Competitive Health Insurance Reform Act of 2017

Mr. Speaker, I yield myself such time as I may consume, and I thank the gentleman from Georgia (Mr. Collins) for yielding me the customary 30 minutes.

Mr. Speaker, I rise in opposition to this rule today, one that provides for consideration of H.R. 372, the Competitive Health Insurance Reform Act of 2017, a good bill that I support.

Mr. Speaker, the Competitive Health Insurance Reform Act amends the McCarran-Ferguson Act so that the health insurance companies would no longer be exempt from Federal antitrust regulation.

Currently, unfortunately, most types of insurance, including property or life insurance, are exempt from Federal antitrust regulations and statutes. The McCarran-Ferguson Act makes it clear that the insurance industry heretofore has been regulated only by States. Additionally, the Department of Justice and the Federal Trade Commission have retained authority for antitrust enforcement involving mergers and acquisitions of insurance companies, but not dominations of markets and competition.

As a result of this exemption, the health insurance industry does not

have to share pricing information, and actually can currently communicate with one another to fix prices. Now, that doesn't make sense.

I firmly believe that the more transparency in our healthcare system, the better off consumers will be. Repealing the health insurance exemption of the McCarran-Ferguson Act may improve competition, but it would almost also result in more transparency in health insurance. It is something that we sorely need. So I intend to join many of my colleagues on both sides of the aisle in supporting the underlying bill because it increases transparency.

The reality is that this bill does nothing to replace the protections of the Affordable Care Act. It doesn't even make a dent in addressing the many problems created by the Republican healthcare legislation, the American Health Care Act.

Mr. Speaker, so I don't want anybody listening to this to be distracted by a bipartisan bill that we hope becomes law. In any way, shape, or form, this bill does nothing when, in 2 days, we are considering a bill that threatens the health care for 24 million Americans, increases prices for Americans who are currently insured by 15 to 20 percent, and throws millions off of the rolls of the insured.

The Republican healthcare bill that is coming to the floor Thursday will cause a huge disruption in coverage for millions of Americans. It creates an entirely new entitlement program. It would throw 24 million people who currently have insurance out of insurance. And for anybody who still has insurance, their rates go up 15 to 20 percent.

How is that a good idea? It is not.

This bill today does nothing. Nothing. I don't even think the advocates of it would say it does anything to address those increases in costs for consumers or 24 million people losing their health care or the creation of a brand-new costly entitlement program in a time of record deficits.

For constituents--and we all represent people from our districts--for people like Greg and Nikita, Coloradoans who have shared their stories with me, the passage of the American Health Care Act, the Republican healthcare bill, would devastate their lives.

Greg was diagnosed with a rare form of cancer in 2014, in his midforties. After several surgeries, his doctors told him his condition is inoperable and could only be treated chronically by medication. It is a very expensive injection that has so far been successful, thank goodness, at keeping the tumor from growing and allowing Greg to live an ordinary life.

Now, Greg needs this shot every 3 weeks. It is thousands of dollars each time. And despite working at least two jobs, it is not something that Greg could afford to have--Greg would not have health care without the Affordable Care Act. He would have to quit his jobs and become destitute and go on Medicaid.

The Republicans are basically saying to people like Greg: We want you to be lazy. We want you to quit your job so you could have health care. We want you to live off the government dole of this brand-new entitlement program that we created to hand you money rather than work for yourself and pay for your own insurance.

That is the message the Republicans are sending to people like Greg across the country.

Nikita lives in Boulder and has spent much of her life battling endometriosis. In 2014, she was having trouble walking because of her condition and she missed work for a few weeks. After the passage of the Affordable Care Act, she was able to afford the surgery that she needed to improve her mobility and manage her pain.

In her message to me, Nikita emphasized that affordable health care is what allows her to work and to be a citizen that pays taxes and contributes to society rather than somebody who is shut in at home, living off the government dole like Republicans are trying to force her to do with the new entitlement program that they are creating.

If Nikita didn't have the healthcare coverage she obtained through the Accordable Care Act, she said that she would be on disability and Medicaid, costing the government far more money and preventing her the dignity of holding a job and working to support herself and paying taxes.

Both Greg and Nikita expressed fear that the benefits they receive under the Affordable Care Act would disappear if the Affordable Care Act is dismantled in favor of this new Republican entitlement program that encourages people not to work. The American Health Care Act threatens to pull the rug out from so many of my constituents and millions across the country while simultaneously raising rates by 15 to 20 percent for people who are currently insured and paying for their own insurance.

Look, H.R. 372 is a fine bill. Republicans are using it as a talking point, claiming that somehow it addresses costs in some meaningful way. And given how complicated the healthcare system is and the critical role that we all have to play in it and every little piece plays, it is important to lay out the facts of the Republican plan, which H.R. 372 does nothing to address.

It is a fact fewer people will be covered under the Republican plan. The Congressional Budget Office says 24 million people will lose their healthcare coverage over the next decade.

It is a fact that middle-aged Americans will pay five times more in premiums. The age tax is a big part of the Republican healthcare bill. Americans ages 55 to 64 will see their cost increase by over $8,000. Most of my constituents in that age group simply can't afford that every year.

It is a fact that those currently enrolled in Medicaid programs are at risk of losing their coverage. The Republicans' concern that Medicaid expansion to the Affordable Care Act was coercive, they should be equally concerned about the per capita cap in the Republican plan. It is the flip side of the same coin.

Those are just some of the many troubling facts about the Republican healthcare bill.

H.R. 372, removing the antitrust exemption, is a fine bill. It does nothing to address any of those problems or change any of those facts and figures that I cited as to why this bill doesn't fix health care.

In fact, frankly, this bill is a distraction from the real topic we should be discussing--how to improve health care in this country. I don't think we should improve it by giving tax cuts to millionaires and billionaires, forcing people like Greg and Nikita not to work and to be destitute in order to get health care and go on the government dole, creating a brand-new entitlement program that States administer, increasing the costs of insurance for people who are already insured by 15 to 20 percent.

Mr. Speaker, if those are the answers, what is the question? Is it how to make health care cost more and how to have less people covered?

If that is the question, the Republican bill is a good answer.

That is not the question my constituents are asking me, and I don't think it is a question their constituents are asking my Republican colleagues.

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

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

Two weeks ago, the Republicans pushed ahead with their healthcare bill, despite not knowing the impact of the legislation. A week later, the nonpartisan Congressional Budget Office announced that the bill would take health insurance away from 24 million people and increase costs by 15 to 20 percent for those who currently have insurance.

Mr. Speaker, late last night the Republicans introduced a major manager's amendment that changes the bill, frankly.

Mr. Speaker, just as it was irresponsible to move forward without knowing the full effects of the original bill, it is completely reckless to even know whether this manager's amendment makes it better or worse and the impact that it has on health care for American families. It is reckless to consider and vote on their amended bill before the Congressional Budget Office even says how much it costs, or how much it will increase insurance by, or whether it throws people off insurance rolls.

Mr. Speaker, if we defeat the previous question, I will offer an amendment to the rule that would require a CBO cost estimate that analyzes the impact of any legislation amending or repealing the Affordable Care Act, as well as the impact of any manager's amendment to that legislation to be made publicly available before the bill may be considered on the House floor.

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

Mr. Speaker, I am proud to yield 4 minutes to the distinguished gentleman from Kentucky (Mr. Yarmuth), the ranking member on the Committee on the Budget, to discuss our proposal.

I yield an additional 1 minute to the gentleman.

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

Mr. Speaker, I am awaiting the graphic presentation about some of what is at stake in this debate about the Affordable Care Act, the fundamental debate about whether we try to fix health care in this country, make insurance cost less, or whether we move backwards under this Republican healthcare proposal.

The Republican healthcare proposal would create an entirely new entitlement program administered by the States. In creating this program, it would throw 24 million people who have healthcare insurance today off of the insurance rolls. They would become uninsured Americans.

It would add an age tax on older Americans. It would also increase the cost of health care for people who have health care today and pay for it, by 15 to 20 percent. Now, they wouldn't be getting more for that 15 to 20 percent.

Mr. Speaker, if you can believe it, they would actually be getting less insurance for that 15 to 20 percent because many of the requirements that insurance has to have are rolled back, the Federal protections under this Republican healthcare bill.

Somehow, at the same time it does all these things, the same time it costs 24 million Americans their insurance, the same time it increases rates by 15 to 20 percent--and, by the way, these figures are from the nonpartisan Congressional Budget Office, the head of which was appointed by Republicans.

These are solid predictions that are done by people who were appointed by Republicans. We are not citing any outside group or naysayers who don't like the bill. These are the objective Congressional Budget Office numbers that we are citing here in their entirety.

So, in addition to costing people 15 to 20 percent more, this bill also, for reasons unknown, gives an enormous multibillion-dollar tax break to millionaires and billionaires in New York and California. That is where most of them live. Now, there are a few in other places, of course, too.

But it is just unclear why, at the same time Republicans are trying to change the healthcare law, they want to go back to giving enormous tax cuts to the wealthiest Americans. We are not even talking the wealthiest 1 percent. We are talking, like, one-tenth of a percent who are going to see the bulk of the benefit from these tax cuts, at the same time that health care is being taken away from 24 million people who have insurance today, and at the same time those who are fortunate enough to be able to continue to have it will have to pay 15 to 20 percent more.

That is why, Mr. Speaker, this bill is so unpopular. If you are going to go through the trouble of creating an entirely new entitlement program, at least do it in a way where it actually helps people afford coverage versus hurts their ability to afford coverage.

Now, I gave the example in my remarks of Greg, and that is far from unique because people today, who rely on the subsidies to be able to get health insurance within the Affordable Care Act, if the Republican bill passes, would have to quit their jobs and rely on Medicaid instead, or they would have to take a lower-wage job. Instead of earning $40,000 or $50,000 a year, they would have to quit that job and try to take a minimum-wage job so they could qualify for Medicaid.

Essentially, this Republican healthcare bill is telling Americans, you need to be lazy and not work if you want health care because, if you want to work a job, we are going to take it away. We are only going to provide it if you quit your job or take a minimum-wage job under Medicaid.

So that is not the message or the incentives that we want to send to the American people. One of the great aspects of the Affordable Care Act is it actually, for the first time, provided an incentive for people to get increases in their wages, to get better jobs, to work additional hours.

Before the Affordable Care Act, we were locked into a scenario where people who were on Medicaid lost their Medicaid benefits if they got a raise at work, depending on the size of their family. It could have been a raise from, let's say, $14 an hour to $16 an hour. They couldn't work overtime. They couldn't work a second job, as so many people do to escape from poverty because they would lose their health care.

The Affordable Care Act said: You know what? We are going to allow you and encourage you to work that second job, to get a raise and support your health care as you make your way out of poverty into the middle class. What a great idea.

The Republican proposal creates a brand new entitlement program, but rolls back those affordability protections that help people work their way out of poverty, and leaves no alternative for people like Nikita and Greg, other than you have to quit your job or work a minimum-wage job because, otherwise, we are going to take your health care away from you.

That is the reason that the projections came back--no surprise--that 24 million people will lose their healthcare insurance. It is the reason that healthcare insurance rates will increase 15 to 20 percent.

We don't know the reason that they are also giving a tax cut to billionaires in the same bill. We know they want to do that, but they should do that in a tax bill. There is an effort at tax reform. I think they are talking about giving an additional tax cut to billionaires in that bill. That will be debated separately. But it is unclear how--or it is more than unclear as to why it would help make health care more affordable to give a tax cut to billionaires. It just doesn't make any sense. Let's debate that under a different bill.

I am happy to do that. As part of a broader tax proposal, we will see what else is in it. We know Republicans want to do that, but they shouldn't do that under the guise of health care.

So, again, Mr. Speaker, what you have here in this Republican bill, which this current bill does nothing to change--and this bill will pass, it has passed before, and we hope the Senate acts on it to remove the antitrust exemption. This bill does nothing to change the facts on the ground that the Republican healthcare bill that creates a brand new entitlement program would make Americans pay more for less, 24 million people would lose their insurance, there is an age tax on older Americans, guts Medicaid, huge tax cuts for millionaires and billionaires, increases of 15 to 20 percent for Americans who are lucky enough to retain their insurance, and discourages work and encourages people to be lazy at home to get health care.

It is the opposite of what we want to do. It is contrary to the American work ethic, and it is contrary to all incentives around cost containment. I hope--I really hope, Mr. Speaker--that the House defeats this awful bill to replace the Affordable Care Act, even as we pass some of these commonsense bipartisan measures like the one before us today that, around the edges, could potentially affect antitrust within insurance companies.

Mr. Speaker, the bill under consideration today is a commonsense piece of legislation. It has passed the House before. Ultimately, however, it distracts from the elephant in the room. The American Health Care Act is the Republican bill to roll back and change the Affordable Care Act and create a brand new entitlement program while increasing the insurance rates for American families, providing tax cuts to billionaires, and throwing 24 million people off of the insurance rolls.

My colleagues across the aisle had 7 years to work with us to improve the Affordable Care Act, but they refused to work with us to make health care more affordable and to expand coverage. Instead, they have drafted a bill that does the exact opposite. No wonder we were unable to find common ground when our goals were different.

The goals of myself and Democrats have always been to reduce costs and expand coverage. Reading into what the Republican goals must be if this bill meets them, it seems like they are working to decrease coverage and increase costs--the opposite of what we are working for.

How will my colleagues look into the eyes of a former veteran or a small-business owner or a middle class family or my constituents like Greg or Nikita and somehow tell them that they would be better off under a plan that forces them to quit their jobs and become destitute? How will Republicans defend the vote to senior citizens when the age tax in this bill will force most seniors to pay premiums five times higher than what others pay for healthcare coverage? What will my colleagues say to 24 million people who lose healthcare coverage entirely under this bill?

The Republican healthcare bill that this body will consider on Thursday will do extraordinary damage to the healthcare system and leave millions of Americans guessing as to how much healthcare costs will cost and what will be covered. The American healthcare bill threatens to roll back important protections in coverage gains delivered by the ACA, and discussion of anything else at this point is a diversionary tactic, plain and simple.

Mr. Speaker, let's defeat the previous question and figure out how much this mysterious manager's amendment even changes the bill for better or worse. My colleague, Mr. Yarmuth, made a very compelling argument about how we need to know the actual costs and benefits of any bill we vote on; yet, this body is being forced to vote blind on a manager's amendment that we saw for the first time today and could even change by tomorrow, and we won't even know how it affects the costs of this bill or how it affects the lives of Americans who have health care today or aspire to it.

Mr. Speaker, I encourage my colleagues to defeat the previous question and vote ``no'' on the rule, to vote ``yes'' on this commonsense bill to modify our antitrust statutes which Democrats and Republicans have supported overwhelmingly in the past, but never, not once, to take our eye away from the ball of trying to decrease costs rather than increase costs and trying to expand coverage rather than retract coverage.

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

Mr. Speaker, I demand a recorded vote.

Mr. Speaker, I rise for the purpose of inquiring of the majority leader the schedule for the week to come, and it is my pleasure to yield to the gentleman from California (Mr. McCarthy), the majority leader.

Mr. Speaker, I must hasten to add that the gentleman from California added a little comment that ``it is known.'' I don't share that view, Mr. Speaker, that it is known that the Affordable Care Act is failing.

In fact, we had a hearing yesterday when the former Director of the Congressional Budget Office appointed by Democrats testified on the Affordable Care Act and testified on the American Health Care Act. Lo and behold, Mr. Speaker, Mr. Elmendorf agreed with the present CBO Director. In other words--and everybody in America ought to be pleased on this because they all are asking for bipartisan--the former Director appointed by Democrats of the CBO agrees with the Republican Director of the CBO, who just came down with his advice and counsel to the Congress just a few days ago.

That ought to give pause to those who are pressing to pass a bill, which would result in the loss by 24 million Americans of their insurance and would result in the increased costs to almost every American of their insurance.

Now, yes, there are some Americans who would choose not to have health care. Then they would get sick or they would get in an automobile accident or something else would happen where they would require medical care, and they would not be able to pay for it. Guess what? We would all pay for it.

That is what was happening before the Affordable Care Act. It is still happening with some who choose either to pay their contribution toward health--some people call it a penalty; I call it a contribution--to meet their personal responsibility, as the Heritage Foundation suggested, of having provisions that, if they get sick, they will be able to pay for it.

Now, last week, Mr. Speaker, the majority leader had some quotes from people who did not like the Affordable Care Act. At this hearing that we had, we had a number of people, and I want to quote some of them:

I certainly never imagined I would have a child who would

rely so much on a government program like Medicaid.

This child, Mr. Speaker, suffers from Rett syndrome, which is a neurology disorder that strikes mostly young girls with normal development for the first 18 or 24 months of their life. Then their development is arrested and, in fact, in some respects, there is a retreat in their abilities.

She went on to say:

Medicaid provides skilled nursing care, which allows us to

raise our daughter, Caroline, in our home instead of a

hospital or institution.

Of course, a hospital or institution would be far more expensive, Mr. Speaker.

She went on to say:

This allows my husband and me to hold jobs and take care of

other family needs. The House Republican plan for Medicaid

would put my daughter's life at risk, and my family is

terrified.

That was Marta Conner, mother of a child with Rett syndrome covered under Medicaid.

I titled yesterday's hearing: The hearing that the Republicans refused to have on the American Health Care Act or the Affordable Care Act itself.

This quote is by a doctor:

In public debate in Congress, the actual people can be

obscured by graphs and numbers. But, ladies and gentlemen,

every day in clinic, I am one-on-one with the real people,

real Americans who could take steps closer to health or

suffer more with this Congress' decision. I urge you and your

colleagues to reject the American Health Care Act and,

instead, strengthen the Affordable Care Act.

To that extent, Mr. Speaker, as the majority leader knows, that testimony joined hundreds in the medical field: The American Medical Association, associations of physicians with particular skill sets, of hospitals, of insurance companies, of patients, of providers, of urban hospitals, suburban hospitals, rural hospitals, and literally hundreds of people intimately involved in the healthcare system who are urging us not to pass the American Health Care Act and to leave in place but improve the Affordable Care Act.

Mr. Speaker, I have indicated to many on this side of the aisle that we are prepared to work to improve any piece of legislation that has been passed and particularly a piece of legislation which affects so many Americans. Unfortunately, we have not had that opportunity since this bill, the Affordable Care Act, was first considered and passed.

This week, the Congressional Budget Office released their estimate and impacts of the House Republicans' bill to repeal the Affordable Care Act.

Mr. Speaker, as the majority leader knows, President Trump, in this body and at that rostrum, promised insurance for everybody that is much less expensive and much better. He has not offered such a bill. The American Health Care Act certainly does not provide that.

In fact, the CBO--both Republican and Democratic directors--opined at least 24 million people will lose their insurance and, by 2026, there will be 58 million people in America without health insurance.

Mr. Speaker, the majority leader has indicated this bill will be on the floor next week. I hope that everybody takes the opportunity to read the CBO report and the testimony given in yesterday's hearing on the bill. It was the first and only hearing that was held on the bill that will be on the floor. Previous hearings on the Affordable Care Act are not good, and previous hearings that there are alternatives out there don't deal with the bill that is going to be on the floor next Wednesday or Thursday.

Senator Susan Collins has said of the bill that is going to be on the floor:

It should prompt the House to slow down and reconsider

certain provisions of the bill.

She was referring, of course, to the CBO report.

Senator Bill Cassidy from that liberal leftwing bastion of Louisiana said:

Can't sugarcoat it. Doesn't look good. The CBO score was,

shall we say, an eyepopper. I also hope it was a thought

provoker.

And Senator Rob Portman, who served in this body for many years, said:

I am concerned about the Medicaid population. That is the

biggest part of coverage for Ohio.

That is why their Governor, a Republican, and Rob Portman, a Republican who served on the Ways and Means Committee, is urging caution and has great reservations about the bill that has been announced to come to the floor.

Mr. Speaker, I would like to ask the majority leader whether or not he can confirm whether changes will be made to the repeal bill, that is the American Health Care Act, that was reported out of the Budget Committee, whether he can confirm whether or not the repeal bill will be changed before it comes to the floor.

Mr. Speaker, I yield to my friend.

Reclaiming my time, just to clarify, Mr. Speaker, that the bill to which he is referring is not the bill to which I was referring. I was referring to the Affordable Care Act and improvement of the Affordable Care Act.

He is now referring to the American Health Care Act which, we think, bears no resemblance to the Affordable Care Act.

Of course, with the Affordable Care Act. We think the bill that has been, as I said, Mr. Speaker, offered will devastate many individuals, millions and millions and millions of people in this country. We have said that pretty clearly.

But more importantly, the CBO Director, appointed by Republicans, said that in his report, which was, by the way, Mr. Speaker, given after, after it was considered in either one of the

committees, either the Energy and Commerce Committee or the Ways and Means Committee.

They did not wait for the CBO report. My opinion, Mr. Speaker, they did not wait for the CBO report because they knew how devastatingly negative the CBO report would be to the legislation they were considering.

Mr. Speaker, I yield to my friend.

I certainly will do that.

Mr. Speaker, I thank the gentleman for his information. People, I am sure, listening to this colloquy must get confused because they hear one representation from somebody who sounds pretty reasonable, my friend, Mr. McCarthy, and then they hear exactly the opposite from me. So they will have to make a judgment.

The bill that is going to be on this floor next week was introduced a week ago Monday. It was marked up less than 42 hours later.

My friend, the majority leader, Mr. Speaker, said: I love to listen to constituents. Not a single constituent on his side of the aisle or my side of the aisle, Mr. Speaker, had the opportunity to testify on this bill. Not a single one of my constituents, or the majority leader's constituents, had the opportunity to know what the CBO said was going to happen; that 24 million people

would lose their insurance, 14 million next year; that Medicare would be put at risk; and Medicaid would be gutted by 2021. Not a single constituent was listened to because they had no opportunity to come and say: this is what I think.

The testimony to which I referred was yesterday. I don't know the dates on the letters that the gentleman just read, but perhaps they were just within the last few days.

But I will tell that 63-year-old woman that what this bill does, if you got a 60 percent increase, will up that by 66 percent because you are going to go from a 3-to-1 ratio to a 5-to-1 ratio on which seniors, and 63 years of age, regrettably, from my standpoint, are referred to as seniors. The bill that is going to be considered will allow the insurance company to do a 5-to-1 ratio, rather than a 3-to-1 ratio, so that 60 percent is going to go up by 40, maybe get to 100 percent.

Mr. Speaker, the American people know about transparency. That means they can see something.

The gentleman says: Well, now it is online. Yes, they had 40 hours, give or take, to see this bill from Monday night to Wednesday, when it was marked up, and it was marked up and passed in the Ways and Means Committee in the dead of night, sort of like they passed the prescription drug bill, at 5:59 in the morning. The majority leader wasn't here. I was here. Perhaps there is a predilection to middle of the night. By the time the Energy and Commerce Committee passed it, they had been in session for over 24 hours and were bleary-eyed.

As I told him last week, Mr. Speaker, my folks were not up at 4 a.m. watching the Energy and Commerce Committee. And I would tell him further that--he said the bill was now online and people had an opportunity to read it. Perhaps, Mr. Majority Leader, Mr. Speaker, that is why the Affordable Care Act has now got more support from the country than it has had at any time since its existence; where there are 49 percent of Americans who now like the Affordable Care Act. Perhaps the reason that is happening now is because they have had the opportunity to see the alternative that the Republicans have offered and are offering on Wednesday.

This bill that they offered is going to significantly raise--I will tell Colleen--her out-of-pocket expenses.

And, yes, under their bill, the CBO says that perhaps the premiums will go down. Why will the premiums go down? Why does insurance go up and down? Because the risk goes up and down; and the greater the risk, the more the cost. But if you don't allow people who are sick people to get into the system because they can't afford it, then the risk goes down. When the risk goes down and you shut people out of the system and 24 million people are out of the system, yes, of course, the rates go down because you are insuring the healthy.

Now, Americans know that very well because they know they have automobile insurance--which, by the way, they are mandated to have in almost every State, if not every State. Why are they mandated to have it? So the rest of us are protected when we have an accident or we are protected from our rates going up because there is not a broad spectrum of the insured so that the risk can be minimal for the insurance company.

So I say to my friend that CBO has told the truth. The Americans are seeing that, and they don't like that. I would urge those on the other side of the aisle to be very careful when they vote either Wednesday or Thursday on this bill because this bill is going to have a very detrimental effect on the American people.

Now, I understand there are going to be two other bills. There are going to be four bills on the floor, as I understand it. Can the gentleman inform us of when we will see the details of this additional legislation?

I yield to the gentleman.

The third bill and the fourth bill.

Are they available now to be reviewed prior to them coming up later in the month?

I yield to the gentleman.

Lastly--and I know you are glad to hear that comment, as are the folks waiting to do 1-minutes--we have received a letter from Secretary Mnuchin on March 8. It was directed to the Speaker, Mr. Leader, and like most Secretaries of the Treasury, he is hoping that we will pursue financially responsible and confidence-building policies.

I won't read the whole letter, but he says in the last paragraph: ``As I said in my confirmation hearing, honoring the full faith and credit of our outstanding debt is a critical commitment. I encourage Congress to raise the debt limit at the first opportunity so that we can proceed with our joint priorities.''

Mr. Speaker, I ask the majority leader whether that is going to be scheduled in the near term because, on March 15, we met the debt-limit extension. This administration and every previous administration have taken steps to prolong the time before we default by using extra mechanisms so that we are, in effect, not investing in the retirement system or something else and paying our debts.

I have indicated publicly, Mr. Speaker, and I reiterate here, that I will urge my side to support a debt-limit extension if it is clean. What I mean by ``clean,'' if it does not incorporate something that is not agreed to and there is not a consensus on. By that I mean, simply, if there are things that we have a consensus on that need to be passed, certainly including those in the debt-limit extension would not be objectionable. But if there are items in that bill designed to force us to vote for what is a responsible policy but takes something that we obviously very strongly disagree with, we will not do so.

So my questions to the majority leader are: A, can we expect a clean debt-limit extension? B, can we expect that in the near term, as Secretary Mnuchin requests, so that we can put that matter behind us and not undermine confidence in our fiscal posture as a nation?

I yield to my friend.

It will probably be my last question. I have an additional observation.

Mr. Speaker, I ask that the gentleman's words be taken down. I have never had such a vicious attack made on me.

But I must admit I was deeply disappointed last night. My congratulations to the young men at Xavier and their coach, but my, my, my, I was disappointed in the quality of our play. We have got a great group of young people playing, but it was not their night.

I am sure that I will pick another team sometime as the March Madness continues. What I would hope, though, is we would not have March Madness on this floor next week.

Mr. Speaker, I yield to the gentleman.

I guess the answer to that question, Mr. Speaker, is what will determine an upset. Will the American people be upset? Will the Republicans be upset? The answer to that question remains in the hands of our Republican colleagues, because what I want to do in observation, I disagree with all three of the propositions that the majority leader said in his closing statement.

This is not going to reduce the budget. Yes, on its face, they give a $600 billion tax cut to the wealthiest in America. Where do they take it from? Medicaid, some of the poorest people in America. That is where that money comes from.

Premiums are going to go up. Deductibles are going to go up. You can quote me on this 2, 3 years from now. I don't think your bill is going to pass. But if it did pass, that is what would happen. You won't be able to test me because I don't think the bill is going to pass. It may pass this floor, but it will not become law.

The majority leader's statement, Mr. Speaker, that that is what the American people are expecting, I disagree with that. What the President of the United States said he was going to give to the American people is insurance for everybody. The majority leader ignores the 24 million. He hasn't spoken about that. He spoke about some other observations in the CBO report, as did Speaker Ryan. I don't blame him. I would try to point to some positive indicators myself.

I think this is going to up the deficit, it is going to up costs, and it will decrease the insured and make hospitals have more uncompensated care. We will have this debate next week, Mr. Speaker.

But on the last issue, I would hope, Mr. Leader, that we do agree on fiscal responsibility. I happen to believe, as you know, the debt limit issue is a phony issue, a totally political issue. It has been used as a political issue on both sides of the aisle. There should be no question but of course the United States is going to pay its debt, of course the United States is going to pay people whom it has bought things from, and of course it is going to pay people moneys that they have been promised. Of course it is going to do that. This is not about new spending. It is about spending that we have already incurred.

I would urge the majority leader to bring a clean bill to the floor. I will work with him. We will get the overwhelming majority of Democrats to vote for that. Let's not blame one another for the debt. There is plenty of opportunity to do that, and both sides are guilty of that result.

Mr. Speaker, if the gentleman has nothing further he wants to say, I yield back the balance of my time.

Mr. Speaker, let me thank the gentleman very much for his leadership. I acknowledge the chairman of the committee for his, as well.

I thank the gentleman for yielding to me, and although I will make the points that I think are important, I wanted to take the time to thank Mr. Conyers for the thoughtful legislation that he has introduced over the years.

This leads me to call this the Conyers bill because of the important contributions it makes to ensuring that our health care is competitive, our health insurance is competitive, and his thoughtfulness in this legislation. As it comes to the floor, I am reminded of Mr. Conyers' influence on this legislation. It is an interesting time at which it comes, Mr. Speaker.

Mr. Speaker, I rise to acknowledge the importance of H.R. 372, the Competitive Health Insurance Reform Act of 2017, a proposal to remove the antitrust exemption in the McCarran-Ferguson Act as it applies to health insurance.

Overall, the proposed legislation, as well as previous attempts by the Judiciary Committee to repeal the McCarran-Ferguson Act's antitrust exemption for health insurance, does not raise new or pressing issues.

Opponents of repeal assume problems that cannot be documented, unlike the very tangible and real economic and competitive costs that will be incurred if the exemption is allowed to continue.

As the Justice Department has explained, where there is effective competition, coupled with transparency, in a consumer-friendly regulatory framework, insurers will compete against each other by offering plans with lower premiums, reducing copayments, lowering or eliminating deductibles, lowering annual out-of-pocket maximum costs, managing care, improving drug coverage, offering desirable benefits, and making their provider networks more attractive to potential members.

That sounds, of course, like the Affordable Care Act, which we will celebrate tomorrow, for that was the day it was signed. That is what health insurance should be for the American people.

This legislation is a very thoughtful legislative initiative, and I am hoping that its coming to the floor is not like trying to put lipstick on a pig. That, of course, is the latest configuration of the meaningless TrumpCare, and which the amendment that will be coming forward will, again, in essence, throw people off health insurance. It will take away all that we are intending it to do, but this legislation has reason.

Other current enforcement tools and regulatory policies already in place address competition issues at the State and Federal level to police health insurance competition. In this and numerous other ways, effective regulation can promote improved healthcare delivery and improved cost control by ensuring that all insurance companies are required to follow certain basic consumer-friendly rules of the road.

Again, wouldn't it be great to have this very thoughtful legislation with all of the points of the Affordable Care Act: it eliminates preexisting conditions, has lowered premiums and continues to lower premiums, and is lowering or eliminating deductibles. All of those were thoughtful of Mr. Conyers, and they would have been the right complement to the Affordable Care Act.

However, the additional risks of adding new regulatory uncertainty, increasing boundary-testing litigation, and distracting policymakers from more important ways to reduce healthcare costs and improve healthcare competition suggest that further caution and delay on this front is inadvisable, given present circumstances and conditions.

But let us not fool ourselves into thinking that the legislation before us is a panacea that will lead to affordable, accessible, high- quality health care for all Americans. If that worthy goal is the objective sought, the best way to achieve it is to retain and strengthen the Affordable Care Act and abandon the misguided effort of House Republicans to repeal this landmark legislation and replace it with the pay more for less act masquerading as a healthcare bill.

The Affordable Care Act works. I think we in the Judiciary Committee know it full well. We held hearings and briefings; we heard from the victims of those who did not have insurance, who had lost insurance, did not have enough insurance, or the insurance would not cover them.

I am reminded of a very emotional story of an 8-year-old girl in the office of an insurance company where her family was begging for coverage because she had leukemia; obviously, a preexisting condition. It is sad to say, but I understand that she lost her life.

The Affordable Care Act has significantly improved the availability, affordability, and quality of health care

for tens of millions of Americans, including millions who previously had no health insurance at all.

Americans are rightly frightened by Republican attempts to repeal the ACA without having in place a superior new plan that maintains comparable coverages and comparable consumer choices and protections, not throwing off 24 million Americans who will have no insurance.

It is beyond dispute that the pay more for less plan proposed by Republicans fails this test miserably. The Republican pay more for less act is a massive tax cut for the rich, paid for on the backs of America's most vulnerable: those who work and who happen to be of low income. This Robin-Hood-in-reverse bill is unprecedented and breathtaking in its audacity. No bill has ever tried to give so much to the rich while taking so much from the poor.

One number comes to mind: $880 billion taken away from Medicaid insurance covering nursing homes, patients, the blind, the disabled; again, then giving a great plus and a great refund in tax credits to the richest in America. They will be happy. It won't be health care. They have got private health insurance. But it certainly will be a big check that they get in the mail.

This pay more for less bill represents the largest transfer of wealth from the bottom 99 percent to the top 1 percent in American history. This Republic scheme gives gigantic tax cuts to the rich, and pays for it by taking insurance away from 24 million.

In addition, Republicans are giving the pharmaceutical industry a big tax repeal, worth nearly $25 billion over a decade, without demanding in return any reduction in the cost of prescription and brand-name drugs. That is very important.

To paraphrase Winston Churchill, of this bill, it can truly be said that never has so much been taken from so many to benefit so few.

The pay more for less plan destroys the Medicaid program. CBO estimates 14 million will lose Medicaid. In 2026, 52 million Americans will be uninsured.

We know that these combined policies will not help to cure some of the thoughtful deliberations that went into the underlying bill. We want more competition. We want the insurance products to be the kind of products that we can be sure provide health care.

In short, the Republican pay more get less plan represents a clear and present danger to the financial and health security of American families and to the very stability of our Nation's healthcare system.

Mr. Speaker, the healthcare marketplace is complex in how it operates and how it motivates providers, insurers, and consumers.

If I can quote the 45th President, he said: ``I didn't know how difficult this would be.'' Well, we know how difficult it can be, and was.

Mr. Speaker, Democrats held some 79-plus hearings. We had 181 witnesses-plus. We had hundreds of hours of hearings. We held thousands, I might imagine, of townhall meetings. We didn't hold one here and one there. I myself held 11 townhall meetings.

We continue to hear from not only the consumers, but the rural hospitals, the major hospitals, the senior citizens, and particularly those senior citizens on dealing with the cost of prescription drugs.

I am proud to say that we saved the dastardly Medicare part D by closing the doughnut hole, which is closed today, so that seniors under the Affordable Care Act do not fall into an abyss, a deep ocean, and have to, in essence, not take their drugs because they don't have enough money.

An effective regulatory framework is needed to shape this complex environment--and this is a word to the administration--to help safeguard consumers, help keep costs under control, and help make a full range of healthcare services. But our country's long experience shows that we cannot expect a healthcare system to run effectively on market competition alone. Markets can and do fail when proper regulation is lacking.

So the goodness of this bill has to go along with--a good example is recognizing what happens in the ACA's provision, banning insurance companies from denying coverage of preexisting disease--we had to help them along--preexisting conditions. We had to help them along. You have to help them along to be a good steward of the insurance that the American people need.

This is a key consumer protection that the free market demonstrates time and time again that it could produce and needed to do. That is where regulation and the antitrust laws come in to protect consumer choice. Let me go back and say that it could not produce on its own. It is a per se violation of antitrust laws for competing companies to agree to divide markets or to fix prices. The other sectors in the healthcare supply chain are already subject to antitrust laws, and it will be beneficial to the healthcare marketplace and to consumers if the healthcare industry joins them. That is why I said this bill is a thoughtful, important bill to dealing with the complex issues of insurance and health care.

I am sad to say that tomorrow, as we celebrate the Affordable Care Act, we will be looking toward Thursday, where we will be, in essence, debating a bill that takes 24 million people off of health insurance, period. 24 million will lose their coverage. Tax giveaways will continue again to the top 1 percent. That will be $600 billion in tax breaks to the rich and big corporations. In fact, the Republican bill gives $2.8 billion to 400 of the richest families in America.

Then to add to the downside, the Affordable Care Act was known to create more jobs. Unfortunately, this will see 2 million jobs destroyed and lost. Families will be paying more for less. Young people will be hit with a millennial penalty. And we don't know if this formula that they have still stops the 50- to 64-year-olds from paying higher premiums. Women lose comprehensive care, middle-aged Americans pay the age tax, seniors see Medicaid and Medicare weakened, preexisting conditions and disabilities may suffer, and it does not reduce the deficit as the ACA does.

My final point, if I can, we are glad to come to the floor and honor Mr. Conyers for this important bill and support H.R. 372. I believe this legislation before us does a lot more good than it does harm, but I hope that we can, in a bipartisan manner--maybe even in a nonpartisan manner--reflect on what is needed to really insure the American people and we can work with the Affordable Care Act, which has all of these positive elements, and move this country forward through competition and health care that saves lives.

Mr. Speaker, overall, the proposed legislation, as well as previous attempts by the Judiciary Committee to repeal the McCarran-Ferguson Act's antitrust exemption for health insurance, does not raise new or pressing issues.

Opponents of repeal assume problems that cannot be documented, unlike the very tangible and real economic and competitive costs that will be incurred if the exemption is allowed to continue.

As the Justice Department has explained, where there is effective competition, coupled with transparency, in a consumer-friendly regulatory framework, insurers will compete against each other by offering plans with lower premiums, reducing copayments, lowering or eliminating deductibles, lowering annual out-of-pocket maximum costs, managing care, improving drug coverage, offering desirable benefits, and making their provider networks more attractive to potential members.

Other current enforcement tools and regulatory policies already in place address competition issues at the state and federal level to police health insurance competition.

In this and numerous other ways, effective regulation can promote improved health care delivery and improved cost control, by ensuring that all insurance companies are required to follow certain basic consumer-friendly ``rules of the road.''

It might be argued that increasing the federal government's role in regulating health insurance, through expanded antitrust enforcement, would appear to conflict with proposed reforms to delegate more responsibility to state governments.

However, the additional risks of adding new regulatory uncertainty, increasing boundary-testing litigation, and distracting policymakers from more important ways to reduce health care costs and improve health care competition suggest that further caution and delay on this front is inadvisable given present circumstances and conditions.

But let us not fool ourselves into thinking that the legislation before us is a panacea that will lead to affordable, accessible, high quality health care for all Americans.

If that worthy goal is the objective sought, then the best way to achieve it is to retain and

strengthen the Affordable Care Act and abandon the misguided effort of House Republicans to repeal this landmark legislation and replace it with their Pay More For Less Act, masquerading as the American Health Care Act.

The Affordable Care Act has significantly improved the availability, affordability, and quality of health care for tens of millions of Americans, including millions who previously had no health insurance at all.

Americans are rightly frightened by Republican attempts to repeal the ACA without having in place a superior new plan that maintains comparable coverages and comparable consumer choices and protections.

It is beyond dispute that the ``Pay More For Less'' plan proposed by House Republicans fails this test miserably.

The Republican ``Pay More For Less Act'' is a massive tax cut for the wealthy, paid for on the backs of America's most vulnerable, the poor and working class households.

This ``Robin Hood in reverse'' bill is unprecedented and breathtaking in its audacity--no bill has ever tried to give so much to the rich while taking so much from the poor and working class.

This ``Pay More Get Less'' bill represents the largest transfer of wealth from the bottom 99% to the top 1% in American history.

This Republican scheme gives gigantic tax cuts to the rich, and pays for it by taking insurance away from 24 million people and raising costs for the poor and middle class.

In addition, Republicans are giving the pharmaceutical industry a big tax repeal, worth nearly $25 billion over a decade without demanding in return any reduction in the cost of prescription and brand-name drugs.

To paraphrase Winston Churchill, of this bill, it can truly be said that ``never has so much been taken from so many to benefit so few.''

The ``Pay More Get Less'' plan destroys the Medicaid program under the cover of repealing the Affordable Care Act Medicaid expansion.

CBO estimates 14 million Americans will lose Medicaid coverage by 2026 under the Republican plan.

In addition to terminating the ACA Medicaid expansion, the ``Pay More Get Less'' plan converts Medicaid to a per capita cap that is not guaranteed to keep pace with health costs starting in 2020.

The combined effect of these policies is to slash $880 billion in federal Medicaid funding over the next decade.

The cuts get deeper with each passing year, reaching 25% of Medicaid spending in 2026.

In short, the Republican ``Pay More Get Less Act'' represents a clear and present danger to the financial and health security of American families, and to the very stability of our nation's health care system overall.

Mr. Speaker, the health care marketplace is complex in how it operates and how it motivates providers, insurers, and consumers.

An effective regulatory framework is needed to shape that complex environment, to help safeguard consumers, help keep costs under control, and help make a full range of health care services available.

But our country's long experience shows that we cannot expect a health care system to run effectively on market competition alone; markets can and do fail when proper regulation is lacking.

A good example is the ACA's provision banning insurance companies from denying coverage of preexisting conditions.

This is a key consumer protection that the free market demonstrated time and again that it would not produce on its own.

And that is where regulation and the antitrust laws come in to protect consumer choice.

It is a per se violation of antitrust law for competing companies to agree to divide markets or to fix prices.

The other sectors in the health care supply chain are already subject to the antitrust laws, and it will be beneficial to the health care marketplace, and to consumers, if the health insurance industry joins them.

For these reasons, I believe the legislation before us does more good than harm and, accordingly, I urge my colleagues to join me in supporting H.R. 372.

Mr. Speaker, before I begin, I do want to wish everybody a happy St. Patrick's Day.

Mr. Speaker, on Monday, the House will meet at noon for morning hour and 2 p.m. for legislative business. Votes will be postponed until 6:30.

On Tuesday and Wednesday, the House will meet at 10 a.m. for morning hour and noon for legislative business.

On Thursday, the House will meet at 9 a.m. for legislative business. Mr. Speaker, late votes are likely in the House on Thursday, and Members are advised to adjust their schedules accordingly.

Mr. Speaker, the House will consider a number of suspensions next week, a complete list of which will be announced at close of business today.

In addition, the House will consider several critical pieces of the Republican plan to repeal and replace ObamaCare:

First, H.R. 372, the Competitive Health Insurance Reform Act, sponsored by Representative Paul Gosar, creates competition in the healthcare market by eliminating antitrust protection for insurance providers.

Next, H.R. 1101, the Small Business Health Fairness Act, sponsored by Representative Sam Johnson of Texas, allows small businesses to pool together and purchase plans, an important step toward purchasing health care across State lines.

Finally, Mr. Speaker, we will consider the FY 2017 reconciliation bill, also known as the American Health Care Act. This bill eliminates the many taxes and mandates of ObamaCare. It gives patients enhanced tools to take control of their healthcare decisions, and it expands choice so Americans are free to pick the plan that is best for themselves and their families.

Mr. Speaker, it is known that ObamaCare is failing, and we have a responsibility to provide Americans relief. These bills are the result of much deliberation and hard work, and their passage will help create a competitive marketplace that provides high-quality care at an affordable cost.

Mr. Speaker, I thank the gentleman for yielding.

And his question, based upon scheduling, and I know there were a lot of questions in there, so please let me work through and try to answer all of his questions.

The last question was in regard to the bill itself, and we are working through the process. It will be in the Rules Committee. As the legislative process works, there are always ways that you refine the bill, and I expect that there will be some elements that get refined inside the Rules Committee before it comes to the floor.

You had about five different questions there if I may follow all the way through. First, you talked about, and I was happy to hear--I wrote it down--you are glad to work to help to improve the bill--because when we were in the more than 26 hours of Energy and Commerce, the amendments the Democrats offered, we spent a couple of hours on just the one amendment about a hashtag of renaming the bill. So there is a change in attitude. I appreciate that from the other side of the aisle because we are always willing to work with you.

But you are not willing to help with it, then?

Mr. Speaker, I thank the gentleman for yielding to me, and I ask if he would let me finish through.

It seems as though the gentleman has a little short- term memory of how they brought the Affordable Care Act and the CBO report when it came before us. It was not brought before us until it came right before the floor.

But let me follow through on all your questions because my response back was, I was actually excited to hear that Democrats wanted to work with us, that their attitude has changed from when we were in committee and they had amendments going forward, that it was no longer going to be hashtag amendments, it was actually going to be productive amendments; and I thank you for having that change of attitude.

Mr. Speaker, I am proud of the transparent process we have taken in the House, and I think this needs to be reminded to all the American public.

As I mentioned last week, our healthcare bill is the result of 113 hearings. I know the gentleman on the other side of the aisle, he is proud of the 72 hearings they had before they did the Affordable Care Act.

We have now marked up this bill in three separate committees, with over 18 hours of debate in Ways and Means, and over 27 hours of debate in Energy and Commerce, and the countless amendments from both Republicans and Democrats.

By the time we vote on the floor, this bill will have been publicly available online for 3 weeks. Now, it is only 127 pages. That is a far contrast to the 2,700-plus pages, if you want to compare it to ObamaCare.

So far, nearly 590,000 people have visited our website, and over 200,000 have downloaded this legislative text.

So, Mr. Speaker, that means more people have read our healthcare bill than went to Woodstock. I call that transparency. Republicans have been committed to repealing and replacing ObamaCare for years, and so now I think it is time to act.

The gentleman also commented about the CBO. Well, I am actually excited that you had another person who confirmed what the CBO said because what the CBO says about this bill is it will lower the deficit by $337 billion.

It will also reduce premiums by 10 percent by 2026, and it will secure major entitlement reform by capping Medicaid spending, giving States certainty and flexibility, saving taxpayers $880 billion, and making the program solvent for future generations, because that was a concern in one of the letters.

Now, Mr. Speaker, those are the facts. With regard to the coverage numbers, the CBO reports that most of that increase would stem from repealing the penalties associated with individual mandates. Let me repeat that. Most of the increase would stem from repealing the penalties associated with the individual mandate.

Now, that makes sense to me, because if we no longer force Americans to buy something they do not want, one-size-fits-all health care, they will naturally choose not to buy it.

But, Mr. Speaker, I know the gentleman across the other side of the aisle argues with me about the knowledge that everybody knows ObamaCare is failing. I would ask the gentleman to visit one-third of the counties in this country that only have one option.

Or why don't you go to Tennessee, where the President just was because, you know, 16 counties in Tennessee have no option. But ObamaCare will penalize you for not having health care when you can't even buy it.

But if ObamaCare was working so well, why do more people accept the penalty or the exemption than actually buy ObamaCare? That is a number that is quite interesting. That is why I am encouraged to see our plan will decrease the average premiums that people have been asking for.

Now, our goal is not just to sign up people for insurance. Our goal is to get America better health care.

Now, the gentleman also commented and had letters--and I love to read letters. I love to listen to constituents because that is what our work should be. And you read a letter when it came to Medicaid. And I would not scare people, I would actually talk to that individual.

Medicaid is on an unsustainable path. In one 10-year window, it will cost $1 trillion.

Mr. Speaker, the gentleman on the other side knows what $1 trillion is because that is about the entire amount we spend on discretionary spending. From all of the appropriations that we go through, that would take up everything we have.

Well, we know that is not sustainable, so we should do something about it. That is why we had a meeting with 18 Governors, Republicans and Democrats. And the number one thing they told us, give us flexibility to be able to manage. That is exactly what this bill does.

But I like to read some letters. Here is one from Colleen from Annapolis:

I just received the notice for my 2017 health insurance

policy. It will skyrocket, not by the advertised Maryland

State average of 20 to 25 percent but, rather, by 60 percent.

In addition, my deductible is going up 45 percent. Since the

inception of ObamaCare, my policy has increased 75 percent.

I am a 63-year-old female in excellent health who takes no

medication. My only benefit from the ACA has been two

mammograms, which I paid $12,600 in premiums to get. What a

disaster of a program.

I will be voting Republican this year, in the hope of

finally getting the ACA repealed. I just hope it happens

before my checkbook goes on life support.

Or the letter to the editor from Carl in Lusby, Maryland:

I can't afford my health insurance now under ObamaCare.

It's been a burden on our joint income, which is just above

the limit for qualifying for subsidies; and for 2017, I am

facing a 61 percent rate increase.

I'm faced with either paying a premium that will bankrupt

me and my wife, or paying the tax penalty at the end of the

year, which will also be unaffordable. And there are probably

several million Americans who are in the same boat as I am.

You know what, Carl? We listened to you. We listened, and now we are going to lead. We have moved a bill from the legislative process to the rules, what it says, for reconciliation. We have done hours of debate in three other committees. We will continue the process, as the rules say. We will go to the Rules Committee and then we will come to this floor. And for those who have written, change will come.

Yes, the Republican-appointed CBO Director and the Democratic CBO Director, as the gentleman, Mr. Speaker, from across the aisle says, agree that the premiums will go down, as so many Americans have asked for. We will put Medicaid on a sustainable path.

We will give Republican and Democrat Governors flexibility so they can manage their States in a better form. And most importantly, we will give America exactly what they asked for, the freedom to choose their own health care, the options of having more so they can direct what they want and desire, at the same time, having a lower cost.

So I welcome the gentleman for his questions. I know that wasn't about scheduling, but I think this is too important, because those 113 hearings we listened to the people before us, and we promised we would act, and we are keeping that promise as we move forward.

I ask the gentleman which bills he is referring to?

Those will be later in the month. Next week we will have two of those up that you referred to.

Yes. The committee has marked them up.

I think we both agree that responsible fiscal policy is important to our country's ability to succeed, and that includes honoring the full faith and credit of the United States. We expect to continue working closely with Secretary Mnuchin to ensure that America is on the right path to a strong fiscal future.

We know the amount of debt that has been added in the last 8 years has been tremendous. I know that the gentleman, when he looks to what we do next week--to be able to lower premiums, save more than $300 billion of the deficit, and let people have more choice--that is also a first step.

Now, I do not have any immediate action to announce, but we will relay any information to the Members as we move forward.

I thank the gentleman.

Is that going to be your last question?

Before I depart, though, I would like, Mr. Speaker, to wish my friend from the other side of the aisle a very happy St. Patrick's Day. I do apologize. I feel bad, when we look at the basketball round, what happened to Maryland; but if you look at NIT, Cal State Bakersfield is still on the march, so I have another team you can root for.

There will be no upsets.

Mr. Speaker, pursuant to House Resolution 209, I call up the bill (H.R. 372) to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers, and ask for its immediate consideration.

Mr. Speaker, I ask unanimous consent that all Members

may have 5 legislative days within which to revise and extend their remarks and include extraneous materials on H.R. 372.

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

Mr. Speaker, I rise today in support of a bill that will move us a step closer towards restoring healthy competition in the health insurance industry. Today, the health insurance industry is besieged by dwindling competition and skyrocketing premiums. Insurance providers, States, and the public have been dealing with the disastrous repercussions of ObamaCare for the past 6 years and overregulation by States for much longer.

Congress finally has the opportunity to pass legislation to reverse the downward spiral of our health insurance industry. Any such legislation must encourage a robust and competitive health insurance market in which insurance providers actively compete for customers. Healthy competition ensures premiums are accurately priced and that customers are able to find a variety of policies to meet their specific needs and demands.

H.R. 372, the Competitive Health Insurance Reform Act of 2017, represents a step on that journey, repealing the McCarran-Ferguson Act as it applies to the business of health insurance. There is wide support for this bill, and the Judiciary Committee has favorably reported similar legislation in the past, including legislation that was passed by the House, 406-19 during the 111th Congress.

The stated goal of the bill is to help restore competition in the healthcare market. I support this goal and firmly believe this bill must be coupled with larger changes to the existing Federal and State healthcare regulatory schemes.

As Speaker Ryan has noted, States ``should be empowered to make the right tradeoffs between consumer protections and individual choice, not regulators in Washington.''

This bill does not impact the State's ability to regulate the insurance market. Rather, this legislation levels the playing field for all healthcare industry participants. While insurers have been exempt from Federal antitrust laws for the past 70 years, healthcare providers and other participants have not.

This bill removes this exemption, ensuring that health insurers are better able to compete to provide quality coverage, thereby benefiting hospitals, doctors, and, most importantly, patients.

In addition, if separate legislation is passed to allow for the more open sale of health insurance across State lines, the Competitive Health Insurance Reform Act will allow uniform Federal antitrust laws to be applied across the marketplace while allowing States to maintain authority as the primary regulators of the health insurance market outside of the antitrust sphere.

The McCarran-Ferguson Act was originally passed to leave the regulation of the business of insurance with the States and to allow insurers to engage in certain procompetitive collaborative activities.

This legislation limits significant uncertainty and unnecessary litigation that would likely result from a broader McCarran-Ferguson repeal, through the use of safe harbors for such historically procompetitive collaborative activities, specifically the collection and distribution of historical loss data, the determination of loss development factors, the performance of actuarial services that do not involve restraints of trade, and the use of common forms that are not coercive.

Absent these safeguards, insurers will likely disengage from certain proconsumer collaborative activities, eliminating or impeding smaller insurers from competing and disincentivizing larger insurers from exploring new products and markets. This will lead to further market consolidation and fewer product choices, the impact of which will eventually be borne by the consumer.

These narrow safe harbors create a presumption that certain procompetitive activities can continue while maintaining regulation and oversight to the extent any activity crosses over into a restraint of trade. As a result, insurers can continue to engage in proconsumer business practices and will be encouraged to provide a diverse range of offerings at fair and reasonable prices.

I thank Mr. Gosar for introducing this legislation, and I urge all of my colleagues to vote for the Competitive Health Insurance Reform Act.

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

Mr. Speaker, I yield 5 minutes to the gentleman from Arizona (Mr. Gosar), who is the chief sponsor of the legislation.

Mr. Speaker, I am prepared to close, so I reserve the balance of my time until the other side closes.

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

Our health insurance industry is in a dire situation. Premiums and deductibles are skyrocketing, hundreds of percent in some cases. In the State of the gentleman who is the chief sponsor of this bill, the State of Arizona, there has been a more than 100 percent increase in just the last year.

In 2017, the national State average of insurers participating in Federal exchanges dropped to four, down from six the previous year. Five States will only have one insurer providing plans on their Federal exchanges this year. It is time to reverse this trend. The Competitive Health Insurance Reform Act is an important step in restoring competition to the health insurance industry and will help to set the foundation for additional essential reforms that must follow.

I say to the gentleman from Michigan (Mr. Conyers), the ranking member of the committee and my friend, I appreciate very much working with him on this legislation, but I would also say to him that this legislation, as bipartisan as it is, cannot save the Affordable Care Act. It is drowning. It is denying people coverage. Its costs are going up so much that somebody who likes it this year will not be able to afford it next year.

The promise that if you like your health insurance you will be able to keep it was never true, and it is still not true with ObamaCare. The promise that if you like your doctor you can keep your doctor was never true. The promise that health insurance premiums would go down under ObamaCare has been proven to be totally false. Instead, what we have done is we have denied the American people the right to choose for themselves what access to health care that they need and can afford.

We have denied the American people the freedom to decide whether or not they want to purchase a product that is mandated upon them by the Federal Government. That is wrong. It has got to change. That is why we are taking action this week--including the Competitive Health Insurance Reform Act, but certainly not only the Competitive Health Insurance Reform Act--to return a patient-centered healthcare system to the American people, one that reconnects them with their healthcare providers, one that will make sure that they have the maximum amount of choice and the maximum amount of access to real, affordable health insurance and quality health care in America. I support this bipartisan legislation. I urge my colleagues to do the same.

Mr. Speaker, I include in the Record three letters in support of H.R. 372.

Small Business &

Entrepreneurship Council,

Vienna, VA, February 27, 2017.

Hon. Paul A. Gosar,

House of Representatives,

Washington, DC.

Dear Representative Gosar: The Small Business &

Entrepreneurship Council (SHE Council) and our nationwide

membership of small business owners and entrepreneurs support

the ``Competitive Health Insurance Reform Act of 2017'' (H.R.

372). Perhaps more than any other group, small business

owners understand the need for increased competition in the

health insurance marketplace. Indeed, it is the actions of

entrepreneurs that bring down costs, enhance innovation, and

boost quality in a competitive marketplace. H.R. 372 is a

common sense and long-overdue step to repeal special-interest

exemptions to federal antitrust laws for health insurance

companies.

These exemptions have existed for more than 70 years, and

were initially instituted to help newly formed insurance

companies deal with data sharing. Given the dramatic changes

in the industry over these past many decades, such special-

interest treatment is no longer warranted.

Considering the government-imposed distortions within the

health care industry as a result of the Affordable Care Act

and other regulatory restrictions, full-blown review and

reform of health care policies focused on expanding

competition, and consumer choice are needed. That includes

foundational changes, such as, in the case of H.R. 372,

removing special-interest treatment that could reduce or

retrain competition.

In order to bring down health insurance costs and utilize

the models and technologies of our modern economy to drive

value and innovation within this sector, entrepreneurs need a

system that allows for such freedom and creativity. Your bill

is an important step in bringing down artificial barriers

that are preventing much needed innovation and competition.

Thank you for your leadership on this important issue. Please

let SBE Council know how we can help you advance H.R. 372

into law.

Sincerely,

Karen Kerrigan,

President & CEO.

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

Mr. Speaker, I claim the time in opposition to the motion.

Mr. Speaker, the McCarran-Ferguson Act was originally passed to leave the regulation of the business of insurance with the States and to allow insurers to engage in certain procompetitive collaborative activities.

This legislation limits significant uncertainty and unnecessary litigation that would likely result from a broader McCarran-Ferguson repeal through the use of safe harbors for such historically procompetitive collaborative activities, specifically the collection and distribution of historical loss data, the determination of loss development factors, the performance of actuarial services that do not involve restraints of trade, and the use of common forms that are not coercive.

Absent these safeguards, insurers will likely disengage from certain proconsumer collaborative activities, eliminating or impeding smaller insurers from competing and disincentivizing larger insurers from exploring new products and markets. This will lead to further market consolidation and fewer product choices, the impact of which will eventually be borne by the consumer.

These narrow safe harbors create a presumption that certain procompetitive activities can continue while maintaining regulation and oversight to the extent any activity crosses over into a restraint of trade. As a result, insurers can continue to engage in proconsumer business practices, and will be encouraged to provide a diverse range of offerings at fair and reasonable prices.

There is no reason to make an exception to these safe harbors. Therefore, I oppose the motion. I urge my colleagues to reject this motion to recommit and to support the underlying bill.

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