Floor Statements

Madam Speaker, I rise today to congratulate Al and Valerie Bishop who are being recognized by the Friends of St. Nick organization in Norwood, Massachusetts, for their generosity in helping those in need for over 25 years. The Bishops' planes have been on call 24/7 to assist with organ transplants and charitable flights that would not have been possible otherwise.

Norwood is not in the Second Congressional District, but I feel I must add my congratulations to this fine couple, as their good deeds certainly affect people throughout the Commonwealth of Massachusetts. In May of 2007, Carol and Vincent Pietroniro of Feeding Hills, Massachusetts, were trying to help their terminally ill son Michael find a way to realize one of his lifelong wishes--to come to Washington, DC, and see the White House. When contacted about this special request, Al and Valerie Bishop did not hesitate; they supplied the private jet and pilots for Michael and his parents, as well as for 3 physicians and an ICU nurse to make the trip.

Needless to say, the trip was so special for young Michael. Sadly, Michael passed away a few short weeks later. I know that the kindness and generosity of Al and Valerie Bishop will forever be in the hearts and minds of Michael's parents, family and friends. Knowing that their son did get to realize his dream is so comforting to both them.

I.commend the Friends of St. Nick on selecting Al and Valerie Bishop as their Couple of the Year for 2009, and I add my congratulations, best wishes and appreciation for all that they do.

Mr. Speaker, I rise in support of this Medicare Physician Payment Reform Act, and remind our friends on the other side that this is similar to the 2-minute drill. We do this every year. It's like the 2-minute warning in professional football. H.R. 3961 is about preserving patient choice, which is a fundamental element of our health care system, and very important to the reform measure that we passed about a week ago.

This legislation will ensure that seniors on Medicare and TRICARE across America continue to have access to care and to the physician of their choice. But conversely, this bill also provides physicians with the certainty they need and have been missing to operate their offices in a predictable way and to continue to serve Medicare patients.

It eliminates the steep payment cut scheduled for next year, a cut that, if it were allowed to happen, could reduce physician access across the country. H.R. 3961 is a good piece of legislative work. It increases payments to primary care providers for office visits, and it encourages the formation of accountable health care organizations. It goes a long way in preserving the vital patient-doctor trust contract and to strengthening that relationship.

I urge support of this legislation.

Thank you, Chairman Rangel.

Mr. Speaker, let me stand in support of this health care bill today. Reforming this health care system has not been easy, but we come here today after deliberating for countless years, weeks, months--and as recently as this morning more hours added--because we are building a baseline of health care for the American family.

We've worked hard to reform this health care system because, if we do nothing, family premiums will increase $1,800 a year; and by 2020, 61 million Americans will be uninsured. We have analyzed, and we have debated the details of the bill line by line and section by section.

To the critics, yes, we've read the bill.

For all of the misinformation that has surrounded this legislation, there is a great deal that we all here today agree upon: this bill ends discrimination based on preexisting medical conditions; it limits out- of-pocket expenses for families; it bans lifetime limits on health care coverage that a family with a critically ill child can bump up against in no time at all.

Limiting out-of-pocket expenses is something we do all agree on. Half the bankruptcies in America are health care-related. This bill removes the uncertainties of our health care system for families and for businesses, for young adults who are no longer eligible for their parents' insurance coverage, and for senior citizens in the Medicare part D doughnut hole. This is a solid piece of legislation.

As I close, remember the party that stood with Social Security, and remember the party that stood with Medicare as we proceed to this vote this evening.

Mr. Speaker, I thank the gentleman, and I want to offer my strong support for this legislation that is before us today and certainly to acknowledge the role that Mr. Rangel and Mr. McDermott played and the leadership they offered to us on this legislation.

This bill before us is fully vetted and fully paid for. It is bipartisan in nature. I take great satisfaction from the fact that not only does it extend unemployment insurance benefits for many families that need help in this difficult economy, but the reminder that we all ought to embrace, and that is, that in this atmosphere, you are far better off as being perceived for being for something than against everything.

This bill extends the first-time homebuyer credit to help our ailing housing industry get back from the worst record in our history. I support both provisions.

Finally, the bill provides net operating loss relief for many businesses that have been simply hanging on in this country over the last year. It is particularly important to retailers. Based on a bill that I filed with Representative Tiberi which became the basis for this provision, this relief for businesses, big and small, will provide quick capital at a time when it is currently impossible to find. I think that this is an affirmative position, it ought to be embraced, and I thank Mr. McDermott for moving it forward.

Madam Speaker, I rise today to introduce the Supporting Colorectal Examination and Education Now (SCREEN) Act. This legislation will remove barriers to one of the most effective preventive health screenings available, saving lives and reducing health care costs in the process. I

urge all of my colleagues to support this important legislation.

Background

The statistics surrounding colon cancer are startling. Colon cancer is the number two cancer killer in the United States. Nearly 50,000 people will die this year from this disease. According to the American Cancer Society (2009 Fact & Figures), of the nearly 50,000 people expected to die from colorectal cancer in 2009, early detection could save more than half. These statistics alone are a tragedy.

But the statistics become even more tragic when one considers that colorectal cancer is highly preventable with appropriate screening. And the disease is detectable, treatable, and curable if found early. According to the American Cancer Society (2009 Facts & Figures), the 5 year survival rate is 90 percent for those diagnosed at an early stage; however, only 40 percent of the cases are diagnosed at the stage.

The U.S. Preventive Services Task Force (USPSTF) recognizes the preventable nature of this disease and provides its only grade `A' recommendation of cancer screenings for colorectal cancer screens.

Unfortunately, almost half of the Medicare population is not being screened, despite the availability of a Medicare colon cancer screening benefit. According to CMS, Medicare claims indicate that only 52 percent of beneficiaries have had a colorectal cancer test and there is ``clearly an opportunity to improve colorectal cancer screening rates in the Medicare population.'' (CMS website ``overview of colorectal cancer screening'')

Numerous barriers account for this fact, including structural issues in the Medicare program, significant Medicare cuts to providers, and lack of knowledge and preparation among patients.

The SCREEN Act

The SCREEN Act is designed to address these barriers and increase the participation of patients in this preventive service. The bill accomplishes this is several main ways.

Reducing Patient Barriers

First, the bill would reduce patient barriers to being screened. The legislation would waive Medicare co-insurance for diagnostic and screening colorectal cancer tests in order to increase utilization.

In addition, the bill would provide coverage for a pre-operative visit with a physician prior to a screening colonoscopy. This is the standard of care, but is not currently covered by Medicare.

Finally, under the legislation all Medicare beneficiaries will be notified about the Medicare colorectal cancer screening benefit and reminded of the benefits periodically.

These common sense steps will ensure that more patients are screened and more lives are saved.

Provider Quality and Accessibility

We must also ensure that there are adequate numbers of high-quality physicians performing colonoscopies. The legislation reverses years of provider reimbursement cuts by creating a preventive services payment modifier for colorectal cancer screens that is adequate to incentivize physicians to perform colorectal cancer screens. It would base this incentive on a national colorectal cancer screening goal established by the Secretary of the Department of Health and Human Services.

The bill would also require the Secretary to establish a national minimum standard for basic knowledge, training, continuing education and documentation for physicians and facilities. A physician would not be permitted to receive the preventive services modifier if he or she did not meet this standard.

State Interventions to Increase Screening

The legislation would also support state-level interventions to increase colorectal cancer screening. The legislation authorizes grants to states for colorectal cancer programs that include: screening to high risk individuals; case management and referrals for treatment; follow up and care for individuals screened; health professional education, training, and skills; and public information and education programs.

Information on What Works

Finally, the legislation gathers information on best practices in incentivizing colorectal cancer screening. The bill requires reporting on screening rates and interventions in Medicare Advantage and commissions a study by the Secretary of HHS on levels of coinsurance for screening tests under private plans.

Conclusion

More than 50,000 Americans will die from colon cancer this year alone. Ninety percent of these cases might have been prevented. We cannot afford to wait another moment before doing something to eliminate these and other barriers that are standing in the way of preventing colon cancer.

Therefore, I urge all of my colleagues to co-sponsor the Supporting Colorectal Examination and Education Now (SCREEN) Act and support its passage this year.

Madam Speaker, today I am pleased to come before the House to introduce legislation ending the use of excessive affiliate reinsurance by foreign insurance groups to strip their U.S. income into tax havens, avoid tax, and gain a competitive advantage over American companies. In the past, I have offered a number of bills to limit offshore tax avoidance. Today's bill follows on that trend but focuses specifically on one area of the financial services sector.

The financial services industry has, like all us, experienced a tough year with the economic upheaval. As businesses realign, merge, and in some cases, cease operations, the advantages of a no- or low-tax jurisdiction from which to operate is tempting. The benefits of being headquartered in a tax haven can be quite significant for a company with investment income over long periods of time. Use of affiliate reinsurance allows foreign-based companies to shift their U.S. reserves and their investment income overseas into tax havens, thereby avoiding U.S. tax.

The President has recently suggested a number of proposals tightening tax rules for U.S.-based companies operating overseas. Those proposals deserve a thorough review to assess their merits. But before we consider cracking down on the foreign earnings of U.S. companies, we should make sure we are taxing the earnings of foreign groups that do business in the United States the same way we do for those based here. Ending the tax advantage for foreign-based insurance groups from use of affiliate reinsurance was even a platform issue for candidate Obama last year.

There is no doubt that there is a legitimate role for reinsurance. It is a fundamental business technique for risk management and is to be fostered. However, reinsurance among affiliates can serve other purposes as well, including tax avoidance. Just as Congress and Treasury have attempted to measure what is legitimate in debt transactions between affiliates, there have been previous attempts to address the problem of excessive reinsurance between related entities. Unfortunately, as recent data shows, those attempts have been unsuccessful.

Since 1996, the amount of reinsurance sent to offshore affiliates has grown dramatically,

from a total of $4 billion ceded in 1996 to $33 billion in 2008, including nearly $21 billion to Bermuda affiliates and over $7 billion to Swiss affiliates. Use of this affiliate reinsurance provides foreign insurance groups a significant market advantage over U.S. companies in writing direct insurance here in the U.S. We have seen in the last decade a doubling in the growth of market share of direct premiums written by groups domiciled outside the U.S., from 5.1 percent to 10.9 percent, representing $54 billion in direct premiums written in 2006. Again, Bermuda-based companies represent the bulk of this growth, rising from 0.1 percent to 4 percent. And it should be noted that during this time, the percentage of premiums ceded to affiliates of non-U.S. based companies has grown from 13 percent to 67 percent. Bermuda is not the only jurisdiction favorable for reinsurance. In fact last year, one company moved from the Cayman Islands to Switzerland citing ``the security of a network of tax treaties,'' among other benefits.

Congress first recognized the problem of excessive reinsurance in 1984 and provided specific authority to Treasury under Section 845 of the tax code to reallocate items and make adjustments in reinsurance transactions in order to prevent tax avoidance or evasion. In 2003, the Treasury Department testified before Congress that the existing mechanisms were not sufficient. In 2004, Congress amended this provision to expand the authority of Treasury to not only reallocate among the parties to a reinsurance agreement but also to recharacterize items within or related to the agreement. Congress specifically cited the concern that these reinsurance transactions were being used inappropriately among U.S. and foreign related parties for tax evasion. Despite this grant of expanded authority, Treasury has still been unable to stem the tide moving offshore.

Recently, a coalition of U.S.-based insurance and reinsurance companies has been formed to express their concerns to Congress. With more than 150,000 employees and a trillion dollars in assets here in the U.S., I believe it is a message of concern that we should heed. Last month, they wrote to the leadership of the House and Senate tax- writing committees urging passage of my bill because, as they wrote, ``This loophole provides foreign-controlled insurers a significant tax advantage over their domestic competitors in attracting capital to write U.S. business.''

That is why I am again filing legislation to disallow deductions for excess reinsurance premiums with respect to U.S. risks paid to affiliated insurance companies that are not subject to U.S. tax. The excess amount will be determined by reference to an industry fraction, by line of business, which will measure the average amount of reinsurance sent to unrelated parties by U.S. companies. The bill allows foreign groups to avoid the deduction disallowance by electing to be treated as a U.S. taxpayer with respect to the income from affiliate reinsurance. Thus, the bill merely restores a level-playing field, treating U.S. insurers and foreign-based insurers alike. The legislation provides Treasury the authority to carry out or prevent the avoidance of the provisions of this bill.

My colleagues may be thinking that this sounds similar to another provision in the code, and they would be right. The tax code currently tries to limit the amount of earnings stripping--that is, sending U.S. profits offshore through inflated interest deductions--by disallowing the interest deduction over a certain threshold. In the reinsurance context, U.S. affiliates of foreign based reinsurance entities may be sending offshore excessive amounts of reinsurance to strip those premiums out of the purview of the U.S. tax system. My bill limits the deduction for those premiums to the extent the reinsurance to a related party exceeds the industry average.

I hope that in the coming weeks, my colleagues and experts in the industry will carefully review this new proposal and provide constructive commentary on it. A fuller technical explanation of the bill will be posted on my website, which will provide some background on the industry as well as a technical description of the bill. Madam Speaker, I appreciate the opportunity to address the House on this important matter and I assure my colleagues that I will continue my efforts to combat offshore tax avoidance, regardless of what industry is impacted.

Mr. Speaker, I want to thank Mr. Lewis for bringing this legislation to the floor. I am in full support of this proposal, and I want to speak additionally in support of the transfer of the Highway Trust Fund as it appears before us.

None of us would like to see pink slips issued around the country at vital road and bridge building projects, including about 4,000 jobs in Massachusetts. We are doing our best to create more of these jobs, not to end the current ones.

Last week, my subcommittee, the Select Revenue Measures Subcommittee, held a 4-hour, four-panel hearing on long-term financing options for the Highway Trust Fund. The consistent statement we heard was that States are desperate for funding.

We heard that roads and bridges are deteriorating at such a pace that current funding will not cover the maintenance, let alone the improvements that are needed. That is why our colleague, Mr. Oberstar, has pushed for a short-term patch while we continue to sort out the longer-term solutions for our transportation infrastructure. I am in support of the Oberstar position.

I understand the hesitance of some our colleagues to talk about increasing fund revenues in this economy. I want to assure you, they will be at every groundbreaking and they will be at every ribbon cutting, even though they question the financing we propose down the road.

But the reality of this situation is simple: we need to pay for these repairs. There were a variety of proposals discussed at our hearing, last week, good ones, by Republicans and Democrats. Good options were offered: tolls, vehicle miles traveled, excise taxes, the gas and diesel tax, among other ideas.

I want to say of interest, the United States Chamber of Commerce last week proposed a 10 cent increase in the gasoline tax for many of these long-term needs. I think that in and of itself speaks to the bipartisan nature of what we are trying to do now, and I hope in about another month a long-term proposal as well.

Now, whether these proposals are through triggers, indexing or commissions, we need to start working on the long-term plan in whatever politically feasible way we can find a way forward. Kicking the can down the road on infrastructure needs will not work. Our

highways, our roadways, our airports, our bridges and our railroads are all in need of an infusion of public support. We all ought to be able to agree on that basic responsibility as Members of this House.

As one witness told us last week, the costs of delaying the longer- term bill are higher than the costs to pass it. A reminder as well, there is an opportunity in this atmosphere with the downturn to get some great pricing, and we should take advantage of that as well.

So I want to urge support of this proposal today, and I hope it takes us on to a longer-term solution.

I thank the gentleman.

Mr. Speaker, I understand the desire of an individual or individuals to be professional scolds on any and every issue that comes to this floor. But the obligation that we have today is far greater than the examples that he cited.

To argue that we ought to hold up a Federal highway bill that benefits this entire Nation because of a handful of initiatives he doesn't like, the truth is he won't vote for the final bill anyway, and time and again we have rejected the proposals that he has come forward with, largely because there was a process and procedure for vetting these differences. And when we buy into the end-game solution, that is part of our responsibility as Members of Congress.

Let me close quickly on this note. One of the reasons that our highway system is the envy of the world is because we have not given in to the temptation to fall easy prey to demagoguery that surrounds some of these proposals. Scolding is one thing. Offering positive suggestions is quite another.

I want to commend Mr. Rangel and Mr. Waxman and Mr. Markey, who have attempted against long odds to forge a consensus on this legislation.

Mr. Speaker, the bottom line to this legislation as proposed today is it will make America less dependent on foreign oil. And, remember, despite protestations to the contrary from our friends on the other side, there is an element on the other side who rejects to this day the concept of climate change and global warming. It is very difficult to find middle ground if there's a side that simply rejects the science of our times. Part of our job in leadership in governing is to make some difficult decisions and, indeed, some very tough choices. This climate- change bill we have before us today makes those tough choices for our future and our children's future. It's in the interest of America, but just as importantly, it's in the interest of the world. America leads the way, and this is an opportunity for us to reclaim that leadership.

This legislation will lead our consumers, our businesses, and our communities towards smarter, cleaner, and more efficient energy use. And it will not be alone. Strong trade enforcement mechanisms will mean that the American business community will not be disadvantaged by importers who skirt the rules. This long legislation is a vote for innovation and environmental stewardship.

I almost would be remiss if I didn't mention this as well. For the previous 8 years, the administration rejected the idea of global warming. The other side was given fancy talking points to grudgingly acknowledge that perhaps it might be happening but to spin the argument that it presented a peril to our times. You would be hard pressed to find scientists anywhere across this globe who have not at least forged a consensus on identifying and defining the problem. As is always the case in public life, it is difficult once definition has settled in to offer a solution. This legislation today offers a solution.

Madam Speaker, I rise today to introduce a resolution that affects families across America. This resolution expresses support for the designation of a ``National Hereditary Hemorrhagic Telangiectasia, HHT, Month'' as well as other efforts to increase public awareness of the disease. Hereditary Hemorrhagic Telangiectasia (HHT) is complex genetic disorder of the blood vessels affecting approximately 70,000 Americans. It is characterized by malformations that occur in major organs, including the lungs, brain, and liver. If left untreated, it can lead to chronic health problems or even sudden death due to the rupture of blood vessels in major organs.

Unfortunately, due to a widespread lack of knowledge of the disorder, approximately 90 percent of Americans suffering from HHT currently remain undiagnosed. These people are at risk of sudden death or becoming disabled. However, tests exist for the early detection and diagnosis of HHT and certain treatments are available for those suffering from the disease. It is estimated that between 20 and 40 percent of deaths and disabilities resulting from HHT would have been preventable if the condition had been diagnosed.

This resolution aims to reduce future HHT-related deaths and disabilities. The HHT Foundation International's designation of a ``National Hereditary Hemorrhagic Telangiectasia, HHT, Month'' and other efforts to educate the public should increase public awareness of the disease, leading to more HHT testing and fewer instances of undiagnosed HHT. Additionally, support for further research will improve outcomes, reduce costs, and increase the quality of life for those living with HHT, while also searching for a cure for the disorder.

This important bill will decrease the suffering of families affected by this devastating disease. It is my goal to improve the quality of life of the approximately 70,000 Americans suffering from HHT. I urge my colleagues to support this resolution to make the public aware of this national health problem.

Madam Speaker, I rise today to introduce The Defined Contribution Plan Fee Transparency Act of 2009. During the last Congress, we expected some guidance from the Department of Labor on the issue of fee transparency, but not much was

finally implemented. Therefore, I believe that Congressional action is warranted and this bill provides a strong disclosure requirement to benefit both workers and companies in understanding fees.

A few years ago, AARP conducted a survey of 401(k) participants to find out what they knew about the fees paid by their plans. Plan fees can make a huge difference in your account balance. As the Department of Labor has pointed out in a helpful guide on the issue, ``Fees and expenses paid by your plan may substantially reduce the growth in your account.'' Literally, it pays to know what these expenses are. What the AARP found in their survey is instructive: 83 percent of participants acknowledged they do not know how much they pay in fees or expenses. Considering the number of people who have told me they do not dare to even open their 401(k) statement in this devalued market, that percentage may have increased even more!

But fees are a serious issue and one which participants need to understand from the outset. The House Education and Labor Committee has held several hearings to highlight this issue over the past 18 months, and I commend the Committee Chairman, Mr. Miller, for his leadership and thoughtful ideas about how to address fair disclosure.

The growth in defined contribution plans offers great opportunities for workers, with alternatives and options they did not have before. Many workers, however, are simply overwhelmed with the information distributed and, because of that, may not be able to utilize these opportunities. Certainly, more disclosure is preferred. But, as AARP found out, the need to better understand this information means it must be in an easily digestible format and in plain English.

The legislation I am filing today, which updates the bill I filed last Congress, would provide for disclosure both to the worker and to the employer. Participants, or workers, would get both an enrollment notice up-front and a quarterly notice updating them on their account. At enrollment, the bill requires that for each of the plan's investment alternatives, the employer would have to disclose the alternative's objective and investment manager, its risk and return characteristics and its historic rates of return in comparison to a benchmark. In addition, the employer must indicate whether the alternative is passively managed, as with an index fund, or actively managed, plus the differences between these two investment styles and whether or not the alternative is a single-alternative investment solution, such as a lifecycle or target retirement date fund.

Regarding fees, the bill requires employers to disclose to employees at enrollment the annual operating expenses for each investment alternative (together with a translation of these asset-based fees into illustrative dollar amounts), whether such fees pay for services beyond investment management, such as plan administration, and whether there are additional charges for buying or selling the particular alternative, such as redemption fees. In addition, participants must be provided with information about any separate fees they will be charged for plan administration as well as a notice that certain plan services they may decide to use could have separate charges associated with them, such as investment advice programs, brokerage windows, or plan loans. Accompanying these disclosures would be a statement that participants should not select investments based solely on fees but based on careful consideration of a range of factors including the alternatives' risk level, returns and investment objectives. The bill requires this information about plan investments to be provided to employees annually as well.

In addition to this enrollment notice, each quarter, participants would receive information about the investments they had selected and the fees applicable to their accounts. This quarterly notice would describe which investment alternatives the individual participant was invested in, what percentage of the participant's total account each alternative represented, the risk and return characteristics of each such alternative and whether such alternatives were passively or actively managed. The statement would also summarize for participants what asset classes their account is invested in, with percentage breakdowns. On fees, the quarterly notice must describe the annual operating expenses (with dollar examples) and any sales charges for the alternatives the participant has selected, any separate charges for plan administration and any deductions for participant-initiated services. In addition, to assist employees who may want to make investment changes, the notice must tell participants how to access investment characteristic and fee information for alternatives in which they are not invested.

My bill also requires service providers to disclose to employers various fee and expense information in advance of a contract. This will ensure that employers have the information they need to bargain effectively with plan service providers and to keep costs at reasonable levels for participants.

Providers must give the employer an estimate of total fees, a detailed and itemized list of all the services to be provided under the contract and a schedule of any transaction charges that participants may face. Providers that offer multiple bundled services must separate the fees charged under the contract into fees for investment management and fees for administration and recordkeeping and must also disclose fees paid to intermediaries or other third-parties. Providers must also disclose whether they expect to receive payments from third-parties in connection with providing services to the plan, also referred to as revenue-sharing, and if so, must name those parties and the amount expected to be received from each. This revenue-sharing information is critical so that employers understand how their providers are being paid and whether any such financial relationships give rise to potential conflicts of interest. Providers will likewise have to disclose whether they may benefit from the offering of proprietary investment products or those of third parties and must tell employers if the investment products offered to the plan are available at other price levels. Plan service providers must also provide this detailed disclosure statement to employers every year the contract is in place and prior to any material modification of the contract. In addition, employers must make such statements available to plan participants upon written request so that those employees who want to delve into the details of the plan's financing can do so.

The Department of Labor's guide on 401(k) fees states that fees and expenses generally fall into three categories: plan administration, investment, and individual services fees. By requiring all service providers, whether they just provide recordkeeping or if they perform it all, to disclose fees in broad categories, such as these, companies and employees can better evaluate what they are getting for what price they pay. It is my understanding that some service providers are already disclosing more than what is required. I hope that we can capture those ``best practices'' and implement them across the board so that all workers and employers have the best data available.

Additionally, my bill would apply not only to 401(k) plans, but to all tax-preferred, participant-directed defined contribution plans, including 403(b) plans and governmental 457(b) plans. The amendments contained in the bill are all within the Internal Revenue Code, and therefore, penalties for not complying will be taxes assessed per violation per day, subject to a cap. The bill is forward-thinking, pushing electronic delivery as much as possible. I hope to work with the Chairman of the Ways and Means Committee, Mr. Rangel, to address this issue within the Committee very soon as I know he shares my concern that the taxpayers' interests be protected.

Despite the fact that 8 in 10 participants do not know what fees are charged, there is some good news out there too. According to a survey released in April by Deloitte, the International Foundation of Employee Benefit Plans, and the International Society of Certified Employee Benefit specialists, the average expense ratio for plan investments was down from the prior survey period. Clearly, the attention to fees is having some impact resulting in lower costs.

It is my hope that this bill will provide much more information about plan fees and expenses in a useful way without overwhelming recipients. I urge my colleagues to join me in this effort.

Madam Speaker, today I am pleased to introduce legislation to help millions of American workers keep their jobs in this difficult economy. This bill provides a simple change in the rules for businesses with net operating losses. Already, businesses can carry these losses back or forward to offset taxes paid in more profitable years. This provision helps businesses smooth out the inevitable ups and downs of our economy.

You would be hard pressed to find an economist now that would say the recession we are currently in is not one of the worst on record. In fact, almost all the economic data we can gather shows it is as bad as it has been since the Great Depression. Congress has already responded with the American Recovery and Reinvestment Act earlier this year, which did include a provision for businesses to carry back losses incurred in 2008 and 2009 for 5 years, instead of 2. However, at the last minute, this legislation was limited only to small businesses.

I support broad and general net operating loss relief and am filing legislation today to do so. I am pleased to be joined in this effort by my friend and Ways and Means colleague, Mr. Tiberi from Ohio. Our bill is based on the budget proposal made by President Obama just this week. While the Administration has indicated the legislation the President supports is that which earlier passed in the Senate, officials have also said they do not support limits of certain industries to claim this relief from operating losses. I believe that is the right approach, but until we have clear guidance from the Administration, the bill I am filing today mirrors that which was filed in the Senate.

Just this week, I was visited by one business that did not qualify under the stimulus bill--Brookstone. Any traveler will be happy to share with you their favorite Brookstone product--talking alarm clocks or compact hair dryers. Their stores are in most major airports now. But this 45-year old company, founded in my home State of Massachusetts, had a loss last year for the first time in the company's history. That loss impacts not only the bottom line, but its ability to restock inventory, and its ability to borrow money based on inventory. For many American businesses, like Brookstone, net operating loss relief can be a life-line to help a struggling business through a historic economic downturn.

With consumer confidence at its lowest level ever, retailers across the country have been hurting. Retailers lost 535,000 jobs last year and 2009 is sure to rival that number. And the bad news just keeps on coming. Today, about 2,000 auto dealerships around the country will be eliminated. That's about 60 jobs at each dealership, averaging $50,000 a year for those workers. These are difficult times for American businesses, and we can offer a life-line with this bill. I hope my colleagues will join us in this effort to provide modest relief through a simple accounting change for businesses with true operating losses.

Madam Speaker, I rise today to introduce the Medicare Ambulance Access Preservation Act. This bill would ensure that my constituents in Massachusetts, and people across the country, continue to have access to ambulance services. Ambulance service providers are a critical part of our country's first responder and health care systems. In fact, as we discuss how to reform our health care system I can think of nothing more fundamental than ensuring that people have access to life-saving emergency ambulance care.

We all know the importance of ambulance services. Many of us see them every day transporting ill or injured individuals to the hospital. Some of us have even been transported and received pre-hospital care in an ambulance. Dedicated, skilled professionals work in these ambulances, ensuring that patients receive the care they need and ensuring that communities are prepared in the case of a disaster. The need to ensure the availability of these services is clear. Yet, Medicare reimbursement policy has harmed rather than helped to reach this goal.

Under the Balanced Budget Act of 1997, Congress authorized the Centers for Medicare and Medicaid Services (CMS) to develop a Medicare ambulance fee schedule. The rates developed under the fee schedule were significantly below what it cost many providers in Massachusetts to deliver services. In May 2007, the Government Accountability Office (GAO) confirmed this problem by determining that Medicare reimburses ambulance service providers on average 6 percent below their costs and 17 percent below cost in ``super rural'' areas. Ambulance providers aren't even breaking even in Medicare--Medicare reimburses ambulance providers below their costs for every person they transport.

Congress has recognized this shortfall and included temporary Medicare ambulance relief provisions in both the Medicare Modernization Act (MMA) and the Medicare Improvements for Patients and Providers Act (MIPPA). However, all of these provisions expire at the end of 2009. To address this problem, I have worked with ambulance service providers in my state to develop a permanent Medicare relief package.

My legislation would increase reimbursement to rural and urban ambulance suppliers by 6 percent, and super rural providers by 17 percent. These numbers are consistent with the GAO report. This package will ensure not only continued availability of ambulance services, but also that ambulance service providers will be able to maintain standards of providing quality health care to patients.

As we address health care reform, we must begin by remembering the basics. Ambulance services are a fundamental part of our health care system. Congress must ensure that all Americans continue to have access to ambulance services and that the dedicated men and women who provide ambulance services have the tools and resources they need to serve patients when timely, expert medical care is needed most. I ask my colleagues to join me in this effort by cosponsoring this important legislation.

Madam Speaker, I rise today to introduce legislation that will end practices that obstruct women from attaining affordable insurance policies on the individual market. The Women's Health Insurance Act of 2009 would end discrimination against those women looking for health coverage who either do not have access to an employee-sponsored plan or those who earn too much money to qualify for Medicaid. Recent findings from the Kaiser Family Foundation have shown that 5.7 million American women in 2007 received health insurance on the individual market. During this difficult economic climate and with unemployment rising, it is becoming much more likely that more women will be looking for health coverage through individual insurance markets.

Unfortunately it is common practice in the individual market today to charge women higher premiums than men for the identical coverage. Individual market insurers also can limit coverage due to pregnancy or delivery methods. This is because individual market insurers have the ability to deny coverage based on a ``pre-existing condition.'' For instance, a woman who has had a Cesarean section in the past can currently be charged a higher premium, imposed a waiting period, or denied coverage until she has been sterilized or can no longer bear children. The vast majority of these policies also do not provide coverage for maternity care. These conditions exist today because there is no federal protection to stop these practices on policies sold in the individual market.

Due to the aforementioned problems, the Women's Health Insurance Fairness Act of 2009 is that much more important. This legislation will prevent insurers in the individual market from charging women higher premiums than men. The current practice is gender discrimination and should not be accepted in today's system. This gender rating harms women by not only inflating premiums, but by

blocking women financially from obtaining proper health care coverage. Furthermore, this act will prevent insurers in the individual market from either denying or limiting coverage based on a current or past pregnancy as well as method of delivery. This bill will eliminate the insurers from punishing women who are either pregnant or have been in the past. The bill will also require individual market insurers to provide comprehensive maternity coverage. This legislation will not only save the insurer money, but I believe it will improve the health outcomes of both the mother and the child.

To ensure that individual market insurers enforce these regulations, this bill will provide the Secretary of Health and Human Services with the authority to monitor compliance with this act. The Secretary will be able to assess fines of at least $10,000 against any health insurance company that fails to submit the required data. The act will also require the Government Accountability Office to issue a report by December 31, 2010. This report will address any remaining problems for women on the individual insurance market throughout the entire country.

This bill will grant more women access to affordable health insurance that will meet their health needs. No longer will women be punished for their gender. I urge my colleagues to support my legislation to prevent this type of gender discrimination in the health insurance market.

Madam Speaker, I rise today to celebrate the 125th Anniversary of the Sisters of St. Joseph. I would like to share some local history as provided by the Springfield Diocese.

The Sisters of St. Joseph of Springfield were founded in 1883 following a request by the pastor of St. Patrick's in Chicopee Falls. He needed help starting a parish school and so seven sisters from the New York Congregation moved to the Springfield Area. The small community grew slowly but steadily while educating poor immigrant children in central and western Massachusetts and Rhode Island.

By the mid 1960s, the ranks of the Springfield Congregation swelled to over one thousand women. The group had founded or staffed sixty schools and had established the Elms College.

Following the Second Vatican Council, the Sisters restructured their community life. Many moved out of convents and into small houses and apartments in local towns and cities. Their ministries expanded as well. No longer limited to schools, the Sisters worked in prisons, parishes, homeless shelters and other social services.

In the mid 1970s, the Sisters of St. Joseph of Fall River merged with the Springfield Congregation. In 2001, the Sisters of St. Joseph of Rutland, Vermont joined the community which also covers Worcester, the Berkshires, Rhode Island and even Louisiana and Uganda. Today, the Springfield Congregation of about 300 Sisters continues to serve the people of God through a variety of Ministries.

Today we salute the Sisters of St. Joseph for 125 years of ministry as educations, pastoral ministers, innovators, evangelizers and social justice ministers. We thank the Sisters for their loving service to our communities. The Sisters of Saint Joseph have provided quality, values- based Catholic education to countless students and we are grateful for their immeasurable impact.

Madam Speaker, I would like to acknowledge Martin J. and Eleanor R. Kearney for being named the Irish Couple of the Year by the John Boyle O'Reilly Club in Springfield, Massachusetts. They were awarded this deserved title on February 7, 2009 for their support and contributions to the club. The couple has been active with the club for over fifty years. Both have helped with fundraisers and dances. Eleanor is an avid baker for the club and Martin was a strong supporter of the new building fund. A reception dinner was held in their honor on March 1, 2009.

Martin was born in the Great Blaskett Islands in Dingle, County Kerry, Ireland on December 31, 1926. Eleanor is a life-long Springfield resident who was born on December 17, 1932. Martin came to America in 1951 where he soon met Eleanor. In 1953, they were married in Saint Thomas Aquinas Church in Springfield. Martin became a member of the John Boyle O'Reilly Club in 1953 and now both Martin and Eleanor are life members.

The John Boyle O'Reilly Club was founded in 1880. The club consists of dedicated Irish and Irish-Americans whose goal is to preserve and promote their Irish heritage. The club's motto is culture, family and tradition. Since March 1970, the club has been located on 33 Progress Avenue in Springfield, Massachusetts. Today, the club is very active in their community, awarding the John Boyle O'Reilly Scholarship every year to college-bound students.