Floor Statements

Mr. Speaker, I rise today to re-introduce legislation to establish a carbon tax on fossil fuels. Earlier this month, the Third U.S. National Climate Assessment, the most comprehensive and authoritative scientific report ever generated about climate change in the United States, was released, offering just the latest in dire warnings of the impact climate change is already inflicting on our planet. This is not an abstract notion for future generations to cope with and address; it is happening now and will only get worse with inaction.

I am re-introducing this legislation to continue the serious discussion on climate change that has long been overdue. With extreme weather events becoming more common, every corner of the United States is already grappling with the effects of climate change. As the problem grows more urgent, businesses and even the U.S. military are recognizing the very real costs associated with doing nothing. President Obama's Climate Action Plan underscores the need to address this issue, and with the U.S. Environmental Protection Agency releasing its climate rule for existing power plants next week, I am pleased to see the discussion turning into action.

My legislation, the Managed Carbon Price Act of 2014, places a price on carbon emissions that would increase over time, which would in turn create a market incentive to reduce emissions. The proceeds from this legislation go into a newly-created Energy and Economic Security Trust Fund where 100 percent of the revenue goes back to the public to offset any price increases. This bill is good for the environment and good for business. The legislation recognizes and incentivizes the market for green technologies and innovation and levels the playing field for companies already investing in sustainable business practices. By putting a price on carbon we are setting the stage to export these technologies worldwide.

We owe it to ourselves and to our children to do more than just watch idly as droughts, floods, sea ice melt, ocean acidification, rising sea levels and other effects of climate change continue to take their toll. This legislation is a small step toward meeting this commitment. I urge my colleagues to support this legislation.

Mr. Speaker, I rise today to introduce the Investing to Modernize the Production of American Clean Energy and Technology Act of 2014, a bill that will continue this Nation's march towards sustainable power solutions.

This bill will continue a number of valuable tax provisions used by clean energy companies to level the playing field so that clean energy can compete with its more established traditional-energy counterparts. This is done by extending tax provisions for onshore and offshore wind and other renewable energy production.

The bill also provides incentives for clean energy manufacturing, energy efficient appliances and homes, electric vehicles, and a new era of natural gas-powered vehicles.

At the same time, this bill prevents major oil companies from continuing to benefit from corporate giveaways tucked into the tax code at a time when their industry is making record profits.

This bill is a statement of principles and vision as much as it is about tax policy. America

needs clean renewable energy sources in the coming decades, resources that cannot be developed overnight. This bill will ensure America remains a strong and prosperous Nation while laying the groundwork for an economy built on clean energy.

Madam Chairman, I have an amendment at the desk.

Madam Chairman, fisheries management is something that has had a long history on the Pacific coast. As we built the dams on the Columbia River back in the 1930s, we made treaties with the Canadians. The Mitchell Act was passed, and we have been subsidizing the propagation of fish since that period.

We also have Canadian and United States treaties for the fish caught in the rivers along our borders. The fish don't know where they came from. They don't know whose fish they are, and the human beings have got to sort it out.

We have had these treaties in place, but we have been gradually reducing the amount of money we spent in this enforcement and propagation of fish.

Now, this $3 million seems like a very small amount, but what it is really all about is it means a hatchery closure, which will reduce, by 3 million, the Chinook that are released next year, along with another 500-some odd thousand other kinds of salmon.

You can't do this fisheries management by turning on the switch and turning off the switch. The fish go out for 3 years, they come back, and it is a longstanding process, and we are gradually whittling down what we are doing to one of the major sources of protein for this country.

It is a huge economic effect on Alaska, Washington, Idaho, and northern California, and it is money well-spent.

If you don't understand fish and you don't live in a community, as I do, where the entire Alaska fishing fleet is right now getting ready to go up and catch the salmon that you are used to eating in this country, you don't understand what it means when you don't have hatcheries producing salmon.

The enforcement issue is really a matter of getting people to count and make sure that we get what is ours and also make sure that the fish are counted, so we know about the sustainability.

One of the issues that is going on in the world today that people are not paying attention to is the acidification of the ocean. Acidification of the ocean means that salmon eggs are not as fertile as they were before, and you are coming to a time when we are going to have serious problems with our fisheries all along the northwest coast of the United States.

So this $3 million, although it seems like a very minimal amount, is necessary to continue the treaties with the Canadians and to continue the propagation.

Madam Chair, I yield back the balance of my time.

Mr. Speaker, I rise today in support of the Medicaid Physician Self-Referral Act of 2014. This important legislation provides a necessary clarification to Section 1902 of the Social Security Act. The legislation provides that Medicaid designated health services claims are subject to the same requirements as Medicare designated health services claims are under the Physician Self-Referral Law. Health care providers subject to the Physician Self-Referral Law should not be able to avoid penalties under the law simply because a claim is a Medicaid claim rather than a Medicare claim. Both programs involve taxpayer money and we need to ensure the long-term solvency of the Medicaid program, just as we do with the Medicare program.

The Department of Justice, mindful of this, has worked to bring causes of action against providers under the False Claims Act involving violations of the Physician Self-Referral law--even in the Medicaid context. In one recent case, the Department of Justice relied on 42 U.S.C. Sec. 1396b(s), which provides that a state shall not receive federal reimbursement for a claim submitted through the Medicaid program if the same claim would be rejected under the terms of the Medicare program, had the service been covered by Medicare instead of Medicaid.

It is important to align Title XIX with other provisions involving the Physician Self-Referral Law and the Medicaid program. Thus, while the law has always provided that the Medicaid and Medicare programs were on equal footing vis-a-vis the Physician Self-Referral Law, this clarification makes this clear and leaves no doubt that Congress intends this to be the case.

Mr. Speaker, I rise today to introduce legislation that would make a simple modification to the Civil Monetary Penalty Law. The modification will ensure that physicians and hospitals can align incentives, which is especially important since they are being called upon to do this more often in the pursuit of providing improved care at a lower cost. In the movement to replace fee for service medicine with a model that emphasizes quality, this legislation will facilitate relationships that will allow movement in this direction. The modification will ensure that the penalties for the Civil Monetary Penalty Law are fully retained; the modification makes no change to the penalties prescribed under the law. However, the modification will allow hospitals and physicians to enter into relationships designed to decrease the provision of medically unnecessary services. This legislation recognizes that in the new delivery system models, the emphasis should be on reducing the provision of medically unnecessary services for patients. After all, such services do not serve the patient--who may suffer from hospital acquired infections, if kept in the hospital longer than necessary, for example. Such services also are not in furtherance of the goal of operating a more efficient, higher quality health care system. I urge my colleagues to support this important legislation.

Mr. Speaker, I rise today to honor the 100th anniversary of the Women's University Club in Seattle. For a century this commendable organization has been a steadfast leader within the women's movement and a critical source of education and empowerment for women throughout Seattle and the United States.

Since its founding in 1914, WUC has continuously broadened its reach throughout the community to meet increasing demand for social and educational fulfillment. What started as a small, local establishment to network and learn grew into a treasured institution with 900 current members representing over 400 different colleges and universities. The home of WUC, which was built in 1922, proudly stands today as a local and national historical landmark.

I applaud WUC for generously committing its resources to scholarships and community service. Since 2003, 31 scholarships have been awarded to deserving young women seeking to pursue higher education. WUC helps keep the American Dream alive by providing hard- working individuals with the networking and educational opportunities to permanently improve their lives. With the publication of a commemorative book, The First 100 Years: Women's University Club of Seattle, 1914-2014, WUC shares the rich tapestry of its first century and reaffirms its commitment to remain a stalwart presence in the community for the future.

I would like to convey my sincere congratulations to WUC on its proud centennial and express my heartfelt gratitude for all the WUC has done over this last century.

Madam Chairman, I was one of the 16 people who was on that committee. It used to be a committee with four Republicans from the Senate and four Republicans from the House, four Democrats from the Senate and four Democrats from the House. It was a balanced committee. It looked at the technological questions of what we are spending billions of dollars on.

Now we have a choice of where we get our information. The GAO looks backward. All of the government organizations look backward. They don't look forward. That is not their role to imagine what will happen out there. What we need is an organization that can look forward as we proceed to spend billions of dollars in technology. We can either get the information from a nonpartisan organization that is controlled evenly by both sides of the House and the other body, or we could go to industry. They will come in here, and they will give us all of the information of their having the best thing since sliced bread.

I think we need the OTA, and I urge you to adopt the amendment.

Mr. Speaker, I rise today to introduce the Fair Playing Field Act of 2014. In 1978, Congress was concerned that lack of clarity as to the proper classification of some workers, increased IRS enforcement activity, and retroactive application by IRS of interpretations that were arguably new had caused hardships for some small businesses and other taxpayers and confusion as to the applicable rules.

To allow time to develop a comprehensive approach to the problem, Congress enacted section 530 of the Revenue Act of 1978 as an interim measure protecting taxpayers from liability for misclassification if the taxpayer has a reasonable basis for classifying a worker as an independent contractor and meets certain other conditions. In addition, the Act prohibited the Secretary of the Treasury from publishing regulations or revenue rulings on workers' employment tax status pending the expected near-term enactment of clarifying legislation.

During the ensuing 33 years, Congress made section 530 of the Revenue Act of 1978 permanent, however, changes in working relationships and the continued prohibition on new guidance have increased the uncertainty as to the proper classification of workers.

Many workers are properly classified as independent contractors. In other instances, workers who are employees are being treated as independent contractors. Such misclassification for tax purposes contributes to inequities in the competitive positions of businesses and to the Federal and State tax gap, and may also result in misclassification for other purposes, such as denial of unemployment benefits, workplace health and safety protections, and retirement or other benefits or protections available to employees.

Workers, businesses, and other taxpayers will benefit from clear guidance regarding employment tax status. In the interest of fairness and in view of many service recipients' reliance on current section 530, such guidance should apply only prospectively.

Mr. Chairman, a budget is a statement of a society's moral principles. The Democratic budget is an investment plan that creates a job for a marine who comes back from Afghanistan. It guarantees health security for a single mom and her asthmatic daughter. It expands the opportunity for a bright-eyed son of immigrant parents to go to college.

On the other hand, the Ryan manifesto doesn't create a job for that marine. The Ryan budget fires 3 million Americans over the next 2 years, and it protects tax breaks for companies shipping those jobs overseas. The Ryan budget repeals the Affordable Care Act, forcing that single mother and baby daughter back into the intolerable days when families could not afford health care.

In summary, the Republican budget asks not what you can do for your country, but proclaims your country refuses to do a thing for you.

The Democratic budget invests in our greatest resource, the American people, the key to our Nation's continued greatness in the years to come. Vote ``yes'' on the Democratic alternative.

Madam Speaker, I yield myself such time as I may consume.

The Republicans have branded this bill as clarification. But what demands clarification is the cold, hard fact that this legislation is a bailout for insurance companies.

This has never had a hearing in the House. It has never been discussed. We have never had witnesses. No regular order whatsoever. This appeared out of nowhere.

This bill, pure and simple, is a case of Republicans seeking special treatment for certain insurance companies who would like nothing more than to avoid the responsibilities under the law and sell inferior insurance policies to Americans and foreign workers and their families in the United States, which is exactly why the American people are fortunate to have the ACA as the law of the land.

It is currently protecting them from these kinds of intolerable insurance company practices.

Republicans have focused on coming out against bailouts for insurance companies in several other ACA contexts, but it is all sound and fury because it means nothing.

With this legislation, however, Republicans want a bailout for a few insurance companies that sell so-called expatriate coverage. But why should this situation be any different?

Why do the Republicans get to pick and choose?

As the Republicans are now in the business of picking and choosing winners in this case, the losers are going to be the patients.

Republicans claim this bill is a simple fix intended to clarify the ACA when it comes to expatriate coverage, and perhaps there is a need for that. Perhaps there is a need. We might have found it out if we had had one hearing.

The current guidance defines individuals under expat plans as those who are out of the country for at least 6 months during the year. The theory is that the people are gone more than they are here.

But this bill overrides current regulations and ignores the comments given by the administration to define a covered individual, and it does it and says, you are an expat if you are out of the country for as few as 90 days, or 15 trips.

Now, I don't know how many people in Seattle make 15 trips out of the country in a year when they are working for Boeing or working for Microsoft or all the international companies. I have got those people in my district.

This means that to serve people who move across the border daily, or frequent fliers for work, they would be exempt from the enrollees who are gone for only a few weeks.

In addition, the legislation says that all foreigners who are living and working in the United States but are outside their own country for 90 days or 15 trips can also be covered by these plans.

As a result, the provisions of this bill would severely undermine current H1B visa requirements that level the playing field with American workers. If you are bringing people in from the outside and they go home, or they are gone for only 90 days, well, you can somehow pay them less.

This legislation will open the door for U.S. employers who wish to avoid the ACA to hire foreign workers rather than American citizens. That is why the United Farm Workers are against this bill.

The United Farm Workers do a pretty good job of clarifying this bill when they say ``Congress should not pass laws that create an economic incentive to hire guest workers over professional U.S. agricultural workers.''

The AFL-CIO is against this bill because it would undermine the health security of 13 million green card holders, people with work visas, and individuals who are granted visas for humanitarian reasons.

The National Immigration Law Center is against this bill because it eliminates minimum essential standards for ``expatriate health insurance plans provided to individuals who travel abroad.'' As a result, this bill would deny health coverage security for low-wage immigrant workers, including farm workers and caregivers.

This bill contains too many loopholes that amount to an extraordinary bailout for insurance companies. This bill also establishes a precedent for employers to hire guest workers. It is being brought here as a suspension bill with no opportunity to amend it. It might be that we could make it a better bill if it had been through the process, but it is being rammed through here by insurance companies who want to get a benefit.

This bill is yet another attempt on the part of the Republicans to repeal the Affordable Care Act. They want to drill another hole in the bottom of the bill. They are going to keep drilling holes--trying--this is number 53.

I reserve the balance of my time.

Madam Speaker, I yield 4 minutes to the gentleman from California (Mr. Waxman).

Madam Speaker, I yield 4 minutes to the gentleman from California (Mr. Becerra).

Madam Speaker, I will yield myself the balance of my time to close, having no further requests for time.

I have been an expat. I was in the State Department. The State Department sent me overseas. I lived over there. I came home 1 month a year. I would leave. The rest of the time, I was an expat. That is pretty clearly an expat.

My daughter teaches at the King's Academy in Amman, Jordan. She is an expat. She lives over there. She comes home in the summertime for a month or so. She is an expat. Everybody understands that.

What this bill says is, if you live in Seattle and you make 15 trips a year out of the country, then you are an expat, or you could be considered an expat. Now, that is not exactly what I think most people think of when they think of an expat--or somebody who works as a contractor.

Suppose you work for the Federal Government for 3 months overseas. Are you an expat? According to this, you are. You can easily be put in that category and not be offered the protections. That means you don't have any protections around the issues of preexisting conditions. You can't necessarily put your kids on your insurance up until age 26.

Your lifetime limits, all of the things that are built into the Affordable Care Act, the insurance companies now can say: we don't have to offer that to you because you are out of the country 15 times a year, or you have worked overseas for 90 days.

As Mr. Waxman said, you are creating a second class of citizen in this country, and Mr. Becerra raised the issue on the reverse side. People who come from other countries are expats, right, because they came from somewhere else, so they can be put into a plan that does not give them the protections of the ACA.

That is not what I think my friend from Delaware or my friend from California really wanted to do. What is missing here is that we did a backroom deal. We had Members of Congress sit in a back room somewhere with somebody from the White House, talk about something and decide something, and here it is, fait accompli, no chance to change it, no chance to make it better or make it closer to what people really thought.

And most interestingly for Republicans is you are sending a bill to the House and expecting that the Senate is going to fix it. Now, our experience here on the floor and in the Congress the last few months, expecting the Senate to do something is, well, it is probably--it is not like wishing for the tooth fairy, but it is certainly putting your trust in a rather weak situation. The House sent over--what?--500 bills in the last session and got 12 or 15 back? And you are saying that this one is going to be fixed? I doubt it.

I yield back the balance of my time.

American Federation of State,

County and Municipal Employees,

Washington, DC, April 8, 2014.

Dear Representative: On behalf of the 1.6 million members

of the American Federation of State, County and Municipal

Employees (AFSCME), I urge you to oppose the Expatriate

Health Coverage Clarification Act which is scheduled for a

vote tomorrow. While the bill may be intended to address

concerns of health plans covering those who work part of the

year outside the United States, the reach of the bill is much

greater.

The bill's definition of expatriate workers include 13

million individuals who are lawful permanent residents,

people with work visas and individuals who were granted visas

for humanitarian reasons. The bill exempts employers and

insurance plans from meeting Affordable Care Act (ACA)

coverage standards for these millions of people living and

working in the United States. Instead, the bill would allow

these employers to use their own judgment in determining

whether coverage is adequate.

This bill does much more than simply clarify a technical

matter of the ACA. It defines a large group of people who

will be treated

differently by the ACA and afforded weaker protections than

others. The bill undermines the premise that all families are

entitled to a minimum standard of coverage and could lead to

erosion in standards for other groups and eventually all

families.

We urge you to oppose the Expatriate Health Coverage

Clarification Act.

Sincerely,

Charles M. Loveless,

Director, Federal Government Affairs.

Mr. Speaker, on that I demand the yeas and nays.

Mr. Chairman, this budget is not a real plan to address the urgent needs of the American people. This budget is an announcement of a campaign for the Presidency of the United States. This bill is intended not to stir great debate in Congress that ultimately delivers fiercely needed solutions for Americans; instead, this bill is written for the 2016 Republican National Convention.

When you listen to the chairman talk about this budget, what you are really hearing is the inaugural address of the 45th President of the United States, a rousing address that asks not what you can do for your country, but proudly proclaims your country refuses to do a thing for you: millions of seniors will be tossed off Medicare; the social safety net will be gutted to pay for millionaire tax cuts; infrastructure projects left to rot; denying millions of Americans health security; and Medicaid slashed to the bone. And that is just going to be the first 100 days.

Remember as you vote: a budget is a statement of your moral principles of what you think ought to go on in a society. Today's vote is the first vote. If that kind of people get elected either in the Senate or in the Presidency in 2016, this is what you are going to see. They are putting it right out there for everybody in America to see. And that is why you must vote ``no.''

Madam Speaker, I yield myself such time as I may consume.

Madam Speaker, on a rainy September day in 2008, a constituent of mine named Ingrid was badly injured after a terrible fall in her home. She was rushed to the emergency room, where she was cared for and her life was spared, yet Ingrid came out of that experience stuck with a $23,000 hospital bill because she couldn't afford to have health insurance. A few months later, Ingrid was forced to sell her home to pay off that enormous hospital bill.

Today, on a rainy day in April of 2014, there is a different story to tell. It is a rainy day in Seattle, not here. It is the story of the Affordable Care Act, the story of 7.1 million mothers and sons, fathers and daughters, who have a newfound sense of health security and peace of mind.

That is 7.1 million honest, hardworking Americans, in addition to the 2 million young adults who are protected by staying on their parents' plan, in addition to the millions more who are now covered through the Children's Health Insurance Program and Medicaid expansion. One of them is Ingrid.

Ingrid's life is vastly different now from what it was in 2008. She still is one of the hardest working people her friends and neighbors have ever met. She still loves the outdoors and drives a pickup truck, but today, she is happy, healthy, and covered because of the ACA.

So as this Chamber, for the 52nd time, considers a radical and extremist Republican bill to kill the Affordable Care Act, I stand with millions of people who have been covered because of the ACA and the millions who still need health security. I stand in opposition to the idea that this Nation is incapable of guaranteeing health security for all its citizens.

Republicans have no plan to cover the American people. Speaker Boehner earlier this week would not commit to releasing a Republican plan until after the election. How transparent can you be? Proof that this is political.

So the introduction of this bill is simply surrender in the face of the health care crisis in America. How else can you explain the Republicans' introduction of a bill that cancels the health insurance policies of 1 million Americans? That sounds like surrender to me.

How else can you explain a bill that raises the deficit by $75 billion? More surrender.

How else can you explain a bill that puts five times the number of American workers at risk of losing hours at work? How else do you explain a bill that does anything but dare employers to slash work hours for workers in order to avoid the responsibility to offer health insurance coverage?

How can they say this bill solves a problem of employers cutting hours and refusing benefits when it really only makes it worse?

It is unconditional surrender by the Republicans, pure and simple, to force yet another vote on a bill that has no chance of becoming law. There isn't one chance in a million.

One thing I learned in medicine was you never say never, but this is one time I can say it. It will never, ever pass the Congress. It is a bill crafted purely to appeal to the Koch brothers and the producers of FOX News, rather than forged to protect honest Americans like Ingrid.

The latest Republican bill also denies a confirmed truth; the ACA is succeeding in its primary mission to expand access to quality health care for each and every American.

So make no mistake. I have got news for you. The ACA is not going away. It is not going away. It is here to stay.

The mission before the Congress now should be--in fact, must be--to move forward to further implement the ACA and to improve the law, where needed.

I talked to Bill Frist about a year ago, former Republican leader of the Senate. He said: Don't repeal; fix.

That is what we ought to be about doing--but we are not doing that-- in order to guarantee not just access for each and every American, but to lower health care costs across the board; yet this rather perverse bill raises health care costs for everyone by increasing the number of uninsured. That is surrender, pure and simple surrender.

It is surrendering to an idea that our Nation is no longer capable of accomplishing great things and surrendering to the idea that America, the richest and the most advanced country on the Earth, can't guarantee that its citizens won't lose their homes when they get sick. That is what you are admitting by this bill.

You are saying they have to choose between food on the breakfast table instead of medicine on their bedside table. That, in my view, is a situation that has no explanation, other than the fact that you have surrendered. You have given up the idea that America can take care of its own people.

It was a choice that Ingrid once had to make, but she will never have to make again. That is what is true about the ACA. She has health care coverage. That is what is right about the ACA, and this bill under consideration, H.R. 2575, has nothing to do with what is either true or right.

I urge my colleagues to vote ``no,'' and I reserve the balance of my time.

Madam Speaker, I yield 4 minutes to the gentleman from Maryland (Mr. Van Hollen).

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I yield myself such time as I may consume.

A little history might be helpful here. There was a time in this country where people worked 60 hours a week, 7 days a week, 6 days a week. The only reason we have a 40-hour week at all were labor unions who went out and struck and forced the process to get a 40-hour workweek.

They also were the ones who created the health care system in this country after the Second World War. People didn't have health insurance prior to that. When the President said, we can't have an increase in wages, that we can't have an increase in benefits, that prices can't go up, the labor unions said, well, let's have something called a benefits package.

The benefits package that was created in the middle forties included health care and pensions. It came from the union movement. They are the ones that stood in the rain and the sleet and the snow on the picket lines to get these changes.

Now, we have a law that comes in and says, let's deal with everybody in this country, and the judgment of this Congress was that an employer had the responsibility to provide health insurance for his or her employees if they worked 30 hours a week. That was considered full time.

It doesn't change the other laws, the labor laws or any of the other things. It is for the purpose of this act that employers must consider their people full time if they work 30 hours.

Now, if employers don't care, if they say, well, let me figure out how I can cheat my people out of any benefits, I am going to drop them down to 29 hours--well, you know, there are people like that. But the law says, if do you that, then you have to pay a penalty for everybody you didn't cover.

So we tried in every way possible to make it possible to give people flexibility. But this law will not work, according to the American Enterprise Institute, without a mandate that everybody be covered.

We are not changing the labor law. We are not changing overtime rules. We are not changing any of that stuff. We are saying, for the purpose of this law, an employer must cover anybody who works 30 hours. And if they don't care about their employees, if they run a restaurant, and they don't want their employees to be healthy, knock them all down to 29 hours, and let them come in sick. Then you have got a restaurant where you are going to eat lunch, and the employees haven't been able to see a doctor. That is what you are asking for.

We are saying everybody in this country ought to have health insurance, and they ought to have the access to go to a doctor when they need it. So this business about we are somehow destroying the work ethic in this country and all that kind of nonsense is simply nonsense. That is not what this is about. This is about another way to destroy the act. And you know it. We know it. And the world should understand that this is the 52nd attempt to repeal the law, to undermine it so it will not work. I urge people to vote ``no.''

I reserve the balance of my time.

I reserve the balance of my time.

I reserve the balance of my time.

Madam Speaker, I yield 4 minutes to the gentleman from Oregon (Mr. Blumenauer).

I yield an additional 1 minute to the gentleman from Oregon.

Madam Speaker, I yield 4 minutes to the gentleman from California (Mr. Becerra).

I yield the gentleman an additional 30 seconds.

Madam Speaker, I yield 5 minutes to the gentleman from California (Mr. Miller), my good friend.

Madam Speaker, I reserve the balance of my time; but could you give us an accounting of our time?

Madam Speaker, I yield 3 minutes to the gentleman from New Jersey (Mr. Pallone).

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I yield myself 30 seconds to point out to my colleagues that CBO did not say people would lose their jobs. They said because they have health care, they no longer have to stay in the job that they have, and they will be able to stay home or do something else, and that will reduce the number of hours of work. They did not say the bill cuts them out or knocks them out of work.

Madam Speaker, I yield 2 minutes to the gentleman from Virginia (Mr. Connolly).

Madam Speaker, I yield 2 minutes to the gentleman from Illinois (Mr. Lipinski).

Mr. Speaker, would you give us an accounting of the time?

I reserve the balance of my time.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I now yield 3 minutes to the gentlewoman from Chicago, Illinois (Ms. Schakowsky).

I yield the gentlelady an additional 1 minute.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield myself such time as I may consume.

My colleagues out here today have really had a good time telling personal stories, so I have got a few of them for them.

Last week, the distinguished Senator from Texas, Senator Cruz, put a poll up on his Facebook, asking if people are better off under the law. The responses were not what he expected. The overwhelming number of responses--he got nearly 56,000 responses--were in support of the ACA. If you look at it online, of the most recent 100 comments, there are just two that appear more negative than positive, so that is 2 percent that are against it.

One of them said:

Not only am I better off now, but I have friends who are

better off, too.

The second one said:

Yes. I have MS, and I lost my job, and I wasn't able to get

any other insurance because of my preexisting condition.

Thank you, President Obama.

Another one said:

This Nation is better off for helping people avoid the

devastation that poor health can bring. Thank you, ACA.

I reserve the balance of my time.

Senator Ted Cruz

Quick poll: Obamacare was signed into law four years ago

yesterday. Are you better off now than you were then?

Comment with YES or NO!

Like--Comment--March 24 at 5:45am--

Martha Hall Hansen, Pat White Garcia, Linda Hidy and Top

Comments 10,204 others like this.

5,120 shares

Carol Rietz Gates: Not only am I better off, but I have

friends that are better off. Furthermore, this nation is

better off for helping folks avoid the devastation that poor

health can bring. Thank you, ACA!

1,359--March 25 at 6:46pm

13 Replies--1 hr

Kris Williams: I and a few million other people are a lot

better off. I hope you are enjoying your Cadillac plan given

to you by your wife's employer, Goldman Sachs. Stop trying to

deny the rest of us the peace of mind that quality,

affordable health insurance provides us.

1,342--March 24 at 10:13pm

16 Replies--11 mins

Benjamin Corey Feinblum: Yes. Costs stopped climbing. I'm a

small business guy and I don't have to worry because

insurance companies can't drop us anymore.

2,901--March 24 at 3:14pm

52 Replies--10 mins

Lili Ann Fuller: YES, best law ever! And way overdue! I

spent all my retirement savings on overpriced insurance in

order to save my life when I got cancer in 2005. I had no

income and now have no savings. If it had been in place back

then, I wouldn't be looking at a poor retirement, but at

least I am not worried about having care anymore.

2,300--March 24 at 2:04pm--Edited

25 Replies--7 hrs

Lashawn Bell: Yes I have MS and I lost my job I wouldn't be

able to get any other insurance because of my pre existing

condition thank you President Obama. If people get sick they

will realize how this is good.

1,288--March 24 at 2:00pm

16 Replies--1 hr

Anne Wittig Pryor: I don't have Obamacare, but someone I

know who had bad mouthed it for the past for years, recently

had to get coverage after her husband recently passed away.

The first words out of her mouth, ``Thank God for

Obamacare.'' She is a staunch Republican and believes

everything she hears on Fox News. And those who are saying

they won't comply are cutting off their noses to spite their

faces. Wake up!

2,798--March 24 at 1:49pm

52 Replies--2 hrs

Paige Brennan: Impeach Ted Cruz! He caused the shutdown

that hurt this country badly!

3,188--March 24 at 1:18pm

73 Replies--1 hr

Joe Caparco: Isn't it funny that the govemment ``makes''

you buy car insurance and home owners insurance and no one

says a word. For those of you who say you can't afford health

insurance what will you do when you need your health

insurance. No need to answer I alre . . . see more

1,984--March 24 at 1:11pm

68 Replies

Larry E White: Absolutely better off, now lets push for

universal healthcare for everyone.

2,705--March 24 at 1:08pm

26 Replies--1 hr

Sherry Scott Stewart: Absolutely Yes! I have pre-existing

condition that I was born with but didn't appear until later

in life and could not get health insurance at all. I finally

have decent affordable insurance.

What a huge relief!

1,134--March 24 at 1:05pm

4 Replies

Dave Ninehouser: Yes, my wife's little niece who is very

sick would have hit her lifetime limit by now if not for the

ACA. The nation is better off.

1,684--March 24 at 11:44am

10 Replies

Kris Williams: What is really sad is how the American

people have been kept in the dark as to what the ACA really

is. The whole purpose and driving force behind the ACA was to

Improve care and lower costs. The majority of the law deals

with Medicare. The medical cost . . . See More

1,047--March 25 at 1:08am--Edited

32 Replies

Robin Conrad: Yes, my son has Healthcare for the first time

and I know many friends it is helping. The ACA is awesome.

1,101--March 24 at 7:16pm

18 Replies

Shelley Laysi Peterson: hummm something tells me this isn't

quite the response Mr Cruz was hoping for ROFLMAO

1,828--March 24 at 5:58pm

36 Replies--4 hrs

Shelley Laysi Peterson: YES, YES & YES!! Hands Off My

Obamacare!!

1,076--March 24 at 5:52pm

16 Replies--14 mins

Felicia Willems: Yes! Everyone in my family has a pre-

existing condition that range from minor to serious. We were

uninsurable on the individual market Now we've got

great coverage through healthcare.gov. We did NOT get a

subsidy but it still fits our budget!

2,711--March 24 at 3:19pm

69 Replies

Meredith Stark: Oh Senator Cruz, four years ago we didn't

have health insurance, and now we do. It's helping my husband

and I.

914--March 24 at 2:26pm

11 Replies--1 hr

Laura Eakes: Only in America would people be cursing other

people for finally being able to get health insurance, and

calling them mooches and socialists. I'd rather be a

socialist than a selfish psychopath like many right wingers

on here

1,081--March 24 at 2:09pm

27 Replies--9 hrs

Jeffrey Albuna: Well Mr. Cruz, firstly I want to say, I

think your actions putting our country hostage for your 21

hour publicity stunt were awful and despicable. You stood up

there for 21 hours railing against Obamacare, to show the Tea

Party you ``care'' about their v . . . See More

1,444--March 24 at 1:53pm

18 Replies

Brenda Myrick Yasulevicz: For those of you who think that

anyone who answered yes ``is a part of the problem'', I have

worked hard my entire life and done fairly well. I always had

jobs with insurance. Then I became self employed and found

out I couldn't get insured because of pre-existing

conditions. (None are serious or life threatening, or even

require much care) I am very grateful for this insurance!

997--March 24 at 1:26pm

16 Replies--2 hrs

David C. Brown: Yes Ted. In spite of your empty pandering

rhetoric I am better off now that I was four years ago. I now

have an insurance plan, purchased from a private company,

that must insure me rather than suck profit from me. Before,

I was dumped from insurance f . . . See More

2,071--March 24 at 11:47am

47 Replies--2 hrs

Art Zimmerman: Damn straight I am . . . we all are after

the Bush/Cheney near destruction of our country and the

bullshit trickle-down Republican garbage!!

576--March 24 at 6:34pm--Edited

Joy Williams: Of course we are better off. We will now have

consistent care without it destroying our finances.

491--March 24 at 4:32pm

2 Replies

Chuck Provonchee: Yes, Cruz, you pitiful waste of space, we

are all much better off under the ACA. The only ones who

would not agree with that are the mindless people who blindly

follow the GOP and vote against their own best interests. You

should enjoy your time as senator because I don't think you

will ever win another election.

548--March 24 at 2:45pm

11 Replies--2 hrs

Russ Campbell: Thank God for Obama Care. I now have health

care and they discovered I have cancer. I'm going to have

surgery in one week and I might live. Without Obamacare I

would just die.

576--March 24 at 1:10pm

34 Replies--2 hrs

Terry Kelley-King: YES . . . I have insurance and am very

happy to have it . . . of course it could be better by making

it single payer . . . but this is a republican health plan so

it can't be perfect

1,699--March 24 at 1:05pm--Edited

47 Replies

Dave Posmontier: Definitely YES!. We now have drug coverage

and do pay a little bit more in co-pays but get this--My wife

and I are saving $550 a month in premiums. Thanks you

President Obama . . .

609--March 24 at 1:04pm

4 Replies

Kevin Lawton: Much better off. We'd be even better off if

people like you weren't in the US Senate.

1,736--March 24 at 12:15pm

32 Replies

Barbara J Cobuzzi: Yes, much better off.

1,042--March 24 at 12:06pm

11 Replies--1 hr

LN Winchester: YES, It's great! Not only for myself and my

kids, but for the other five million people who can now get

the medical care they need! I'm actually paying a bit more,

but I don't mind because so many families are getting the

medical services they need, in some cases desperately. That

makes it all worthwhile.

1,169--March 24 at 11:56am

28 Replies

Amanda Rosales: YES . . . I was denied heath insurance

because of having MS as a pre-existing condition and would

soon be going medically bankrupt or stop getting treatment. I

now have excellent coverage and have a brighter future!

1,205--March 24 at 11:52am

33 Replies--6 hrs

Bruce Lindner: I just left my insurance agent's office. He

walked me through my options with the ACA, and to put it

mildly, I'm one happy customer! As a self-employed cancer

survivor and a heart attack survivor--factoring in the

outrageous prices they've been gougin . . . See More

397--March 28 at 3:56pm

11 Replies

Alisha Clark: Obamacare does not regulate health care, it

regulates health insurance companies. Who in their right mind

wouldn't want health insurance companies to be regulated?

472--March 26 at 12:26pm

15 Replies--1 hr

Alisha Clark: This morning I received a private message

from one of my many fb friends This person would like me to

share her story. I can only imagine what this person is going

through and I want her to know that we are now in this fight

together.

Hi Alisha: I am n . . . See More

434--March 26 at 5:48am

23 Replies--4 hrs

Cathy Paganelli Kaelin: YES! Saving $350 per month,

preventative care plus dental & vision. And now my 2 adult

children have health insurance which they went without for 2

years. Yes, this family is grateful for the ACA. Thank you,

President Obama, for taking this country into the direction

of health care for all!

434--March 25 at 5:17am

13 Replies

Bonnie Flournoy: Yes. Previously, I had your plan whereby

the ER was my primary physician. Having a strategy alone to

seek medical help has lifted a burden. The burden was making

me just as sick as my condition. In fact, I think the stress

caused the illness.

874--March 24 at 2:08pm

15 Replies

Kathe Mendelsohn-White: YES! Without the ACA, my 21 year

old autistic son would not have any insurance. Thank you

President Obama.

1,778--March 24 at 1:12pm

66 Replies

Paulina Trefault: At the same time, costs are coming down.

The Congressional Budget Office found the health care law is

making significant contributions to fiscal responsibility.

The CBO's most recent estimates show that repealing the law

would actually increase deficit . . . See More

435--March 24 at 12:15pm

8 Replies

Tricia Barsamian-Wise: Yes . . . I no longer work 2 jobs

and have the security of not being denied, my insurance going

up or being canceled. I clearly understand Ted Cruz's POV on

this, his financial backers only hired him to do their dirty

work. But what I find so hard to comprehend is average

Americans being so cruel and hateful.

950--March 24 at 11:52am

28 Replies--6 hrs

Vik Verma: Yes

404--March 24 at 11:34am

Charles Reff: Yes, it allowed me to get better insurance

then my job was offering and for less.

1,368--March 24 at 6:38am

28 Replies

Chuck Myers: What I'd REALLY like to know, Senator Cruz, is

are you a big enough man to READ the tens of thousands of

comments below and admit that just MAYBE, you were WRONG!!!!!

If you were truly a representative OF THE PEOPLE you would

instantly see how desperat . . . See More

351--March 29 at 10:51pm

13 Replies--4 hrs

Ilene Leftwing: Yes, but would be even better off if my

Republican Governor, Nathan Deal, saw fit to help the

citizens of Georgia by implementing the medicaid expansion.

Anyone who stands against the ACA does not get MY vote.

316--March 25 at 9:26am

11 Replies--33 miss

Sandie Cohen: Please do not take away our health coverage.

357--March 24 at 3:43pm

11 Replies--32 mins

Scotty-Miguel Sandoe: YES! Access to Obamacare saves me

money, and as former cancer patient, it means I can no longer

be denied health insurance because of a pre-existing

condition. This is the best government program since

Medicare--thank heavens we have a President who cares about

American citizens for a change!

1,404--March 24 at 11:38am

54 Replies

Jeanne Carver: Yes I am. I had a junky plan, which paid

nothing until after 7500 per year. I now have affordable

healthcare, which costs much less.

780--March 24 at 1:12pm

14 Replies

David Davis: No. I couldn't afford healthcare before and I

still can't and now will also have to pay a fine. Wish I

could fine the government for making my life hell everyday.

1,458--March 24 at 5:47am

322 Replies--4 hrs

Rick LaCrosse: The politicians that rule should live by

their rules & laws!!!

253--March 24 at 5:52am

13 Replies--1 hr

Elizabeth Dubrulle: What an incredibly stupid and badly

written question! Were you actually trying to start a

discussion about healthcare, in which case your question

should have been: is your health care better today than it

was four years ago? (my answer would have been . . . See More

406--March 24 at 8:05am

23 Replies--2 hrs

Chris Marko: As a concerned Canadian, I apologize for both

Ted Cruz and Justin Beiber, that being said, you can keep

both of them, we have a no return policy for defective

merchandise.

135--March 29 at 8:28pm

Breana Corea: LMAO!!! Nice!

14--March 29 at 9:40pm

Something Liberal: please take them back . . . you can

imprison them or torture them . . . we don't care.

15--March 29 at 10:22pm

View more replies

Lamar Birdsey: In 1995 I had my first heart attack. At that

point I was insured. However, my coverage was immediately

terminated by my insurance company. Six months

later I had my second heart attack and had no insurance.

Subsequently I have had two more attacks and was not covered.

I have spent my life savings attempting to stay alive. In

2014, I purchased a wonderful Florida Blue policy. My premium

is $88.73 per month. My deductible is $600.00 annually and

any co-payments are extremely low. EVERYTHING IS COVERED! The

most out of pocket expense I will have to pay in a given year

is $2250.00. I am much better off now that the ACA has become

law. Senator Cruz, I suggest you pack your bags and go back

to where you came from, Canada. You are a scourge on this

great nation. We do not need or want your ilk here. If you

want to screw up a health care program, by all means return

to Canada and mess with that one. DO NOT TREAD ON MY

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I continue to reserve the balance of my time.

Mr. Speaker, can you tell us how much time remains?

Is the gentleman ready to close?

Mr. Speaker, I yield 2 minutes to the gentleman from Massachusetts (Mr. Capuano).

Mr. Speaker, I yield myself such time as I may consume.

It is an old political tactic to use confusion. We have watched for almost 4 years the Republican Party try to confuse the American people about the Affordable Care Act. It was the worst thing that was ever going to happen on the face of the Earth. We would have storms, hurricanes, unemployment, wars, and famines, all because of the Affordable Care Act.

Well, we are up here today with yet another attempt to confuse people about the 40-hour workweek and whether or not we are going to cause people to lose their jobs.

On page 125 of the CBO report on the budget outlook for 2004 to 2024, it says:

In CBO's judgment, there is no compelling evidence that

part-time employment has increased as a result of the ACA.

Everything you have learned out here about losing jobs is not true. There is nothing in the law that says people have to shorten the workweek.

I don't know if anybody on the other side understands the free enterprise system. Businesses are run by entrepreneurs who decide what kind of product they are going to produce. They hire people to do that. They decide the hours. They decide the pay. They decide everything.

You keep saying that ObamaCare came in and it is forcing these entrepreneurs in America to cut their employees' wages and hours. There is no such thing in the law. That is not true.

In fact, my colleague from Washington State (Mr. Reichert) just said, Mr. Speaker, that people's hours were already being cut before ObamaCare.

It is not ObamaCare that decides how much somebody works. It is the person who runs the company. If he doesn't care about his employees and doesn't want to give them health care, that is one thing. There are people like that, but there are a lot of people who would like to give health insurance to their people, and we are trying to help them do that with the subsidies in this bill.

Let me come to one other issue, and that is this whole question of women.

I have flown back and forth across the country every week, 35 flights a year, for 25 years, and I know most of the flight attendants on United Airlines between Seattle and Washington, D.C.

I can't tell you how many of those women are working because they get health care benefits. Their husband has a job, but has no benefits, and if they don't have their job, they simply won't have health care in their family.

United Airlines has been through two bankruptcies. They have lost pay increases. They have lost their pension rights. The only thing they have left is that health care benefit, and that is what is holding the family together.

I am sort of interested to watch what happens to the older flight attendants I know, to see whether they leave flying, because they would like to. Their husband has a job, but before, he couldn't get health insurance, and now, he can under the Affordable Care Act, and they can quit working.

When the CBO talks about people working less, it is because the job lock is gone. People are not locked into their jobs because of the fact that they can't get health insurance anyplace else. It makes it available for any American.

The fact is that the cuts you are seeing--if you see employers that are going to take people down from 40 hours a week to 39 so that they can avoid giving benefits, take a look at the morals. I wonder if that person goes to church and talks about how they take care of the poor and the weak and the sick and all the rest.

No, no. You can't have it both ways. You cannot cut your people down 1 hour just to get out of giving them benefits, and that is what you are suggesting is going to go on in this country.

I don't think that badly of owners of businesses myself. Now, there may be some people out there looking for a

way to get around the law, but this law doesn't make anybody do anything, and this law is going to create more problems.

You hear 1 million people are going to lose their health care benefits, and that is not good. This whole idea of continuing to undermine this law by confusing the American people, and making them think it bad isn't working. 1.7 million joined.

Labor Market Effects of the Affordable Care Act: Updated Estimates

Overview

The baseline economic projections developed by the

Congressional Budget Office (CBO) incorporate the agency's

estimates of the future effects of federal policies under

current law. The agency updates those projections regularly

to account for new information and analysis regarding federal

fiscal policies and many other influences on the economy. In

preparing economic projections for the February 2014

baseline, CBO has updated its estimates of the effects of the

Affordable Care Act (ACA) on labor markets.

The ACA includes a range of provisions that will take full

effect over the next several years and that will influence

the supply of and demand for labor through various channels.

For example, some provisions will raise effective tax rates

on earnings from labor and thus will reduce the amount of

labor that some workers choose to supply. In particular, the

health insurance subsidies that the act provides to some

people will be phased out as their income rises--creating an

implicit tax on additional earnings--whereas for other

people, the act imposes higher taxes on labor income

directly. The ACA also will exert conflicting pressures on

the quantity of labor that employers demand, primarily during

the next few years.

How Much Will the ACA Reduce Employment in the Longer Term?

The ACA's largest impact on labor markets will probably

occur after 2016, once its major provisions have taken full

effect and overall economic output nears its maximum

sustainable level. CBO estimates that the ACA will reduce the

total number of hours worked, on net, by about 1.5 percent to

2.0 percent during the period from 2017 to 2024, almost

entirely because workers will choose to supply less labor--

given the new taxes and other incentives they will face and

the financial benefits some will receive. Because the largest

declines in labor supply will probably occur among lower-wage

workers, the reduction in aggregate compensation (wages,

salaries, and fringe benefits) and the impact on the overall

economy will be proportionally smaller than the reduction in

hours worked. Specifically, CBO estimates that the ACA will

cause a reduction of roughly 1 percent in aggregate labor

compensation over the 2017--2024 period, compared with what

it would have been otherwise. Although such effects are

likely to continue after 2024 (the end of the current 10-year

budget window), CBO has not estimated their magnitude or

duration over a longer period.

The reduction in CBO's projections of hours worked

represents a decline in the number of full-time-equivalent

workers of about 2.0 million in 2017, rising to about 2.5

million in 2024. Although CBO projects that total employment

(and compensation) will increase over the coming decade, that

increase will be smaller than it would have been in the

absence of the ACA. The decline in full-time-equivalent

employment stemming from the ACA will consist of some people

not being employed at all and other people working fewer

hours; however, CBO has not tried to quantify those two

components of the overall effect. The estimated reduction

stems almost entirely from a net decline in the amount of

labor that workers choose to supply, rather than from a net

drop in businesses' demand for labor, so it will appear

almost entirely as a reduction in labor force participation

and in hours worked relative to what would have occurred

otherwise rather than as an increase in unemployment (that

is, more workers seeking but not finding jobs) or

underemployment (such as part-time workers who would

prefer to work more hours per week).

CBO's estimate that the ACA will reduce employment reflects

some of the inherent trade-offs involved in designing such

legislation. Subsidies that help lower-income people purchase

an expensive product like health insurance must be relatively

large to encourage a significant proportion of eligible

people to enroll. If those subsidies are phased out with

rising income in order to limit their total costs, the

phaseout effectively raises people's marginal tax rates (the

tax rates applying to their last dollar of income), thus

discouraging work. In addition, if the subsidies are financed

at least in part by higher taxes, those taxes will further

discourage work or create other economic distortions,

depending on how the taxes are designed. Alternatively, if

subsidies are not phased out or eliminated with rising

income, then the increase in taxes required to finance the

subsidies would be much larger.

CBO's estimate of the ACA's impact on labor markets is

subject to substantial uncertainty, which arises in part

because many of the ACA's provisions have never been

implemented on such a broad scale and in part because

available estimates of many key responses vary considerably.

CBO seeks to provide estimates that lie in the middle of the

distribution of potential outcomes, but the actual effects

could differ notably from those estimates. For example, if

fewer people obtain subsidized insurance coverage through

exchanges than CBO expects, then the effects of the ACA on

employment would be smaller than CBO estimates in this

report. Alternatively, if more people obtain subsidized

coverage through exchanges, then the impact on the labor

market would be larger.

Why Will Those Reductions Be Smaller in the Short Term?

CBO estimates that the ACA will cause smaller declines in

employment over the 2014--2016 period than in later years,

for three reasons. First, fewer people will receive subsidies

through health insurance exchanges in that period, so fewer

people will face the implicit tax that results when higher

earnings reduce those subsidies. Second, CBO expects the

unemployment rate to remain higher than normal over the next

few years, so more people will be applying for each available

job--meaning that if some people seek to work less, other

applicants will be readily available to fill those positions

and the overall effect on employment will be muted. Third,

the ACA's subsidies for health insurance will both stimulate

demand for health care services and allow low-income

households to redirect some of the funds that they would have

spent on that care toward the purchase of other goods and

services--thereby increasing overall demand. That increase in

overall demand while the economy remains somewhat weak will

induce some employers to hire more workers or to increase the

hours of current employees during that period.

Why Does CBO Estimate Larger Reductions Than It Did in 2010?

In 2010, CBO estimated that the ACA, on net, would reduce

the amount of labor used in the economy by roughly half a

percent--primarily by reducing the amount of labor that

workers choose to supply. That measure of labor use was

calculated in dollar terms, representing the approximate

change in aggregate labor compensation that would result.

Hence, that estimate can be compared with the roughly 1

percent reduction in aggregate compensation that CBO now

estimates to result from the act. There are several reasons

for that difference: CBO has now incorporated into its

analysis additional channels through which the ACA will

affect labor supply, reviewed new research about those

effects, and revised upward its estimates of the

responsiveness of labor supply to changes in tax rates.

Effects on Retirement Decisions and Disabled Workers

Changes to the health insurance market under the ACA,

including provisions that prohibit insurers from denying

coverage to people with preexisting conditions and those that

restrict variability in premiums on the basis of age or

health status, will lower the cost of health insurance plans

offered to older workers outside the workplace. As a result,

some will choose to retire earlier than they otherwise

would--another channel through which the ACA will reduce the

supply of labor.

The new insurance rules and wider availability of subsidies

also could affect the employment decisions of people with

disabilities, but the net impact on their labor supply is not

clear. In the absence of the ACA, some workers with

disabilities would leave the workforce to enroll in such

programs as Disability Insurance (DI) or Supplemental

Security Income (SSI) and receive subsidized health

insurance. (SSI enrollees also receive Medicaid; DI enrollees

become eligible for Medicare after a two-year waiting

period.) Under the ACA, however, they could be eligible for

subsidized health insurance offered through the exchanges,

and they cannot be denied coverage or charged higher premiums

because of health problems. As a result, some disabled

workers who would otherwise have been out of the workforce

might stay employed or seek employment. At the same time,

those subsidies and new insurance rules might lead other

disabled workers to leave the workforce earlier than they

otherwise would. Unlike DI applicants who are ineligible for

SSI, they would not have to wait two years before they

received the ACA's Medicaid benefits or exchange subsidies--

making it more attractive to leave the labor force and apply

for DI.

Possible Effects on Labor Supply Through Productivity

In addition to the effects discussed above, the ACA could

shape the labor market or the operations of the health sector

in ways that affect labor productivity. For example, to the

extent that increases in insurance coverage lead to improved

health among workers, labor productivity could be enhanced.

In addition, the ACA could influence labor productivity

indirectly by making it easier for some employees to obtain

health insurance outside the workplace and thereby prompting

those workers to take jobs that better match their skills,

regardless of whether those jobs offered employment-based

insurance.

Some employers, however, might invest less in their

workers--by reducing training, for example--if the turnover

of employees increased because their health insurance was no

longer tied so closely to their jobs. Furthermore,

productivity could be reduced if

businesses shifted toward hiring more part-time employees to

avoid paying the employer penalty and if part-time workers

operated less efficiently than full-time workers did. (If the

dollar loss in productivity exceeded the cost of the employer

penalty, however, businesses might not shift toward hiring

more part-time employees.)

Whether any of those changes would have a noticeable

influence on overall economic productivity, however, is not

clear. Moreover, those changes are difficult to quantify and

they influence labor productivity in opposing directions. As

a result, their effects are not incorporated into CBO's

estimates of the effects of the ACA on the labor market.

Some recent analyses also have suggested that the ACA will

lead to higher productivity in the health care sector--in

particular, by avoiding costs for low-value health care

services--and thus to slower growth in health care costs

under employment-based health plans. Slower growth in those

costs would effectively increase workers' compensation,

making work more attractive. Those effects could increase the

supply of labor (and could increase the demand for labor in

the near term, if some of the savings were not immediately

passed on to workers).

Whether the ACA already has or will reduce health care

costs in the private sector, however, is hard to determine.

The ACA's reductions in payment rates to hospitals and other

providers have slowed the growth of Medicare spending

(compared with projections under prior law) and thus

contributed to the slow rate of overall cost growth in health

care since the law's enactment. Private health care costs (as

well as national health expenditures) have grown more slowly

in recent years as well, but analysts differ about the shares

of that slowdown that can be attributed to the deep recession

and weak recovery, to provisions of the ACA, and to other

changes within the health sector. Moreover, the overall

influence of the ACA on the cost of employment-based coverage

is difficult to predict--in part because some provisions

could either increase or decrease private-sector spending on

health care and in part because many provisions have not yet

been fully implemented or evaluated. Consequently, CBO has

not attributed to the ACA any employment effects stemming

from slower growth of premiums in the private sector.

Effects of the ACA on the Demand for Labor

The ACA also will affect employers' demand for workers,

mostly over the next few years, both by increasing labor

costs through the employer penalty (which will reduce labor

demand) and by boosting overall demand for goods and services

(which will increase labor demand).

Effects of the Employer Penalty on the Demand for Labor

Beginning in 2015, employers of 50 or more full-time

equivalent workers that do not offer health insurance (or

that offer health insurance that does not meet certain

criteria) will generally pay a penalty. That penalty will

initially reduce employers' demand for labor and thereby tend

to lower employment. Over time, CBO expects, the penalty will

be borne primarily by workers in the form of reduced wages or

other compensation, at which point the penalty will have

little effect on labor demand but will reduce labor supply

and will lower employment slightly through that channel.

Businesses face two constraints, however, in seeking to

shift the costs of the penalty to workers. First, there is

considerable evidence that employers refrain from cutting

their employees' wages, even when unemployment is high (a

phenomenon sometimes referred to as sticky wages). For that

reason, some employers might leave wages unchanged and

instead employ a smaller workforce. That effect will probably

dissipate entirely over several years for most workers

because companies that face the penalty can restrain wage

growth until workers have absorbed the cost of the penalty--

thus gradually eliminating the negative effect on labor

demand that comes from sticky wages.

A second and more durable constraint is that businesses

generally cannot reduce workers' wages below the statutory

minimum wage. As a result, some employers will respond to the

penalty by hiring fewer people at or just above the minimum

wage--an effect that would be similar to the impact of

raising the minimum wage for those companies' employees. Over

time, as worker productivity rises and inflation erodes the

value of the minimum wage, that effect is projected to

decline because wages for fewer jobs will be constrained by

the minimum wage. The effect will not disappear completely

over the next 10 years, however, because some wages are still

projected to be constrained (that is, wages for some jobs

will be at or just above the minimum wage).

Businesses also may respond to the employer penalty by

seeking to reduce or limit their full-time staffing and to

hire more part-time employees. Those responses might occur

because the employer penalty will apply only to businesses

with 50 or more full-time-equivalent employees, and employers

will be charged only for each full-time employee (not

counting the first 30 employees). People are generally

considered full time under the ACA if they work 30 hours or

more per week, on average, so employers have an incentive,

for example, to shift from hiring a single 40-hour, full-

time employee to hiring two, 20-hour part-time employees

to avoid bearing the costs of the penalty.

Such a change might or might not, on its own, reduce the

total number of hours worked. In the example just offered,

the total amount of work is unaffected by the changes.

Moreover, adjustments of that sort can take time and be quite

costly--in particular, because of the time and costs that

arise in dismissing full-time workers (which may involve the

loss of workers with valuable job-specific skills); the time

and costs associated with hiring new part-time workers

(including the effort spent on interviewing and training);

and, perhaps most important, the time and costs of changing

work processes to accommodate a larger number of employees

working shorter and different schedules. The extent to which

people would be willing to work at more than one part-time

job instead of a single full-time job is unclear as well;

although hourly wages for full-time jobs might be lower than

those for part-time jobs (once wages adjust to the penalty),

workers also would incur additional costs associated with

holding more than one job at a time.

In CBO's judgment, there is no compelling evidence that

part-time employment has increased as a result of the ACA. On

the one hand, there have been anecdotal reports of firms

responding to the employer penalty by limiting workers'

hours, and the share of workers in part-time jobs has

declined relatively slowly since the end of the recent

recession. On the other hand, the share of workers in part-

time jobs generally declines slowly after recessions, so

whether that share would have declined more quickly during

the past few years in the absence of the ACA is difficult to

determine. In any event, because the employer penalty will

not take effect until 2015, the current lack of direct

evidence may not be very informative about the ultimate

effects of the ACA.

More generally, some employers have expressed doubts about

whether and how the provisions of the ACA will unfold.

Uncertainty in several areas--including the timing and

sequence of policy changes and implementation procedures and

their effects on health insurance premiums and workers'

demand for health insurance--probably has encouraged some

employers to delay hiring. However, those effects are

difficult to quantify separately from other developments in

the labor market, and possible effects on the demand for

labor through such channels have not been incorporated into

CBO's estimates of the ACA's impact.

Effects of Changes in the Demand for Goods and Services on the Demand

for Labor

CBO estimates that, over the next few years, the various

provisions of the ACA that affect federal revenues and

outlays will increase demand for goods and services, on net.

Most important, the expansion of Medicaid coverage and the

provision of exchange subsidies (and the resulting rise in

health insurance coverage) will not only stimulate greater

demand for health care services but also allow lower-income

households that gain subsidized coverage to increase their

spending on other goods and services--thereby raising overall

demand in the economy. A partial offset will come from the

increased taxes and reductions in Medicare's payments to

health care providers that are included in the ACA to offset

the costs of the coverage expansion.

On balance, CBO estimates that the ACA will boost overall

demand for goods and services over the next few years because

the people who will benefit from the expansion of Medicaid

and from access to the exchange subsidies are predominantly

in lower-income households and thus are likely to spend a

considerable fraction of their additional resources on goods

and services--whereas people who will pay the higher taxes

are predominantly in higher-income households and are likely

to change their spending to a lesser degree. Similarly,

reduced payments under Medicare to hospitals and other

providers will lessen their income or profits, but those

changes are likely to decrease demand by a relatively small

amount.

The net increase in demand for goods and services will in

turn boost demand for labor over the next few years, CBO

estimates. Those effects on labor demand tend to be

especially strong under conditions such as those now

prevailing in the United States, where output is so far below

its maximum sustainable level that the Federal Reserve has

kept short-term interest rates near zero for several years

and probably would not adjust those rates to offset the

effects of changes in federal spending and taxes. Over

time, however, those effects are expected to dissipate as

overall economic output moves back toward its maximum

sustainable level.

Why Short-Term Effects Will Be Smaller Than Longer-Term Effects

CBO estimates that the reduction in the use of labor that

is attributable to the ACA will be smaller between 2014 and

2016 than it will be between 2017 and 2024. That difference

is a result of three factors in particular--two that reflect

smaller negative effects on the supply of labor and one that

reflects a more positive effect on the demand for labor:

The number of people who will receive exchange subsidies--

and who thus will face an implicit tax from the phaseout of

those subsidies that discourages them from working--will be

smaller initially than it will be in later years. The number

of enrollees (workers and their dependents) purchasing their

own coverage through the exchanges is projected to rise from

about 6 million in 2014 to

about 25 million in 2017 and later years, and most of those

enrollees will receive subsidies. Although the number of

people who will be eligible for exchange subsidies is similar

from year to year, workers who are eligible but do not enroll

may either be unaware of their eligibility or be unaffected

by it and thus are unlikely to change their supply of labor

in response to the availability of those subsidies.

CBO anticipates that the unemployment rate will remain high

for the next few years. If changes in incentives lead some

workers to reduce the amount of hours they want to work or to

leave the labor force altogether, many unemployed workers

will be available to take those jobs--so the effect on

overall employment of reductions in labor supply will be

greatly dampened.

The expanded federal subsidies for health insurance will

stimulate demand for goods and services, and that effect will

mostly occur over the next few years. That increase in demand

will induce some employers to hire more workers or to

increase their employees' hours during that period.

CBO anticipates that output will return nearly to its

maximum sustainable level in 2017 (see Chapter 2). Once that

occurs, the net decline in the amount of labor that workers

choose to supply because of the ACA will be fully reflected

in a decline in total employment and hours worked relative to

what would otherwise occur.

Differences From CBO's Previous Estimates of the ACA's Effects on Labor

Markets

CBO's estimate that the ACA will reduce aggregate labor

compensation in the economy by about 1 percent over the 2017-

2024 period--compared with what would have occurred in the

absence of the act--is substantially larger than the estimate

the agency issued in August 2010. At that time, CBO estimated

that, once it was fully implemented, the ACA would reduce the

use of labor by about one-half of a percent. That measure of

labor use was calculated in dollar terms, representing the

change in aggregate labor compensation that would result.

Thus it can be compared with the reduction in aggregate

compensation that CBO now estimates to result from the act

(rather than with the projected decline in the number of

hours worked).

The increase in that estimate primarily reflects three

factors:

The revised estimate is based on a more detailed analysis

of the ACA that incorporates additional channels through

which that law will affect labor supply. In particular, CBO's

2010 estimate did not include an effect on labor supply from

the employer penalty and the resulting reduction in wages (as

the costs of that penalty are passed on to workers), and it

did not include an effect from encouraging part-year workers

to delay returning to work in order to retain their insurance

subsidies.

CBO has analyzed the findings of several studies published

since 2010 concerning the impact of provisions of the ACA (or

similar policy initiatives) on labor markets. In particular,

studies of past expansions or contractions in Medicaid

eligibility for childless adults have pointed to a larger

effect on labor supply than CBO had estimated previously.

Mr. Speaker, apparently, Winston Churchill once said:

Americans will always do the right thing but only after

they have tried everything else.

Then again, Churchill never tried to get the doc fix passed in the United States Congress.

For 10 years, we have been trying to fix the sustainable growth rate in Medicare, and for 10 years, we have kicked the can down the road with 17 different short-term patch votes. The Protecting Access to Medicare Act of 2014 is a mixed bag of some important compromises, like ensuring that there is an accurate valuation of services of the Physician Fee Schedule; some problematic provisions, such as the end- stage renal disease policy; and some provisions that have never been vetted in front of the Congress, in front of committees--at all. More importantly, this bill represents our 18th failure to rebuild the bedrock of the Medicare program, our 18th failure to provide America's seniors with the safety and security of a permanent fix to the SGR.

That is why the AMA is voting ``no'' on this bill. That is why most physicians' groups are strongly opposed to this bill. Last night, my office was flooded with messages from various physician groups.

I, for one, still believe in finding the will to do what is right. I, for one, am dedicated to the principle of seizing the moment and accomplishing big things on behalf of the American people. We thought we were going to do it this time.

When it comes to this mixed-bag piece of legislation, cooked up in the dead of night, put on the Web at 2 minutes before midnight a couple of days ago, revised several times since--not much more than 48 hours ago this stuff started--I vote ``no.'' Enough with trying everything else. It is time to do what is right--a permanent doc fix that is argued, debated, agreed upon. It is what our seniors need. It is what our doctors need to help them manage their practices. It is what our Nation needs and deserves.

Mr. Speaker, I rise today to commemorate Girl Scout Day, the anniversary of founding of Girl Scouts of the United States of America (GSUSA). On March 12th, 102 years ago, Juliette Gordon Low held the first Girl Scout meeting with the vision of empowering women through service, education, and community. The Girl Scouts have continued to build on their decorated legacy by instilling their values into the young women who will grow up to be the leaders and thinkers of future generations.

For over a century, the GSUSA has successfully spread the principles of egalitarianism through its leading role in the women's movement. The GSUSA has been at the forefront of many social justice movements as a result of its longstanding commitment to diversity and inclusion. Recently, they joined with other leaders to call attention to unfair double standards and stereotypes of women in leadership roles by launching the ``Ban Bossy'' campaign. I applaud the GSUSA for highlighting the workplace in this regard, and for demanding equality in all areas of society.

The 18-member organization that Juliette Gordon Low started in 1912 has seen participation of over 60 million women, including 2.3 million current active members. I thank the GSUSA for all its active involvement in Washington's 7th district and communities throughout America. I am proud to take part in Girl Scout Day, and I wish the GSUSA continued success for years to come.

Mr. Speaker, this 51st attempt to repeal the ACA by stopping the individual mandate is part of the long-term propaganda campaign done by the Republicans to destroy the health care plan that the President put together.

They know that we agree on the policy--everybody here agrees on the policy--but they put a poison pill in it. They knew that this amendment of how to pay for it--that is, by delaying the mandate--would kill any Democratic support in the House. They have no intention of passing this bill. This bill is directed at the propaganda campaign to the people at Koch Brothers and at FOX News so that anybody who is watching this will get the idea that somehow it is a bad bill.

The fact is that people are benefiting every single day. The AARP and the American Medical Association have denounced this bill because they want the SGR--the doctors' payment reform--to go through, and they know that the Republicans have designed this to fail.

A mandate that has been supported even by the Tea Party--before the Tea Party said ``we have got to be against it''--is what is at issue here. Doctors and health insurance companies will not be able to operate if you don't have an individual mandate. The Republicans said this. The Heritage Institute said it. Everybody said it, but they want to kill it.

This is an alternative universe that we are creating with this propaganda campaign. We see wild claims about people who live in inner cities in that they are somehow worthless and that they don't want to take care of their families and feed them, and we hear things coming out of the Speaker's office that clearly aren't true about the ACA.

Let's suppose that actually happened. What would happen if we repealed and destroyed the ACA today?

We would get rid of 13 million people on the rolls by 2018. We would take away health insurance. Health insurance premiums would rise 10 to 20 percent by 2018. Millions of Americans would not be able to afford the health care they need.

This is a failure of leadership. They would rather run a propaganda campaign to hold onto the House. We watched in Florida just in the last week when $13 million, I guess, was spent on that campaign to tar the Affordable Care Act. That is what this is all about. No one should be the least bit confused. That is not what America wants. America wants health security.

Vote ``no'' on this bill.