaker, this bill is just another example of House Republicans playing political games rather than working together to get things done for the American people. This is no longer about helping people. It never really was for the Republicans. These repeal votes are about ideological purity. They are about politics for the sake of politics. That is why people across America are frustrated and disappointed by this Congress--because this Chamber has become a bubble, and Republicans have stopped listening and have stopped working on anything productive.

It is not just on health care. It is on giving Americans a raise by increasing the Federal minimum wage. It is the refusal to bring up comprehensive immigration reform even though there are votes in the House to pass it. It is on unemployment insurance and on the failure of this Congress to extend benefits to now more than 2 million Americans who have lost coverage. It is about creating jobs and helping to improve and grow our infrastructure.

Now, this vote may seem routine. It may seem like this is just Congress' continuing Groundhog Day, but this is the 50th time that we have done this. We are wasting time, and we have a full docket of things that we need to be doing. This vote is a symptom of something very wrong in Washington, and it is time to wake up and to do something more than play Tea Party politics in this House. The bill offered by my colleagues on the other side would increase out-of-pocket costs to American consumers. It would increase health premiums and the number of uninsured Americans, and it hurts those with preexisting conditions.

Last year, I underwent a six-way bypass. Open heart surgery--no question--was terrifying, and when you are on an operating table in an emergency room, the last thing you should be focusing on is becoming medically bankrupt. You should be focusing on taking care of yourself and your family and on getting them the best care that you can. Whether it is heart disease, cancer, diabetes, or any other preexisting condition, people shouldn't go bankrupt because of an illness or a disease in this country.

Thankfully, my surgery went well. I was able to afford it. My heart condition is now a preexisting condition. There are thousands of my constituents who are in the same or worse boat but who are not financially well off. If we repeal or delay the Affordable Care Act, what are they supposed to do? There is no solution being offered by the House Republicans. It is not repeal and replace. It is repeal and return to a broken health care system. That is it. That is the Republicans' plan.

Last year, they passed H.R. 2668, a virtually identical bill to the one we are considering today. They have run out of ways to repeal this law, so now we are stuck on repeat. We should, instead, be focusing on renewing unemployment insurance benefits for 2 million struggling Americans, on passing comprehensive immigration reform so that we can fix the system that has got families torn apart, and on giving 30 million Americans a raise.

My motion to recommit would protect three of the most important provisions of the Affordable Care Act that are overwhelmingly supported by the American people: lower out-of-pocket costs for consumers, tax credits and rebates to purchase health care, and ensuring that no one in America can be denied coverage due to a preexisting condition in America.

It is time for this Congress to wake up and to do the right thing--to protect Americans and their health care.

I yield back the balance of my time.

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

Mr. Speaker, I would ask my colleagues a very simple question: Can this Congress approve legislation that is supported by over 85 percent of the American public that is truly bipartisan legislation, with distinguished Republican cosponsors, and will not cost anything and, in fact, could even save billions of dollars? Can we give the American public something they not only want, but they need and to which they're entitled?

I would hope so. I would hope that Congress could act on the Personalize Your Care Act, H.R. 1173, which I've introduced along with Dr. Roe, Mr. Reed, Mr. Hanna, Dr. McDermott, and Dr. Bera.

I would make part of the Record survey research by the Regence Foundation and the National Journal that shows overwhelming public support for this type of protection for families. Ninety-six percent of Americans surveyed said it was important that these health and end-of- life issues be a top priority for our health care system; 97 percent agree that it's important that patients and their families be educated about palliative care and end-of-life option treatments available, along with curative treatment; and 86 percent agree that these discussions about palliative care and end-of-life treatment should be fully covered by health insurance.

Americans agree that people need to know what faces them in difficult situations approaching end of life or when people are temporarily unable to make medical decisions for themselves. But Medicare, which will pay tens of thousands of dollars for a full hip replacement for a 93-year-old woman with terminal cancer, will not authorize a couple hundred dollars for her and her family to have medical consultation about her personal choices and circumstances for the future. Our legislation will change that.

There have been fascinating studies about how doctors die differently from the rest of us because they know what works and what doesn't. Doctors, it turns out, tend to consume health care much differently and often less in their final year of life. It's not that they don't understand. It's not that they don't have access to health care. They can afford it. They just know their situation better than the rest of us, they know what works, they know what they want, and usually that means comfort and quality of life and more control.

Our legislation will be a small, but important, step to make sure that every American is treated like a doctor in their last year of life: knowing their choices, knowing their prospects, being able to identify what they want, and make sure that their wishes are known and respected.

I don't think there are any of us on the floor of the House who has not felt some frustration. Can't we get something done? Here's an opportunity that doesn't depend upon what your view of ObamaCare is. Whether it's implemented, delayed, or repealed doesn't matter.

This is legislation that doesn't need to cost anything. It actually will end up saving money, but money is not the point.

Can we act together to do something for the public, show that we're not paralyzed, that we can work together, that

we can make progress in a difficult environment?

I would urge my colleagues to join the bipartisan and growing list of Members who have cosponsored the Personalize Your Care Act, H.R. 1173. Some day Congress is going to deal with the vast looming crisis we face. In the meantime, helping patients understand their choices and make their wishes known and respected is an important step to start.

Survey Research From the Regence Foundation and the National Journal

Americans agree that discussions about palliative care and end-of-life

care treatment options should be fully covered

Now, please tell me whether you agree or disagree with the

following statements regarding these health and life issues.

Discussions about palliative care and end-of-life care

treatment options should be fully covered by health

insurance: 86% agree.

Discussions about palliative care and end-of-life care

treatment options should be fully covered by Medicare: 81%

agree.

Americans of all stripes say it's important for these issues to be a

top priority for the health care system

Now that you've heard some more information, how important

is it that these health and life issues be a top priority for

the health care system in this country?

96%: important.

72%: `very' important.

Americans widely agree on the importance of educating patients about

their options and the value of a public debate

Now, please tell me whether you agree to disagree with the

following statements regarding these health and life issues.

It is important that patients and their families be

educated about palliative care and end-of-life care options

available to them along with curative treatment: 97% agree.

A public dialogue and debate about these health and life

issues will help patients and their families by providing

them with more information about their treatment options: 86%

agree.