Providing for consideration of the bill (H.R. 596) to repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010, and for other purposes.

Mr. Speaker, I want to thank the gentleman from Texas for the customary 30 minutes.

I yield myself such time as I may consume.

Mr. Speaker, first of all, I rise in very strong opposition to this closed rule and to the underlying bill. Let me just say to my colleagues, to make it crystal clear, that this is an absolutely closed rule.

This bill had no hearings in any of the committees of jurisdiction; it was not reported out by any of the committees of jurisdiction; and the Committee on Rules decided last night that no Member, no Republican or Democrat, has the right to offer any amendments. This is a closed process.

Whatever happened to regular order?

So, Mr. Speaker, here we are again, back on the House floor with yet another pointless attempt by the Republican majority to repeal the Affordable Care Act. Today's exercise in time-wasting gamesmanship marks the 56th time that we have been down this well-traveled road.

Fifty-six. Let's see. That is two score and 16. It is 4\1/2\ dozen. But no matter how you add it up, it has to be some sort of world record in political futility.

So it is tempting to say that nothing has changed, but that is not exactly true because, in fact, a great deal has changed since my Republican colleagues first tried to repeal the ACA. Here are some of the things that changed:

The number of uninsured Americans has dropped by 10 million people; 3 million young adults have been able to gain coverage through a parent's plan; insurance companies can no longer discriminate on the basis of a so-called preexisting condition, like, say, being a woman; lifetime limits and caps on coverage have been eliminated; seniors have saved more than $11 billion in prescription drugs, an average of $1400 per Medicare beneficiary; copays and deductibles for preventive services for Medicare patients have been eliminated, and the solvency of the Medicare trust fund has been extended by 13 years; and the growth in health care spending in this country is the slowest on record, while health care price inflation is at its lowest rate in 50 years.

All that has happened thanks to the Affordable Care Act. If the Republicans get their way, much of it will disappear in an instant. If Republicans get their way, millions of Americans would lose their health care coverage, millions more would lose the subsidies they receive to purchase plans, millions of children would lose CHIP coverage, millions of seniors would lose benefits, and the deficit would increase.

So let's be crystal clear, Mr. Speaker: this is no longer a theoretical political exercise; this is very, very, very real. If this Republican bill were ever to become law, then real people would see real benefits taken away. That is why President Obama has said very plainly that he would veto this bill if it ever reached his desk.

There is something else new about this 56th version of Republicans banging their heads against a brick wall. For the first time, according to Politico:

House Republicans want to postpone the full repeal of

ObamaCare for 6 months to allow time to come up with a

replacement plan.

I have to say, Mr. Speaker, when I read that, I actually laughed out loud. The health care crisis in this country has been happening for years and years--decades. How many studies have been done? How many reports issued? How many hearings and debates and news stories? But after all of that, my Republican friends still need another 6 months to come up with a replacement plan.

Here is an idea. Let's vote down this rule with the understanding that in 6 months--actually, I will give you 7, until after Labor Day-- that in 7 months you will be back here with your magic replacement plan, which I assume will be flown in on a unicorn sliding down a rainbow.

I will tell you why, Mr. Speaker. Because Republicans have absolutely no intention of actually doing the hard work of health care reform. This is just a gimmick. It is a chance for their new freshmen to cast their symbolic vote against ObamaCare so they can put out a press release and act like they have accomplished something.

As the Washington Examiner reported:

Republicans know that the repeal legislation isn't ever

going to become law. ``We are just getting it out of the

way,'' one GOP aide told the Examiner when asked about the

repeal vote.

Just getting it out of the way, Mr. Speaker? What a cynical abuse of this House. It is a sham. It is a waste of everyone's time. It deserves to be defeated in this House, and if it ever makes it out of the Senate, it deserves the quickest veto President Obama can muster.

I reserve the balance of my time.

Mr. Speaker, at this time, I yield 1 minute to the gentlewoman from Michigan (Mrs. Dingell).

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

I want to thank the gentleman from Texas for the wonderful commercial for Texas. We all should visit Texas.

He said something that I thought was particularly interesting. He said: We're bringing this bill to the floor because every freshman deserves a vote on the repeal of the Affordable Care Act.

I guess I would ask the chairman: Does he believe that every freshman also deserves a vote on increasing the minimum wage or on comprehensive immigration reform or on adequate child care for our children in this country or on a whole number of other issues which we have routinely been denied the right to even have a vote on these issues on the House floor, which is supposed to be the greatest deliberative body in the world?

What he neglects to tell everybody, including these freshmen--some of whom are Republicans--is that under this rule, you can't amend anything. You have been totally locked out.

The committees of jurisdiction didn't hold a hearing. The committees of jurisdiction didn't hold a markup. Nothing was reported out of any of these committees, notwithstanding the fact that they have been constituted and organized--nothing.

It just shows up in the Rules Committee, and they bring it to the floor under a completely closed process. This is a lousy way to run a Congress.

With that, Mr. Speaker, I yield 2 minutes to the gentlewoman from California (Ms. Matsui).

I yield the gentlewoman an additional 30 seconds.

Mr. Speaker, I thank the gentleman for his comments. There is no replacement here. All the Republicans want to do is repeal the Affordable Care Act and take away all these important benefits that people have received as a result of it.

At this point, Mr. Speaker, I yield 2 minutes to the gentleman from Colorado (Mr. Perlmutter).

Mr. Speaker, I am proud to yield 2 minutes to the gentleman from Kentucky (Mr. Yarmuth), a member of the Committee on Energy and Commerce.

Mr. Speaker, can I inquire of the gentleman from Texas if he has any more speakers?

I was just curious because it seems like there is no enthusiasm on your side for debating this for the 56th time.

Mr. Speaker, if we defeat the previous question, I will offer an amendment to the rule for consideration of legislation that would encourage schools to provide career education about local manufacturing jobs.

To discuss our proposal, I yield 2 minutes to the gentlewoman from California (Ms. Brownley).

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

Mr. Speaker, I am puzzled by what I just heard from the gentleman about all these alternatives to fix and improve our health care system.

Four years ago, the Republicans passed an identical bill like the one we are considering today in which they said they ordered their committees to report out alternative replacement language or their vision of what a health care reform should be. That was 4 years ago.

They have done nothing but demagogue this issue for 4 years, and here we are again today, playing political gamesmanship with a bill to repeal the Affordable Care Act and take away health insurance for millions of Americans, increase prescription drug prices for our senior citizens, raise taxes on middle class families, and they have nothing to replace it with. This is a waste of our time. This is an insult to the American people.

Mr. Speaker, I yield 1 minute to the distinguished gentlewoman from California (Ms. Pelosi), the Democratic leader.

Mr. Speaker, if only we were debating another subsidy for Big Oil or another tax break for some special corporate interest, my colleagues would be down here with great joy advocating for it.

But when it comes to a bill to ensure that millions and millions of our citizens get health insurance, they want to repeal it. When it comes to protecting our senior citizens who are seeing their prescription drugs being lowered because of this bill, they want to repeal it. When it comes to eliminating preexisting conditions, they want to repeal it. I mean, that tells you all you need to know about where their priorities are.

Mr. Speaker, I yield 2 minutes to the gentleman from Pennsylvania (Mr. Boyle).

Mr. Speaker, I just would remind the gentleman from Iowa that there was a Republican Presidential candidate named Mitt Romney who ran on the platform of total repeal of the Affordable Care Act, and he lost. And, by the way, Obama won Iowa by 51-46.

With that, I yield 2 minutes to the gentlewoman from Connecticut (Ms. DeLauro).

Mr. Speaker, at this time, I yield 2 minutes to the gentlewoman from Texas (Ms. Jackson Lee).

I yield the gentlewoman an additional 15 seconds

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

Mr. Speaker, first of all, I ask unanimous consent to insert the text of the amendment that I intend to offer in the Record along with extraneous materials immediately prior to the vote on the previous question. This would be the amendment that Ms. Brownley of California talked about, providing manufacturing training for our high school students.

Now, Mr. Speaker, let me begin by talking about the process. Let me say two words about this process: it stinks.

We have a bill before us today on the House floor that bypassed all of the committees of jurisdiction. And I say to my colleagues, Republicans and Democrats alike, if you are on the Energy and Commerce Committee, on the Education and the Workforce Committee, or on the Ways and Means Committee, you should be outraged that legislation that is under your jurisdiction never went to your committees. It just showed up in the Rules Committee last night. And on top of all of that, no amendments are allowed; nobody can offer any ideas.

I have heard some of my Republican colleagues talk about they have ideas for making the Affordable Care Act better or for replacing it. They don't have the opportunity even to bring those ideas to this House floor.

Four years ago, we voted on a similar measure which said that the Republicans would have the committees of jurisdiction report out alternatives. It is 4 years later, and we are doing the same thing over and over and over again. It is a waste of taxpayer time. It is an insult to the American people.

And as far as the substance of what my Republican friends are trying to do, I just wonder if any of my friends on the other side of the aisle would have the courage to say to people face to face, ``I am going to take your health care away,'' because that is what this

bill would do. That is what this bill would do, and it is shameful.

When I first ran for office, I said to my constituents that one of the things I was committed to was to making sure that everybody in this country had health insurance. Health care ought to be a right. Nobody should have to worry whether or not they can afford to get the health care that, quite frankly, every American is entitled to and deserves. We have made a great stride forward with the Affordable Care Act.

Is it perfect? No.

Could it be better? Yes.

But to come up with bill after bill after bill, 56 times of repeal, repeal, it is getting old. It is getting boring. People are sick of this.

Let me just remind my colleagues about what this bill has accomplished, just because this is no longer a theoretical, abstract debate. These are some real things that have changed.

The number of insured Americans has dropped by about 10 million people. I mean, that is a good thing. I am sorry my colleagues have a problem with that. But I think most Americans, Democrats and Republicans, think that is a good thing.

Three million young adults have been able to gain coverage through a parent's plan. I think that is good.

Insurance companies can no longer discriminate on the basis of a so- called preexisting condition, like, say, being a woman. I think that is a great thing. I am sorry my colleagues have a problem with that.

Lifetime limits and caps on coverage have been eliminated. That is wonderful.

Seniors have saved more than $11 billion in prescription drugs, an average of $1,400 per Medicare beneficiary. That is positive. We knew that there was a flaw, the doughnut hole, in the Medicare prescription drug bill. This fixed it.

Copays and deductibles for preventive services for Medicare patients have been eliminated, and the solvency of the Medicare trust fund has been extended by 13 years. That is a good thing. Now, I know my friends on the other side of the aisle want to privatize Medicare or have no use for Medicare, but for those of us who want to see this program move well into the next century in complete solvency, this is a good thing.

The growth in health care spending in this country is the slowest on record while health care price inflation is at its lowest rate in 50 years. This didn't happen by accident. This happened because we passed the Affordable Care Act, and if Republicans get their way, all of these things will disappear.

This is a debate, I think, about values more than anything else. This is about whether or not we believe that everybody in this country ought to have health insurance, whether or not we ought to make the reforms that I have just mentioned part of the permanent culture of this country.

I think this is good. I voted for the Affordable Care Act. I am proud I voted for the Affordable Care Act. My friends, this issue about health care and access to health care has been around for decades and decades and decades, and my friends have done nothing.

Their prescription for health care reform has been: take two tax breaks, and call me in the morning. That is the total reform that they have advocated in the time I have been here and in the time I have been paying attention to what has been going on in this Congress.

Mr. Speaker, it is time for us to appreciate that this Congress did something positive in passing the Affordable Care Act, and we ought not to let extremists on the other side take the protections away from the American people.

We are going to fight you every step of the way because we believe that people in this country are entitled to health insurance.

Mr. Speaker, I urge my colleagues to vote ``no'' and defeat the previous question. I urge a ``no'' vote on the rule, 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. Speaker, by direction of the Committee on Rules, I call up House Resolution 70 and ask for its immediate consideration.

Mr. Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentleman from Massachusetts (Mr. McGovern), pending which I yield myself such time as I may consume. During consideration of this resolution, all time yielded is for the purpose of debate only.

General Leave

Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days to revise and extend their remarks.

Mr. Speaker, House Resolution 70 provides for a rule to consider the full repeal of the flawed and ill-conceived Affordable Care Act.

The rule provides for 90 minutes of debate, divided and controlled by the Committee on Energy and Commerce, the Committee on Ways and Means, and the Committee on Education and the Workforce. Further, the rule self-executes the Byrne amendment, which provides for a clean repeal of the entire Affordable Care Act. The rule further provides the minority with one motion to recommit with or without instructions.

This approach--a full repeal--will give the House, particularly freshmen from both parties, an opportunity to have an up-or-down vote on the Affordable Care Act.

More than just a full repeal, the legislation before us provides for a process whereby the committees of jurisdiction are tasked with coming up with a replacement for the flawed law now being implemented. We know what ideas don't work. Those are the ideas enshrined into law in the Affordable Care Act. Now let's look toward ideas that will work.

I do look forward to working with the Energy and Commerce Committee's chairman, Fred Upton, to craft meaningful legislation that will actually help the American people instead of strangle them with more government regulation, which is what the Affordable Care Act actually does.

Americans should have the freedom to make their own health care decisions. In March of 2010, the Patient Protection and Affordable Care Act was signed into law. It was drafted quickly and behind closed doors. It included secret deals, loopholes, drafting errors, and funding cliffs that allowed Federal agencies to be created without congressional knowledge or oversight.

More and more of the Affordable Care Act's supporters are having to admit to

the American people that, in their rush to pass a bill, the same people who put their voting cards in the slot and helped the ACA become law didn't actually know what was in the bill.

Now people are finding out what is in the bill, and they are upset. So upset are the American people that in every election for the House and Senate since the passage of the Affordable Care Act, more and more Republicans were chosen to replace supporters of the flawed law.

Indeed, this past fall, President Obama, in no uncertain terms, declared:

Make no mistake, my policies are on the ballot.

It is actually one of the few times I have ever agreed with this President. His policies were on the ballot, and the American people soundly rejected them, placing a historic majority of Republicans in the House and taking control of the Senate out of the hands of Harry Reid.

The bottom line: the drafting and passage of the Affordable Care Act was not the way to achieve meaningful reform. Many errors occurred through the language. This is why the Supreme Court this spring will be hearing a case that could upend the Affordable Care Act's subsidy structure. This case is entirely the fault of people who drafted and implemented the bill so poorly.

With the Supreme Court case looming, this body--this body--must be prepared to work for the American people and stave off the possible chaos which could ensue. The health care system in America needs reform and improvement, but the law that was passed will cost the American taxpayer millions of dollars, will not improve care, nor will it make it more affordable.

The bill that this House will vote on puts in place a procedure that will begin the process of crafting a replacement that could truly bring affordable access to health care to all Americans. The so-called Affordable Care Act does not accomplish that goal.

We need to start, and start fresh, and we need to address the issues with commonsense improvements that focus on the real issues at hand: creating a health care system that is focused on patients instead of payment, quality instead of quantity, affordability instead of cheapness, and innovation instead of stagnation. The first step is eliminating this bad legislation that simply does not work. That is why, today, I strongly support the repeal of the President's health care law.

I reserve the balance of my time.

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

Mr. Speaker, at this time, I am pleased to yield 4 minutes to the gentleman from Texas (Mr. Sessions), the chairman of the Committee on Rules.

I yield the gentleman an additional 30 seconds.

Mr. Speaker, I am pleased to yield 1\1/2\ minutes to the gentleman from Florida (Mr. Bilirakis), a member of the Energy and Commerce Committee.

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

Yes.

I generally reserve my enthusiasm for closing.

Mr. Speaker, at this time, I yield 2 minutes to the gentleman from the Upper Peninsula of Michigan, Dr. Dan Benishek.

Mr. Speaker, I yield myself 2 minutes for the purpose of response.

First off, I don't know. Maybe people weren't paying attention, but the House has passed a funding bill for the Department of Homeland Security. It awaits action over in the Senate. So if the minority leader is concerned, perhaps she can talk to people in the other

body about whether or not it might be a good idea for them to take some action, and that would be the correct way to proceed. The House acts; the Senate acts. I refer people who are unclear on that concept to ``Schoolhouse Rock,'' and it will tell you how a bill becomes law.

People talk about the 56th time we have had something on the floor. Obviously, I don't know that I can attest to the accuracy of that count, but what I can attest to the accuracy of is that 11 times the President of the United States has signed into law some action passed by the House of Representatives and the Senate and then subsequently signed by the President--11 times--modifying or changing his signature legislation, the Affordable Care Act. Probably what is more telling is the 28 times--28 times--that the President has simply set aside part of his law because it wasn't convenient.

If the other side wants, I can go through and delineate these one by one. I have, actually, a document prepared by the Galen Institute, and I would refer people to them if they would like to look at this.

But really, some of the things that the President himself has set aside--I mean, who can forget, in a blog post, the administration setting aside the employer mandate, the entire employer mandate. Not surprising, because when the President was a candidate and he came down to Texas and debated Hillary Clinton for the nomination in 2008, he was against the mandate, and then he was for it. So then he set it aside right before the Fourth of July in 2013. And for people who aren't paying attention, guess what? It actually started January 1 of this year.

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

Mr. Speaker, I yield 3 minutes to the gentleman from Iowa (Mr. King).

I yield an additional 30 seconds to the gentleman.

Mr. Speaker, I yield myself 2 minutes for the purpose of a response.

First off, when Medicare passed, it was passed with a bipartisan vote in the House of Representatives, and that is a matter of historic record. In fact, that is one of the weaknesses of the President's takeover of health care in this country is that it passed only with Democratic votes in both the House and the Senate on final passage.

Mr. Speaker, I also went through the number of times that the President has unilaterally delayed, deferred, or simply dismissed parts of his own law. One of, perhaps, the most troublesome, one of the most curious, is when the President set aside entry into his own preexisting pool in January of 2013, they did that because they were worried that they were going to run out of money in the preexisting fund. But the reality was that for anyone who was hoping to get coverage under the preexisting pool beginning in January-February of 2013, they were told: Sorry. Window closed. Go somewhere else.

Then to add further insult to injury, when they couldn't get the Web site up and working at the end of 2013, they actually had to extend coverage in the Federal preexisting pool until March of 2014 so those patients would not be left out in the cold.

So the President has been deeply involved in delaying parts and deferring parts and repealing parts of his very own law.

I reserve the balance of my time.

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

Mr. Speaker, let me first address the question of process because the Affordable Care Act did pass in the 111th Congress. The Affordable Care Act, as it came to the 111th Congress under then-Speaker Pelosi, was not a bill that had been considered in any of the committees of jurisdiction. H.R. 3590 came to us from the Senate of the United States.

Now, in fairness, H.R. 3590 had passed the floor of the House, I believe it was July of 2009; but H.R. 3590, when it passed the floor of the House, was a bill dealing with veterans housing.

So it goes over to the Senate to await further work, and to be sure, in the meantime, H.R. 3200 and then a couple of follow-on bills were marked up in committees, and then the Speaker condensed things and introduced her own bill.

We heard it on the floor of the House; and, indeed, it passed in November of 2009. Mr. Speaker, that was the end of the line for that bill. No one has seen or heard from it again.

My friends on the other side may remember some parts of that bill. What about the Independent Payment Advisory Board? Was that included in the House-passed bill? No, it was not.

Well, there was a public option because the Democrats felt very strongly about having a public option. Really, they wanted a single- payer system, so a way to move to a single-payer system was to include the public option, but the public option wasn't in H.R. 3590.

Mr. Speaker, H.R. 3590, a House-passed bill dealing with veterans housing, went over to the Senate where, sometime between Thanksgiving and Christmas, it was pulled out of Harry Reid's desk and amended.

The amendment read ``strike all after the enacting clause and insert.'' All of the housing language was removed, and all of the health care language was inserted. This travesty was passed on Christmas Eve in 2009.

A big snowstorm was bearing down on Washington, D.C., Senators wanted to get home to be with their families before the airport closed, and so it was passed in the early hours of Christmas Eve in 2009.

Now, shortly after that, Massachusetts had a special election to fill the vacancy that occurred after the unfortunate death of Senator Kennedy. That vacancy was filled for the first time by a Republican from Massachusetts.

I think that was really the first time since the Earth cooled, the first time that a Republican had been elected from Massachusetts. The critical point on that was that Harry Reid no longer had 60 votes over in the Senate.

Prior to that, he had been pretty much impervious: I have got 60 votes. I am going to do what I want. Democrats can bust a filibuster on anything because they have got 60 votes.

After the loss of that 60th vote, H.R. 3590 could not be changed--or at least Harry Reid's assertion was that it could not be changed, and Speaker Pelosi would simply have to pass what he gave her.

Now, there was a lot of resistance here on the House to passing--even on the Democratic side--there was a lot of resistance to passing that bill that came over from the Senate because it was not a House product.

It had the Independent Payment Advisory Board in it. It didn't have a public option in it. Many of the Democratic Members were reluctant to engage on this. In fact, I think the quote from Speaker Pelosi that day was: I don't have 100 votes for this thing over on the House side.

Over the ensuing 3 months, they did convince and cajole enough of their Members to pass this by the slimmest of majorities in the early part of March of 2010, and that leads us to where we are today.

Mr. Speaker, it was the 111th Congress that passed this thing. I had 18 amendments to the Affordable Care Act that I dutifully took up to the Rules Committee when we were in the minority and said: Look, I don't like what you are doing, but let's at least keep it from being quite the problem that it is going to be.

Every one of those was rejected. I lost on a 9-4 vote. No surprise-- it is the Speaker's committee, she held the votes on the committee, but don't tell me that this was a process of anything other than what was a very flawed and partisan process.

Now, several people today have referenced the Founders and the Declaration of Independence. The reality is,

Mr. Speaker, we are a country that was founded on the principle of government with the consent of the governed.

No one was asking for this thing. No one wanted this thing. Sure, 14 percent of people in this country have been helped, so they like it. Seventeen percent have been hurt, such as myself. I lost my health savings account under the Affordable Care Act. Seventeen percent of the country doesn't like it.

Most everyone else feels as if, ``I am basically unaffected, I may have a problem ideologically either pro or con, but I have not been affected.''

Mr. Speaker, I do recommend that people pay attention. The employer mandate actually became effective January 1 of this year. It won't really affect people until next year when medium-sized businesses begin to file their taxes and find that if they have not kept up with all of the laborious reporting requirements and paperwork requirements under the employer mandate, they are going to be in a world of hurt when they file their taxes for calendar year 2015.

Mr. Speaker, today's rule provides for the consideration of a bill to repeal the Affordable Care Act, a piece of legislation that the American people have time and again said they do not want.

I thank Mr. Byrne for his legislation and for working on this matter. I urge my colleagues to support both the rule and the underlying bill.

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

Mr. Speaker, I yield myself such time as I may consume, and I rise in opposition to H.R. 596.

As the new ranking member on the Committee on Education and the Workforce, I know that protecting access to affordable health care for America's workers and families is a high priority. Despite scare tactics and misinformation, the bottom line is that the Affordable Care Act is working. Perhaps those who want to repeal the Affordable Care Act have a short memory. It is important to remember why the Affordable Care Act was passed in the first place.

Before the ACA, employer-provided coverage was shrinking. More and more employers were dropping coverage altogether. There were months in 2008 and 2009 when 14,000 people a day were losing their health insurance because employers were not providing it and because it was above their ability to pay. From 1999 to 2010, the cost of premiums for employer-provided health insurance increased by 138 percent while workers' earnings only went up around 40 percent. And those who were employed were often locked into their employment for fear of losing their health care insurance because even though they wanted to retire, they couldn't get insurance somewhere else, and so they were stuck in that job.

Every American family with insurance had to pay a hidden tax of approximately $1,000 per family for the cost of paying for those without insurance who would go to the hospital and not pay, and so when they went to the hospital, they would have to pay a little extra. That little extra was about $1,000 per year for every family with insurance. This was the reality that American workers and their families faced before the passage of the Affordable Care Act. We should not go backwards.

Today, thanks to the ACA, workers are enjoying the peace of mind that they have options. If employer-provided coverage is not available, they can enter the marketplace. If it is available, they have the security of new consumer protections such as the requirement that at least 80 percent of the premiums be spent on actual health care, not corporate jets and CEO bonuses. And we ended insurance practices such as caps on payments that would only pay so much overall and then you are on your own, or so much for your lifetime and then you are on your own. And cancelations where they could just arbitrarily cancel your insurance after you have paid premiums year after year. You get sick, and they check and just want to cancel your premium. Those abuses can no longer take place.

Employers will also suffer under a repeal. In 2014, premiums for employer-provided health care grew at the lowest rate in 15 years. If the ACA is repealed, many employers could again be charged health- related premiums, so if they have a few sick employees, they will see their premiums skyrocket. The vast majority of large employers who provide health insurance to their employees may suffer an increase in premiums due to the return of the hidden tax, the cost shifting of uncompensated care.

And when employees leave a job, they are on their own to get insurance, if they can, because there was a prohibition that they could deny people with

preexisting conditions. So if you have a preexisting condition and leave your job, who knows what is going to happen.

In addition, small employers would suffer since all small group market reforms, including rating reforms, would disappear. Small employers used to pay 18 percent more in premiums than large businesses, on average. ACA leveled the playing field so now they are paying rates like everybody else. If you repeal the Affordable Care Act, they are up another 18 percent, where it was before.

Now we have heard all of the statistics: over 3 million uninsured young adults have access to health insurance through their parents' policies; 8 million senior citizens in the so-called Medicare doughnut hole have been getting relief and have saved billions. Twelve million more Americans have health insurance because of the Affordable Care Act.

These numbers represent real people, and these real people would lose access to their benefits if the Affordable Care Act is repealed. Those trying to repeal the law should be honest to seniors about what would happen to their free preventive care in the absence of the Affordable Care Act. They should explain to young adults that repealing the law would kick them off their parents' policies. They would have to explain to millions of Americans who only have insurance because of the Affordable Care Act--many for the first time in their lives--why they will now have to go without coverage.

And while the Republican majority continues to talk about repeal, we should be talking about the progress we have already made and how we can continue to move in the right direction. So when the Republicans talk about replacement of legislation, it is important to note that there is no meaningful replacement proposal on the table. Delaying the effective date of this repeal for 180 days does not make a meaningful replacement any more plausible or likely.

This is the 56th attempt to repeal or undermine the Affordable Care Act. This is a distraction, and I hope the Republican majority will refocus efforts on real policy solutions for the American people, American families, and workers.

I reserve the balance of my time.

Mr. Speaker, I yield 3 minutes to the gentleman from Colorado (Mr. Polis).

Mr. Speaker, I enter into the Record the following letters in opposition: one from the National Committee to Preserve Social Security & Medicare, another from Easter Seals, another from the AFL-CIO, and another from the SEIU.

February 2, 2015.

House of Representatives,

Washington, DC.

Dear Representative: On behalf of the millions of members

and supporters of the National Committee to Preserve Social

Security and Medicare, I urge you to oppose H.R. 596, a bill

to repeal the Patient Protection and Affordable Care Act.

Repealing the Affordable Care Act (ACA) would be

detrimental to Americans of all ages: It would undercut the

ability of marketplace insurance plans to offer affordable

health coverage to individuals, including those with pre-

existing conditions. Repeal would mean that young adults

could no longer count on remaining on their parents'

insurance plans until age 26. In addition, the number of

uninsured ``young seniors,'' aged 50-64, would increase,

leaving them in poorer health by the time they are eligible

for Medicare--thereby increasing Medicare's costs.

Repealing the ACA would also eliminate many of that law's

provisions that benefit Medicare beneficiaries today,

including help with prescription drug costs and preventive

screenings and wellness visits with no out-of pocket costs.

In addition, the payment and delivery system reforms that are

being implemented due to the ACA are slowing the rate of

increase in health spending while improving the care that is

being provided, especially care to people with multiple

chronic conditions. Slowing the rate of increase in health

spending has also lowered costs for beneficiaries--the Part B

premium has stayed level for three years in a row--and is

extending the solvency of the Part A trust fund.

We oppose H. R. 596 because it interferes with the ability

of marketplace insurance plans to offer affordable health

coverage, and hurts millions of seniors who benefit from the

Medicare improvements contained in the ACA. The National

Committee strongly urges you to vote against this anti-senior

legislation.

Sincerely,

Max Richtman,

President and CEO.

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

Mr. Speaker, I enter into the Record letters in opposition from the following organizations: the American Academy of Family Physicians, the American Diabetes Association, and the American Public Health Association.

February 3, 2015.

House of Representatives,

Washington, DC.

Dear Representative: The House of Representatives is

scheduled to vote on HR 596, which would repeal the Patient

Protection and Affordable Care Act (ACA). The AAFP urges

Congress not to repeal this nearly 5-year-old health care

reform law, but rather focus on how the measure can be

revised to improve patient care and restrain health system

costs.

The ACA addresses several important persistent problems

with the nation's delivery of health care. First of all, it

has demonstrably improved access to health care. As the most

recent Gallup poll of the uninsured shows, the uninsured rate

in the fourth quarter of 2014 fell to 12.9 percent, which is

the lowest since Gallup began measuring it. By comparison,

17.1 percent were uninsured at the end of 2013. This

substantial decline in the uninsured rate in one year has

been broadly felt since it was evident in all the demographic

categories.

Second, the ACA establishes critical insurance reforms to

prevent abuses such as reducing or eliminating coverage due

to preexisting conditions, or setting prohibitively high

prices on the individual market based on health status.

Third, it encourages innovation in health care delivery

through extensive research performed by the CMS Innovation

Center. As recently as last week, for example, CMS announced

early results of the Comprehensive Primary Care Initiative

which demonstrate significant cost reductions in the first

year due to investments in primary care. Fourth, the ACA

requires both Medicare and private health plans to cover

preventive health services (without cost-sharing), which is a

proven long-term strategy to improve health while reducing

costs.

There are elements of the ACA that cause the AAFP concern,

including the poorly constructed Independent Payment Advisory

Board (IPAB). Congress should carefully review these elements

with an eye to improving them for patients, for physicians

and other providers, and for taxpayers, generally. The AAFP

will continue to offer you our support for such efforts.

However, in the meantime, it is important to avoid the

disruptions and turmoil that repeal of the ACA would cause.

Sincerely,

Reid B. Blackwelder, MD, FAAFP,

Board Chair.

Mr. Speaker, I yield 3 minutes to the gentleman from Connecticut (Mr. Courtney).

I yield the gentleman an additional 30 seconds.

Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman from North Carolina (Ms. Adams).

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

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

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

Mr. Speaker, well, the majority leader says we need a new system. This has been for 4 years their new system--a total blank page.

Their problem is that it is working, that health care is working. It is working for these people: 12 million uninsured Americans who got coverage; over 10 million enrolled in Medicaid and CHIP; 3 million young adults, 3 million who are now covered because of their parents' health policy.

It is working. It is working for the 129 million Americans with preexisting health conditions, so many of whom were out in the cold; for 105 million Americans who no longer have a lifetime limit or an annual limit; and for seniors who got the benefit of filling the doughnut hole.

There is some reference here to increased health care costs. It is a lie. Health care costs have been going down. It is a fib. It isn't true.

I think what bothers Republicans most of all is that it is working, and their ideology is blind to success, or they don't want to see it.

We are going to vote ``no.'' What is this, the 56th time? We have lost track of how many times we voted ``no.''

We are voting ``no'' because of the millions of people who were left out by our insurance coverage, who now have the decency of health care coverage and the protection of health care coverage.

We are proud of health care reform, so we stand up to say ``yes'' to it by voting ``no.''

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

Mr. Speaker, I yield 1\1/2\ minutes to the distinguished gentleman from New York (Mr. Rangel) who has worked on health care for how many years, Mr. Rangel?

I yield the gentleman an additional 30 seconds.

I now yield 2 minutes to the gentleman from Washington, Dr. McDermott.

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

Mr. Speaker, I now yield 2 minutes to the gentleman from New Jersey (Mr. Pascrell), another distinguished member of our committee.

I yield the gentleman 30 seconds.

It is now my pleasure to yield 2 minutes to the gentleman from New York (Mr. Crowley), a member of our committee and also the vice chair of our Caucus.

Mr. Speaker, how much time is there remaining, please?

Mr. Speaker, we may have one additional speaker who is not here yet, so I reserve the balance of my time.

Mr. Speaker, I yield 2 minutes to the gentleman from Washington (Mr. McDermott).

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

Mr. Brady, are you ready to close?

And then you will close?

I yield myself the balance of my time.

Mr. Speaker, I insert in the Record a Statement of Administration Policy.

Executive Office of the President, Office of Management

and Budget,

Washington, DC, February 2, 2015.

Statement of Administration Policy

H.R. 596--Repealing the Affordable Care Act

(Rep. Byrne, R-AL, and 48 cosponsors)

The Administration strongly opposes House passage of H.R.

596. The House has now attempted to repeal or undermine the

Affordable Care Act more than 50 times. H.R. 596 would take

away critical benefits and health care coverage from hard-

working middle class families. In addition to taking away

Americans health care security, the bill would increase the

deficit, remove policies that have helped slow health care

cost growth and improve the quality of care patients receive,

and detract from the work the Congress could be doing to

further job creation and economic growth.

The Affordable Care Act is not only working, it is hilly

integrated into an improved American health care system.

Discrimination based on pre-existing conditions is a thing of

the past. And under the Affordable Care Act, we've seen the

slowest growth in health care prices in nearly 50 years,

benefiting all Americans.

Repealing the Affordable Care Act would mean that Health

Insurance Marketplaces where millions of Americans now

compare private insurance plans and get tax credits to

purchase them would shut down. Tax credits for small business

owners who cover their employees would be taken away. States

would lose substantial Federal assistance under Medicaid to

provide coverage for the neediest Americans. According to the

most recent projections by the Congressional Budget Office

(CBO), 27 million Americans are expected to gain coverage due

to the law. Repeal will likely result in most of these

individuals remaining uninsured or losing their insurance

altogether. An estimated 10 million Americans gained coverage

during 2014, and repealing the law would erase most of these

coverage gains and strip these Americans of the security and

peace of mind they now have.

Further, repealing the health care law would have

implications far beyond Americans who have or will gain

insurance.

More than 250 million Americans with insurance private

insurance, Medicare, and Medicaid would lose the benefits and

protections they receive under the health care law. Insurance

companies would no longer have to cover as dependents

millions of young adults who have been able to stay on or

sign up on their parents' plans. Lifetime limits and

restrictive annual limits on coverage could be reimposed.

Women could be charged more than men and up to 129 million

Americans with pre-existing conditions would be at risk of

not being able to access or afford health coverage. Policies

that promote efficiency and accountability in health care and

health insurance would be erased.

Reforms that strengthen Medicare's long-term finances also

would be repealed. Seniors also would lose the more generous

prescription drug coverage provided under the health care

law, as well as free preventive care, and Medicare's Hospital

Insurance Trust Fund would become insolvent years earlier.

Moreover, by repealing these reforms to Medicare and other

reforms that encourage doctors and hospitals to provide

efficient, high-quality care, the legislation would drive up

costs and worsen patient care throughout our health care

system.

CBO has previously estimated that repealing the health care

law would add more than $100 billion to the deficit over the

ten years ending in 2022, and more than $1 trillion in the

following decade. This not only hurts the Government: it

hurts State and local economies, job creation, and the

Nation's long-term prosperity.

The last thing the Congress should do is refight old

political battles and take a massive step backward by

repealing basic protections that provide security for the

middle class. Right now, the Congress needs to work together

to focus on the economy, helping middle-class families, and

creating jobs.

If the President were presented with H.R. 596, he would

veto it.

Mr. Speaker, this came from the President. The President said, when he ran for office, ``Yes, we can.'' He came here and eventually secured a majority to pass a bill to rectify 75 years of inaction, 75 years for Americans without health care by the millions, and so we did it.

Mr. Speaker, the Republicans have said, ``We will,'' but they never have. We have never seen a bill that addressed this issue comprehensively. Now, they are on the run because millions and millions of people have now benefited for a variety of reasons who never had a single hour of health care for themselves or their children. Now, the Republicans say, ``We will come up with something.'' It is too late.

Health care reform is here to stay. We can improve it, but Republicans will never destroy it. The American people know it is complex, but they know their health needs. We responded. We responded.

That should be and is respected, not the disrespect of coming here 56 times

to say ``no'' when they have never come up with anything.

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

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

Mr. Speaker, I rise today in support of H.R. 596, legislation to repeal the President's controversial and expensive health care law, a law that put 159 Federal agencies, commissions, and bureaucracies in between you and your physician.

Mr. Speaker, today the House of Representatives again acts to repeal the costly mistake known as the Affordable Care Act. In the years since the law's passage, too many Americans have discovered the reality behind the President's promises.

Americans lost plans that they liked and wanted to keep. They saw their premiums soar, and their deductibles, and they discovered their family doctor was suddenly out of network and unaffordable.

They saw their hours reduced at work, and hiring slowed as a result of the law's $1 trillion in new taxes. They realized that, under the law, more work doesn't necessarily mean more pay.

They saw their tax dollars risked on insurance organizations that are now failing. They tried, frustratingly, to navigate the complicated health care site to get help buying what turned out to be more costly coverage. And soon, millions of unsuspecting Americans may learn that errors beyond their control could leave them on the hook to the IRS.

Today's action is not simply opposing the Affordable Care Act. It is about standing up for our families, patients, small businesses, and local health care providers who have been hurt by this law.

The American people deserve better than this. We need to start over, and that begins with the full repeal of the President's health care law.

But we can't just stop there. We also have to continue to advance our own patient-centered solutions to the problems in health care, solutions that actually lower the cost of health care; to make our current system more fair; to

protect the most vulnerable; and put our crucial safety net programs on a path to sustainability for the long term.

I am pleased, Mr. Speaker, that this bill will allow us another opportunity to put forward these ideas, and I encourage my colleagues to support this bill.

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

Mr. Speaker, I am pleased to yield 1 minute to the gentlewoman from Tennessee (Mrs. Black), one of the health care leaders on the Ways and Means Committee.

Mr. Speaker, I am pleased to yield 1 minute to the gentleman from Minnesota (Mr. Emmer), one of the new Members of the House of Representatives.

Mr. Speaker, I am pleased to yield 1 minute to the gentlewoman from California (Mrs. Walters), a businesswoman and former State legislator who understands the harm of the Affordable Care Act.

Mr. Speaker, I am proud to yield 1 minute to the gentleman from North Carolina (Mr. Rouzer), a new Member of Congress and a former State legislator who helped lead the fight against the damage caused by the Affordable Care Act.

Mr. Speaker, I am pleased to yield 1 minute to the gentleman from Missouri (Mr. Smith), a new member of the Ways and Means Committee, who has quickly become a leader on health care issues.

Mr. Speaker, I yield the gentleman an additional 30 seconds.

Mr. Speaker, I am pleased to yield 1 minute to the gentleman from Pennsylvania (Mr. Kelly), a businessowner who has provided health care to his workers and is a leader on the Ways and Means Committee.

Mr. Speaker, I am pleased to yield 1 minute to the gentleman from North Carolina (Mr. Pittenger), a small business person and a dynamic Member of our House of Representatives.

Mr. Speaker, I am pleased to yield 1 minute to the gentleman from Florida (Mr. Yoho), a veterinarian involved deeply in health care issues.

Mr. Speaker, I yield myself 1 minute.

Mr. Speaker, we have heard a lot about 56, 56 times we have voted to repeal or defund this bill, but think about the hundreds of times this White House and our Democrat colleagues have tried to force tax increases on families and small businesses.

How many hundreds of times have they tried to force global warming mandates that only drive up energy costs? How many hundreds of times did they force red tape down our local businesses so that they can't possibly survive? How many millions of people have been forced into the health care plans they don't want and forced into higher monthly premiums, higher deductibles, and they can't see their doctor or their hospital or their provider?

Mr. Speaker, these numbers matter. We can do better.

Mr. Speaker, we are ready to close, so if the ranking member would like to proceed, I would reserve the balance of my time.

Mr. Speaker, how much time do we have remaining?

Mr. Speaker, I am pleased to yield 1 minute to the gentleman from Virginia (Mr. Brat) to speak about health care and the Affordable Care Act.

In a moment, sir, yes, sir. So if you would like to close, we will follow.

Yes, sir.

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

Frightened--in the days before this health care law was brought to the floor, Democrats were meeting in the White House in secret, cutting special deals, trying to find a way to pass this bill because they were frightened that if they did it in the public, out where the people could see what they were creating, that they would fail.

The night they brought it to the House floor, they were frightened that the American public would know what was in it. They brought it to the floor, and literally no one on this floor knew what was in this bill. They were frightened about what the American public would believe.

Since it has passed, frankly, too many Americans are frightened by what they have been exposed to, which is forced into health care plans. They had good ones in their business, and now, they are forced into ones that cost more, the deductibles have soared, and they can't see their local doctor or go to their local hospital or even pay for medicines for their children because of this health care plan.

Democrats at the time didn't allow a vote on any other alternative-- no ideas, no options--because they were frightened the American public could see there is a better way.

The question today, Mr. Speaker, is: Can we do better? Can we do better than this law? Yes. It has helped some but has hurt so many more.

Today is about taking the first step to allowing a better option for American families, providers, and patients by first repealing this controversial and troubling law and then bringing to the floor-- directing our committees to bring a better idea to the floor so that the American public has a chance for real, affordable health care that is directed toward them--not Washington--that goes with them from job to job and State to State, home to raise a family or to start that small business, one that is tailored to them, not Washington.

Mr. Speaker, this law is about not top down, but bottom up; and it is long overdue. I support and strongly urge repeal of the health care law and passage of this bill.

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