Providing for consideration of the bill (H.R. 1628) to provide for reconciliation pursuant to title II of the concurrent resolution on the budget for fiscal year 2017.

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

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

Mr. Speaker, I want to thank the gentleman from Texas (Mr. Sessions), my friend, for yielding me the customary 30 minutes.

Mr. Speaker, the majority is rushing to congratulate itself for finally having a bill to repeal the Affordable Care Act. For 7 years, Republicans had nothing to actually replace the law with, but that didn't stop them from making one empty political promise after another.

And after all that, what do we have in front of us today? This bill will take away health care from 24 million hardworking Americans. It forces families to pay higher premiums and deductibles, increasing out- of-pocket costs. It is a crushing age tax, forcing Americans age 50 to 64 to pay premiums five times higher than what others pay for health coverage, no matter how healthy they are. Not to mention the $880 billion cut to Medicaid or the fact that it steals from Medicare, shortening the life of the Medicare trust fund by 3 years and ransacking funds that seniors depend on to get the long-term care they need.

I don't see anything there to be excited about. But then again, I come from the old-fashioned school of thought that we should actually take care of our fellow citizens as they grow older, rather than tossing them off the ship without a life preserver.

It is no wonder that after developing such an ill-conceived and far- reaching bill on the fly, the majority has had to try and jam this legislation through our Chamber.

First, they rushed this bill through the committee process without holding a single hearing, and without the benefit of a nonpartisan Congressional Budget Office score outlining its costs and impacts.

Then the majority came out of a back room somewhere and filed four managers' amendments in the dark of

night to try to appease the conservative and moderate holdouts, including the infamous Buffalo bribe. The Republican leadership has been trying to strong-arm their conference into voting for this bill all week, and nobody knows how today's vote will go. The only thing we do know is that this is a terrible bill that is only getting worse, not better.

This thing has been a mess from beginning to end. Now, I know our President prides himself on his negotiating skills, but this seems more like the art of no deal to me, no matter what the final vote tally looks like.

That brings us to this early morning, when we met at 7 a.m. in the Rules Committee to report out this rule, which rewrites the bill to make it far worse.

Last night, we were presented with a provision, concocted in some back room, that boggles the mind with its cynicism. So what is this mysterious grand bargain that will appease the Republican Conference and finally buy Speaker Ryan enough votes to pass this disaster of a bill? Well, Mr. Speaker, it is so cartoonishly malicious that I can picture someone twirling their mustache as they drafted it in their secret Capitol lair last night.

Republicans are killing the requirements that insurance plans cover essential health benefits--essential health benefits. Now, perhaps you are wondering: What are these so-called essential benefits? Well, I will give you a partial list: emergency room trips, maternity care, mental health care and substance abuse treatment, and prescription drugs. These are the types of exotic, extravagant benefits that Republicans apparently don't think are important for working Americans to be able to afford.

It would be literally unbelievable if we weren't here considering it right now, Mr. Speaker. Now, I have been awake since before dawn-- thanks to our Rules Committee meeting--so I know that this isn't a nightmare. We are actually voting on a bill with a backroom deal, made in the dark of night, that would take away any guarantee that plans would cover these basic essential benefits.

And, of course, we have no idea what the costs will be or how many people it will affect. We can't know those things until we get an analysis from the nonpartisan Congressional Budget Office, which, obviously, we will not have before we vote on this reckless legislation.

And that is the real problem. Because every time you come out of a back room, this bill gets worse. For the sake of our country, maybe we should consider putting locks on the back rooms you huddle in.

President Trump keeps talking about crowd size. My colleagues across the aisle keep talking about page size. This morning, in the Rules Committee, Republicans kept saying that the fifth manager's amendment is only 4 pages long. How bad could it be?

Well, they need to stop worrying about size and pay more attention to how this bill will affect regular, working Americans. These 4 pages are the worse 4 pages on this planet because of the terrible consequences it will have on real people. It will be devastating for millions and millions of Americans.

So, Mr. Speaker, instead of rushing this horrendous bill, patched together with backroom deals, to the floor and voting on it just hours after seeing the final product, we should be working together in a bipartisan way to improve people's lives, and certainly not putting them at risk. My colleagues seem too concerned about winning at any cost to stop and think about the consequences for millions upon millions of Americans. This is a lousy bill.

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

Mr. Speaker, I include in the Record a letter from the AARP; a letter from the National Rural Health Association; a letter from the American Society of Addiction Medicine; and a letter from the American Medical Association--all strongly opposed to the Republican bill.

Mr. Speaker, I just want to say to my colleague from Texas, he said this bill was talked to death. It was talked to death by politicians. There were no hearings on this bill, so no experts came to testify, and none of these people who are now writing to us in opposition had the opportunity to be able to come before us and tell us how awful this bill is.

Mr. Speaker, I yield 3 minutes to the gentleman from Florida (Mr. Hastings), a distinguished member of the Rules Committee.

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

Mr. Speaker, I hear my friend talking about what came out of the Ways and Means Committee. I will tell you what came out of Ways and Means Committee: a $1 trillion tax cut for the wealthy.

Mr. Speaker, I yield 2 minutes to the gentleman from Colorado (Mr. Polis), a distinguished member of the Rules Committee.

Mr. Speaker, I would respond to the gentleman from Alabama with the words of another Alabama Member, Congressman Mo Brooks, who this morning said:

This is one of the worst bills I've seen in my 30 years in

Congress.

Mr. Speaker, I yield 1 minute to the gentleman from Michigan (Mr. Kildee).

Mr. Speaker, I notice the gentleman from Georgia relied on a tweet from Donald Trump for his facts in explaining the bill. I might suggest a more scholarly source, maybe, like, beginning with the Congressional Budget Office, which says that 24 million people will lose their health coverage as a result of the bill.

I will also point to the Quinnipiac poll that says only 17 percent of the American people approve of what my Republicans friends are doing. Seventeen percent is lower than Trump's rating. That is quite an accomplishment.

Mr. Speaker, I yield 1 minute to the gentlewoman from California (Mrs. Davis).

Mr. Speaker, I include in the Record a statement from NETWORK, the lobby for Catholic Social Justice; a letter from the National Alliance on Mental Illness; a letter from the Mental Health Liaison Group; and an article in the New York Times entitled ``Late GOP Proposal Could Mean Plans That Cover Aromatherapy but Not Chemotherapy.''

Dear Representative: NETWORK Lobby for Catholic Social

Justice urges you to vote NO on the American Health Care Act

(AHCA). This legislation fails to protect access to quality,

affordable healthcare for vulnerable communities. It would

widen the gaps in our society by making massive cuts to

Medicaid, giving large tax breaks to the very wealthiest

families and corporations, and threatening the health

security of American families.

Our faith teaches that access to healthcare is an essential

human right that is necessary to protect the life and dignity

of every person. The bill would drastically increase the

number of people without health insurance--and I know that

behind those numbers are millions of stories of families

facing medical bankruptcy, forgoing treatment, and losing

loved ones who could have been saved by preventative care.

The AHCA cuts Medicaid spending--an essential source of

care for millions of children, seniors, people with

disabilities, and people experiencing poverty in our nation--

and a per-capita cap would force states to ration care. The

legislation would also increase costs for older and sicker

patients and burden low- and moderate-income families with

much higher premiums by cutting $312 billion of financial

assistance for people purchasing health insurance on the

individual market. This is far from the Gospel mandate to

care for our most vulnerable sisters and brothers.

For any replacement to the ACA to be sufficient, it must

meet these 10 conditions--a Ten Commandments of Healthcare if

you will--and the AHCA breaks nine of 10 commandments:

1. Thou shalt provide affordable insurance and the same

benefits to all currently covered under the Affordable Care

Act. AHCA fails.

2. Thou shalt continue to allow children under the age of

26 to be covered by their parents' insurance.

3. Thou shalt ensure that insurance premiums and cost

sharing are truly affordable to all. AHCA fails.

4. Thou shalt expand Medicaid to better serve vulnerable

people in our nation. AHCA fails.

5. Thou shalt not undercut the structure or undermine the

purpose of Medicaid, Children's Health Insurance Program

(CHIP), and Medicare funding. AHCA fails.

6. Thou shalt create effective mechanisms of accountability

for insurance companies and not allow them to have annual or

lifetime caps on expenditures. AHCA partial fail.

7. Thou shalt not allow insurance companies to discriminate

against those with pre-existing conditions. AHCA partial

fail.

8. Thou shalt not allow insurance companies to discriminate

against women, the elderly, and people in poverty. AHCA

fails.

9. Thou shalt provide adequate assistance for people

enrolling and using their health coverage. AHCA fails.

10. Thou shalt continue to ensure reasonable revenue is in

the federal budget to pay for life-sustaining healthcare for

all. AHCA fails.

At its heart, this bill has lost sight of community and the

common good. Its biggest problem is that it lacks the

awareness that it is community which makes healthcare

effective. Healthcare is not just about the individual--it is

a communal good. The hyper individualism evident in the AHCA

is sucking the life out of our nation. Just focusing on one's

individual self is contrary to our Catholic faith and

contrary to our Constitution. We will track the vote and

score it in our 2017 voting record.

This dangerous legislation is not the faithful way forward

and must be rejected. Stand by Gospel principles and vote NO

on the AHCA.

Sincerely,

Sr. Simone Campbell, SSS,

Executive Director, NETWORK Lobby

for Catholic Social Justice.

Mr. Speaker, I yield 1 minute to the gentleman from Indiana (Mr. Visclosky).

Mr. Speaker, I yield 1 minute to the gentlewoman from California (Ms. Matsui).

Mr. Speaker, I just want to take a second to summarize this rule because people have been asking about it.

It is a closed rule. The only amendments allowed are amendments offered by people who wrote the bill. Those amendments are fixes to fixes to fixes to fixes in their bill and, in the words of Trump, sad.

I would just say, you know, usually when you have a lousy process you have a lousy bill, and that is why only 17 percent of the American people support what my Republican friends are doing.

I yield 1 minute to the gentleman from Texas (Mr. Castro).

Mr. Speaker, I yield 1 minute to the gentleman from Colorado (Mr. Perlmutter).

Mr. Speaker, I would like to inquire of the gentleman from Texas, if I can.

I know he has a few more speakers than he did yesterday, but we have a ton over here, and if there is additional time that he could share with us, we would appreciate it.

Mr. Speaker, I yield 1 minute to the gentlewoman from Illinois (Ms. Kelly).

Mr. Speaker, I yield 1 minute to the gentleman from North Carolina (Mr. Price).

Mr. Speaker, I yield 1 minute to the gentleman from Rhode Island (Mr. Langevin).

Mr. Speaker, I yield 1 minute to the gentlewoman from Hawaii (Ms. Gabbard).

Mr. Speaker, I include in the Record the CBO score for the underlying bill and the first four manager's amendments. We just got it last night, and it is already out-of-date given the fifth manager's amendment that was just submitted late last night.

U.S. Congress,

Congressional Budget Office,

Washington, DC, March 23, 2017.

Hon. Paul Ryan,

Speaker of the House, House of Representatives, Washington,

This analysis confirms that the Republicans will give a trillion-dollar tax break to the wealthiest people in this country, and they will kick 24 million Americans off their health insurance.

I will say that is why we are packed with speakers on this side, and there is probably only a couple of people on the gentleman's side, because we are standing with the American people who are outraged by this bill.

Mr. Speaker, I yield 1 minute to the gentleman from Rhode Island (Mr. Cicilline).

Mr. Speaker, I yield 2 minutes to the gentlewoman from Connecticut (Ms. DeLauro).

Mr. Speaker, I yield 30 seconds to the gentlewoman from New Hampshire (Ms. Kuster).

Mr. Speaker, I yield 1 minute to the gentleman from Virginia (Mr. Connolly).

Mr. Speaker, I yield 30 seconds to the gentleman from Florida (Mr. Crist).

Mr. Speaker, I yield 30 seconds to the gentleman from California (Mr. Panetta).

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

Mr. Speaker, I include in the Record a letter from 87 patient and provider organizations, including the Cystic Fibrosis Foundation, which is strongly opposed to this bill.

March 20, 2017.

Hon. Mitch McConnell,

Senate Majority Leader,

Washington, DC.

Hon. Paul Ryan,

Speaker of the House,

Washington, DC.

Dear Leader McConnell and Speaker Ryan: The undersigned

organizations write to express grave concern about proposals

put forth in the American Health Care Act (AHCA) to alter the

fundamental structure and purpose of Medicaid, a vital source

of health care for patients with ongoing health needs.

We feel compelled to speak out against proposals to phase

out Medicaid expansion and implement per capita caps, which

threaten the ability of Medicaid to provide critical health

care services to many of our most vulnerable citizens. These

proposals aim to achieve cost savings of approximately $880

billion, according to the Congressional Budget Office, at the

expense of tens of millions of patients who rely on Medicaid

for life-sustaining care. While we appreciate the

opportunities we have had to work with your staff, we cannot

support the Medicaid provisions in this bill and cannot

accept policies that prioritize cutting costs by limiting

patients' access to care.

Medicaid is Critical for Patients

Medicaid is a crucial source of coverage for patients with

serious and chronic health care needs. Pregnant women depend

on Medicaid, which covers roughly 50 percent of all births

including many high-risk pregnancies. Medicaid covers cancer

patients: nearly one-third of pediatric cancer patients were

enrolled in Medicaid in 2013 and approximately 1.52 million

adults with a history of cancer were covered by Medicaid in

2015. Over fifty percent of children and one-third of adults

living with cystic fibrosis rely on Medicaid to get the

treatments and therapies they need to preserve their health.

Nearly half of children with asthma are covered by Medicaid

or CHIP and adults with diabetes are disproportionally

covered by Medicaid as well. The patients we represent are

eligible for Medicaid through various pathways, including

through income-related and disability criteria.

Reject Per Capita Caps

The proposal to convert federal financing of Medicaid to a

per capita cap system is deeply troubling. This policy is

designed to reduce federal funding for Medicaid, forcing

states to either make up the difference with their own funds

or cut their programs by reducing the number of people they

serve and the health benefits they provide.

For patients with ongoing health care needs, this means

that Medicaid may no longer cover the care and treatments

they need, including breakthrough therapies and technology.

In order to save money, the per capita caps are set to grow

more slowly than expected Medicaid costs under current law.

As the gap between the capped allotment and actual costs

increases over time, states will be forced to constrain

eligibility, reduce benefits, lower provider payments, or

increase cost-sharing. Moreover, by capping the federal

government's contribution to Medicaid in this manner, states

will be less able to cover the cost of new treatments. This

could be devastating for people with serious diseases, for

whom groundbreaking treatments represent a new lease on life.

For people with cystic fibrosis, cancer, and other diseases,

new therapies can be game changers that improve quality of

life and increase life expectancy. In fact, we have already

seen Medicaid programs respond to current budget constraints

by using clinically inappropriate criteria to restrict access

to therapies old and new. A per capita cap will only

exacerbate the downward pressure on Medicaid budgets and will

further reduce access to these therapies for patients.

Pairing financing reforms with increased flexibility, as

has often been proposed, would further undermine Medicaid's

role as a safety net for patients. Without current guardrails

provided by federal requirements--coupled with reduced

federal funding--states will have the authority to reduce

benefits and eligibility as they see fit and to impose other

restrictions, such as waiting periods and enrollment caps.

These policies have serious implications for patients--for a

person with cancer, enrollment freezes and waiting lists

could mean a later-stage diagnosis when treatment costs are

higher and survival is less likely. For a person with

diabetes, this would risk the ability to adequately manage

the disease. Many of our patients rely on costly services

that will be quickly targeted for cuts if states are given

such flexibility, so it is imperative that current federal

safeguards remain in place.

Maintain Medicaid Expansion

While the AHCA has been described as preserving Medicaid

expansion for those already enrolled in coverage, we are

concerned that estimates show that eliminating the enhanced

match for any enrollee with even a small gap in coverage

would actually result in millions of people losing

coverage. By eliminating the enhanced federal match for

any enrollee with a gap in coverage, eventually states

will be on the hook for billions of dollars to continue

covering this population--an insurmountable financial

hurdle. Additionally, seven states have laws that would

effectively end Medicaid expansion immediately or soon

thereafter when the expansion match rate is eliminated.

Nearly half of adults covered by the Medicaid expansion

are permanently disabled, have serious physical or mental

conditions--such as cancer, stroke, heart disease,

arthritis, pregnancy, or diabetes--or are in fair or poor

health. Repealing Medicaid expansion will leave these

patients without coverage they depend upon to maintain

their health.

The proposed financing reforms are a fundamental shift away

from Medicaid's role as a safety-net for some of the most

vulnerable members of our society. Repealing Medicaid

expansion would leave millions without the health care they

rely on. Our organizations represent and provide care for

millions of Americans living with ongoing health care needs

who rely on Medicaid and we cannot support policies that pose

such a grave risk to patients.

We hope that we can continue our dialogue as you move

forward in this process to arrive at solutions that provide

all Americans with high-quality, affordable care regardless

of an individual's income, employment status, health status,

or geographic location.

Sincerely,

ADAP Advocacy Association; AIDS Action Baltimore; The AIDS

Institute; Alpha-1 Foundation; Alport Syndrome Foundation;

ALS Association; American Academy of Pediatrics; American

Behcet's Disease Association; American Congress of

Obstetricians and Gynecologists; American Diabetes

Association; American Lung Association; American Parkinson

Disease Association; American Society of Hematology; American

Thoracic Society; Amyloidosis Support Groups Inc.; ARPKD/CHF

Alliance; Arthritis Foundation; Batten Disease Support &

Research Association; Bladder Cancer Advocacy Network.

Bridge the Gap--SYNGAP Education and Research Foundation;

Bronx Lebanon Hospital Center Department of Family Medicine;

CADASIL Together We Have Hope Non-Profit; Cancer Support

Community; Child Neurology Foundation; Children's Cause for

Cancer Advocacy; Children's Dental Health Project; Chronic

Illness and Disability Partnership; Community Access National

Network; Congenital Adrenal Hyperplasia Research Education &

Support Foundation, Inc.; COPD Foundation; Cure HHT;

Cutaneous Lymphoma Foundation; Cystic Fibrosis Foundation;

Cystinosis Research Network; debra of America; Endocrine

Society; Fibrous Dysplasia Foundation; First Focus Campaign

for Children.

FORCE: Facing Our Risk of Cancer Empowered; Foundation for

Prader-Willi Research; Friedreich's Ataxia Research Alliance

(FARA); Genetic Alliance; Hannah's Hope Fund; Hide & Seek

Foundation for Lysosomal Disease Research; Hispanic Health

Network; Hope for Hypothalamic Hamartomas; Huntington's

Disease Society of America; Immune Deficiency Foundation; The

International Pemphigus and Pemphigoid Foundation; Kids v

Cancer; Latino Commission on AIDS; LFS Association (Li-

Fraumeni Syndrome Association); Liver Health Connection;

March of Dimes; Medicare Rights Center; MLD Foundation.

Moebius Syndrome Foundation; Muscular Dystrophy Association

(MDA); NASTAD (National Alliance of State & Territorial AIDS

Directors); National Alliance on Mental Illness; National

Coalition for Cancer Survivorship; National Health Law

Program; National Hemophilia Foundation; National Multiple

Sclerosis Society; National Organization for Rare Disorders;

National Patient Advocate Foundation; National Tay-Sachs &

Allied Diseases Association (NTSAD); National Urea Cycle

Disorders Foundation; National Viral Hepatitis Roundtable;

NBIA Disorders Association; Needle Exchange Emergency

Distribution (NEED); Parent Project Muscular Dystrophy

(PPMD); Parkinson Alliance; The PCD (Primary Ciliary

Dyskinesia) Foundation; Polycystic Kidney Disease Foundation;

Pulmonary Fibrosis Foundation.

PXE International; Rett Syndrome Research Trust;

Scleroderma Foundation; The

Sudden Arrhythmia Death Syndromes Foundation; T1D Exchange;

Trisomy 18 Foundation; Tuberous Sclerosis Alliance; United

Way Worldwide; VHL Alliance; Wilson Disease Association;

Wishes for Elliott: Advancing SCN8A Research.

Mr. Speaker, I would say to my colleagues that this is a sad day for this institution. This process has been awful. But this is even a sadder day for the American people.

I remind my colleagues that we are supposed to care about one another, especially the most vulnerable in our society. In this era of Trump, Washington has become a mean place. It is a place where it has become unfashionable to worry about the poor, about older Americans, and about those who struggle.

There is absolutely no justification for giving huge tax breaks to billionaires--$1 trillion in tax breaks to millionaires and billionaires, and at the same time throwing 24 million people off of health care and denying millions more essential healthcare protections.

Twenty-four million people--my Republican colleagues have lost their human ability to feel what that means. That is the entire population of Australia.

Mr. Speaker, I have a great deal of respect for my colleagues, but when I look at this bill and I read this bill, I have to wonder: What are you thinking? How could you do this?

I have come to the conclusion there are only two reasons--there are only two ways you can vote for this bill. One is you don't know what is in the bill; or two is you have to have a heart of stone, because this bill is shameful. It is going to hurt people. It is going to hurt your constituents.

Withdraw this bill or vote ``no'' on this bill, but this bill cannot become law. The health care and healthcare protections for the American people are too important.

Mr. Speaker, I urge all my colleagues--both Democrats and Republicans--reject this. Vote ``no.''

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

Mr. Speaker, I demand a recorded vote.

Mr. Speaker, I thank the distinguished gentleman of the Budget Committee for his leadership.

Our mothers and our doctors have warned us about poison pills. Well, let me say that, this morning, the Republicans are giving to the American people a poison meal that would affect my friend, the senior citizen, with $175 billion being taken away from Medicare; a poison meal that will affect a young child who is being seen by a doctor.

The Children's Hospital Association, including the Texas Children's Hospital, has said to vote ``no'' on this bill because 30 million children will have no health insurance.

This will impact working families making $31,000 a year. They will have to pay $4,000 more out of pocket. In 2026, under pay more for less, $52 million Americans will be uninsured.

This poison meal is getting worse and worse.

Then, in the dark of night, what did they do?

They took away hospitalization. They took away pregnancy, maternity, and newborn care. They took away mental health and substance abuse care.

Those States that are experiencing the opioid abuse and epidemic, what are they going to do?

They have threatened community health centers. They are closing rural hospitals.

What is this disaster of TrumpCare?

It is injuring my good friend who is sitting there in the hospital room. It is injuring Anna Nunez. It is injuring small businesses who say that they can live better under the Affordable Care Act, and the youngster that is a junior in college who said she would not be alive had it not been for the Affordable Care Act.

More than half of the American people--and it is growing--are against this bill done in the dark of night. It is the poison meal that is keeping those who need health insurance away from health insurance.

I ask my colleagues to vote ``no.'' Don't feed the American people a poison meal.

Mr. Speaker, as a member of the Budget Committee and the representative of a congressional district that has benefited enormously from the Affordable Care Act, I rise in strong and unyielding opposition to H.R. 1628, the so-called ``American Health Care Act,'' which more accurately should be called ``Trumpcare, the Pay More For Less Act.''

Seven years ago yesterday, March 23, 2010, President Barack Obama signed into law the landmark Affordable Care Act passed by the Democratic controlled 111th Congress.

Seven years later, the verdict is in on the Affordable Care Act; the American people have judged it a success and are adamantly opposed to any effort to repeal a law that has brought to more than 20 million Americans the peace of mind and security that comes with

knowing they have access to affordable, high quality health care.

Before the passage of the Affordable Care Act, 17.1 of Americans lacked health insurance; today nearly nine of ten (89.1%) are insured, which is the highest rate since Gallup began tracking insurance coverage in 2008.

Because of the Affordable Healthcare Act:

1. insurance companies are banned from discriminating against anyone, including 17 million children, with a preexisting condition, or charging higher rates based on gender or health status;

2. 6.6 million young-adults up to age 26 can stay on their parents' health insurance plans;

3. 100 million Americans no longer have annual or life-time limits on healthcare coverage;

4. 6.3 million seniors in the ``donut hole'' have saved $6.1 billion on their prescription drugs;

5. 3.2 million seniors now get free annual wellness visits under Medicare, and

6. 360,000 Small Businesses are using the Health Care Tax Credit to help them provide health insurance to their workers;

7. Pregnancy is no longer a pre-existing condition and women can no longer be charged a higher rate just because they are women.

We are becoming a nation of equals when it comes to access to affordable healthcare insurance.

The President and congressional Republicans call this enviable record of success a ``disaster.''

The American people do not agree and that is why they reject overwhelmingly (56%-17%) this Republican attempt to repeal the Affordable Care Act according to the latest Quinnipiac poll.

Americans know a disaster when they see one and they see one in the making: it is called ``Trumpcare,'' masquerading as the ``American Health Care Act,'' which will force Americans to ``pay more for less.''

And they are right to be alarmed at what they see.

This ``Pay-More-For-Less'' bill is a massive $900 billion tax cut for the wealthy, paid for on the backs of America's seniors, the vulnerable, the poor, and working class households.

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

Trumpcare represents the largest transfer of wealth from the bottom 99% to the top 1% in American history.

This callous Republican scheme gives gigantic tax cuts to the rich, and pays for it by taking insurance away from 24 million people, leaving 52 million uninsured, 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-For-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 bill 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.

These steep cuts will force states to drop people from Medicaid entirely or ration care for those who most need access to comprehensive coverage.

The Pay-More-For-Less plan undermines the health care safety net for vulnerable populations.

Currently, Medicaid provides coverage to more than 70 million Americans, including children, pregnant women, seniors in Medicare, people who are too disabled to work, and parents struggling to get by on poverty-level wages.

In addition to doctor and hospital visits, Medicaid covers long-term services like nursing homes and home and community-based services that allow people with chronic health conditions and disabilities to live independently.

To date, 31 states and D.C. have expanded Medicaid eligibility to low-income adults, which, when combined with the ACA's other coverage provisions, has helped to reduce the nation's uninsured rate to the lowest in history.

Trumpcare throws 24 million Americans off their health insurance by 2026 according to the Congressional Budget Office.

Low-income people will be hit especially hard because 14 million people will lose access to Medicaid by 2026 according to CBO.

Trumpcare massively shifts who gets insured in the nongroup market.

According to CBO, ``fewer lower-income people would obtain coverage through the nongroup market under the legislation than current law,'' and, ``a larger share of enrollees in the nongroup market would be younger people and a smaller share would be older people.''

The projected 10% reduction in premiums is not the result of better care or efficiency--it is in large part the result of higher-cost and older people being pushed out of a market that is also selling plans that provide less financial protection.

People with low incomes suffer the greatest losses in coverage.

CBO projects the uninsured rate for people in their 30s and 40s with incomes below 200% of poverty will reach 38% in 2026 under this bill, nearly twice the rate projected under current law.

Among people aged 50-64, CBO projects 30% of those with incomes below 200% of poverty will be uninsured in 2026.

Under current law, CBO projects the uninsured rate would only be 12 percent.

Being uninsured is not about ``freedom.''

Speaker Ryan has argued that people will happily forgo insurance coverage because this bill gives them that ``freedom.''

The argument makes as much sense as the foolish claim that slaves came to America as ``immigrants'' seeking a better life.

The freedom to be uninsured is no freedom at all to people in their 50s and 60s with modest incomes who simply cannot afford to pay thousands of dollars toward premiums.

They do not really have a choice.

The claim of our Republican friends that Trumpcare provides more freedom to all Americans calls to mind the words of Anatole France:

``The law, in its majestic equality, forbids the rich as well as the poor to sleep under bridges, to beg in the streets, and to steal bread from the market.''

Trumpcare raises costs for Americans nearing retirement, essentially imposing an ``Age Tax.''

The bill allows insurance companies to charge older enrollees higher premiums than allowed under current law, while reducing the size of premium tax credits provided.

Again, these changes hit low-income older persons the hardest.

A 64-year-old with an income of $26,500 buying coverage in the individual market will pay $12,900 more toward their premiums in 2026, on average.

Trumpcare raises costs for individuals and families with modest incomes, particularly older Americans.

A recent analysis found that in 2020, individuals with incomes of about $31,000 would pay on average $4,000 more out of pocket for health care--which is like getting a 13% pay cut.

And the older you are, the worse it gets.

An analysis by the Urban Institute estimates that for Americans in their 50s and 60s, the tax credits alone would only be sufficient to buy plans with major holes in them, such as a $30,000 deductible for family coverage and no coverage at all of brand-name drugs or many therapy services.

Another reason I oppose the Trumpcare bill before us is because its draconian cuts in Medicaid funding and phase-out of Medicaid expansion put community health centers at risk.

Community health centers are consumer-driven and patient-centered organizations that serve as a comprehensive and cost effective primary health care option for America's most underserved communities.

Community health centers serve as the health care home for more than 25 million patients in nearly 10,000 communities across the country.

Across the country, 550 new clinics have opened to receive 5 million new patients since 2009.

Community health centers serve everyone regardless of ability to pay or insurance status:

1. 71% of health center patients have incomes at or below 100% of poverty and 92% have incomes less than 200% of poverty;

2. 49% of health center patients are on Medicaid; and

3. 24% are uninsured;

4. Community health centers annually serve on average 1.2 million homeless patients and more than 300,000 veterans.

Community health centers reduce health care costs and produce savings--on average, health centers save 24% per Medicaid patient when compared to other providers.

Community health centers integrate critical medical and social services such as oral health, mental health, substance abuse, case management, and translation, under one roof.

Community health centers employ nearly 190,000 people and generate over $45 billion in total economic activity in some of the nation's most distressed communities.

Community health centers serve on the front lines of public health crises such as the Zika virus and the opioid epidemic.

Mr. Speaker, community health centers are on the front lines of every major health crisis our country faces, from providing access to care (and employment) to veterans to addressing the opioid epidemic to responding to public health threats like the Zika virus.

We should be providing more support and funding to community health centers, not making it more difficult for them to serve the communities that desperately need them by slashing Medicaid funding.

Trumpcare Republican plan leaves rural Americans worse off.

Mr. Speaker, health insurance has historically been more expensive in rural areas because services cost more and it is hard to have a stable individual market with a small population.

Under the Affordable Care Act, premium subsidies are tied to local costs, which helps keeps premium costs down.

But they are not under the Republican plan.

So, under the Republican plan residents in rural areas, who tend to be older and poorer, will pay much more and get much less health insurance.

At the end of the day, Mr. Speaker, the powerful and compelling reasons to reject Trumpcare lies in the real world experiences of the American people.

Let me briefly share with you the positive, life affirming difference made by the Affordable Care Act in the lives of just three of the millions of Americans it has helped.

Joan Fanwick: ``If Obamacare is repealed, I don't know if I'll live to see the next President''

``After nearly a decade of mysterious health scares, I was diagnosed with an autoimmune disorder called Sjogren's Syndrome last year, when I was a junior at Temple University.

``It's a chronic illness with no known cause or cure, and without close medical surveillance and care, it can lead to life-threatening complications (like the blood infections I frequently experience).

``For me, having this disorder means waking up every morning and taking 10 different medications.

``It also means a nurse visiting my apartment every Saturday to insert a needle into the port in my chest, so I can give myself IV fluids throughout the week.

``Without insurance, my medical expenses would cost me about $1,000 per week--more than $50,000 per year. And that doesn't even include hospitalizations.

``My medical bills aren't cheap under Obamacare, but I can afford them.

``Under Obamacare, insurance companies aren't allowed to cut you off when your costs climb so right now, the most I personally have to pay out of pocket is $1,000 per year.''

Brian Norgaard: ``I am a small business owner and leadership trainer who Obamacare has helped tremendously.''

Brian Norgaard, a Dallas, Texas resident, called my office to express his opposition to Trumpcare and to offer share how the Affordable Care Act has helped small business owners like himself:

``I am a small business owner and leadership trainer who Obamacare has helped tremendously.

``My wife and I both own small businesses in the Dallas, Texas area and as a result of the huge savings we received after paying lower [healthcare] premiums under Obamacare, we were able to reinvest those saving into both of our businesses and the community.

``And the healthcare we received was quality, at that.''

Ashley Walton: ``For cancer survivors, we literally live and die by insurance''

Ashley Walton was 25 when a mole on her back turned out to be melanoma.

She had it removed, but three years later she discovered a lump in her abdomen.

She was then unemployed and uninsured, and so she put off going to a doctor.

She tried to buy health insurance. Every company rejected her.

Ashley eventually became eligible for California's Medicaid program, which had been expanded under the Affordable Care Act.

The 32-year-old Oakland resident credits her survival to the ACA.

Without it, ``I would likely be dead, and my family would likely be bankrupt from trying to save me.''

Before any of our Republican colleagues supporting this bill cast their vote, I urge them to reflect on the testimony of Joan, Brian, and Ashley, and to on this question posed by a constituent to Sen. Cotton of Arkansas at a recent town hall:

``I've got a husband dying and we can't afford--let me tell you something.

``If you can get us better coverage than this [Obamacare], go for it.

``Let me tell you what we have, plus a lot of benefits that we need.

``We have $29 per month for my husband. Can you beat that? Can you?

With all the congestive heart failures, and open heart surgeries, we're trying. $29 per month. And he's a hard worker.

$39 for me.''

I urge all Members to reject Trumpcare, one of the most monstrously cruel and morally bankrupt legislative proposals ever to be considered in this chamber.

To paraphrase a famous former reality television personality, ``believe me, Trumpcare is a disaster.''

We should reject it and keep instead ``something terrific'' and that is the Affordable Care Act, regarded lovingly by millions of Americans as ``Obamacare.''

March 24, 2017.

Re Changes to the Affordable Healthcare Act.

The President of the United States of America,

The White House,

Washington, DC.

Greetings Mr. President: Today is a very crucial and

important day for the residents of the City of Houston's

District D, where I serve as the elected City Council Member,

which also falls under Congressional Districts 18 and 7. As a

local elected official whose mother is on a fixed income,

this will not only impact her but many other senior citizens

who I represent.

In the news, we see how the Affordable Healthcare Act is

proposed to be changed. Under the new revisions to the

healthcare bill, which is called The American Health Care

Act, about $337 Billion will be cut from the current plan

over a 10 year period causing 24 million Americans, including

Democrats, Republicans, Independents, poor and the middle

class, to lose their healthcare. This proposed health care

bill is receiving criticism from the health care providers,

some conservatives and a united Democratic Party. The

Congressional Budget Office even showed how this current

proposed plan will negatively impact everyone. What is most

concerning to me in regards to this program is the impact

that it will have on our senior citizens.

52% of my District is made up of Senior Citizens who are on

fixed incomes. These senior's will have to pay more for their

health care under this proposed American Health Care Act. In

no way is this acceptable. I am an advocate for my seniors

and I refuse to quietly sit back while this is being

considered.

I have encouraged everyone to reach out to their Members of

Congress to let them know that this isn't something that we

stand for and to work on their behalf to vote this item down

today.

Sincerely,

Dwight Boykins,

Houston City Counsel,

District D.

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

Mr. Speaker, after 7 years of campaigning against the Affordable Care Act, congressional Republicans have finally produced what they cynically describe as a replacement plan.

Sadly, however, this bill will unravel all of the progress we made under the ACA, including expanding access to health insurance to 22 million Americans and improving the quality of coverage and care for tens of millions more.

It nearly doubles the amount of uninsured people in this country, guts Medicaid by almost $900 billion, and weakens the Medicare trust fund.

That was bad enough. But the last-minute changes to this bill are astonishing and appalling. This legislation now allows insurers to end coverage for prescription drugs, mental health, maternity and newborn care, preventive care, emergency room visits, hospitalizations, outpatient care, rehab visits, lab services, and pediatric care. That is not progress. That is not a fix. That is a potential health crisis for every American.

My Republican colleagues are well aware of this. Why else would they have drafted this bill and these last-minute changes in secret? Why else would complicated legislation affecting the lives of millions be sent to the floor just 2 weeks after it was introduced with no congressional hearings, not a single one, on a bill that impacts the health care of nearly every American family? Why else would they rush the bill to the floor without an updated Congressional Budget Office estimate of how much coverage and care will be lost by their backroom deal that ends consumer protections?

I get it. I wouldn't want to, nor would I know how to justify giving nearly $1 trillion in tax cuts to corporations and the wealthy paid for by threatening the health and well-being of millions of American families.

Who is getting these huge windfalls?

Companies like Amgen, with annual profits of more than $3 million; Medtronic, with annual profits of more than $6 billion; and Gilead Sciences, with $13 billion in profits in 2016 alone.

When the CBO released its report last week showing that 24 million hardworking Americans will be left without healthcare coverage by 2026 if we pass this bill, that premiums will rise 15 to 20 percent next year, that people will pay thousands of dollars more in deductibles and out-of-pocket costs, and that older Americans will be priced out of the market by an age tax, I thought for sure it was dead on arrival, that there was no way my Republican colleagues would walk this plank. But here they are, and they are trying to take millions of American families with them.

Fourteen million Americans will lose health coverage next year if this bill is approved. Twenty-one million Americans will lose coverage in the next 3 years alone, wiping out all of the coverage gains from the ACA in just 3 years. For pretty much everyone else in the individual market, deductibles and other costs will be higher. And for lower-income individuals, out-of-pocket costs will be much higher.

Insurance companies will again be able to sell plans that offer much less financial protection, and we will return to the days when millions of people in this country will live in fear that they are always one serious illness or accident away from bankruptcy.

This bill will result in the largest transfer of wealth from struggling families to the well-off in our Nation's history, giving $1 trillion in tax breaks to millionaires, billionaires, and corporations. It is Robin Hood in reverse, but this is far worse because access to lifesaving care is being stolen.

I don't say that casually. I have met people, constituents of mine, whose lives have been saved because of the Affordable Care Act.

This is from one of my constituents:

``My name is Kevin Schweitzer. I am 62 years old and I'm a lifelong resident of Louisville, Kentucky.

``I worked hard, took risks and built a successful small business that I sold at age 59. My wife and I were excited about our prospects as we headed into early retirement. As a retiree too young for Medicare, I purchased health insurance on the open market. Less than a year later, I was diagnosed with lymphoma. I have undergone multiple scans and 2 cycles of chemo. I am winning the battle so far, but since this disease is in my blood I will be fighting it for the rest of my life.

``A cancer diagnosis is a life-changing event that not only attacks the body, but the mental stress is just as tough to deal with. Thanks to ObamaCare, I've been able to rest easier knowing that my illness wouldn't bankrupt my family and that I'll be able to provide for my wife even after I'm gone.''

I also heard from a young woman named Sarah Adkins. She suffers from chronic kidney disease. Sarah was able to get health insurance because of the ACA. On January 9, 2011, it saved her life. One of her kidneys shut down and almost went septic. If she didn't have coverage, she would have waited or not gone to the hospital at all. The doctor told her that if she had arrived at the ER an hour later, she would have died.

Mr. Speaker, the health of my constituents Kevin Schweitzer and Sarah Adkins is at stake in this debate. They, and the hundreds of other constituents I have heard from who have serious and chronic health conditions, will need high-quality, affordable health coverage for the rest of their lives. Under this bill, they will get less coverage, it will cost more, and eventually they will be priced out of the market, leaving them nowhere to turn for the care they need.

And that is not all. Because of the last-minute changes to this bill, insurers will be able to sell stripped-down coverage to weed out people with preexisting conditions. They will be able to refuse, for example, to offer coverage for chemotherapy drugs and cancer treatments, insulin pumps, hospital stays, and prescription drugs that treat chronic conditions across the board. Basically, if you have a serious health problem, the care you need may not be available to you at all.

When the American people were promised by President Trump and Republican congressional leadership that their existing coverage would be preserved and that everybody would have insurance and it would be less expensive and much better, they, understandably, believed they would be treated much better than this. None of those promises are in this bill. In fact, the opposite of every one of those promises is what is in this bill. Those were promises made to every family in our congressional districts, and this bill fails them at every turn.

Mr. Speaker, I urge my colleagues to oppose this legislation, and I reserve the balance of my time.

Mr. Speaker, I remind my colleague that his vote for this bill will result in 38,200 people from his congressional district in California losing health care and coverage.

Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman from California (Ms. Lee), a distinguished member of the Budget Committee.

Mr. Speaker, I remind my colleague that his vote for this bill will result in 40,500 people from his congressional district in Ohio losing health coverage and care.

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Massachusetts (Mr. Moulton), a distinguished member of the Budget Committee.

Mr. Speaker, I remind my colleague that his vote for this bill will result in 50,200 people from his congressional district in Minnesota losing health coverage and care.

I yield 1\1/2\ minutes to the gentleman from New York (Mr. Jeffries), a distinguished member of the Budget Committee.

Mr. Speaker, I remind my colleague that his vote for this bill will result in 60,400 people from his congressional district in Texas losing health coverage and care.

I yield 2 minutes to the gentleman from New York (Mr. Higgins), a distinguished member of the Budget Committee and the Ways and Means Committee.

Mr. Speaker, I remind my colleague that his vote for this bill will result in 65,800 people from his congressional district in New York losing health coverage and care.

I yield 2 minutes to the gentlewoman from Washington (Ms. DelBene), a distinguished member of the Budget Committee and the Ways and Means Committee.

Mr. Speaker, I remind my colleague that his vote for this bill will result in 56,000 people from his congressional district in Florida losing health coverage and care.

I yield 1\3/4\ minutes to the gentlewoman from Florida (Ms. Wasserman Schultz), a distinguished member of the Budget Committee.

Mr. Speaker, I remind my friend from Indiana that his vote for this bill will result in 37,900 people from his congressional district losing health coverage and care.

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Pennsylvania (Mr. Brendan F. Boyle), who is a distinguished member of the Budget Committee.

Mr. Speaker, I remind my colleague that the gentleman's vote for this bill will result in 50,100 people from his congressional district in Louisiana losing health coverage and care.

Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman from Washington (Ms. Jayapal), who is the distinguished vice ranking member of the Budget Committee.

Mr. Speaker, I remind my colleague that his vote for this bill will result in 38,200 people from his congressional district in California losing health coverage and care.

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from California (Mr. Carbajal), who is a distinguished member of the Budget Committee.

Mr. Speaker, I mention to my colleague that his vote against this bill will result in 56,600 people from his congressional district in South Carolina losing health coverage and care.

Mr. Speaker, I yield 1\3/4\ minutes to the gentlewoman from Texas (Ms. Jackson Lee).

Mr. Speaker, I remind my colleague that his vote for this bill will result in 44,600 people from his congressional district in Wisconsin losing health coverage and care.

Mr. Speaker, I yield 2 minutes to the gentlewoman from Illinois (Ms. Schakowsky), a distinguished member of the Budget Committee and the Energy and Commerce Committee.

Mr. Speaker, I remind my colleague that his vote for this bill will result in 50,000 people from his congressional district in Kansas losing health coverage and care.

Mr. Speaker, I yield myself 2 minutes.

Mr. Speaker, in concluding the presentation from the Budget Committee, I just have to say that the bill we are considering today is a mess. It is not a healthcare bill at all.

This bill is driven by a desire to cut taxes for the wealthiest Americans and many wealthy corporations by nearly $1 trillion in all. It is paid for by making health care unaffordable for millions of people.

This is irresponsible. It is not what the American people want, it is not what they deserve, and it is certainly not what they can afford.

We are not the only ones opposing this legislation. It is opposed by an amazing array of American organizations and individuals, including the American Medical Association, the American Hospital Association, the American Nurses Association, the National Rural Health Association, AARP, the National Disability Rights Network, the American Diabetes Association, American Cancer Society, and Easterseals, virtually every healthcare and consumer advocacy group, Governors from both sides of the aisle, and a growing list of our Republican colleagues.

Mr. Speaker, I thank the Budget Committee staff for the incredible job they have done throughout this process.

Mr. Speaker, I reserve the balance of my time, and I ask unanimous consent that the gentleman from New Jersey (Mr. Pallone), chairman of the Energy and Commerce Committee, control the balance of my time.

Mr. Speaker, pursuant to House Resolution 228, I call up the bill (H.R. 1628) to provide for reconciliation pursuant to title II of the concurrent resolution on the budget for fiscal year 2017, and ask for its immediate consideration.

Mr. Speaker, I ask unanimous consent that all Members have 7 legislative days in which to revise and extend their remarks on H.R. 1628, the American Health Care Act of 2017.

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

I rise today to speak in favor of the American Health Care Act, a bill that repeals many of the worst aspects of ObamaCare, and begins to repair the damage caused by the law by bringing choice, competition, and patient-centered solutions back into our healthcare system.

Standing here today in the House debating this bill is a proud moment for me. I was working as a nurse in Nashville in the 1990s when, fresh off of the failure of HillaryCare, the Clinton administration pushed out a single-payer pilot program in Tennessee called TennCare.

As the story goes, Vice President Gore and the Democratic Governor sketched out a program on a napkin while sitting in a local bar. I saw firsthand the negative impact of government-run health care on patient care. I saw the costs rise, and the quality of care fall. I saw the burdens being placed on doctors, patients, hospitals, and care providers. I saw patients faced with fewer choices and more regulation. And I saw the devastating impact that TennCare was having on our State's budget, gobbling up so much State spending that other priorities like education and infrastructure were getting squeezed.

I couldn't sit idly by while this was happening in my State, so I decided to get involved in public service, and it is what inspired me to run for office at the very beginning. And when, in 2009 and 2010, I saw the same principles being debated and eventually implemented on the national level, I thought my experience in Tennessee would be valuable to the national debate. I told the people in my district that, if elected to Congress, I would fight to repeal and replace ObamaCare.

In 2011, I sponsored the first piece of legislation that repealed a part of ObamaCare. And today, we take the largest step yet in rescuing the American people from the damage that has been done by ObamaCare.

We are united in our goal to repeal ObamaCare and replace it with patient-centered health care. Right now, ObamaCare is imploding. We were promised premiums that would decrease by $2,500; instead, average family premiums in the employer market have soared by $4,300.

We were promised healthcare costs would go down; instead, deductibles have skyrocketed.

We were promised we could keep our doctor, and keep our health insurance plans; instead, millions of Americans have lost their insurance and the doctors that they liked.

In short, the Affordable Care Act was neither affordable, nor did it provide the quality of care that the American people deserve.

The American Health Care Act is a first step in our efforts to deliver patient-centered healthcare reform. This bill returns to the American people freedom and choice in their healthcare decisions. It gets government out of the relationship between patients and their doctors--where it has never belonged--and puts people back in charge of their own health care. It brings the free market principle of competition to an industry that has long been dominated by government intervention.

Today we are faced with a stark choice: Do we vote to continue the damage ObamaCare is doing to our country and our constituents, or do we vote to go down another path, a better way of doing health care in this country?

While no legislation is perfect, this bill does accomplish some important reforms. It zeros out the mandates. It repeals taxes. It repeals the subsidies. It allows people to choose health insurance plans that are unique to their families, instead of purchasing a one- size-fits-all plan that is mandated by some Washington bureaucrat, and it modernizes Medicaid, a once-in-a-lifetime entitlement reform.

Ending Medicaid's open-ended funding structure will play an important role in addressing the future budget deficits and our growing national debt. I applaud my colleagues who have stayed in this fight and continue to make this bill better.

The members of the Budget Committee, which I chair, outlined four principles they believed would improve the bill. Those principles led to significant changes to allow more State flexibility in Medicaid and ensure that tax credits truly served the people they are meant to serve.

Others fought to eliminate Federal ObamaCare regulations that drive up the cost of health care for all Americans and give those powers back to the States. At the same time, we also ensure that States have the resources to provide maternity and newborn care and treatment for mental health and substance abuse.

I agree with these changes, and I applaud my colleagues for the work to make sure that we truly reverse the damage ObamaCare is doing to our healthcare system and our economy.

ObamaCare's legacy is clear: more government, less choice, and higher costs. Our vision for health care in America is the opposite: more freedom, more choice, and lower costs. Put simply, the American Health Care Act is a good first step, but it is only a first step.

My good friend and our former colleague, Dr. Tom Price, will use his position as Secretary of Health and Human Services to address some of the regulatory burden of ObamaCare through administrative action. We have voted already and will continue to vote on individual pieces of legislation to implement even more patient-centered, free market reforms that we cannot address through reconciliation.

In fact, we just passed two bills already this week. One would allow small businesses to join together to purchase insurance, and the other would increase competition by tearing down antitrust regulations. That bill received 416 votes. This shows that these bills are commonsense measures that include bipartisan support.

The day is finally here where we have an opportunity to fulfill that promise that we have made to the American people. I, for one, cannot sit idly by and let this opportunity go to waste. Campaigning is easy compared to governing, but our constituents did not elect us to do what is easy. They elected us to do what is right.

I urge my colleagues to join me in voting ``yes'' on the American Health Care Act, to rescue the American people from ObamaCare.

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

Mr. Speaker, I yield 2 minutes to the gentleman from California (Mr. McClintock).

Mr. Speaker, I yield 2 minutes to the gentleman from Ohio (Mr. Johnson), a member of the Budget Committee.

Mr. Speaker, I yield 2 minutes to the gentleman from Minnesota (Mr. Lewis), who is a distinguished member of the Budget Committee.

Mr. Speaker, I yield 2 minutes to the gentleman from Texas (Mr. Arrington) who is a member of the Budget Committee.

Mr. Speaker, I yield 2 minutes to the gentleman from New York (Mr. Faso), a distinguished member of the Budget Committee.

Mr. Speaker, I yield 2 minutes to the gentleman from Florida (Mr. Gaetz) who is a distinguished member of our Budget Committee.

Mr. Speaker, I yield 2 minutes to the gentleman from Indiana (Mr. Rokita), who is the vice chair of the Budget Committee.

Mr. Speaker, I yield 2 minutes to the gentleman from Louisiana (Mr. Higgins).

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

Mr. Speaker, I want to recognize that our Members on the other side of the aisle are sharing some data on the coverage of per congressional district based on a study that was conducted by the Center for American Progress, which is a left-leaning organization to begin with. The Center for American Progress employs a flawed methodology for estimating this coverage. In

fact, their foundational numbers are actually based on CBO's coverage estimates, estimates that the CBO itself has established are not infallible.

These coverage numbers only take into account plans that they consider comprehensive major medical policies. This is a term that is used in the very law that we are trying to dismantle today. These coverage estimates do not account for things that we have in our bill, such as HSA plans that allow purchase with tax credits, and many medical plans.

So the AHCA increases freedom for Americans to purchase the kind of coverage that works for them, not the narrowly defined coverage that we see that the Federal Government likes.

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from California (Mr. McClintock), who is a member of our committee.

Mr. Speaker, I yield 1 minute to the gentleman from South Carolina (Mr. Sanford).

Mr. Speaker, I yield 2 minutes to the gentleman from Wisconsin (Mr. Grothman), who is also a member of the Budget Committee.

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

Mr. Speaker, I yield 2 minutes to the gentleman from Kansas (Mr. Marshall), who is a physician.

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

Mr. Speaker, I want to remind my fellow colleagues that, currently, when we look at the access to care for people, one-third of our counties only have one provider; two-thirds of our counties only have two providers. In my State of Tennessee, there are 14 counties where they will have no insurance provider on the marketplace. So when we talk about people losing their insurance, they are losing their insurance by not having access to even purchase the insurance.

One of my former colleagues, the gentleman from Minnesota, asked: What are my colleagues on the other side of the aisle trying to preserve?

I want to point to this chart here to ask that question, because these are the broken promises of ObamaCare.

Why are you trying to preserve something where they say premiums will decrease by $2,500, and we see the average family premiums have soared by $4,300, making insurance unaffordable for many families?

Another broken promise: the cost of health care will go down.

We see some deductibles that have gone up as much as 60 percent. In my own State, they have gone up by 63 percent, making coverage unaffordable.

You can keep your doctor--70 percent of the plans consist of narrow networks, which means they cannot keep their doctor. I cannot tell you the number of people who have called me because their doctor was not on their inept plan.

Finally, ``middle class Americans won't see a tax increase.'' This was a promise by former President Obama. ObamaCare penalties were put in place, so people are receiving a tax penalty.

These are the broken promises that the other side of the aisle wants to continue to protect. As opposed to that, we

want a system that is going to be open with patient care and give affordability so people can get the services that they want with a cost that they can afford.

I also thank the Budget Committee for the work that they have done, and all the staff that have worked endless hours to make it possible for this to be here on the floor today.

Mr. Speaker, I yield 30 minutes to the gentleman from Oregon (Mr. Walden), and I ask unanimous consent that he may control that time.

Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 228 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), my friend, 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 may have 5 legislative days to revise and extend their remarks.

Mr. Speaker, I rise in support of this rule and the underlying legislation.

This rule is a fair rule that adequately provides both sides of the aisle with ample time to debate the merits of the underlying legislation. In fact, the Rules Committee thought it was so important that ample time be provided to this debate, that we are provided 4 hours of general debate on the underlying bill.

Mr. Speaker, in honor of our former President, Ronald Reagan, I wear brown today. The former President, when he was President, believed that wearing brown was good luck to him and good luck for the things which he was undertaking. So, in honor of Ronald Reagan, I, too, wear my brown jacket today.

Mr. Speaker, it has become abundantly clear that ObamaCare has failed the American people. Our Nation's healthcare system today is broken and only getting worse under the current law, known as the Affordable Care Act, or ObamaCare.

Simply put, ObamaCare is collapsing, and it is collapsing fast. Options and choices are disappearing for consumers, and an anticompetitive marketplace has been created that firmly harms patients.

How bad is it? Nearly one-third of all U.S. counties currently have only one insurer offering plans on their State's exchanges. That is a government-created monopoly, Mr. Speaker, and that kills the free market, meaning no choices for the American people and higher costs are what the American consumer and the healthcare market are finding.

And it is only continuing to get worse. As more and more insurers leave the marketplace, prices will continue to rise, forcing healthy individuals to make economic decisions not to purchase health care, creating a self-defeating spiral of rising costs and less options. That is why we must act, and act today, which is what we are doing.

It is no wonder that in such a government-controlled system that premiums have increased by an average of 25 percent on the ObamaCare exchanges this year alone. And it is no wonder that some 19.2 million taxpayers chose to outright pay the individual mandate penalty or claimed an exemption. What this means is that ObamaCare is not a good option to these 19.2 million people.

Mr. Speaker, the American people, I believe, sent us to Washington, D.C., to fix this issue. They are telling us directly: this must be fixed now. And people certainly outside of Washington resent the Federal Government telling them how to purchase health care and what that healthcare marketplace would look like. But we really do not have to tolerate this. We do not have to agree that we will accept the status quo.

Mr. Speaker, I believe the American people are smart. I believe the American people want independence, they love freedom, and they want to know that they can make their own choices, because they believe they make better choices than a one-size-fits-all plan out of Washington,

Mr. Speaker, I yield 10 minutes to the gentleman from Lewisville, Texas (Mr. Burgess), a distinguished member of the Rules Committee, a gentleman who sits on both the Energy and Commerce and the Rules Committee. He is quite literally the most knowledgeable person on health care in the United States Congress.

Mr. Speaker, I yield myself such time as I may consume, and I thank the gentleman from Florida very much. In fact, the gentleman is correct. We had an opportunity to quote the Bible, Janis Joplin, and ZZ Top when we were doing our hearings. We had so much time with each other, and I enjoyed the hours and hours that we had to debate these essential items.

But the other side of the story is essential health benefits are not being done away with. They are being transferred entirely to States. States have asked for the ability to manage their own money, and manage their own people's benefits of what would be required in the States. So in no way should a person take away, well, we just did away with it. In fact, we transferred the authority and the responsibility of essential health benefits to the States because Governors have been asking for this.

Mr. Speaker, I want to take just a moment to explain what I believe is at the heart of the legislation and really, in reality, the key to fixing health care. It is the second part of this.

We heard the gentleman from Lewisville, Texas, Dr. Burgess, speak about the Energy and Commerce portions. I now would like to take a minute to talk about the portions that come directly out of the Ways and Means Committee.

The gentleman, Mr. Brady, from The Woodlands, Texas, today, spoke about many of these; but at the heart of it, 170 million Americans currently receive their health care through an employee-employer tax advantage or tax benefits, an untaxed benefit whereby people who have an employer who can provide their health care, it is not taxed-- pretaxed to the employee, allowing them to have a good healthcare system. Well, all the while, millions of Americans pay higher premiums out of their pockets in the individual market. Those are people that do not have an employer who is able to help them. So that is not fair. That does not help these people.

What we are doing here is putting together an addition of, really, a great Republican idea; and it takes the important step to provide the same tax-free benefits for those employer-sponsored plans that we will give to regular employees, and it is called a tax credit. This tax credit is going to work because it allows every single American that does not receive the tax benefit at work to get it for themselves.

Who is this? Well, quite honestly, it is small-business owners; it is low-income workers; it is entrepreneurs. It includes, really, a lot of real estate agents and people that work for a small business, maybe heating and air-conditioning systems like we have all across this country. It will give their families an opportunity.

How much money? Well, we will provide them between $2,000 and $14,000 a year for their families to be able to have these opportunities to purchase a nongovernment healthcare plan, meaning that, as they would go to the marketplace, we are going to help these people through a tax credit available January 1, providing them with an opportunity to purchase health care on a benefit basis.

Why is this important? It saves money because what it does, it creates two things: a family then has an insurance plan, including a healthcare component that goes to the hospitalization; and secondly, it gives them an opportunity to have their own doctor or healthcare plan that they choose. This is important because many of these people end up in the hospital in the most expensive kind of way we can provide health care: at the emergency room.

So this gives these families parity in the marketplace. We believe that that is important and is another part of this Republican healthcare plan.

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

Mr. Speaker, I yield 2 minutes to the gentleman from Alabama (Mr. Byrne), a distinguished member of the Rules Committee.

Mr. Speaker, I yield 5 minutes to the gentleman from Georgia (Mr. Woodall), who will be describing the third piece of this, and that is the putting together of the piece from the Budget Committee.

Mr. Speaker, I yield 2 minutes to the gentleman from Oklahoma (Mr. Cole), the vice chairman of the Rules Committee.

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

Mr. Speaker, we are going to keep moving on. We were allocated the same amount of time. I guess the answer would be no.

Mr. Speaker, I yield 1 minute to the gentlewoman from Wyoming (Ms. Cheney), who is the favorite daughter of Wyoming and serves on the Rules Committee.

Mr. Speaker, I yield 1 minute to the distinguished gentleman from Pasco, Washington (Mr. Newhouse), who is a member of the Rules Committee.

Mr. Speaker, I reserve the balance of my time, and I am prepared to close.

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

Mr. Speaker, I want to begin by thanking our colleagues, the gentleman from Massachusetts leading the Rules Committee, and his ranking members as they came from each of the committees, some 50 hours' worth of hearings and markups, including some 16 hours in the Rules Committee to not only talk about and vet, but to understand more clearly what we would be voting on.

Mr. Speaker, today is a bill that is a compromise bill, no doubt about it. I had my own plan and I had my own ideas. I took 2 years to get involved in this process. It is difficult to write a healthcare bill. But it didn't have to be my bill; it had to be a bill that we could all work together on.

President Trump has been a part of that. President Trump took time out of his schedule to do this. It is important to the American people. President Trump, more than any single Member of Congress, gave the message to the American people about what was necessary and what he would do. He is going to live up to that, and we should, too.

Mr. Speaker, the bottom line to this whole thing is we are going to present a Republican plan, and we are going to stand behind what we sell. It is better for the American people. But make no mistake about it: we are transferring power, authority, and responsibility not just to States, but also to the American people. It will be up to them to make determinations about their own health care because, for the first time, we will allow some 50 million Americans to have a tax equity, an opportunity to use tax credits that will be available to families anywhere from $2,000 for an individual to $14,000 for a family.

This will empower people who have not found a fair shot at the tax advantages it will give them: small-business owners; the American people; the average worker in this country, including those who work two or three different jobs; as well as those who are uninsured. We believe it is a better shot, an opportunity. We are willing to put our name on it and behind it.

For these reasons, Mr. Speaker, I urge us to move forward. There will be 4 hours of debate that remain in this opportunity. For that reason, I urge my colleagues to support this 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, on that I demand the yeas and nays.