Improving Trauma Care Act of 2014

Mr. President, I wish to speak about where we are right now. We are moving toward confirming a number of individuals with the majority deciding that the majority could do that by themselves. Apparently, they had the right to change the rules, which I guess means there really are no rules and the majority can change the rules any day they want.

What we are seeing now with the health care implementation is what happens, frankly, when one side decides they don't want to make any effort necessary to get even one other person from the other side to agree with them on moving forward with something as big as the health care legislation. That should have been an example to us, but apparently the example was the example that they, the majority, can do whatever the majority wants to do.

Let me share for a few minutes some of the things I am hearing in our office from people who are contacting us to tell us the problems they are having that they didn't anticipate.

This is a letter from Pam from Chesterfield, MO. She says: My husband and I have always played by the rules and carried insurance. I had no idea we were going to have to change plans and go to the exchange, but our provider apparently doesn't want to have individual plans any longer because it is too costly to figure out the complexities that would apply to individual plans.

Then Pam says: At least for now, my husband and I are not getting health insurance, and I guess we have to hope for the best. What a mess, she says. So much for playing by the rules. I never expected the two of us to be uninsured. But, now, she thinks that is what is likely to happen.

Jennifer, a college student from St. Louis said that she initially supported the Affordable Care Act. She worked part-time at a Home Goods store where she had what she thought were great health benefits--or at least the health benefits she wanted--and where she could work as many hours as she wanted. But, she says, because of the health care plan, her employer reduced the maximum number of hours she could work to 24 hours.

So, she says:

My name is Jennifer, a hard-working student from St. Louis,

MO, and I would like to share my emerging problems. At first

I was supportive of the Patient Protection and Affordable

Health Care Act. Insurance for everyone--that sounds so

appealing, but now that it has affected my life in a negative

way, I am not so sure I can be supportive anymore. I have

worked for my employer for almost 3 years while going to

school. It has been an excellent place to work until now, and

now not only do I not have the health care benefits I had

before, but I am not able to work as much as I was able to

work before.

Carla and her husband are farmers from Oreck, MO. They farm full- time; neither of them is employed off the farm. They have two sons, one just graduated from college and just went to work; another is a junior in college. They have one full-time employee on the farm. Her family provides their own insurance. In order for them to have insurance they have had a health savings account through Humana. Their deductible is $10,000, and they still pay a little over $500 a month or $6,057 a year for their family insurance. But she tells me beginning January 1, 2014, their deductible goes to $12,600. Their premium goes to $11,422, an 89- percent increase in a family that provides their own insurance. By the way, they provide insurance with dollars they earned and they pay taxes on, so we can add another premium to that and find out how this family, that has done all they could to have insurance for their family, now has an 89-percent increase in their insurance and a deductible they hope they never use. But if they do, it is a big problem if they use that deductible. The deductible is going to be over $12,000.

If a family is paying $11,000 for premiums and then they develop health care needs, they pay another $12,000 before their insurance helps them, that is $23,000 a year before their insurance benefits them in any way for a family that had insurance coverage that, until right now, they thought was working for them while doing all they could to have it.

Catherine from Springfield, MO, says a few weeks ago she was informed she was going to lose her health coverage because of the President's health care plan. She has been concerned that she might not be able to sign up because the Web site wasn't working. Whether the insurance costs more or not wasn't as big of a concern to her as having insurance. She says: The nightmare that is ObamaCare is going to affect us in a major way, and the stress of what is coming is affecting many people. Not only are we losing health insurance plans we liked, and possibly the doctors we trust, but the new coverage is not as good and it costs us more. This is--to paraphrase the Vice President, ``a big deal'', she says.

Ken writes:

Dear Senator Blunt. I am writing to inform you of my recent

experience with health insurance and the ACA. My wife and I

make a decent income but are far from wealthy. On September

30 I received a notice that due to the ACA, my employer-

sponsored health insurance plan would no longer be available.

Yesterday--after worrying about this since September 30,

apparently--yesterday, he continues--I discovered that my

employer was able to renegotiate an early renewal and our

monthly premium will only increase by 12.5 percent. However--

by the way, 12.5 percent is a pretty good increase by my

books except the ones that compare what is happening right

now. However,

he continues,

I have been made aware that next year my plan premiums will

increase by a minimum of 39 percent.

So it increased 12.5 percent this year, and they have already notified this family that their increase will be a minimum of 39 percent next year, and his deductible, according to him, will double. So reading his letter further, he says: So I guess I will not be able to keep my insurance and my costs will not decrease as the President said they would.

Carol from Republic, MO, says her monthly premiums have gone from $600

to $800, and the part-time jobs she and her husband both had at the local community college have actually gone down because they are not able to teach as much as they were able to teach before, because the community college has decided they can't let any of their part-time faculty work more than 30 hours. So their income went down, their expenses went up, in both cases because of the President's decisions on health care and the legislative decisions on health care in both cases. We know this has impacted the workplace, part-time workers, people holding their workforce down so they wouldn't be covered, holding their worker hours down so they wouldn't have to pay the penalty if they didn't offer insurance or offer the insurance for the first time at levels they hadn't had before.

Now we are also seeing--not only did the hours of work go down, but the cost of health insurance goes up. Surely, we can come up with a better plan than that.

Christian from St. Peter's, MO, just learned that his wife's employer will start excluding him from their family coverage and that he now has to receive insurance in some different way. It looks like he is going to be able to do that with his employer for $1,300 more per year. This is actually the best story I have told so far--only $1,300 that this family used to have to spend for something else, and they are now spending for health care. He says: I am not sure who ObamaCare benefits, but it sure isn't my family.

These stories are just examples of some of the things we are hearing.

Last weekend I noticed that one of the architects of the President's health care bill, Dr. Zeke Emanuel, on Fox News to Chris Wallace, said that what the President really should have said--and this is his exact quote: ``If you want to pay more for your insurance company that covers your doctor, you can do that.''

I don't know what he is looking at, and some may be able to find their doctor for more money, but in our State some of the health care providers aren't on the exchange.

I read the other day that more than half of the hospitals in New Hampshire aren't on the exchange. So if your doctor happened to work for more than half of the hospitals in New Hampshire, there is no amount of money you can pay on the exchange and keep your doctor, because your doctor is no longer available through the way that you are told by the health care act that you can get insurance as an individual.

The President promised that. He said: My plan begins by covering every American. If you already like your health insurance, the only thing that will change for you under this part is the amount of money you will spend on premiums, and that will be less.

I think we are going to quickly see not only are people losing insurance, but for most people the premiums are not going to be less and the deductibles are going to be higher, not lower.

This is going to be a story that is going to affect American families as nothing the Federal Government has done in a long time, and maybe nothing the Federal Government has done ever.

If you truly want to impact the lives of families, impact their health care. Somebody told me one time: When everybody in your family is well, you have lots of problems. When somebody in your family is sick, you have one problem.

We are dealing with the one focusing problem for American families: their access to health care that they can afford with decisions they like.

I yield back.

Mr. President, as if in legislative session, I ask unanimous consent that if the Senate receives H.R. 3548 from the House of Representatives and the bill is identical to S. 1689, as introduced, then the bill be considered as having been read three times and passed; and that the motion to reconsider be considered made and laid upon the table, with no intervening action or debate.

Mr. President, I wish to thank my colleagues, in the Christmas spirit, despite these contentious times, for letting this bill move forward. Let me just briefly explain.

On Christmas Eve, 2012, nearly one year ago today, the 125-member West Webster Volunteer Fire Association--a volunteer fire department outside of Rochester--faced an unimaginable tragedy when four of their brave members were wounded, two fatally, when they responded to a fire but in instead faced an ambush of unspeakable proportions.

While many of our families across our Nation were waking up last Christmas Eve morning preparing Christmas dinner, shopping, wrapping presents or picking up family from the airport, four families in Webster, NY, were instead confronting a heart-wrenching tragedy.

The call of a house on fire came in to the West Webster Fire Department at 5:30 a.m. that morning, December 24. It was a cold, snowy morning, still dark, but the everyday heroes from the West Webster Fire Department courageously did what they volunteered to do on behalf of their neighbors and on behalf of their hometowns. They left their homes and their families to put out a fire.

Instead, this routine call turned into a tragedy which shocked this community and people throughout the country and even the world. What they didn't know was that the fire was intentionally set by the home's owner in order to lure these innocent firefighters into a senseless sniper ambush. The sniper was hiding behind a berm amid the chaos of the fire and began shooting at the responding firefighters.

The firefighters were confused at first to hear popping sounds; they thought it might be the fire, but Lieutenant Mike Chiapperini, who was also a Webster police officer, knew better and shouted to his fellow volunteers to take cover, but it was too late.

Firefighter Hofstetter was shot in the pelvis while trying to alert dispatchers on the radio to the situation.

Ted Scardino was shot in the shoulder, and 5 minutes later shot in the leg. A 16-year volunteer lay there bleeding for an hour, enduring the December cold while sustaining second-degree burns on his head.

Lieutenant Chiapperini and firefighter Kaczowka both died in the ambush.

As news of this horrific senseless Christmas Eve tragedy spread, well meaning people from Rochester, New York State, the Nation, and the world reached out to the West Webster Fire Association to offer their support and prayers.

Not realizing that collecting and distributing the funds to the family would jeopardize the association's tax exempt status with the IRS, the association accepted donations from generous people all around the Nation wanting to help the poor families who suffered so on that day. They collected these donations for the victims and their families. They wanted to give these donations to the victims and their families. It defies reason that they would be unable to do so because of a technicality in the Tax Code.

Just as we did after 9/11 and again after a similar fire department tragedy in California, it is our obligation to make sure the West Webster Volunteer Firemen's Association can now distribute to these families the contributions their neighbors and unknown countless generous others wanted them to have. With the passage of this legislation, that will happen.

I thank my colleagues, particularly on the other side of the aisle. I know these are contentious times, and this was done truly in the Christmas spirit, and I thank them.

Wolford Confirmation

One more brief moment. We just confirmed to the U.S. district court the first woman to serve on the Federal bench in the Western District of New York, Elizabeth Wolford. She is going to be a great judge. Ms. Wolford is right out of central casting for the role of a Federal judge. Not only will the legal community of Western New York be well served by her ascension on the bench, the entire community will benefit from her leadership, wisdom, and judgment.

It is an honor to have nominated and to now confirm Elizabeth Wolford, the first woman to represent the Western District of New York, a very distinguished bench.

I yield the floor.

Mr. Speaker, today I rise in support of five bipartisan public health bills that will help individuals with traumatic brain injuries, newborns, burn patients, and those with autism. The Energy and Commerce Subcommittee on Health, under the leadership of Rep. Joe Pitts, has been a workhorse that boasts an outstanding record of bipartisan accomplishment on legislation that truly touches people's lives. With a number of bills already

signed into law, and these under consideration this evening, the 113th Congress is shaping up to be known as the public health Congress.

I would like to take this opportunity to highlight each of the five bills before us this evening.

H.R. 1098, the Traumatic Brain Injury Reauthorization Act, would address a problem that affects millions of Americans, including both veterans and children. Introduced by Mr. Pascrell, this bill would assist states in developing and expanding service delivery capacity for individuals with a traumatic brain injury. According to some estimates, the economic burden of such injuries is more than $70 billion, and the physical and emotional toll endured by patients and their families is even more burdensome. This bill would help alleviate the problems associated with this unique and complex health problem, providing peace of mind to families across the country.

H.R. 1281, the Newborn Screening Saves Lives Reauthorization Act, introduced by Reps. Roybal-Allard and Simpson, funds grants to allow states to expand their newborn screening programs, educate parents and health care providers, and improve follow-up care for infants diagnosed with a condition. Before the first passage of this bill in 2008, the number and quality of newborn screening tests varied from state to state. Today, with guidelines created by the bill, screenings reach 4 million babies in the United States every year. Reauthorization will continue this important program and encourage more timely efforts to identify diseases, such as Spinal Muscular Atrophy, and ensure best practices. Early screening and diagnosis often means better disease management and better outcomes for these children.

H.R. 3548, the Improving Trauma Care Act, introduced by Energy and Commerce Committee member Rep. Bill Johnson, is designed to correct the inconsistencies in the definitions of trauma that have resulted in gaps in care and coverage. This bill will help important trauma centers like Bronson Methodist Hospital's Burn Center in Kalamazoo, Michigan to better care for their patients.

We will also consider H.R. 4080, the Trauma Systems and Regionalization of Emergency Care Reauthorization. Introduced by Energy and Commerce Committee members Dr. Burgess and Rep. Green, the bill reauthorizes two programs related to the planning and development of regional emergency care. Both of these programs will improve trauma care so that Americans can promptly receive specialized, life-saving treatment after a traumatic injury.

Finally we will consider H.R. 4631, the Autism CARES Act of 2014, introduced and championed by Reps. Chris Smith and Mike Doyle. The sad reality is that in the United States, autism now affects 1 in 68 children and can cost a family approximately $60,000 annually. H.R. 4631 continues autism-related research, early identification and intervention, education, and the activities of the Interagency Autism Coordinating Committee. It also asks the Secretary of Health and Human Services to collaborate with other federal agencies to prepare and submit a report concerning young adults with autism spectrum disorder and the challenges related to their transition into adulthood. Finally, the research funded by this legislation also permits diagnosing and intervening earlier and thus help improve the quality of life for children with autism.

This bill is supported by the American Academy of Pediatrics, the Autism Society, and the Consortium for Citizens with Disabilities, which includes over thirty different organizations including Autism Speaks, the Autism National Committee, and the Council for Learning Disabilities.

We began our day in a bipartisan manner advancing the 21st Century Cures initiative and I am pleased to conclude the day by continuing our efforts to advance legislation to improve the public health. It is through these bills and this initiative that we can truly have an impact on the lives of all Americans.

I urge my colleagues to support these bills.

Mr. Speaker, I want to express my support for five public health bills before the House today.

H.R. 1098, the Traumatic Brain Injury Reauthorization Act of 2014, extends surveillance and research activities for traumatic brain injuries (or TBI), as well as other programs for TBI services and supports overseen by the Department of Health and Human Services. I represent the nation's largest Veterans Affairs health facility--the West Los Angeles VA Medical Center. TBI is one of many complex health problems affecting the veteran community served by this facility. I am pleased that we were able to include a provision in the bill that calls on HHS and the Departments of Defense and Veterans Affairs to report on their progress in coordinating TBI efforts for current and former members of the military. I also want to commend the sponsors of the legislation, Congressman Pascrell and Congressman Rooney, for their work on this issue.

H.R. 1281, the Newborn Screening Saves Lives Reauthorization Act of 2014, extends newborn screening services and related activities for many conditions that are not otherwise apparent at birth and, if left untreated, can cause severe disability or even death. I want to thank the sponsors of this legislation, Congresswoman Roybal-Allard and Congressman Simpson, as well as the sponsors of the Senate companion bill, Senators Hagan and Hatch. The bill before the House today is the product of bipartisan and bicameral negotiations to assure House and Senate passage of this measure. I would also like to thank Senators Harkin and Alexander for their leadership on this measure in the Senate Health, Education, Labor, and Pensions Committee.

H.R. 4080, the Trauma Systems and Regionalization of Emergency Care Reauthorization Act, reauthorizes four grant programs that seek to improve access to trauma care services within states and in rural areas. Energy and Commerce Members, Congressmen Burgess and Green, are to be commended for their sponsorship of this legislation and leadership on trauma care issues.

We are also considering another bill today related to trauma care: H.R. 3548, the Improving Trauma Care Act. This legislation expands the current definition of trauma for the purposes of trauma care grants to include burns and other injuries resulting from electrical, chemical, or other exposures. Congressman Johnson should be commended for his work on this issue.

Finally, H.R. 4631, the Autism Collaboration, Accountability, Research, Education, and Support Act of 2014, would extend autism spectrum disorder activities at the Department of Health and Human Services and ensure these efforts are better coordinated with activities across the federal government. The legislation before us reflects bipartisan and bicameral efforts to advance a bill that can pass both chambers well in advance of the September 30 sunset provisions that are in current law. I want to thank Congressmen Smith and Doyle, as well as Senators Menendez and

Enzi, who sponsored the Senate companion bill. And again, I would like to thank Senators Harkin and Alexander for their work on this issue in the HELP Committee.

All of these bills were worked out with Mr. Pallone, Mr. Pitts, and Mr. Upton. I appreciate their cooperation and contributions, and I am pleased to support all five of these bipartisan measures and urge my colleagues to do the same.

Finally, I want to acknowledge the hard work of staff on both sides of the aisle, and to commend them for their work on these bills, I particularly want to recognize Anne Morris Reid, our lead public health staffer, who has moved on to a job in the Senate, but leaves the House with an impressive record of accomplishment.

Mr. Speaker, today, I rise in strong support of H.R. 3548, the Improving Trauma Care Act of 2014, bipartisan legislation I am proud to have sponsored with the support and counsel of the Energy and Commerce Committee.

I commend the committee staff for their hard work to move this legislation forward through markup at the subcommittee and full committee levels and to steer it to the House floor today.

This simple but important bill seeks to refine inconsistent definitions of what constitutes ``trauma'' as outlined in the United States Code.

Common sense would certainly point to many burn injuries as a type of trauma, but the U.S. Code doesn't recognizes them as such. The failure to incorporate the full range of traumatic injuries in the description of ``trauma,'' including burns, can result in gaps in coverage and in provisions of care throughout the care system. By modernizing this term as federally defined, Congress can ensure that it accurately reflects the medical realities of trauma and protects access to the provision of trauma care.

There are important gains to be made in the field of traumatic medicine by the further integration of care and by finding synergies between burn and trauma centers. This has been all too evident in efforts to save lives after national tragedies, such as 9/11 and the Boston Marathon bombing. The importance of strengthening our Nation's burn care infrastructure can't be stressed enough. Inadequacy and inconsistency in the U.S. Code around the classification of burns further compound serious shortfalls in our Nation's traumatic emergency medical care system.

Traumatic injury is the leading cause of death for those under age 44, but getting a victim of trauma to a level 1 or 2 trauma center within the first golden hour can make all of the difference. However, 45 million Americans do not have access to a level 1 or 2 trauma center within an hour's travel.

I applaud the efforts of my colleague Dr. Burgess to reauthorize trauma programs and improve this system with his bill H.R. 4080, which I am also proud to support. I thank him for his endorsement of H.R. 3548, and I am grateful for his efforts to improve trauma care more broadly.

In addition, this legislation has the strong support of a broad coalition of the major medical societies and associations representing the trauma care community, including: the American Burn Association, the American College of Surgeons, the American Association for the Surgery of Trauma, the American Trauma Society, the American College of Emergency Physicians, the Trauma Center Association of America, and America's Essential Hospitals.

I want to thank Chairman Upton and Chairman Pitts for their hard work in promoting the Improving Trauma Care Act of 2014.

I hope my colleagues will support this commonsense legislation that prevents gaps in coverage and improves the provision of trauma care, and I strongly encourage a ``yes'' vote.