Floor Statements

Mr. Chair, on rollcall No. 711 I was detained. Had I been present, I would have voted ``no.''

Amendment No. 7 Offered by Ms. Foxx

Yes. To answer the gentlewoman's question, obviously, with advanced technology and energy-efficient vehicles, we're looking at all sorts of modes of transportation. Of course, in Europe, these modes of transportation, for the most part, are these small motor scooters. In fact, if we're looking to become energy independent and efficient and if we're trying to incentivize in this country the production and manufacturing of vehicles that are going to reduce our dependence on foreign oil and are going to promote energy efficiency, we cannot do this and miss a large part of the market that the rest of the world is utilizing in order for them to become more energy independent and more energy efficient.

That's why it is important that we actually put this in the language of the bill, because, otherwise, they will not be eligible for the incentives that we make available for 4-wheel vehicles. In fact, if the idea is to promote all of these kinds of vehicles, we ought to make sure that it says that distinctly in the language.

We have found already that these vehicles have not been able to garner the loan assistance that has been already available in other pieces of legislation and in the stimulus bill and previous legislation because they don't come under the strict definition of a 4- wheel vehicle.

We have tried to make the regulations flexible enough to say that they are two and can be retrofitted to become four, but, of course, that's kind of a stretch in the fact that the manufacturing process can be expanded to make 4-wheel vehicles out of these 2-wheel kinds of systems, but it's not the intended purpose of these manufacturing facilities. That's why we want to put it in specifically to mention 2- or 3-wheel vehicles.

I appreciate the gentlelady, and thank the gentleman from Tennessee for yielding me this time.

I won't go on any further than I have already explained except to say that obviously there are good green jobs. We talk about good green jobs in this bill. This is about good green jobs.

These vehicles are already being sold to police departments as public safety vehicles all across America. These Vectrix vehicles that are made in my State are electrical vehicles that have enormous capacity in the metropolitan areas. And, frankly, they are obviously great for the environment, but they are also fuel efficient, and they provide a great alternative to vehicles that we have since relied on that create such pollution in our air.

So I think this is good. It's creating good jobs here domestically.

And if we provide the loans, then we can keep these manufacturing jobs here at home. Roughly, 16,000 jobs are anticipated, conservatively, within the next 5 years as a result of just loans that can be made through the Department of Energy as a result of this amendment.

So I would ask that my colleagues favorably support this amendment.

Mr. Chair, I rise in support of my amendment, offered by Mr. Gordon, an amendment to ensure that this valuable legislation includes all manufacturers of qualified plug-in electric vehicles.

Right now, there are a dozen companies in our country that are designing and manufacturing 2- and 3-wheeled electric vehicles. They have not been able to participate in Department of Energy funding opportunities, not because they lack merit, but because they simply don't have 4 wheels.

If these companies had access to Department of Energy loans on the same basis as the rest of their industry, they could create 900 green jobs in the next year and 16,000 jobs in the next 5 years. With our current unemployment, we cannot afford to leave one job on the table.

My amendment is simple. It ensures that all manufacturers producing qualified plug-in electric vehicles are eligible under this legislation. In the past, innovative vehicles like electric motorcycles were left out simply because they did not conform to outdated definitions.

My amendment clarifies that these ground-breaking vehicles and their manufacturers are eligible under the program using a definition from existing law.

The electric vehicle industry has an opportunity to profoundly influence our nation's future. It can help to preserve our environment, revitalize our manufacturing base and help free us from our dependence on fossil fuels.

I urge my colleagues in the House to join me in support of all plug- in electric vehicles and adopt this amendment.

Madam Chair, as we know from legislation that this committee worked on many years ago called the Foundations for Learning program as part of the Elementary and Secondary Education Act, social and emotional development are as important as anything in the early part of a child's life. Importantly, in this piece of legislation, we recognize these same important facts, and in this legislation we reflect these findings by acknowledging the importance of intervening early in a child's life who has had domestic violence exposure, has had homelessness exposure, has had their parents exposed to mental illness. Intervention in these children's lives makes an enormous difference in their social/emotional development and in their educational abilities later on in life. For these reasons, I think this is an important piece of legislation that needs to be adopted.

I appreciate the chairman for acknowledging these facts and incorporating this legislation into the body of his bill.

Mr. Speaker, on rollcall No. 697, I was unavoidably detained. Had I been present, I would have voted ``yea.''

Mr. Chair, I want to commend your hard work on this bill which shows our strong commitment to America's children, seniors, families, and others in most need.

In particular, I want to thank the Chairman for increasing funding for the NIH, CDC and SAMHSA.

When it comes to medical research the bill moves our nation forward. It provides $500 million over the President's Budget for the National Institutes of Health so that NIH can get us closer to the cures that we all wait for.

When it comes to addressing our national security from the H1N1 virus it moves our nation forward. The bill gives $545 million total for critical pandemic flu activities at NIH, CDC and the Office of the Secretary.

When it comes to public and preventative health the bill moves our nation forward. It provides increases to health professions and nursing education, which have been starved in recent years. This year instead, we will be able to train the doctors, nurses, and other health professionals the country needs to ensure that more people get quality health care.

When it comes to mental health and substance abuse services the bill moves us forward. In particular, I want to commend the new initiative funded by the Chairman in SAMHSA regarding the effects of the economic downturn on mental health. There is $5 million provided for a Community Resilience Initiative.

Nowhere are our economic hard times felt more than in Rhode Island, where we have over twelve percent (12%) unemployment and a state in budget crisis. This new initiative will help workers across the nation and in my state, to better cope with the stress this economy is placing on them.

I also would like to commend the Chairman for his commitment to funding the Senator Edward M. Kennedy Serve America Act. Named after my father, the senior Senator from Massachusetts, this bill provides the public and volunteer service roadmap for the Twenty-first Century, much like my uncle's call to service over 40 years ago.

Named after a steadfast leader of so many of the programs that are funded in this bill, from vocational education to AmeriCorps, from NIH research to the Corporation for National and Community Service, it is only fitting that funding for the Senator Edward M. Kennedy Institute for the Senate be included in this Labor, HHS, Education and Related Agencies Appropriations bill. I thank the Chairman for his support for what will be a part of a tremendous legacy.

Again, I want to thank the Gentleman from Wisconsin and his staff, for their unwavering commitment to the vital programs in this bill.

Madam Speaker, the America's Affordable Health Choices Act of 2009 vitally enhances the provision of mental health care in our nation. Perhaps most importantly, the legislation includes mental health and substance-use disorders benefits in the essential benefits package. It is because of the precedent set by the mental health parity law, fortifying the civil rights of those with mental illnesses, which lead to the clear recognition by the bill that optimal health cannot be achieved without the inclusion of mental health and substance-use disorder services. I am pleased to have worked with the Committees to have accomplished this victory.

This bill also bolsters the provision of primary care in our country, and in particular prevention. However, if mental health and substance- use disorders are to be included as an essential benefit, we need to be sure that our Nation's physicians, both primary care doctors and specialists, have the behavioral health training and education necessary for them to meet these new provisions. Current medical education, and in particular continuing medical education, does not include enough behavioral health components for physicians to adequately meet the mental health needs of their patients. Substance- use disorder education in particular is rarely offered as a separate component of education, leading medical school graduates with a lack of confidence in their skills to screen, assess, or provide the needed interventions to their patients, according to the 2005 National Academy of Sciences' Institute of Medicine (IOM) Improving the Quality of Health Care for Mental and Substance-Use Conditions report. This report also found that even in preventative medicine, most substance-use education focused solely on tobacco.

The recommendations from this report were so essential for the health of our Nation that I developed legislation based on them--the Improving the Quality of Mental and Substance Use Health Care Act. These issues are now more pertinent than ever as we craft a reform of the current system which will greatly increase the access to mental health care for Americans. Sadly, a recent study showed that barely a third of Americans with mental illness get proper treatment, and that most people who do get care obtain it through their care from primary care physicians. Yet about two-thirds of U.S. primary care physicians reported in 2004-05 that they could not get outpatient mental health services for their patients--a rate that was at least twice as high as for other services, according to the Commonwealth Fund. It is more crucial now than ever that physicians receive the proper behavioral health training--we cannot increase access without arming our workforce with the tools needed to meet this challenge. I therefore respectfully ask the Committees' and my colleagues to ensure that this essential education and training is included in the workforce and education enhancements sections of this bill.

Madam Speaker, this legislation, America's Affordable Health Choices Act of 2009, otherwise known as our health bill this year, will guarantee all Americans access to affordable health care without preexisting condition discrimination. Imagine that, getting health care insurance without being told that your preexisting condition is going to result in higher premiums, higher deductibles or higher copays. Imagine being able to change your job at will without having to worry that you're going to lose your health insurance. Imagine having no worry that you're going to have to exceed a lifetime cap. Imagine being able to know that you're going to have catastrophic health care coverage.

Imagine knowing that we're going to now move in our health care system from a sick care system that just is the most expensive that we know to actually a health care system where we actually pay for preventive care so that we actually get health care in this country, not sick care; where we pay for prevention, not sick care. We don't have to wait until an asthmatic gets an asthma attack before we get a doctor to that asthma patient. We don't have to wait until a diabetic gets an amputation before we get that critical care. We get prevention and chronic care management.

And what is so great about this legislation is that it includes full parity for mental health coverage. I was proud last year to author the Mental Health and Addiction Equity Act of 2008. What it required is that we finally recognize that mental health and addiction equity is part of our health insurance system, meaning insurance companies can no longer discriminate if you had alcoholism or addiction or depression. Imagine that, we finally acknowledge that the brain is part of the body.

Mental illness is a big part of our country's health care system. It accounts for over 50 percent of the trauma admissions in our trauma one centers and emergency rooms every single weekend. Suicides in our country exceed homicides by two to one, suicides do. And you know what, we don't have a mental health system in this country to speak of because, you know why, there's a stigma out there against mental illness.

We still believe in this country that it's your fault if you have a brain illness. If somehow you have a lower dopamine level or seratonin level, it's your fault. We think you ought to pick yourself up by your boot straps; it's your fault. It's a moral problem.

We forget the fact that now, even to this day, we can take brain scans and tell whether someone has a differing brain or not from a normal functioning brain. But today, we are enforcing what we know to be scientifically true, what the AMA said in 1955, and that alcoholism is a disease, that there is such a thing as brain disorders, substance abuse disorders, eating disorders, depression, bipolar disorder, and things of that nature.

In this legislation, in this health care bill, we require parity in health care coverage. We say that we ought to recognize these disorders for what they are, and furthermore, we say we ought to have prevention. And even more in

this legislation, we're going to say we're going to require medical school education to have education teaching all doctors to recognize this.

That is what is important in this legislation, and I am pleased to ask my colleagues that they ought to support this legislation so that we can finally have justice for all in health care in this country.

Mr. Speaker, the health care bill that we are now considering contains a very important item, and that is mental health parity, requiring all health insurance plans to treat mental illness and addiction on the same grounds as other physical illnesses. If we are to do this and also to include prevention, it's important that we have the appropriate education and medical education for all doctors so that they may be able to properly screen and treat all patients. Irrespective of their specialties in some other areas, doctors ought to be able to identify and to treat, at least in the primary care setting, mental health challenges before referring them to specialists. This has been an issue within the Institute of Medicine report, and I encourage my colleagues to support this in a section for medical education and training within the base of the bill.

Chairman Obey, I want to commend you for the very hard work that you put into this bill, which shows a strong commitment to America's children, seniors, families, and others most in need. In particular, I want to thank you for increasing funding for the NIH, CDC and SAMHSA.

When it comes to medical research, this bill moves our Nation forward. It provides $500 million over the President's budget for the National Institutes of Health so the NIH can move us closer to the cures that we all wait for.

When it comes to public and preventative health, this bill moves our Nation forward. It provides increases to health professionals and to nursing education and to the very serious public health and national security crises posed by the H1A1, avian flu. This bill prepares us for that uncommon threat.

When it comes to mental health and substance abuse services, this bill moves us forward. In particular, Mr. Chairman, I want to thank you for funding a new initiative regarding the effects of the economic downturn on mental health, called the Community Resilience initiative. Through this funding, we are going to be able to design a health program that meets our public's mental health resilience needs at a time of economic downturn and of very strong public stress.

In my State of Rhode Island, with 12 percent unemployment and in a state of budget crisis, my people and our country's needs are much greater because of this pressure, not only on our economy but on the public at large in their personal lives.

For that, I want to thank you, Mr. Chairman, for these increases in funding.

Madam Speaker, as we continue to craft a meaningful, necessary reform of our health care system, we must continue to embrace prevention, the provision of whole-body care, and the reversal of the current ``sick-care'' system. With this in mind, I respectfully ask you to ensure that screening for mental health and substance abuse is included as one of the preventative services proposed by the America's Affordable Health Choices Act of 2009.

The pervasiveness of mental illness and substance abuse in our society continues to be disconcerting. In 2007, over 20 million individuals were diagnosed with substance dependence or abuse. However, less than 10 percent received treatment for their disorders. By some estimates, the societal health and economic costs of alcohol and drug abuse are estimated at $366 billion per year. Conversely, screening has an estimated net savings of $294 per person offered screening.

Extensive data documents that drug and alcohol addiction treatment is as effective as treatment for other chronic medical conditions such as cancer, diabetes, and heart disease. Substance addiction, like cancer, diabetes, and heart disease, is a preventable and treatable chronic disease. Likewise, mental illnesses are among the most expensive and disabling chronic diseases. Severe mental illnesses are estimated to cost the U.S. $193 billion in lost wages in 2002. The World Health Organization has pronounced mental health disorders to be the leading cause of disability in the U.S. based on burden of disease. Moreover, mental illnesses often accompany and greatly increase the cost of treating other chronic conditions. Tragically, individuals with serious mental illness have a life expectancy of 25 years less than general population.

Currently, mental health and substance abuse screening tools, such as Screening, Brief Intervention and Referral to Treatment (SBIRT or SBI), are being used effectively in many academic centers, hospitals, trauma centers and community health settings across the country. A cost assessment conducted of SBIRT in Washington State demonstrated a cost savings for the State of $2 million in Medicaid costs for just 1,000 patients. SBIRT is already effectively being used by the Federal Employees Health Benefits Program, and the Center for Medicare Services has also allocated approximately $300 million for states specifically for reimbursement of SBIRT. I look forward to continuing to work with my colleagues to ensure that this life-saving preventative strategy is included in the America's Affordable Health Choices Act of 2009.

Mr. Speaker, I want to commend my good friend and colleague, Chairman Ruben Hinojosa, for his work on this issue of adult illiteracy which he just spoke about.

Just like Ruben Hinojosa and his district in Texas, in my State of Rhode Island where unemployment rates continue to rise, 23 percent of the adult population in my district alone lacks a high school diploma. Last June when the National Commission on Adult Literacy released its report, it served as a wake-up call for all those concerned with the quality of our adult workforce. The commission found that 80 to 90 million adults in this country have deficiencies in basic education and that our investments in adult education and training were reaching less than 3 percent of those who need it. That's why we need to ensure that our adult education and workforce training programs have the tools and resources they need to prepare our workers for the next generation of jobs in energy, in health care and in technology. We need to improve the way we deliver adult education and workforce training programs and the way we provide career paths to higher growth fields through greater involvement with business leaders, State agencies and adult education community and workforce leaders. We need to better leverage employers to provide educational programs to their employees. We need to enhance the use of technology to improve quality learning access and delivery of adult education, literacy and workplace skills services.

The Adult Education and Economic Growth Act which Ruben Hinojosa and I are introducing will do all of these things in order to provide those employed and unemployed with the ability to attain the skills they need to compete in an ever-changing workplace.

I urge my colleagues to support this important legislation.

The Adult Education and Economic Growth (AEEG) Act of 2009

Mr. Speaker, today I rise in favor of the health care bill this Congress is considering. It would cap out-of-pocket expenses. It would eliminate preexisting condition discrimination. It would give patients a choice between our own physician and a government plan. It would eliminate lifetime caps for health care. It would eliminate the ability for people to no longer have the choice of having to choose a job and not be able to leave that job because of health care discrimination, no more denial because of a preexisting condition, and mental health parity for all insurance plans, irrespective of mental health preexisting condition.

Mr. Speaker, we need to have mental health screening annually covered, and that is what this bill does so that we treat it as a preventive item. For the 130 million Americans with mental health conditions, this will act as a preventive measure, saving us millions and millions of lives and dollars from suicide and the like.

Madam Speaker, I would like to thank you, Speaker Pelosi, for bringing to the floor of this House a piece of sweeping health care legislation, the likes of which we haven't seen in over 60 years since the Congress passed the Medicare legislation.

Madam Speaker, I want to thank you because it's about time the American people had an opportunity to have

health care for all, irrespective of preexisting conditions.

Madam Speaker, I want to thank you on behalf of the millions of Americans who suffer from mental illness because health insurance companies do not acknowledge that the brain is part of the body, that there is such a thing as alcoholism and addiction in this country.

Madam Speaker, thanks to your leadership, we passed the Paul Wellstone-Pete Domenici Mental Health and Addiction Equity Act last session, and thanks to your leadership with this legislation, there is no discrimination against those with mental illness. And in each and every one of the health care plans, there is absolute parity in health care coverage for those with mental illness.

Thank you, Madam Speaker, for this historic legislation.

Mr. Chair, on rollcall Nos. 556, 558, 559, 560 and 564, I was detained by a phone conversation with George Soros regarding the state/the U.S. economy and world economy and what would be done to rectify it.

Had I been present, I would have voted ``no.''

Amendment No. 13 Offered by Mr. Flake

Mr. Speaker, anyone ever heard the expression, ``the proof is in the pudding''? Well, when the private health insurance companies found out that there may not be a government option, you know what happened to the health insurance stocks on Wall Street? They went through the roof. Profits skyrocketed because, you know why? The health insurance companies make money off of the consumers when they don't have competition, when they're able to cut your health care and make profits out of denying you health insurance. That's how the private marketplace makes money, by denying you health care. They only want to cover the healthy and well.

We have the government option, the public option, to guarantee the American people that they get the health care that they paid for. * * *

We're on the side of the American people. We want to protect the people so that they can get their health care, irrespective of a preexisting health care condition.

I'm proud that this health care plan covers all preexisting conditions, including mental health parity as covered by the Mental Health Parity and Addiction Equity Act that was passed and signed by President Bush.

MR. GOHMERT. Mr. Speaker, the words were just said that the Republicans, pointing over here, are bought and paid for. I would ask that those words be taken down.

Mr. Speaker, I did not mean to impugn the reputation of any individual Member. I was merely speaking about the party that was representing the insurance companies.

I ask unanimous consent to withdraw the words.