Floor Statements

Mr. Speaker, as the diplomats gather in Geneva today, I applaud their hard work in moving toward an interim agreement on the Iranian nuclear challenge.

After years of confrontation, today marks an important moment for all of us who support a diplomatic solution. We have spent a great deal of time to get to this place: taxpayer dollars, political capital, and global influence. We must not turn back now.

Right now, we have the maximum amount of leverage for a deal vis-a- vis Iran without fracturing the international coalition. Therefore, we should focus 100 percent on reaching a deal in Geneva under the P5+1 framework. It is absolutely critical.

Like using a wrench to tighten a nut, you can strip it if you push too hard. We have pushed to exactly the right point, and I hope that we will be successful.

We must, however, remember Mr. Reagan said, ``Trust, but verify.'' It is possible to prevent nuclear problems if we trust, but verify. That is what these diplomats are doing.

Mr. Speaker, I associate myself with all the remarks of my friends.

We have had a remarkable occurrence in my time in the Congress. This was once a death sentence. Today, we are on the verge of being able to produce an AIDS-free generation.

Now, it is great and we are always excited when we do something new and big and exciting, but maintaining and pushing forward to finish the project is really where we are. This bill will pass without a vote against it, I am quite sure. But the real question is: What do we put in the budget? Because if we don't maintain what is going on in the world today, we will lose. We will go backward.

It is like we have built a dike and we are holding back the sea. But the fact is if we don't have the drugs available when mothers deliver children and you do that intervention right at the appropriate time, you will not prevent the children from getting it. You will not be able to give the long-term care to the mothers as they raise these children.

In my view, that is really where we are.

This was the crowning achievement, I think, of the administration of George Bush. His starting this was a statement to the world that the United States cared about an epidemic that affected the entire face of the universe. And we have done a good job.

But I say this because I worry about the sequester. What does sequester mean to this? What will be the reductions? Because I am getting calls from my friends in South Africa, Zambia, Zimbabwe, Uganda, and Kenya, saying, How much money is there going to be next year? Will we be able to expand the program, keep it the same, or are we going to have to retrench?

That is what the world is watching as we face this upcoming vote on the budget.

I hope that we have as many votes for funding the program as we do for reauthorizing it here today in this bill.

Mr. Speaker, I rise today to introduce the Honoring Our Fallen Heroes with Dignity Act of 2013.

This act protects the rights of families to leave small keepsakes at the gravesites of servicemembers buried in Section 60 of Arlington National Cemetery, many of whom bravely served their country in Iraq and in Afghanistan.

During the summer of 2013, officials at Arlington National Cemetery came through Section 60 and, without providing advance notice to families, threw away mementos left behind for the heroes buried in Section 60.

Teresa Arciola, a mother whose son was killed in Iraq in 2005, cried when she found out that the mementos she left at her son's gravesite had been removed. ``It was like no one cared anymore,'' she told The Washington Post.

The act would allow mementos to be left on the top of and immediately next to grave markers in Section 60 of Arlington National Cemetery as long as they did not interfere with normal operations and maintenance procedures, such as mowing the grass.

The items can not be a health or safety hazard, be permanently affixed to gravestones, and can't interfere with normal operations of the Section 60 of Arlington National Cemetery. At end of each month, items left on the grave stone will be collected, cataloged, and stored.

Mr. Speaker, I rise today to introduce two important legislation that would make common-sense reform to Section 3319 of title 38 of the United States pertaining to post-9/11 educational assistance, also known as ``Post-9/11 GI Bill.'' I supported the creation of the Post-9/11 GI Bill because the brave men and women in uniformed services deserve our nation's support in attaining education. I have heard from many constituents who are benefiting from this worthy program. I have also heard from some who say that the law needs to be amended to ensure that the benefits are fully used.

My first bill, Post-9/11 Educational Assistance Enhancement Act, would expand the authority of veterans to transfer post-9/11 educational assistance to dependents within five years of separation from the uniformed services. Currently, members of the uniformed services must transfer their benefits to their dependent before leaving the services. My bill would give veterans more time to ascertain whether or not life circumstance dictates the need to transfer the educational benefits to their dependents. The goal is to ensure that more people can take advantage of the educational assistance.

My second bill, Increased Age Limit for Post-9/11 Education Assistance Dependents Act, would increase the age limit to use transferred post-9/11 educational assistance from 26 years old to 29 years old. This is again intended to capture more beneficiaries of the Post-9/11 GI Bill, particularly those who are pursuing medical school or other professional degrees where the typical age of entry is higher than other degrees.

I encourage all of my colleagues to support these two measures so that we can better serve our veterans and military families.

Mr. Speaker, my mother used to say ``patience is a virtue.'' I haven't seen so much panic on this floor since 9/11.

Now, the fact is that a couple of Members who used to be here--Jay Inslee, who is now Governor of the State of Washington, and Mike Kreidler, who is the insurance commissioner of the State of Washington--have already said they will not implement this because it is not good for the people of the State of Washington. They have looked at it.

We have worked hard to implement the Affordable Care Act. Now we have a bill out here with no hearings whatsoever run out here, and we are told there will be no confusion. There will be nothing but confusion. You have 50 insurance commissioners around this country who are going to be suddenly given a bill after we write some rules and regulations here that require the insurance companies to sell policies to people.

I can't believe what I am hearing. I thought that the Republicans believed in the free enterprise system. This is socialism. This is government saying to insurance companies: you must sell a policy to somebody next year that you sold to them this year.

When did we shift on the Republican side to the Congress telling an insurance company who they have to sell a policy to or what is in the policy?

The fact is that they are going to have to put the policy out there. They have been working on implementing this law for 3 years. Now 6 weeks before it actually begins to take effect, we run in here and say, wait a minute, wait a minute, you got to start selling policies like the ones that you sold last year.

Do you think they didn't think through what they are doing? I mean, I don't understand. The free enterprise system is lions and they are eating antelopes.

I urge you to vote ``no'' against this because you are going to create endless confusion in this country and the insurance market.

Washington State Office of the Insurance Commissioner,

November 14, 2013.

Kreidler Statement on President Obama's Announcement Today

Olympia, WA.--``We have worked for three years to implement

the Affordable Care Act in a way that works best for

Washingtonians. One goal of our efforts has been to build a

stable, fair and competitive individual health insurance

market.

I know that many people who buy their own health insurance

have struggled to keep their coverage. That is why we have

worked so hard to make these significant changes. We have

brought meaningful benefits to this market that the rest of

us with employer-sponsored health plans have enjoyed for

years; benefits like prescription drug coverage, maternity

care, and reasonable limits on out-of-pocket costs. Our

state-based Exchange--Wahealthplanfinder.org--is up and

running and successfully enrolling thousands of consumers.

I understand that many people are upset by the notices they

have recently received from their health plans and they may

not need the new benefits today. But I have serious concerns

about how President Obama's proposal would be implemented and

more significantly, its potential impact on the overall

stability of our health insurance market.

I do not believe his proposal is a good deal for the state

of Washington. In the interest of keeping the consumer

protections we have enacted and ensuring that we keep health

insurance costs down for all consumers, we are staying the

course. We will not be allowing insurance companies to extend

their policies. I believe this is in the best interest of the

health insurance market in Washington.

We estimate that 290,000 people will need to buy new

coverage and that at least half of them will qualify for a

premium subsidy. I encourage anyone who is shopping for new

health plans--whether you've been uninsured or have received

a cancellation notice from your insurer--to look at all of

your options. Don't just take what your insurance company

says. You may find better, more affordable coverage with a

different insurer. There are 46 individual health plans for

sale in the Exchange and 51 plans available outside the

Exchange. If you need help reviewing your options, contact a

navigator or an agent or broker.

Mr. Speaker, I rise today to introduce the Internet Gambling Regulation and Tax Enforcement Act of 2013. This bill would generate new streams of revenue for the federal government as well as state and tribal governments, create an estimated 30,000 new jobs in America, and provide funding for children in foster care and for historic preservation and the arts. This is a companion bill to H.R. 2282, legislation sponsored by Cong. Peter King and Capuano, which would license and regulate online gambling at the federal level. Under current law, intra-state online gambling is legal, but inter-state online gambling is not, except for betting on horseracing, which is legal on an inter-state basis.

Under my legislation, the federal government along with state and tribal governments would recognize a new, untapped stream of revenue. The revenue could help jurisdictions fund needed services at a time when many governments are struggling with tightening budgets.

Online gambling operators would pay a tax to the federal government as well as state and tribal governments equal to a percentage of the total deposits they collect. The money paid to the governments would not be deducted from the accounts of online gamblers.

Operators will pay a tax to the federal government equal to four percent of the funds deposited by players who reside inside the U.S. Operators will pay a tax to state and tribal governments equal to eight percent of the funds deposited by individuals residing within their jurisdiction. The deposits to state and tribal governments would be made automatically every month by website operators, in lieu of them (the governments?) imposing other taxes of their own. This deposit tax for states and tribes would be an optional, simple, and uniform way to participate.

A quarter of the revenue raised by the bill would go to providing assistance to the nearly 500,000 children in America who live in foster care. The funds generated would be directed at helping foster children through grants to each State to carry out educational and transitional support for individuals who are or were in foster care.

Finally, the bill sets aside 0.5 percent for historic preservation and the arts. I helped enact a similar program in my home state of Washington, and it has been hugely successful over the years.

Some in this body may be concerned that legalizing online gambling would further open the door of the virtual casino to children, but evidence shows the current availability of online gambling options on the Internet has not led to an increase in gambling among minors. Moreover, technology is widely available and used in the United States and abroad to verify identity, age and location for online financial transactions from online banking to online gambling on horseracing.

The future is happening. People in small towns and big cities across America are gambling online either legally under a patchwork of inconsistent state laws or illegally without any consumer protection. We have to deal with this issue. If we regulate online gambling, we can create jobs, generate revenue, and expand aid to children in foster care.

Mr. Speaker, as we have this debate over opening the government, I want to talk about an agency that people are not thinking about.

The National Institutes of Health started in 1887 in one room, the Public Health Service Hospital in Staten Island, New York. It was modeled on something that the Germans had been doing for a number of years that was called the Laboratory of Hygiene.

In 1891, it came to D.C.

In 1901, they built the first building. The appropriation was $35,000. It was for the investigation of infectious and contagious diseases.

In 1912 in St. Louis, 12 kids died when they got a diphtheria vaccine that was contaminated with tetanus. At that point, they decided they would pass the Biological Control Act, and that was given to the Institutes of Health. Joseph Goldberger, a doctor, discovered the cause of the pellagra, which was a scourge of the South in this country, a dietary deficiency because of bad diet. That came from the Institutes of Health.

In 1930, a Senator from Louisiana by the name of Ramsdell started the National Institute, one, the National Institute of Health. It was to give fellowships to physicians to study problems in the health care system. That situation went on from that day to this day.

Now they tried to do it in the private sector. After the First World War and all of the problems of chemical warfare, the Congress said let the private sector figure out how to do it, and they couldn't do it. They couldn't find anybody to finance it, and so they came and established the National Institute of Health in the government.

In 1937, they added the National Institute of Cancer. And in 1938, they built the first building up in Bethesda, Building 6.

Now until the Second World War, they discovered and worked on various things, and then the war came, and they spent an enormous amount of effort trying to figure out the health problems of this country. People don't realize, 43 percent of the people who were inducted or brought forward to be inducted into the Army were rejected because they were unfit physically. The National Institutes of Health went to work on that. There were a whole variety of issues--diet, teeth, syphilis, all kinds of things that were not being done in this society, and they did the initial research on that.

In 1946 after the war, they decided we've got to expand this thing and they began creating new Institutes of Health. One was arthritis and metabolic diseases. That's where we started working on diabetes. Then they did allergy and infectious disease, which is what went on to deal with AIDS.

In 1970, there were 15 Institutes of Health. Today, there are 27. All over this country in every university and everywhere you look, there are scientists and physicians who are submitting grants to the Institutes of Health on issues that affect all of us. It has been the practice until very recently that one out of five of them is accepted. One is good, four are not so good. We're going to pick the one that's good and put our effort there. We are down at the point where we are now doing 6 out of 100; 6 out of 100. This country that boasts about our health care system is killing it by this kind of bill, by squeezing the National Institutes of Health to death.

Mr. Speaker, bring out a clean bill and let's start up the National Institutes of Health.

Madam Speaker, the Republican Caucus is standing out here naked, and they keep bringing fig leaves out to cover themselves. This is another fig leaf. It is not intended to do anything.

At the end of the Second World War, it was determined that 43 percent of the people who were drafted were unfit for military service because of nutritional deficiencies. We have, as a public policy, from that point onward, fed people at every level. School lunches, Head Start, WIC program, SNAP--they have all been designed for making this a healthy country.

One of my colleagues says, well, this has nothing to do with ObamaCare. It has everything to do with ObamaCare. If you don't feed kids the proper things, they get sick. Everybody knows that, apparently, except the Republican caucus, Madam Speaker.

The fact is that what we need to do is bring out a clean resolution and reopen the government and feed all the people. This business about picking one group that's entitled to a little something and leaving some others out is absolutely cynical beyond belief, and it should not happen in this place.

We have the ability to have the most healthy people in the world. We produce food, we ship it everywhere, and yet you hear from my colleague, Mr. McGovern, how many people are

hungry in this country because they don't have it.

Now, somehow you think a mother's going to sit there, she's got her stuff from the WIC program, right? She's got a kid that's 1 year old and one that's 3 and one that's 7, and she's going to say to the 3 and the 7-year-old, you don't get anything; but I've got a little something for your brother Johnny?

What kind of situation is this? Do you understand what it's like to be deprived in this country?

We can do better than this. You ought to be ashamed of yourselves for this cynical fig leaf.

I urge you to vote ``no.''

Mr. Speaker, on rollcall No. 513 I was delayed in traffic and missed the vote. I would have voted ``no.'' Had I been present, I would have voted ``no.''

Mr. Speaker, my father used to get up in the morning and say:

Today is the day which the Lord hath made. Let us rejoice

and be glad in it.

It's a verse from the Book of Psalms.

This is a day I think we can be positive about. All we're hearing is negative stuff and bad stuff, but let's talk about the good things.

Today is the first day in our country that you have the ability to apply for health insurance. No matter what your status is, you can go down to the exchange and ask for a quote and buy an insurance policy, no matter what your condition is. No matter your employer, no matter what illnesses you have in your family, no matter what, you can have insurance. That brings the United States up to the level of every other country in the industrialized world. For the first time, we have joined the countries that take care of the health security of their people. But it's very clear it's going to be uneven across this country.

I come from the West Coast. We call it the ``Left Coast.'' Washington, Oregon, and California are up and running. They have been planning for 3 months how they're going to get out and get everybody enrolled. The State of Washington's goal is something like 70 percent in the first 6 months for those people who don't have insurance. We're serious about making this thing work. The Governor of Kentucky has just said almost the same thing.

There are spots across this country where you are going to see this law take effect, and people, for the first time in their life, can relax and know that they won't be bankrupted by an illness or injury or be able to say: I'm sorry, we can't do for you whatever is necessary for you or some member of your family.

This is a great day.

In other States, people are going to stand around watching what is going on on the West Coast and say: Why can't we have what they have in California? Why can't we have what they have in Washington? And the answer is: Look to your political leadership. Look to your Members of Congress who said: No, we don't want to put a plan in. We don't want a plan. They'll say: Yes, we want to repeal and replace, but they never once put a ``replace'' on the table.

I sit on the Ways and Means Committee, where Medicare and the Affordable Care Act came from. The Republicans have been in control ever since it passed in 2009. They have never put a plan on the table to repeal and replace.

They do not care about people who do not have health insurance. It is very clear. The Governors across this country who refuse to take the Congress's generous offer of full funding for Medicaid are simply saying: We don't care about the poor people in our State. We are not going to provide health care for them. Even if the Federal Government will pay the whole thing, they say: No, they can't have it.

The people of those States are going to have to look, Mr. Speaker, at their leadership and say: What are you doing? Do you not understand what it is to be a human being in this society without health insurance and wait and wait and wait until whatever it is that's bothering you is so bad that you have to go to the emergency room?

The reason some people have good health care in this country is because they have health insurance and they can have preventive care. They can have mammograms, colonoscopies, blood pleasure checks, sugar checks, and all kinds of things that people who do not have health insurance don't have access to because they can't afford it.

Beginning today, anybody in this country can have their blood pressure checked and their blood sugar checked to see if they have high blood pressure or diabetes. They will be able to begin the process of having much better health care and not have to worry about what happens to their family.

I talked to Bill Frist, who was the Republican leader of the Senate, for

about an hour the other day on the phone. He said: Jim, what those guys ought to do is simply amend the bill that's there and make it work. There hasn't been a single amendment brought in the House to make it work better.

This is a wonderful day for everybody.

Mr. Speaker, in Psalm 118:24 it says:

This is the day which the Lord has made. Let us rejoice and

be glad in it.

This is a day of rejoicing. The Republican wrecking ball that was supposed to take out ObamaCare has failed. It was a failed idea. It was a bad idea. And ObamaCare is going into effect today.

So rejoice. Everyone in this country now has a chance to have health insurance coverage. We've been waiting for 100 years since Teddy Roosevelt first proposed it. And finally, it's here.

Newt Gingrich said, If we allow Mrs. Clinton's health care plan to pass, the Democrats will be in for the next 60 years, like they were after we passed the Social Security Act of 1935.

Well, folks, that day is here. It's a glorious day. Rejoice. You can get your health insurance.

Mr. Speaker, as we approach the 1st of October when everyone in this country is going to have an opportunity to have health insurance, you know that there are some people who always like the status quo and they will say anything and do anything.

The public is today being subjected to a propaganda campaign, the likes of which we have never seen in this country, against ObamaCare. Somehow it is the worst thing that has ever happened--the sky is going to fall, the world is going to end as we have known it, we should run and pray that in the latter days we will be saved.

The fact is that ObamaCare is going to go into effect. The Supreme Court has looked at it and said it is constitutional. It is going to happen, folks.

Will there be a few problems? Of course. You can't make the change and bring 30 million people into a program without having a problem here and there. Some of the complaints I hear on the other side are from people saying: Oh, it's going to do this, it's going to do that, it's going to do this, it's going to do that--but they didn't want to make one single change to make it better. We should just be calm.

Mr. Speaker, I applaud my colleague from Arizona for bringing this issue to the floor.

Forty-five years ago, I was a part of another era when there was a draft, and everybody was subject to that draft. In 1975, we stopped that draft,

and we changed the nature of our military. We made it an all-voluntary military.

What we've done in this country is we've taken 1 percent of the people and said, You volunteered for this. You go and do this for us.

We buy the guns, the bullets, and everything else and send them out there. When they come back, we don't know them.

There's a fascinating book, called, ``Breach of Trust,'' by a man named Andrew Bacevich. He is a colonel in the United States Army. He lost a son in Iraq, and he has written an incisive account of what the problem today is. The subtitle is ``How Americans Failed Their Soldiers and Their Country.''

I know about PTSD because I dealt with it as a psychiatrist with people coming back from Vietnam. The kids that were in ``Apocalypse Now'' are the kids that came to my clinic. So I saw what people who went through tough war was all about. What is happening today that we do here on this floor--and I'm always uneasy when we do it--is we stand up and we have a moment of silence. It's nice. We should do it, and we do it. We thank people for their service.

Every veteran finds that as hollow, because they didn't go and get us a cup of coffee; they were under orders to go and kill people. They did it on our behalf.

We bear the responsibility for sending them out there to do it. Every one of us on this floor, all 435 of us, bear the responsibility, as does the American public.

When we receive them back, what do they get--homelessness? joblessness? They get PTSD that may or may not be treated.

We say, Oh, well. The Veterans Administration will take care of that.

You can't put it off on the Veterans Administration. It is all our responsibility.

There is a movie, called, ``The Invisible War,'' about what happens to women who are now serving in the military. You can look at brain injuries of kids who could do all kinds of things and come back and can't remember their phone number, can't remember what their house address is, and they are suffering from things that have happened to them because of the war that they've been involved with, and what happens to them is they get isolated. They get isolated, feeling that nobody really understands what's going on with them. For some, suicide seems like the only way.

Now, Native American tribes, more ancient people, understood this, that when they sent warriors out to war, they received them back into the tribe. The samurai did it. There was a whole process by which we brought people back in and cleansed them of the guilt of what they've done on our behalf. That collateral damage you read about or hear about is our responsibility as well as theirs for having actually pulled the trigger. We sent them, and they did it on our behalf. They cannot get away from that.

We have put a provision in the National Defense Authorization Act that will create a commission for high-level people to look at how we bring these people back, and it's more than just fixing the process at the VA. That's not enough. There is a much larger process of getting us to accept what we're sending people to do. This recent brush we had with Syria, we were about to send people down there to kill people all over the place and say, Well, it was the Air Force that did it. I didn't direct the smart bomb to go in there.

Yes, you did. Yes, I did. Yes, all of us did.

So when we talk about suicide and these isolated young men and women who come back and feel there's no other hope, it is a much bigger issue. It's an issue of getting them to come and talk to us and tell us what they've done and accept, as we accept, the grief from that kind of event.

I thank you for the time, and I encourage you to read the book, ``Breach of Trust.''

Mr. Speaker, I rise today to introduce bipartisan legislation that will fix an error and enable homeless veterans and youth to pursue full time education while living in Low Income Housing Tax Credit financed housing.

Low Income Housing Tax Credits (LIHTC) have been a crucial foundation to incentivize the building of affordable low income housing. LIHTC housing has been invaluable in providing much needed shelter for those living in poverty or on the streets.

Unfortunately, a provision in the law is having unintended consequences. Currently, a homeless veteran or youth that wishes to pursue full time education must choose between an education and living in LIHTC housing. This is not a choice they should be forced to make, nor is this a policy America has ever supported.

Education is the cornerstone of American excellence and ingenuity and remains the best means to escape poverty. It is critical that we fix this defect in the law, and ensure that our youth are given every opportunity to reach their educational goals.

Mr. Speaker, I rise today to introduce the Fairness for Beneficiaries Act of 2013.

Before Medicare beneficiaries can access skilled nursing facility (``SNF'') care, they must have a preceding three (3) day inpatient stay at a hospital. Historically, this made sense. The goal was to ensure the use of SNF care was limited to certain circumstances where such care was medically necessary. The relatively arbitrary 3-day requirement was acceptable; medical developments and technology were such that beneficiaries usually would need 3 days of inpatient care prior to accessing SNF care.

I contend that times have changed. First, many Medicare beneficiaries are simply not medically appropriate for inpatient stays; they require direct admission to a SNF. Thus, the 3 day stay requirement imposes a burden--both physical and financial. We know inpatients can often acquire healthcare-associated infections (``HAIs'') during their stay at a hospital. The potential for beneficiaries who may have compromised immune systems to acquire an HAI is substantially higher, compared with the rest of the population. One recent estimate projects the annual direct cost of HAIs to United States hospitals at $28.4 to $45 billion. Some of this financial burden could be avoided potentially if beneficiaries could bypass the inpatient setting and go directly to a SNF, when a physician certifies that SNF care is appropriate.

There is another reason that this legislation is of critical importance. The use of observation status by physicians has cause a substantial burden for patients. Medicare beneficiaries may go to a SNF thinking that because they had been sitting in a hospital bed for 3 days, that their SNF care would be paid for by Medicare--only to find that this is not the case because 1 or 2 of the days that they spent at the hospital were spent in observation status. Such patients are hit with substantial financial liability time and time again when they access

SNF care. This issue has directly affected my constituents and I am seeking to put an end to this problem by eliminating the requirement for a 3 day stay prior to beneficiaries accessing SNF care.

Finally, I recognize that some critics may say there is a substantial cost to this legislation and that the cost to the Medicare program is simply too great. I believe that some of the cost associated with this legislation could be offset. First, as described above, there is a potential savings in reducing some HAIs that Medicare beneficiaries acquire during the inpatient stay since the beneficiaries can now go straight to a SNF when medically indicated. Second, I note that there will be a decrease in the use of inpatient hospitals by this population when beneficiaries are ready to go straight to a SNF. Third, I note that beneficiaries deserve the best care that we can afford to them. As such, the right policy in this regard is to allow them to access SNF care where medically appropriate as certified by a physician. Finally, the legislation contains certain protections to protect against fraud, waste and abuse in the Medicare program relative to this benefit. First, a physician certification continues to be required prior to a beneficiary being able to access SNF services. Second, the legislation requires CMS to develop uniform requirements that will allow CMS and its contractors to audit to ensure that SNF care is appropriate.

For all of these reasons, the Fairness for Beneficiaries Act of 2013 is the right thing to do. I encourage my colleagues to support this legislation.