Floor Statements

Madam Speaker, it is with deep sadness that I report that a law officer was killed in the line of duty in my Congressional District on Tuesday, December 8, 2009. Thirty-eight-year-old Martin County Sheriff's Deputy Charles ``Charlie'' Douglas Brown, Jr. was killed in an exchange of gunfire while on duty.

Funeral services will be held on Saturday, December 12, 2009 as the entire community mourns his untimely death. He is survived by his wife, Cindy, and their two daughters, Morgen and Carlie. He was a member of Maple Grove Christian Church.

Sheriff's Deputy Brown was a U.S. Marine veteran having served in Desert Storm. He served as a member of the U.S. Marines Honor Guard and was recognized with the Elegance Medal. He also assisted with the Katrina disaster in New Orleans, Louisiana and the Tsunami Disaster in Thailand. He was a K9 officer serving with his faithful dog H2.

He had a great love of fishing and hunting, and he was well liked by his fellow officers and throughout the community.

As a nation, we have lost more than 20,000 officers in the line of duty over the course of our history. Mr. Brown was the 115th law officer killed in the line duty this year, and the seventh officer killed in the line of duty in North Carolina.

Despite the constant threats of harm and danger, day after day, and year after year, dedicated professionals, like Mr. Brown, make the sacrifices for their communities, without asking for thanks or praise.

Sheriff's Deputy Brown unwaveringly upheld the values that make this country great--duty honor, sacrifice. Those values and their sacrifice are a somber reminder that the freedoms that we share do not come without a cost.

He and his fellow officers who will carry on this essential work deserve our strong support

and our thankful recognition. Madam Speaker, I ask that my colleagues join me in recognizing Mr. Brown's extraordinary service and sacrifice.

Madam Speaker, prescription drugs are among the most expensive components of the American health care system. Unfortunately, the system for delivering drugs that has emerged since Congress created the Medicare Part D prescription drug benefit program continues to needlessly drive up these costs for taxpayers and consumers.

Failing on the promises to deliver prescription drugs more efficiently, effectively or at lower costs, pharmacy benefit managers, or PBMs, are reducing consumer choice and adding billions of dollars in costs for government and private health care plans.

As a result, today I will introduce the ``Patient Health and Real Medication Access Cost Savings Act of 2009'' to ensure cost savings, accountability and transparency. The bill will ensure that taxpayers, providers and patients can escape the mandates, secret pricing schemes, and marginal savings provided by PBMs in favor of an improved pharmacy model that guarantees choice, transparency and measurable savings.

Madam Speaker, nearly 60 large employers that collectively spend $4.9 billion for prescription drugs recently dropped or forced PBMs to disclose their costs. The University of Michigan started the trend in 2005, and reported an annual savings of $2.5 million when it dropped its PBM in favor of direct purchases. Officials at the University of Michigan are on record as saying that most of its derived savings came from eliminating fees from its former pharmacy benefit manager and from using the claims data to help school officials better negotiate prescription drug prices.

Additionally, companies like Caterpillar are leading the trend away from the PBM model. According to a recent report in CFO.com, Caterpillar's pharmacy benefit manager indicated that the company ``found that there was a great deal of waste inherent in a system that uses PBMs as middle men.''

This information led the House Committee on Oversight and Government Reform's Subcommittee on Federal Workforce, Postal Service, and the District of Columbia to hold a hearing on June 24, 2009 to assess the value PBMs are providing to the Federal Employees Health Benefits Program (FEHBP). At that hearing, the subcommittee chairman indicated, ``federal employee plans pay substantially more for drugs than other agency programs, including those run by the departments of Veterans Affairs and Defense, and Medicare, Medicaid and the Public Health Service.''

Mark Merritt, who represents PBMs as president of the Pharmaceutical Care Management Association (PCMA), told the sub-committee that PBMs contributed to an annual reduction in drug spending by the FEHBP of 3-9 percent. At the same hearing, however, Office of Personnel Management (OPM) Inspector General Patrick McFarland testified that the PBM contracts with FEHBP make auditing them ``almost insurmountable.''

There is no question that if Congress is to produce large savings as part of its efforts on health care reform, it must challenge the PBM model that has emerged over the past few years with new models that contain costs and improve efficiency and transparency.

PCMA successfully lobbied Congress from 2001-2003 to allow PBMs to manage the massive new Medicare Part D drug delivery program. As a result of the industry's expanded market power, PBMs are now using new tactics to divert patients into higher-cost services, and to divert taxpayer savings into higher PBM profits. These practices represent a significant abuse of taxpayers and patients in the health care system. PBMs should be held accountable to taxpayers. No other providers in the health care sector are allowed to conduct business like PBMs.

With regards to patient data, pharmacists have complained for years to regulators that PBMs violate patient privacy laws by using their prescription data to push new products and steer patients to pharmacies owned by the PBMs. By comparison, physicians who ``self-refer'' to facilities they own face very serious legal liabilities. In addition, there is a concern that pharmacy benefit managers routinely sell patient drug histories to drug companies without the knowledge of patients, doctors or plan sponsors.

According to the Association of Community Pharmacists (ACP), patients receive letters every day from PBMs that use the confidential patient data pharmacies must collect to force them to move to pharmacies the PBMs own. ACP has collected thousands of petitions from patients who are asking Congress to stop this abuse of patient confidentiality. ACP has also collected actual letters to patients from PBMs that threaten to cut off pharmacy benefit coverage unless the patients fill their prescriptions at PBM-owned pharmacies.

In fact, PBMs have merged with pharmacy chains to accommodate this new marketing model, which relies on monopolization of drug care for patients in plans that are administered by the PBM. For example, CVS purchased the Caremark PBM company as soon as Congress passed the Medicare Part D program, which directs virtually all pharmacy services to go through PBMs. CVS/Caremark now mandates that all patients in its system use CVS exclusively to fill any prescriptions not mailed by Caremark. Patients who opt out, even if they are not near a CVS store, must pay 100 percent of their prescription costs regardless of how much they have paid in premiums for drug coverage. As a result, CVS now fills one of every seven prescriptions in the U.S.

PBMs also use predatory practices to steer patients away from competing pharmacies and into mail-only prescription drug services. For example, PBMs allow patients to obtain 90-day prescriptions--usually at big discounts--from their mail-order services. While this can be a bargain for patients, the retail pharmacies where patients may prefer to fill their prescriptions are prohibited from offering the same terms to the patient.

Coupled with the lack of enforcement action by the Federal Trade Commission, these PBM tactics are combined with a practice of systematic underpayment to any pharmacy that provides services to a patient whose drug benefit is managed by a PBM. The Association of Community Pharmacists has collected thousands of examples from pharmacies across the country that clearly demonstrate

that PBMs are refusing to reimburse any pharmacy for its actual cost of a drug if the pharmacy is competing with the PBM to serve the patient. This is despite the fact that the pharmacies are required under Medicare and other federal programs to submit all costs they incur for the programs to the PBMs for reimbursement. Today, these tactics are being used to consolidate market power and destroy competition. The result is higher prices for taxpayers and consumers.

An additional concern for Congress, taxpayers and consumers is the complete lack of information about the actual prices PBMs pay for drugs. As a result, we have no way of knowing just how much PBMs profit from underpayments to pharmacies. I am also sure that many of my colleagues here are unaware that PBMs require pharmacies filling prescriptions under their plans to sign non-disclosure agreements that cover drug prices. This includes pharmacies that must deal with PBMs through Medicare and other government programs.

The role of the PBM has evolved in a relatively short period of time. PBMs emerged during the advent of managed care as pharmacy benefit administrators. Their role was to help large plans simply process drug benefit claims. The companies evolved into pharmacy benefit ``managers'' when they reached a scale large enough to steer volume sales for drug manufacturers.

Today, PBMs have tremendous and questionable impact on the rising costs in the current drug program. Community pharmacies purchase drugs from wholesalers to fill prescriptions, and submit reimbursement forms to the PBMs for any patients covered by the PBM plan.

PBMs that own their own pharmacies or mail programs simply pay the pharmacies below their actual acquisition cost for the drugs and pocket the difference. This provides two benefits to the PBMs. First, they make big profits on the spread between the low reimbursement they pay for the medication and the inflated price they charge the program. Second, it drives the competing pharmacies out of business, which allows further market share gains and increased pricing power.

More recently, the PBMs have developed an additional revenue stream. When Congress passed the Medicare Part D program, large pharmacy chains realized the value of merging with PBMs. The merged companies now control huge shares of the prescription drug market, and use this control to extract fees from competing pharmacy retailers that service Part-D patients.

In short, Madam Speaker, PBMs have simply placed themselves in the middle of the drug supply chain between manufacturers or wholesalers and retailers without any proof that they add value. The ``Patient Health and Real Medication Access Cost Savings Act of 2009'' will help end these abuses by requiring transparency. It will also ensure that lower-cost generic medications are prescribed when appropriate whenever taxpayers are paying the bill. Most important, the bill will make sure that Congress and the taxpayers we serve can actually measure the savings they have been promised.

In closing, Madam Speaker, let me say that my home state of North Carolina is a model for how to achieve savings by moving away from the PBM model in its state administered drug benefits program. Under its plan, generic utilization has already increased, and the state projects annual utilization to reach nearly 75% in the first year. The North Carolina model proves that when retail pharmacies manage the drug benefits for plans, generic utilization increases even more. I am proud of what has been accomplished in my state, and can only hope that Congress will choose to focus on this issue so that all Americans can reap the benefits and savings from a similar approach at the federal level.

I thank the gentleman for yielding the time.

Mr. Speaker, later today we will have an opportunity to fix a broken health care system. I have listened to both sides of this debate, I have read everything available, and I have prayed for guidance.

We have an obligation, constitutional and moral, to provide for the general welfare of every American citizen. Allowing a broken health care system to continue to bankrupt families, businesses and hospitals and deny coverage to millions is a failure of duty.

We must act now. Reject the false rhetoric surrounding this debate. Reject the false claims about Medicare coverage reductions. The bill strengthens Medicare. Reject the false rhetoric about government-run health care. The bill provides healthy and needed competition.

Reject the claim that this legislation will increase the debt. Doing nothing will increase the debt by billions. We should not delay any longer.

I urge my colleagues to vote ``yes'' on this legislation.

Mr. Speaker, what we are seeing today is terribly disappointing. Health care reform is necessary and it is urgent. There are powerful forces in this country who are determined to keep 47 million Americans without health insurance, and this same group is opposed to giving competition to the insurance industry.

If we don't reform health care, Medicare costs will surely bankrupt our Nation. That is a fact. If we don't reform the cost of employer- sponsored insurance, we will bankrupt companies and families. If we don't act now, uncompensated care will close the doors of rural hospitals in my district and your districts across the country.

We are ready to move forward. Democrats are ready to make this bold and visionary decision. I am disappointed we don't have help from the other side.

Madam Speaker, on October 25, 2009 friends and family will gather to honor Mrs. Minnie Hill McClease, a retired teacher who has had a tremendous impact on North Carolina's First Congressional District. On this special occasion, Mrs. McClease's loved ones will join her to pay special tribute to this extraordinary woman.

Born on December 17, 1908, Mrs. McClease will soon celebrate her 101st birthday. After graduating from State Normal High School in Elizabeth City, North Carolina, she earned a bachelors degree from Shaw University and later a masters degree from New York University.

Retiring on June 4, 1971 after 37 years, Mrs. McClease served as a mathematics teacher at Elizabeth City's P. W. Moore High School and at Northeastern High School. To this day, the Cooper/McClease Scholarship is presented in her honor annually at Northeastern High School to a student who excels in mathematics.

During her career, Mrs. McClease earned the respect of her students, fellow teachers and the entire community. She fully dedicated herself to teaching because she cared so very deeply about the education of children. And, as we all know, good teachers like Mrs. McClease make a remarkable difference in the lives of their students.

During her extraordinary teaching career, Mrs. McClease inspired countless students. She made an undeniable impression on every student, and many of them went on to do great things. Among her students were Superior Court Judge J.C. Cole, cardiologist Dr. Lindsey White, retired principal and Pasquotank County Commissioner Cecil Perry, Virginia Beach Health Director Dr. Venita Newby-Owens, retired U.S. Army General Hawthorn Proctor, cardiologist Dr. Kermit Brown, retired educator Eddie Davis and Elizabeth City-Pasquotank Public Schools Superintendent Linwood Williams. These accomplished people represent just a few of the many great students Mrs. McClease helped inspire to reach their full potential.

Mrs. McClease has also been a highly active member of Olive Branch Missionary Baptist Church.

Madam Speaker, I ask that my colleagues join me in recognizing Mrs. McClease. She is truly a remarkable person deserving of our deepest gratitude for the enormous contributions that she made in the lives of children in eastern North Carolina and to the entire community.

Madam Speaker, according to a study of recent U.S. Census Bureau figures, the National Academy of Science found that the level of American poverty is even worse than the government's official number.

The official measure, created in 1955, failed to factor in rising costs of medical care, transportation or childcare. It also ignores geographical variations in the cost of living. Further, it also fails to consider non-cash government aid when calculating income. As a result, the poverty figures released by Census last month may overlook millions of people suffering in poverty, many of whom are 65 and older.

The National Academy of Sciences' revised formula calculates that about 47.4 million Americans lived in poverty last year--7 million more than the Census figure.

The National Academy of Sciences formula shows a poverty rate of 15.8 percent, which is nearly 1 in 6 Americans. This is far higher than the poverty rate of 13.2 percent, or 39.8 million, reported by the U.S. Census Bureau recently.

The National Academy of Sciences found that about 18.7 percent of Americans 65 and older, or nearly 7.1 million, are suffering in poverty compared to 9.7 percent, or 3.7 million, under the traditional Census measure. This is largely due to out-of-pocket expenses from rising Medicare premiums, deductibles and a coverage gap in the prescription drug benefit.

The National Academy of Sciences also found that 14.3 percent of people 18 to 64, or 27 million, are suffering in poverty, compared to 11.7 percent under the traditional Census measure. Many of the additional poor are low-income, working people facing growing transportation and childcare costs.

It should also be noted that food stamp assistance, which is at an all-time high of about 36 million, likely softened these figures.

These figures are especially troubling and could get worse. In 2008, U.S. median income fell to $50,303 from $52,163 in 2007. That 3.6% decline is the largest one-year drop since records began. And, the Economic Policy Institute projects that in the next two years, incomes could decline by another $3,000 and poverty could increase by 1.9 percentage points.

These figures have special meaning for me because I represent one of the poorest Congressional districts in the country. In fact, a recent report in Forbes Magazine declared Rocky Mount, North Carolina as one of America's 10 most impoverished cities.

Forbes used the new data from the U.S. Census Bureau's 2008 American Community Survey, and also looked at per capita incomes for a region, the percentage of food stamp recipients, the percentage of people under age 65 receiving public health care and the unemployment rate.

According to Forbes, nearly 8 percent of Rocky Mount area residents were among the nation's extreme poor in 2008, living at below 50 percent of the poverty line. And, about 17 percent of area residents received food stamps last year, and nearly 23 percent of residents under age of 65 received Medicaid. Also, Rocky Mount's unemployment rate at the time of the report was 8.7 percent and since has risen to 13.8 percent.

While Forbes also ranked Rocky Mount as the 119th best small places for business and careers, largely because of the city's available workforce, this is a region that suffers with a great number of needs. This is a community with great pride and potential that continues to work hard to provide opportunities and improve the quality of life for its residents.

As we look at ways to make sure our resources are going where they are needed most, we should look at the way poverty is measured. Unfortunately, the official U.S. poverty measure has changed very little since it was originally adopted in 1969, with the exception of annual adjustments for overall price changes in the economy, as measured by the Consumer Price Index for all Urban Consumers.

Currently, the poverty threshold reflects a measure of the economic realities of the mid-1950's. The poverty line has not been adjusted to reflect changes in needs associated with improved standards of living that have occcurred over the decades since the measure was first developed.

A congressionally commissioned study conducted by the National Academy of Sciences has recommended that the poverty level be reset to take into account economic changes that have occurred over the past four decades. The National Academy of Sciences recommended that non- cash benefits, taxes and tax credits be counted as income while expenses such as work-related child care, housing and out-of-pocket medical expenses be deducted from income in determining families' poverty status. As a result, comparatively more working families and elderly people would be counted as poor.

The National Academy of Sciences also recommended that the poverty income levels be adjusted for regional cost of living differences. The current poverty income thresholds are uniform across the 50 states and the District of Columbia.

The Measuring American Poverty Act of 2009 introduced by Representative McDermott and a companion bill introduced by Senator Dodd would instruct the U.S. Census Bureau to adopt many of the modern poverty measurement recommendations made by the National Academy of Sciences. If adopted, the legislation would result in a new poverty measure that would coexist with the official poverty measure, and re- designate the current ``official'' measure as the ``traditional'' poverty measure. The new poverty measure would not affect programs that use poverty as criteria for either determining eligibility or allocating funds, but would stand as an additional statistical indicator to measure the effects of programs on poverty.

This would be a helpful step toward ensuring that we have a system that is fair to people who need help as well as to the taxpayers providing that help. This economic crisis serves as a reminder to all Americans just how vulnerable we all are, and that reducing our existing poverty will require a great deal of effort and attention.

Madam Speaker, I rise to remind my colleagues about the rich history of Pea Island, North Carolina.

On January 24, 1880, Captain Richard Etheridge became the first African-American to command a United States Life-Saving Service station after being appointed as keeper of the Pea Island Life-Saving Station. At the time, Captain Etheridge was one of only eight African Americans in the entire Life-Saving Service. Because of his skill and expertise, he was promoted from the lowest rank at the neighboring Bodie Island station to take over the incompetently run station at Pea Island.

In order to avoid repeating the previous failures at the Pea Island station, Captain Etheridge developed and implemented rigorous lifesaving drills. Under his leadership and direction, the station earned a reputation as the best on the east coast. Captain Etheridge became renowned as one of the most able, prepared, innovative, courageous and resourceful lifesavers in the Service.

On October 11, 1896, Captain Etheridge and his alert Life-Saving Service crew at Pea Island station were put to the test when the E.S. Newman ran aground nearby during a hurricane. Despite the raging storm and enormous waves, the surfmen succeeded in swimming to the ship and heaving a line aboard. Starting with the ship captain's three-year-old son, all nine people aboard the schooner were rescued one by one.

On February 29, 1992, the Coast Guard Cutter Pea Island was commissioned at Norfolk, Virginia, in memory of the African American crews at Pea Island, including Captain Etheridge and his lifesavers. And in 1996, Coast Guard Rear Admiral Stephen W. Rochon successfully spearheaded the effort to award the Gold Lifesaving Medal in recognition of the daring 1896 rescue.

Captain Etheridge served at Pea Island for twenty years. In January 1900, he fell ill and died at the station. Pea Island continued to be manned by all-black crews through the Second World War. The station was decommissioned in 1947, and, in 1949, turned over to the U.S. Department of the Interior's Fish and Wildlife Service to be used in connection with the Pea Island Migratory Waterfowl Refuge.

Today, Pea Island provides nesting habitat for loggerhead sea turtles, piping plover and other shorebirds. Despite its small size, the refuge receives over 2.5 million visitors annually.

Madam Speaker, I ask my colleagues to join me in recognizing and applauding the brave efforts of the life-saving crews on Pea Island.

Madam Speaker, I rise today to honor my friend and constituent, Mr. Vernon J. Bryant, for nearly 30 years of public service to the people of the State of North Carolina in the Department of Correction.

Since joining the North Carolina Division of Community Corrections in 1981, Mr. Bryant has steadily advanced in his responsibilities. He currently serves in the Probation/Parole division of the Department of Correction as District Manager of District 6A where he manages about 30 corrections staff. Vernon Bryant began his career as a Court Intake Officer and performed admirably over the next 19 years as Probation and Patrol Officer, Intensive Officer and as Chief Probation and Parole Officer. It was in these capacities that I became most acquainted with Mr. Bryant while I served as a Superior Court Judge presiding over the Courts of District 6A. Mr. Bryant interacted with me on a daily basis and I came to believe that he is one of the finest corrections officials in North Carolina. He is a true professional.

Madam Speaker, the Speaker of the North Carolina House of Representatives appointed Vernon Bryant to the North Carolina Criminal Justice Education and Training Standards Commission, which is responsible for the issuance, suspension, and revocation of law enforcement and criminal justice officers' certification. He has also served as a member of the North Carolina Probation and Parole Association and Criminal Justice Partnership Advisory Board for Halifax County.

In addition to his work at the North Carolina Division of Community Corrections, Mr. Bryant provides community service through Church, boards, commissions and other activities. He is a member and Chairman of the Roanoke Rapids Board of Education. He was first appointed to the Board of Education 1997 and has served as Chairman of the board since 1999. Mr. Bryant also serves as a volunteer youth coach for basketball and soccer, serves on the Halifax Regional Medical Center Board of Directors as Vice Chairman, and is Board Chairman for the State Employee's Credit Union Advisory Board.

Vernon Bryant is a devout Christian and demonstrates his values and beliefs in every aspect of his life. He serves as a member of the Roanoke Rapids Recreation Department Advisory Board and is president and co-founder of Exodus of Youth, Inc., a volunteer non-profit organization that mentors 75 at-risk youth in four northeastern North Carolina counties. Mr. Bryant continues to give countless hours to bettering his community and there is no doubt that he will continue his community service following his well deserved retirement.

Vernon Bryant is married to Sandra W. Bryant and is the father of two adult children, Kendel and Kevin, who are also distinguishing themselves with their educational pursuits.

Madam Speaker, on Monday, September 28, 2009, friends and colleagues will join together to celebrate Vernon Bryant's three decades of exemplary service to the people of Halifax County and the State of North Carolina.

I ask my colleagues to join me in wishing Mr. Vernon Bryant much success in his retirement and thank him for all his years of outstanding public service.

Mr. Speaker, I rise today to voice concern over the thousands of automobile dealers who have been forced to close their doors as the industry is now reshaping. While the national conversation has shifted from the auto industry to health care, we must remember that car dealerships continue to be shuttered and thousands of hardworking Americans continue to lose their jobs.

In my State of North Carolina, 49 Chrysler and General Motors dealerships have closed, along with all of the Pontiac dealers. Thirty Cadillac dealers are slated to close and, unfortunately, the closures are continuing.

One of the dealerships is J.C. Harris Pontiac and Cadillac. This dealership is in my hometown of Wilson, North Carolina. They have been serving the community for more than 40 years. Despite the fact that they lead Cadillac dealerships statewide in sales, service and customer satisfaction, J.C. Harris is being forced to close its doors. Customers from the region will be forced to drive 120 miles round trip for sales and service.

With American taxpayers becoming investors in GM, they should expect better.

I want to thank Chairman Pallone for yielding me this time, and I really thank him for his leadership on our committee.

Mr. Speaker, this is an important bill. Holding down the cost of Medicare premiums means so much to millions of Americans. We cannot ever lose sight of the plight of our senior citizens, who are struggling to make ends meet.

I want to thank the various chairmen who have decided to move decisively on this measure this week. I would only hope that our Republican friends would work with us on this one. Let's not use this issue as a weapon in the health care reform debate. This is a separate issue. Not only does it affect my district, but it affects all of our districts. In my State of North Carolina, 1.392 million North Carolinians have Medicare, and they need this legislation this week.

I ask my colleagues to join with me in voting for the Medicare Premium Fairness Act.

Madam Speaker, this week we mark 10 years since the floodwaters of Hurricane Floyd devastated eastern North Carolina, killing 52 people, causing over $6 billion in damage, and leaving thousands homeless. In the eastern part of the state, it is known simply as ``The Flood.'' It remains the most devastating natural disaster in our state's history.

On September 16th, 1999, Hurricane Floyd hit North Carolina as a strong Category 2 hurricane. Hurricane Floyd made landfall at Cape Fear and moved north along Interstate 95, hitting eastern North Carolina with 100-mph winds and up to two feet of rain. Of the two, the rain proved the more fatal element. Arriving on the heels of Hurricane Dennis, which had already soaked the ground and water table, Floyd's rains created massive flooding.

Over a period of a month, nearly every river basin in eastern North Carolina exceeded 500-year flood levels. The cresting waters destroyed 7,000 homes, left 17,000 uninhabitable, and damaged 56,000. The brave men and women of the National Guard and the Coast Guard performed nearly 1,700 freshwater rescues of people trapped on the roofs of their homes due to the rapid rise of the water. In total, Floyd was responsible for 57 fatalities in the United States, mostly in North Carolina.

Sixty-six counties in North Carolina were declared federal disaster areas. There were more than $6 billion in losses of property and agriculture. After the storm, over 88,500 North Carolinians registered state or federal disaster aid.

Every community I represent was in some way affected by ``The Flood.'' From flooded towns of Greenville, Kinston, Tarboro, Snow

Hill and Rocky Mount, where 30 percent of the city was underwater, to communities on higher ground that served as refuges for newly homeless neighbors, nearly every person in the eastern North Carolina experienced the Flood in a real way. But one of the hardest hit communities was Princeville, North Carolina. Princeville was completely submerged for more than a week--people's homes were underwater and the business community was virtually leveled.

Princeville, originally called Freedom Hill, is the oldest town incorporated by African-Americans in the United States. It was settled in 1865 by newly freed slaves on low and soggy swampland across the Tar River from the town of Tarboro. It had survived smaller floods over the years, but The Flood of 1999 nearly killed this historic town. With water up to the rooftops, FEMA offered the people of Princeville a buyout to abandon the town.

Though a difficult decision, the town rejected the offer 3-2. At the time, Mayor Delia Perkins said, ``Rebuilding is staying with your heritage. We plan to stay.''

The community's struggle to rebuild attracted the attention of many people, including then-President Bill Clinton. President Clinton issued Executive Order (EO) 13146, tasking an interagency President's Council with developing ``assessments and recommendations to repair and rebuild Princeville, and, to the extent practicable, protect Princeville from future floods.'' Hosts of other national figures visited and lent their support. Today, much of the town is rebuilt, though a handful of flooded homes still await demolition.

Today we remember the devastation caused by the Hurricane Floyd flood of 1999. The scars are still seen on the sides of buildings and in the hearts of people, but these communities have overcome and continue to work toward full recovery after these 10 years.

Mr. Speaker, the vast majority of American workers have private health insurance. If you are among those with health insurance, do you really know what you have or what you will have in 5 years? Unfortunately, many people do not understand the limits of their insurance until they get sick.

Without health care reform, insurance companies will continue to deny coverage or increase rates because of preexisting conditions. They will continue to drop people when they get sick or water down coverage when it's needed the most, and they will continue to set caps on the coverage in a given year or over a lifetime.

If you watch your current policy very closely, read the fine print, the American people will see that they are paying more and more for less and less. For Americans with health insurance, these reforms provide stability, affordability, security and peace of mind. Americans should not have to wait for reform.

Congress must get it done this year.

Mr. Speaker, during the August recess, not only did I conduct townhall meetings, but I toured medical facilities throughout my district. One of those visits has been etched vividly in my mind.

In Elizabeth City, North Carolina, I met Derrick Williams at DaVita Dialysis Center. He tearfully explained to me that he had received a kidney transplant from his sister. The kidney worked well, but he was required to take a variety of antirejection medicines. He liked his insurance.

His insurance company started reimbursing for the medicines, and he was very happy. But after just 2 years, the insurance company refused further reimbursement. Unable to afford the medicines, the kidney failed, he's back on dialysis, his sister is without a kidney, and Derrick is awaiting another kidney. What a tragedy.

Health insurers should work with us and their policyholders. Instead, they continue to rake in huge profits by raising premiums $1,800 per year and cutting back on coverage.

I urge the insurance industry to embrace health care reform, please.

Madam Speaker, I rise to recognize Pastor Brenda Timberlake's deep commitment to improving the lives of others and the community. On September 18, 2009, friends, family and well wishers will gather in Cary, North Carolina to celebrate Pastor Timberlake's 60th birthday and her 30 years of ministry.

Over the years, Pastor Timberlake and her late husband, Bishop Mack Timberlake, engaged in a great number of important efforts and projects that continue to help and serve the community.

Among the many successful endeavors undertaken by Pastor Timberlake include: establishing the Christian Faith Center Academy to provide Christian-based education to students from kindergarten through 12th grade; constructing the Royal Pavilions of Creedmor, a 28-unit housing complex for the elderly and disadvantaged; collaborating with the North Carolina Department of Public Health to reduce infant death rates and provide assistance to single mothers through the Family First of Granville County program; and establishing the Raven's Nest Food Bank.

Madam Speaker, these are but a few of Pastor Timberlake's many efforts. I ask that my colleagues join me in recognizing her accomplishments as her friends and family celebrate her birthday, ministry and achievements.

Pastor Timberlake continues to serve as exceptional community leader. Please join me in expressing gratitude for her service to the community and in wishing her continued success as she celebrates her birthday.

Mr. Speaker, I am disappointed that our Republican colleagues are refusing to work with us in crafting health care reform legislation.

Yes, you are.

Instead of working with us, you have cranked up your message machine. You have labeled our legislation with every label except ones that are accurate. Most disappointing, Republicans are frightening our seniors with false statements that they will experience a reduction in Medicare benefits. Wrong.

The truth is this legislation would not only maintain important Medicare benefits, but it will enhance them. We cannot afford to continue to do nothing about health care reform. There are 45 million who are uninsured. There are 14,000 Americans who are losing their benefits every day. Employer-sponsored group plans are getting more expensive. They have high deductibles and high copays, and they simply don't provide the security that families need. The cost of family health insurance will continue to rise five times faster than wages.

We must have reform and we must have it now. I urge my Republican colleagues to reconsider their strategy to block this legislation.