Floor Statements

Madam Speaker, on December 14, 2009, I was unable to be in the chamber for two Rollcall votes. Had I been present, I would have voted ``yea'' on rollcall No. 969, H. Res. 776, a resolution recognizing and supporting the goals of National Runaway Prevention Month and ``yea'' on rollcall No. 970, H. Res. 942, a resolution commending the Real Salt Lake soccer club for winning the 2009 Major League Soccer Cup.

Madam Chair, I rise in strong support of H.R. 4173, the Wall Street Reform and Consumer Protection Act, which will rebuild our economy and crack down on Wall Street to prevent another economic collapse caused by institutions that are ``too big to fail.''

Over the past year, I, like many Rhode Islanders, have been angered by the greed exhibited by Wall Street and other companies that took advantage of their investors, preyed on our constituents, and rewarded executives with outrageous pay packages. With this bill, consumer protection will come first, and irresponsible companies will be held accountable for their actions.

H.R. 4173 establishes the Consumer Financial Protection Agency, which will protect families and small businesses by ensuring that bank loans, mortgages, credit cards and other financial products are fair, affordable and transparent. Merchants will be excluded from the oversight of the CFPA, and small banks and credit unions will not be subject to undue regulatory burdens. However, the CFPA will play a backup role if the primary regulators fail in their oversight responsibilities.

This measure also establishes an orderly process for dismantling large, failing financial institutions like AIG or Lehman Brothers, which will protect taxpayers and prevent collapse throughout the rest of the financial system. These large institutions will pay into a fund that will be tapped if a company faces dissolution. There will be no more taxpayer bailouts for these ``too big to fail'' institutions.

Additionally, H.R. 4173 responds to the failure to detect frauds like the Madoff scheme by ordering a study of the entire securities industry. This measure will also increase investor protections by strengthening the Securities and Exchange Commission and boosting its funding level. For the first time ever, the over-the-counter derivatives marketplace will be regulated under this bill and hedge funds will have to register with the SEC. It also takes steps to reduce market reliance on the credit rating agencies and impose a liability standard on the agencies.

I would like to thank the committees for their work on this bill, and especially want to thank Chairman Frank for his leadership on this strong reform measure. I encourage all my colleagues to vote for this bill.

Madam Chair, I rise in strong support of H.R. 4173, the Wall Street Reform and Consumer Protection Act, which will rebuild our economy and crack down on Wall Street to prevent another economic collapse caused by institutions that are ``too big to fail.''

Over the past year, I, like many Rhode Islanders, have been angered by the greed exhibited by Wall Street and other companies that took advantage of their investors, preyed on our constituents, and rewarded executives with outrageous pay packages. With this bill, consumer protection will come first, and irresponsible companies will be held accountable for their actions.

I would like to thank the committees for their work on this bill, and especially want to thank Chairman Frank for his leadership on this strong reform measure. I encourage all my colleagues to vote for this bill.

Madam Speaker, I rise today to express my deep sorrow over the tragic fire that took the lives of one hundred forty-two people at a nightclub in the city of Perm, Russia, on December 4th.

News of this fire hit close to home for me, and for many of my constituents, as it closely mirrors the devastating 2003 Station Nightclub fire in West Warwick, Rhode Island, which killed 100 people and injured over 200 more. According to early reports, the Perm fire started when performance pyrotechnics ignited the ceiling of the nightclub, sending patrons stampeding for one narrow exit. One hundred forty two people were killed and scores more were injured as patrons tried to escape the flames.

In the United States, fires caused over $15.5 billion in damages last year, but their most horrific toll were the over 3,400 lives, including 118 firefighters, who were lost as a result. Studies have shown that fire sprinklers can dramatically reduce property damage and, more importantly, save lives. In fact, the National Fire Protection Association has no record of a fire killing more than two people in a public assembly, or an educational, institutional or residential building, with a complete and fully operational automatic fire sprinkler system.

This is why earlier this year I reintroduced the Fire Sprinkler Incentive Act of 2009 that provides tax incentives for property owners to retrofit buildings with automatic fire sprinkler systems. I hope that through this and other measures, we can raise awareness and improve fire safety--not only in this country, but around the world-- and ensure that tragedies like those in Russia and Rhode Island are never repeated.

I want to once again extend my sympathy, and that of the people of Rhode Island, for the families of the victims of the Perm fire and to the Russian people. We know all too well the pain and loss you are feeling, and we send our thoughts and prayers to your community in this difficult time.

Mr. Speaker, I rise today to recognize a very special event happening tonight in my district thanks to the efforts of a very special young boy and his family. This evening, the second annual Cereal Night will take place at North Kingstown High School in Rhode Island, which is where hundreds will gather to donate to our local food pantries.

The mastermind behind this event is one of my young constituents, Patrick Gannon, an 11-year-old 5th grader and Cub Scout from North Kingstown. Like all Rhode Islanders, Patrick has seen the devastating effects of the economic downturn in our State, where unemployment has reached 13 percent, where record numbers of foreclosures continue to force people from their homes, where food pantries are struggling to meet the needs in their communities, and where too many of our neighbors are desperate for a hand.

Well, last year, when he was only 10 years old, Patrick came up with a way to help. His idea was that, one night of the year, families could eat cereal for dinner and could donate the money or food they saved to a local food pantry. While encouraged by his parents, Bill and Jackie, he began to organize the first Cereal Night last December. Soon, friends, local businesses, and even our Governor were involved in highlighting this initiative.

On the night before the event, though, a snowstorm hit Rhode Island, making it doubtful that there would be a big turnout. Nevertheless, Patrick was there the next day at one of the drop-off sites, running out to cars through the snow to accept their donations. At the end of the day, three tons of food were donated to the Rhode Island Food Bank, and plans to build on this success were put in motion.

Like any proud mother, Jackie did her best to spread the word-- reaching out to nonprofit organizations and even writing to President and Mrs. Obama, telling them about Patrick's work and asking them to make Cereal Night a national event. Well, sadly, she won't be able to see those efforts come to fruition. On November 7 of this year, 2 days before Patrick's 11th birthday, Jackie suffered a ruptured aneurysm and passed away. Well, her death was a shocking and heartbreaking blow to her family and friends, but they have channeled their grief towards the cause that she was inspired to embrace by her son Patrick.

This year, Cereal Night will be an opportunity for the community to come together to give something back to those in need, to celebrate Patrick's imagination and commitment and to honor the life of a beloved mother who touched all those who were lucky enough to know her.

This holiday season, we are reminded of how important it is to help each other get through these tough times. We are all reminded of families like the Gannons, where the spirit of giving and of serving the community is passed down from generation to generation. We are reminded that you are never too young to make a difference.

Patrick is an inspiration to me, and I encourage my colleagues and all those who are listening to follow his example by donating to a local food pantry, by starting a Cereal Night in your own community, and by spreading the word about this simple effort that can mean so much to a neighbor in need.

My thoughts and prayers go out to Jackie's family, including Patrick, her husband, Bill, and their younger son, Liam, as well as her friends and all those who mourn her loss.

Recognizing the Importance of PAH Awareness

Mr. Speaker, I start a second statement, which is equally inspiring.

I consider it a privilege to recognize and commend the extraordinary efforts of a young man named Matt Moniz. This 11-year-old from Boulder, Colorado, scaled three of the world's seven summits in order to raise money and awareness for his best friend, Iain Hess, who suffers from Pulmonary Arterial Hypertension, or PAH.

PAH is a rare, progressive disorder characterized by abnormally high blood pressure in the pulmonary artery--the blood vessel that carries blood from the heart to the lungs. For people living with PAH, like Matt's friend, Iain, the simplest of daily activities can cause shortness of breath, dizziness, fatigue, chest pain, and swollen legs and ankles.

As an experienced climber, Matt is very familiar with these symptoms, which can often affect climbers at high altitudes; but while Matt knows that he'll be fine as soon as he descends the mountain, there is no known cure for those who suffer from PAH. It's a life-threatening disease that can cost thousands of dollars a month to treat. In fact, Iain's medical bills run more than $100,000 a year. Right now, Iain's family is fortunate to have health insurance that absorbs much of the cost of his care. However, they are all too aware that Iain may soon reach the lifetime limit of his coverage, leaving them no

choice but to pay for the care themselves.

That's why, Mr. Speaker, by the way, it is so important that we pass national health insurance that this House passed just a short time ago.

Equally cognizant of difficulties that Iain and his family face, Matt decided to do his part to help. In a noble act of true empathy and friendship, Matt Moniz joined his family and friends in a campaign to climb 14 of Colorado's 14,000-foot peaks in 14 days, covering a total of 42,020 vertical feet and 71 miles. This, in and of itself, would have been an incredible feat, but this extraordinary young man accomplished it in 8 days. His goal was to give each climber a firsthand sense of a typical day in the life of a patient living with PAH while simultaneously raising money to ease the financial burden for his friend Iain and his family.

Well, on Saturday, July 18, 2009, Matt and his fellow climbers completed this extraordinary endeavor, raising a total of $20,000 for the Iain Hess Breathe Easy Fund and the Pulmonary Hypertension Association. Of course, he could not have accomplished this amazing task without the love and support of his father, Mike, of his mother, Deidra, and of his twin sister, Kaylee--all of whom took part in the climb--as well as Iain's sister, Olivia Hess, and numerous other friends, family, supporters, community partners, and sponsors.

Mr. Speaker, Matt's compassion and tenacity exemplify the best of who we are and what we aspire to be. Matt is in the audience today with his family. I want to applaud Matt for his extraordinary effort, and I look forward to supporting his campaign to raise awareness of PAH so we can work toward a cure for everyone so that everyone can breathe a little easier.

Mr. Speaker, I rise in support of H.R. 4213, the Tax Extenders Act of 2009. This bill provides $31 billion in tax relief to individuals, families, businesses and charitable organizations by extending over forty tax provisions that are set to expire at the end of 2009. These tax breaks are an important component to rebuilding the financial and economic strength of Rhode Islanders struggling in the wake of the worst recession in decades.

H.R. 4213 contains more than $5 billion in individual tax relief and more than $17 billion in tax cuts for American businesses. To strengthen pocketbooks of families and inject demand into the economy, this measure extends property tax relief for up to 30 million homeowners. It helps 4.5 million families better afford college with tuition deductions and saves 3.4 million teachers money with a deduction for classroom expenses. This measure further extends the research and development tax credit for thousands of American corporations, encouraging businesses to increase investments in technology and create more high-tech jobs for the twenty-first century.

Also included in this package is more than $7 billion in tax provisions that encourage charitable contributions, provide community development incentives, and support alternative energy investments.

In tough economic times, it is important to enact tax policies that spur job creation and foster economic growth, innovation and opportunity. The annual extension of these tax cuts is an important step toward achieving that goal, and I look forward to working with my colleagues on more permanent solutions to simplify the Internal Revenue Code and ease the tax burden on millions of Americans.

Will the gentleman yield?

I thank the gentleman for yielding.

Let me just commend the gentleman from Massachusetts for his incredible work on the issue of addressing global climate change, an issue that I know in many ways has become his life's work for so many years. I deeply appreciate his work here in the Congress, particularly as he leads the committee on the environment and global climate change here in the Congress.

Madam Speaker, I rise tonight to join my colleague, Mr. Markey, and so many others, in addressing this issue of global climate change, particularly during tonight's Special Order hour to recognize the critical negotiations that are beginning to take place at Copenhagen at the United Nations Climate Change Conference.

Like so many of us, I am greatly concerned with the permanent damage that we have already inflicted on the planet by failing to curb carbon emissions, but I believe that there is still time to enact meaningful reform that will not only stop the harmful effects of pollution, but will also jump-start our economy with a greater investment and demand for clean energy.

This issue, in terms of addressing global warming, is important for our environment, it's important for our national security, it's important for our economy in creating jobs of the 21st century, and clearly it's so vitally important to the future of our planet.

The predictions of what will happen to our planet if we do not take action on global warming are startling, and often they are even too dire to comprehend. But as a representative of the Ocean State, I simply can't ignore the situation that is facing my State today and in the near future. In my home State, just off our coast, the temperature of Narragansett Bay has risen 2 degrees in the past 30 years, leading to dramatic changes in the fisheries population. In Rhode Island, our economy relies on the fishing industry, and they are being so adversely affected right now because of these issues.

Conservative graphs of our coastal communities in the year 2100 shows cities that are halfway underwater. What happens to the investment that we've made to restore our fisheries, upgrade our ports, and to refurbish our wastewater infrastructure? Well, they will slowly be underwater, and the Federal investments that we made will be gone.

When I listen to my colleagues speak about things like the deficit, they often lament that we are focused on short-term fixes while perpetuating a long-term burden that our grandchildren will have to carry. Well, I

agree with them. I don't want the next generation to be burdened with the decisions that we make here today and I don't want to leave them with air they can't breathe, water they can't drink, and destroyed infrastructure up and down the coastline.

We need to address this issue now. I look forward to working with my colleagues on addressing global warming.

I commend the gentleman from Massachusetts again for his extraordinary work on global climate change issues.

Mr. Speaker, I rise to express my deep sorrow and most sincere condolences to the families of Sergeant Mark Renninger, Officer Tina Griswold, Officer Ronald Owens, and Officer Greg Richards. These four officers, who so honorably served the Lakewood, Washington, Police Department, were tragically gunned down as they began their shifts last Sunday morning.

I, like all Americans, was shocked and horrified to hear of this brutal crime against four uniformed officers. Having grown up around law enforcement as a young police cadet, I know firsthand the challenges and dangers of the job, and the selflessness of those who wear the uniform and dedicate their lives to protecting their communities.

I come to the floor today to add my voice to all those expressing their grief and their outrage over these senseless killings, and I want to send my thoughts and prayers to the officers' families, especially the children these public servants have left behind. They will need untold strength in the coming days, but I know they will find all they need and more in the memory and example that their courageous parents have left for them.

Let us remember always the service of not only these four officers, but of all those who wear the uniform and make our safety their first priority.

Mr. Speaker, I'd like to thank President Obama for convening a forum on jobs and economic growth in the White House today.

As too many of our constituents enter this holiday season perhaps having lost their jobs or facing lower wages, higher health care costs, or out-of-control mortgages, and many of whom have lost their homes, we absolutely must focus on rebuilding our economy and pursuing all avenues to create jobs. Rhode Island felt the painful effects of the current economic downturn, and that is why it is so important to me that we have a seat at this forum.

I am pleased to say that President Di Pasquale of the Community College of Rhode Island will be there to share their perspective on workforce development, job training, retraining workers, and educational opportunity for the 21st century.

Economic development continues to be my top priority, and I look forward to working with my friends in Congress and with President Obama to increase job opportunities across our country.

Mr. Speaker, I rise in strong support of H.R. 1242, which would provide additional and necessary monitoring of Troubled Asset Relief Program funds.

H.R. 1242 would create a database to easily track the status of distributed funds, making it easier for those overseeing the program to spot inconsistencies in spending and ensure the most effective use of the funding. It would also require the Treasury Department to adjust the future use of TARP funds if its intended goals are not being met.

Along with my constituents, I am deeply disappointed that the past administration did not adequately track how taxpayer money was spent to ensure that banks were using it for the intended purposes. Earlier this year, I was pleased to vote for legislation that would have ensured TARP funding was spent responsibly and transparently in an effort to get the economy back on track. Unfortunately, this measure was not taken up by the Senate.

In order to stabilize our economy and get credit flowing again to families and small businesses, we need to fundamentally change the practices of the Troubled Assets Relief Program. By strengthening accountability and increasing transparency, this measure ensures that public resources are being spent correctly and wisely. I urge my colleagues to vote for this measure.

Mr. Speaker, I rise in strong support of H.R. 3962, the Affordable Health Care for America Act. Congress has made unprecedented strides this year in the fight to reform our nation's health insurance system and provide coverage to all Americans, and today's vote represents a historic culmination of these vast, collaborative efforts. This transformative bill offers real solutions for Rhode Islanders by providing better access to affordable, quality health care coverage and finally puts America back on the path to an efficient and sustainable health care system.

This summer, I traveled across the district to meet with Rhode Islanders and discuss health reform. I met with constituents who had health insurance all their lives, but then lost it when they were diagnosed with cancer. I met with small business owners who provided coverage for their employees for decades, but were forced to discontinue it when they could no longer keep up with skyrocketing costs. And I met with parents who were desperate to protect their childrens' health, but feared they would soon run up against lifetime insurance caps.

All of these stories conveyed the same message--health care costs in the United States are rising at an unsustainable rate, and they are placing a huge burden on Rhode Island families, employers and health care providers. This year alone, over 13,000 Rhode Islanders lost their insurance coverage due to rising unemployment. And those who still have coverage are struggling with rising premiums, co-pays and crushing medical debt. Meanwhile, yearly double-digit premium increases are forcing businesses to choose between keeping their employees' health coverage and keeping their employees.

As a longtime advocate of universal health care, I made a promise to my constituents to change the status quo of health care in America. The time for inaction is over--we must join together to pass this bill.

H.R. 3962 will institute the changes we need to provide more security and stability to Americans who have health insurance, guarantee insurance to the millions who don't, and lower health care costs for our families, businesses and the government.

This legislation builds on the strengths of our current employer- based system by encouraging businesses who offer their own coverage to continue doing so. Americans who don't have coverage through their employer will be able to shop for their choice of a health plan through a new ``health insurance exchange,'' modeled after the tried and true Federal Employees Health Benefits Program, which successfully provides coverage for over 9 million federal employees, retirees and their dependents.

Unlike the limited options that are available to most consumers today, the exchange will

provide a more convenient, transparent and affordable way to choose among a variety of health plans that meets individual needs. Americans who cannot afford to purchase coverage within the exchange will receive financial assistance to ensure that they can obtain comprehensive coverage. Additionally, small businesses will receive tax credits that will make it more affordable to offer insurance to their employees.

I am also pleased that this bill encourages competition by ensuring that Americans will have the ability to choose a public plan alternative. Unlike private insurance carriers, the public option will not be obligated by big profits for shareholders or large salaries for CEOs. And while it represents just one option for the consumer and one component of health care reform, it will serve as an important tool to increase choice and competition and lower overall insurance costs.

Included in this proposal are a number of important health consumer protections. It will finally end insurance discrimination against people with pre-existing conditions and prevent insurance companies from imposing lifetime limits or dropping coverage when people are sick and need it most. It will cap out-of-pocket expenses so people don't go broke when they get sick; eliminate extra charges for preventive care like mammograms and diabetes tests; and protect Medicare for seniors while working to eliminate the ``donut-hole'' gap in coverage for prescription drugs. It will also require that insurers reinvest at least 85 percent of their premiums back into health coverage. This will limit the amount of money spent on advertising, underwriting, overhead and profits that do nothing but reduce health benefits for patients.

Improving access to coverage will also require investments in our health care workforce. Our system is strained by a lack of nurses and primary care physicians, particularly in underserved areas. That is why our bill contains important workforce development initiatives like new scholarships and loan repayment programs, grant programs for primary care training and immediate financial support for community health centers. This will strengthen the number of nurses, doctors and other health care professionals necessary to meet the increased demand for services.

This bill also makes historic changes to our antitrust laws by removing exemption enjoyed by insurance companies so that they are no longer shielded from liability for price fixing or dominating their market--all of which reduce competition and increase prices for consumers. It establishes new grant programs designed to encourage states to implement alternatives to traditional medical malpractice litigation with the goal of reducing frivolous lawsuits while allowing legitimate cases to be heard. This bill also has my strong support because every portion will be completely paid for, and it will reduce the deficit by $109 billion over the next ten years.

Mr. Speaker, I believe it is incumbent on us as policymakers to offer a new vision for health care in America--one that contains costs, improves quality, increases efficiency, promotes wellness, puts health care decisions back in the hands of patients and doctors, and guarantees coverage as a right to our citizens.

Every American deserves the promise of quality, affordable health care. I urge my colleagues to join me in fulfilling that promise today, and support the Affordable Health Care for America Act.

Mr. Speaker, I rise today in support of H.R. 3961, the Medicare Physician Payment Reform Act of 2009. This legislation will prevent a scheduled 21 percent Medicare payment cut to physicians, while providing a long-term fix to the flawed Medicare reimbursement formula that has threatened access to care for over a decade.

Congress has made unprecedented strides this year in the fight to reform our nation's health insurance system. On November 7, I was proud to support the first comprehensive health reform bill to pass the House in several decades. This was an historic achievement, but we have more work to do. Low Medicare reimbursement rates have made it difficult to retain qualified doctors in Rhode Island, particularly those who practice primary care. This is not just a problem for Rhode Island's seniors; it is an issue that affects every patient in Rhode Island and throughout the country.

The Medicare Sustainable Growth Rate formula, or SGR, was a cost control measure instituted in 1997 that has required repeated cuts in physician reimbursements that don't reflect the true costs of care. Since 2002, Congress has recognized this fact and passed yearly fixes to prevent these cuts from taking effect. If left unresolved, this problem will result in a total reimbursement cut of 40 percent to doctors by 2016, the same time period during which we will see even more baby boomers entering the Medicare program.

H.R. 3961 replaces the pending 21 percent fee cut with an update for 2010 based on the Medicare economic index, estimated at 1.2 percent. Beginning in 2011, the update adjustment factor would be based on spending for each category of service since 2009, wiping the slate clean from the onerous accrual of cuts that have loomed over doctors for years. In addition, it provides an extra growth allowance for primary care services to promote access to primary care practitioners in Medicare and throughout the health care system.

Successful health reform must include a Medicare payment structure that ensures fair reimbursement for doctors and continued access for seniors. H.R. 3961 is a necessary step toward achieving that goal, and I urge my colleagues to support its passage.

Mr. Speaker, I thank the gentlelady for yielding, and I want to commend the sponsor of this act before us today.

Mr. Speaker, I rise in strong support of H.R. 3014, the Small Business Health Information Technology Financing Act. As this Congress is moving aggressively to solve our Nation's health care crisis by establishing universal health care, we are going to have to move aggressively also to look at ways of controlling costs. That really is one of the vital reasons why we have to overhaul our Nation's health care system. Health information technology will be a vital part of the effort to both improve quality and cut costs.

But, of course, with this there will be an up-front cost that many doctors, in particular, are going to have to absorb. We have to work aggressively, I believe, to try to support them in this transition to adopt these new health information technologies. Again, many of these doctors are just, if you will, small businesses themselves. Today, the Congress is debating several bills supporting small business.

In order to create jobs we absolutely have to look to small businesses. In many ways they are the backbone of our economy. Certainly in my home State of Rhode Island that's true, with 96 percent of employers being small businesses. My constituents right now are struggling with a heavy burden of 13 percent unemployment in a State whose recession began almost a year earlier than most of its neighbors, and the need for job creation could not be more urgent.

Many of the new jobs we need will be created through new business endeavors, and that's why this legislation and other pieces of small business legislation that we're debating today are so important. By looking at new business models, we will better target the needs of our communities. We need to help our small businesses grow, keep people employed, and train them for new, sustainable jobs. American prosperity clearly depends on the success of small businesses and the innovative spirit of the American people. I'm certainly committed to bringing relief to Main Street and small businesses that are struggling in our State. Certainly, doctors, as I said, many of them are small businesses themselves, and helping them with the up-front cost of adopting this health information technology will assist them to stay in business. And particularly, as we try to grow our primary care system, this will become more and more important.

I commend the gentlelady for introducing the legislation. I am proud to support it, as I am proud to support all of our small businesses and helping them to stay in business and grow jobs.

Mr. Speaker, I rise in strong support of the Financial Services Committee's work to overhaul our financial system. Across the Nation, including my home State of Rhode Island, predatory lending and unregulated mortgage brokers led to unsustainable home loans and a drain on our economy. Now, with unemployment at 13 percent, my constituents, like many across the country, have had no other choice but to turn to credit cards to support their families and small businesses. Now what's happening is these struggling Rhode Islanders are subjected to the deceptive practices of credit card companies

greedily generating more profit before new regulations go into effect. We've all seen it. These practices include rising minimum payment amounts and interest rates, decreasing limits and closing accounts without proper notification. For these reasons and many more, consumer protection must be the cornerstone of financial reform. Further, we must restore accountability and transparency of financial institutions and eliminate risks that contributed to the financial collapse.

I look forward to voting on legislation which will address these past failures, strengthen regulation and oversight and put our country back on a path to economic stability.

Mr. Speaker, I rise today in strong support of this rule and the underlying bill which finally puts us on the path to solving our Nation's health care crisis.

Since coming to Congress, I have heard from countless constituents in Rhode Island struggling with the failures of our health care system. I have heard from constituents forced to make unconscionable choices between seeing a doctor or their next meal, paying their mortgage or losing their coverage, and families facing bankruptcy due to catastrophic medical costs.

The time for inaction is over. This bill represents an historic opportunity to enact reforms that will allow constituents who lose their jobs to keep their health care coverage, eliminates preexisting conditions, and protects people by abolishing lifetime insurance caps.

Every American deserves the promise of quality affordable health care, and this is our moment to fulfill that promise.