Floor Statements

Mr. Speaker, I thank the gentleman for yielding me this time.

Mr. Speaker, the legislation before us today solves no problems. In fact, it just maintains the great uncertainty hanging over the U.S. and the global economy--whether or not we're going to jeopardize the full faith and credit of the United States of America and default on our Nation's financial obligations for the first time in our Nation's history. I do not for the life of me understand why anyone would jeopardize that safe haven that's been established in this country.

But we all know what needs to be done to get our fiscal house in order. Both parties are going to have to lock arms and jump into the icy water and make difficult decisions together. Every bipartisan commission that has been formed to address this issue has come up with the same conclusion. There's going to have to be some additional revenue, and there's going to have to be major spending reforms in our budget to make this work.

But my friends on the other side have not been exactly up front with the American people. They've finished two national campaigns promising to restore $700 billion to the Medicare program and increase defense spending by over $2 trillion over the next 10 years. That's $2.7 trillion additional dollars in the two largest spending programs. So we do need an honest conversation about this.

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

Madam Speaker, I rise in strong support of H.R. 1845. It's a combination of two strong, bipartisan commonsense bills before the House today. I want to thank the gentleman on the Ways and Means Committee, Mr. Brady, for his support of this important legislation.

As one of the coauthors of the SMART Act, one of the bills that have been combined today, with Representative Tim Murphy, and as an original cosponsor of the Medicare IVIG Access Act, I'm glad these two bipartisan bills have been combined and brought to the floor for consideration and hopefully passage later today.

The SMART Act had 139 bipartisan cosponsors; the Medicare IVIG Access Act, with 65 bipartisan cosponsors, are perfect examples of, at times, Democrats and Republicans joining forces and getting something done around this place. And hopefully that spirit will continue in the days to come with the difficult decisions that face this body.

I would like to thank my good friend Tim Murphy for his leadership and hard work in moving the SMART Act through the Energy and Commerce Committee. I'd also like to recognize the extraordinary, broad stakeholder coalition that has worked so hard to help get the SMART Act on the floor today, particularly the American Association For Justice and the MARC Coalition.

Finally, I want to thank Representative Brady and Doris Matsui for their tireless efforts on behalf of the Medicare IVIG Access Act. Their legislation is a step toward ensuring all seniors with primary immunodeficiency diseases are able to access life-saving IVIG drugs in their own home.

But let me just take a few minutes to discuss the need for the SMART Act. The SMART Act reforms the badly broken Medicare secondary payer system. For background, the Medicare secondary payer system requires Medicare to recoup the cost of hospital and doctor bills for a senior if her injuries are the responsibility of a private insurer or some other third party. So far so good. Making sure Medicare doesn't pay for injuries caused by another third party is good policy to help keep Medicare solvent.

The problem is that under the current system, seniors and parties that want to settle a claim often cannot determine how much they owe Medicare. That often results in the settlements collapsing. The result is that seniors are denied settlements to compensate for their injuries, and the Medicare trust fund is never reimbursed. That's bad for seniors, and it's bad for the Medicare program. We're talking about cases where seniors are trying to give money back to the government and the government simply won't say how much they owe it. It's outrageous that seniors can't even give money back to Medicare that the government is owed because the system is broken down.

At a time when Congress is considering cuts to the Medicare benefits and provider payments, we need to at least make sure that Medicare is getting the money seniors want to send it.

The SMART Act will improve the Medicare secondary payer system by making the government work more efficiently, reducing unnecessary burdens and waste, and speeding the repayment of amounts owed to the Medicare trust fund. The best way to demonstrate the need for the legislation is with a few examples of the current system's unfairness and outright absurdity.

I have a handful of demand letters here sent by CMS to seniors asking to be repaid $1.59, or $2.81, or $4.82, or even $36.75. Those amounts CMS has sought to recoup from seniors is far less than the amount it actually costs CMS to pursue these claims. That's penny wise and a pound foolish.

The SMART Act makes sure CMS is only pursuing Medicare secondary payment claims that will recoup at least the cost that it takes CMS to pursue these claims. That's commonsense reform.

This bill makes financial sense for Medicare, but it will also make a meaningful difference for seniors who are awaiting settlements that are held up by Medicare's process today.

In fact, I heard the story of one gentleman who fell on a retailer's handicapped ramp while using a walker. Now, Mr. Law cut his left hand; he hit his head on the fence alongside the ramp. He and the retailer discussed the medical charges, and they agreed to settle for $2,000.

It took 18 months and eight written exchanges with CMS to resolve this simple MSP claim, which delayed settlement of the claim by the same 18 months. Plus, Mr. Law actually passed away during the extended timeframe.

We can do better for seniors. We can get Medicare the money it's owed a lot faster. This legislation would accomplish that.

These are just a few of the examples of why the SMART Act is needed. The toll this broken system takes on seniors and the burden it imposes on businesses is unacceptable.

I urge my colleagues to vote for H.R. 1845 to support this commonsense reform, including the IVIG program.

And, Madam Speaker, since this may be the last time I'll have a chance to address you in the chair, I too want to echo the sentiments of so many of our colleagues, to congratulate you on such a distinguished career here in the House.

You did well in representing your constituents back home in Missouri. We'll miss you as a colleague, someone who tried hard to work on finding bipartisan, commonsense solutions to the challenges facing our Nation. And, of course, we wish you all the best in your future endeavors.

I reserve the balance of my time.

Madam Speaker, I want to thank my good friend, the gentleman from California, for his support of H.R. 1845, in particular, the SMART Act, and congratulate him, as well, on his distinguished career since he will be retiring at the end of this session of Congress as well.

At this time I yield as much time as she may consume to the gentlewoman from California (Ms. Matsui), the principal author of the Medicare IVIG Act.

I yield such time as he may consume to my very good friend, the gentleman from New Jersey, one of the leaders in the Energy and Commerce Committee, Mr. Pallone.

I have no further speakers. I encourage my colleagues to support H.R. 1845, and I yield back the balance of my time.

Mr. Speaker, I rise in strong support of H.R. 6582, the American Energy Manufacturing Technical Corrections Act as it provides technical corrections and regulatory certainty to a number of domestic manufacturers. The legislation, which I am proud to cosponsor, has bi- partisan and bi-cameral support, not to mention the support of manufacturers and the NGO community. More specifically I would like to thank Chairman Whitfield and Mr. Aderholt for including H.R. 482, the Water Heater Rating Improvement Act of 2011, or Section 3 of the underlying bill, that will fix a regulatory problem related to the test methodology that the Department of Energy uses to calculate the efficiency levels of water heaters, which the Department has acknowledged is broken. The legislation will also level the playing field for domestic water heater manufacturers vs. foreign manufacturers and provide the necessary regulatory and business certainty that domestic water heater manufacturers have been calling for over four years. This will also lead to significant energy saved by highly efficient U.S. produced water heaters, many of which were designed in my home state of Wisconsin. In addition, Mr. Speaker, the legislation has the potential of adding up to 1,000 jobs in domestic water heater factories, one of which is in Wisconsin, and thousands of more indirect jobs associated with the manufacturers supply chain.

Finally Mr. Speaker, I'd again like to thank Chairman Whitfield and Mr. Waxman for their hard work on the bill and steering an accommodative process, and Mr. Aderholt and Mr. Carnahan for their leadership on the legislation.

I thank the gentleman for yielding me this time.

I want to first commend the chairman and the ranking member of the Ways and Means Committee, Mr. Camp and Mr. Levin, for the work they did in getting this legislation to the floor.

I rise in strong support of extending permanent normal trade relations with Russia and Moldova. I also want to commend the chair and the ranking member of the subcommittee, Mr. Brady and Mr. McDermott, for the work that they've done, as well as a gentleman who's not on the floor today--we're going to miss his leadership, he's retiring at the end of this session--Mr. Dreier from California. He's been a great leader on trade policy. He's been a great colleague. We will miss that leadership, and I commend him for his one last lift that he made into making this legislation possible.

In a lot of ways I wish we had passed this before the August recess because every day we delay right now we are losing market share in a large and expanding marketplace in Russia. Our goods, our services, our products, the Made in America goods that we should be exporting right now, we're not until we're able to pass this bill. Russia has already agreed to lower their trade barriers and other nontariff barriers for the entry of our goods.

Just as one example, Great Britain alone over the last couple of years has expanded their exports into the Russian market by over 80 percent. But this legislation will also allow us to enforce rules and have dispute resolution mechanisms that are available through the World Trade Organization, higher rules that Russia now has to comply with.

As another example from my home State of Wisconsin, Russia has, since 2010, shut out all dairy exports that we could make from our country into Russia due to phytosanitary concerns that we view as highly suspect and highly questionable. Now we'll have a mechanism in order to resolve that dispute through the WTO.

Something that is not available to us until we're able to move this legislation here today.

Now, as was pointed out earlier, Governor Romney indicated that Russia, in his view, is America's greatest geostrategic adversary in the 21st century.

I don't know if that's true or not, but I do know that when goods and products cross borders, armies don't. This gives us another tool of diplomatic engagement with Russia, economic engagement with Russia, as well as another piece to what we need to do to get our economy fully functioning and creating the good-paying jobs that we need right here in America at this time.

So I encourage my colleagues to support this. Hopefully, we will have a wide bipartisan vote, and I thank the leadership on this issue.

Mr. Speaker, my Republican colleagues this week are attempting to make a case for the importance of education, yet their budget this year slashed funding for education and for basic and applied research, creating barriers for traditional students, returning students and worker training. This is not the approach to ensure our students have the skills they need to match the jobs that are available. And this is not the approach to capitalize on the American ingenuity that will lead to economic growth.

We know that students trained in science, technology, engineering and math (STEM), are acquiring the skills to fill and succeed at the jobs of the future. In order to increase American competitiveness, create good paying jobs, and ensure our position on the global stage, we have to invest in education, worker training and research in STEM studies. For years in my position as Co-Chair of the Innovation, Competitiveness and Tax Reform Task Force of the New Democratic Coalition I have called for exactly that--a renewed focus on STEM skills in the workforce.

And not just in our own students, but we must also remove the barriers to success for international students training in STEM studies at U.S. institutions. Instead of sending these highly-skilled international students back to their native countries, where they contribute to the foreign economies we are competing against, let's provide them with visas and let the American economy take advantage of these skills.

There is a real opportunity for these highly trained international students to achieve the American dream and contribute talent, creativity and innovative skills that will help ensure our place in a competitive global economy. And there is an actual opportunity to get something signed into law but we know the real work will have to come next Congress, as there are few days left to get much done this fall.

America's future as a global competitor depends on our ability to come together as leaders and make the hard decisions and smart investments as well as enact the policies that put us on a long-term path to prosperity. We cannot let America's future get bogged down by politics. There is too much at stake.

Mr. Speaker, today I rise in honor of the sesquicentennial celebration of Ellsworth, Wisconsin. With its origins as a village going back to 1862, Ellsworth serves as the country seat for Pierce County, named after our 14th President, Franklin Pierce. Since a proclamation made in 1984 by Wisconsin Governor Anthony S. Earl, Ellsworth has been known as the Cheese Curd Capitol of Wisconsin.

Originally established with the name Perry, the village immediately began to grow. It wasn't until a number of years later that it was renamed Ellsworth after Colonel Elmer E. Ellsworth, who fought in the Civil War. Still to this day, Colonel Ellsworth's likeness symbolizes the strength of a thriving community.

With a population of 3,284 residents, Ellsworth is proud of its many close-knit community connections. The village boasts two amazing parks, Summit Hill Park and East End Park, where residents can come together to enjoy Wisconsin's great summers and cheer on the Ellsworth Hubbers Baseball Team to victory.

The village also hosts a number of extremely popular events in the area. These include the Ellsworth Polka Fest, the Beldenville Old Car Show, the Pierce County Fair, and of course the annual Cheese Curd Festival.

The beautiful wooded lands surrounding the city make it an excellent destination for outdoorsmen and women of all sorts. With streams filled with trout and miles of premier snowmobile and hiking trails, you can't go wrong in Ellsworth.

On July 4, 2012, Village President DeWolfe, local elected leaders, and Ellsworth residents came together to celebrate Ellsworth's sesquicentennial with music, an art show, food, and fireworks. Today, I recognize Ellsworth's sesquicentennial and join in their celebration.

Mr. Speaker, I thank my good friend from Michigan for yielding me this time and for his leadership on this issue.

Mr. Speaker, just to address the previous speaker's comments, if you're a small business in America with 50 or fewer employees, you don't have to do a god-dang thing under the Affordable Care Act other than receive tax credits for offering health care coverage to your employees. So let's stop this nonsense of trying to scare small businesses throughout America.

It's been pointed out on the floor by numerous colleagues that this is the 31st attempt in this session of Congress to repeal all or part of the Affordable Care Act. Even The Washington Post pointed out earlier this week that Baskin Robbins only offers 30 flavors of ice cream. Enough is enough.

And when I first heard that the United States Supreme Court upheld the constitutionality of the Affordable Care Act, my first feelings were relief and happiness, not for me or anyone else who was involved in advancing the cause of health care reform, which was desperately needed--it is a system that has failed too many Americans for too long--but it was happiness for a 1-year-old little boy who I had a chance of meeting back home in western Wisconsin by the name of Henry.

See, Henry's mother informed me that before he was even born he suffered a seizure in her womb and, therefore, the very first breath he took in his life, they were informed that he was uninsurable because he had a pre-existing condition. And that family was depleting their entire life savings making sure that Henry was getting the health care treatment that he needed to survive in his life.

We're better than that as a Nation, folks. The Affordable Care Act, as this family pointed out, changed that immediately for Henry and that family, and for 39,000 other children throughout western Wisconsin who have a pre-existing condition.

Forty-five thousand young adults in Wisconsin now can stay on their parents' plans because of this act. Seniors on Medicare get a 50 percent price discount for the prescription drugs they need in their lives.

Do you want to talk about a big tax increase?

Take away the 35 percent in tax credits that small businesses are getting today for providing health care coverage, which goes up to 50 percent in 2014, or the $800 billion in tax credits that individuals and families will receive under the exchange so they can afford health care coverage. Let's talk a little bit about that tax increase that people are going to be facing if they are successful in repealing this legislation.

What we need is more cooperation and more effort in reforming a health care system that is complicated, that is too expensive. We have tools in place now in this legislation that will not only enable reforming the way health care is delivered, which is more integrated, coordinated and patient-centered, but in how we pay for it so that it is based on the value, or the quality of care that is given, and no longer on the volume of services that is rendered, oftentimes with poor results.

I encourage my colleagues to vote ``no'' on this. Let's work together to improve a health care system that is in desperate need of improvement.

I thank the ranking member on the Ways and Means Committee for yielding me this time.

Mr. Speaker, in the waning days of the work we were doing to get the Affordable Care Act in shape for consideration before the entire Congress, I wasn't an enthusiastic supporter of the medical device manufacturing tax as one of the pay-fors in order to pay for health care reform. I, however, agreed with the President wholeheartedly that health care reform had to be fully paid for. In fact, the idea was to pay for it, and then some, so that we had the ability to start reducing our budget deficits out into the future.

Because of the work that was done and because of the hard negotiations and the tradeoffs that were made, the Congressional Budget Office, in its analysis of the Affordable Care Act when it passed, said it would reduce the budget deficit by over $1.2 trillion over the next 20 years. Now, that is a significant achievement--that we are able to start reforming a health care system in desperate need of reform, pay for it at the same time, work to improve the quality of care and the access of care for 33 million uninsured Americans, but also start bending the cost curve in healthcare.

I was concerned about the medical device tax as an element of the pay-for, however, because of the vital role that the medical device industry has in our economy. They play an important role when it comes to job creation. They enjoy certain competitive advantages here in the United States market. I was concerned about the tax applying to the sales of the products as opposed to profits because of the impact it will have on smaller manufacturers, which operate on a much smaller margin.

That's why I support the legislation before us today, but I do so under the proviso and with the understanding that the pay-for that is being used right now is controversial on our side. I don't think it's the ideal pay-for. I don't believe that it's going to be the pay-for that the Senate would consider if it takes this measure up. It certainly won't be the pay-for that the President will feel comfortable signing into law. So there is going to be additional work that we're going to have to do together to try to find an acceptable bipartisan pay-for if we're going to repeal this tax on an important industry in our country.

I would also submit to my colleagues on the other side that there are many proposals under the Affordable Care Act that have enjoyed wide bipartisan support in the past, proposals that can help find savings in the healthcare system. They include the build-out of the

health information technology system that our health care providers desperately need, which will not only improve the efficiency of care delivered and reduce medical errors, but will finally start collecting that crucial data so we know better what works and what doesn't work in the delivery of health care. There are delivery system reforms in the health care reform bill that are already proving effective and that lead us towards a system that is more integrated, that is more coordinated, that is patient-focused, thus producing a much better outcome of care but at a better price.

Ultimately, we have to continue working together to change the way we pay for health care in this country so that it's based on the value--or the quality or outcome of care that's given--and no longer on the volume of services and tests and things that are done regardless of the results. There has been wide bipartisan agreement in the past over these issues which are included in the Affordable Care Act, but you would never guess it by listening to the terms of the debate today.

While I support the legislation and what it's trying to accomplish here, I still think, following today's debate, there is going to be a lot more work that we're going to have to do in dealing with the other side of the Capitol, with the Senate, as far as coming up with acceptable pay-fors, in its mind, and also in working with this administration.

So hopefully we can reduce this tax burden on an important industry. But we can do it in a more reasonable and commonsense fashion so we don't jeopardize the health care access of over 350,000 Americans, which may be adversely impacted with this ``true-up'' provision, that is being used today to pay for the repeal of this revenue measure.

I thank my colleague for the time I was yielded.

Mr. Speaker, I rise today in support of the amendment to permit the National Guard and Federal agencies performing homeland defense activities to enter into a military cooperative agreement with facilities capable of providing emergency response training.

Providing our National Guard units and public service employees with increased opportunities to train at the state of the art homeland defense training facilities is just plain commonsense. It's a win for the military and service personnel who will be better prepared to safely work in the field and a win for the local communities, who will see local job creation.

My amendment does not call for any increase in funding. It is simply a legislative fix to allow the training facilities to competitively bid for training contracts with the National Guard and Federal agencies. This will allow for additional, comprehensive training for those who are on the front lines during a domestic emergency.

I encourage my colleagues to support this amendment to ensure that our National Guard and homeland disaster first responders have all of the training and tools necessary to carry out their mission.

Mr. Speaker, I rise today in support of the amendment to waive the time limitation for awarding Lt. Alonzo Cushing the Medal of Honor.

A Wisconsin native, Lt. Cushing, on the third day of the Battle of Gettysburg, commanded

110 men and six cannons positioned on Cemetery Ridge, where they received the full force of Pickett's Charge. Despite the death of all of his officers and receiving multiple gunshot wounds, Lt. Cushing refused to withdraw from battle and was killed by Confederate fire. In February 2010, Secretary of the Army John McHugh recommended the approval of the nation's highest honor for Lt. Cushing.

Lt. Cushing's actions in the Battle of Gettysburg were so inspiring that a book detailing his life, Cushing of Gettysburg, was written in 1998.

I would like to give special thanks to Margaret Zerwekh and the city of Delafield for their tireless advocacy to ensure Lt. Cushing receives the honor he deserves. I encourage my colleagues to support this amendment and honor a true American hero.

Mr. Speaker, I rise today in support of the amendment to compensate National Guard troops for miscalculated leave time.

This amendment corrects a government error to pay approximately 575 Army National Guard troops for leave time they earned but were unable to take after their last deployment. These soldiers have spent time overseas defending our great nation--some in multiple deployments--and have earned their leave benefits.

The Army agrees that these Guardsmen should have received PDMRA leave. However, the Army's only legal remedy is to allow them use their PDMRA leave after a future deployment. Since some of these soldiers will not deploy again and others have left the service entirely, this remedy has no value in many cases.

I would like to give special thanks to Congressman Petri for working with me to ensure that this egregious bureaucratic error is rectified. I encourage my colleagues to support this amendment and properly support our service members who selflessly serve.

Mr. Speaker, it is with great pleasure that I rise before you today to honor the historic City of Lancaster as we celebrate its 175th anniversary.

Lancaster was established for its central location in Grant County. Though it wasn't located on a stream or major source of power, its location was ideal for the efficiency and accessibility of a county government. Shortly after its founding, Lancaster was named the seat of Grant County. In fact, the county courthouse was built before Lancaster's founding, creating a unique opportunity for entrepreneurs once Lancaster was established. Hotels and stores were among the first establishments to be built. But, growth in Lancaster was slow with only 350 residents in 1853. However, the dedication of a few people, including Wisconsin's first Governor, Nelson Dewey, was all Lancaster needed to thrive. After the construction of houses, commercial buildings, warehouses, stores, and a railroad depot, Lancaster's population surpassed 1,000 residents by 1880, enough to allow incorporation.

Just as Lancaster was beginning to mature, a fire destroyed half of the square and the city was faced with the challenge of starting anew. The folks of Lancaster took on that challenge and as they always have; the people of Lancaster worked together and the square was built again. Many of these buildings still stand today, signifying the deep historical roots in Lancaster and its ability to endure the test of time. The Grant County Courthouse, Lancaster Municipal Building, and the Lancaster Post Office are all listed on the National Register of Historic Places.

Today, Lancaster is home to more than 3,800 people. Lancaster embodies the quintessential small town that is a staple in rural Wisconsin. The historically rich community still thrives on the agricultural successes of surrounding farms and its quaint and pure atmosphere make Lancaster a beautiful place to call home. I wish the City of Lancaster and its residents a happy 175th anniversary and all the best in the years to come.

Mr. Speaker, I rise before you today to congratulate a second-generation dairy farmer from my home district in western Wisconsin. Dale Hines is a hard-working man from the beautiful small town of Ellsworth who was recently recognized as a Master Agriculturist. This distinction, awarded by the magazine Wisconsin Agriculturist, recognizes Wisconsin farmers who not only display an ability to raise crops or livestock, but those who also dedicate significant time to their family, communities, churches, farm organizations, and other local efforts.

I'm proud to be from an area so rich with agricultural history--an area which celebrates and appreciates the hard-working men and women who work on our farms, raising crops and livestock, helping to put food on our tables. The family farm is an important American institution, and Dale Hines and the rest of the Hines family are an embodiment of that spirit. As a child, Dale grew up surrounded by farming. Even at a young age, he spent his time milking his family's 30 Holstein cows along with his older brothers--a chore which became a full-time career for Dale after graduating from Ellsworth High School in 1977. Today, the Hines Ranch, which was recognized in 1987 as the Wisconsin Conservation Farm of the Year, has grown exponentially. They cultivate 810 acres of land and milk 80 cows, a herd which produces more than 28,000 pounds of milk per cow.

However, despite their farm's growth amidst the ever-changing world of farming, one thing has never changed for the Hineses: the importance of the family-run operation. Although only Dale's family lives in the farmhouse, the entire extended family is still very much involved with the farm's day-to-day operations. Everyone helps out in whatever way they can, whether it's helping with the planting and harvesting of the crops, constructing all of the farm's buildings, or keeping track of the books--a task which Dale's 85-year-old mother Joyce still does to this day.

The Hines family is truly an example to follow, both due to the success of their farm and the importance they place on family. It is with great pride that I rise today and congratulate Dale Hines, a dedicated father, farmer, and citizen, on having received proper recognition of the hard work that he and his family have put forth over the last half-century. He is truly deserving of the title of Master Agriculturist, and I wish him and the rest of the Hines family all of the best in the future.

I want to thank the ranking member for yielding me this time.

Mr. Speaker, just to set the record straight, the amendment that was offered by Mr. McDermott at the Rules Committee, and what our Ranking Member Levin and we Democrats in the Ways and Means Committee supported, offered immediate expenses, a bonus depreciation for capital investment for small businesses that was fully offset and fully paid for by eliminating the tax breaks that large oil companies are receiving today, who are sitting on record profits, with record high prices. And it wouldn't add a nickel to the deficit.

That's why I adamantly oppose the underlying bill before us today. It's the here-we-go-again syndrome around here. How deep are we going to create this hole? It's a $46 billion tax cut that's not offset, that's not paid for, will go straight to deficit, close to half of it going to millionaires. An average tax savings of over $58,000 is not the way to get this economy out of the hole that it's in. In fact, when the Joint Committee on Taxation and the Congressional Budget Office analyzed the Republican underlying bill, they said this is probably the worst thing for the buck that we can invest in the economy to create the jobs that we need today. Yet, this is a syndrome that happens over and over again from the other side. They support huge tax cuts without paying for them, driving our Nation deeper into debt.

If they think it's worthwhile enough and important enough to invest in, then pay for it. Find offsets in the spending, and let's have that discussion as far as our priorities. But don't go down the easy route of trying to offer this illusion of tax relief to all Americans, especially the iconic small business owner out there, without paying a nickel for it and adding to the budget deficits that are accumulating today.

I tried to explain to folks back home how we got into this hole. Certainly, the most important driving factor is the underperforming economy and the huge recession that we're trying to climb out of right now. But you can also look back at previous policies not so long ago supported by the other side: two huge tax cuts that weren't paid for; two wars that weren't paid for; the largest expansion of entitlement spending in the prescription drug bill that wasn't paid for. It's little wonder we're facing huge deficits.

I reject the underlying bill and support the Levin amendment.

I thank the gentleman from Michigan for yielding me this time.

Madam Chair, I rise in opposition to H.R. 5.

Two years ago, the Affordable Care Act was passed, and I was a proud supporter of that legislation. Not because I thought it was the perfect bill, but because I thought it gave us the tools and the potential to reform a health care system that was in desperate need of reform, of putting things in place that could deliver better quality of care that is given for a better price, and also increasing access to health insurance throughout the country, and to finally address the 52 million uninsured Americans that we have living in our own communities.

Yet the ultimate verdict on whether health care reform works or fails for everyone in this country is whether we can figure out creative ways of bringing down those costs in health care.

One thing I do know under the health care reform bill that has been enacted is that in my congressional district in western Wisconsin, this year alone 4,200 young adults are able to stay on their parents' health care plan; whereas, before they couldn't. What a relief that has been to those families, making sure that those kids, many of whom are in school, can stay on the family plan.

Of the 5,800 seniors this year who have fallen into the doughnut hole, they are seeing a cost savings of roughly $610 apiece because of the 50 percent price discount they now get under this legislation. That's not peanuts in western Wisconsin. There are 86,000 seniors now that are able to go and get preventive care services without copays, without deductibles, without out-of-pocket expenses. We want them to go in and get those tests so something worse doesn't happen to them, which will inevitably drive up the cost for everyone in the Medicare system.

There are 15,000 small businesses in western Wisconsin that now qualify for tax credits for providing health care to their employees to make it more economically feasible for them to do what they want to do, and that is provide health care coverage for their workers. That 35 percent tax credit goes up to 50 percent in 2014, when we're able to move forward on the creation of the health insurance exchanges. And 39,000 children in western Wisconsin who have a preexisting condition can no longer be denied healthcare coverage in their lives.

This is the right thing to do, and yet we have to figure out some cost-containment measures to make sure that it's sustainable and affordable in the future.

The Independent Payment Advisory Board is a backstop in that effort. It's not the first thing we go to in order to find cost savings, but if costs do exceed target growth rates, the Independent Payment Advisory Board is able to come forward--with Congress--with recommended cost savings that will be implemented only if Congress refuses to act ourselves. And that has been the problem around here for too long. We get recommendations from MedPAC and other entities on where we can find cost savings, but because of the inability of Congress to stand up to some powerful special interests, quite frankly, it's very difficult for this institution to act by itself in order to implement those cost savings.

I find it a little bit humorous that my colleagues on the other side are so fearful of this payment advisory board making some decisions when it comes to the rising health care costs when they feel perfectly comfortable turning these decisions over to private insurance companies who are motivated by profit and trying to maximize their margin of gain by providing health care coverage. I think that's nonsensical.

Ultimately, if health care reform is going to work, we have to change the way health care is delivered in this country so that it is more economical in how we pay for it, so that it is value- and not volume- based anymore.

I come from an area of the country with health care providers that have models of care that are highly integrated, they are very coordinated, they are patient-focused, and they are producing some of the best results in the Nation. Yet a Medicare recipient in La Crosse, Wisconsin, receives on average about $5,000 a year compared to $17,000 in Miami. Yet the results in La Crosse are much better than the results in Miami, and there are studies out there showing there is over- utilization in the delivery of health care, which is driving up costs for everyone.

I thank the gentleman.

The studies show that one out of every three health care dollars is going to tests, they are going to procedures, they are going to things that don't work. They're not improving health care. And oftentimes, because of the over-utilization that patients are receiving, many of these patients are being left worse off rather than better off. So we've got to reform the delivery system, which the Affordable Care Act puts in place. But ultimately, we have to change the way we pay for health care. We need to end and destroy the fee-for-service system, which is all volume-based payments, and move to a value-based reimbursement system. The IPAB commission can help us get to that promised land.

And this has been a bipartisan issue for a long time. Dr. Frist has been talking about payment reform that's value-based for as long as I can remember. My own former Governor, former HHS Secretary Tommy Thompson, has said repeatedly that if we do anything, make sure that we change the payment system so it is value- and not volume-based anymore. Mark McClellan, President Bush's CMS Director, the same thing. So there's been bipartisan recognition that we have to do it. IPAB gives us an opportunity to do that, but it's not the final say. They merely come forward with their recommended cost savings and challenges the Congress to come up with an alternative cost savings.

So, folks, this is gut-check time. This is whether we are serious about trying to bend the cost curve. Their plan would get rid of Medicare. It turns it into a private voucher and a voucher that's inadequate to address the costs that seniors face. They don't reform the way health care is delivered. They're not reforming how we pay for health care. They're merely changing who pays for health care under Medicare, and those costs are going to be shifted on the backs of our seniors. That's no way of reforming a health care system that's in need of reform, that only address the Medicare portion within our budget.

What we need to be working on and what the Affordable Care Act gives us the tools to do is to reform the entire health care system, both public programs and private programs. And that's something that we fundamentally have to do to get our economy back on track, creating good-paying jobs. Because if you just repeal it now, we go back to the status quo, which means more uninsured, higher costs, and our businesses are less able to compete globally. I encourage my colleagues to reject H.R. 5.