Floor Statements

I welcome the President's budget submission, which will mark the first time since 2009 that the House, the Senate, and the President have all submitted budgets. It's an encouraging development, but the larger question is whether Congress can actually use the budgeting process to show how we will do business differently.

Despite the media sideshows about the artificial sequestration crisis, the major issues we have to address to fix the budget and our current deficit are spending on defense, health care, and the tax system itself.

Although the administration has started us down a path to manage Pentagon spending in the future, we have barely scratched the surface. There are too many unnecessary bases at home and abroad that should be phased down or closed. There's far too much invested in an antiquated nuclear arsenal that we haven't used in 68 years and contains many, many times more weapons than we would ever need for deterrence. The $700 billion scheduled to be spent over the next 10 years must be reduced dramatically. We have yet to come to grips with the long-term costs of an all-volunteer Army and the right balance between reserve and regular forces. Until these fundamental issues are addressed, the challenges of the future are going to be difficult to face because we spend too much time and energy and money preparing for the conflicts of the past while we avoid hard budget reality.

Health care expenditures continue to be the greatest overall threat to the budget, but not because the United States doesn't spend enough money on health care. We spend more than anybody else in the world-- twice as much as many countries. But even spending far more than anybody else, we're still not able to deliver quality health care for most Americans. Instead of fighting health care reform, we should be working together to accelerate that process so that we can reward value over volume of health care. If the Oregon model of health care that we are working on diligently to implement were applied on a national scale, it could save over $1 trillion over the next 10 years--as much as was fought about in the battle over sequestration.

We must also reform the Tax Code, which is unfair, complex, and costly, with over $160 billion just to administer it. I would suggest that we think about implementing a carbon tax, which has the potential of reducing the deficit and tax rates for individuals and business in a fair and comprehensive form. The carbon tax has the added benefit of being the most direct way to reduce the threat to the planet caused by extreme weather events promoted by carbon pollution.

It's very encouraging that the President's budget again speaks to infrastructure improvement and investment, but we need to be bolder and more comprehensive in our approach, especially at how we deal with funding rebuilding and renewing America. At a time when 17 States have stepped up to increase transportation funding, it's unacceptable that we pay for the highway trust fund with a gas tax that hasn't been increased since 1993 and is increasingly collecting less money as fuel efficiency improves.

The introduction of the President's budget is an important step forward. It

will hopefully spark an earnest, thoughtful, focused discussion about how we do business differently, how we pay for the needs of a growing and aging America, and how we can get more value for the investments we are already making, all while laying the foundation for a more prosperous future.

Mr. Speaker, I appreciate the comments we just heard on the floor from my colleague from Tennessee talking about Dr. Hansen's retirement, a gentleman who has faced a great deal of criticism, including many from this Congress, because of his forceful presentation of his point of view. And time after time after time, Dr. Hansen has been proven correct.

This is the most important issue that we're really not debating in Congress. There are a group of us here who have formed the Safe Climate Caucus to be able to promote this discussion. Today we extended an invitation to the leadership of the Commerce and Energy Committee to join us on the floor of the House for a bipartisan debate, encouraging our Republican colleagues to come to the floor to be able to deal with this issue that, frankly, deserves to be in the spotlight.

We're not aware of any Republican Member who's spoken on the floor of the House about the dangers of climate change or the need to reduce emissions and prepare for its impact in this entire session of Congress. In fact, as near as we can determine, no Republican Member of Congress has even uttered the words ``climate change'' on the floor in this Congress.

It's, I suppose, better that they're not talking about it at all than what we had in the last Congress where the Republican-led House of Representatives voted 53 times to block action on climate change. My Republican colleagues voted to defund research, to block action by the EPA to control pollution, to prevent energy efficiency measures from going into effect.

Remember, one of the most comical was the assault on light bulb efficiency, an efficiency standard that was developed, admittedly, when Democrats were in charge, but signed with legislation that we worked out with the Bush administration. That was certainly a travesty.

It was interesting. The industry looked at them and shrugged and said, we're moving on, we're not going back to produce less energy- efficient light bulbs.

They voted to stop the administration from encouraging developing countries to do their part.

This year, the Republican members of the Energy and Commerce Committee, which is the committee of primary jurisdiction over energy policy, even voted against holding hearings with scientists who could explain the role of climate change in causing extreme weather, drought, heat waves and wildfires. That's why we've created the Safe Climate Caucus, to work to end the conspiracy of silence here in the House about the dangers of climate change.

But we hope, we sincerely hope, that our Republican colleagues would join us here on the floor of the House in one of these Special Orders to discuss our various approaches. If they don't agree with human- caused impacts of extreme weather events, engage in the debate to explain why. If they do agree that we are at least having extreme weather events, whether or not they're human-caused, let's debate what we should do to be protecting us from those impacts. The American public deserves no less.

So until we're able to engage our Republican colleagues in a spirited, thoughtful debate on the floor of the House, we will continue pointing out the problems that we face, the risks, the danger, the paths forward, because in 2012, there were over 3,500 weather-related records set due to extreme heat, rain, drought, cold and wind. The American public has seen that. They've suffered the consequences. They're concerned.

Hurricane Sandy was one of just 11 weather disasters last year in the United States that caused more than a billion dollars in losses, a total of over $60 billion, which taxpayers are being forced to help assume the burden.

Here in Washington, D.C., we set another record, 90 degrees today, for April 10. At the same time, there are snowstorms in Colorado.

2012 was the 36th consecutive year with a global temperature above the 20th century average. The last time there was a year with a global temperature that wasn't above average was 1976, before Jimmy Carter was elected President. We were celebrating the Bicentennial. Most of our staff here in Washington, D.C., on Capitol Hill, has never experienced a year where temperatures weren't above average.

Now, just because our Republican friends don't want to debate it, just because they have fought to prevent our initiative, doesn't mean that it's not having an economic impact. The United States Congress has appropriated $188 billion for climate-related disasters over the last 3 years.

Just 2 months ago, the Government Accountability Office released a GAO report listing the Federal Government's vulnerability to climate change impacts as one of its greatest areas of potential risk. Climate change could increase investment portfolio risk by 10 percent over the next 2 decades by disrupting supply chains.

Those of us in Congress who are noticing these problems, these changes, these challenges, are not alone. According to the Gallup poll last month, 58 percent of the American public worry a fair amount or a great deal about climate change and its impacts. Sixty-two percent of Republicans believe that America should take steps to address climate change.

Monday, Arnold Schwarzenegger joined the list of Republican politicians who now acknowledge that climate change is a serious concern, speaking at the Price School of Public Policy in California. Governor Schwarzenegger said, if we're smart, we listen to our doctors. If we're stupid, we ignore our doctors, and it takes a heart attack to realize that we should listen.

Schwarzenegger said the national climate assessment report is our physical, and these scientists can give us a prescription for what we need to do to improve our climate. It's our duty to listen to them and encourage action, action all over the country. And Republican Governor Schwarzenegger is to be commended for his vision and stepping forward.

Another of my colleagues from California is with us here this evening, and I notice that he may be willing to step in. He's been greatly concerned about infrastructure, climate, the environment in a long and distinguished career in California politics and now here in Congress.

We're honored that you would be willing to join us, and I would be happy to yield to you if you would like to join in this conversation.

Thank you, Congressman Garamendi. Thank you for your comments and for your leadership in your native State of California on so many different levels in pressing this point. Your observation is that there's a great deal of economic opportunity. The installed wind energy has exploded in recent years. In fact, not only are we producing the energy here in the United States, it's American wind. It's not dollars that we're exporting.

And part of what we need to be harvesting. That's why I have a small wind energy tax credit that I think we can install here in the House Chamber. But part of what we've done with the Recovery Act has increased dramatically the amount of manufacturing that's here in the United States for that installed energy.

We are joined by one of our colleagues, Congressman Tonko from New York. Before he came to Congress, where he's been very active in these areas, he's had his own series of activities providing leadership and technology and energy efficiency.

We'd be honored for you to join in the conversation.

Thank you, Congressman Tonko. I appreciate your comments. I appreciate your leadership on this issue before and after you joined Congress. And I like the notion about thinking outside the barrel.

Indeed. Well, the cheapest electron is one that we don't have to use. If we just double American energy efficiency, we can cut carbon emissions 22 percent by 2020--and, by the way, that would save American consumers $327 billion a year. This is a tremendous opportunity to achieve savings, generate economic activity, and pay a dividend, economically as well as environmentally.

That last element is one that makes it so surprising that my Republican friends don't want to talk about dealing with climate change, energy efficiency on the floor, especially given the fact that an amazing stellar array of distinguished foreign policy and military experts who have identified climate change and fossil fuel dependency as a strategic vulnerability for this country, and why they have argued that we ought to move forward aggressively dealing with climate change, dealing with energy efficiency because it strengthens America, rather than sending dollars, as you point out, to people who don't necessarily share our interests or our beliefs. It has been pointed out more than once that we are financing both sides of the war on terror.

But I would like to turn, if I could, to my friend from Memphis, Congressman Cohen, who started us off this evening with a terrific 1- minute observation about Dr. Hanson's retirement. We would welcome your thoughts and further observations about our moving forward.

Well, the threats are manyfold.

One is just when we are subjecting our armed services to try and deal with the extremes that you talked about, it's unpredictable. They have to be dealing with drought and with flood extreme weather events. When we find the disruption that occurs in other parts of the world with drought and with famine, it provides an instability that creates a security challenge for us. And the fact that we are vulnerable still, in terms of energy supply for the United States and for our allies and the world economy can be held hostage, all of these were part of this challenge.

Last but not least, the Department of Defense, the United States military, is the largest consumer of energy in the world. Energy supply, energy cost, energy efficiency is a matter of military readiness and operational efficiency. When we spend $18 billion for air-conditioning in Iraq and Afghanistan, that's a drain on the budget. When we are sending to the front tanker trucks, because we are so dependent on fossil fuel, they might as well have a great big bull's- eye on them. We've lost thousands of Americans on these fuel convoys.

Being able to be energy efficient, being able to stretch the dollars, being able to promote American security is all part of an equation where these experts are saying, it ought to be a no-brainer to move forward with energy efficiency. Security experts are deeply concerned about the disruptive impact globally of this uncertain climate effect.

I notice that we are joined by my colleague from the State of Oregon, Congresswoman Bonamici, who has long exercised leadership in areas of environment and energy in her previous career as a distinguished State legislator in Oregon. I welcome her and would invite comments in conversation with us.

I appreciate that comment. I was just thinking, as you were describing the threats on our Oregon coast, to what we just read in the Washington Post a couple of days ago here where the impacts of climate change are having a profound effect on the blue crab, breeding a super crab that's actually growing more rapidly; at the same time, climate impacts are weakening the oysters, making them more vulnerable, so the potential here of completely disrupting this critical part of the ecosystem in the Chesapeake Bay.

I appreciate very much your joining in this conversation. I wish that my Republican friends would join us in the invitation to actually debate this issue in the finest tradition of the House of Representatives. There was a time when, in this Chamber, there were echoes of great challenge, debate, where people went back and forth with ideas to be able to bring out the best in us. We actually saw that when the Republicans took control 23 months ago, one of the first things they did was abolish the Special Committee on Climate Change and Global Warming, and since then we haven't really had an opportunity to engage in this fashion.

It is an all-time record for today.

Absolutely.

Those 11 weather disasters last year cost us over $60 billion. It's also creating uncertainty in agriculture and in the business of insurance where it's more difficult for them to be able to calculate what they're doing. It places more burden on the Federal Government because in many cases there aren't private alternatives available. That's why we had to create flood insurance. You're touching on an area that has profound economic consequences because of this environmental instability.

It's very important for us to take a step back and evaluate exactly what the economic employment opportunities are because things that we do to rebuild and renew America in a sustainable way-- Keystone has a few thousand temporary construction jobs and maybe a handful--I've heard various estimates--a few dozen, a couple hundred permanent jobs and has, as you pointed out, significant environmental consequences.

But when we're investing in wind, solar, geothermal, these are areas that are producing far more jobs already and that they are using a sustainable source of energy that pays a continuing dividend over time. This wind is American. This geothermal energy is American. It's renewable, and it doesn't cost us anything.

Well, energy transmission is something that is a part of the broader equation.

Pipeline reliability is something that we all need to be concerned about. More fundamentally, we need to deal with the sources of energy, what is driving them, how we reduce carbon emissions, not sort of how we shift the pieces around. The priority, I think, ought to be sustainable energy, more economic investment, reducing greenhouse gas emissions, not cooking the planet.

I recently had my first two grandchildren in a course of a few months. It was interesting to me--some of these dry debates that we have that talk about by 2100, sea levels may rise 3 or 4--that always seemed kind of remote to me until I realized that these two young men, if they live as long as their great-grandmother, will be alive in the year 2100, and what we do as a Congress helps shape the world that they inherit.

That's our responsibility. That's why I deeply appreciate both of you being a part of this discussion this evening and why I hope that our Republican friends will join us in an actual debate of these policies, practices, what the choices are. Hopefully, it may actually lead to action in the floor of the House for a more sustainable future.

I'm prepared to yield back, unless my friend from Memphis wants any concluding comment.

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

Mr. Speaker, this bill represents the lowest common denominator. I am extremely disappointed that it does not prevent the unnecessary cuts of the sequester and that it fails to fund many programs that are vital to Oregon and the Nation.

At this point, however, this bill is the best that we can do. I am voting for it in order to avoid a government shutdown. With this most recent manufactured crisis behind us, I hope that Congress can come together and get serious about making the investments that will implement healthcare reform, rebuild and renew America's crumbling infrastructure, help our neediest families, and protect public health and the environment.

I want to thank my colleague from California for being here this evening, for sharing the time, allowing me to speak with him. And I must say how excited I was that a friend who actually had a rewarding career was willing to jump into the political fray, which has been difficult at times, particularly as we've had the contentious issues surrounding health care, and that you would be willing to bring your expertise, time, and energy when you had other choices with your life and career. We really appreciate it. Because the experience you have had in the medical profession, the years of study, the actual experience with real-life people adds a dimension that is helpful here in ways that I don't know that you fully appreciate, but I certainly do. I also appreciate focusing on the critical nature of Medicare and where we're going in the world of health care reform.

I just spent last week dealing with my Republican friends' approach to the budget. It can only be described as an exercise in fantasy.

They start with the notion that somehow they're going to eliminate ObamaCare entirely; and they seek to transfer the burden of Medicare and Medicaid from the government onto the shoulders of some of America's most vulnerable poor and disabled, and our senior citizens. I really appreciate your focusing on the importance of Medicare in providing dignity and stability to millions of Americans.

Now, I think there have been, between the House and the Senate, about 50 efforts or more to repeal the health care reform. I must say I hope that finally people get it out of their system. I was surprised that we went in this direction, to turn Medicare into a voucher, a block grant for Medicaid, and put

this burden on our senior citizens and some of our poor and disabled Americans, because this was the centerpiece of their campaign for the last 6 months. This was part of what our friend Paul Ryan and Governor Romney preached from coast to coast, advertised, campaigned; and all of a sudden it was rejected by the American public overwhelmingly. The President was comfortably reelected. In fact, there were more Democratic Senators added who support this effort. In the House of Representatives, not only did we gain seats, but more than a million voters--more voted for Democrats than Republicans.

So you would think that this canard would be put to rest; but it is important for people to know that it is still a viable option as far as our Republican friends are concerned. It's unfortunate because we are making some progress in reforming the health care system--not by turning our back on Medicare, not by transferring the risk and responsibility to seniors and the most vulnerable, but by making it more efficient, by taking some of the experiments that we've done in my home State of Oregon--and as you well know there are some health care systems in California that have already found ways to reward value over volume, to be able to extend care, and do so more efficiently, and squeeze the approximately one-third to 40 percent or more of our health care spending that is wasted.

We can do a better job. We start, I think, by protecting Medicare. We start by recognizing that a voucher--or premium support, or whatever they call it--that caps the investment does nothing to reform health care; but, instead, it puts seniors and our most vulnerable citizens out navigating the health care maze with fewer resources and more responsibility and actually making it harder. Because that's why we have Medicare in the first place. The private market did a terrible job meeting the needs of America's oldest and least healthy population.

I am hopeful that we're going to be able to continue this effort that you're spearheading here tonight, for people to understand the opportunities to continue reform, to note that we are actually seeing a gradual stabilization of health care spending right now, and that there are things in the hopper that we can do going forward without taking advantage of people who deserve the security of a solid, reformed health care system, not one that the Federal Government vouchers and turns their back.

I would yield back to the gentleman if there are comments. I look forward to hearing what you have to say, and perhaps there may be a little more interaction if it's useful.

Thank you, Dr. Bera.

I appreciate your focus on this and pointing out that this is something that shouldn't be a partisan issue, doesn't have to be a partisan issue, and it is in fact a success story that has made a huge difference in the lives of seniors from coast to coast. It's helped, in many cases, stabilize what's happened in terms of local health care economics.

The pattern that we have seen in escalating health care costs for the last 40 years, yes, there are concerns about health care as it relates to Medicare; but if you compare the rate of increase of private health insurance versus the rate of increase in Medicare, Medicare spending has not gone up as rapidly as what's happened with the private insurance sector.

No senior citizen under Medicare needs to go bankrupt because of medical costs. The security that you mentioned, I find it embarrassing and shameful that the United States is the only major country in the world where there are still people going bankrupt for health care costs. Half of all bankruptcies are a result of health care emergencies. It doesn't have to be this way, and it is not that way for American seniors.

But if we're going to change our health care commitment to our senior citizens, taking away the guarantee of Medicare, flinging people into an uncertain private market that failed them in the past, which is why we had Medicare in the first place, that guarantee is not certain to be there.

No one thinks that we shouldn't have a health care system with a Medicare that is flexible going forward. We're open to reforms, absolutely. We want to reward value instead of volume. We want to be able to deal with the pattern of unnecessary medical readmissions for Medicare patients after they've been in the hospital. It's too high still.

But we are working on mechanisms in Medicare and with the hospitals to be able to reward keeping them out of the hospital with preventable conditions that require readmission.

We're in the process of looking at Medicare Advantage, which is growing dramatically. I come from the district that has probably the highest penetration of Medicare Advantage in the entire country, and it serves in many cases my constituencies pretty well, but there are wide variations across the country in Medicare Advantage. Not all Medicare Advantage programs are created equal.

Again, part of what we've done with the Affordable Care Act is not to turn our backs on potential opportunities to improve it, but to dive in and find ways to reward the most efficient and effective Medicare Advantage programs and, frankly, reduce the support for programs that aren't measuring up. That's what we should be doing.

We are moving in this direction. We don't have to take away the commitment that we have made to America's seniors to improve Medicare, Medicare Advantage, to be able to get even more value out of the system--not just tax dollar savings--but better quality care for our senior citizens, which should be our objective.

I know, Doctor, that is something you've practiced both as an elected official and as a professional; and I deeply appreciate it.

Mr. Speaker, this week, we begin the Republican charade of pretending to balance the budget in 10 years, without a hint of how it really is possible. They intend to repeal ObamaCare, which was the central issue in the last campaign, where you will remember President Obama was reelected, the Senate went even more Democratic, and House Democrats gained seats and won over 1 million more votes than the Republicans.

Normal people would think that the ObamaCare issue might be settled. Does anybody realistically think it's going away anytime soon?

The Republican fantasy budget reduces taxes dramatically without a hint of how it would be possible, without exploding the deficit or dramatically raising taxes on the middle class.

This is consistent with what the Romney-Ryan ticket said on the campaign trail last fall. The same issue where they dodged, dissembled, or ignored the perfectly reasonable question: How is it possible? Six months later, it's back in the budget, but there still is no answer.

During the last 40 years, there have been only four budgets without deficits: the last three Clinton budgets and the one that George Bush inherited from Bill Clinton. In each case, taxes as a percentage of the total economy were over 20 percent. In this Republican fantasyland, budgets are balanced with revenues at 19 percent of the economy, yet meeting the needs of 78 million more seniors and an infrastructure deficit that is growing as America is falling apart.

Clearly, this is not remotely possible if we're going to enjoy anything like our current quality of life. There is a real-world intersection of budget-saving opportunities with potential areas of agreement. Health care reform is one, but not just by shifting the burden to seniors and the disabled, as the Republicans propose in their fantasy budget.

My home State of Oregon is in the middle of an exciting demonstration of how to squeeze out the waste we all know is there and realign incentives. Instead of the empty ritual of pretending to repeal ObamaCare, let's work together to accelerate reform for all Americans.

If the Oregon experiment works--and frankly, many of these efficiencies, by the way, are already achieved in other parts of the country and with some private health systems--we could save more than $1.2 trillion that the flawed sequester is supposed to achieve in the next 10 years.

Another area of irresponsibility in the Republican budget is defense. Instead of increasing Pentagon spending, we should reform it. The most obvious target is the nuclear arsenal larger than anything we need for nuclear deterrence. Ten percent of our nuclear weapons would decimate Russia. A handful of missiles would wipe North Korea off the map, yet they propose to spend over two-thirds of $1 trillion over the next 10 years on this bloated arsenal.

Before we increase the Pentagon budget, maybe we should figure out why the F-35 Joint Strike Fighter is now 7 years behind schedule, 70 percent over budget, and the Pentagon still doesn't know how it's going to meet the more than $1 trillion in operating and maintenance costs.

Amazingly, the Republicans want to increase spending for the Pentagon, the only major budget so flawed it can't even be audited. There are bipartisan opportunities to reduce and reform the military, but you're not hearing about it in the Republican budget this week.

Instead of a Republican rerun of a bad reality TV show, let's consider working together on areas to change how the government does business and give more value to the taxpayer while we get spending under control.

Madam Chair, I am voting against H.R. 803, ``The SKILLS Act,'' because it significantly limits the important role that community colleges, labor unions, and local community leaders play in assessing workforce needs and delivering important workforce development resources. It also ignores the unique needs of many individuals who are disadvantaged in the workforce and represents a step backward from current policy.

Effectively investing in workforce development programs that train workers to compete in an ever changing and increasingly technology- based job market is essential to improving quality of life, rebuilding our fragile economy, and bolstering our competiveness over the long- term. Decisions about the best way to channel resources to ensure success should represent a wide variety of perspectives. While industry and local elected officials have an essential role to play in these conversations, this legislation favors the private sector while unnecessarily limiting the participation of institutions that offer workforce training programs, of groups representing workers rights, and of organizations advocating for minority and underrepresented groups.

The legislation also consolidates workforce and training programs into state-level block grants designed to serve everyone. There are many groups that face unique challenges to obtaining employment, such as veterans, minorities, workers with disabilities, and young people. It is important that we ensure these groups have access to Workforce Investment Act programs, and consolidating programs into a block grant runs the risk of overlooking these unique needs.

Many of my colleagues on both sides of the aisle agree that the Workforce Investment Act needs reform. This is why I support H.R. 798, which would reauthorize the Workforce Investment Act while strengthening partnerships between employers, community colleges, labor unions, and other stakeholder groups. It also streamlines and coordinates workforce programs without eliminating the important focus on disadvantaged groups.

Unemployment remains stubbornly high across the country. As we slowly continue to recover from the economic recession, it is essential that we make smart investments in workforce development. In Portland, Oregon, our region saw 155,900 people use workforce services in 2012, with 68,000 completing workforce programs, and 35,400 being placed for work. Under the guise of streamlining programs, H.R. 803 runs the risk of reducing these numbers, limiting access and limiting the effectiveness of our investments in Oregon and around the country at the exact time we should be increasing access to and enrollment in workforce training programs.

Mr. Speaker, advances in health care have led to increasingly complex health care decisions and more treatment options than we have ever before had the benefit--or the burden--of choosing between. Both Democrats and Republicans agree that individuals should be fully involved in decisions related to their own health care and should be able to make informed decisions about that care reflecting their values and their needs. We also agree that when people have expressed their wishes, particularly in a formal and legally binding manner, those wishes should be known and respected.

While there is widespread agreement regarding these principles, too often this is not the reality. Most adults have not completed an advance directive; if documents are completed, they are not regularly revisited and can be difficult to locate. Because these issues are difficult to discuss, surrogates often feel ill-prepared to interpret their loved ones' written wishes.

It is for these reasons that I am introducing the bipartisan Personalize Your Care Act, legislation that would support individuals and their doctors having voluntary conversations about patients' wishes and health care decisions.

Failing to have conversations about these decisions ahead of time can leave families and health care proxies faced with the burden of determining their loved ones' wishes in the midst of crisis, sometimes with little or no information about how best to direct care. This adds not only stress and anxiety to an already difficult situation, but studies show that lack of advance care planning actually prolongs the grieving process after losing a loved one.

One of the greatest misconceptions about advance care planning is that it is a one-time event. Attempting to plan for all possibilities in a single document or within a single conversation is overwhelming and, quite likely, impossible. Where possible, this should be an ongoing conversation. Careful, early advance care planning is important because a person's ability to make decisions may diminish over time and he or she may suddenly lose the capability to participate in his or her health care decisions.

Successful advance care planning is less about legal documentation and more about facilitating ongoing communication about future care wishes among individuals, their health care providers, and surrogates. The Personalize Your Care Act recognizes that documents like advance directives and physician orders for life-sustaining treatment are not ``ends'' but ``means''--the tools individuals can use to document their care preferences based on informed decisions incorporating their own values and current circumstances. It is important that individuals work with their care providers to update these documents as treatment options and personal preferences change.

This process not only provides higher quality care, but personalized care.

The Personalize Your Care Act aims to support advance care planning by providing Medicare and Medicaid coverage for voluntary consultations about advance care planning every 5 years or in the event of a change in health status. This periodic revisiting of advance care documents and goals of care recognizes that an individual's preferences can change over time. It also recognizes that the advance care plan should be updated if an individual develops a serious or chronic illness, if additional curative and palliative treatment options become available, and to consistently reflect the individual's current circumstances and preferences.

Honoring the expressed wishes of individuals must also be a priority. For this to occur, advance care planning documents must be accessible wherever care is provided. The legislation ensures that an individual's electronic health record is able to display his or her current advance directive and/or physician orders for life sustaining treatment (POLST), so that his or her wishes are easily accessible and respected. Furthermore, under the legislation, advance directives would be portable, ensuring that advance directives completed in one state are honored in another state, in the event care is needed to be provided there.

The legislation also provides grants to states to establish or expand physician orders for life sustaining treatment programs. For instance, the National POLST Paradigm Program Task Force provides consultation, guidance and mentorship to developing states for program and form development, recognizing the uniqueness of each state. These programs have a track record of promoting patient autonomy through documenting and coordinating a person's treatment preferences, clarifying treatment intentions and minimizing confusion, reducing repetitive activities in complying with the Patient Self Determination Act, and facilitating appropriate treatment by emergency personnel.

These investments in advance care planning will reinforce patient- centered care--engaging individuals in planning and decision-making about their future care and ensuring that those preferences are documented, accessible, and can be honored in any state and in any care setting. The Personalize Your Care Act is supported by members of Congress on both sides of the political aisle and by patient advocates, physicians, nurses, and the faith community who see every day how advance care planning improves individuals' and families' peace of mind and the quality of their care.

Mr. Speaker, I am voting against H.R. 890 because it, just like nearly identical legislation brought before the Ways and Means Committee last year, is based on partisan charges that have been widely discredited by independent fact checker. It would also block new and innovative ways to move more people from welfare to work. At a time when Congress confronts so many pressing issues, not the least of which is preventing the misguided cuts in the sequester from hurting our economy, H.R. 890 is a step in the wrong direction.

H.R. 890 prevents the administration from pursuing flexible, innovative ways to return people to work. As Health and Human Services Secretary Sebelius informed our committee, ``the Department is providing a very limited waiver opportunity for states that develop a plan to measurably increase the number of beneficiaries who find and hold down a job. Specifically, Governors must commit that their proposals will move at least 20% more people from welfare to work compared to the state's past performance.''

The Congressional Research Service (CRS), in reviewing the administration's authority to permit demonstration projects, found that the current waiver initiative is ``consistent'' with prior practice. The CRS review found that dozens of waivers for demonstration projects have been approved in the past when their subject matter has been referenced in Section 402 of the Social Security Act (just as the administration currently proposes). CRS also found nothing in the law bars Secretary Sebelius from providing waivers related to employment activities in the Temporary Assistance for Needy Families program.

H.R. 890 seems more focused on politics than on policy. On that basis, and because it would impede progress in helping more welfare recipients move into work, I oppose this legislation.

Mr. Speaker, I oppose this legislation. In Congress, we continue to talk past ourselves on how to get to fundamental financial sustainability. If flexibility is necessary for some agencies, then why not provide all of them with the necessary flexibility to deal with the draconian impacts of the sequester?

I opposed the sequester from the beginning and still believe it's a terrible idea. Congress should have dealt with it comprehensively at the end of last year; we should have had a bigger solution then. Now that we are stuck with it, we have to deal with the consequences.

Providing flexibility to some of the agencies but not others makes no sense--it merely allows the Defense Department to mitigate some of the worst effects on its budget, while continuing to hamstring vital domestic priorities. For instance, the $1.6 billion cut in the NIH budget will cut research into illnesses affecting millions of Americans, senior meal programs like Meals on Wheels will be cut by up to 4 million meals for needy seniors, and in my State, head start and early head start programs are being cancelled.

In my home State of Oregon, we will lose approximately $10.2 million in funding for primary and secondary education, putting about 140 teacher and aide jobs at risk. Our Head Start and Early Head Start services will be eliminated for approximately 600 children, reducing access to critical early education. Oregon could lose up to $81,000 in funds that

provide services to victims of domestic violence, resulting in up to 300 fewer victims being served.

Overall, this reckless policy will cost our country roughly 750,000 jobs, according to the CBO. They also estimate that allowing sequester to take place will lower economic growth from 2.0 percent to 1.4 percent, cutting anticipated economic recovery by a third.

Instead of throwing our hands up, we should make smart, targeted budget decisions that, taken over 10 years, are an alternative to the arbitrary sequester cuts and can put the country on a more sustainable fiscal path.

Mr. Speaker, as we wait for the Congress and administration to deal with how to do business differently for defense, for health care, for the Tax Code, we can take a break today as we welcome over 750 men and women from every State in the Union who are here for the 14th Annual Bike Summit. They represent, as you might expect, people from cycling clubs and the mountain bike industry. There are also dedicated recreational cyclists, those who are involved with bike tourism, which has become very big business, by the way. And speaking of business, there are representatives of bicycle repair, bicycle manufacturers, and others who design, manufacture, and sell equipment and apparel. Bicycles mean business, in my hometown alone over $150 million of economic activity in a year, employing over 1,000 people.

As the Bike Summit attendees visit Capitol Hill later this week, we will have an opportunity to hear from people of all ages, all walks of life, communities large and small. They are firm in the belief that the Federal Government should be a stronger partner in capitalizing on the most efficient form of urban transportation ever designed.

Bicycles burn calories, not fossil fuel, and take up a 10th of the space of a car. More importantly, for those who drive, every bicycle in the protected bike lane next to you is not a car in front of you or competing for a scarce parking space.

The goal here is to give Americans more choices about how they move, making it safe for children to walk or bike to school. It helps those children, it relieves stress on the family, and can cut 30 percent of the rush-hour congestion. Bicycling helps kids stay active at a time where we are obsessing about a lack of physical activity for our children, a level that is already too low and declining. Bicycling is a natural remedy.

Cities of all size are participating in the bicycle revolution. It would not be nearly as advanced as it is, but for $8.9 billion of Federal investment since the original ISTEA reauthorization. It has accelerated programs, leveraged other investments and has increased transportation capacity for everybody, and done so more cost effectively than any other expenditure. By the way, $1 million invested in bicycle facilities creates more family-wage jobs than simply constructing more miles of highway.

It is also easier and faster to accomplish. At a time when America has an infrastructure deficit that is in the trillions of dollars, when that infrastructure is falling apart and unreliable, our coalition for policies and resources to rebuild and renew America will be stronger if it includes the millions of Americans who travel by bike.

I strongly urge my colleagues and their staff to take the time to visit with these advocates this week. Hear their stories about transforming communities of all sizes: rural, urban, suburban. Most important, learn how they are giving families safe transportation choices that they never had before. Visit with these cycling leaders. More important, at home, when you are back, get on a bike, walk a trail, join the volunteers, witness an event with your family and talk to the bike businesses and community partners. All of these stakeholders can help us visualize what the Federal partnership could mean in making communities across America more livable and our families safer, healthier, and more economically secure.

What's so maddening about the sequester drama, just like the earlier fiscal cliff drama and the looming government shutdown drama, is that it is hopelessly beside the point.

The path to fiscal sustainability is not merely cutting budgets, raising tax rates, or closing a few loopholes. It is about fundamentally doing business differently.

Health care costs demand that we accelerate health care reform, which we're already working on in Oregon and in a number of other communities and health care systems across the country. These reforms, if put into effect nationally, would save more in health care costs over the next 10 years than the entire $1.2 trillion sequester.

Everybody is getting excited about across-the-board cuts in the Department of Defense, but no one is talking about how we fundamentally change

our philosophy of military compensation, benefits, and the size of the force to come to grips with the cost of an all-volunteer Army.

Of course, at a minimum, we should also dramatically reduce and shift resources away from the vast nuclear weapons stockpile and the three redundant delivery systems which we haven't used in 68 years and probably never will. We have 10 times more nuclear firepower than we need for deterrence. It is past time to scale down that archaic symbol of the Cold War and save hundreds of billions of dollars at no risk to American security.

It is time for Congress and the administration to work meaningfully for agriculture reform to give more support for America's farmers and ranchers at a fraction of the cost. We should reform the outrageous, inefficient, and unproductive crop insurance program. We should restore investments in nutrition, conservation, research, and marketing that will make a difference for most farmers and ranchers, improve long-term productivity, and support value-added agriculture. This saves money in the long run and doesn't distort our trade position or make Americans unhealthy.

By all means, we must reform our Tax Code, but reform is not likely to raise anything near what a growing and aging America is going to need.

Yes, close more of the egregious loopholes, but we need another broad-based source of revenue. A carbon tax would fit the bill, help reduce the deficit, and help us protect the planet from increasingly catastrophic weather events and the budget-busting disaster relief that inevitably follows.

We should, for the first time in 20 years, increase the gas tax, as recommended by the Simpson-Bowles report, a user fee that will help enable us to provide more support for transportation, put more people to work rebuilding and renewing America.

We might take a lesson from the history and our failed 14-year effort to prohibit alcohol, where the government spent a fortune in a fruitless effort to enforce prohibition, lost a fortune in revenue, and made a fortune for the Mafia, the underworld cartels of the 1920s, that haunts us to this day.

We ought to treat marijuana like we treat alcohol: the Federal Government regulates and taxes while the States decide what they want to do to legalize for medical or recreational use. Given what's already happened in 23 States and the District of Columbia, let's save money on enforcement, raise revenue from taxation, and invest in drug treatment and efforts to keep drugs out of the hands of children.

Let's take a break from the endless debates that are basically beside the point. Let's commit to doing business differently with health care, the military, enact broad-based taxes to both raise money and fix a broken Tax Code, stop cheating the majority of farmers and ranchers and the environment.

This is not rocket science. We could start now if people address the big issues in a thoughtful way. Even when some of the measures may be controversial or hard, it's a whole lot better than doing stupid things that alienate everybody.

Mr. Speaker, I submit this letter, which is an example of an opportunity for a bipartisan climate action.

The Cost of Inaction . . .

The effects of climate change in the world's most

vulnerable regions present a serious threat to American

national security interests. As a matter of risk management,

the United States must work with international partners,

public and private, to address this impending crisis.

Potential consequences are undeniable, and the cost of

inaction, paid for in lives and valuable U.S. resources, will

be staggering. Washington must lead on this issue now.

Countries least able to adapt to or mitigate the impacts of

climate change will suffer the most, but the resulting crises

will quickly become a burden on U.S. priorities as well. Both

the Department of Defense and the State Department have

identified climate change as a serious risk to American

security and an agent of instability. Without precautionary

measures, climate change impacts abroad could spur mass

migrations, influence civil conflict and ultimately lead to a

more unpredictable world. In fact, we may already be seeing

signs of this as vulnerable communities in some of the most

fragile and conflict-ridden states are increasingly displaced

by floods, droughts and other natural disasters. Protecting

U.S. interests under these conditions would progressively

exhaust American military, diplomatic and development

resources as we struggle to meet growing demands for

emergency international engagement.

It is in our national interest to confront the risk that

climate change in vulnerable regions presents to American

security. We must offer adaptive solutions to communities

currently facing climate-driven displacement, support

disaster risk reduction measures and help mitigate potential

future

impacts through sustainable food, water and energy systems.

Advancing stability in the fare of climate change threats

will promote resilient communities, reliable governance and

dependable access to critical resources.

We, the undersigned Republicans, Democrats and

Independents, implore U.S. policymakers to support American

security and global stability by addressing the risks of

climate change in vulnerable nations. Their plight is our

fight; their problems are our problems. Even as we face

budgetary austerity and a fragile economic recovery, public

and private sectors must work together to meet the funding

demands of this strategic investment in internationally-

backed solutions. Effective adaptation and mitigation efforts

in these counties will protect our long-standing security

interests abroad.

Madeleine Albright, Secretary of State 1997-2001; Richard

Armitage, Deputy Secretary of State 2001-05; Samuel

Berger, National Security Advisor 1997-2001; Sherwood

Boehlert, US Congressman (R-NY) 1983-2007; Carol

Browner, Administrator, Environmental Protection Agency

1993-2001; Michael Castle, US Congressman (R-DE) 1993-

2011, Governor (R-DE) 1985-92; GEN Wesley Clark, USA

(Ret), Fmr. Supreme Allied Commander Europe of NATO;

William Cohen, Secretary of Defense 1997-2001, US

Senator (R-ME) 1979-97; Lt Gen Lawrence P. Farrell,

Jr., USAF (Ret.), Fmr. Deputy Chief Of Staff for Plans

and Programs, HQ USAF; BG Gerald E. Galloway, Jr.,

P.E., Ph.D., USA (Ret.), Fmr. Dean of the Academic

Board, US Military Academy; Wayne Gilchrest, US

Congressman (R-MD) 1991-2009; James Greenwood, US

Congressman (R-PA) 1993-2005; VADM Lee F. Gunn, USN

(Ret.), Fmr. Inspector General of the Department of the

Navy; Lee Hamilton, US Congressman (D-IN) 1965-99, Co-

Chair, PSA Advisory Board; Gary Hart, US Senator (D-CO)

1975-87; Rita E. Hauser, Chair, International Peace

Institute; Carla Hills, US Trade Representative 1989-

93; Thomas Kean, Governor (R-N) 1982-90, 9/11

Commission Chair; GEN Paul J. Kern, USA (Ret), Fmr.

Commanding General, US Army Materiel Command; Richard

Leone, President, The Century Foundation 1989-2011;

Joseph I. Lieberman, US Senator (I-CT) 1989-2013;

Richard G. Lugar, US Senator (R-IN) 1977-2013; VADM

Dennis V. McGinn, USN, (Ret.), Fmr. Deputy Chief of

Naval Operations for Warfare Requirements and Programs;

Donald McHenry, US Ambassador to the UN 1979-81;

Constance Morella, US Congresswoman (R-MD) 1987-2003,

US Ambassador to OECD 2003-07; Sam Nunn, US Senator (D-

GA) 1972-96; John Porter, US Congressman (R-IL) 1980-

2001; Tom Ridge, Secretary of Homeland Security 2003-

05, Governor (R-PA) 1995-2001; ADM Gary Roughead, USN

(Ret.), Fmr. Chief of Naval Operations; Warren Rudman,

US Senator (R-NH) 1980-92, Fmr. Co-Chair, PSA Advisory

Board; Christopher Shays, US Congressman (R-CT) 1987-

2009; George Shultz, Secretary of State 1982-89;

Olympia J. Snowe, US Senator (R-ME) 1995-2013; GEN

Gordon R. Sullivan, USA (Ret.), Fmr. Chief of Staff, US

Army, Chairman, CNA Military Advisory Board; Timothy E.

Wirth, US Senator (D-CO) 1987-93; Frank Wisner,

Undersecretary of State 1992-93; R. James Woolsey,

Director of Central Intelligence 1993-95, Co-founder,

US Energy Security Council; GEN Anthony Zinni, USMC

(Ret.), Fmr. Commander in Chief, US Central Command.

Madam Speaker, while Congress is dealing with this manufactured sequester crisis, we have a real climate crisis occurring right outside the window.

There is clarity on what should be a bipartisan issue with the public. Seven out of 10 Americans believe the scientists that climate change is happening and that humans are making it worse. Every day, Americans see the impact. With record droughts and extreme storm events, 2012 set more than 3,500 monthly records for extreme heat, rain, and snow.

This week, 38 leading Republicans and national security advisors urged international action to prevent and mitigate the impact of climate change. The letter highlights the importance of immediate action and expresses national security concerns should we fail to address these issues.

We should be addressing the real climate crisis instead of dealing with a phony, made-up fiscal crisis.

Madam Speaker, the satisfaction I have that we've finally renewed the Violence Against Women Act is tempered by how hard it was to get the acceptance of two critically important provisions. Why should there be any question about respect for Native Americans' sovereignty in their own territory to protect their own female citizens? Arguments to the contrary are bogus and demeaning.

It was also critical that protection be extended to people regardless of their sexual orientation.

This victory is a small sign of the shifts in the House where Democrats are united in supporting core values and a minority number of Republicans, increasing in number, are willing to buck their leadership and the Tea Party majority. It would be nice if this could carry forward to other critical issues of the day.

The sequester drama that we are watching play out this week is exactly why I voted against the New Year's Day budget package.

Two months ago, all of the forces were aligned to force a bigger agreement, but we set our sights too low. It generated too little revenue, and, most importantly, there was not a fundamental reform in the way that we do business.

We merely put off the fiscal cliff in order to have not one, not two, but three such dramas between now and next summer. Friday is the sequestration; March 27, the continuing resolution runs out; and sometime this summer, the Treasury Department is going to run out of capacity to keep juggling the national debt, and we face that drama all over again.

Actually, there's a fourth cliff if you count the so-called ``dairy cliff'' which will potentially double milk prices in September.

The path forward is to focus on areas of potential agreement between the right and the left. A great place to start is health care. Reform is taking place around the country. And, in fact, nowhere is it more exciting and promising than what is happening in Oregon where we are working in concert with the implementation of the Health Care Reform Act to squeeze out waste and inefficiency. We are working to reward value instead of volume, and the Federal Government has bet $1.9 billion that we will be able to reduce health care inflation at least 2 percent a year and maintain quality.

Helping people stay well rather than paying people for disease and illness is a logical way to go. After all, the Affordable Care Act embedded every one of these major reforms that used to be bipartisan, that had been implemented by business, health care plans in red States and blue States, that had been advocated by Democratic and Republican Governors alike, and, indeed, supported by Members of the House and Senate in both parties. Instead of fighting health care reform, we ought to accelerate it. If we can deliver on the Oregon promise, it in and of itself will save more money nationally over the next 10 years than we're arguing about with the sequestration.

We also must address the huge budget challenges that are facing the Pentagon, in large measure because neither it nor Congress has insisted on change and, indeed, in some cases, has institutionalized bad decisions.

We haven't scaled back our horribly expensive, outmoded, inefficient nuclear deterrent program, maintaining perhaps 8-10 times the warheads for what we need for actual deterrence today with three massive, expensive, redundant delivery systems that are out of sync with today's threats. We haven't used nuclear weapons for the last 68 years. We probably won't use them for the next 68 years, and there is no imaginable circumstance when we would use even a fraction of the weapons we have. And the cost for that conservatively is in excess of two-thirds of $1 trillion over the next 10 years.

We've never come to grips with the cost of an all-volunteer Army. Our forces are significantly above what we had a decade earlier when we were supposedly staffed to fight two wars simultaneously. We need to scale that down, to refocus it, to supplement reductions in troop levels with beefed-up support to the National Guard, which is far more cost-effective and easier on our troops.

We need to reform our bloated, fossilized, outdated farm bill to spend less, help more farmers and the environment, and show that we can rise above politics and habits to have a farm program for this century, not 1949. The majority of farmers and ranchers in the United States get nothing. The majority of the support flows to the top 10 percent, who don't need it at all, and it distorts our international trade posture.

The final looming threat is the dysfunction, unfairness, and inefficiency of our tax system. It costs us huge sums to administer. It leaks hundreds of billions of dollars in tax avoidance, evasion, and mistakes, to say nothing of misplaced incentives, and it costs over $160 billion a year to administer.

Now, clearly there's a need for more revenue in a growing and aging population, but fundamentally, we need a new broad base of support that will help us pay the transition necessary for a reformed system.

Madam Speaker, this is not rocket science. This is within our capacity. We ought to get started on it now.