Floor Statements

I thank the gentleman for yielding.

I rise in strong support of the Fairness for American Families Act. As chairman of the Health, Employment, Labor, and Pension Subcommittee, I've held three hearings outside the Beltway--one in North Carolina-- where we talked to businesses and individuals about the effect of the Affordable Care Act on them and their businesses.

Let me just tell you about some people that I heard from. One was a divorced server in a restaurant that had her hours cut from 40 to 29 so that the company could stay in business. This woman now is missing an entire week's worth of hours every single month. She can't pay her bills unless she gets another job. The same problem for adjunct professors at the local community college.

And now, the audacity of what we've done is we've forced businesses to cut these hours, where they make less money, and then penalize you when you don't buy something. That's wrong. The right thing to do is to delay this for both individuals and businesses so they can work out the problems. That was the President's suggestion. I strongly support this bill.

Mr. Speaker, I rise today in support of designating June 20, 2013 as American Eagle Day and celebrating the recovery and restoration of the bald eagle, the national symbol of the United States. On June 20, 1782, the eagle was designated as the national emblem of the U.S. by the Founding Fathers at the Second Continental Congress.

The bald eagle is the central image of the Great Seal of the United States and is displayed in the official seal of many branches and departments of the Federal Government.

The bald eagle is an inspiring symbol of the spirit of freedom and the democracy of the United States. Since the founding of the Nation, the image, meaning and symbolism of the eagle have played a significant role in art, music, history, commerce, literature, architecture and culture of the United States. The bald eagle's habitat only exists in North America.

Over the years, several members of Congress have introduced and passed resolutions in support of the designation of American Eagle Day.

I hope my colleagues will join in celebrating today, June 20, 2013 as American Eagle Day, which marks the recovery and restoration of the bald eagle.

President Obama took the stage last Friday in California and admitted that some Americans will see higher costs on their health care premiums, but blamed employers for shifting costs rather than taking responsibility for the damage caused by his damaged health care reform.

The President also said the law was ``working the way it was supposed to,'' but many employers, myself included, cannot tell their employees exactly what their health insurance premiums will look like next year.

Worse, President Obama neglected to include all the facts in his stump speech, touting a recent report that claimed health care would be less expensive for Californians under the law. The truth is: in California, the cheapest plan under ObamaCare for a 25-year-old man is roughly 64 percent to 117 percent more expensive than the five cheapest policies sold today, according to The Wall Street Journal.

The uncertainty around the implementation and cost of the Affordable Care Act is causing economic chaos during a time employers need stability, and it appears this train wreck is only going to get worse.

Madam Speaker, ObamaCare was a bad idea 3\1/2\ years ago, and today we're seeing exactly how this law is bad medicine for this country.

Mr. Speaker, yesterday, during a hearing on the Education and Workforce Committee, Secretary Sebelius dismissed concerns regarding the impact that the Affordable Care Act will have on small businesses as ``speculation.''

But in my district--and all across this country--the negative impact of this law is a sad reality. I've held field hearings in Indiana, Pennsylvania, and most recently North Carolina to hear directly from job creators about how they will have to cut hours or hire fewer employees because of the Affordable Care Act.

Just this past Sunday, my hometown paper, the Johnson City Press, ran an advertisement from a Burger King franchisee owner announcing he was being forced to close one of his stores as a result of, among other things, ``a law so unfriendly to business and workers it forces the business to limit hardworking Americans to less hours and lower pay at a time of high unemployment and less opportunity for people to prevail.''

This entrepreneur wants to grow his business, not shrink it. But instead, we are limiting his opportunities and those of Tennesseans that he would employ. Speculation? I hardly think so. We can--and must--do better.

I thank the chairman.

I rise in support of the Smarter Solutions for Students Act. Student loan debt, I agree with my colleagues on the other side of the aisle, is a huge issue in this country.

And how did we get to the current rate of 6.8 percent, I asked myself. I went back and reviewed it, and in 2006, the Congress decided that interest rates were too high, so they wanted to lower the interest rates, but found out they couldn't afford the cost of it.

So gradually, stepwise, it went down last year. In 1 year we had a 3.4 percent student loan rate tied to nothing other than the whims of Congress. It created a fiscal cliff for loan rates. So we voted to extend it for 1 year to give us time to have a permanent solution for this.

The permanent solution that we're offering is to simply treat a student loan like any other loan and tie it to a Treasury note plus 2.5 percent for a Stafford loan.

Now, what does that mean?

Certainly, Mr. Speaker, very eloquently, Mr. Miller spoke just a moment ago about how rates can go. Variable means rates can change. That's absolutely true. But rates can also go down. It doesn't necessarily mean that rates will go up. And in acknowledging this, an 8.5 percent cap was put on those loans.

I checked the student loan rate if you went to your local bank or credit union to see what a loan rate would be, and it's about 7 percent now, higher than that.

And I agree with my good friend, Ruben Hinojosa, who believes that we

should work for ways to help make college more affordable. I could not agree more.

The Secretary of Education, just this past Wednesday, said he agreed and supported a permanent solution. The President said he supported a market-based approach. This will give certainty to it, and certainly I would urge my colleagues to vote and support this very-needed piece of legislation.

I yield myself 2 minutes.

Today, I rise in strong support of H.R. 45, the repeal of a flawed health care reform bill.

I came to this body 4\1/2\ years ago understanding that the greatest problem with the American health care system was cost and access. I knew this because I practiced medicine in east Tennessee for 31 years. I also have been involved with health care reform in Tennessee beginning in 1993 with our attempt to reform our Medicaid program called TennCare. I knew here what not to do. ObamaCare is what not to do. We saw costs skyrocket, and we saw our then-Democratic Governor cut benefits and cut the rolls, therefore rationing care.

We need health care reform today in this country, but we need patient-centered health care reform where patients, their families, and their physicians make health care decisions, not government bureaucrats with 20,000 pages worth of rules or insurance companies.

Health care should not be a partisan issue. I, as a physician, have never seen a Republican or a Democrat heart attack. I have never operated on a Republican or Democrat cancer in my life.

We were made promises during the health care debate: your insurance premiums would go down, jobs would be created, and access would be expanded. What's really happened? Insurance premiums have skyrocketed by as much as 100 percent. We're looking at tax increases for individuals, taxes on productive companies, and taxes on lifesaving medical devices. Small business owners are being forced to cut hours, delay investment, and stop hiring just to stay afloat. This comes at a time when families need more income to make ends meet, not less hours to work and higher insurance premiums.

Are patients getting lower costs? It's an emphatic ``no.'' And maybe the biggest insult of all, the IRS will determine if your insurance coverage is adequate.

Mr. Speaker, I stand ready to repeal this flawed bill and work with my Democratic colleagues on health care

reform that will truly work for the American people, and I reserve the balance of my time.

Madam Speaker, I yield myself 15 seconds.

I just left in my office the Tennessee insurance commissioner who said the first of January, the individual market, 40 to 75 percent higher premiums; the smaller-group market, 50 to 55 percent higher. Plans would be less rich, with higher copays, higher deductibles, young healthy males get a huge increase. Instead of having eight statewide plans, we're now down to two and maybe one.

I now yield 1 minute to the gentleman from Montana (Mr. Daines).

Madam Speaker, I now yield 2 minutes to my

good friend from Indiana (Mr. Bucshon).

Madam Speaker, I now yield 2 minutes to the gentleman from Arkansas (Mr. Cotton).

Madam Speaker, I now yield 1 minute to the gentleman from Pennsylvania, Keith Rothfus.

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

Madam Speaker, very briefly, Republicans and Democrats did vote to repeal the 1099 and the IPAB and to repeal the device tax and the CLASS Act. Then we hear we didn't have any solutions. There were 80 amendments to this bill. None of them were ruled germane to the bill. I had 10 amendments on which I wanted to work with the other side. The Republican substitute was voted on, which is an across-State-lines association of health plans actually funding high-risk pools for preexisting conditions, HSAs and consumer-driven, putting the patient in charge of health care decisions.

I now yield 1 minute to my good friend from South Carolina, Joe Wilson.

Madam Speaker, it is now my pleasure to yield 1 minute to the Republican Majority Leader, the gentleman from Virginia, Eric Cantor.

Madam Speaker, I now yield 1 minute to my friend from North Carolina, Richard Hudson.

May I inquire about the time.

I now yield 1 minute to the gentleman from Texas, Randy Weber.

Madam Speaker, I would now like to yield 1 minute to Scott Perry of Pennsylvania.

Madam Speaker, I now yield 1 minute to Mr. Doug LaMalfa from California.

Mr. LaMALFA Madam Speaker, I'm pleased to be able to join my colleague, Mrs. Bachmann, on this legislation.

We do have a history in the past of repealing bills, such as Prohibition. It has been done, so this one would have near the same status in size by the time it's all done.

I'm from California. We know a lot about boondoggles in California, going back to high-speed rail and other issues like that. They call this the Affordable Care Act, and it's still being done with a straight face. Really? Price tag: it was advertised as $900 billion. Now it's approaching $2 trillion.

Jobs--48 percent of business owners are saying that they're holding off on new hires because of the ObamaCare health care takeover.

Taxes--again, affordable? There's over a trillion dollars in new taxes with more in sight. How are we calling this affordable?

We've had seven different measures to repeal portions of the Obama health care takeover, with more on the way.

And this part is really great: thousands of new IRS enforcers will be hired to help implement ObamaCare. Isn't that great. I ask you to support H.R. 45.

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

Madam Speaker, I came here 4\1/2\ years ago in a bipartisan way to work on health care reform which this country desperately needed. We've now had 3 years to look at the Affordable Care Act, and I wish the bill had done as everyone had described here today. I wish that it had done that. I wish that costs had gone down. I wish that businesses were hiring everybody because of this bill. I wish that taxes were not going up. But none of these are true. They are. And I wish that we had debated this bill in an open manner here by regular order, the Senate version of the bill on this very floor of the House, which we did not.

So I asked our insurance commissioner today in Tennessee, if we did not pass this bill--and you just heard me say earlier in the debate about premiums going up 50-plus percent--I said if we did absolutely nothing, what would happen to rates in Tennessee? They would go up about 8 to 10 percent. We would be much better off in my State and around this country; and, again, I came here in a bipartisan way not to work on a partisan bill, which is what this is.

Madam Speaker, we need to repeal this bill and to replace it with patient-centered reforms that put patients and doctors back in charge of health care decisions.

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

I thank the chairman.

Mr. Speaker, I rise in support of H.R. 1406, and I encourage my colleagues to support this.

In my previous life, I served as an employer for over 30 years, as a single parent and as a mayor of a city.

We had an issue several years ago with our fire department on compensatory pay versus overtime. We agreed with the firefighters. It worked out fine. The firefighters all understood they couldn't all be gone on the same day. They worked with us great, and it was not a problem. It works in the public sector. I don't know why it cannot work in the private sector.

All this bill does is leave the decision to receive comp time. It's completely voluntary. You don't have to do it. You can choose to do it if you want to. Number two, workers can withdraw from the comp time agreement whenever they choose. They can do that. It's not a problem. All existing protections in the Fair Labor Standards Act are maintained, the 40-hour workweek and how overtime compensation is accrued. It is up to the employee to decide when to use his or her comp time as long as there is reasonable notice to the employer.

I certainly have heard mentioned what happens if an employer goes bankrupt. Well, what happens when a city like Stockton, California, goes bankrupt?

I will finish by saying over and over that more work and less pay for working mothers doesn't make it true. I support this bill, and I urge my colleagues to do so.

I thank the Speaker. The hour we are going to spend with our Physicians' Caucus is going to be on health care today. I'm joined by numerous colleagues here on the House floor from the Doctors' Caucus to discuss this extremely important issue.

When I was elected 4 years ago to the House, one of the burning issues at that time was health care reform in this country, and the greatest problem with health care in America was the cost. Certainly I could see it every day. I practiced for 31 years as an obstetrician- gynecologist in Johnson City, Tennessee, a small town in northeast Tennessee. I saw where it was becoming harder and harder and harder for my patients to afford care. The major problem was that.

Number two, we had a problem with access. We had working people out every day. Maybe one was a carpenter, maybe the wife worked at a local store that didn't have health insurance coverage. Together they made a living that was livable in northeast Tennessee, but certainly not enough money to pay $1,000 or $1,500 a month for a health insurance policy.

Thirdly, we have a liability crisis. When I began my practice, I thought about it, I began in 1977. I know this is hard to believe, but we would take care of a woman who was pregnant for 1 year and see her for a 6-week checkup and stay as long with her as we needed to when she was in labor, and that cost was $360. And if you had a Caesarean section, it cost another $100. So it was very affordable. Even young families could come in and make payments and pay for it. The hospital bill was more than that, but it certainly wasn't the exorbitant prices that we see today.

The malpractice premium I first paid, and obstetricians and neurosurgeons and others are very high risk, was about $4,000 a year. Five years ago when I retired from my practice to run for Congress, the malpractice premiums had ballooned to the mid-$70,000s, and the patients didn't get anything more for that. They didn't get better care. They just got a higher bill. It didn't improve the quality of their care. So we can see, number one, cost.

I remember when we had the debate down here. I stood in the well of the House the night we debated that bill, in March of 2010, to vote on it. I was one of the last people to stand down here, and I remember the President's remarks: If you like your health insurance, you can keep it. And your costs are going to go down by $2,500.

Now 3 years later, let's see what the reality is. Many of us here in the Doctors' Caucus brought decades, and I do mean decades. I look around, and I wish each speaker as they step up, would tell how many years they practiced medicine. You'll see the experience that's on the floor today. So what happened was the cost has gone up; it didn't go down. And I'm not even sure after this is all implemented that access is actually going to increase because as we discuss during this hour, you'll see that for some people there's more access, but for others it may be cut off; and I think it was unintended. I don't believe that they wrote a bill to actually do that, to actually cut access. But I think the reality is it's going to happen.

Before I continue, I want to introduce one of my colleagues, Dr. Phil

Gingrey, who is in the well today. Dr. Gingrey and I are both OB/GYN doctors. He is from Georgia, and a good friend. Dr. Gingrey, I yield to you.

It reminds me, Dr. Gingrey, of biochemistry in college. Looks like the Krebs cycle, the sugar cycle. It is incredibly complicated, this bill is, and I think we need to spend more time explaining it to the American people.

And one of the frustrations, Dr. Gingrey, that I've had is that I've read the bill, as you have, as many of us have, probably all of us have in the Doctors Caucus.

I went to a hearing the other day on the Veterans' Affairs Committee on which I serve. We spent 2 hours and 15 minutes explaining the effects of the Affordable Care Act on veterans with Dr. Petzel, who is the medical director of the VA. The IRS, the Treasury Department was represented. And when we walked out of that room, I don't think anybody could explain to you the effects of the Affordable Care Act on our veterans.

I yield to Dr. Gingrey.

Correct.

I now yield to my good friend, Dr. Andy Harris from Maryland One. And Dr. Harris serves on the faculty of Johns Hopkins University. He's an anesthesiologist.

Dr. Harris.

I thank the gentleman.

Dr. Harris, if you would stay there just a moment so that people understand: How could this possibly happen? How could young people-- which I have three children, and I think it's a good idea to keep our under-26-year-olds on. I think there were a lot of things we could have all agreed upon. But the thing that we didn't explain to people is: How did you get this number? Why did that happen?

Well, here's why it happened. Young healthy people are going to be subsidizing people who are not as healthy and older. How does that happen?

Well, this bill does not allow you--when actuaries look at it, they know that I'm six times more risky than someone who is my children's age, who is in their twenties. In other words, I've got six times the actuarial risk that they have. The bill only allows an actuary to charge 3 to 1.

So a healthy young person that's 25--Dr. Harris and I were laughing. Having a son--and I know that he has a fine-looking young son. We know that you insure young boys for stupidity. They're going to go out and trip and fall and jump off things, but illness is not it. So we're taking young healthy men and women, 20 to 25 years of age, sometimes doubling and tripling their costs so that someone else's can be a little less expensive.

Now, what would a young person do if all of a sudden they were going to pay $80 or $90 a month for a basic health insurance policy and now it's $300, or they can pay the first year a $95 fine, a $95 fine and they have guaranteed issuance, they cannot be turned away? There can be no preexisting conditions, so they can get the insurance. So what do you think these smart young people are going to do? They're going to figure it out pretty quickly. They're not going to subsidize that, and they're going to be very upset when they look at their first paycheck and realize what's happened to them.

I yield to Dr. Harris.

I thank the gentleman for yielding.

I would now like to yield to my friend and colleague, a new Member, Dr. Brad Wenstrup from Ohio, near Cincinnati. Dr. Wenstrup also has served in Iraq in our military. I now yield to Dr. Wenstrup.

I thank the gentleman.

And before you leave, Doctor, I want to ask you a question. This is an issue that is very near and dear to my heart. I have a bill, H.R. 351, which is to repeal the Independent Payment Advisory Board. When I read that health care law, this was not in the original version of the House version of the bill. This version came from the Senate version. The House version did not. And Representative Neal from Massachusetts wrote a letter to then-Speaker Pelosi, which I signed in a bipartisan way, to not put this in. It was included in this side.

So to better understand, let me sort of go over just a minute and we'll talk about it in just a little more detail. I know you have another appointment, but there are 15 people on here, and only one of them may be a doctor. These are health care policy people. Basically, all this board does is to determine how Medicare dollars are spent. There's a preset budget in Medicare, and if you spend more than that, this board is charged to give the Congress, they have to cut. If they don't make different cuts, they have to make the ones that this board-- and that's how it's going to affect care.

Guess where the cuts are coming from? They come from providers. And if you keep cutting the providers, you will lessen access. I've seen it happen, and I'll go through that after you leave. But that is exactly what's going to happen. If you don't believe me, simply read a New England Journal of Medicine article in June 2011. This is an article that is not for it or against it. It just analyzed it. It looked at the formula, and they looked back 25 years. In 21 of the 25 previous years, this would have cut providers.

Guess what the Congress has been able to do? The Congress has been able to override those cuts in the SGR, the way doctors are paid through Medicare now, and prevent that loss of access. Without a three- fifths majority in the Senate, we've lost that ability; we've given up our constitutional right for the people to come to us and say that we don't believe this is the way it ought to be going. It is a huge mistake.

I believe in that poster of gibberish down there that you're looking at. It's the single worst thing in there because it will ultimately deny access for our seniors. I believe that in my heart of hearts. I've seen it in Tennessee with our TennCare program, which I'll discuss later.

I will yield back to you if you would like to make any closing comments.

I thank the gentleman.

He pointed out something that's clear from his statement down there-- he is and has been a practicing physician--because each of us know this, Mr. Speaker, that health care decisions should be made between a patient, the doctor, and that patient's family. It shouldn't be made by insurance companies. It shouldn't be made by organizations, ACOs, the government, IPABs and so forth.

When you're in need, you see the person, the doctor most capable of taking care of your needs, and you make a decision based upon that between you and that family. We're losing that in this country with the doctor-patient relationship, and it is a very, very, very bad thing to happen.

I would now like to yield to my good friend, John Fleming, from Louisiana. He is also a veteran and a three-decade family practitioner.

Dr. Fleming.

I thank the gentleman for yielding. And let me reminisce before I yield to my friend from Indiana.

As a young medical student in Memphis many, many years ago in the late 1960s, my first pediatric rotation was at St. Jude Children's Hospital, a remarkable place. At that point in time almost 90 percent of children died of their disease. I would go in and start an IV, and Dr. Fleming, I can still remember seeing some of those kids, I knew they wouldn't survive. It was very hard for me emotionally to deal with that.

Fast forward today, almost 90 percent of those children live today. And they are treated at no cost, their families are sent there at no cost. I've had children of patients of mine who have gone to that wonderful place. I hope that we don't end up in a Middle Ages in health care, with device taxes and disincentives for new medications.

You and I both remember, when I graduated from medical school there were five or six anti-hypertensives, three or four of them made you sicker than high blood pressure did. Well, today there is a plethora of wonderful new medications to use for people. There wasn't a day that went by that I went in the operating room that I didn't see somebody that needed surgery for a bleeding ulcer--almost every day. It's unheard of now because of new medications.

I just found out today, in my own State of Tennessee--and I did not know this--the largest thing that we export in the State of Tennessee is, guess what? Medical devices. It will hurt my State dramatically in jobs, as you clearly point out--and I know, Dr. Bucshon, in Indiana you're very concerned about that.

You mentioned the IPAB. If the President right yet has not appointed anyone and no one is approved, or they don't have a quorum, they don't have at least eight people confirmed by the Senate, guess who makes all those decisions at the IPAB? One person. That's the Secretary. That's who makes all the decisions. Not the Congress. We have given up, this body--even though it may look funny down here with us debating and contentious, that's what we're elected to do. We are turning over that power--could be--to one single individual. It's Secretary Sebelius right now; there will be a different name 4 years from now. I don't want that person, be it Republican or Democrat--that power should be here.

I yield to the gentleman.

I thank the gentleman.

Mr. Speaker, I would now like to take the opportunity to yield to my good friend from Indiana, a cardiothoracic surgeon, Dr. Larry Bucshon.

Will the gentleman yield?

Here is what absolutely amazes me about--and I'm glad Senator Baucus mentioned this as a train wreck. I wrote an editorial about it 3\1/2\ years ago describing the train wreck of TennCare. But that's not what I want to talk about.

What I want to talk about, Dr. Bucshon, is we have people right now today, for instance, in Medicaid, a system that what did we do? We expanded a system that was already broken.

If you look at surgical outcomes for Medicaid patients, they're worse. The outcome is a huge study--eight hundred and something thousand patients--done by the University of Virginia. Those outcomes were worse than people who did not have health insurance coverage.

Why would you expand a program that's already broken? Why don't we fix that first? I know Dr. Fleming has talked about this at length.

I've always thought this: Why do our lower- income patients deserve different care than somebody else? They don't.

And they do not. They should get the same care and deserve the same care that anyone else has.

Maybe the President when he said, I'll go over this bill line by line with anybody who wants to, maybe he should have taken that up with us and gone over it with the Doctors' Caucus line by line, because we came here in a totally nonpartisan way.

Health care should not be a partisan issue. Dr. Bucshon has taken care of numerous cardiac patients with heart attacks. He doesn't know whether they're Republicans or Democrats. He could care less. They are just patients who need care.

I yield back to the gentleman.

I just spoke to a physician today from Massachusetts. He said what had happened there, and what's not clearly understood by the public--unless you're in this line of work you don't--is how the payers pay.

Medicaid, for instance, pays about 60 percent of the cost of actually providing the care. Let's say private insurance is a 1. Medicare would pay about 90 percent.

The people they added in Massachusetts paid about the same as Medicaid. What happened was big insurers, big corporations with lots of employees could negotiate a really good price, but small business could not. So when the hospital had bills to pay, they shifted those costs to private business, forcing their premiums up and up and up and up. That's why you are seeing those premiums for small business escalate until you really force them out of business.

We talk about the exchange, and what absolutely frustrates me is that, on the 1st of October--and this is a person who works in Congress, who is a doctor who understands health care--I can't even tell the people who work for me here in the Washington office and in my office back in the district in Tennessee what their health care premiums are going to be or how they're going to get their health insurance coverage, and that is 90 days from now I can't tell them. You can imagine what other businesses are going through. I can tell them this: that I bet it's going to cost them a lot more money.

I thank the gentleman.

It is ultimately about the patients that we take care of. Really, it's not about systems and organizations and insurance--it's about people. That's the frustrating part to me because I think people are going to be harmed by this.

I know Dr. Fleming mentioned small business. I was in North Carolina last Tuesday, a week ago today, holding a hearing, which I hope we have time to go through maybe a little later, on small businesses and how this is going to affect them. It's really eye opening to see businesses that have done everything exactly right. Mr. Horn is someone I want to talk about in just a minute who provided health insurance--all preventative services. He is

self-insured. He did everything right. It shouldn't have cost him a nickel, and yet it is going to cost his business thousands of dollars. So we'll go into that.

At this point, I want to yield some time to my good friend G.T. Thompson from Pennsylvania, who is part of our Health Care Caucus and who is a health care administrator.

I thank the gentleman.

As we finish, I want to go over just a couple of things. One of the things the Secretary stated, Dr. Fleming and Mr. Thompson, is that she needed to use some money, and the prevention fund was one of the things she was going to use to help implement the exchanges. We've now had prevention funds used for massage therapy, kickboxing, kayaking, Zumba and pickleball. I didn't know what pickleball was. But that's tennis, badminton and ping pong. I can go on and on. It's utterly ridiculous. It should have been spent on health care. That's what this bill was supposed to be about.

Let me finish by saying that even with this 1 hour here, we have lots more to talk about. We've barely scratched the surface. It's a complicated issue. Democrats and Republicans should have gotten together in a bipartisan way to work out a health care plan that does the principles that were pointed out here today, which is to increase access and quality, lower costs and to leave health care decisions in the hands of doctors, patients and those patients' families.

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

Mr. Speaker, I stand today to express my horror at the accusations made in the trial of Kermit Gosnell, an abortionist in Pennsylvania. If these charges are true, they're horrific.

Let me speak from my heart. I am an OB/GYN physician who has delivered almost 5,000 babies. In my heart of hearts, I cannot imagine what must have gone on in the guise of health care in that abortionist clinic. It is physically nauseating for me to think about what this doctor did.

Life is a precious miracle, and the children who lost their lives in Philadelphia were blessed with this miracle only to have it so cruelly ripped away from them. Regardless of whether one is pro-life or pro- abortion, we should all agree that these children deserved a chance at life.

This country carries a responsibility and duty to protect those who do not have a voice, including the unborn children of America that represent our greatest silent minority. They're the most innocent among us and deserve the protections we afford to all other people in this great country.

One of government's most important duties is to protect the most vulnerable among us. I pledge to continue to remember and to strive toward this.

If found guilty, I expect the full weight of the law to be used to punish the accused.

I simply will finish by saying, as a reminder to all of us, what a precious gift of life our children are.

Mr. Speaker, I rise today in strong support of H.R. 1120, the Preventing Greater Uncertainty in Labor-Management Relations Act.

First, some history. The National Labor Relations Act was passed in the mid-thirties, and the National Labor Relations Board of five members--three from the majority party and two of the minority party-- are to act as a fair arbiter. Basically, the referee for disputes.

And there was a ruling of the Supreme Court not long ago with regard to New Process Steel that said that two members--one Democrat and one Republican--both who agreed on over 600 decisions, that a quorum was not present and all of those decisions had to be thrown out. Therein calls the question.

The President made a pro forma recess appointment. Presidents, as has been stated here many times, have

made recess appointments to various boards and they had the constitutional right to do that; but no President has ever made a recess appointment during a pro forma session. Let me read here from the Senate Congressional Record of November 16, 2007. This is Leader Reid:

Mr. President, the Senate will be coming in for pro forma

sessions during the Thanksgiving holiday to prevent recess

appointments.

The recent ruling of Noel Canning stated that the appointments were unconstitutional. The unique part of the National Labor Relations Board is that any other court circuit ruling in the country can be appealed to the D.C. circuit. So they have standing, and the standing says that the aggrieved party can do one of two things: they can ask for a vote of the entire court or they can appeal it to the Supreme Court.

This is a very simple bill. It does several things, and it asks the following:

One, that the Supreme Court rule;

Two, that the President go ahead and make the appointments;

Three, that the Board not issue any further rulings that may be overturned and create this uncertainty; and that once a board is approved, that it goes back and reviews all of the various rulings that have been made in order to get rid of this uncertainty.

We need the certainty for both labor and management to move forward. It's a very confusing time, and I would ask for the support of this bill.

I thank the gentleman for yielding. I appreciate the opportunity to speak again here on the House floor about health care, something that I've dedicated my life to, as many of us have here on the House floor--Dr. Burgess, Dr. Harris, and others.

I think the thing that has bothered me so much about this, and the reason I've made a choice to come to Congress, is to work on health care. There are many other things I wanted to work on, but this was primary. And I've brought a wealth of experience from our State that tried health care, a program called TennCare, where we reformed our Medicaid program in the '90s and then re-reformed it in the mid-2000s when we realized it didn't work.

What happened? What was the argument? Well, the argument and the promise. What was the promise that the President and the opposing party made during the health care debate? We want to include--which is a good thing--more people in health care, provide coverage for more people.

As Dr. Burgess just pointed out, we had 160 million people in the private insurance market that needed a little tweaking, but didn't need to be blown up, as we are seeing has happened right here. We have our Medicare patients, 47 million of them, already covered.

Medicaid, which we tried to reform in Tennessee, is an entirely different issue because Medicaid doesn't provide, in my opinion, the best quality of care for lower-income people.

There are studies out there. I read one this morning: 900-and- something-thousand patients who were uninsured actually got better health care outcomes than those patients covered by Medicaid. There is something wrong with a plan that you're expanding that doesn't work now. So I think that was one of the things.

What did we find out in Tennessee? What did we discover? Well, we found out we were spending $2.5 billion a year on TennCare in our State; 10 years later we were spending $8.5 billion, over three times what we started out. Half the people that got on TennCare had health insurance and dropped it. This is exactly what you are going to see in the market.

And quality of care went down. Why did it go down? Because when Medicaid paid less, doctors saw less, patients lost access. That is one of the great concerns I have here now, is that right now we don't have enough primary care people, and you are going to see access lost in this State.

I certainly think we have a plethora of ideas about how to improve the health care system. Three years ago, I stood out with Michele Bachmann at midnight outside this Capitol with thousands of people who passionately did not want the Federal Government making their health care decisions. They're still out there. When you go home, you will find out that 55 percent of the folks do not want this and they want it reformed. They want health care reform; they do not want this plan.

I appreciate the opportunity to be down here and speak on this extremely important issue on the third anniversary of ObamaCare.

There's no question, Dr. Burgess. What we saw happen in our State was--the way governments always fix their problem when they overpromise--is they put a plan out there, more people sign up than they thought, as will happen in the exchanges and the subsidies and so forth; and when that happens, the way they balance the budget is they cut the providers--the doctors, the nurse practitioners, the hospitals, the home health care. The people that actually give the care get cut.

They finally cut it enough that it doesn't cover the cost of the care. And when that happens, the providers can no longer afford to see you, which means if you lose access, even if you've got the prettiest looking card in the world but you can't get a doctor to see you, the quality of your health care goes down, and ultimately it increases the cost because the severity of your problem which goes undiagnosed, untreated, is more severe to take care of. And then you show up in the emergency room, which is exactly the wrong place. We saw this over and over in our State.

For instance, in New Jersey right now, I think 60 percent of the primary care providers don't take Medicaid. What good does it do to expand Medicaid in a State when you don't have providers that will see those patients.

If you look at Massachusetts, we were told that the number of ER visits were going to go down. They didn't. They went up. That's exactly where they end up. They end up in the emergency room for primary care, which is where they should not be.

Dr. Burgess, one of the great frustrations I've had in my short 4-year political career here--this is my third term-- was there were nine of us in the Physicians Caucus when I showed up here. Not one of us was asked about this bill. I spent my life out there in the private world, 31 years, practicing medicine, providing care for patients, not bureaucracies and this, but actually seeing one patient right after another, delivering their babies, operating on them.

And what happens is, when you have a public program that promises more than it can produce, guess what? You get that patient in the hospital, and because it doesn't pay for the cost of the care, what happens? You shift that cost to the private sector, not only taking in inflation, but that cost shifting, to force it up. And you were led to believe it was the ``free riders.'' It's the public programs that are the biggest problem there, that are forcing those shifts in costs, and hospitals are caught in a dreadful situation.

They agreed to take the cuts in Medicare because they thought they were going to get an increase in insured people. It turns out what Congresswoman Bachmann brought up about how can you lose your private insurance, there may be as many people that lose their private insurance as we increase in Medicaid, which is a failed program now.

How bad is that when you take people who had insurance they liked, and they lost it, and now they are forced to no program or a Medicaid program that is fading?

Will the gentleman yield?

One of the things I noticed with our Democratic Governor, Phil Bredesen, who is a health care specialist and was the Governor of our State of Tennessee 8 years during the 2000s, the Obama administration would have been well-served to pay attention to Governor Bredesen, because Governor Bredesen was forced with a situation where he had to balance a budget. The health care costs were eating up this budget, and he had to cut the rolls. That's how the Governor elected to take care of this. After they cut the providers until there weren't any providing, he then had to cut the rolls from the TennCare program. That was very painful and hard to do.

And I would certainly warn Governors out there, when you massively expand these rolls, let me tell you, politically that was very difficult for the legislature and for our Democratic Governor. My hats are off to him for the decisions he had to make. Those were not easy for him to make. And you're absolutely right, the Governors are really the thought processes and the experiments in the local governments and State governments that you can actually do something and see whether it works instead of this massive mess that we have.

I just got a schematic of this yesterday. It's a 21-page--and I should have brought it down here on the House floor--schematic about trying to figure out whether you qualify for health insurance.

Let me tell you how it was when I hired somebody in my office. When I hired a new employee, guess what I did? They came in said, Dr. Roe, do you have health insurance? I said, Yes, we provide health insurance; go sign up on the way out. It took 5 minutes.

This thing is going to take you a week to go through to figure out whether you belong in the Medicaid box, whether you belong in the private insurance box, whether you're going to get it at all, whether you get the subsidy or you don't. It's maddening. And it provides nothing to increase the quality of the care that we are required to do to give to our patients.

Mr. Speaker, I submit these remarks today to recognize Mr. David Pickler, who has recently been elected as President of the National School Boards Association for 2013-2014.

David has served on the Shelby County Board of Education since 1998 and has served as Chairman of the Board for 12 years. In 2008, David was elected to the National School Boards Association's Board of Directors and served as the Southern Region Representative. In 2009, David served as President of the Tennessee School Boards Association and has held several positions of leadership with It.

David is an excellent example of the spirit of volunteerism, which we Tennesseans hold close to our hearts. His community service and philanthropic endeavors are both numerous and extraordinary, casting a legacy of selflessness and determination to better education across Tennessee. Perhaps the highlight of this legacy is the creation of the Shelby County Schools Education Foundation, which has provided more than $1 million in financial support for public education. David's awards and accolades at the local, state and national level are extensive and serve as a testament to the positive impact he has had on the children of Tennessee.

Mr. Speaker, I commend Mr. Pickier for his unwavering commitment to improving education for the students of Shelby County, Tennessee, and the United States of America.

Mr. Speaker, I was not present for votes on March 18, 2013 due to a declared state of emergency in my district. Had I been present, I would have voted yea on rollcall votes Nos. 76, 77, and 78.

I thank the chairman.

Madam Chair, today, there are more than 12 million Americans who are out of work. These lives are on hold until the economy gets better-- provided that we here in Washington can stop ourselves from taxing, borrowing, spending, and regulating it to a standstill. But even in this time of economic uncertainty, there are 3.6 million job openings in this country that remain unfilled--unbelievable when you have 12 million people out of work.

I support the bill on the floor today, H.R. 803, the SKILLS Act, because it will help give some of our neighbors the sense of dignity and satisfaction that only comes from a hard day's work done well.

This legislation will help to bridge the gap between unemployment and work in three significant ways. First, the SKILLS Act will ensure that workers can access job training programs immediately, eliminating the need to navigate a complicated bureaucracy. By cutting through the red tape, we can get workers trained and back into the workforce more quickly.

At the same time, this bill removes some of the burdens on State and local officials by repealing 19 mandates that impact who can serve on workforce training boards, the entities that oversee local job training programs.

Second, the SKILLS Act will require State and local leaders to use common performance measures to measure the quality of services offered to workers. This will ensure that there's accountability in workforce training programs, ensuring a good return on taxpayer dollars.

The bill also empowers job creators by requiring that two-thirds of workforce board members are from the business community. Giving more say to the people who know the needs of their businesses and the local economy is just plain good common sense.

Finally, the SKILLS Act will ensure that taxpayers are seeing a good return on investment by eliminating or streamlining 35 ineffective or duplicative Federal programs. It also gives Governors additional flexibility to further consolidate any additional employment and job training programs at

the State and local level to ensure efficiency and cut waste.

Let me just, Madam Chair, go through a few of these. We talk about duplicative programs. This will help consolidate some of these. These are the names of the programs: Reintegration of Ex Offenders; Grants to States for Training for Incarcerated Individuals; Second Chance Act Prisoner Reentry Initiative. It looks to me like we could have one program for all of these.

Let me read a few more: Refugee and Entrant Assistance--Targeted Assistance Grants; Refugee and Entrant Assistance--Social Services Program; Refugee and Entrant Assistance--Targeted Assistance. And I could go on and on with 35 programs. We heard our chairman speak that one in five actually completes one of these programs here.

Let me just tell you what happens in our State of Tennessee. Every Tennessean is within 1 hour of a technology center. These are all across our State. Even in today's economy, with the economy being what it is and hard to find a job, 90 percent of these people get a job, are hired right now today, not one in five.

I thank the chairman for yielding.

I wanted to finish by saying there are things that work today out here--today--that we can emulate. And we need to streamline this. You should read all these 35. I agree with Ranking Member Miller. We do need to reform these, and that's what this is an attempt to do. I want to commend Dr. Foxx and Chairman Kline for the leadership on this issue, and I encourage my colleagues to support this bill.

I thank the chairman for yielding.

Mr. Speaker, I rise today in support of H.R. 890 and preserving one of the most significant and successful Federal reform initiatives in the last 20 years.

Seventeen years ago, a Republican-led Congress worked with President Clinton to fix a broken welfare system. The bipartisan law that resulted established the Temporary Assistance for Needy Families block grant program. This law also required individuals to work, prepare for work, or look for work as a condition of receiving public assistance.

In the years following passage, the number of individuals receiving welfare dropped by a whopping 57 percent. The poverty level among single mothers fell by 30 percent, and I saw this in my practice as an OB-GYN physician. No question that it worked.

And this is while their income and earnings increased significantly. Poverty levels among young African Americans dropped to its lowest level in 2001. Last July, the Department of Health and Human Services issued an unprecedented guidance indicating that it would allow States to waive welfare work requirements. The law and the historical record are clear: the administration does not have this power.

But if there's any confusion, H.R. 890 will dispel it. This commonsense bill would prohibit the Secretary of HHS from moving ahead with this illegal waiver plan. More than 80 percent of Americans support the work requirements included in welfare reform, and this legislation ensures the hard work of the 104th Congress and President Clinton isn't undone by this administration.

Mr. Speaker, we should celebrate work in this country. We should help those who are down on their luck find a job--something all the House will do later this week when it considers the SKILLS Act. And for those Americans who need help, we should offer it--but not as a permanent entitlement.

I commend Chairmen Camp, Kline, and Scalise, along with Mr. Southerland, for their leadership on this issue, and I urge my colleagues to vote ``yes'' on this bill.