Floor Statements

Mr. Speaker, I appreciate the patience and understanding, just coming from a classified hearing.

I want to first thank the chairman and his staff, as well as committee Democratic staff, for working so hard and so diligently and collaboratively to come to an agreement on legislation that will help guide American job and economic growth.

There is a strong incentive to invest in America, which remains the best place on Earth to find talented, motivated employees who are the core of the middle class.

My home State of Illinois ranks number one in the Midwest in terms of foreign direct investment, with nearly 1,600 foreign-based firms employing more than 300,000 Illinois residents. In attracting the investment, Illinois has showcased its world-class transportation infrastructure, its diversified economy, its productive workforce, and its cultural diversity and attractions.

It has also maintained its strong labor, health, and environmental standards that helped build the middle class, which I believe is the key to successful foreign direct investment.

Some companies are working to respect the rights of workers as they invest in the United States. On Friday, it was announced that Volkswagen is working collaboratively with the United Auto Workers to unionize its Chattanooga, Tennessee, plant. That will help to ensure that the best interests of American workers are a major consideration at the plant and the company as it continues its investment in the United States.

That being said, it is important that the study authorized in this legislation examine both the benefits and the costs of foreign direct investment. Doing so will allow us to determine the ways to drive investment that maintains high labor, health, environmental, and national security standards.

And on that subject, I'd like to enter into a colloquy on the amendment in the nature of a substitute offered by Mr. Terry. While I will not oppose this amendment, I must express my reservations.

Mr. Chairman, you worked with me in a very collegial and bipartisan manner to craft a bipartisan bill. H.R. 2052 is a good product.

Now we have before us an amendment that makes three changes that could be perceived to weaken important provisions of the bill. I have concerns about each of them, but I would like to focus on the elimination of cost-benefit language regarding the bill's required review of the current economic impact of foreign direct investment.

During our negotiations, I suggested that language because I believed that we needed to ensure that the review be balanced, and you agreed.

In addition, some of the language in the findings and in the sense of Congress could be read as if there are only benefits of FDI, and we wanted to be evenhanded. While I do believe that there are benefits to FDI, there are also costs that must be considered.

Regardless of the amendment before us now, can you assure me that the bill's requirement of a review of the current economic impact of foreign direct investment required under this bill will include a review of both the benefits and costs of foreign direct investment?

I yield to the gentleman from Nebraska.

Thank you so much.

Reclaiming my time, if I could just say, I will not oppose the amendment, but I do expect to work with you to ensure that the review, should this bill become law, is balanced and to ensure that any report of this committee on H.R. 2052 include the clarification that you just made.

Mr. Speaker, last year I met with a fourth grade constituent named Lily McSheffery. Lily was concerned about the impact of oil and gas drilling on sources of drinking water, and she was determined to do something about it. She urged me to introduce a law that would protect consumers from contamination associated with drilling operations.

Today, I will introduce the Safe Hydration is an American Right in Energy Development, or SHARED, Act. The bill would require testing of water sources near hydraulic fracturing operations and the public disclosure of the results of that testing. The SHARED Act would improve the lives of people all over this country, making sure Lily and future generations of kids have access to safe, clean water.

I am inspired by Lily's dedication to this issue, and I urge my colleagues to join as cosponsors of the SHARED Act.

Mr. Speaker, I rise today to pay tribute to Hedy Ratner and Carol Dougal, the founders of Women's Business Development Center (WBDC), for their exemplary leadership in supporting women's entrepreneurship. As Hedy and Carol step down from their role as co- presidents of the WBDC, let us recognize the work that these two remarkable women have done for more than 25 years to empower other women to start, improve and expand their small businesses.

In 1986, Hedy Ratner and Carol Dougal created the Women's Business Development Center to address the lack of support for women in the business world. Since then, Hedy and Carol have worked tirelessly to accelerate the growth of women-owned businesses and microenterprise ownership, increase the economic impact of women business owners on families and communities, build awareness of business ownership as a path to economic self-sufficiency, and help stimulate policy and system changes to empower women in the economy. Today, the positive impact of the WBDC is clear, and the Center continues to be a leader in expanding opportunities for women.

Over the years, the WBDC has helped more than 66,000 women in the greater Chicago area in their entrepreneurial efforts. Its success has spurred the creation of 14 other centers in 6 states. The oldest and largest women's business assistance center in the country, the WBDC is constantly developing and implementing new approaches to help potential and current women business owners. The Center and its outstanding staff give women the tools, the needed support and the confidence to know that they can become successful entrepreneurs.

Hedy and Carol are recognized leaders who have advised business groups and public officials at all levels about ways to help women improve their families' well-being and our nation by creating new business opportunities. I am one of many who have been fortunate enough to receive their advice on ways to improve federal contracting and lending policies and to learn about the barriers that must be torn down so that more women can enter the realm of business ownership.

I congratulate Hedy and Carol on the extraordinary contributions they have made through the Women's Business Development Center. Although they are leaving their posts as co-presidents of WBDC, I know that they will remain leaders in advocating for women-owned businesses in Chicago and nationwide. I look forward to watching their next steps toward helping women business owners successfully achieve economic independence through entrepreneurship.

Mr. Speaker, I rise to recognize one of my constituents, Transportation Security Officer Jacob Neal, who saved a life at Chicago O'Hare International Airport with the help of two other TSA officials earlier this month.

When TSO Marvin Jackson noticed that a passenger had collapsed and lost consciousness, he quickly placed a call to his supervisor, Jacob Neal. TSO Neal, who served in the U.S. Air Force as a firefighter and medic before joining the TSA, demonstrated great leadership and poise as he took control of the situation, asking everyone to step away unless they were certified in CPR. He put on his gloves and started to give chest compressions, while also comforting the passenger's wife by letting her know that he was a former paramedic. His quick thinking, expertise, and professionalism made the difference.

``When someone is suffering like that you just feel compelled to jump in and help,'' said TSO Neal, a two-time O'Hare TSO of the Year honoree.

Jacob Neal along with the others who helped save a man's life that day showed extraordinary strength and exemplified what it means to go above and beyond the call of duty. It is acts like these that inspire us to be better people and better citizens. Due to the quick thinking and composure of the men and woman involved, a potentially tragic situation was avoided.

Again, I would like to thank Jacob Neal for his commendable efforts in saving a life this past month. I also want to recognize him and his TSA colleagues, and other federal employees who work hard each and every day to serve the public and keep our nation strong and secure.

Mr. Speaker, on the 48th anniversary of Medicare and Medicaid, I rise to voice my strong support for these national treasures and to share with my colleagues the voices of older Americans from around the nation who rely on them.

Before 1965, nearly half of all seniors were uninsured. If they became sick or injured, they were forced to use their savings, rely on their family, or go without needed medical care. Today, Medicare serves over 50 million seniors and persons with disabilities, providing them with the guaranteed benefits that they have earned over their working lives.

Medicare is literally a life-saver. It can be improved--and we did so in Obamacare by lowering drug costs, eliminating cost-sharing for preventive services like colonoscopies and cancer screenings, and coordinating care to improve quality.

Unfortunately, there are some who want to change Medicare not by making it better, but by shifting costs to those who cannot afford it. Some of those proposals involve increased premiums, deductibles and new cost-sharing requirements for home health services. Others--like those in the Republican-passed budget resolution--would radically change Medicare's very structure by turning it into a voucher program and leaving seniors and people with disabilities to bear dramatically higher costs.

I urge my colleagues to consider the critical importance of Medicare and to join me in opposing proposals that would add to the financial burden of seniors and persons with disabilities who are already struggling. Here are some of the voices of those who need Medicare's guaranteed benefits.

Michelle Adams, from Fallston Maryland, has been on Medicare for the past 13 years because she is disabled. If she didn't have Medicare, she says, ``I would be in bad shape without my prescription and possibly homeless because I wouldn't be able to afford both my medication and rent.''

Madeline Levine from Evergreen, Illinois has diagnosed with breast cancer shortly after she became eligible for Medicare. ``Without Medicare, I could not have afforded my treatment,'' she says. ``This gives me a peace of mind that I have protection.''

Juandra Drumgold from Dorchester, Massachusetts, depends on her family for a roof over her head and to pay for basic necessities. She says that not being able to work at such an elderly age and having to maintain her health care can be quite costly. If she did not have Medicare, she says, she would have to cut her living expenses even more, making a choice between medication and food.

B. Peter Brandt-Sorheim from Mt. Morris, New York, saw his medical expenses drop by nearly two-thirds once he became eligible for Medicare last year. Before, he had to pay about $1,625 for a three-month supply of medication, he currently pays $135. If it weren't for Medicare, he says, ``I would be walking on the edge, crossing my fingers, and praying that someone would donate my Insulin medication to me.''

Toni Rosenberg of Boca Raton, Florida relies on Medicare for services related to high-blood pressure, lymphedema, and kidney disease. She says, ``If it was not for Medicare, I would be dead. If my Medicare benefits were cut or became more expensive, I would have to stop eating. By being single, Medicare has provided me with a safety net. Medicare is not an entitlement--it is something that we've paid into and should have when we 65. Medicare has provided me with not having to choose between eating healthy foods or being able to get my prescriptions. I do not have to worry about my health because I know I have coverage to take care of me. I am a voice for the people who cannot speak for themselves, please keep your hands off Medicare. My parents and family all fought to have Medicare in our golden years so that my children and grandchildren will have what I have to keep them going in their senior years.''

Harlan Lang from La Plata, Maryland, has been on Medicare for twelve years. He says, ``If I did not have Medicare coverage, the quality of my life would change terribly, because if I was in a crisis, I would not be able to make it without the coverage. I believe so strongly in Medicare, it is so important to me. I cannot afford to be without the coverage. Healthcare is so expensive; I wish it was even better.''

Rosie Woods lives in Richmond Virginia. ``I have been enrolled in Medicare for twenty years. Medicare has helped me to save on my prescriptions,'' she says. ``My health issues for which I am receiving treatment covered through Medicare is for cholesterol and I had a stroke in 2012. If I did not have Medicare my quality of life would change because I would have to go on the soup line. If my Medicare benefits were cut or if I was charged more, I would have to give up a whole lot. It would be a lot of stress that I would have to go through. Taking care of my home will be hard with the expenses. We work very hard for them to take money out of our checks expecting the benefits to be there when we retire.''

Barbara Bonfield of Birmingham, Alabama has been enrolled in Medicare for eleven years. She says, ``Medicare has helped me on most of my expenses. My husband died of a heart attack at the age of 64. At the age of 65, I was diagnosed with breast cancer and I am a survivor, Medicare was my primary insurer. Medicare has kept me well and it is a vital part of my community, without Medicare coverage I probably would not be alive today, it has kept me alive. If my Medicare benefits were cut or if I was charged more, I would be spending a lot of money to obtain my health care. I would have to re-adjust to everything (travel, food etc.). The last thing that I would have to reduce is my medications. I am very aware of the rising cost of medical care in this country and it is good to know that the Affordable Care Act will reduce the medical cost.

Cynthia Ochs Saur from Melbourne, Florida says, ``I reside in Florida and have been enrolled in Medicare for four years. I have had two wellness exams for breast cancer and a lot of health issues which were treated thanks to Medicare. If I did not have Medicare coverage my quality of life would change quite a bit. If my Medicare benefits were cut or if I were charged more, I would have to give up other necessities in order to pay for the help for my medical problems. I would not be able to survive in many ways and would suffer greatly.''

Bruce Russell, Sr. is from Missoula, Montana and has been enrolled in Medicare for five years. He says, ``Two weeks ago I was operated on for a growth on my neck, had a colonoscopy test done and one growth was removed--neither one was cancerous. If I did not have Medicare coverage I would die young. My sister had severe arthritis and shingles, she put up with the pain for three years until she was enrolled in Medicare. People who retire on fixed incomes without medical insurance face serious quality of life issues

daily when they do not have the benefits of Medicare which they worked for.''

Madam Speaker, I rise this afternoon to celebrate the 48th anniversary of Medicare and Medicaid and the security they provide for seniors and persons with disabilities, half of whom live on less than $22,000, total, a year. Half of all seniors before Medicare had no insurance at all.

Listen to my constituent, Nan Anderson from Evanston:

It was a tremendous relief to become eligible for Medicare.

Basically, I am a well person but have had some costly

procedures, all of which have been covered. Currently, I am

recovering from a spinal fusion. If it weren't for Medicare,

I would never have reached this point. Without the surgery, I

would likely have been reduced to a dependent person. Now I

know that I will be able to walk normally and unaided for

several years.

We made improvements in Medicare in ObamaCare--lower drug costs, free preventive services, fraud-cutting, and improved quality. Medicaid pays for 40 percent of all long-term care costs.

Today, I voice my support for Medicare and Medicaid and my vigorous opposition to benefit cuts that will harm those who depend on them.

Mr. Speaker, I ask unanimous consent that my name be removed as a cosponsor of H.R. 1213.

Mr. Speaker, there's a word in Yiddish, ``chutzpah,'' that generally translates to ``nerve.'' It has been described as that quality enshrined in a man who, having killed his mother and father, throws himself on the mercy of the court because he's an orphan.

But ``chutzpah'' is also a pretty accurate description of the antics of the Republican Party today that--after throwing up roadblock after roadblock, obstruction after obstruction to ObamaCare, is now trying to delay access to care for millions of Americans on the grounds that we're not ready.

Despite Republican obstructionism we are going to be ready, we are ready--and not a day too soon--for those who have been locked out of coverage, hit by annual benefit limits, or faced preexisting condition exclusions. Imagine the worry that is lifted off of the shoulders of Americans that have preexisting conditions that won't exist once we pass this.

This is just another Republican attempted roadblock to progress, another obstructionism. It is ``chutzpah.''

Mr. Speaker, it is time for the Republicans to stop efforts that will prevent Americans from getting the health care they need.

Mr. Chairman, I move to strike the last word.

First, I want to express my thanks to the chairman for saying that he would accept this bipartisan amendment, and to my colleagues who have spoken about it.

The decision to eliminate many of the functions from the Chicago and the Buffalo offices were done without consultation with the local communities and without seeking the approval of the Congress, which is what they are supposed to do.

The downsizing just in Chicago could cause as many as 200 jobs lost in our area, and it certainly could affect the health and safety of our waterways. Chicago is the point of entry from the Mississippi River to the Great Lakes, and its harbors are of major economic importance not just to Chicago, but to the entire Great Lakes region. As my colleague pointed out, it's a shoreline greater than either the Pacific or the Atlantic Coast. Actually, I just learned that from you today. Thank you for that important information.

Its harbors are of major economic importance to all of us, and it assists in the rehabilitation of the Chicago shoreline. It also, from the Chicago district office, leads the fight against the spread of the Asian carp into Lake Michigan.

I have very serious concern about the downsizing of the Chicago district and the impacts it would have on those efforts. Like the chairman, I understand the Corps' efforts to reduce costs and our interest in doing that; but the minimization of the Chicago and Buffalo areas would trade short-term savings with much more significant and lasting long-term costs.

As my colleague pointed out, Senator Kirk and Senator Durbin passed a similar amendment in the Senate. I urge all of my colleagues to join in supporting us in this important bipartisan amendment to prevent the Army Corps from reducing its Chicago and Buffalo offices.

I yield back the balance of my time.

Mr. Speaker, like many of my colleagues, I am hearing from constituents who are looking but unable to find jobs, and who are now faced with cuts to their Federal unemployment insurance (UI) benefits because of the sequester.

These are people like Janice in Chicago, who last month wrote me, ``Yesterday, I received an email from the Illinois Department of Employment Security stating that starting in June and through the month of September, my unemployment benefits will be reduced by 16.8%'' because of the budget sequester.

Or Mary in Arlington Heights, who emailed me, ``I am currently unemployed. These cuts will cost me $200 a month. This is a lot of money for a single woman living on her own. These effects are real. They're more than just numbers on a piece of paper.''

Mary is right--the effects of the sequester are happening to real people--people like her and Janice and their families. The Department of Labor estimates that by October 1, as many as 3.8 million unemployed workers could see reductions in their federal Emergency Unemployment Compensation benefits as a result of the sequester.

For these families, the sequester means that they will have less money available to pay their mortgage or rent, doctor's and grocery bills. UI cuts ripple out into local communities, since unemployed workers will spend less on goods and services. Experts tell us that a $1 spent on UI benefits results in higher consumer spending and increased economic activity of between $1.50 and $2.00--so a $1 cut from UI benefits means an even greater loss in the effort to strengthen local economies. As Mark Zandi, chief economist at Moody's Analytics says, ``if you cut unemployment insurance, then the economic impact is outsized.'' (``Unemployment Benefit Cut Adds to Drag on U.S. Spending: Economy,'' Bloomberg News, May 6, 2013.)

The National Employment Law Project has released an excellent analysis, ``The Sequester's Devastating Impact on Families of Unemployed Workers and the Struggling Unemployment Insurance System.'' It estimates that, if the sequester continues for the rest of FY2013, federal EUC benefits could be cut by more than $2.3 billion--an average of more than $400 per family.

The NELP analysis also points out that the sequester's impacts do not stop at federal UI cuts--they also mean cuts to the training, job matching and reemployment initiatives designed to help unemployed workers get back to work. Those cuts, too, impose real harm on families and our economy by making it harder for unemployed men and women to get back into the workforce.

I am a cosponsor of H.R. 900, the Cancel the Sequester Act, because it will stop these very harmful cuts to Federal UI benefits and job creation efforts. I urge my colleagues to come together now so that we can stop these across-the-board, meat-ax sequester cuts that are so damaging to our constituents.

Mr. Speaker, I rise today to congratulate the Chicago Blackhawks on winning the 2013 Stanley Cup. As the team lifted the historic Stanley Cup in the air, it was as if they were lifting the City of Chicago itself.

From beginning to end, the Blackhawks were the best team in the National Hockey

League. They had the best start in NHL history, setting the record for most consecutive points scored to start a season. Entering the playoffs they were the overall number one seed. The team faced and defeated the Minnesota Wild, Detroit Red Wings, and the Los Angeles Kings to win the Clarence S. Campbell Bowl as Western Conference champions.

Lead by Coach Joel Quenneville, the Blackhawks faced the Boston Bruins in the Stanley Cup Finals. It was truly a team effort to overcome the physicality and aggressiveness of the Bruins. After a hard-fought series, it came down to 2 goals scored in 17 seconds late in the third period, by Bryan Bickell and Dave Bolland, to overcome a one goal deficit to win the Stanley Cup. Patrick Kane became only the 4th American player to win the Conn Smythe Trophy as NHL Playoff MVP.

As a lifelong Chicagoan I take great pride in congratulating the Blackhawks on another thrilling season. I thank them for bringing the Stanley Cup back to the Madhouse on Madison.

Mr. Speaker, I rise to tell my colleagues about the deleterious effect that sequestration is having on biomedical research and our ability to improve the health of people in communities across this country.

This week, Dr. Teresa Woodruff, a reproductive endocrinologist and the Chief of the Division of Fertility Preservation at the Feinberg School of Medicine at Northwestern University, contacted me to explain how the sequester is harming her ability to perform critical research into the effects of toxins on female reproductive health and fertility.

Last year, Dr. Woodruff applied for a grant from the Superfund Research Program, a joint program of the National Institute of Environmental Health Sciences and the National Institutes of Health, to investigate and develop strategies to combat the proliferation of toxins at the DePue, Illinois Superfund site. Her application received a positive score and, after revising her research plan after being told that NIH lacked the resources needed to fully fund the project, she expected to receive funding and begin work this summer.

Unfortunately, Dr. Woodruff's team will be unable to start this critical research. In May, she was told that NIEHS cannot award the Superfund grant because of the sequester--an additional across-the- board cut to an already-modest research budget. The NIEHS administrator responsible for awarding these grants indicated that he had never seen anything like this before in his career--never before was he unable to fund a grant after a positive award decision was made.

Sequestration has pulled the rug out from under our researchers. Instead of working to understand the threats posed by environmental toxins, Dr. Woodruff's team is forced to delay this extremely valuable research. She is not giving up--and she will spend many more hours completing grant applications in hopes that funding will be available in the future. But, in the meantime, research that could result in real improvements for women's health and the environment is being put on hold.

I hope my colleagues will take the time to read a summary of the important research that Dr. Woodruff's team is unable to perform due to the unnecessary and harmful sequester cuts. I urge my colleagues to restore vital research funding by supporting H.R. 900, the Cancel the Sequester Act, so that our researchers can get back to doing their work.

Northwestern University Reproductive Health Hazards Superfund Research

Center

summary

There is limited understanding of the effects of exposure

to metals on human reproductive health. The proposed

Northwestern University Reproductive Health Hazards Superfund

Research Center was designed to investigate the effects of

metal contaminants on reproductive function in DePue,

Illinois and in Northwestern University laboratories.

In the village of DePue, which was designated a Superfund

site in 1999, the Center would investigate the longitudinal

risk of heavy metal contamination on human reproductive

health and track how such contaminants are dispersed through

the food chain and microbial environments. Additionally, the

Center would work with the village of DePue to educate the

local community and translate new knowledge into policy

changes to improve public health.

At Northwestern University laboratories, Center researchers

would also investigate the impact of metals on gamete (egg

and sperm) function and reproductive health. Additionally,

the team would develop new assays to assess the reproductive

health risks of heavy metals and mitigation strategies for

metal removal and environmental remediation. The knowledge

gained by the Center would be applicable to the village of

DePue, Superfund sites, and other contaminated sites across

the United States.

History

Our team initially applied to the Superfund Research

Program, a joint program of the National Institute of

Environmental Health Sciences and the National Institutes of

Health, in the spring of 2012. In the fall of 2012, we were

awarded a positive score with a good chance or receiving

funding in response to our application, and we were asked to

supply a letter of information responding to the limited

criticisms from the peer review.

In March 2013, we were offered an option informally to

receive funding at a reduced amount for a reduced time period

since our application was well reviewed and deemed

meritorious but available funding was limited. We elected to

accept this funding rather than resubmit and provided

approximately 80 pages of revised budgets and supporting

materials toward this option. That material was well-

received, but two weeks prior to the annual resubmission

deadline, it was suggested that we also resubmit our original

application with revisions because the informally offered

funding was in jeopardy due to sequestration and rescission.

Even on this limited time-frame we managed to resubmit our

application. Despite the continued confidence of the NIH

program officers that the reduced grant would be funded as of

July or August, in May we were formally informed that it

would not be. It is important to note that the NIH receives

funding for Superfund Research through the Interior

Appropriations Subcommittee rather than the standard Labor/

HHS/Education Appropriations Subcommittee, which funds the

majority of the NIH budget. We are now awaiting review of the

resubmitted grant proposal in November and hope to obtain

funding in April 2014.

Sequestration, and the unpredictable nature of funding

during this time, has not only delayed the creation of a

critical research program but has consumed hundreds of man

hours for the research team at Northwestern University.

Contact Information

Kate Timmerman, PhD, Program Director, Oncofertility

Consortium, Northwestern University.

Teresa K. Woodruff, PhD, Vice Chair for Research,

Department of Obstetrics and Gynecology; Director,

Oncofertility Consortium, Northwestern University.

Mr. Speaker, I rise today to congratulate Eric Goldberg and Erika Gray for their achievement in being selected for the National Youth Orchestra of the United States of America. The National Youth Orchestra, spearheaded by Carnegie Hall, showcases America's finest young musicians and reinvigorates interest in youth musicianship at home and abroad. This achievement is the culmination of Eric and Erika's hard work, dedication, and training to hone their talent and develop their skills as musicians.

The National Youth Orchestra provides Eric and Erika the opportunity to build upon their experiences in studying music at the Percussion Scholarship Group of the Chicago Symphony Orchestra and New Trier High School, respectively. They will join an elite group of young musicians from across this country on an international tour that highlights the vast musical talent that exists in the United States. Their whirlwind tour will include performances at the Kennedy Center in Washington, DC; Bolshoi Hall of the Moscow Conservatory in Moscow, Russia; the Mariinsky Theatre Concert Hall in St. Petersburg, Russia; and the Royal Albert Hall in London, England.

I am so proud that these talented young people will represent my congressional district, Illinois, and the United States as cultural ambassadors during their time with the National Youth Orchestra. I wish Eric, Erika, and other members of the National Youth Orchestra the best of luck on their tour and in their future musical endeavors.

I thank the gentleman, who has been such a tremendous leader and head of our Hunger Caucus in the House of Representatives.

Hunger in America--think of that. It ought to be a non sequitur. This is the richest country in the world, and yet one out of four of our children in this country is considered food insecure. That means that there are nights in this country when tens of thousands of children go to sleep hungry--American children.

So, despite what the gentleman from Texas may say about the compassion for these children, 2 million people will be cut off of the food stamp program. Not all of them are rapists and murderers--they are children; they are senior citizens; they are people who go to work every day and yet can't afford to eat.

I'm just finishing a week of living on the average food stamp, or SNAP, budget of $31.50 a week, $4.50 a day. You can spend $4.50 a day for one coffee at a Starbucks. It's not easy to live on that. That is the average food stamp benefit. It's just inconceivable to me that anyone has come to Congress with the idea that one would be willing to take food out of the mouths of hungry children--because it's not just the SNAP program. It's also school lunch programs and school breakfast programs, and 200,000 children are going to be cut off of those programs.

Are you kidding me? This is what we're going to do? This is what the majority is going to vote for to do in our country?

These are working people who often have overcome a rough time. I talked to a woman on SNAP who said she saw it as a trampoline. She was able to get over a rough spot in her life for herself and her children through the SNAP program.

Voting for this cut is immoral and wrong. We should be voting against this cut and against the FARRM Bill.

Mr. Speaker, ten years ago Congress, with the leadership of the Bush Administration, enacted the bipartisan President's Emergency Plan for AIDS Relief (PEPFAR), an initiative which the Institute of Medicine in a Congressionally-requested February 2013 report called ``globally transformative.''

In its 10 years, PEPFAR has saved lives, improved health care delivery systems and, as the IOM concluded, provided a ``lifeline'' that restored hope to areas devastated by the epidemic. Over the course of its existence so far, PEPFAR has spent $46 billion to expand access to prevention, treatment and medical services. Through its contributions, new infections in sub-Saharan Africa, one of the hardest-hit areas, have dropped by 25 percent.

PEPFAR is a success story. It is part of the global effort to prevent, treat, and, soon I hope, find a cure so that we can end AIDS. We should celebrate PEPFAR's decade's worth of achievements, while we must also recommit to its goals. For, as the IOM report stated and all of us know, ``substantial unmet needs remain across HIV services'' both here and abroad.

PEPFAR itself is part of an ongoing effort to respond aggressively and effectively to HIV and AIDS. I would like to draw my colleagues' attention to an article by Dr. Allan Brandt from the June 6, 2013 New England Journal of Medicine, outlining the ways that the effort surrounding HIV/AIDS has reshaped our vision of global health--both what is needed and what is achievable.

As we pause today to recognize the 10th anniversary of PEPFAR, it is also important to recognize the enormous work of AIDS activists and providers who have been leading this fight for decades. Their work, as Dr. Brandt's article details, has had consequences that go far beyond combating AIDS--as critical as that is--

to shape the way we think about the right to medical care, health care justice, and our global relationships and responsibilities. It has also focused on the need to make essential medicines available--a matter of much attention in the ongoing Trans-Pacific Partnership trade discussions--and to build robust networks of medical professionals and community health workers.

Today, PEPFAR continues to partner with countries that rely on the United States to show leadership in meeting ongoing needs and challenges. While we can celebrate its successes today, we cannot be complacent. The fight against AIDS is a fight for global health, and it is one that we must continue to support.

[From the New England Journal of Medicine, June 6, 2013]

How AIDS Invented Global Health

(By Allan M. Brandt, Ph.D.)

Over the past half-century, historians have used episodes

of epidemic disease to investigate scientific, social, and

cultural change. Underlying this approach is the recognition

that disease, and especially responses to epidemics, offers

fundamental insights into scientific and medical practices,

as well as social and cultural values. As historian Charles

Rosenberg wrote, ``disease necessarily reflects and lays bare

every aspect of the culture in which it occurs.''

Many historians would consider it premature to write the

history of the HIV epidemic. After all, more than 34 million

people are currently infected with HIV. Even today, with

long-standing public health campaigns and highly active

antiretroviral therapy (HAART), HIV remains a major

contributor to the burden of disease in many countries. As

Piot and Quinn indicate in this issue of the Journal (pages

2210-2218), combating the epidemic remains a test of our

expanding knowledge and vigilance.

Nonetheless, the progress made in addressing this pandemic

and its effects on science, medicine, and public health have

been far-reaching. The changes wrought by HIV have not only

affected the course of the epidemic: they have had powerful

effects on research and science, clinical practices, and

broader policy. AIDS has reshaped conventional wisdoms in

public health, research practice, cultural attitudes, and

social behaviors. Most notably, the AIDS epidemic has

provided the foundation for a revolution that upended

traditional approaches to ``international health,'' replacing

them with innovative global approaches to disease. Indeed,

the HIV epidemic and the responses it generated have been

crucial forces in ``inventing'' the new ``global health.''

This epidemic disrupted the traditional boundaries between

public health and clinical medicine, especially the divide

between disease prevention and treatment. In the 1980s,

before the advent of antiretroviral therapies, public health

officials focused on controlling social and behavioral risk

factors; prevention was seen as the only hope. But new

treatments have eroded this distinction and the historical

divide between public health and clinical care. Clinical

trials have shown that early treatment benefits infected

patients not only by dramatically extending life expectancy,

but by significantly reducing the risk of transmission to

their uninfected sexual partners. Essential medicines benefit

both patients and populations, providing a critical tool for

reducing fundamental health disparities. This insight has

encouraged the integration of approaches to prevention and

treatment, in addition to behavioral change and adherence.

The rapid development of effective antiretroviral

treatments, in turn, could not have occurred without new

forms of disease advocacy and activism. Previous disease

activism, for example, had established important campaigns

supporting tuberculosis control, cancer research, and the

rights of patients with mental illness. But AIDS activists

explicitly crossed a vast chasm of expertise. They went to

Food and Drug Administration meetings and events steeped in

the often-arcane science of HIV, prepared to offer concrete

proposals to speed research, reformulate trials, and

accelerate regulatory processes. This approach went well

beyond the traditional bioethical formulations of autonomy

and consent, As many clinicians and scientists acknowledged,

AIDS activists, including many people with AIDS, served as

collaborators and colleagues rather than constituents and

subjects, changing the trajectory of research and treatment.

These new models of disease activism, enshrined in the Denver

Principles (1983), which demanded involvement ``at every

level of decision-making,'' have spurred new strategies among

many activists focused on other diseases. By the early 2000s,

AIDS activists had forged important transnational alliances

and activities, establishing a critical aspect of the ``new''

global health.

Furthermore, HIV triggered important new commitments in the

funding of health care, particularly in developing countries.

With the advent of HAART and widening recognition of HIV's

potential effect on the fragile progress of development in

resource-poor settings, HIV spurred substantial increases in

funding from sources such as the World Bank. The growing

concern in the United Nations and elsewhere that the epidemic

posed an important risk to global ``security'' elicited new

funding from donor countries, ultimately resulting in the

establishment of the Global Fund to Fight AIDS, Tuberculosis,

and Malaria. In 2003, it was joined by the U.S. President's

Emergency Plan for AIDS Relief (PEPFAR), which, with

bipartisan support, initially pledged $15 billion over 5

years. Since PEPFAR's inception, Congress has allocated more

than $46 billion for treatment, infrastructure, and

partnerships that have contributed to a 25% reduction in new

infections in sub-Saharan Africa.

HIV has also attracted remarkable levels of private

philanthropy, most notably from the Bill and Melinda Gates

Foundation. HIV funding led to new public private

partnerships that have become a model for funding of

scientific investigation, global health initiatives, and

building of crucial health care delivery infrastructure in

developing countries. These funding programs have fomented

contentious debates about priorities, efficiency, allocation

processes, and broader strategies for preventing and treating

many diseases, especially in poorer countries. Nonetheless,

they offered new approaches to identifying critical resources

and evaluating their effect on the burden of disease. The

success of future efforts will depend on maintaining and

expanding essential funding during a period of global

economic recession, as well as new strategies for evaluating

the efficacy of varied interventions.

AIDS also spurred another related debate that continues to

roil global health about the cost of essential medicines.

Accessibility of effective and preventive treatments has

relied on the availability of reduced-cost drugs and their

generic equivalents. A recent decision by the Indian Supreme

Court upheld India's right to produce inexpensive generics,

despite the multinational pharmaceutical industry's claims

for stronger recognition of patents.

Another central aspect of the new activism was an

insistence that the AIDS epidemic demanded the recognition of

basic human rights. Early on, lawyers, bioethicists, and

policymakers debated the conditions under which traditional

civil liberties could be abrogated to protect the public from

the threat of infection. Such formulations reflected

traditional approaches to public health and the ``police

powers'' of the state, including mandatory testing,

isolation, detention, and quarantine. Given the stigma

attached to HIV infection at the time, as well as ungrounded

fears of casual transmission, affected people often suffered

the double jeopardy of disease and discrimination. As a

result, Jonathan Mann, the first director of the World Health

Organization's Global Program on AIDS, explained, ``To the

extent that we exclude AIDS infected persons from society, we

endanger society, while to the extent that we maintain AIDS

infected persons within society, we protect society. This is

the message of realism and of tolerance.'' Mann argued that

HIV could never be successfully addressed if impositions on

human rights led people to hide their infections rather than

seek testing and treatment. Only policy approaches that

recognized and protected human rights (including the rights

to treatment and care, gender equality, and education) would

permit successful clinical and population-based

interventions.

These complementary innovations are at the core of what we

now call ``global health'' which has demonstrated its

capacity to be far more integrative than traditional notions

of international health. It draws together scientists,

clinicians, public health officials, researchers, and

patients, while relying on new sources of funding, expertise,

and advocacy. This new formulation is distinct, first of all,

in that it recognizes the essential supranational character

of problems of disease and their amelioration and the fact

that no individual country can adequately address diseases in

the face of the movement of people, trade, microbes, and

risks. Second, it focuses on deeper knowledge of the burden

of disease to identify key health disparities and develop

strategies for their reduction. Third, it recognizes that

people affected by disease have a crucial role in the

discovery and advocacy of new modes of treatment and

prevention and their equitable access. Finally, it is based

on ethical and moral values that recognize that equity and

rights are central to the larger goals of preventing and

treating diseases worldwide.

For more than the past decade, major academic medical

centers, schools of public health, and universities have

created global health programs and related institutes for

multidisciplinary research and education. Thus, the

institutionalization of this formulation is not only

affecting services worldwide, but also changing the training

of physicians, other health professionals, and students of

public health. When the history of the HIV epidemic is

eventually written, it will be important to recognize that

without this epidemic there would be no global health

movement as we know it today.