[Congressional Record Volume 155, Number 166 (Saturday, November 7, 2009)]
[House]
[Pages H12598-H12622]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 PROVIDING FOR CONSIDERATION OF H.R. 3962, AFFORDABLE HEALTH CARE FOR 
  AMERICA ACT, AND PROVIDING FOR CONSIDERATION OF H.R. 3961, MEDICARE 
                  PHYSICIAN PAYMENT REFORM ACT OF 2009

  Ms. SLAUGHTER. Mr. Speaker, by direction of the Committee on Rules, I 
call up House Resolution 903 and ask for its immediate consideration.
  The Clerk read the resolution, as follows:

                              H. Res. 903

       Resolved, That upon the adoption of this resolution it 
     shall be in order to consider in the House the bill (H.R. 
     3962) to provide affordable, quality health care for all 
     Americans and reduce the growth in health care spending, and 
     for other purposes. All points of order against consideration 
     of the bill are waived except those arising under clause 9 or 
     10 of rule XXI. The amendment printed in part A of the report 
     of the Committee on Rules accompanying this resolution, 
     perfected by the modification printed in part B of such 
     report, shall be considered as adopted. The bill, as amended, 
     shall be considered as read. All points of order against 
     provisions of the bill, as amended, are waived. The previous 
     question shall be considered as ordered on the bill, as 
     amended, and on any further amendment thereto, to final 
     passage without intervening motion except: (1) four hours of 
     debate equally divided among and controlled by the chair and 
     ranking minority member of the Committee on Energy and 
     Commerce, the chair and ranking minority member of the 
     Committee on Ways and Means, and the chair and ranking 
     minority member of the Committee on Education and Labor; (2) 
     the further amendment printed in part C of the report of the 
     Committee on Rules, if offered by Representative Stupak of 
     Michigan or his designee, which shall be in order without 
     intervention of any point of order except those arising under 
     clause 9 of rule XXI, shall be considered as read, shall be 
     separately debatable for 20 minutes equally divided and 
     controlled by the proponent and an opponent, and shall not be 
     subject to a demand for division of the question; (3) the 
     further amendment in the nature of a substitute printed in 
     part D of the report of the Committee on Rules, if offered by 
     Representative Boehner of Ohio or his designee, which shall 
     be in order without intervention of any point of order, shall 
     be considered as read, and shall be separately debatable for 
     one hour equally divided and controlled by the proponent and 
     an opponent; and (4) one motion to recommit, with or without 
     instructions, which shall be considered as read.
       Sec. 2.  During consideration of an amendment printed in 
     the report of the Committee on Rules accompanying this 
     resolution, the Chair may postpone the question of adoption 
     as though under clause 8 of rule XX.
       Sec. 3.  Upon the adoption of this resolution it shall be 
     in order to consider in the House the bill (H.R. 3961) to 
     amend title XVIII of the Social Security Act to reform the 
     Medicare SGR payment system for physicians. All points of 
     order against consideration of the bill are waived except 
     those arising under clause 9 or 10 of rule XXI. The bill 
     shall be considered as read. All points of order against 
     provisions in the bill are waived. The previous question 
     shall be considered as ordered on the bill to final passage 
     without intervening motion except: (1) one hour of debate 
     equally divided and controlled by the chair and ranking 
     minority member of the Committee on Energy and Commerce; and 
     (2) one motion to recommit.
       Sec. 4.  In the engrossment of H.R. 3961, the Clerk shall--
        (a) add the text of H.R. 2920, as passed by the House, as 
     new matter at the end of H.R. 3961;
       (b) conform the title of H.R. 3961 to reflect the addition 
     to the engrossment of the text of H.R. 2920;
       (c) assign appropriate designations to provisions within 
     the engrossment; and
       (d) conform provisions for short titles within the 
     engrossment.

  The SPEAKER pro tempore. The gentlewoman from New York is recognized 
for 1 hour.
  Ms. SLAUGHTER. Mr. Speaker, for the purpose of debate only, I yield 
the customary 30 minutes to the gentleman from Texas (Mr. Sessions). 
All time yielded during consideration of the rule is for debate only.


                             General Leave

  Ms. SLAUGHTER. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days within which to revise and extend their remarks 
and to insert extraneous materials into the Record.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from New York?
  There was no objection.

                              {time}  1045

  Mr. Speaker, H. Res. 903 provides for consideration of H.R. 3962, the 
Affordable Health Care for America Act, under a structured rule. The 
rule waives all points of order against consideration of the bill 
except those arising under clause 9 or 10 of rule XXI and provides 4 
hours of debate controlled by the Committees on Energy and Commerce and 
on Education and Labor.
  The rule makes in order the amendment in part C of the report if 
offered by Representative Stupak or a designee. The rules makes in 
order the substitute amendment in part D of the report if offered by 
Mr. Boehner or his designee.
  H. Res. 903 also provides for consideration of H.R. 3961, the 
Medicare Physician Reform Act, under a closed rule. The rule waives all 
points of order against consideration of the bill except those arising 
under clause 9 or 10 of rule XXI, and upon passage of the bill, the 
Clerk is directed to add at the end the text of H.R. 2920 as passed by 
the House.
  I am pleased to yield to the gentlewoman from Illinois (Ms. 
Schakowsky) for a unanimous consent request.
  (Ms. SCHAKOWSKY asked and was given permission to revise and extend 
her remarks.)

[[Page H12599]]

  Ms. SCHAKOWSKY. Mr. Speaker, I rise in support of reform that will 
allow millions of American women to get the health care they need.
  Ms. SLAUGHTER. I yield for a unanimous consent request to the 
gentlewoman from New York (Mrs. Lowey).
  (Mrs. LOWEY asked and was given permission to revise and extend her 
remarks.)
  Mrs. LOWEY. Mr. Speaker, I support health care that helps senior 
women afford their medications through Medicare.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield for a unanimous 
consent request to the gentlewoman from New York (Mrs. Maloney).
  (Mrs. MALONEY asked and was given permission to revise and extend her 
remarks.)
  Mrs. MALONEY. Mr. Speaker, I support ending gender discrimination in 
premium prices.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield to the gentlewoman 
from Texas (Ms. Eddie Bernice Johnson).
  (Ms. EDDIE BERNICE JOHNSON of Texas asked and was given permission to 
revise and extend her remarks.)
  Ms. EDDIE BERNICE JOHNSON of Texas. Mr. Speaker, I support the 
Democratic health care bill because it eliminates disparities that harm 
a woman's health.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from 
California (Ms. Lee) for a unanimous consent request.
  (Ms. LEE of California asked and was given permission to revise and 
extend her remarks.)
  Ms. LEE of California. Mr. Speaker, I support affordable health care 
and this Democratic bill so that domestic violence may never be used 
ever again as a preexisting condition.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from Michigan 
(Ms. Kilpatrick) for a unanimous consent request.
  (Ms. KILPATRICK of Michigan asked and was given permission to revise 
and extend her remarks.)
  Ms. KILPATRICK of Michigan. Mr. Speaker, I support our House bill 
which will let women and doctors control their health decisions.
  Ms. SLAUGHTER. Mr. Speaker, I yield for a unanimous consent request 
to the gentlewoman from California (Ms. Zoe Lofgren).
  (Ms. ZOE LOFGREN of California asked and was given permission to 
revise and extend her remarks.)
  Ms. ZOE LOFGREN of California. Mr. Speaker, I support the Democratic 
bill to let our kids in their 20s get insurance and keep healthy.
  Ms. SLAUGHTER. Mr. Speaker, I yield for a unanimous consent request 
to the gentlewoman from Ohio (Ms. Sutton).
  (Ms. SUTTON asked and was given permission to revise and extend her 
remarks.)
  Ms. SUTTON. Mr. Speaker, I support health care reform that improves 
the nursing workforce and is endorsed by the American Nursing 
Association.
  Ms. SLAUGHTER. Mr. Speaker, I yield for a unanimous consent request 
to the gentlewoman from California (Mrs. Davis).
  (Mrs. DAVIS of California asked and was given permission to revise 
and extend her remarks.)
  Mrs. DAVIS of California. Mr. Speaker, I support the Democratic bill 
because it will keep women and their families healthy, not just take 
care of them when they are sick.


                        Parliamentary Inquiries

  Mr. PRICE of Georgia. Mr. Speaker, parliamentary inquiry.
  The SPEAKER pro tempore. The gentleman may state his parliamentary 
inquiry.
  Mr. PRICE of Georgia. Mr. Speaker, I was just wondering if this was a 
stalling tactic by the majority party on delaying the vote on this 
important bill which will kill 5.5 million jobs today?
  The SPEAKER pro tempore. The Chair will observe that is not a correct 
parliamentary inquiry. The Chair will observe, on this side of the 
aisle, I don't think anybody wants to stall the bill.
  Mr. PRICE of Georgia. Mr. Speaker, continuing to reserve the right to 
object.
  The SPEAKER pro tempore. The gentleman is recognized on his 
reservation.
  Mr. PRICE of Georgia. I understand that this may be a train that is 
rolling, but it appears that the majority side is interested in 
stalling this bill. Would it be appropriate to ask unanimous consent 
that all extension and revision of remarks could be done en bloc.
  The SPEAKER pro tempore. The Chair would observe that such unanimous 
consent has already been granted. The Chair would note that there are a 
lot of Members around here that want to ask unanimous consent. The 
Chair intends to recognize them and let their unanimous consents be 
judged by the Chair and the House as suitable.
  Mr. PRICE of Georgia. Mr. Speaker, continuing to observe the right to 
object, how about increasing the debate time? It appears that the 
majority party is attempting to expand their debate time.
  I would ask unanimous consent that each side be added 1 hour of 
debate time.
  Ms. SLAUGHTER. I object.
  The SPEAKER pro tempore. Objection is heard.
  Mr. PRICE of Georgia. Mr. Speaker, I continue to reserve the right to 
object.
  The SPEAKER pro tempore. The Chair would be delighted to hear the 
gentleman on his reservation.
  Mr. PRICE of Georgia. Again, Mr. Speaker, it is my understanding that 
the majority party appears to be continuing to delay the process here. 
It would be appropriate, if the majority party is interested in 
fairness in this process, to provide for increasing debate time on both 
sides of the aisle.
  The SPEAKER pro tempore. The Chair observes that regular order has 
been demanded. As such, the gentleman must either object, or withdraw 
his reservation.
  Mr. PRICE of Georgia. Mr. Speaker, I object.
  The SPEAKER pro tempore. The Chair hears objection. The Chair would 
hope the gentleman would not object, but if he does, it will be in the 
Record.
  Mr. PRICE of Georgia. Mr. Speaker, continuing to reserve then, if you 
are not interested in obtaining my objection, continuing to reserve, 
again it appears that this is a process by which the majority party is 
interested once again in trying to subvert the rules and expand the 
debate time on the majority side.
  Mr. SESSIONS. Parliamentary inquiry.
  The SPEAKER pro tempore. Objection was heard. The gentleman from 
Texas will state his parliamentary inquiry.
  Mr. SESSIONS. The question is, could the Speaker please advise us of 
the time that is being consumed. Does it come off the time that would 
be allowed in the rule for debate by the gentlewoman from New York?
  The SPEAKER pro tempore. A Member asking to insert remarks into the 
Record may include a simple declaration of sentiment toward the 
question under debate but should not embellish the request with 
extended oratory.
  The gentlewoman from New York is recognized.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield to the gentlewoman 
from California (Ms. Woolsey) for a unanimous consent request.
  Ms. WOOLSEY. Mr. Speaker, I ask unanimous consent to revise and 
extend my remarks in support of this bill because it will make health 
care affordable for women who still earn 77 percent less than men.
  Mr. SESSIONS. Mr. Speaker, I reserve the right to object.
  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Texas on his reservation.
  Mr. SESSIONS. Mr. Speaker, I believe that what is occurring is that 
the facts of the case are that this has gone beyond the rules of the 
House in the presentation, and I object and would ask for regular 
order.
  The SPEAKER pro tempore. The gentleman from Texas has objected.
  The gentlewoman from New York continues to be recognized.
  Ms. SLAUGHTER. I am pleased to yield to the gentlewoman from Hawaii 
(Ms. Hirono) for a unanimous consent request.
  Ms. HIRONO. Mr. Speaker, I ask unanimous consent to revise and extend 
my remarks because the women in my district cannot wait any longer for 
meaningful health care reform.
  Mr. SESSIONS. Mr. Speaker, I reserve the right to object.
  The SPEAKER pro tempore. The gentleman from Texas is recognized on 
his reservation.

[[Page H12600]]

  Mr. SESSIONS. Mr. Speaker, I believe what is occurring now is not 
only opposed to the House rules but is containing further comment, 
which was not allowed in the rule nor in the general provisions of the 
House.
  The SPEAKER pro tempore. The Chair will restate the ruling that the 
Chair made earlier.
  A Member asking to insert remarks may include a simple declaration of 
sentiment towards the question under debate but should not embellish 
the request with extended oratory.
  The Chair has heard nothing which contravenes that, and the Chair 
makes the statement to my good friend that we will continue as we have 
in allowing each Member----
  Mr. SESSIONS. Mr. Speaker, parliamentary inquiry.
  The SPEAKER pro tempore. The gentleman is out of order. The Chair is 
busy ruling.
  Mr. SESSIONS. Could the Speaker please advise me about the time that 
is presently being consumed?
  The SPEAKER pro tempore. The gentleman will suspend.
  The Chair recognizes the distinguished gentlewoman from New York.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield for a unanimous 
consent request to the gentlewoman from California (Ms. Roybal-Allard).
  (Ms. ROYBAL-ALLARD asked and was given permission to revise and 
extend her remarks.)

                              {time}  1100

  Ms. ROYBAL-ALLARD. Mr. Speaker, I rise in support of the Democratic 
bill because it will help women with breast cancer pay for 
chemotherapy.
  Mr. PRICE of Georgia. Mr. Speaker, reserving the right to object.
  The SPEAKER pro tempore. The unanimous consent request has been 
entered. That is the business of the House.
  Ms. SLAUGHTER. Mr. Speaker, regular order, please.
  The SPEAKER pro tempore. The Chair has ruled.


                         Parliamentary Inquiry

  Mr. PRICE of Georgia. Parliamentary inquiry, Mr. Speaker.
  The SPEAKER pro tempore. The gentleman will state his parliamentary 
inquiry.
  Mr. PRICE of Georgia. Is it not appropriate for a Member of the House 
to be able to reserve a right to object on a unanimous consent request?
  The SPEAKER pro tempore. The Chair is going to inform the gentleman 
that he has the right to make a timely reservation. The Chair is going 
to observe that such was not made.
  Mr. PRICE of Georgia. Further inquiry, Mr. Speaker.
  The SPEAKER pro tempore. The gentleman will state his inquiry.
  Mr. PRICE of Georgia. I object.
  The SPEAKER pro tempore. An objection is no longer timely.
  The gentlewoman from New York continues to be recognized.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlelady from California 
(Mrs. Capps) for a unanimous consent request.
  Mrs. CAPPS. Mr. Speaker, I ask unanimous consent to revise and extend 
my remarks in support of reforms that ensure that no mother will ever 
have her child's care denied because of a preexisting condition.
  Mr. PRICE of Georgia. I object.
  The SPEAKER pro tempore. Objection is heard.
  The Chair wants to remind my colleagues, we are going to try and have 
a fair and orderly debate.
  The Chair is going to remind my colleagues that every Member has a 
right to place a unanimous consent before the House. The Chair is going 
to protect that right for the majority and the Chair is going to 
protect that right for the minority. And if delay occurs, at this 
moment it appears to the Chair that the delay occurs less on the 
Chair's right than it does on the Chair's left.
  The Chair will observe if the gentleman is concerned about speeding 
the business of the House, the business of the House can best be 
speeded by allowing the unanimous consent requests to be made.


                         Parliamentary Inquiry

  Mr. PRICE of Georgia. Parliamentary inquiry, Mr. Speaker.
  The SPEAKER pro tempore. The gentleman will state his inquiry.
  Mr. PRICE of Georgia. At the time that a unanimous consent request is 
made, the Speaker has apparently determined that the statement, as soon 
as it is completed, does not allow for a reservation. Is it not, under 
the rules of the House, appropriate for a Member of the House to 
reserve a right to object based upon a unanimous consent request?
  The SPEAKER pro tempore. The Chair is going to instruct the gentleman 
lightly upon the rules of the House by observing that reservations must 
be made in a timely fashion.
  The Chair will protect the rights of the gentleman to assert timely 
objections or to proceed in an appropriate manner under the rules.
  The Chair now recognizes the gentlewoman from New York.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlelady from California 
(Mrs. Napolitano) for a unanimous consent request.
  (Mrs. NAPOLITANO asked and was given permission to revise and extend 
her remarks.)
  Mrs. NAPOLITANO. Mr. Speaker, I rise in support of health care reform 
that eliminates out-of-pocket costs for osteoporosis screenings.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlelady from Ohio (Ms. 
Kilroy) for a unanimous consent request.
  Ms. KILROY. Mr. Speaker, I ask unanimous consent----
  Mr. DREIER. Mr. Speaker, reserving the right to object.
  The SPEAKER pro tempore. The gentleman is recognized on his 
reservation.
  Mr. DREIER. Thank you very much, Mr. Speaker.
  Ms. SLAUGHTER. Regular order, please.
  The SPEAKER pro tempore. Regular order is demanded.
  The Chair is going to make this observation for the benefit of my 
colleagues. After a demand for regular order, a reservation of 
objection may no longer be entertained. A Member must either object or 
withdraw the reservation.
  Mr. DREIER. Mr. Speaker, I have reserved the right to object. Am I 
allowed to be heard under that reservation at this juncture?
  Ms. SLAUGHTER. Regular order.
  The SPEAKER pro tempore. That, the Chair regrets, cannot be done 
because the Chair has heard a demand for regular order, which precludes 
that.
  Mr. DREIER. Mr. Speaker, I cannot reserve the right to object to the 
unanimous consent request?
  The SPEAKER pro tempore. Not after a demand for the regular order has 
been heard.
  What is happening, the Chair will inform my dear friends, is we are 
getting ourselves into an unnecessarily deep parliamentary morass. If 
my colleagues on the Chair's left would withhold these objections, we 
would not be in this snarl at this time.
  Now, does the gentleman object?
  Mr. DREIER. Mr. Speaker, I reserve the right to object and wish to be 
heard on my reservation.
  The SPEAKER pro tempore. The Chair rules that out of order.
  The Chair makes the observation that since a demand for the regular 
order has been made, reservations may no longer be raised. Perceiving 
that the gentleman from California has withdrawn his reservation, the 
Chair recognizes now, again, the gentlewoman from New York, who 
controls the time at this moment.
  Ms. SLAUGHTER. Mr. Speaker, I have already yielded to the gentlelady 
from Ohio (Ms. Kilroy).
  Ms. KILROY. I thank the gentlelady from New York.
  Mr. Speaker, I ask unanimous consent to revise and extend my remarks 
in support of the Democratic bill because----
  Mr. SESSIONS. Mr. Speaker, I object.


                         Parliamentary Inquiry

  Ms. KILROY. Mr. Speaker, parliamentary inquiry.
  Do I not have the right to be able to continue my sentence without 
objections that are trying to censure my remarks here on the floor that 
I have a right to make as a Member of Congress?
  The SPEAKER pro tempore. Objection is heard. The gentlewoman will 
suspend.
  The gentlewoman from New York again is recognized.

[[Page H12601]]

  Ms. SLAUGHTER. Mr. Speaker, I would inquire of Ms. Kilroy, have you 
had time to raise your objection?
  Ms. KILROY. I ask unanimous consent again to revise and extend my 
remarks because this----
  The SPEAKER pro tempore. Objection is heard.
  Ms. KILROY. I rise in support of this Democratic bill because it 
won't force women into a bare bones policy, high deductible, and high-
cost plan.
  The SPEAKER pro tempore. Objection has been heard.
  Mr. SESSIONS. Mr. Speaker, I would ask to be heard.
  Mr. Speaker, the Republicans are asking for an extension of 1 hour on 
both sides under the rule that will equally allow both sides 30 
additional minutes to be heard, because it's obvious that Members of 
Congress need to be heard and this rule does not provide the amount of 
time necessary, and the people who are here is an example of why this 
is wrong.
  The SPEAKER pro tempore. The gentleman from Texas has not yet been 
recognized for debate. The gentleman will resume his seat and we will 
proceed with the business of the House.
  The Chair continues to recognize the gentlewoman from New York.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlelady from the Virgin 
Islands for a unanimous consent request.
  Mrs. CHRISTENSEN. Mr. Speaker, I ask unanimous consent to revise and 
extend my remarks in support of providing affordable coverage for the 
39 percent of Latinos, 23 percent of African Americans, and 34 percent 
of Native Americans who are not insured.
  Ms. FALLIN. Mr. Speaker, I object.
  The SPEAKER pro tempore. Objection is heard.
  The gentlewoman from New York is recognized.
  Ms. SLAUGHTER. I yield to the gentlewoman from California (Ms. 
Harman) for a unanimous consent request.
  Ms. HARMAN. Mr. Speaker, because it eliminates cost sharing and makes 
access to health care more affordable, as a mother of four and a 
grandmother of three, I ask unanimous consent to revise and extend my 
remarks in support of the Democratic bill.
  Ms. FALLIN. Mr. Speaker, I object.
  The SPEAKER pro tempore. The objection is heard.
  The Chair requests the gentlemen and gentlewomen of the House to heed 
the gavel. The Chair will try to protect the rights of all and will see 
that the proceedings are conducted in accordance with the rules. And 
the Chair asks the Members not to make that any more difficult than 
they must.
  The Chair continues to recognize the gentlewoman from New York.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from Florida 
(Ms. Castor) for a unanimous consent request.
  Ms. CASTOR. Mr. Speaker, because the Democratic bill gives women more 
opportunities and offers to modernize health care, I ask unanimous 
consent to revise and extend my remarks in support of the Democratic 
bill.
  Ms. FALLIN. I object.
  The SPEAKER pro tempore. Objection is heard.
  The Chair continues to recognize the gentlewoman from New York.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from Wisconsin 
(Ms. Baldwin) for a unanimous consent request.
  Ms. BALDWIN. Mr. Speaker, because it is time to protect older women 
by closing the doughnut hole, I ask unanimous consent to revise and 
extend my remarks in support of this bill.
  Mrs. BACHMANN. I object.
  The SPEAKER pro tempore. Objection is heard.
  The Chair has a comment to make here. The Chair is going to request 
the Members on both sides of the aisle to respect the rights of other 
Members. Members have the right, under the rules, to ask unanimous 
consent. If Members on one side of the aisle want their right 
protected, the Chair observes that they should then respect the rights 
of Members on the other side of the aisle. It will be the purpose of 
the Chair to try and see that all Members are heard at the proper time 
and fashion and to see that the rules are carried out. The Chair will 
also try to see that the debate is conducted with a measure of comity 
and grace and decency, and the Chair would request my friends on both 
sides of the aisle to respect that.


                        Parliamentary Inquiries

  Mr. CULBERSON. Parliamentary inquiry, Mr. Speaker.
  The SPEAKER pro tempore. The gentleman will state it.
  Mr. CULBERSON. Mr. Speaker, to fulfill your proper admonition of the 
House that we proceed with comity and respect and allow the voices on 
both sides to be heard, my parliamentary inquiry, Mr. Speaker, is to 
ask that we would--and we are prepared to do so with a unanimous 
consent--agree to expand the debate by 1 hour to allow other Members of 
the House on both sides--could we have a unanimous consent request, Mr. 
Speaker, to expand the debate?
  The SPEAKER pro tempore. The Chair will observe that my friend has 
not stated a proper parliamentary inquiry.
  The Chair simply wants to make this observation. We can spend a long 
time here on this particular wrangle or we can allow the proceedings to 
go forward. Everybody will have a chance to be heard as long as the 
House is presided over by this particular Member.
  The Chair just requests my friends on the minority side, let's let 
the discussion go forward. It isn't hurting anything, and there is no 
advantage to be achieved by making all of this fuss.
  Mr. CULBERSON. Parliamentary inquiry.
  The SPEAKER pro tempore. The gentleman will state his parliamentary 
inquiry.
  Mr. CULBERSON. Mr. Speaker, is it in order, I would like to make a 
unanimous consent to expand the debate by 1 hour.
  The SPEAKER pro tempore. The Chair observes that that can only be 
done at this time by the gentlewoman from New York yielding for the 
purpose of that kind of unanimous consent request.
  Mr. CULBERSON. Will the gentlelady from New York yield to expand the 
debate by 1 hour? I would like to make that unanimous consent request 
to expand the debate by 1 hour so that everyone can speak.
  Ms. SLAUGHTER. I am calling for regular order. I would like to really 
get on with this bill.
  The SPEAKER pro tempore. The Chair observes that the gentlewoman from 
New York has not yielded for that purpose and that, therefore, the 
request is not in order.
  The gentlewoman from New York continues to be recognized.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlelady from California 
(Ms. Eshoo) for a unanimous consent request.
  Ms. ESHOO. Mr. Speaker, I ask unanimous consent to revise and extend 
my remarks on this bill which will limit age ratings that make coverage 
unaffordable for older women.
  Mrs. BACHMANN. I object, Mr. Speaker.
  The SPEAKER pro tempore. Objection is heard.
  The gentlewoman from New York continues to be recognized.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlelady from 
Massachusetts (Ms. Tsongas) for a unanimous consent request.
  Ms. TSONGAS. Because women shouldn't have to buy a separate policy 
for maternity care, Mr. Speaker, I ask unanimous consent to revise and 
extend my remarks in support of the Democratic bill.
  Mrs. BACHMANN. I object, Mr. Speaker.
  The SPEAKER pro tempore. Objection is heard.


                        Parliamentary Inquiries

  Mr. HASTINGS of Florida. Mr. Speaker, parliamentary inquiry.
  The SPEAKER pro tempore. The gentleman will state the parliamentary 
inquiry.
  Mr. HASTINGS of Florida. Mr. Speaker, is it not correct procedure in 
the House of Representatives for the purpose, when a Member offers a 
unanimous consent request, that the objection be heard after the 
conclusion of the unanimous consent request?
  The SPEAKER pro tempore. The gentleman is correct in that the Chair 
has been trying to see to it, amidst a somewhat disorderly House, that 
the request for unanimous consent is uttered before the objection is 
heard.
  Mr. PRICE of Georgia. Parliamentary inquiry, Mr. Speaker.
  The SPEAKER pro tempore. The gentleman will state the parliamentary 
inquiry.

[[Page H12602]]

  Mr. PRICE of Georgia. Does the rule not provide on a unanimous 
consent request that there be no significant embellishment of remarks, 
and in fact the majority party has continued to embellish their remarks 
upon their UC request?

                              {time}  1115

  The SPEAKER pro tempore. The Chair is kind of wearing out this 
ruling, but the Chair will respond again for the benefit of my good 
friend by observing this:
  A Member asking to insert remarks may include a simple declaration of 
sentiment toward the question under debate, but should not embellish 
the requests with extended oratory. The Chair is going to try and 
enforce that, and the Chair would suggest to all Members that we 
respect each other's rights and, on this side, that Members observe the 
rule and on that side that the Members permit the Members on this side 
to observe the rule and to make their necessary points. The Chair will 
try and enforce these rules in a fair and proper way.
  The Chair observes that the proceedings will proceed more speedily if 
the Members will assist the Chair in this particular way.
  Ms. SLAUGHTER. I am pleased to yield to the gentlewoman from Nevada 
(Ms. Titus) for a unanimous consent request.
  Ms. TITUS. Mr. Speaker, because the Democratic bill covers the 
preventative services that women need to stay healthy, I ask unanimous 
consent to revise and extend my remarks in support of such bill.
  Mrs. BACHMANN. I object.
  The SPEAKER pro tempore. Objection is heard.
  Now the Chair would like to make an observation for the benefit of 
everybody.
  The whole process will proceed more speedily if we, first of all, 
observe the rules and, second of all, if we afford reasonable courtesy 
to our colleagues on the other side of the aisle. The Chair calls on 
the Democrats to do that and the Republicans.
  Now, the Chair simply wants to make this statement for the benefit of 
Members on the minority side who may not have understood the Chair's 
motives, but the Chair will hear each unanimous-consent request 
individually and will hear each objection individually, and the Chair 
will ask the Members to cooperate in that. The House should have an 
orderly process that will reflect well on it in historical perspective.


                         Parliamentary Inquiry

  Mr. CULBERSON. Mr. Speaker, a parliamentary inquiry.
  The SPEAKER pro tempore. The gentleman will state it.
  Mr. CULBERSON. Mr. Speaker, is there any other motion that the 
minority can make other than a unanimous consent to expand the debate 
and allow more Members of the House to be heard in an amicable way?
  The SPEAKER pro tempore. The Chair just will adhere to the 
traditional practices of the House and not respond to hypothetical 
questions, and the Chair will rule on questions as they become ripe 
under the rules. The Chair regrets that the Chair can go no further 
than making that observation at this time.
  The Chair continues to recognize the gentlewoman from New York, and 
hopes that the process will be speeded by a more gracious acquiescence 
of the House.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield to the gentlewoman 
from California (Ms. Speier) for a unanimous consent request.
  (Ms. SPEIER asked and was given permission to revise and extend her 
remarks.)
  Ms. SPEIER. Mr. Speaker, I am in support of health care reform, as it 
will guarantee coverage for maternity and well-child care.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield to the gentlewoman 
from California (Ms. Loretta Sanchez) for a unanimous consent request.
  (Ms. LORETTA SANCHEZ of California asked and was given permission to 
revise and extend her remarks.)
  Ms. LORETTA SANCHEZ of California. Mr. Speaker, I support health care 
reform that invests in a health care workforce dedicated to meeting the 
needs of all women.


                         Parliamentary Inquiry

  Mr. BURTON of Indiana. Mr. Speaker, a parliamentary inquiry.
  The SPEAKER pro tempore. The gentleman from Indiana.
  Mr. BURTON of Indiana. Mr. Speaker, if there is a request for a 
unanimous consent, does that allow the person asking unanimous consent, 
if there is an objection, to continue on with hyperbole?
  The SPEAKER pro tempore. The Chair is going to read the rule again to 
the House. I think it will probably be helpful. I think this is the 
fourth or fifth time the Chair has done it.
  A Member asking to insert remarks may include a simple declaration of 
sentiment toward the question under debate, but should not embellish 
the requests with extended oratory; and with the assistance of the 
House, the Chair is going to do his very best to see to it that that is 
observed on both sides of the aisle.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from 
California (Ms. Richardson) for a unanimous-consent request.
  Ms. RICHARDSON. Mr. Speaker, because I stand in support of health 
care reform that helps more than half of women who cannot afford health 
care today, I ask unanimous consent to revise and extend my remarks.
  Mr. BURTON of Indiana. I object.
  The SPEAKER pro tempore. Objection has been heard.


                         Parliamentary Inquiry

  Mr. BURTON of Indiana. Mr. Speaker, with great respect, I ask 
unanimous consent for a parliamentary inquiry.
  The SPEAKER pro tempore. The gentleman from Indiana will state his 
parliamentary inquiry.
  Mr. BURTON of Indiana. Mr. Speaker, you have just ruled that you 
cannot embellish, if an objection has been heard, a unanimous-consent 
request, and yet the other side continues to embellish their remarks 
when an objection has been heard, and I wish you would restate what you 
just said, that if an objection is heard they cannot embellish their 
remarks.
  The SPEAKER pro tempore. The Chair has heard the gentleman's 
comments, and the Chair is going to make this observation. The decision 
as to whether the rules are being adhered to is the decision of the 
Chair. It is the right of Members to raise questions as they might 
choose, and this particular occupant in the chair is going to do his 
best to be fair to all parties.
  The Chair is going to now make a further admonition to the House. The 
Chair will advise Members that, as indicated by previous occupants of 
the Chair going a long way back, although a unanimous consent request 
to insert remarks in debate may comprise a simple declaration of 
statement of the Member's attitude toward the pending measure, it is 
improper for a Member to embellish such requests with other oratory and 
that it can become an imposition on the time of the Member who yielded 
for that purpose.
  The Chair will entertain as many requests to make insertions by 
unanimous consent as may be necessary to accommodate the Members, but 
the Chair also asks the Members to cooperate by confining such remarks 
to the proper form.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield to the gentlewoman 
from Florida (Ms. Wasserman Schultz) for a unanimous consent request.
  (Ms. WASSERMAN SCHULTZ asked and was given permission to revise and 
extend her remarks.)
  Ms. WASSERMAN SCHULTZ. Mr. Speaker, being a breast cancer survivor 
shouldn't disqualify a woman from getting health care coverage. I rise 
in support of health care reform.


                         Parliamentary Inquiry

  Mr. GOHMERT. Mr. Speaker, a parliamentary inquiry.
  The SPEAKER pro tempore. The gentleman will state it.
  Mr. GOHMERT. Mr. Speaker, we are hearing the requests over and over 
for unanimous consent to speak outside the rule. You see that we have a 
lineup of people over here to do the same thing on our side. The 
majority has the power to extend debate either by UC, as I understand 
it, and so my inquiry is:
  Would it be in order to go back and forth, making unanimous consents 
on each side to speak outside the rule and so we can do this in an 
equitable way, which appears to be what the Speaker is trying to do?
  The SPEAKER pro tempore. The Chair understands the concerns of the

[[Page H12603]]

gentleman. The Chair is going to make this observation:
  Looking down from the Rostrum here, the Chair observes that the line 
on the Speaker's right is getting shorter and that the time of the 
gentlewoman from New York will shortly expire. That time will then move 
to the minority side, at which time Members of the minority may want to 
make the same requests that Members of the majority have made. The 
Chair is going to do the level best to see to it all Members are 
protected in their rights.
  The question of yielding for the purpose of the unanimous consent is 
up to the gentlewoman from New York. At a later time, perhaps the 
Member of the minority handling the rule will want to make a unanimous 
consent request along those lines. If that happens, then the House will 
deal with the matter, and the Chair will preside over the decision.
  The Chair observes that the House is out of order. The Chair has 
tried to be considerate of the concerns of my friends on the minority 
side.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield to the gentlewoman 
from Maryland (Ms. Edwards) for a unanimous consent request.
  (Ms. EDWARDS of Maryland asked and was given permission to revise and 
extend her remarks.)
  Ms. EDWARDS of Maryland. Mr. Speaker, I rise in support of the 
Democratic bill because it eliminates higher premiums for women who are 
more likely than men to have chronic diseases or to be disabled.
  The SPEAKER pro tempore. Now the Chair is going to make this 
statement, and will ask Members on both sides of the aisle to listen.
  The Chair is asking for a simple statement of unanimous consent at 
this time or the person controlling the time--in this instance, my dear 
friend, the gentlewoman from New York--will find that her time is 
charged.
  So the Chair calls upon my colleagues on the majority side to listen 
to that, but the Chair reminds my colleagues on the minority side that 
the same rules and behavior will probably be applied when the minority 
is recognized.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield to the gentlewoman 
from New Hampshire (Ms. Shea-Porter) for a unanimous-consent request.
  (Ms. SHEA-PORTER asked and was given permission to revise and extend 
her remarks.)
  Ms. SHEA-PORTER. Mr. Speaker, I support health care reform because 
more than 14 million women with incomes up to 400 percent of poverty 
are uninsured.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield to the gentlewoman 
from California (Ms. Watson) for a unanimous-consent request.
  (Ms. WATSON asked and was given permission to revise and extend her 
remarks.)
  Ms. WATSON. Mr. Speaker, single women are twice as likely to be 
uninsured as married women, and they need coverage. I support the 
Democratic bill.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield to my fellow New 
Yorker (Ms. Velazquez) for a unanimous-consent request.
  (Ms. VELAZQUEZ asked and was given permission to revise and extend 
her remarks.)
  Ms. VELAZQUEZ. Mr. Speaker, I rise in support of health care reform 
as it will empower millions of women, particularly of low income, with 
information they need to make wise decisions for themselves and their 
families.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield to the gentlewoman 
from Illinois (Mrs. Halvorson) for a unanimous-consent request.
  (Mrs. HALVORSON asked and was given permission to revise and extend 
her remarks.)
  Mrs. HALVORSON. Mr. Speaker, we are in the middle of a health care 
crisis and doing nothing is not an option. I support health care 
reform.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield to the Delegate 
from the District of Columbia (Ms. Norton) for a unanimous-consent 
request.
  (Ms. NORTON asked and was given permission to revise and extend her 
remarks.)
  Ms. NORTON. Mr. Speaker, I rise in support of the Democratic bill to 
bend the curve that has seen health care costs rise three times faster 
than wages.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield to the gentlewoman 
from Florida (Ms. Corrine Brown) for a unanimous-consent request.
  (Ms. CORRINE BROWN of Florida asked and was given permission to 
revise and extend her remarks.)
  Ms. CORRINE BROWN of Florida. Mr. Speaker, I strongly support health 
care reform, which will benefit women who change jobs; and I want to 
add that health care insurance companies cannot deny people health care 
because of preexisting conditions.

                              {time}  1130

  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield to the gentlewoman 
from Wisconsin, Ms. Gwen Moore, for a unanimous consent request.
  (Ms. MOORE of Wisconsin asked and was given permission to revise and 
extend her remarks.)
  Ms. MOORE of Wisconsin. Mr. Speaker, I rise in support of this bill 
because domestic violence costs as much as $750 billion to our health 
care system.
  Ms. SLAUGHTER. Mr. Speaker, because of the kind indulgence of our 
friends on the other side, we have no further speakers, but we would 
like to sit quietly and listen to the other side.
  I reserve the balance of my time.
  Mr. SESSIONS. Mr. Speaker, I would like to inquire of the time 
remaining on both sides.
  The SPEAKER pro tempore. The gentlewoman from New York has 28 minutes 
remaining, and the gentleman from Texas has 30 minutes remaining.
  Mr. SESSIONS. Mr. Speaker, I appreciate that.
  Mr. Speaker, at this time, I would like to yield to the gentlewoman 
from Ohio (Mrs. Schmidt) for a unanimous consent request.
  (Mrs. SCHMIDT asked and was given permission to revise and extend her 
remarks.)
  Mrs. SCHMIDT. Mr. Speaker, I rise in opposition to this job-killing 
bill before us.
  Mr. SESSIONS. Mr. Speaker, I would like to yield to the gentlewoman 
from Oklahoma (Ms. Fallin) for a unanimous consent request.
  (Ms. FALLIN asked and was given permission to revise and extend her 
remarks.)
  Ms. FALLIN. Mr. Speaker, I rise in opposition against this freedom-
killing, constitutional affront, job-killing bill, health care bill.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentlewoman from Tennessee 
(Mrs. Blackburn) for a unanimous consent request.
  (Mrs. BLACKBURN asked and was given permission to revise and extend 
her remarks.)
  Mrs. BLACKBURN. Mr. Speaker, I rise in opposition on this record-
killing, job-killing bill that is going to cut Medicare and pile debt 
on our children, our precious grandchildren and raise health care costs 
and taxes on the American people.
  The SPEAKER pro tempore. The Chair is going to observe, the rules are 
going to be observed on both sides of the aisle.
  For the benefit of my colleagues, the Chair will simply observe that 
Members asking to insert remarks may include a simple declaration of 
sentiment towards the question under debate but should not embellish 
the request with extended oratory.
  The gentleman from Texas continues to be recognized.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentlewoman from California 
(Mrs. Bono Mack) for a unanimous consent request.
  (Mrs. BONO MACK asked and was given permission to revise and extend 
her remarks.)
  Mrs. BONO MACK. Mr. Speaker, I rise in opposition to this job-killing 
bill that raises taxes on the American people.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentlewoman from Florida 
(Ms. Ros-Lehtinen) for a unanimous consent request.
  (Ms. ROS-LEHTINEN asked and was given permission to revise and extend 
her remarks.)
  Ms. ROS-LEHTINEN. Mr. Speaker, I rise in opposition to this job-
killing bill because it piles on debt on my brand-new 3-month-old 
grandbaby.
  We agree that real healthcare reform is a necessity.
  We must provide uninsured Americans with meaningful healthcare 
reform.
  But the trillion dollar Pelosi bill is not the answer.

[[Page H12604]]

  The Pelosi bill will drive already hurting hardworking families and 
seniors further into debt.
  My home state of Florida is suffering with 11.2% unemployment.
  This is not the right time to burden families with increased taxes.
  Also, with over 162 billion dollars in harmful cuts to Medicare 
Advantage, the Pelosi plan will force millions of seniors to lose their 
current health coverage.
  And Medicare prescription drug premiums will likely rise by 20 
percent.
  The trillion dollar Pelosi bill makes it tougher on seniors to get 
the coverage and treatment they deserve after a lifetime of hard work 
and sacrifice.
  There is a disconnect between Congress and reality when we think 
creating bureaucracies is the same as creating solutions.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentlewoman from Michigan 
(Mrs. Miller) for a unanimous consent request.
  (Mrs. MILLER of Michigan asked and was given permission to revise and 
extend her remarks.)
  Mrs. MILLER of Michigan. Mr. Speaker, I rise in opposition to this 
job-killing, deficit-exploding government takeover of our health care 
system.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentlewoman from the State 
of Washington (Mrs. McMorris Rodgers) for a unanimous consent request.
  (Mrs. McMORRIS RODGERS asked and was given permission to revise and 
extend her remarks.)
  Mrs. McMORRIS RODGERS. Mr. Speaker, I rise in opposition because this 
bill will take away the ability of women, the chief health officer in 
85 percent of American households, for making the best decisions for 
their families.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentlewoman from West 
Virginia (Mrs. Capito) for a unanimous consent request.
  (Mrs. CAPITO asked and was given permission to revise and extend her 
remarks.)
  Mrs. CAPITO. Mr. Speaker, I rise in opposition because this bill puts 
crushing debt on everyone and puts the government between a woman and 
her doctor.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentlewoman from Illinois 
(Mrs. Biggert) for a unanimous consent request.
  (Mrs. BIGGERT asked and was given permission to revise and extend her 
remarks.)
  Mrs. BIGGERT. Mr. Speaker, I rise in opposition to this bill which 
raises health care costs and taxes.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentlewoman from Minnesota 
(Mrs. Bachmann) for a unanimous consent request.
  (Mrs. BACHMANN asked and was given permission to revise and extend 
her remarks.)
  Mrs. BACHMANN. Mr. Speaker, I rise in opposition to this job-killing 
bill that will cut $500 million from Medicare and potentially collapse 
the economic economy.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentlewoman from Kansas 
(Ms. Jenkins) for a unanimous consent request.
  (Ms. JENKINS asked and was given permission to revise and extend her 
remarks.)
  Ms. JENKINS. Mr. Speaker, I rise in opposition because this bill 
kills jobs, cuts Medicare, piles on debt, increases costs and raises 
taxes.
  While there are many reasons why I'm opposed to Speaker Pelosi's 
health care bill, there is one that has been highlighted in today's 
headlines.


                                  JOBS

  Americans from coast to coast are struggling to make ends meet and 
many are looking for work.
  Yet on the day unemployment in our nation hit 10.2 percent, the 
highest level since 1983, the Democrat Party continues to move forward 
with yet another job-killing bill.
  According to a model used by President Obama's own economic advisors, 
Speaker Pelosi's health care plan would kill another 5.5 million jobs.
  That is downright criminal.
  Before voting on Speaker Pelosi's plan later this weekend, I urge my 
colleagues to respond to the needs of the American people by supporting 
solutions to create jobs, not kill them.
  I yield back the remainder of my time.
  The SPEAKER pro tempore. The Chair is going to announce again the 
rules of the House as they affect this part of our proceedings.
  A Member asking to insert remarks may include a simple declaration of 
sentiment towards the question under debate but should not embellish 
their requests with extended oratory.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentlewoman from Wyoming 
(Mrs. Lummis) for a unanimous consent request.
  (Mrs. LUMMIS asked and was given permission to revise and extend her 
remarks.)
  Mrs. LUMMIS. Mr. Speaker, I rise in opposition to this job-killing 
bill at a time when our Nation has 10.2 percent unemployment that cuts 
Medicare, piles debt on our children, and raises health care costs.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentlewoman from Florida 
(Ms. Ginny Brown-Waite) for a unanimous consent request.
  (Ms. GINNY BROWN-WAITE of Florida asked and was given permission to 
revise and extend her remarks.)
  Ms. GINNY BROWN-WAITE of Florida. Mr. Speaker, I rise in opposition 
to this job-killing bill that's estimated to cut 5.5 million jobs in 
America. It's not going to help health care, and the bottom line is 
Medicare is imperiled as a result of it.
  The SPEAKER pro tempore. The Chair will ask for a simple statement of 
unanimous consent, or the gentleman from Texas will be charged for time 
just like the gentlewoman from New York.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentlewoman from North 
Carolina (Ms. Foxx) for a unanimous consent request.
  (Ms. FOXX asked and was given permission to revise and extend her 
remarks.)
  Ms. FOXX. Mr. Speaker, I rise in opposition to this exercise of 
tyranny of the majority that our Founders so feared on this job-killing 
bill that cuts Medicare, piles debt on our children, raises health care 
costs, and raises taxes on the American people.
  The SPEAKER pro tempore. The Chair observes that the gentleman from 
Texas is being charged for the time now being used.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentleman from Kentucky 
(Mr. Davis) for a unanimous consent request.
  (Mr. DAVIS of Kentucky asked and was given permission to revise and 
extend his remarks.)
  Mr. DAVIS of Kentucky. Mr. Speaker, I rise in opposition because of 
the tyranny that is being exercised by the majority to step in between 
the American people and their freedom to make their own health 
decisions.
  The SPEAKER pro tempore. The gentleman from Texas is charged for the 
time.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentleman from Louisiana 
(Mr. Alexander) for a unanimous consent request.
  (Mr. ALEXANDER asked and was given permission to revise and extend 
his remarks.)
  Mr. ALEXANDER. Mr. Speaker, I rise in opposition against this 
government takeover of health care.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentleman from Texas (Mr. 
Culberson) for a unanimous consent request.
  (Mr. CULBERSON asked and was given permission to revise and extend 
his remarks.)
  Mr. CULBERSON. Mr. Speaker, I rise in opposition on behalf of the 
people of District Seven to register my strenuous opposition to this 
government takeover of the health care system which will bankrupt our 
children.
  The SPEAKER pro tempore. The gentleman from Texas is charged for the 
time.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentleman from Texas (Mr. 
Gohmert) for a unanimous consent request.
  (Mr. GOHMERT asked and was given permission to revise and extend his 
remarks.)
  Mr. GOHMERT. Mr. Speaker, I rise in opposition to the abuse of 
process in not allowing people to come to the people's House and just 
make statements over 18 percent takeover of the U.S. economy.
  The SPEAKER pro tempore. The gentleman is charged for the time.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentleman from South 
Carolina (Mr. Wilson) for a unanimous consent request.

[[Page H12605]]

  (Mr. WILSON of South Carolina asked and was given permission to 
revise and extend his remarks.)
  Mr. WILSON of South Carolina. Mr. Speaker, I rise in opposition to 
this job-killing bill that cuts Medicare, piles debt on our children 
and grandchildren, raises health care costs, and raises taxes on the 
American people.
  Additionally, this bill cuts approximately $150 billion from Medicare 
Advantage, leaving 4.6 million women without their choice of insurance.
  The SPEAKER pro tempore. The gentleman from Texas is charged with the 
time.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentleman from Illinois 
(Mr. Roskam) for a unanimous consent request.
  (Mr. ROSKAM asked and was given permission to revise and extend his 
remarks.)
  Mr. ROSKAM. Mr. Speaker, I rise in opposition to this bill that would 
lead to possible jail time if you don't comply.
  Mr. SESSIONS. Mr. Speaker, I would like to yield to the gentleman 
from Colorado (Mr. Coffman) for a unanimous consent request.
  (Mr. COFFMAN asked and was given permission to revise and extend his 
remarks.)
  Mr. COFFMAN of Colorado. Mr. Speaker, I rise in opposition as this 
bill is punitive to both small businesses and seniors.
  Mr. SESSIONS. Mr. Speaker, I would yield to the gentleman from 
Illinois (Mr. Shimkus) for a unanimous consent request.
  (Mr. SHIMKUS asked and was given permission to revise and extend his 
remarks.)
  Mr. SHIMKUS. Mr. Speaker, I rise in opposition because this bill's 
main intent is government control of health care.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentleman from Arizona (Mr. 
Flake) for a unanimous consent request.
  (Mr. FLAKE asked and was given permission to revise and extend his 
remarks.)
  Mr. FLAKE. Mr. Speaker, I rise in opposition to this bill. When there 
is 10 percent unemployment, you stop digging.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentleman from Indiana (Mr. 
Burton) for a unanimous consent request.
  (Mr. BURTON of Indiana asked and was given permission to revise and 
extend his remarks.)
  Mr. BURTON of Indiana. I hope I don't get a hernia, Mr. Speaker, and 
say to all my colleagues, if you haven't read this thing, it's going to 
cost billions and billions of dollars and hurt the economy. I would 
just like to say that I hope before we vote on this thing you will read 
it.
  The SPEAKER pro tempore. The gentleman from Texas will be charged 
with the time.
  Mr. SESSIONS. Mr. Speaker, at this time I would like to inquire upon 
the time that is left on both sides, please, sir.
  The SPEAKER pro tempore. The gentlewoman from New York has 28 minutes 
remaining, and the gentleman from Texas has 28\1/4\ minutes.
  Mr. SESSIONS. Mr. Speaker, I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, let me say, once again, to get to this 
great debate, we are greatly in your debt, Mr. Speaker, to find 
ourselves here this morning.
  The legislation that we take up today is the culmination of a fight 
for health care reform that dates back at least a century and has been 
one of the greatest political struggles of our era. It shouldn't be 
this way. Many years ago, every other western nation enacted broad 
health care coverage for its citizens but not in the United States. 
Only in this country has there been such a visceral anti-government 
urge to resist something that benefits almost everyone. Only here do 
efforts to bring about improved health care for all Americans crash 
against entrenched interests and corporate resistance. And only here do 
arguments about reforming insurance spark ideological attacks from the 
far right.
  One need only to have looked at the windows of the Capitol earlier 
this week to see the manifestation of that anger. Thousands of 
protesters showed up to threaten us into not voting in favor of this 
bill. If they expected us to run for cover or vote against this bill, 
they are going to be disappointed. Hearing those extreme views only 
made most of us more confident that we are doing the right thing here 
today by approving this bill.
  Throughout the years, those same voices of opposition, whether it's 
Republicans or corporate interests, have rallied against reforms. It is 
worth pointing out for the record that Republicans who want to 
participate in this process did. We had more than 100 hearings, heard 
from 181 witnesses, Democrat and Republican, and considered hundreds of 
amendments. Fully 121 were approved in the committees, including 22 
from Republicans. Their input has been heard when they wanted to 
participate.
  In 1912, President Theodore Roosevelt split from the Republican Party 
to lead a more progressive effort and champion health care for all 
Americans, but he lost the next election to Woodrow Wilson and the 
effort failed. Later, President Franklin D. Roosevelt would lead 
another charge on this front as part of the New Deal platform. While 
Roosevelt was able to win passage of Social Security over great and 
extreme opposition, again by the same people who oppose this today, he 
was able to enact Social Security in 1935, but he was not able to 
extend that coverage to all Americans for health.

                              {time}  1145

  Still later, President Harry Truman made another try for health care, 
followed by President Lyndon Johnson, who was able to pass legislation 
in 1965 that implemented Medicare and Medicaid. Once again, it passed 
over Republican opposition that extends to this day.
  President Richard Nixon followed up on President Johnson's Great 
Society by seeking to expand Federal programs and favoring broad health 
insurance. Sadly, those efforts were again derailed.
  By the time President Clinton attempted to revisit the issue in 1993, 
the debate had become so polarized and fraught with special interests 
that the entire process collapsed almost before it started. I don't 
need to remind most of my colleagues here about the awful vilification 
of reform embodied by the ``Harry and Louise'' television ad campaign 
and by mail house threats to senior citizens that going to what they 
called the ``wrong doctor'' could result in a $10,000 fine and perhaps 
prison time.
  These ads and those mail-order ads were paid for by big contributions 
from insurance companies and were led by the Republicans. And the same 
forces are still fighting us. The insurance industry and the big drug 
companies have partnered with the extreme right fringe to try to stop 
this effort in its tracks. We saw a lot of that this past summer.
  Let me say this loud and clear: Eliminating the stranglehold that big 
insurance companies have on health care is one of the best parts of 
this bill, and, for the first time, 85 percent of the premium dollars 
have to go for health care, not for outrageous salaries and 
compensation.
  We are poised for victory. We stand here today on the brink of 
history, with the opportunity to make good on a promise that will 
forever improve the lives of nearly 36 million Americans who have no 
health insurance. This is the most important vote we will ever take, 
and I am proud to stand here today.
  With this bill we can end the constant worry by people who don't have 
insurance to cover sudden illness or an accident, who are the parents 
of a child who had severe brain trauma before he reached his teenage 
years and within a year or two could reach his lifetime cap on 
insurance, and though he was not yet a teenager, would be forever 
uninsurable in the United States of America.
  We will stop telling women, as we discussed last night in the Rules 
Committee, that they have to pay 48 percent more for health insurance 
because, as it was explained last night, it is all right to do that 
because women have different diseases. We want to have an end to that.
  How many small businesses in little towns in America have had to 
close up or to end coverage for employees because they could not afford 
exorbitant insurance premiums? Small business has to compete with big 
business and

[[Page H12606]]

gets no break on providing insurance for their employees.
  And now this year we have literally thousands of organizations on our 
side favoring the bill. From AARP, who would never go for any bill that 
in any way would hurt senior citizens because that is their life's 
work, the Consumers Union, the American Cancer Society and the American 
Medical Association, they have all joined in this cause.
  The reason we are here at this moment is because of the leadership of 
our Speaker, Ms. Pelosi, who is a powerful leader, a compassionate 
woman, and an inclusive colleague who deserves all the credit for 
bringing us here to this momentous event that we face today, the most 
momentous in the history of America.
  Before we vote, it is also fitting that we recall the words of the 
late Senator Kennedy, who spoke as far back as 1978 about the lack of 
health care coverage in this country. Senator Kennedy said, ``One of 
the most shameful things about modern America is that in our 
unbelievably rich land, the quality of health care available to many of 
our people is unbelievably poor, and the cost is unbelievably high.''
  I agree with Senator Kennedy. We cannot afford not to pass this 
legislation.
  Now is our chance to fix our health care system, improve the lives of 
millions of Americans, and make more corporations in America 
competitive in a global economy.
  With great heartfelt thanks to our great Speaker pro tempore this 
morning, Mr. Dingell, I reserve the balance of my time.
  Mr. SESSIONS. Mr. Speaker, at this time I would like to yield to the 
gentlewoman from Texas (Ms. Granger) for a unanimous consent request.
  (Ms. GRANGER asked and was given permission to revise and extend her 
remarks.)
  Ms. GRANGER. Mr. Speaker, I rise in opposition on behalf of District 
12 on this job-killing bill that cuts Medicare, piles debts on our 
children, raises health care costs, and raises taxes on the American 
people.
  The SPEAKER pro tempore. The Chair observes that the Chair has asked 
for a simple statement of unanimous consent or the gentleman from Texas 
will be charged out of his time.
  The Chair repeats that, and the Chair charges the gentleman for the 
time.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentleman from Utah (Mr. 
Bishop) for a unanimous consent request.
  (Mr. BISHOP of Utah asked and was given permission to revise and 
extend his remarks.)
  Mr. BISHOP of Utah. Mr. Speaker, I rise to illustrate how this bill 
will stop health care reform already instituted by the States.
  This may seem hard to believe, but over 200 years ago the Founding 
Fathers foresaw the health care problems we have today and they 
proposed a solution. We call it federalism. See, if something has to be 
done the same way, at the same time by everybody, only the federal 
government can do it. The feds are good at one-size-fits all solutions. 
But if you want creativity, innovation or justice, and consideration 
for unique circumstances, states are, as Louis Brandeis once called 
them, the true laboratories of democracy.
  The Founding Fathers understood the Federal Government should be 
limited, not just for the fun of it, but the federal government has 
limitations to its effectiveness. In Federalist Number 45 James Madison 
said, ``Powers delegated to the federal government are few and defined. 
Those to the State governments are numerous and indefinite.'' Why? 
Because states can be more effective than a large national government. 
The federal government can't and shouldn't try to solve all our 
problems, even when the intention may be good. A Supreme Court Justice 
wrote: ``The Constitution protects us from our own best intentions. It 
divides power . . . precisely so that we may resist the temptation to 
concentrate power in one location as an expedient solution to the 
crises of the day.''
  He wasn't speaking about health reform specifically, but if there 
ever was a bill that sought to concentrate power as an expedient 
solution to the crisis of the day, it's Speaker Pelosi's health care 
bill.
  If we were to pass it, we would be losing sight of the structure the 
Founders put in place to ensure reforms were done at the most 
appropriate and helpful level, and power wasn't concentrated.
  Balance is key, and the Pelosi bill would be a permanent shift of 
power to the federal government to control our daily lives and our 
health care decisions. You see, that as why the Constitution was 
designed with this balance in mind. James Madison said, ``Parchment 
barriers, a few luminous words on paper, would not keep ambitious men 
from exercising undue power--freedom can be preserved not by glowing 
statements but by the balance of real forces.''
  Our health care system needs reform and costs need to be lowered. 
Hey, in 2000, 54% of all firms (in Utah?) offered health benefits, 
today only about 44% of them do. But the reforms needed for the state 
of California are not the reforms needed for the state of Massachusetts 
or the state of Utah. Massachusetts has their program; it's expensive, 
but they appear to like it; but it won't work in Utah. What Utah is 
trying to do wouldn't fly in Boston. Like every state, Utah's 
demographics are unique.
  We have a very young population that predominately works for smaller 
firms. In Utah, 32 percent of small businesses offer insurance, but 
that is 10 percent less than the national averages--a unique challenge 
to Utah. Utah needs reform that will take the burden off small  
business and give competitive, affordable pricing to consumers.

  That is why I'm so encouraged about the reforms taking place in Utah. 
The changes taking place right now in our state are based on consumer 
choice and options, businesses have stable costs, workers have 
affordable, portable options, and it's tailored for our demographics. 
If the Pelosi bill were to pass, though, that state innovation is 
stopped. That would be the true health care tragedy.
  You know, we can't solve every issue by getting all the experts in a 
room in DC. All the creativity and intelligence is not just here in 
this city. Creative solutions can happen throughout the country when 
the federal government gets off the backs of individuals and businesses 
with their mandates and regulations, and out of their pockets with 
their taxes and then allows real people the ability to find real 
solutions.
  The Pelosi bill seeks to dramatically alter the healthcare landscape 
for the U.S. and Utah forever. For example, prohibits the sale of 
private individual health insurance policies, beginning in 2013, 
forcing individuals and businesses to purchase coverage through the 
federal government.
  PG 49--provides a huge liability loophole for (large) insurance 
companies, and I bet not more than 10 people know about it.
  Small business will be hit with a mandate to provide insurance, with 
penalties for not providing insurance . . . and a surtax of 5.4% on 
small business owners. It is estimated that fifty five hundred (5,500) 
businesses in Utah will be hit with this additional tax. This is 
devastating for small business owners, already sick and tired of being 
nickel and dimed by the federal government.
  Tort reform, allowing interstate insurance competition and block 
grants to states for high risk pooling are things the federal 
government can reform to drive down costs. These are common sense 
changes that won't damage the work states are doing to provide what 
their citizens need.
  Individual merits of the bill notwithstanding, the biggest problem is 
the idea that health care decisions can be dictated by Washington, DC 
bureaucrats--a health care czar.
  To paraphrase PJ O'Rourke, the Pelosi bill would have the same effect 
as giving alcohol and keys to the car to a teenage boy.
  The federal government can play a role, but real health reform must 
happen on the state level. We . . . you and I, know what our unique 
healthcare needs are, and frankly what types of treatment or access we 
require to live the healthiest possible life. Despite the fanciful 
rhetoric coming from both sides of the aisle, our ability to choose 
will be lost if we fail to allow individual states to address their 
unique and diverse needs.
  Mr. SESSIONS. I would like to yield to the gentleman from California 
(Mr. Herger) for a unanimous consent request.
  (Mr. HERGER asked and was given permission to revise and extend his 
remarks.)
  Mr. HERGER. Mr. Speaker, I rise to say this job-killing bill would 
cause as many as 112 million Americans to lose their current health 
care insurance.
  The SPEAKER pro tempore. The gentleman from Texas is again charged 
time.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentleman from New York 
(Mr. Lee) for a unanimous consent request.
  (Mr. LEE of New York asked and was given permission to revise and 
extend his remarks.)
  Mr. LEE of New York. I rise to say this job-killing bill cuts 
Medicare, piles debt on our children, and does nothing to address the 
issue of medical liability reform.
  Medical liability reform would decrease the need for physicians to 
practice defensive medicine and could save $54 billion, according to 
the CBO.

[[Page H12607]]

  As we all know, the majority refused virtually all amendments to the 
underlying bill. An amendment that I proposed would play a meaningful 
role in reforming medical liability laws.
  My amendment would administer a pilot program in five states in which 
a three-member panel--a judge, a physician and a lawyer--would hold a 
hearing to determine if the facts of an alleged medical malpractice 
case are sufficient to raise a question of liability. This will lower 
costs and help eliminate defensive medicine.
  Modeled after a Massachusetts program, all cases can proceed past 
this panel and go to trial regardless of whether the panel believes the 
defendant was at fault.
  However if the panel believes that the case is frivolous, the person 
who files the case would have to file bond in an amount, determined by 
the judge, payable to the defendant for costs should the plaintiff not 
prevail in the final judgment.
  The pilot program would look at the changes in the cost of 
malpractice insurance, the number of physicians practicing, number of 
liability carriers, and the amount of pay-outs from liability carriers 
with respect to lawsuits.
  In more than 2,000 pages there is not one meaningful piece that will 
address the issue of medical liability reform.
  This pilot program would show Congress and the American people how 
meaningful reforming medical liability will be, and that is the only 
reason I can assume the majority did not allow it to proceed.
  The SPEAKER pro tempore. The gentleman from Texas is again charged 
time.
  Mr. SESSIONS. I would like to yield to the gentleman from Florida 
(Mr. Posey) for a unanimous consent request.
  (Mr. POSEY asked and was given permission to revise and extend his 
remarks.)
  Mr. POSEY. Mr. Speaker, I rise in opposition to this job-killing bill 
that the overwhelming majority of Americans don't want and don't need.
  Madam Chair, I rise to express my deep concerns not only about the 
specific provisions in the bill before us, but over the lack of 
transparency and openness throughout this process.
  In just a few short hours, the U.S. House of Representatives will 
vote on the most sweeping changes ever in our nation's health care 
system. The final version of this bill, including last minute 
amendments, was made available to Members of Congress just a few short 
hours ago. The final text of this bill has not been made available to 
the public or Members of Congress for at least 72 hours.
  I believe that when the Congress considers changes of this magnitude 
which will affect 17 percent of our entire economy, we should have more 
transparency and openness. I will be voting against H.R. 3962, not only 
because of the many provisions I find objectionable, but also because 
of the lack of transparency about what it is specifically that we are 
voting on.
  The House should not be considering or passing this 2,000-page bill 
which has not even been subjected to a single committee hearing. Over 
200 amendments were filed to this 2,000-page bill. Sadly, out of these 
200 amendments, only 1 is allowed to be offered.
  Now, let me turn to some specific concerns with the bill.
  H.R. 3962 is the wrong prescription for our economy. Yesterday, the 
Department of Labor reported that the national unemployment rate hit a 
26-year record high of 10.2 percent. Florida's unemployment rate is 
above 11 percent. Furthermore, as reported in this morning's New York 
Times, the broadest measure of underemployment and unemployment 
reaches. 17.5 percent, which is higher than the record 17.1 percent 
reached at the height of the 1982 recession.
  This is the wrong time to be considering legislation that will cost 
us jobs. The hundreds of billions of dollars of higher taxes and the 
unfunded mandates that H.R. 3962 places on small businesses will result 
in the elimination of between 4 and 5 million American jobs. That is 
the estimated job loss as measured using a formula developed by 
President Obama's own Chief Economic Advisor, Kathleen Romer. This 
would be in addition to the estimated 2.5 million jobs that would be 
lost if the Cap and Trade National Energy Tax legislation is enacted 
into law. (Estimated job loss by the Heritage Foundation.)
  Small businesses across America create nearly 65 percent of all new 
jobs and this bill's 8 percent employer health care tax is only going 
to make it that much harder for small business to create jobs. H.R. 
3962's provision to impose a $500,000 fine for inadvertent errors will 
only serve to bankrupt many small businesses.
  America cannot afford this bill. They cannot afford more legislation 
that will lead to higher unemployment. The American people need 
legislation that promotes job creation, not legislation that will 
stifle the creation of American jobs.
  H.R. 3962 is excessively costly and completely unaffordable. 
Washington just ended the year with a record $1.4 trillion debt. The 
Congressional Budget Office, CBO, estimates trillion dollar deficits as 
far as the eye can see. Our Nation's debt is so serious that in May the 
Secretary of the U.S. Treasury had to fly to China to ensure that the 
Chinese would continue to purchase our U.S. Treasury notes and to 
assure them that Washington would get serious about getting its fiscal 
house in order.
  Sadly, this health care bill creates a new unaffordable entitlement 
program that we cannot afford and will indebt future generations of 
Americans for decades to come. CBO says of H.R. 3962 that it ``would 
put into effect (or leave in effect) a number of procedures that might 
be difficult to maintain over a long period of time.'' In other words, 
this bill creates serious long-term budget problems for our Nation.
  The President said in his September address to Congress and the 
Nation that health care reform legislation would not exceed more than 
$900 billion. Unfortunately, when you assemble all of the pieces of 
this health care agenda together, you come up with a price tag of 
nearly $1.6 trillion for the first 10 years of this bill--56 percent 
above the $900 billion cap. This includes CBO's $1.05 trillion cost 
estimate for H.R. 3962 and the $209 billion for the Medicare doctor 
fix. Further increasing the cost is the administration's $70 billion 
Medicare adjustment, more than $200 billion in discretionary spending 
required in the future as a result of H.R. 3962, and more than $34 
billion in unfunded Medicaid mandates on the States ($1 billion for 
Florida as estimated by the State).
  Furthermore, when you consider that the costs of H.R. 3962 begin to 
significantly increase in 2014, thus a more accurate 10 year cost 
estimate for the bill (2014-2024) shows a cost of $2.4 trillion. H.R. 
3962 sets us up for serious budget challenges for 2020 and will indebt 
our children for decades to come.
  H.R. 3962 will have an adverse impact on Medicare recipients. I am 
very concerned about the nearly $500 billion in cuts that H.R. 3962 
makes to Medicare. This, I believe will have a long-term negative 
impact on Medicare. Taking the money out of Medicare only makes the 
challenge of averting Medicare's projected 2017 insolvency more 
difficult. Furthermore, those hardest hit are likely to be seniors 
enrolled in Medicare Advantage, MA, plans, including over 42,000 
seniors in my congressional district who are enrolled in MA plans. Many 
of these seniors would lose their current Medicare plan and be forced 
back into the traditional Medicare fee-for-service plan, which will 
cost them more money and less coordination of their care.
  Failure to buy government approved plan can result in fines and jail 
time. A November 5, 2009, letter from the Joint Committee on Taxation 
affirmed that if an American citizen fails to purchase a government 
approved health care plan or pay the mandatory 2.5 percent national 
health care tax, they will be subject to Federal penalties which may 
include up to 5 years and a fine of up to $25,000. It is simply 
unthinkable that Washington would enact legislation carrying such 
mandates and penalties, but that is what H.R. 3962 would do. Such 
coercion is wrong and quite frankly runs counter to the freedoms and 
liberties that have made this Nation what it is today.

  The American people should be allowed to choose whatever health care 
plan they want. They should not be restricted to only buying health 
insurance that Congress or an unelected group of bureaucrats say you 
can buy.
  The word ``shall'' is included more than 3,400 times throughout H.R. 
3962. Shall is a term used in legislative language to mandate what can 
or cannot be done. With the use of the word ``shall'' more than 3,400 
times, the choices and liberties of the American people to choose what 
they want are clearly undermined. Clearly, these mandates seriously 
undermine and change the health care that 80 percent of Americans have 
today and want to keep.
  Illegal Immigrants Covered Under H.R. 3962. It is wrong to use 
taxpayer dollars to subsidize the enrollment of illegal immigrants into 
this new government plan. While H.R. 3962 includes language stating 
that funding in the bill cannot be used to enroll illegal immigrants in 
the national health care plan, the nonpartisan Congressional Research 
Service, CBO, and the Social Security Administration all agree that the 
provisions in H.R. 3962 are insufficient to actually prevent their 
enrollment in taxpayer subsidized health care. Millions of illegal 
immigrants will receive taxpayer subsidies for enrollment in subsidized 
health care plans.
  Other Concerns. The American people were told earlier this year that 
health care reform legislation would lower their average health care 
costs by about $2,500. H.R. 3962 does just the opposite. Estimates by 
the Joint Committee on Taxation, the CBO, and six other

[[Page H12608]]

studies show that imposing new taxes on insurance policies, as H.R. 
3962 does, will drive up the cost of medical coverage.
  We were told that health care reform was needed in order to lower the 
overall amount of spending on health care. However, according to the 
CBO, ``On balance, during the decade following the 10-year budget 
window, the bill would increase both federal outlays for health care 
and the federal budgetary commitment to health care, relative to 
amounts under current law.'' So, H.R. 3962 will actually result in more 
spending on health care rather than less.
  I oppose the provisions in H.R. 3962, which would use taxpayer 
dollars to pay for elective abortions and subsidize enrollment in 
health insurance plans that pay for elective abortions. H.R. 3962 would 
for the first time use taxpayer dollars to subsidize elective abortions 
and expand mandate that insurance coverage of elective abortion be 
expanded to every jurisdiction in the country. I oppose this mandate, 
but I am supportive of the Stupak/Smith amendment, which will remove 
from this bill any expansion of taxpayer funding for abortions.
  Health Care Solutions. I was greatly disappointed that the debate in 
the House was so severely restricted as only 1 of more than 200 
amendments was allowed. This is truly a sad day for the American people 
as constructive contributions to health care reform have been silenced.
  We should focus on creating more choices for the American people, not 
less. Rather than move in the direction of more choices and increased 
competition, H.R. 3962 undermines choice in many ways. By creating a 
national Health Benefits Advisory Committee, HBAC, H.R. 3962 creates a 
one-size-fits-all set of benefits with which every health plan in 
America must conform. Estimates are that millions of Americans will be 
moved into this new government health care plan, losing the coverage 
that they currently have and want to keep.
  There are steps that can be taken--without reducing these choices--to 
address the concerns of those who lack coverage or who have 
difficulties paying for the coverage they want. We should expand the 
deductibility of health insurance for all Americans. Refundable health 
care tax credits of $2,500 for an individual or $5,500 for a family 
will enable working Americans to secure affordable health care coverage 
and empower them to choose the type of coverage that meets their needs.
  Enactment of Association Health Plan, AHP, legislation would make it 
easier for small businesses to pool together and negotiate with 
insurance providers for the purchase of more affordable insurance for 
their employees. Similarly, nonprofit civic groups should be empowered 
to create health plans and offer them to their members and the public. 
Sadly, liberals in the Congress have blocked these efforts for the past 
decade.
  Health Savings Accounts, HSAs, should be expanded enabling more 
individuals to purchase a high deductible health plan while also 
putting money aside in an HSA to cover medical expenses below the 
catastrophic coverage cap. For many, this would be a more affordable 
alternative to traditional insurance and over 8 million Americans have 
chosen to enroll in HSAs in just the past 5 years. For those with 
preexisting conditions or who otherwise have difficulty finding 
affordable coverage, we should expand high-risk insurance pools and 
other approaches to make sure that those with such challenges are able 
to find affordable coverage.
  Community health centers, like the ones I recently visited throughout 
my district, can play an important role in serving those in need of 
affordable medical care. These centers provide cost-effective primary 
care and preventive care to millions of lower- and lower-middle-income 
Americans, and we should continue to encourage their development and 
expansion.
  Expanding health care coverage also means taking steps to reduce 
waste in medical care expenditures. One of the main factors behind 
greatly increasing costs of health care premiums is the skyrocketing 
cost associated with medical malpractice. H.R. 3962 does nothing to 
move us in the direction of adopting medical malpractice solutions that 
have proven successful in many States.
  The SPEAKER pro tempore. The gentleman from Texas is again charged 
time.
  Mr. SESSIONS. Mr. Speaker, I would yield to the gentleman from New 
Jersey (Mr. Lance) for a unanimous consent request.
  (Mr. LANCE asked and was given permission to revise and extend his 
remarks.)
  Mr. LANCE. Mr. Speaker, this health care proposal would be harmful to 
New Jersey's taxpayers, senior citizens and businesses, and contains no 
malpractice insurance reform.
  The SPEAKER pro tempore. The gentleman is again charged time.
  Mr. SESSIONS. Mr. Speaker, I would like to yield to the gentleman 
from Texas (Mr. Poe) for a unanimous consent request.
  (Mr. POE of Texas asked and was given permission to revise and extend 
his remarks.)
  Mr. POE of Texas. Mr. Speaker, I rise in opposition to this tax-
increasing, runaway-spending, government-controlled, rationed health 
care bill.
  Mr. SESSIONS. Mr. Speaker, I would like to yield to the gentleman 
from South Carolina (Mr. Barrett) for a unanimous consent request.
  (Mr. BARRETT of South Carolina asked and was given permission to 
revise and extend his remarks.)
  Mr. BARRETT of South Carolina. Mr. Speaker, this bill is a massive 
government takeover of our health care.
  Mr. Speaker, today, I rise in strong opposition to this so-called 
Democrat health care reform package.
  I do believe health care reform is necessary. However, what this 
looming health care legislation essentially amounts to is a Government 
takeover of the health care system, which will result in devastating 
consequences for families and small businesses across the country.
  This massive Government expansion will cost nearly $1.3 trillion, 
which is offset with job-killing tax increases. Small businesses will 
be hardest hit by these tax increases, which will total to a staggering 
$729.5 billion. This will be especially devastating in my home State of 
South Carolina, where small businesses represent 97 percent of the 
State's employers. According to the Heritage Foundation, 8,700 of South 
Carolina's small businesses will be required to pay this new, 
burdensome tax.
  Currently, my State is trying to recover from a recession that has 
swept the entire country. South Carolina is struggling with double 
digit unemployment rates. This legislation will place unnecessary 
burdens on our small businesses, which will result in even more job 
losses. However, my State is not the only area that will be affected 
negatively by this legislation.
  Today, it was announced that our Nation's current unemployment rate 
is 10.2 percent. With our national unemployment rate at a 26-year high, 
why are Democrats pushing for a Government takeover of health care 
which will only stifle job creation?
  Furthermore, as a firm believer in the sanctity of life, I am 
appalled by provisions in this bill that allow for the Government 
funding of abortions. I adamantly oppose allowing any Government 
funding of abortions because it endangers the lives of unborn children 
across the nation.
  Since I oppose this legislation, I tried to find ways to work with 
the majority to illustrate my concerns with what I believe is a 
reckless bill. However, when I tried offering amendments my efforts 
were declined by the Democrat-controlled House Rules Committee.
  This is a broad sweeping bill that will have ramifications on our 
economy and Government solvency for years to come. Since health care is 
in need of reform, I would have liked to work with the Democrats so 
that we could approach health care reform in a bipartisan matter--so 
that we could create solutions that are in-line with most Americans' 
opinions.
  Mr. Speaker, people across this Nation are scared and they are in 
need of leadership. Many are worried that they will not be able to keep 
their current coverage, and they should be. In South Carolina, some 
studies estimate that up to 178,889 individuals could lose their 
current coverage.
  They are in need of comprehensive reform that does not harm the 
economy and actually facilitates a system that will keep our citizens 
healthy.
  That is why I support the Republican alternative. This Republican 
plan fixes our country's health system in a creative way that requires 
less Government involvement and taxes. Furthermore, this plan results 
in zero job losses, zero medicare cuts, and zero tax increases.
  We in Congress should be working together to achieve real reform--
making health care more affordable and accessible for all Americans 
without dramatically expanding the Federal Government and imposing 
billions of dollars in taxes on American families and businesses.
  Mr. SESSIONS. Mr. Speaker, I would like to yield to the gentleman 
from Alabama (Mr. Bonner) for a unanimous consent request.
  (Mr. BONNER asked and was given permission to revise and extend his 
remarks.)
  Mr. BONNER. Mr. Speaker, this job-killing bill cuts Medicare, piles 
debt on our children, raises health care costs, and raises taxes on the 
American people.
  The SPEAKER pro tempore. The gentleman from Texas is again charged 
time.
  Mr. SESSIONS. Mr. Speaker, I appreciate the Speaker, who is 
forthrightly

[[Page H12609]]

following the procedures which he spoke about.
  Mr. Speaker, at this time I yield to the gentleman from Texas (Mr. 
Carter) for a unanimous consent request.
  (Mr. CARTER asked and was given permission to revise and extend his 
remarks.)
  Mr. CARTER. Mr. Speaker, I rise to say this record job-killing bill 
tyrannically forces government health care on the American people.
  The SPEAKER pro tempore. The gentleman from Texas is again charged 
time.
  Mr. SESSIONS. I yield to the gentleman from Maryland (Mr. Bartlett) 
for a unanimous consent request.
  (Mr. BARTLETT asked and was given permission to revise and extend his 
remarks.)
  Mr. BARTLETT. This bill would mortgage the future of my 10 kids, my 
17 grandkids and my two great-grandkids.
  Mr. SESSIONS. Mr. Speaker, at this time I would like to request the 
time that remains on both sides, please.
  The SPEAKER pro tempore. The gentleman from Texas has 26\1/4\ minutes 
remaining, and the gentlewoman from New York has 21 minutes remaining.
  Mr. SESSIONS. Mr. Speaker, we reserve our time.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield 2\1/2\ minutes to 
the gentleman from Massachusetts (Mr. McGovern), a Member of the Rules 
Committee.
  Mr. McGOVERN. Mr. Speaker, this is a remarkable, historic moment. 
Passage of health insurance reform is a ``Franklin Roosevelt'' moment, 
right up there with the creation of Social Security.
  We have debated this issue for almost 100 years, since Teddy 
Roosevelt ran on the Bull Moose Party. This year alone, House 
committees have spent nearly 100 hours in hearings on health reform. 
They have heard from 181 witnesses, spent 83 hours in committee 
markups, and considered 239 amendments. The Rules Committee spent 
almost 12 hours hearing testimony last night. This has been a very 
thorough and thoughtful process. The time for talk has come to an end. 
Now is the time for action.
  The need for reform is clear. Since 2000, employer-sponsored health 
insurance premiums for American families have more than doubled. 
Because of crushing health care costs, small businesses are losing 
their ability to compete in the global marketplace.
  If we do nothing, as my Republican friends want to do, family 
premiums will increase an average of $1,800 every year and the number 
of uninsured will reach 61 million people by 2020. Not only that, but 
skyrocketing health care costs will bankrupt this country. By the time 
my kids retire, health care will take up 50 percent, half of our entire 
economy. We simply cannot leave that kind of debt for future 
generations.
  My Republican friends see things differently. Their prescription for 
health care is ``take two tax breaks and call me in the morning.'' It 
is the same-old same-old. For 12 years, Republicans had their chance to 
improve health care in America, and for 12 years they let the number of 
uninsured skyrocket, while letting the insurance companies make money 
hand-over-fist.
  Those who vote against this bill are on the wrong side of history. 
With the passage of this bill, we stand for the uninsured, for the 
underinsured, for those discriminated against by insurance companies 
because they have preexisting conditions or because of their gender.
  Mr. Speaker, this is an historic moment. I urge my colleagues to 
stand with the people of this great country; not with the insurance 
companies and not with the special interests, but with the real people. 
Vote ``yes'' on this rule. Vote ``yes'' on this bill. Let's deliver 
real health care insurance reform for the American people.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentleman from Oklahoma 
(Mr. Cole) for a unanimous consent request.
  (Mr. COLE asked and was given permission to revise and extend his 
remarks.)
  Mr. COLE. Mr. Speaker, because H.R. 3962 will bankrupt State 
governments across America through the imposition of unfunded mandates, 
I rise in opposition to the rule and its underlying legislation.

                                    Congress of the United States,


                                     House of Representatives,

                                 Washington, DC, October 30, 2009.
     Hon. Glenn Coffee,
     President Pro Tempore, State Capitol, Oklahoma City, OK.
       Dear Senator Coffee: As you know, yesterday, Speaker Nancy 
     Pelosi and Majority Leader Steny Hoyer, and Representative 
     John Dingell introduced H.R. 3962, the ``Affordable Health 
     Care for America Act''. This 1990 page bill is an attempt to 
     reorganize the entire health care system in the United States 
     to cover more Americans.
       Unfortunately this comes with a price for state 
     governments.
       As your representative in the Fourth District of Oklahoma, 
     I take very seriously your input when it comes to matters 
     involving unfunded mandates and other policy shifts. Before I 
     vote on this legislation, I would appreciate your insight on 
     some important issues.
       It would seem from the text of this bill and the CBO report 
     that it creates an unfunded mandate in the amount of $34 
     billion from 2015-2019 by increasing Medicaid costs to the 
     States. I am concerned that this might present some budgetary 
     challenges for the State of Oklahoma, and I am therefore 
     turning to you to ask your assistance in answering the 
     following questions:
       Can Oklahoma afford these unfunded mandates in the current 
     fiscally constrained environment?
       Should the House version of health care reform pass, what 
     are your plans for fully funding the unfunded mandate that 
     will be transferred to Oklahoma?
       Would new taxes on the citizens of Oklahoma be necessary to 
     cover the increased costs of Medicaid?
       What do you believe the actual cost would be to Oklahoma?
       Before we begin final consideration of this legislation, 
     your thoughts on these matters would be extremely helpful to 
     me. Unfortunately, the scheduling of this legislation is 
     dynamic, and a vote on it could come as early as Thursday. 
     All indications lead me to believe that we will have no 
     opportunity to offer amendments to this legislation.
       Therefore, before I vote on this legislation, I would ask 
     for your insight on these matters.
           Sincerely,
                                                         Tom Cole,
     Member of Congress.
                                  ____



                                        Oklahoma State Senate,

                              Oklahoma City, OK, November 3, 2009.
     Hon. Tom Cole,
     House of Representatives,
     Washington, DC.
       Dear Congressman Cole:  I am in receipt of your letter 
     dated October 30, 2009, regarding HR 3962, the so-called 
     ``Affordable Health Care for America Act,'' and its fiscal 
     impact on the State of Oklahoma.
       You posed some very pertinent and legitimate questions as 
     to the ability of the state to absorb the unfunded mandates 
     which will be transferred to Oklahoma, particularly in terms 
     of the increased costs of Medicaid which will result.
       The state is experiencing major budget difficulties without 
     having to fund additional federal mandates. The budget for 
     the current fiscal year was reduced 7% from the FY'09 budget. 
     A severe revenue shortfall has forced us to further reduce 
     agency budgets for FY'10 by another 5%. If revenues continue 
     to underperform, a larger cut may be required. We will have a 
     better idea when October revenue data becomes available later 
     this week. A larger cut may be called for in order to keep 
     from overspending from the Rainy Day Fund as well. This 
     proposal leaves a $150 million budget gap in FY'11 from Rainy 
     Day alone.
       The state will most likely face a continued reduction in 
     revenues in FY'11. The FY'11 budget assumptions most likely 
     will include spending the last of the Education and Medicaid 
     Stimulus funds as well as Rainy Day funds in order to 
     maintain current levels of service.
       The FY'12 outlook is even more dire as the absence of 
     Stimulus and Rainy Day funds will have a significant impact 
     on the budget. The absence of stimulus funds will be most 
     apparent in the Medicaid program, where over $400 million was 
     used in FY'10 and over $500 million will be used just to 
     maintain current services in FY'11. Adding tens of thousands 
     of adults to the Medicaid rolls when the state is struggling 
     to cover children and the elderly is irresponsible at best.
       The reality of this bill is that more low-income 
     individuals (now up to 150% of the federal poverty level) 
     will be pushed onto the rolls of Medicaid (Sec. 1701) leaving 
     already overstretched State Governments, ours included, to 
     pick up the tab.
       You specifically asked if new taxes on the citizens of 
     Oklahoma will be necessary to cover the increased costs of 
     Medicaid. The simple answer is, without draconian cuts in 
     state services, yes. As a proponent of a smaller, efficient 
     government, and one who believes that the more of one's hard-
     earned money one can keep, the better, I find this option 
     appalling. I'm confident there are ample inefficient or 
     outdated services we could eliminate from the state budget, 
     and we will be aggressively seeking such areas to cut, 
     regardless. But I fear such cuts would not cover the costs 
     imposed upon us by the Federal government.
       Should President Obama, Speaker Pelosi and Senate Leader 
     Reid prevail in pushing their plans for our health care 
     delivery system through to becoming law, I fear for not

[[Page H12610]]

     just our state, but for every state in the nation. Certainly, 
     there will be no good answers for state leaders facing these 
     unfunded mandates. As a former state senator yourself, you 
     know as well as anyone the fiscal crisis facing the states in 
     today's economy. No state in the nation can sustain the 
     financial hit they are about to experience. Fortunately, 
     thanks to the conservative budgeting practices we engage in 
     here in Oklahoma, our situation, while dire, may not be as 
     severe as many other states, but that's small comfort for us, 
     with the realities we face today. Indeed, factoring in the 
     added load of Federal legislation further burdening our 
     economy, I fear for the long-term future for the hard-working 
     taxpayers of our state.
       We will be watching with great interest as you fight the 
     good fight in Washington. Please, let's keep the lines of 
     communication open as this process unfolds.
           With best regards,

                                                 Glenn Coffee,

                                            President Pro Tempore,
     Oklahoma State Senate.
                                  ____

                                    Congress of the United States,


                                     House of Representatives,

                                 Washington, DC, October 30, 2009.
     Hon. Chris Benge,
     Speaker of the House of Representatives, State Capitol, 
         Oklahoma City, OK.
       Dear Speaker Benge: As you know, yesterday, Speaker Nancy 
     Pelosi and Majority Leader Steny Hoyer, and Representative 
     John Dingell introduced H.R. 3962, the ``Affordable Health 
     Care for America Act''. This 1990 page bill is an attempt to 
     reorganize the entire health care system in the United States 
     to cover more Americans.
       Unfortunately this comes with a price for state 
     governments.
       As your representative in the Fourth District of Oklahoma, 
     I take very seriously your input when it comes to matters 
     involving unfunded mandates and other policy shifts. Before I 
     vote on this legislation, I would appreciate your insight on 
     some important issues.
       It would seem from the text of this bill and the CBO report 
     that it creates an unfunded mandate in the amount of $34 
     billion from 2015-2019 by increasing Medicaid costs to the 
     States. I am concerned that this might present some budgetary 
     challenges for the State of Oklahoma, and I am therefore 
     turning to you to ask your assistance in answering the 
     following questions:
       Can Oklahoma afford these unfunded mandates in the current 
     fiscally constrained environment?
       Should the House version of health care reform pass, what 
     are your plans for fully funding the unfunded mandate that 
     will be transferred to Oklahoma?
       Would new taxes on the citizens of Oklahoma be necessary to 
     cover the increased costs of Medicaid?
       What do you believe the actual cost would be to Oklahoma?
       Before we begin final consideration of this legislation, 
     your thoughts on these matters would be extremely helpful to 
     me. Unfortunately, the scheduling of this legislation is 
     dynamic, and a vote on it could come as early as Thursday. 
     All indications lead me to believe that we will have no 
     opportunity to offer amendments to this legislation.
       Therefore, before I vote on this legislation, I would ask 
     for your insight on these matters.
           Sincerely,
                                                         Tom Cole,
     Member of Congress.
                                  ____

                                                 November 3, 2009.
     Hon. Tom Cole,
     Member of Congress, Rayburn House Office Building, 
         Washington, DC.
       Dear Congressman Cole: Thank you for the opportunity to 
     share my insights regarding the Medicaid expansions contained 
     in the ``Affordable Health Care for America Act'' (AHCAA). As 
     I am sure you are not surprised, these expansions would 
     represent significant unfunded mandates on the state of 
     Oklahoma.
       The Oklahoma Health Care Authority, which is in charge of 
     administering the state's Medicaid program, has estimated a 
     preliminary annual state cost of $128 million if the federal 
     health care legislation becomes law. This estimate does not 
     account for decreased federal support of the Medicaid 
     expansions in later years, which inevitably will shift an 
     increasing financial burden to this state as well as others.
       Oklahoma already is experiencing difficulty funding its 
     current Medicaid program due to revenue shortfalls as a 
     result of the national recession and decreased natural gas 
     prices. Revenue collections to the state in the first quarter 
     of FY-10 trailed last year's collections by 29.5 percent. 
     State agencies, on average, experienced an initial budget 
     reduction of 7 percent when compared to FY-09. Agencies are 
     also expected to see 5 percent cuts in their monthly 
     allocations for the remainder of the fiscal year. Even deeper 
     cuts may be necessary if future revenue streams continue to 
     decline.
       In the current economic environment, Oklahoma is struggling 
     to maintain core services for its citizens. And that is 
     before the ramifications of this federal health care policy 
     and its unfunded mandates are even considered.
       American Reinvestment and Recovery Act (ARRA) federal 
     stimulus funds have been employed and are budgeted to offset 
     declining revenue in FY-10 and FY-11. These funds will no 
     longer be available for FY-12 and beyond. Though some 
     economic indicators suggest that revenues may be stabilizing, 
     no firm indicators signal that state revenue can be expected 
     to improve in the near future. Without economic growth, 
     Oklahoma is left with two options to replace current stimulus 
     funds: raise revenue through tax increases or institute 
     deeper budget cuts.
       Like you, I find the idea of tax increases, even if they 
     weren't incredibly difficult to pass under our state's 
     Constitution, in an economic downturn a nonstarter. In tough 
     economic times, increasing taxes on work and productivity is 
     counterproductive and takes more money out of the hands of 
     Oklahomans and Americans when they need it the most. So with 
     tax increases off the table, we will have no choice but to 
     drastically cut government services to free up funds to pay 
     for the unfunded mandates passed onto us from the federal 
     government.
       Our state is already experiencing significant budget 
     challenges and the added burden of AHCAA's $128 million 
     unfunded federal mandate would lead to further budget cuts, 
     jeopardizing existing state programs and services developed 
     for Oklahomans by Oklahomans.
       In Oklahoma, we have put in place market and consumer 
     driven reforms that are working to move our state's uninsured 
     onto private insurance, all while improving access to 
     affordable health care for all of our citizens. I would urge 
     Washington to give states the maximum amount of flexibility 
     possible to craft a health care plan that best meets 
     individual state needs. A one-size-fits-all health care 
     policy is not the answer for Oklahoma, or our country as a 
     whole.
       I know we have an advocate in you and your fellow federal 
     delegates, but I would like to urge you to vote `no' not only 
     on behalf of what this legislation may do to our country, but 
     the disastrous financial burden it will also place on our 
     state.
           Sincerely,
                                                      Chris Benge,
                       Speaker, Oklahoma House of Representatives.

  The SPEAKER pro tempore. The gentleman from Texas is again charged 
with the time.
  Mr. SESSIONS. I yield to the gentleman from Florida (Mr. Miller) for 
a unanimous consent request.
  (Mr. MILLER of Florida asked and was given permission to revise and 
extend his remarks.)
  Mr. MILLER of Florida. Mr. Speaker, this job-killing bill cuts 
Medicare, piles debt on our children, raises health care costs, and 
raises taxes on the American people.
  The SPEAKER pro tempore. The gentleman from Texas is again charged 
time.
  Mr. SESSIONS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, we are here on the floor today to debate the government 
takeover of health care in America. We understand that this bill is 
about a massive tax increase, $740 billion. We understand it is about 
deep Medicare cuts, some $430 billion. We also understand that millions 
of jobs will be lost and that mandates for purchasing insurance will 
cost an incredible $1.2 trillion, and there will be 118 new Federal 
bureaucracies created by this legislation.
  The gentleman from Massachusetts came down and talked about the evil 
insurance companies. Well, the fact of the matter is that the largest 
six insurance companies in this country made about $6 billion 2 years 
ago, but the Federal Government in their mismanagement lost $90 
billion. Mr. Speaker, we know who can best take care of the health care 
for our country.

                              {time}  1200

  For the past 5 months, the American people have called out, written 
and taken part in town hall meetings, calling the Capitol and their 
Members of Congress to express their outrage to the Democrat health 
care proposal. But here we are today. Month after month, this country 
has bled jobs. We are now at a record 10.2 percent unemployment rate, 
and over 15 million Americans are currently unemployed. And what do we 
do? We stick it to them again.
  Mr. Speaker, last night I offered an amendment in the Rules Committee 
that would have prohibited any provisions of this bill to take place if 
the Office of Management and Budget, working with the Department of 
Labor, found that this bill would result in 4 million jobs or more 
being lost, but my Democrat opponents defeated that. That means that 
they really could care less how many jobs are lost in America as a 
result of this legislation. They want a government-controlled and -run 
health care system.
  Chairman Rangel, the chairman of the Ways and Means Committee, was

[[Page H12611]]

up before Rules last night. He admitted to the Rules Committee that he 
had not asked the CBO or any other independent source for employment 
implications of this bill. Yet Republicans, using the same economic 
forecasts and economic models that the White House uses, we find that 
there would be between 4 and 5 million free enterprise-system jobs that 
would be lost.
  During a time of recession where every single American is trying to 
make ends meet, what do we find? We find $730 billion in new taxes that 
are on this bill. Taxes on small businesses, taxes on health savings 
accounts, and the worst part is is that this will surely lead to a 
double dip in the recession. This is a problem not only for employers, 
but it will be a problem for people who want to find jobs.
  Mr. Speaker, this is a hard mandate on business, and it means that 
the free enterprise system will simply not employ more Americans. We're 
concerned about this. We Republicans are on the floor today, and we're 
going to stand and say ``no'' to what is happening.
  Mr. Speaker, the bottom line is that this legislation for health care 
will do about for health care what the stimulus did for jobs, the 
diminishment of employment in America.
  I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Florida (Mr. Hastings), a member of the Rules Committee.
  Mr. HASTINGS of Florida. Distinguished chairwoman and distinguished 
Speaker, this is an extraordinary day for the two of you and the 
Members of the House of Representatives. I, too, am hopeful that our 
legacy is that we achieved health care for more citizens in our great 
country.
  Achieving comprehensive health care reform in a way that is 
sustainable, fiscally responsible, and improves the overall health of 
the American people has proven to be no small task. The facts are 
clear. Despite being the richest country on Earth, the United States 
ranks 45th in life expectancy and has startlingly high rates of infant 
mortality, depression, and chronic disease. What's more, employer-
sponsored health insurance premiums have grown six times faster than 
cumulative wages. This issue hits close to home.
  My State of Florida has the sixth highest number of uninsured people 
in the country. There are millions that are uninsured and tens of 
millions who are underinsured, and they are the prime justification for 
moving forward with one of the most important health care reform 
agendas in modern history.
  Some have sought to dominate the health care debate with fear-
mongering, misinformation, and blind opposition to key reform elements 
without offering substantive and high-quality alternatives. This 
perpetuation of fictions and misinterpretations is off base and has 
steered the health care discussion off course. Such claims as death 
care panels, rationed care, government monopoly, these are not true.
  What is true is that the United States spends more on health care 
than any other country in the world, but yet the high cost of care has 
not brought a high standard of health for millions of Americans.
  What's true is that Medicare, which is a Federal Government plan and 
one of the great health care successes that this gentleman in the Chair 
had something to do with in our Nation's history, was initially met 
with opposition, the same we get now.
  I urge this measure to be adopted.
  Mr. SESSIONS. Mr. Speaker, at this time I yield to the gentleman from 
Minnesota for a unanimous consent request.
  (Mr. PAULSEN asked and was given permission to revise and extend his 
remarks.)
  Mr. PAULSEN. Mr. Speaker, I rise in opposition to this bill that 
increases taxes on small business.
  Mr. SESSIONS. Mr. Speaker, at this time I yield to the gentleman from 
Texas for a unanimous consent request.
  (Mr. OLSON asked and was given permission to revise and extend his 
remarks.)
  Mr. OLSON. Mr. Speaker, I rise in opposition to this job-killing bill 
that cuts Medicare, piles debt on our children, raises health care 
costs, and raises taxes on the American people.


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore. The Chair reminds the House that if a 
unanimous consent request includes debate, the gentleman yielding time 
may be charged.
  Mr. SESSIONS. Mr. Speaker, at this time I yield to the gentleman from 
North Carolina for a unanimous consent agreement.
  (Mr. COBLE asked and was given permission to revise and extend his 
remarks.)
  Mr. COBLE. Mr. Speaker, I rise in opposition to this bill which is a 
major overhaul of our delivery of health care. We need a fine tune-up, 
not a major overhaul.
  Mr. SESSIONS. Mr. Speaker, I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield 3 minutes to the 
gentlewoman from California (Ms. Matsui), a member of the Rules 
Committee.
  Ms. MATSUI. I thank the gentlewoman for yielding me this time.
  Mr. Speaker, it is so appropriate that you are sitting in this Chair 
on this historic bill, considering that you have introduced a health 
care bill every Congress that you were here, so we really love having 
you in the Chair.
  Mr. Speaker, I stand here on the House floor today, humbled by the 
fact that in the wealthiest country in the world that we have so many 
needs. The most pressing of these needs is for a reformed and 
strengthened health insurance system.
  When I listen to my constituents, whether they are doctors, nurses, 
workers, business owners, or government employees, they are united in 
their support for health insurance reform. They know that costs are 
skyrocketing with no end in sight. They know that more people are 
losing their insurance as they lose their jobs, making the burden of 
uncompensated care even harder to bear for hospitals and doctors. They 
know that the doors of our community health centers are in constant 
motion because of overwhelming demand for their low-cost and high-
quality services.
  For my constituents, for all of us as Members of Congress, but most 
importantly, for the American people, the Affordable Health Care for 
America Act is a major victory. It achieves a long-held goal of 
reforming our health insurance system so that it works for all American 
families. In Sacramento, that means 2,000 families who will not have to 
file bankruptcy due to unaffordable health costs.
  This legislation also strengthens Medicare so that our country's 
seniors can continue to rely on this bedrock program for their health 
care. In my district alone, this means nearly 8,000 Medicare 
beneficiaries who will not fall into the doughnut hole.
  It makes health insurance affordable again for businesses who want to 
provide coverage to their employees and for those who are buying 
coverage for the first time on their own. In Sacramento, this means 
affordability credits to help pay for coverage for up to 181,000 
households.
  Finally, the bill invests in prevention and wellness and public 
health, which are some of my highest priorities. Unless we help people 
live healthier lives, we can never get health costs under control.
  In short, the provisions of this legislation build on all that is 
good in our current health system to strengthen it for the future. This 
is why we come to Congress, Mr. Speaker. We come here to improve 
people's lives, to recognize and address the needs of the people we 
represent. I know that today's bill does this, which is why I support 
it so strongly. I look forward to today's debate and to our historic 
vote.
  I urge my colleagues to support this legislation.
  Mr. SESSIONS. Mr. Speaker, at this time I yield 3 minutes to the 
distinguished gentleman from Miami, Mr. Diaz-Balart, a member of the 
Rules Committee.
  Mr. LINCOLN DIAZ-BALART of Florida. Mr. Speaker, it is clear that 
Congress needs to make reforms to expand health care coverage so that 
everyone in this great Nation has health insurance. The problem with 
the legislation the majority is bringing to the floor today is that it 
will seriously and unnecessarily hurt our economy. It will cause severe 
job losses, and that's most unfortunate.
  The Republican alternative has some very good aspects. It will expand 
health care coverage to millions who currently do not have it, and it 
does

[[Page H12612]]

not include the fatal flaw in the Democrats' bill--massive tax 
increases on small businesses; tax increases and regulations that will 
kill jobs.
  The Republican alternative allows small businesses to pool together, 
allows people to buy insurance across State lines. According to the 
Congressional Budget Office, it actually brings down the cost of health 
care premiums.
  The Democrats' bill will raise taxes, according to the CBO by over 
$700 billion and cut Medicare by approximately $500 billion. It will 
make much worse our economic situation, increase unemployment, take the 
country in the wrong direction at a time when unemployment is already 
over 10 percent.
  Especially, Mr. Speaker, when you consider that there is a bipartisan 
consensus in this Nation on the need to increase access to health 
insurance to those who do not have it today, it is sad that this 
destructive legislative product is being brought to the floor.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Maine (Ms. Pingree), a member of the Rules Committee.
  Ms. PINGREE of Maine. Mr. Speaker, I am honored to be here in your 
presence today and to be here with my colleagues. I thank the 
gentlewoman from New York for allowing me this time.
  I am so proud to be here casting the vote that so many of my 
constituents have waited way too long for. There has been a lot of hard 
work, a lot of facts and figures that have gone into the discussion of 
this important piece of legislation before us, and certainly over the 
last 10 months that I've been here. I want to spend my time talking 
about the story that is always on my mind when I'm talking about health 
care and is certainly on my mind today.
  As a young father, my brother was diagnosed with malignant melanoma, 
a disease that I hope no one else ever has to face or face in a loved 
one. He had recently left his job to stay home to take care of his 2-
year-old son. His wife had better pay. His insurance, of course, was 
temporary and soon withdrawn, and he had no public option to choose. He 
did what so many young families did. They spent down their savings. 
They sold everything they had. They became poor so that they could 
qualify for Medicaid because no doctor would see him without insurance. 
The fact is, he passed away 14 months later, and I have often wondered 
would he have survived had he had the medical care that he needed.
  That would be a very sad story if it had been 2 years ago, but in 
fact, my brother's death was 20 years ago, and back then we talked 
about the importance of making sure that no one was ever denied 
insurance because they had a preexisting condition. We talked about the 
fact that no one should have to go into personal bankruptcy or be poor 
because they don't have health care insurance.
  I am here today, looking forward to casting my ``yes'' vote on this 
rule, on this health care bill, in the memory of my brother and of so 
many of my constituents and their families who have suffered through 
exactly the same thing, because I believe that this bill moves us much 
closer to a time when no one can be denied health care coverage because 
of a preexisting condition; no one can be told you can't have health 
care coverage; no one will have to go into personal bankruptcy. I am 
here in the memory of my brother. There can be no more delay.
  Mr. SESSIONS. Mr. Speaker, I appreciate the gentlewoman's story. The 
other side of the story is that it will be $730 billion worth of taxes, 
that we will have a health care system where you will not be able to 
choose your own physician, where you will have to call someone to then 
find out which doctor you go to, and perhaps worst of all, the 
gentlewoman also needs to know--because we heard in the Rules Committee 
last night--if you willingly make the decision that you do not want to 
participate and you do not pay the tax to the IRS, there is a penalty 
and a fine that is a criminal penalty of up to 5 years in prison and up 
to a $250,000 fine. That is not freedom.
  Criminalizing this issue is a bad way. Mr. Speaker, the Democrats 
have it on the floor today. It is not in the Senate bill. It is in this 
bill. So to glorify this bill which has criminal felony penalties is a 
difficult way to have enforcement.
  Mr. Speaker, at this time I would like to yield 1 minute to the 
gentlewoman from Miami Township, Mrs. Schmidt.
  Mrs. SCHMIDT. Mr. Speaker, the American people are speaking, and we 
must listen. An overwhelming majority are against this bill. Americans 
know that health care costs won't be reduced because our Congressional 
Budget Office told all of us so. They fear their insurance premiums 
will rise, and they don't want their hard-earned tax dollars to go to 
pay for abortions. Our seniors do not want the $500 billion cuts to 
Medicare or the cuts to Medicare Advantage, a program that 17,000 
seniors in my district currently enjoy. Our youth do not want to spend 
the rest of their lives paying for the trillion-dollar costs embedded 
in this bill.
  Mr. Speaker, the American people are speaking, and we must listen. We 
must say ``no'' to this trillion-dollar takeover of our health care. We 
can do better.

                              {time}  1215

  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield 2 minutes to the 
gentleman from Colorado (Mr. Polis), a member of the Rules Committee.
  Mr. POLIS. Mr. Speaker, today we make history. After months of hard 
work, my colleagues and I can make good on our promise to deliver 
meaningful health care reform.
  Like most Members of Congress, I held over 50 town halls, tele-town 
halls, roundtables, and ``Congress on Your Corners,'' and listened to 
my constituents about health care reform. Every town hall in America 
from Virginia to Vail and Northglenn to North Dakota shed light on our 
broken health care system. And many Members of this body heard the same 
thing: We need health care reform now and No government takeover of 
health care.
  We took their concerns back with us to Washington. We echoed their 
voices in these Halls, and we created the bill we have before us today: 
a stronger bill, a better bill, a bill that avoids a government 
takeover of health care, a bill that costs less and reduces the budget 
deficit by $100 billion. A bill that we can be proud of.
  We fought to protect Medicare, and we're giving our seniors a bill 
that immediately closes the Medicare part D doughnut hole and 
strengthens Medicare.
  We heard stories from honest, hardworking Americans who were denied 
or lost coverage because of preexisting conditions when they needed it 
the most. Our bill ends that discriminatory process. The Republican 
bill, by their own admission, leaves more uninsured people in 10 years 
than we have today.
  I personally took on the cause of small businesses, the economic 
engine of the American economy and job growth, many of which can't 
afford to provide coverage today. These businesses are the 
entrepreneurs and innovators on which the future of our economy 
depends.
  I'm happy to say this new bill raises the threshold for the surcharge 
to a million dollars in income for most small businesses, significantly 
reducing any impact while giving small businesses access to the 
exchange which provides them the same buying power previously only 
enjoyed by large corporations. I remain hopeful that through the 
conference process, we can further reduce or eliminate the small 
business surcharge while preserving the savings for individuals and 
small businesses.
  My constituents said to include tort reform and interstate 
competition, and their voices have been heard. And I'm proud to say 
this bill provides for insurance companies competing across State lines 
through interstate compacts and includes reforms to reduce defensive 
medicine.
  This summer Americans in every district in this country spoke out 
about health care. We listened. We took their ideas to heart and 
brought them to Washington. This bill was written by patriots across 
our great Nation, and I urge my fellow Members to join me in proud 
support of this bill.
  Mr. SESSIONS. Mr. Speaker, at this time I yield 1 minute to the 
distinguished gentleman from Fullerton, California (Mr. Royce).
  Mr. ROYCE. Mr. Speaker, I think all in this Chamber agree that health 
care costs continue to weigh heavily on Americans. But, unfortunately, 
this trillion dollar government takeover will make matters worse.

[[Page H12613]]

  Medicine will be rationed via politics under this act. The cost of 
private insurance for those not getting the government subsidy will 
undoubtedly skyrocket. It's going to potentially double for a lot of 
people.
  Economists of all political affiliations will tell you that the 
greater government's thumb, the greater government's role in health 
care, the more the bureaucracy that's going to come out of it, the 
higher it's going to drive costs. And this bill would create a costly 
new entitlement.
  It's going to centralize the decisions on what constitutes insurance. 
It's going to impose mandates on individuals, including up to 5 years' 
prison time for noncompliance if you're not in the scheme, and mandates 
on employers. And it adds hundreds of billions of dollars in new taxes 
all without regard to the fundamental problem.
  We can take steps to bring greater choice and competition to health 
care. But, instead, this bill is about government dominating the market 
and it's about an unsustainable debt that's added to the future.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Virginia (Mr. Connolly).
  Mr. CONNOLLY of Virginia. I thank the distinguished chairwoman for 
yielding.
  Mr. Speaker, I rise to address the issue of health care reform. H.R. 
3962, this bill, has been a century in the making.
  Teddy Roosevelt first called for comprehensive health care in the 
early 1900s. Some rush. A hundred years after that Republican's vision, 
T.R. has been vindicated. Americans need the reform he endeavored to 
achieve.
  Today's vote will mark an epic turning point for our country for it 
enshrines national principles far more important than legislative 
pages: the principle of universal access and affordability; the 
principle of protection for American families against bankruptcy from 
the costs of catastrophic illness; the simple justice of shielding 
millions, including our children, from the caprice and devastation of 
health care benefits denied because of a preexisting medical condition.
  If we have common American values that include compassion and 
economic common sense, if we have some sense of commonwealth in which 
your need is also mine, if we can rise above partisan advantage and 
understand our responsibilities to our fellow countrymen here in this 
place, then we will seize this moment, this one transformative moment, 
to make America a better place.
  I will vote for this bill.
  Mr. Speaker, after months of spirited debate in thousands of 
meetings, letters, phone calls, and e-mails with my constituents, I am 
proud to stand here today and pledge my support for meaningful health 
insurance reform that will improve the quality of care and quality of 
life for virtually every family in my district, while reducing the 
deficit by more than $100 billion.
  This bill will: eliminate the insurance company practice of denying 
coverage based on pre-existing conditions; close the prescription drug 
donut hole and save money for our seniors; cap out-of-pocket expenses; 
and make insurance more affordable and accessible.
  I was an early critic of the draft bill because it placed too much of 
the financial burden on families and small businesses in my district. I 
also heard from my constituents that it did not do enough to contain 
costs.
  I have appreciated the opportunity to weigh in with those concerns, 
and I am pleased to see them addressed in the bill we have before us 
today. The thresholds for the income surcharge have more than doubled, 
saving thousands of working families and small businesses in Northern 
Virginia and elsewhere from higher taxes.
  The legislation before us today will provide insurance coverage to 96 
percent of all Americans, reduce long-term premium costs for families 
and small businesses, and bring down the federal deficit by more than 
$100 billion. I will support legislation that does those things.
  Mr. Speaker, with this vote we will deliver on a generations-old 
promise for meaningful health care reform that will endure for 
generations to come.
  Mr. SESSIONS. Mr. Speaker, at this time I yield 1 minute to the 
gentleman from Tarkio, Missouri, the senior Republican member of the 
Small Business Committee.
  Mr. GRAVES. Mr. Speaker, I rise today in opposition to this rule and 
the underlying bill.
  Small businesses have struggled for years to obtain affordable health 
insurance for their employees. However, rather than embrace solutions 
that enjoy the unanimous support of the small business community, this 
bill takes a government-heavy approach that fails in its goal to make 
health insurance more affordable. What is more unfortunate is that the 
bulk of the funding for the health care bill is balanced on the backs 
of small business owners and entrepreneurs.
  I offered an amendment to the Rules Committee to provide relief to 
these job creators by striking the mandate and tax on employers, but my 
fight fell on deaf ears.
  The tax increases included in this bill are job killers, plain and 
simple. At a time when our Nation's unemployment rate exceeds 10 
percent for the first time in 26 years, the first goal of this body 
should be improving the economy and creating jobs.
  Real solutions exist to the problem of affordable health care. This 
bill is not that solution, and I would urge my colleagues to vote 
against the rule and this bill.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Ohio (Ms. Kilroy).
  Ms. KILROY. Mr. Speaker, I rise to address some of the claims made by 
the other side of the aisle that the Democratic health care bill will 
cost our country's economy jobs. In fact, as noted in the June 2009 
Council of Economic Advisers' report, our legislation will most likely 
have a positive impact on job growth, economic efficiency, standards of 
living, and the budget deficit.
  Our bill will provide assistance to small businesses. Small 
businesses in my district have asked over and over again for help with 
the crushing cost of health care insurance and for the problems that 
small groups have in obtaining insurance. Small businesses will see a 
great deal of help and support in this bill, and large businesses as 
well because they will be able to contain the costs of their health 
premiums, which over the years, as employers know, keep increasing at 
double-digit rates of inflation.
  Our bill has features that will improve efficiency in the labor 
market, improve workplace productivity, and lower the rates of 
disability.
  We've heard how long our country has waited to get a bill like this. 
We've heard that it's been since Teddy Roosevelt and other Presidents, 
other Congresses have tried and failed to bring America up to the 
standard of making health care affordable and accessible for all of us.
  You know, we've waited a long time, and there is such a thing as 
waiting too long. It's been too long for the 14,000 Americans a day who 
lose their health care coverage. Too long for the millions of us who 
are deemed uninsurable because we have a preexisting condition. Too 
long for people without insurance who cannot obtain the lifesaving 
medication or life-improving medications that will help them live a 
better life.
  It is time now to pass the Democratic health care bill, time to 
finally make coverage accessible, affordable. Give people a choice of 
doctors and plans and emphasize wellness, prevention, primary care in a 
bill that reduces the deficit and improves our economy.
  Mr. SESSIONS. Mr. Speaker, at this time I would like to yield 1 
minute to a favorite son from Sarasota, Florida (Mr. Buchanan).
  Mr. BUCHANAN. Mr. Speaker, with unemployment over 10 percent, the 
worst thing we could do is raise taxes and expand government, but 
that's precisely what we're doing here today if we pass this bill.
  People are fed up with Federal spending coming out of Washington, and 
they don't want higher taxes like the 8 percent job-killing tax 
increase on small businesses included in this bill, which create 70 
percent of the jobs. This $1.2 trillion bill would also cut Medicare by 
$500 billion and extend health insurance to illegal immigrants. That's 
just plain wrong.
  There's a far better approach, an alternative, which we will vote on 
today that will reduce costs without raising taxes or cutting Medicare. 
Now, that's a better prescription. It makes sense for America and 
Americans and a plan that we can afford.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
New Mexico (Mr. Heinrich).

[[Page H12614]]

  Mr. HEINRICH. Mr. Speaker, during the past few months, we have seen a 
vigorous and at times emotionally charged debate about how to fix our 
broken health care system. I spent the last several months conducting 
an aggressive and thorough health care listening tour across the First 
Congressional District of New Mexico. Just last week I held a telephone 
town hall with nearly 10,000 seniors in my district to discuss how 
reforming the health care system strengthens Medicare.
  Six principles have guided my work and determined my vote on this 
legislation: health insurance reform must create stability, contain 
costs, guarantee choice, improve quality, cover everyone, and include a 
strong public option.
  The Affordable Health Care for America Act delivers on each of these 
principles, and it does so without adding a penny to the deficit. This 
bill will provide greater competition for insurance companies, give 
Americans affordable coverage, choice, and stability that they can 
count on.
  I urge my colleagues to vote in favor of H.R. 3962.
  Mr. SESSIONS. Mr. Speaker, I know that Republicans in our districts 
are also telling seniors and other people that there will be a $730 
billion tax increase to pay for this massive government takeover of 
health care.
  Mr. Speaker, at this time I yield 1 minute to the gentleman from 
Marietta, Georgia (Dr. Gingrey).
  Mr. GINGREY of Georgia. I thank the gentleman for yielding.
  Mr. Speaker, I rise in opposition to the rule and unequivocal 
opposition to the underlying government takeover of the American 
people's health care.
  When I appeared before the Rules Committee last night, I heard the 
chairman designee say that the changes to bring us these 2,000 pages 
that were enacted in the middle of the night were de minimis changing. 
Going from a thousand pages to 2,000 pages is hardly de minimis. And 
what I noted, of course, was of the 20 Republican amendments that had 
been approved in committee, only five remained and none of mine.
  So, Mr. Speaker, I've brought forth amendments that the American 
public has told me that they want, such as that every Member of 
Congress, if the government option is so good, they ought to sign up 
for it; amendments such as medical liability reform, and the CBO has 
told us, Mr. Speaker, that it would save $54 billion; amendments such 
as no cuts to Medicare unless you keep that money in the Medicare 
system, which has a $35 trillion unfunded mandate; and finally no 
individual mandates on our young people who can ill afford it. It is 
unconstitutional.
  Ms. SLAUGHTER. Mr. Speaker, I reserve the balance of my time.
  Mr. SESSIONS. Mr. Speaker, at this time I would like to yield 1 
minute to the star of the Texas delegation from Dallas, Texas (Mr. 
Hensarling).

                              {time}  1230

  Mr. HENSARLING. Mr. Speaker, since the President and the Democrats 
took control of Congress, they have passed a $1.1 trillion stimulus 
plan, a $410 billion omnibus spending plan, they have passed 
appropriations bills that have increased spending 10, 20, 30 percent. 
They passed our first trillion-dollar deficit in our Nation's history. 
They passed a budget that will triple--triple--the national debt in the 
next 10 years. And now today, a $1.3 trillion government takeover of 
our health care system.
  Mr. Speaker, you cannot improve the health of a nation by bankrupting 
its children. There are a trillion reasons, a trillion reasons, to 
defeat this government takeover of our health care system. Let me give 
you one more: government control is the rationing of our health care.
  Think about your loved ones. Think about your constituents. Think 
about your fellow countrymen. Reject this trillion-dollar takeover of 
our government health care.
  Ms. SLAUGHTER. Mr. Speaker, may I inquire of my colleague how many 
speakers he has remaining?
  Mr. SESSIONS. Mr. Speaker, I appreciate the chairman of the Rules 
Committee asking about our further speakers. We have several speakers 
left before I would close.
  Ms. SLAUGHTER. Then I will continue to reserve.
  Mr. SESSIONS. Mr. Speaker, if I may inquire upon the time that 
remains.
  The SPEAKER pro tempore. The gentleman from Texas has 13\3/4\ minutes 
remaining. And the gentlewoman from New York has 5\3/4\ minutes 
remaining.
  Mr. SESSIONS. Mr. Speaker, I yield 1 minute to the gentleman from 
Roanoke, Virginia (Mr. Goodlatte).
  Mr. GOODLATTE. Mr. Speaker, I rise in strong opposition to this 
unfair rule and the underlying bill, and in support of the Republican 
substitute.
  This bill is a tragedy, and to be taking it up a day after the 
unemployment figures were released that showed 10.2 percent, 15.5 
million Americans out of work, the highest number in American history, 
and when you add in those who are underemployed, one out of every six 
Americans is looking for more work.
  That means that the average American can look out from their home, 
their neighbor to their left, their neighbor to their right, and in 
their own home, and they will see at least one person who is looking 
for more work or who is completely unemployed. And the same day a 
report came out showing that this legislation will cost up to 5.5 
million more jobs. It is an outrage. That is why this legislation 
should be opposed.
  Don't let this 2,000-page, 400,000-word, job-killing, tax-increasing, 
bureaucratic legislation fall on your job.
  Ms. SLAUGHTER. Mr. Speaker, I continue to reserve.
  Mr. SESSIONS. Mr. Speaker, at this time I would like to yield 1 
minute to the gentleman from Savannah, Georgia (Mr. Kingston).
  Mr. KINGSTON. Mr. Speaker, in January, with 8.5 percent unemployment 
rates, Speaker Pelosi passed an $800 billion pork-laden stimulus bill. 
In May, unemployment goes to 9.5 percent, and we get an energy tax of 
$1,500 per household. Now, November, unemployment is over 10 percent 
and we are about to pass a $1 trillion government takeover of health 
care. It raises premiums, it raises taxes. It cuts Medicare.
  Mr. Speaker, America does not need a government takeover of health 
care; we need jobs. If your kitchen sink is leaking, you fix the sink; 
you don't take a wrecking ball to the entire kitchen. This bill is a 
wrecking ball to the entire economy.
  We need targeted, specific reforms to help people who have fallen 
through the health care cracks, and we have a lot of bipartisan support 
for that, and I am part of it. The only bipartisanship we have is 
against this monstrosity. Vote ``no.'' Let's start all over and do it 
right.
  Ms. SLAUGHTER. Mr. Speaker, I continue to reserve.
  Mr. SESSIONS. Mr. Speaker, at this time I would like to yield 90 
seconds to the gentleman from Mesa, Arizona (Mr. Flake).
  Mr. FLAKE. Mr. Speaker, there is so much wrong with this bill it is 
impossible to cover in 90 seconds, so let me focus on one aspect.
  Yesterday we learned that unemployment has reached 10 percent in this 
country. Can you imagine being a small businessman and deciding whether 
or not you are going to hire new employees when you face the prospect 
of an 8 percent tax if you are not providing the kind of health care 
coverage that this bill envisions. An 8 percent tax. And depending on 
the kind of business you have, if you file as a Sub S corporation, for 
example, you could face an additional 5.4 percent surtax on top of 
that. Are you going to hire more people? Not a chance. Unemployment 
will get worse.
  We are in a deep economic hole, Mr. Speaker, and the first rule 
should be, stop digging. Yet here we have doubled down, and we are 
trading in our shovel for a backhoe, and we are saying we are going to 
dig faster and deeper. To what effect? What are we saying to people out 
there? That jobs aren't important? That we don't care because we just 
have to pass this legislation?
  We ought to have more responsibility than that.
  Ms. SLAUGHTER. I continue to reserve, Mr. Speaker.
  Mr. SESSIONS. Mr. Speaker, the gentleman from Arizona is correct. 
This bill is as much about health care as the stimulus package was 
about jobs. It is to bust the free enterprise system and for all of the 
control of health care to go to the Federal Government. I get it, and I 
assure you, the American people get it, also. And we

[[Page H12615]]

will give our friends, the Democrats, all of the credit for what they 
are doing.
  Mr. Speaker, at this time I yield 1 minute to the distinguished 
gentleman from Florida (Mr. Stearns).
  (Mr. STEARNS asked and was given permission to revise and extend his 
remarks.)
  Mr. STEARNS. Mr. Speaker, let me ask the Democrats, why did you do 
this in a health care bill: In section 340N, called Public Health 
Workforce Loan Repayment Program, it is going to cost the government 
taxpayers $283 million over 5 years because you are forgiving loans for 
veterinarians. So the real question I have for you folks: Why are 
veterinarians part of this health care bill?
  When you go to section 555, Second Generation Biofuel Producer 
Credit, you remove the eligibility for tax credits for biofuels. My 
question again: What do biofuels have to do with health care?
  I would like the gentlelady from New York to answer why veterinarians 
are included in this bill in terms of loan forgiveness and why you are 
creating a brand new tax on biofuels when it is not necessary. In fact, 
this is a gift for trial lawyers as it lacks real tort reform, and also 
it establishes Health Czars to oversee all health plans and dictate 
coverage options.
  If you are happy with the health care system today, then you won't be 
happy with the new Health Care Czar described in this bill. This is a 
bad bill for the American people. Vote against the rule.
  Ms. SLAUGHTER. Mr. Speaker, I am going to yield myself 30 seconds 
because I need to answer Mr. Stearns.
  Mr. Stearns asks why are the veterinarians covered. Have you ever 
heard of swine flu? Have you ever heard about food safety? Have you 
ever heard that 70 percent of all of the antibiotics produced in the 
United States are given to cattle and poultry even though they are not 
ill? But swine flu should make you worry a little bit, don't you think?
  I want to spend the rest of my 30 seconds saying this morning we have 
heard all kinds of nonsense about the dire things that will happen from 
this bill. This bill does not add one cent to the deficit certified by 
the CBO. In fact, it reduces it.
  Mr. SESSIONS. Mr. Speaker, I yield 1 minute to the distinguished 
gentlewoman from Nashville, Tennessee (Mrs. Blackburn) a member of the 
Energy and Commerce Committee.
  Mrs. BLACKBURN. Mr. Speaker, I thank the gentleman from Texas, and I 
rise in opposition to this rule, and I encourage my colleagues to stand 
in opposition to this rule.
  The reason is this is not what the American people want to see in 
health care reform. It is not what my constituents want to see in 
health care reform. There are some very valid, tangible reasons. This 
is a wrong step for America. This bill costs too much. It is too 
expensive to afford.
  Look at what happened to my home State of Tennessee with the test 
case for public option health care. The cost not only doubled, not only 
tripled--it quadrupled, and it nearly broke the State. Our State was on 
the verge of bankruptcy. We had a 4-year battle over a State income tax 
to pay for this.
  Who do you think is going to pay for this bill? This is too expensive 
to afford. What you are doing is sacrificing the future of our 
children, our grandchildren, and our great-grandchildren to pay, to pay 
for federalizing, nationalizing government control of health care.
  Let's oppose the rule and take it down.
  Ms. SLAUGHTER. Mr. Speaker, 68 percent of Americans want this bill 
very seriously, and I am pleased to yield 1 minute to the gentleman 
from Wisconsin (Dr. Kagen).
  Mr. KAGEN. Mr. Speaker, I thank Chairwoman Slaughter for this 
opportunity to speak on behalf of this rule, a rule that will guarantee 
that we will get an opportunity to pass legislation to help everyone in 
Wisconsin that I represent; a rule that will help everybody that I have 
cared for as a physician for the past 33 years.
  What are we doing? We are fixing what is broken, we are improving on 
what we already have, and making certain it is at a price we can all 
afford to pay. We are putting patients first. We are putting patients 
first so no longer will a family lose their home and go bankrupt simply 
because their children become sick and they can't afford their health 
care bills.
  We are putting patients first by reforming the rules, reforming the 
rules by making sure that we are going to close the doughnut hole in 
Medicare part D, and making certain that we are going to reform the 
medical malpractice rules to guarantee that patients and their doctors 
can decide their decisions amongst themselves. We are putting people 
first because people are more important than corporate profits.
  Mr. SESSIONS. Mr. Speaker, I would like to yield 1 minute to the 
distinguished gentleman from Beaumont, Texas (Mr. Poe).
  Mr. POE of Texas. Mr. Speaker, we debate this great legislation about 
health care, but we forget the obvious. This massive government 
takeover of our health care still allows the 20 million people in this 
country that are illegally here to get one of those fake Social 
Security cards without benefit of even a photo ID and get some of that 
free government health care that everybody else has to pay for.
  We need to fix that problem, and we need to fix some other problems, 
but don't turn the Federal Government loose on the health care of 
America. This bill costs too much, $700 billion in new taxes, and 
citizens and legal immigrants are going to get stuck with the bill with 
poor health quality and health care.
  And that's the way it is.
  Ms. SLAUGHTER. Mr. Speaker, that's not the way it is. There are no 
illegal aliens in this bill who get anything at all.
  I am pleased to yield 30 seconds to the gentleman from Georgia (Mr. 
Johnson).
  Mr. JOHNSON of Georgia. Mr. Speaker, I speak in support of the rule 
and the underlying legislation. I want everybody to look into their 
heart of hearts, their conscience, the loneliness of the recesses of 
their consciousness, and in that moment you know that all Americans 
deserve health care, not just the rich and wealthy. What we are doing 
today is giving that to the average American.
  I support the rule and the underlying legislation.
  Mr. JOHNSON of Georgia. Mr. Speaker, I rise today to support the rule 
and the underlying legislation, H.R. 3962, the Affordable Health Care 
for America Act. I would like to thank Chairman Rangel and Chairman 
Waxman for their leadership and hardwork in bringing this important 
legislation swiftly to the floor. Your efforts are commendable and will 
benefit all Americans.
  Mr. Speaker, today I and many of my colleagues will take a historic 
vote in favor of extending quality affordable health insurance to 
millions of Americans. This is a moral question as well as a financial 
question. When this bill becomes law, 96 percent of Americans will have 
access to primary care doctors, prescription drugs, and preventive 
health services. When this bill becomes law 96 percent of Americans 
will no longer have to worry about choosing between their or their 
children's health and other essentials like food and shelter. If that 
were not enough then I remind my colleagues that the Congressional 
Budget Office says that this bill will reduce the national debt. The 
status quo is no longer acceptable.
  I urge my colleagues to stand today on the right side of history as 
this Congress takes the first step in bringing the security of 
affordable health insurance to millions of people.
  Congress and the public have had ample opportunity to review, comment 
on, and improve upon the health reform legislation that we will vote on 
today. During the month of August many Members of Congress, including 
myself, held town hall meetings. During my town hall meetings I heard 
testimony from constituents across the Fourth District and from across 
the political spectrum. I considered the views of everyone who wishes 
to share their opinion and I came to the consideration that the 
thousands of my constituents--and the millions of Americans--without 
health insurance could no longer wait. I ran for Congress on a pledge 
to take care of home and I believe that there is no better way to take 
care of home than to ensure that all of my constituents and all 
Americans have access to quality affordable health care.
  I have advocated--consistently and strongly--for the inclusion of a 
public option in health reform legislation. While my preference remains 
the more robust version of the public option, I am proud that H.R. 3962 
contains a public option that will create competition in the insurance 
market to drive down costs for everyone, including the Federal 
Government.

[[Page H12616]]

  I worked hard to make this the best bill that it could be. In 
addition to advocating for the public option, I worked to ensure that 
the recommendations of specialty medical associations, patient advocacy 
groups, and scientific societies are considered as part of the minimum 
benefit package by the Task Force for Clinical Preventive Services. 
Currently, when the task force has insufficient evidence to recommend a 
service, it provides an ``I'' or insufficient evidence grade. Many 
valuable preventive interventions do not yet have the evidence base 
needed to obtain a positive recommendation. Others can never be 
evaluated using the gold standard of a randomized clinical trial 
because a trial would be too expensive, recruiting participants is not 
feasible, or investigator interest or funding is lacking. I am pleased 
to report that H.R. 3962 contains report language which clarifies that 
the benefits commission can look beyond Task Force recommendations to 
other sources of evidence and that the commission can consider the 
recommendations of specialty medical associations, patient advocacy 
groups, and scientific societies as part of the minimum benefits 
package.
  Additionally, I worked with my colleague, Mr. Green of Texas, on sec. 
2587 of the bill which requires a report to Congress on the current 
state of parasitic diseases that have been overlooked among the poorest 
Americans. A 2008 study identified high prevalence rates of parasitic 
infections in the poorest areas of the United States--potentially up to 
100 million infections of Acariasis, Chagas Disease, Cysticercosis, 
Echinococcosis, Toxocariasis, Toxoplasmosis, Trichomoniasis, or 
Strongyloidiasis. These diseases disproportionately affect minority and 
impoverished populations, producing effects ranging from asymptomatic 
infection to asthma-like symptoms, seizures, and death. These diseases 
receive less financial support than they deserve with a mere $231,730 
of research funding allocated by NIH since 1995. This discrepancy in 
funding is known as the ``10/90 gap''; a mere 10 percent of global 
health research funding is directed towards diseases affecting 90 
percent of the global population. For example, between 1995 and 2009, 
the National Institutes of Health funded a mere $231,730 of 
Toxocariasis research. The report required by this section would 
provide an up-to-date evaluation of the current dearth of knowledge 
regarding the epidemiology of these diseases and the socioeconomic, 
health and development impact they have on our society. The Secretary 
of Health and Human Services will report to Congress on this as well as 
the appropriate funding required to address neglected diseases of 
poverty, including neglected parasitic diseases. I look forward to the 
completion of this report so that Congress can take appropriate action 
in the future to address these diseases.
  Finally, the goal of health reform is to expand access to quality 
affordable health care. The underlying bill makes commendable strides 
to expand access but I believe that we must go further to ensure that 
Americans can afford the care they need. Many Americans--our friends 
and neighbors--suffer from debilitating and chronic illnesses such as 
multiple sclerosis or severe arthritis. The medications available to 
them are so expensive that insurers create so-called ``specialty 
tiers'' within their formularies for these medications. People living 
with chronic conditions incur heavy financial burdens for treatment and 
prescription drugs--and they are at the breaking point. High out of 
pocket costs limit access to care and ultimately reduce their chances 
of living healthy lives. In a recent study of medical bankruptcies, 
out-of-pocket medical costs averaged $17,749 for the privately-insured, 
and $26,971 for the uninsured. Patients with neurologic disorders such 
as multiple sclerosis faced the highest costs, at an average of 
$34,167. I believe it is time to put a limit on these outrageous costs. 
Last night in the Rules Committee I waited over 4 hours to offer two 
amendments to do just that.
  My first amendment would cap out-of-pocket prescription drug costs at 
$200 per monthly prescription and $500 per month, total. This would 
apply to all insurance plans, including Medicare Part D. My amendment 
would also amend the current Medicare Part D exemption process so low-
income beneficiaries can request an exemption for specialty tier drugs 
that would lower their costs. The amendment would also request two 
MedPAC studies of discrimination and cost-sharing. This amendment is 
supported by the Arthritis Foundation and the Lupus Foundation of 
America.
  My second amendment would build on the underlying legislation by 
reducing the cap on out of pocket medical expenses from $5,000 annually 
to $1,250 quarterly. People whose care results in high out of pocket 
costs could easily reach the $5,000 limit in a one or two month span. 
This is potentially unaffordable for people with chronic disease and 
dividing the cap quarterly would achieve the same policy outcome while 
increasing its affordability. This amendment is supported by the 
Arthritis Foundation and the Lupus Foundation of America.
  According to a 2008 study by the Commonwealth Fund, more than half of 
chronically ill patients did not get recommended care, fill 
prescriptions, or see a doctor when sick because of costs. My 
amendments would have reduced out of pocket costs for the most 
expensive prescriptions, making health care affordable for some of our 
county's neediest citizens.
  While my language was not ultimately included in this legislation, I 
support the underlying bill and I would urge my colleagues to do 
likewise for the benefit of all Americans.
  Mr. Speaker, in my district, the Fourth Congressional District of 
Georgia, the Affordable Health Care for America Act will: improve 
employer-based coverage for 349,000 residents; provide credits to help 
pay for coverage for up to 166,000 households; improve Medicare for 
65,000 beneficiaries, including closing the prescription drug donut 
hole for 5,400 seniors; allow 15,400 small businesses to obtain 
affordable health care coverage and provide tax credits to help reduce 
health insurance costs for up to 14,200 small businesses; provide 
coverage for 153,000 uninsured residents; protect up to 2,200 families 
from bankruptcy due to unaffordable health care costs; and reduce the 
cost of uncompensated care for hospitals and health care providers by 
$98 million.
  I urge my colleagues to support the rule and the underlying bill and 
I thank you for your consideration.

                              {time}  1245

  Mr. SESSIONS. Mr. Speaker, at this time, I yield 1 minute to the 
distinguished gentleman from Iowa (Mr. King).
  Mr. KING of Iowa. I thank the gentleman from Texas for yielding.
  Mr. Speaker, I would first say, as the gentleman from Georgia stated, 
all Americans deserve health care, that all Americans have health care, 
every single one. Eighty-five percent of us are insured and 85 percent 
of us are happy with the policy that we have.
  The President has made two arguments. One of them is that health care 
in America costs too much money. What's your solution? Spend another 
$1.5 trillion. Too much money, throw another $1.5 trillion at it. 
That's upside down. What is the simplest part of logic that you don't 
understand?
  Second thing, too many people in America are uninsured, 47 million. 
Well, subtract from that 47 million illegal aliens which will be funded 
under this bill, immigrants, those that qualify for Medicaid and other 
government programs, employer programs that make over $75,000 a year, 
now you're down to really only 12.1 million Americans who are without 
affordable options. That is less than 4 percent of America. And for 
that you would throw out the liberty of America, throw out the baby 
with the bathwater of the best health insurance industry in the world, 
the best health care delivery system in the world, destroyed by a 
desire to create a dependency society to steal our freedom.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentleman from New York 
for a unanimous consent request.
  (Mr. ACKERMAN asked and was given permission to revise and extend his 
remarks.)
  Mr. ACKERMAN. Mr. Speaker, I rise in support of the rule and in 
strong support of the bill.
  Mr. Speaker, I rise on this historic day in strong support of the 
Affordable Health Care for America Act, H.R. 3962.
  Let me be absolutely clear: every single American should have access 
to affordable and quality health-care coverage. For too many years, 
drastically needed health-insurance reform has been delayed. I'm happy 
to say the long overdue reform of our health-care insurance system has 
finally begun. The status quo is unsustainable and costly: Without 
health insurance reform, the insurance premium for an average family is 
expected to rise from $11,000 to $24,000 in less than a decade. 
Americans want reduced costs and more choices.
  Mr. Speaker, I support this landmark legislation because it changes 
the way that insurance companies ration medical care: The measure would 
require all plans to eliminate coverage denials because of a pre-
existing condition, eliminate dropping coverage when individuals become 
sick, eliminate annual and lifetime caps on how much can be spent on 
care, and eliminate exorbitant out-of-pocket expenses. All Americans 
deserve these basic protections from their health-insurance plans, and 
these important guarantees will improve the coverage for nearly all 
those who already have insurance--even those Americans who are 
extremely satisfied with their current plans.

[[Page H12617]]

  The act starts with what works well in today's health care system and 
fixes the parts that are broken. No one has to discard the health care 
they enjoy today--everyone can keep their current health plan, doctors 
and hospitals. A new marketplace will allow individuals to shop among a 
large number of private plans or choose a public insurance option. For 
the first time ever, American families--even those who keep their 
current health insurance--will benefit from no longer having to worry 
about losing health coverage because of a new or lost job. The bill 
finally brings the type of health insurance reform that Americans need 
and deserve.
  I also strongly support this bill because the 47 million uninsured 
Americans, the 2.6 million uninsured New Yorkers and the 78,000 
uninsured neighbors in my congressional district will have access to 
affordable, secure and quality health-care coverage instead of having 
to rely on the local hospital emergency room. Most recent 
administrations never acknowledged the moral or economic costs we pay 
every day for our failure to fix this problem. Fortunately, President 
Obama has made comprehensive health-insurance reform his top priority. 
I am proud to be voting today to make sure that health-care reform 
contains costs and is affordable; puts our country on a clear path to 
universal coverage; provides portable coverage; ensures choice of 
physicians and health plans; promotes prevention and wellness; improves 
the quality of care, and is fiscally sustainable over the long-term. 
Putting these principles into action is not only doable; it is 
absolutely essential.
  So, Mr. Speaker, I urge all my colleagues to support the Affordable 
Health Care for America Act so that all Americans will have access to 
health care.
  Ms. SLAUGHTER. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman 
from Oregon (Mr. DeFazio).
  Mr. DeFAZIO. I thank the gentlelady.
  The Republican record defies their rhetoric. Remember their so-called 
``prescription drug benefit'' for seniors passed in the dark of the 
night, no one read the bill, didn't know what was in it? It cost $700 
billion because that was subsidizing the pharmaceutical and insurance 
industry. But now they're worried about costs that gave the seniors a 
doughnut hole. Now their concern is not about what they're stating; 
it's about their patrons in the insurance industry.
  This bill has real reforms of the worst abuses of the insurance 
industry. It takes away their unfair antitrust community so they can no 
longer collude to drive up premium prices or restrict coverage. The 
Republicans would continue the antitrust exemption.
  This bill outlaws the unfair preexisting condition restriction. The 
Republicans would continue that for the insurance industry.
  This bill would not allow the industry to cancel your policy even 
though you've been paying your premiums when you get sick. It's called 
recision. The Republicans allow that abuse to continue.
  This bill on our side outlaws the small print that limits your 
lifetime coverage which bankrupts families every day in America. The 
Republicans allow it to continue.
  And that's not enough. They open up a new loophole, their so-called 
``national plan.'' A company would only be regulated by the laws of the 
State in which it was based when it sold you a policy. If you live in 
Oregon but you bought a policy that was written in--oh, and by the way, 
they expand the definition of States to include the territories and the 
Mariana Islands. So if you've got a problem, call the Mariana Islands 
insurance commissioner. That's the Republican plan: Profits for the 
insurance industry.
  Mr. SESSIONS. Mr. Speaker, I yield to the gentleman from Texas (Mr. 
Neugebauer) for a unanimous consent request.
  (Mr. NEUGEBAUER asked and was given permission to revise and extend 
his remarks.)
  Mr. NEUGEBAUER. Mr. Speaker, I rise in opposition to this job-killing 
bill that cuts Medicare, piles debt on our children, raises health care 
costs, and raises taxes on the American people.
  Last week, Speaker Pelosi introduced the long-awaited final draft of 
her health care reform bill. H.R. 3962, combined with the 42-page 
manager's amendment, comes in at over 2,000 pages.
  A preliminary analysis by the nonpartisan Congressional Budget Office 
estimates that the true cost of the bill is $1.3 trillion. Buried 
within this bill are details that would add massive Federal involvement 
in the health care of every American, including the following: creation 
of a government-run insurance program that could cause as many as 114 
million Americans to lose their current coverage; elimination of the 
private market for individual health insurance; taxes on all Americans 
who purchase insurance, individuals who don't purchase insurance, and 
millions of small businesses; and cuts to Medicare Advantage plans that 
will result in higher premiums. Yet with all these taxes, mandates and 
cuts, the majority party still maintain somehow this bill will lower 
the cost of health care to Americans.
  For months, Americans have been telling Congress they want real 
solutions for the health care crisis in America but they are also 
telling us there is a big difference between the right and wrong way to 
reform health care. Republicans listened to the American people and 
have produced a commonsense, fiscally responsible health reform 
proposal--not Speaker Nancy Pelosi's 2,000+ page government takeover of 
one-sixth of our Nation's economy.
  Republicans' alternative solution focuses on lowering health care 
premiums for families and small businesses, increasing access to 
affordable, high-quality care, and promoting healthier lifestyles--
without adding to the crushing debt Washington has placed on our 
children and grandchildren. Even the nonpartisan Congressional Budget 
Office, CBO, confirmed that the Republican health care plan would lower 
health care premiums by up to 10 percent and reduce the deficit by $68 
billion over 10 years without imposing tax increases on families and 
small businesses. The Republican alternative contains no tax increases, 
no cuts to Medicare, no health care rationing, no deficit spending, and 
no huge intrusion of government into your personal health care choices. 
Instead, our plan recognizes that health care reform must be based on 
competition, preserving the relationship between doctors and patients, 
and reducing health care costs for American families without a massive 
government intrusion.
  Health care solutions are badly needed in this country, but we need 
to get it done right. Republicans have listened to the American people 
and put forth commonsense health care legislation that reduces the 
deficit, lowers premiums, and improves coverage options for those with 
preexisting conditions.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  The Chair will ask for a simple statement of unanimous consent or the 
gentleman from Texas will be charged.
  Mr. SESSIONS. Mr. Speaker, the Rules Committee did a great job; they 
held a 12-hour meeting yesterday.
  I would like to say to the American people that everybody understands 
what's in this bill, they have a chance. No unintended consequences 
with this. Republicans have laid out what we believe will happen.
  Mr. Speaker, lots of groups around the country also know what would 
happen, and I would like to insert into the Record the list of people 
who would say vote ``no'' on this bill. They are business organizations 
all across this country.

         H.R. 3962--The Affordable Health Care for America Act


                        Groups Key Voting ``NO''

       American Bakers Association; American Conservative Union; 
     American Council of Engineering Companies; American Hotel and 
     Lodging Association; American Rental Association; Americans 
     for Tax Reform (Double Rating); Associated Builders and 
     Contractors, Inc (ABC); Associated Equipment Distributors; 
     Associated General Contractors of America; Automotive 
     Recyclers Association; Brick Industry Association; Club for 
     Growth; Concerned Women for America; Council for Citizens 
     Against Government Waste; Family Research Council; 
     FreedomWorks.
       Independent Electrical Contractors; International 
     Foodservice Distributors Association; International Franchise 
     Association; National Association of Manufacturers; National 
     Association of Wholesaler-Distributors; National Federation 
     of Independent Business (NFIB); National Lumber and Building 
     Material Dealers Association; National Ready Mix Concrete 
     Association; National Retail Federation; National Taxpayers 
     Union; North American Die Casting Association; Printing 
     Industries of America; Small Business & Entrepreneurship 
     Council; U.S. Chamber of Commerce.


                       Groups Opposing H.R. 3962

       Aeronautical Repair Station Association; Air Conditioning 
     Contractors of America; American Academy of Facial Plastic 
     and Reconstructive Surgery; American Apparel & Footwear 
     Association; American Architectural Manufacturers 
     Association; American Association of Neurological Surgeons; 
     American Benefits Council; American Center for Law and 
     Justice; American Electric Power; American Family Insurance; 
     American Farm Bureau Federation; American Foundry Society; 
     American International Automobile Dealer Association (AIDA); 
     American Petroleum Institute; American Society of General

[[Page H12618]]

     Surgeons; American Staffing Association; American Veterinary 
     Medical Association; American Wire Producers Association; 
     America's Health Insurance Plans (AHIP); AMT--The Association 
     For Manufacturing Technology; Arizona-New Mexico Cable 
     Communications Association; Arkansas Medical Society; 
     Association of Ship Brokers and Agents.
       Association of Washington Business; AT&T Automotive 
     Aftermarket Industry Association; Best Buy Co., Inc.; Blue 
     Cross Blue Shield; Blue Cross Blue Shield of North Dakota; 
     Bowling Proprietors' Association of America; Business 
     Roundtable; Caterpillar, Inc.; CIGNA; Congress of 
     Neurological Surgeons; Corporate Health Care Coalition; Deere 
     & Company; Eastman Kodak Company; Electronic Security 
     Association (ESA); Florida Chamber of Commerce; Florida 
     Medical Association; Food Marketing Institute; Goodrich 
     Corporation; Heating, Air-conditioning & Refrigeration 
     Distributors International; HR Policy Association; HSBC North 
     America; Illinois State Medical Society; Independent 
     Insurance Agents & Brokers of America.
       Independent Office Products & Furniture Dealers 
     Association; Indiana Chamber of Commerce; Indiana 
     Manufacturers Association; International Association of 
     Refrigerated Warehouses; International Housewares 
     Association; International Sleep Products Association; Kansas 
     Medical Society; Land O'Lakes, Inc.; Maine Chamber of 
     Commerce; Marathon Oil Corporation; Marine Retailers 
     Association of America; MeadWestvaco Corporation; Medical 
     Association of Georgia; Medical Society of Deleware; Medical 
     Society of New Jersey; Medical Society of the District of 
     Columbia; Minnesota Chamber of Commerce; Missouri Chamber of 
     Commerce and Industry; Motor & Equipment Manufacturers 
     Association; NAMM, International Music Products Association.
       National Association of Convenience Stores (NACS); National 
     Association of Health Underwriters; National Association of 
     Mortgage Brokers; National Association of Theatre Owners; 
     National Automobile Dealers Association; National Business 
     Group on Health; National Club Association; National 
     Coalition on Benefits (440 Associations and Companies); 
     National Council of Chain Restaurants; National Funeral 
     Directors Association; National Grocers Association; National 
     Newspaper Association; National Roofing Contractors 
     Association; National Rural Electric Cooperative Association; 
     National Teachers Associates Life Insurance Company; National 
     Tooling Machining Association; National Utility Contractors 
     Association; North Carolina Chamber; North Dakota Chamber of 
     Commerce; Northeastern Retail Lumber Association.
       Nursery and Landscape Association; Ohio Chamber of 
     Commerce; Ohio State Medical Association; Pennsylvania 
     Chamber of Business and Industry; Pharmaceutical Research and 
     Manufacturers of America (PhRMA); Plumbing-Heating-Cooling 
     Contractors Association; Precision Machined Products 
     Association; Precision Metalforming Association; Professional 
     Golfers Association of America; Republican Jewish Coalition; 
     Retail Industry Leaders Association (RILA); Self-Insurance 
     Institute of America (SIIA); Small Business Coalition for 
     Affordable Health Care; Society for Human Resource 
     Management; Society of American Florists; Society of Chemical 
     Manufacturers & Affiliates; South Carolina Chamber of 
     Commerce; South Carolina Medical Association; Specialty 
     Equipment Market Association (SEMA); SPI: The Plastics 
     Industry Trade Association.
       Tennessee Chamber of Commerce & Industry; Texas Association 
     of Business; The Black & Decker Corporation; The Business 
     Coalition for Fair Competition; The Business Council of New 
     York State, Inc.; The Dow Chemical Company; The ERISA 
     Industry Committee; The Louisiana State Medical Society; The 
     Medical Association of the State of Alabama; Tire Industry 
     Association; Triological Society; Tyco International; UAM 
     Action Network; United Parcel Service, Inc.; United States 
     Steel Corporation; Universal Health Network; Utah 
     Manufacturers Association; Verizon Communications; Virginia 
     Chamber of Commerce; Wedding & Event Videographers 
     Association International; WellPoint, Inc.; Western Growers 
     Association Wisconsin Manufacturers & Commerce; Wood 
     Machinery Manufacturers of America (WMMA); Xerox Corporation.

  Mr. Speaker, we understand $732.5 billion worth of tax increases. 
Once again, let's get this right. No unintended consequences here. This 
is a job killer.
  I will insert into the Record a list of the tax increases that are 
proposed in this bill.

              Top Ten Tax Increases Included in H.R. 3962

(As scheduled for consideration on the House Floor on November 7, 2009)

       1. Small business surtax (Sec. 551, p. 336): $460.5 
     billion.
       2. Employer Mandate tax* (Secs. 511-512, p. 308): $135.0 
     billion.
       3. Individual Mandate tax* (Sec. 501, p. 296): $33.0 
     billion.
       4. Medical device tax* (Sec. 552, p. 339): $20.0 billion.
       5. $2,500 Annual cap on FSAs* (Sec. 532, p. 325): $13.3 
     billion,
       6. Prohibition on pre-tax purchases of over-the-counter 
     drugs through HSAs, FSAs, and HRAs* (Sec. 531, p. 324): $5.0 
     billion.
       7. Tax on health insurance policies to fund comparative 
     effectiveness research trust fund* (Sec. 1802, p. 1162): $2.0 
     billion.
       8. 20% Penalty on certain HSA distributions* (Sec. 533, p. 
     326): $1.3 billion.
       9. Other tax hikes and increased compliance costs on U.S. 
     job creators: $60.2 billion.
       IRS reporting on payments to certain businesses (Sec. 553, 
     p. 344): $17.1 Billion.
       Repeal implementation of worldwide interest allocation 
     rules (Sec. 554, p. 345): $6.0 billion.
       Cellulosic Biofuel Credit/deny eligibility for ``black 
     liquor'' (New Sec. 555, inserted on p. 346): $23.9 billion.
       Override U.S. treaties on certain payments by 
     ``insourcing'' businesses (Sec. 561, p. 346): $7.5 billion.
       Codify economic substance doctrine and impose penalties 
     (Sec. 562, p. 349): $5.7 billion.
       10. Other revenue-raising provisions: $2.2 billion.
       Total tax increases: $732.5 billion.
       * = Violates President Obama's pledge to avoid tax 
     increases on Americans earning less than $250,000.

  Mr. Speaker, also, last night at the Rules Committee we found out--
which is very devastating and I believe unwise--the Senate does not 
have this provision. They removed it. But the House keeps in this bill 
the failure to comply with individual mandates in this bill could lead 
to a $250,000 fine and 5 years in jail, criminal penalties that are a 
felony if you willingly choose not to participate, if you willingly 
choose then not to pay the fine in your taxes. Mr. Speaker, what we are 
going to do is criminalize Americans who choose not to join in this 
government-run health care system.
  There are not unintended consequences. The Members need to know that 
this is going to raise premiums, it is going to raise taxes, and 
perhaps worst of all, we are going to criminalize with felony penalties 
noncompliance. Mr. Speaker, this is not a way to run a bill.
  Mr. Speaker, I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentleman from 
Michigan (Mr. Stupak).
  Mr. STUPAK. Mr. Speaker, the rule being debated makes in order the 
Stupak-Ellsworth-Pitts-Smith-Kaptur-Dahlkemper pro-life amendment that 
would apply the longstanding Hyde amendment, which states no public 
funding for abortion.
  I appreciate the willingness of Speaker Pelosi to work with all 
Democrats through the day and night Friday to reach an agreement on 
language. Ultimately, the agreement we reached fell apart, and the only 
appropriate consideration was to make our amendment in order.
  The Speaker recognizes that Members deserve the chance to vote their 
conscience and have their voices heard on this most important matter.
  There are a number of critical reforms in this bill, such as a repeal 
to the health insurance industry's antitrust exemption to inject 
competition into the industry, a prohibition on insurance companies 
discriminating against people with preexisting conditions, elimination 
of the practice of recision, except in the cases of fraud, and a 
transition to a health care reimbursement system that addresses 
geographic disparities and rewards quality of care over quantity of 
procedures performed.
  Now is the time to pass health care reform and provide quality, 
affordable health care for all Americans. I urge my colleagues to 
support the rule and to support the Stupak amendment later today.
  I thank the gentlewoman for yielding.
  Mr. SESSIONS. Mr. Speaker, I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I yield 30 seconds to the gentleman from 
Rhode Island (Mr. Langevin).
  (Mr. LANGEVIN asked and was given permission to revise and extend his 
remarks.)
  Mr. LANGEVIN. Mr. Speaker, I rise today in strong support of this 
rule and the underlying bill which finally puts us on the path to 
solving our Nation's health care crisis.
  Since coming to Congress, I have heard from countless constituents in 
Rhode Island struggling with the failures of our health care system. I 
have heard from constituents forced to make unconscionable choices 
between seeing a doctor or their next meal, paying their mortgage or 
losing their coverage, and families facing bankruptcy due to 
catastrophic medical costs.

[[Page H12619]]

  The time for inaction is over. This bill represents an historic 
opportunity to enact reforms that will allow constituents who lose 
their jobs to keep their health care coverage, eliminates preexisting 
conditions, and protects people by abolishing lifetime insurance caps.
  Every American deserves the promise of quality affordable health 
care, and this is our moment to fulfill that promise.
  Mr. SESSIONS. Mr. Speaker, I spoke just a second ago about the 
mandates that would be criminal penalties. I would like to enter a 
letter from the gentleman, Mr. Camp, that is from the Joint Committee 
on Taxation that outlines this part of the law.

                                    Congress of the United States,


                                  Joint Committee on Taxation,

                                 Washington, DC, November 5, 2009.
     Hon. Dave Camp,
     House of Representatives,
     Washington, DC.
       Dear Mr. Camp: This is in response to your request for 
     information relating to enforcement through the Internal 
     Revenue Code (``Code'') of the individual mandate of H.R. 
     3962, as amended, the ``Affordable Health Care for America 
     Act.'' You specifically inquired about penalties for a 
     willful failure to comply.


       Tax on individuals without acceptable health care coverage

       H.R. 3962 provides that an individual (or a husband and 
     wife in the case of a joint return) who does not, at any time 
     during the taxable year, maintain acceptable health insurance 
     coverage for himself or herself and each of his or her 
     qualifying children is subject to an additional tax. The tax 
     is equal to the lesser of (a) the national average premium 
     for single or family coverage, as applicable, as determined 
     by the Secretary of Treasury in coordination with the Health 
     Choices Commissioner, or (b) 2.5 percent of the excess of the 
     taxpayer's modified adjusted gross income over the threshold 
     amount of income required for the income tax return filing 
     for that taxpayer. This tax is in addition to both regular 
     income tax and the alternative minimum tax, and is prorated 
     for periods in which the failure exists for only part of the 
     year. In general, the additional tax applies only to United 
     States citizens and resident aliens. The additional tax does 
     not apply to those who are residents of the possessions or 
     who are dependents, nor does it apply to those whose lapses 
     in coverage are de minimis or those with religious conscience 
     exemptions. The additional tax does not apply if the 
     maintenance of acceptable coverage would result in a hardship 
     to the individual or if the person's income is below the 
     threshold for filing a Federal income tax return.


        Range of civil and criminal penalties for noncompliance

       You asked that I discuss the situation in which the 
     taxpayer has chosen not to comply with individual mandate and 
     not to pay the additional tax. The Code provides for both 
     civil and criminal penalties to ensure complete and accurate 
     reporting of tax liability and to discourage fraudulent 
     attempts to defeat or evade tax. Civil and criminal penalties 
     are applied separately. Thus, a taxpayer convicted of a 
     criminal tax offense may be subject to both criminal and 
     civil penalties, and a taxpayer acquitted of a criminal tax 
     offense may nonetheless be subject to civil tax penalties. In 
     cases involving both criminal and civil penalties, the IRS 
     generally does not pursue both simultaneously, but delays 
     pursuit of civil penalties until the criminal proceedings 
     have concluded.
       The majority of delinquent taxes and penalties are 
     collected through the civil process. In determining whether a 
     penalty applies along with an adjustment to a tax return, the 
     examining agent is constrained not only by the applicable 
     statutory provisions, but also by the written policy of the 
     IRS not to treat penalties as bargaining points but instead 
     to develop the facts sufficiently to support the decision to 
     assert or not to assert a penalty. The goal is consistency, 
     fairness and predictability in administration of penalties.
       If the government determines that the taxpayer's unpaid tax 
     liability results from willful behavior, the following 
     penalties could apply.


                            Civil penalties

       Section 6662(a)--an accuracy related penalty of 20 percent 
     of the underpayment attributable to health care tax, based on 
     negligence or disregard (the former includes lack of a 
     reasonable attempt to comply and the latter includes any 
     intentional disregard of rules or regulations) or substantial 
     understatement, if the understatement of tax is sufficiently 
     large.
       Section 6663--a fraud penalty of 75 percent of the 
     underpayment, if the government can prove fraudulent intent 
     to avoid taxes by clear and convincing evidence.
       Section 6702--a $5,000 penalty for taking a frivolous 
     position on a tax return, if the underpayment is intended to 
     delay or impede tax administration and the return on its face 
     indicates that the self-assessment is substantially 
     incorrect.
       Section 6651--delinquency penalty of .5 percent of the 
     underpayment, each month, up to a maximum of 25 percent of 
     the underpayment.


                           Criminal penalties

       Prosecution is authorized under the Code for a variety of 
     offenses. Depending on the level of the noncompliance, the 
     following penalties could apply to an individual:
       Section 7203--misdemeanor willful failure to pay is 
     punishable by a fine of up to $25,000 and/or imprisonment of 
     up to one year.
       Section 7201--felony willful evasion is punishable by a 
     fine of up to $250,000 and/or imprisonment of up to five 
     years.


            Application of penalties under current practice

       The IRS attempts to collect most unpaid liabilities through 
     the civil procedures described above. A number of factors 
     distinguish civil from criminal penalties, in addition to the 
     potential for incarceration if found guilty of a crime. 
     Unlike the standard in civil cases, successful criminal 
     prosecution requires that the government bear the burden of 
     proof beyond a reasonable doubt of all elements of the 
     offense. Most criminal offenses require proof that the 
     offense was willful, which is a degree of culpability greater 
     than that required in a civil penalty cases. For example, a 
     prosecution for willful failure to pay under section 7203 
     requires proof beyond a reasonable doubt both that the 
     taxpayer intentionally violated a known legal duty and that 
     the taxpayer had the ability to pay. In contrast, in applying 
     the civil penalty for failure to pay under section 6651, the 
     burden is on the taxpayer: the penalty applies unless the 
     taxpayer can establish reasonable cause and lack of willful 
     neglect with respect to his failure to pay.
       Criminal prosecution is not authorized without careful 
     review by both the IRS and the Department of Justice. In 
     practice the application of criminal penalties is infrequent. 
     In fiscal year 2008, the total cases referred for prosecution 
     of legal source tax crimes were as follows.
       Investigations initiated: 1,531.
       Indictments and informations: 757.
       Convictions: 666.
       Sentenced: 645.
       Incarcerated: 498.
       Percentage of those sentenced who were incarcerated: 77.2.
       Of the 666 convictions reported above for fiscal year 2008, 
     fewer than 100 were convictions for willful failure to file 
     or pay taxes under section 7203. Civil penalties outnumber 
     criminal penalties imposed. For example, in fiscal year 2008, 
     compared to the 666 convictions, approximately 392,000 
     accuracy related penalties were assessed on individual 
     returns. Also in fiscal year 2008, the IRS assessed 5,502 
     penalties under section 6702 for frivolous positions taken on 
     returns.
       I hope this information is helpful for you. If I can be of 
     further assistance, please contact me.
           Sincerely,
                                               Thomas A. Barthold.

  Mr. Speaker, at this time, I would like to yield for the close for 
the Republican Party, the distinguished gentleman, the ranking member 
of the Rules Committee, the gentleman from San Dimas, California (Mr. 
Dreier).
  (Mr. DREIER asked and was given permission to revise and extend his 
remarks.)
  Mr. DREIER. Mr. Speaker, I thank my friend for yielding.
  The American people have spoken very loudly and clearly. They do not 
want the Federal Government to control one-sixth of our Nation's 
economy, and they believe that we should be able to scrutinize 
legislation. We have over 2,000 pages here. Many of the changes were 
made late last night, Mr. Speaker, and we have not had what the 
American people said we needed to have following the debate on the cap-
and-trade bill when we had a 300-page amendment dropped on us at 3 
o'clock in the morning; that is an adequate amount of time to look at 
this legislation.
  My friend from Dallas has talked about unintended consequences. 
Obviously in those 2,000 pages there are things that none of us want to 
have happen that we don't know about now, but we've had reported here 
on the floor a wide range of things that we believe will happen.
  Now, Mr. Speaker, it is very unfortunate that the debate on health 
care reform has been cast on those who are in favor of reform and those 
who are opposed to reform. We have continued to hear that over and over 
and over and over again, unfortunately. There is no Member of this 
House, Democrat or Republican, who does not want to ensure access to 
quality health insurance and quality health care for our seniors, for 
our veterans, for our families, for individuals across this country. So 
let's make it very clear, we all want that to happen.
  We all want to do what we can, Mr. Speaker, to increase 
accessibility. We all want to increase accessibility. How do we do 
that? Well, I believe very fervently that increasing affordability will 
increase accessibility. If we can

[[Page H12620]]

make health insurance more affordable, more people in this country will 
have access to quality health insurance. The substitute that we have 
offered does just that. It says that the opportunity to have access to 
the best quality product at the lowest possible price is a right that 
every American should have. They are denied that today by virtue of the 
fact that they can't buy insurance across State lines.
  If you look at our goal of trying to bring about meaningful liability 
reform, doctors today engage in, as we all know, defensive medicine. 
They recommend a wide range of tests simply because of their fear of 
being sued. In my State of California, we have a very, very viable 
package that deals with that. If we were to take the California model 
and apply it here at the Federal level, the Congressional Budget Office 
has estimated that we will save $54 billion. $54 billion will be saved.
  I believe that we need to do everything we can to allow small 
businesses to come together so that they can, in fact, as large 
entities do, get lower insurance rates. And, Mr. Speaker, I believe 
that we can also ensure that we address the challenge of preexisting 
conditions so that Americans with those preexisting conditions are not 
denied access to quality health insurance and health care. We can do 
that, and that is exactly what our substitute does.
  Unfortunately, Mr. Speaker, we have continued to have this 
characterization that if we don't support this measure, if we don't 
support this measure which takes control of one-sixth of our Nation's 
economy, we are not committed to reform. That is outrageous. We believe 
that a step-by-step approach is the proper route for us to take.
  I like very much what our friend from North Carolina earlier said: We 
don't need a complete overhaul. We need to fine-tune this system to 
ensure that every single American does have access to quality, 
affordable health care.
  Vote ``no'' on this rule. We can do better.
  It is truly unfortunate that the healthcare debate has come to be 
cast as a fight between those who favor and those who oppose reform. 
There is not a single Member of this House who does not support the 
idea of improving the accessibility and the quality of healthcare in 
America. We all want to expand access to coverage for the individuals, 
working families, seniors and veterans who are worried about their 
healthcare.
  I am a strong proponent of reforming our healthcare system in a way 
that enhances the affordability and availability of quality healthcare 
options, without limiting patient choice. There are a number of steps 
we can take to reduce costs for working families without rationing care 
or raising taxes. Lowering costs is central to expanding coverage, 
because affordability enhances accessibility.
  For example, we must implement medical malpractice reform and 
redirect resources from trial lawyers to patients. My state of 
California has been a leader in medical liability reform. We have 
realized substantial savings, simply by limiting exorbitant trial 
lawyers' fees, as well as speculative, noneconomic damages.
  Without limiting economic damages, medical expenses or punitive 
damages, the state of California has been able to save consumers tens 
of billions of dollars. The limit on trial lawyers' fees alone has 
saved nearly $200 million over 7 years. As a result, we have some of 
the lowest medical malpractice rates in the country. The nonpartisan 
Congressional Budget Office determined that nationwide implementation 
of reforms similar to California's would result in savings of up to $54 
billion over 10 years.
  This isn't just about companies' bottom lines or state budgets, these 
cost savings have a real impact on working families, especially during 
these difficult economic times. As I said at the outset, affordability 
and accessibility go hand in hand. One independent study showed that 
partially reversing the reforms that California has implemented would 
raise healthcare costs for families of four by over $1,000 a year. That 
is a tremendous burden that families cannot bear. And it underscores 
the reality that excessive costs are the biggest impediment to access 
to healthcare.
  Furthermore, medical liability reform has proven to not only reduce 
costs, but to increase quality as well. States with lower medical 
malpractice premiums tend to have more doctors per capita, including 
surgeons and specialists. For example, Texas implemented reform 6 years 
ago, and subsequently saw an increase in doctors of nearly 18 percent. 
Twenty-four counties that previously had no ER doctors now have 
emergency services.
  We must also address the challenge of overlapping government 
programs. The cost of providing services for those who qualify for both 
Medicare and Medicaid is nearly $250 billion every year. And yet, there 
is no comprehensive effort to coordinate these programs to ensure that 
overlap does not result in wasteful spending. As Governor 
Schwarzenegger proposed, states could be given the authority and 
flexibility to coordinate these programs, as well as the opportunity to 
share in the cost savings.
  We also need to empower small businesses to provide more affordable 
healthcare options.
  They should have the ability to band together, to achieve the 
economies of scale that large corporations and labor unions have. Small 
businesses and individuals should also be able to purchase insurance 
across state lines. And we can provide tax incentives to make coverage 
more accessible. Finally, we must eliminate the rampant waste, fraud 
and abuse that are dramatically and needlessly driving up costs.
  Each of these proposals would significantly reduce costs for 
individuals and families without diminishing the quality of care. In 
fact, they would enhance the quality of healthcare in this country. 
Greater competition and greater accountability in the healthcare 
industry would provide Americans with more choices--and better choices.
  Some have made the very dubious claim that expanding options for 
consumers would somehow diminish the quality of our healthcare. They 
have said that reforms, such as giving small businesses and individuals 
the flexibility to purchase insurance across state lines, would spark a 
race to the bottom.
  But increasing competition and accountability would have precisely 
the opposite effect. When patients have more choices and more 
flexibility, the result will be higher-quality care. And by addressing 
the root issue of affordability, we can effectively expand access for 
all, including those with pre-existing conditions.
  The commonsense reform measures we are proposing would accomplish 
this without raising taxes or diminishing coverage for a single 
American. And we would expand access while allowing those who are happy 
with their current coverage to keep it. Perhaps most important of all, 
these straightforward yet significant reforms would keep patients and 
doctors at the center of healthcare decisions--without the interference 
of government bureaucrats.
  This is a positive, workable, effective reform proposal, and it is 
the reform agenda that Republicans are pursuing.
  If we'd had a collaborative, bipartisan process from the beginning, I 
believe this is the kind of reform proposal that could have gained 
widespread support from both parties here in Congress. Certainly these 
are solutions that are widely supported by the American people.
  So it is extremely unfortunate that the Democratic Majority has 
chosen to put forward a divisive, unworkable, enormously expensive 
proposal that will improve neither accessibility nor the quality of 
healthcare. In fact, I believe this legislation would accomplish 
precisely the opposite of its stated goals. A dramatic expansion of the 
government role in our healthcare system is an utterly nonsensical way 
to try to enhance efficiency, cut costs or improve quality. 
Furthermore, government bureaucrats are the last people that Americans 
want to have making their healthcare decisions for them.
  Our national unemployment rate sailed past 10 percent last month, as 
we just found out on Friday, while California's is at 12.2 percent.
  As our economy continues to struggle on its road to recovery, now is 
the worst possible time to impose significant new taxes on the American 
people. And with the announcement of the Democratic Majority's $1.4 
trillion deficit, we simply cannot afford to enact more than a trillion 
dollars in new government spending--an estimated figure that would be 
sure to balloon if implemented.
  The Democratic Majority's so-called reform bill is a fiscal disaster 
that will make our healthcare system--already in need of reform--
substantially more inefficient, wasteful and costly, and make quality 
care even less accessible. Today's vote is not a vote to reject or 
support healthcare reform. Today's vote is about the path we will 
choose as a nation to pursue better and more affordable healthcare.
  Republicans have put forth solutions that will cut costs while 
improving care, and we can achieve this without raising taxes or 
further crippling our nation with even more debt.
  The Democrats have put forth a proposal that would take us in 
precisely the opposite direction-- higher costs, lower-quality care, 
new taxes and a bigger deficit. I urge my colleagues to support real 
reform.
  Ms. SLAUGHTER. Mr. Speaker, this is a wonderful, exciting day for us 
and the culmination of nearly 100 years of work that we will join the 
community of nations that believe that the people who live within them 
are deserving of decent health care, all of them, regardless of their 
financial situation.

[[Page H12621]]

                              {time}  1300

  This is such a step that I am proud that my life has brought me to 
this moment today; and I am sure, Mr. Speaker, that you share with 
every fiber of your being the same idea that we have finally reached 
the day when we will all brace ourselves to meet the duty ahead and 
will say to the future that this was our finest hour.
  I request a ``yes'' vote on the previous question.
  Mr. ACKERMAN. Mr. Speaker, I rise on this historic day in strong 
support of H. Res. 903--the rule providing for consideration of H.R. 
3962--the Affordable Health Care for America Act.
  Let me be absolutely clear: every single American should have access 
to affordable and quality health-care coverage. For too many years, 
drastically needed health-insurance reform has been delayed. I'm happy 
to say the long overdue reform of our health-care insurance system has 
finally begun. The status quo is unsustainable and costly: Without 
health insurance reform, the insurance premium for an average family is 
expected to rise from $11,000 to $24,000 in less than a decide. 
Americans want reduced costs and more choices.
  Mr. Speaker, I support this landmark legislation because it changes 
the way that insurance companies ration medical care: The measure would 
require all plans to eliminate coverage denials because of a pre-
existing condition, eliminate dropping coverage when individuals become 
sick, eliminate annual and lifetime caps on how much can be spent on 
care, and eliminate exorbitant out-of-pocket expenses. All Americans 
deserve these basic protections from their health-insurance plans, and 
these important guarantees will improve the coverage for nearly all 
those who already have insurance--even those Americans who are 
extremely satisfied with their current plans.
  The Act starts with what works well in today's health care system and 
fixes the parts that are broken. No one has to discard the health care 
they enjoy today--everyone can keep their current health plan, doctors 
and hospitals. A new marketplace will allow individuals to shop among a 
large number of private plans or choose a public insurance option. For 
the first time ever, American families--even those who keep their 
current health insurance--will benefit from no longer having to worry 
about losing health coverage because of a new or lost job. The bill 
finally brings the type of health insurance reform that Americans need 
and deserve.
  I also strongly support this bill because the 47 million uninsured 
Americans, the 2.6 million uninsured New Yorkers and the 78,000 
uninsured neighbors in my congressional district will have access to 
affordable, secure and quality health-care coverage instead of having 
to rely on the local hospital emergency room. Most recent 
administrations never acknowledged the moral or economic costs we pay 
every day for our failure to fix this problem. Fortunately, President 
Obama has made comprehensive health-insurance reform his top priority. 
I am proud to be voting today to make sure that health-care reform 
contains costs and is affordable; puts our country on a clear path to 
universal coverage; provides portable coverage; ensures choice of 
physicians and health plans; promotes prevention and wellness; improves 
the quality of care, and is fiscally sustainable over the long-term. 
Putting these principles into action is not only do- able; it is abs 
essential.
  So, Mr. Speaker, I urge all my colleagues to support the rule for the 
Affordable Health Care for America Act, H. Res. 903, so that all 
Americans will have access to health care.
  Mr. SENSENBRENNER. Mr. Speaker, this past weekend I held two town 
hall meetings in Wisconsin's Fifth District that had record turnout. 
The headline in the local paper summed up the meeting well: ``Health 
Reform Bill Gets Thumbs Down in Elm Grove.''
  Very few people in Wisconsin's Fifth District believe a program 
costing more than a trillion dollars can be deficit neutral. My 
constituents were overwhelming opposed to any government takeover of 
health care.
  I believe the right way to improve health care is to prioritize 
spending and be careful with taxpayer dollars.
  The wrong way is to raise taxes even higher and dig our debt even 
deeper to pay for more wasteful programs that don't work.
  This health care overhaul bill will likely make Cash for Clunkers 
look like a Black Friday door buster item!
  Before we raise taxes to pay for yet another program, we owe it to 
our constituents to cut out the waste, fraud, and abuse of government 
programs.
  One size does not fit all when it comes to health care. A patient and 
their physician should be in charge of their health care decisions, not 
politicians.
  I too, give this bill a thumbs down.
  Mrs. BIGGERT. Mr. Speaker, I rise in strong opposition to this rule 
and the underlying bill.
  Over the month of August, I spoke with over 20,000 of my constituents 
about health care, and one subject in particular kept surfacing over 
and over--the skyrocketing cost of insurance premiums. In fact, a 
recent survey filled out by over six thousand residents of the 13th 
District showed that, at nearly 47 percent, rising costs were far and 
away the number one concern when it comes to health care. Families in 
my district simply cannot keep pace with ever-mounting health care 
bills. And it's no wonder when over the past year, health care costs 
rose at twice the rate of inflation.
  Unfortunately, this bill would do absolutely nothing to address this 
pressing concern. Instead, it cuts seniors' Medicare benefits, taxes 
small businesses struggling to stay afloat, and places government 
bureaucracy between you and your doctor.
  Fortunately, we're offering a better, commonsense alternative to 
increase competition, improve portability for those between jobs, and 
expand coverage for pre-existing conditions--without job-threatening 
tax increases.
  That is why I am very pleased that according to experts at the 
nonpartisan Congressional Budget Office, or CBO, our Republican 
alternative will reduce your premiums by as much as 10 percent. In 
addition, the bill would save the government $68 billion. You heard 
that right--it would save the government--your tax dollars--money.
  And this bill doesn't have any complicated budgetary gimmicks that 
will inflate numbers or circumvent accurate analysis. This bill has 
real reforms like association health plans for small businesses, 
allowing the purchase of health insurance across state lines, and 
medical malpractice reform.
  In addition, the bill would change current law to ensure that 
insurance companies can't drop Americans who play by the rules just 
because they get sick. And no one can be denied treatment because of 
annual or lifetime benefit caps.
  Mr. Speaker, we need reform, not revolution. I urge my colleagues to 
join me in supporting an alternative that will provide real help to 
struggling Americans.
  Ms. SLAUGHTER. I yield back the balance of my time, and I move the 
previous question on the resolution.
  The SPEAKER pro tempore. The question is on ordering the previous 
question.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.


                             Recorded Vote

  Ms. SLAUGHTER. Mr. Speaker, I demand a recorded vote.
  A recorded vote was ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 and clause 9 of rule 
XX, this 15-minute vote on ordering the previous question will be 
followed by a 15-minute vote on adoption of House Resolution 903, if 
ordered, and a 5-minute vote on the motion to suspend the rules on 
House Resolution 892, if ordered.
  The vote was taken by electronic device, and there were--ayes 247, 
noes 187, not voting 0, as follows:

                             [Roll No. 881]

                               AYES--247

     Abercrombie
     Ackerman
     Adler (NJ)
     Altmire
     Andrews
     Arcuri
     Baca
     Baird
     Baldwin
     Barrow
     Bean
     Becerra
     Berkley
     Berman
     Berry
     Bishop (GA)
     Bishop (NY)
     Blumenauer
     Boccieri
     Boswell
     Boucher
     Boyd
     Brady (PA)
     Braley (IA)
     Brown, Corrine
     Butterfield
     Capps
     Capuano
     Cardoza
     Carnahan
     Carney
     Carson (IN)
     Castor (FL)
     Chandler
     Chu
     Clarke
     Clay
     Cleaver
     Clyburn
     Cohen
     Connolly (VA)
     Conyers
     Cooper
     Costa
     Costello
     Courtney
     Crowley
     Cuellar
     Cummings
     Dahlkemper
     Davis (CA)
     Davis (IL)
     Davis (TN)
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Dicks
     Dingell
     Doggett
     Donnelly (IN)
     Doyle
     Driehaus
     Edwards (MD)
     Edwards (TX)
     Ellison
     Ellsworth
     Engel
     Eshoo
     Etheridge
     Farr
     Fattah
     Filner
     Foster
     Frank (MA)
     Fudge
     Garamendi
     Giffords
     Gonzalez
     Gordon (TN)
     Grayson
     Green, Al
     Green, Gene
     Grijalva
     Gutierrez
     Hall (NY)
     Halvorson
     Hare
     Harman
     Hastings (FL)
     Heinrich
     Herseth Sandlin
     Higgins
     Hill
     Himes
     Hinchey
     Hinojosa
     Hirono
     Hodes
     Holden
     Holt
     Honda
     Hoyer
     Inslee
     Israel
     Jackson (IL)
     Jackson-Lee (TX)
     Johnson (GA)
     Johnson, E. B.
     Kagen
     Kanjorski
     Kaptur
     Kennedy
     Kildee
     Kilpatrick (MI)
     Kilroy
     Kind
     Kirkpatrick (AZ)
     Kissell
     Klein (FL)
     Kosmas
     Kratovil
     Kucinich
     Langevin
     Larsen (WA)
     Larson (CT)
     Lee (CA)
     Levin
     Lewis (GA)
     Lipinski
     Loebsack
     Lofgren, Zoe
     Lowey
     Lujan
     Lynch
     Maffei
     Maloney
     Markey (CO)
     Markey (MA)
     Massa
     Matheson
     Matsui
     McCarthy (NY)
     McCollum
     McDermott
     McGovern
     McIntyre
     McMahon
     McNerney
     Meek (FL)
     Meeks (NY)
     Michaud

[[Page H12622]]


     Miller (NC)
     Miller, George
     Mitchell
     Mollohan
     Moore (KS)
     Moore (WI)
     Moran (VA)
     Murphy (CT)
     Murphy (NY)
     Murphy, Patrick
     Murtha
     Nadler (NY)
     Napolitano
     Neal (MA)
     Nye
     Oberstar
     Obey
     Olver
     Ortiz
     Owens
     Pallone
     Pascrell
     Pastor (AZ)
     Payne
     Perlmutter
     Perriello
     Peters
     Peterson
     Pingree (ME)
     Polis (CO)
     Pomeroy
     Price (NC)
     Quigley
     Rahall
     Rangel
     Reyes
     Richardson
     Rodriguez
     Ross
     Rothman (NJ)
     Roybal-Allard
     Ruppersberger
     Rush
     Ryan (OH)
     Salazar
     Sanchez, Linda T.
     Sarbanes
     Schakowsky
     Schauer
     Schiff
     Schrader
     Schwartz
     Scott (GA)
     Scott (VA)
     Serrano
     Sestak
     Shea-Porter
     Sherman
     Shuler
     Sires
     Skelton
     Slaughter
     Smith (WA)
     Snyder
     Space
     Speier
     Spratt
     Stark
     Stupak
     Sutton
     Tanner
     Teague
     Thompson (CA)
     Thompson (MS)
     Tierney
     Titus
     Tonko
     Towns
     Tsongas
     Van Hollen
     Velazquez
     Visclosky
     Walz
     Wasserman Schultz
     Waters
     Watson
     Watt
     Waxman
     Weiner
     Welch
     Wexler
     Wilson (OH)
     Woolsey
     Wu
     Yarmuth

                               NOES--187

     Aderholt
     Akin
     Alexander
     Austria
     Bachmann
     Bachus
     Barrett (SC)
     Bartlett
     Barton (TX)
     Biggert
     Bilbray
     Bilirakis
     Bishop (UT)
     Blackburn
     Blunt
     Boehner
     Bonner
     Bono Mack
     Boozman
     Boren
     Boustany
     Brady (TX)
     Bright
     Broun (GA)
     Brown (SC)
     Brown-Waite, Ginny
     Buchanan
     Burgess
     Burton (IN)
     Buyer
     Calvert
     Camp
     Campbell
     Cantor
     Cao
     Capito
     Carter
     Cassidy
     Castle
     Chaffetz
     Childers
     Coble
     Coffman (CO)
     Cole
     Conaway
     Crenshaw
     Culberson
     Davis (AL)
     Davis (KY)
     Deal (GA)
     Dent
     Diaz-Balart, L.
     Diaz-Balart, M.
     Dreier
     Duncan
     Ehlers
     Emerson
     Fallin
     Flake
     Fleming
     Forbes
     Fortenberry
     Foxx
     Franks (AZ)
     Frelinghuysen
     Gallegly
     Garrett (NJ)
     Gerlach
     Gingrey (GA)
     Gohmert
     Goodlatte
     Granger
     Graves
     Griffith
     Guthrie
     Hall (TX)
     Harper
     Hastings (WA)
     Heller
     Hensarling
     Herger
     Hoekstra
     Hunter
     Inglis
     Issa
     Jenkins
     Johnson (IL)
     Johnson, Sam
     Jones
     Jordan (OH)
     King (IA)
     King (NY)
     Kingston
     Kirk
     Kline (MN)
     Lamborn
     Lance
     Latham
     LaTourette
     Latta
     Lee (NY)
     Lewis (CA)
     Linder
     LoBiondo
     Lucas
     Luetkemeyer
     Lummis
     Lungren, Daniel E.
     Mack
     Manzullo
     Marchant
     Marshall
     McCarthy (CA)
     McCaul
     McClintock
     McCotter
     McHenry
     McKeon
     McMorris Rodgers
     Melancon
     Mica
     Miller (FL)
     Miller (MI)
     Miller, Gary
     Minnick
     Moran (KS)
     Murphy, Tim
     Myrick
     Neugebauer
     Nunes
     Olson
     Paul
     Paulsen
     Pence
     Petri
     Pitts
     Platts
     Poe (TX)
     Posey
     Price (GA)
     Putnam
     Radanovich
     Rehberg
     Reichert
     Roe (TN)
     Rogers (AL)
     Rogers (KY)
     Rogers (MI)
     Rohrabacher
     Rooney
     Ros-Lehtinen
     Roskam
     Royce
     Ryan (WI)
     Sanchez, Loretta
     Scalise
     Schmidt
     Schock
     Sensenbrenner
     Sessions
     Shadegg
     Shimkus
     Shuster
     Simpson
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Souder
     Stearns
     Sullivan
     Taylor
     Terry
     Thompson (PA)
     Thornberry
     Tiahrt
     Tiberi
     Turner
     Upton
     Walden
     Wamp
     Westmoreland
     Whitfield
     Wilson (SC)
     Wittman
     Wolf
     Young (AK)
     Young (FL)

                              {time}  1327

  Messrs. LUCAS and LAMBORN changed their vote from ``aye'' to ``no.''
  So the previous question was ordered.
  The result of the vote was announced as above recorded.
  The SPEAKER pro tempore. The question is on the resolution.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.


                             Recorded Vote

  Mr. SESSIONS. Mr. Speaker, I demand a recorded vote.
  A recorded vote was ordered.
  The vote was taken by electronic device, and there were--ayes 242, 
noes 192, not voting 0, as follows:

                             [Roll No. 882]

                               AYES--242

     Abercrombie
     Ackerman
     Adler (NJ)
     Andrews
     Arcuri
     Baca
     Baldwin
     Barrow
     Bean
     Becerra
     Berkley
     Berman
     Berry
     Bishop (GA)
     Bishop (NY)
     Blumenauer
     Boccieri
     Boswell
     Boucher
     Boyd
     Brady (PA)
     Braley (IA)
     Brown, Corrine
     Butterfield
     Capps
     Capuano
     Cardoza
     Carnahan
     Carney
     Carson (IN)
     Castor (FL)
     Chandler
     Chu
     Clarke
     Clay
     Cleaver
     Clyburn
     Cohen
     Connolly (VA)
     Conyers
     Cooper
     Costa
     Costello
     Courtney
     Crowley
     Cuellar
     Cummings
     Dahlkemper
     Davis (CA)
     Davis (IL)
     Davis (TN)
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Dicks
     Dingell
     Doggett
     Donnelly (IN)
     Doyle
     Driehaus
     Edwards (MD)
     Edwards (TX)
     Ellison
     Ellsworth
     Engel
     Eshoo
     Etheridge
     Farr
     Fattah
     Filner
     Foster
     Frank (MA)
     Fudge
     Garamendi
     Giffords
     Gonzalez
     Gordon (TN)
     Grayson
     Green, Al
     Green, Gene
     Grijalva
     Gutierrez
     Hall (NY)
     Halvorson
     Hare
     Harman
     Hastings (FL)
     Heinrich
     Herseth Sandlin
     Higgins
     Hill
     Himes
     Hinchey
     Hinojosa
     Hirono
     Hodes
     Holden
     Holt
     Honda
     Hoyer
     Inslee
     Israel
     Jackson (IL)
     Jackson-Lee (TX)
     Johnson (GA)
     Johnson, E. B.
     Kagen
     Kanjorski
     Kaptur
     Kennedy
     Kildee
     Kilpatrick (MI)
     Kilroy
     Kind
     Kirkpatrick (AZ)
     Kissell
     Klein (FL)
     Kosmas
     Kucinich
     Langevin
     Larsen (WA)
     Larson (CT)
     Lee (CA)
     Levin
     Lewis (GA)
     Lipinski
     Loebsack
     Lofgren, Zoe
     Lowey
     Lujan
     Lynch
     Maffei
     Maloney
     Markey (CO)
     Markey (MA)
     Massa
     Matheson
     Matsui
     McCarthy (NY)
     McCollum
     McDermott
     McGovern
     McIntyre
     McMahon
     McNerney
     Meek (FL)
     Meeks (NY)
     Michaud
     Miller (NC)
     Miller, George
     Mitchell
     Mollohan
     Moore (KS)
     Moore (WI)
     Moran (VA)
     Murphy (CT)
     Murphy (NY)
     Murphy, Patrick
     Murtha
     Nadler (NY)
     Napolitano
     Neal (MA)
     Nye
     Oberstar
     Obey
     Olver
     Ortiz
     Owens
     Pallone
     Pascrell
     Pastor (AZ)
     Payne
     Perlmutter
     Perriello
     Peters
     Peterson
     Pingree (ME)
     Polis (CO)
     Pomeroy
     Price (NC)
     Quigley
     Rahall
     Rangel
     Reyes
     Richardson
     Rodriguez
     Ross
     Rothman (NJ)
     Roybal-Allard
     Ruppersberger
     Rush
     Ryan (OH)
     Salazar
     Sanchez, Linda T.
     Sarbanes
     Schakowsky
     Schauer
     Schiff
     Schrader
     Schwartz
     Scott (GA)
     Scott (VA)
     Serrano
     Sestak
     Shea-Porter
     Sherman
     Sires
     Slaughter
     Smith (WA)
     Snyder
     Space
     Speier
     Spratt
     Stark
     Stupak
     Sutton
     Tanner
     Teague
     Thompson (CA)
     Thompson (MS)
     Tierney
     Titus
     Tonko
     Towns
     Tsongas
     Van Hollen
     Velazquez
     Visclosky
     Walz
     Wasserman Schultz
     Waters
     Watson
     Watt
     Waxman
     Weiner
     Welch
     Wexler
     Wilson (OH)
     Woolsey
     Wu
     Yarmuth

                               NOES--192

     Aderholt
     Akin
     Alexander
     Altmire
     Austria
     Bachmann
     Bachus
     Baird
     Barrett (SC)
     Bartlett
     Barton (TX)
     Biggert
     Bilbray
     Bilirakis
     Bishop (UT)
     Blackburn
     Blunt
     Boehner
     Bonner
     Bono Mack
     Boozman
     Boren
     Boustany
     Brady (TX)
     Bright
     Broun (GA)
     Brown (SC)
     Brown-Waite, Ginny
     Buchanan
     Burgess
     Burton (IN)
     Buyer
     Calvert
     Camp
     Campbell
     Cantor
     Cao
     Capito
     Carter
     Cassidy
     Castle
     Chaffetz
     Childers
     Coble
     Coffman (CO)
     Cole
     Conaway
     Crenshaw
     Culberson
     Davis (AL)
     Davis (KY)
     Deal (GA)
     Dent
     Diaz-Balart, L.
     Diaz-Balart, M.
     Dreier
     Duncan
     Ehlers
     Emerson
     Fallin
     Flake
     Fleming
     Forbes
     Fortenberry
     Foxx
     Franks (AZ)
     Frelinghuysen
     Gallegly
     Garrett (NJ)
     Gerlach
     Gingrey (GA)
     Gohmert
     Goodlatte
     Granger
     Graves
     Griffith
     Guthrie
     Hall (TX)
     Harper
     Hastings (WA)
     Heller
     Hensarling
     Herger
     Hoekstra
     Hunter
     Inglis
     Issa
     Jenkins
     Johnson (IL)
     Johnson, Sam
     Jones
     Jordan (OH)
     King (IA)
     King (NY)
     Kingston
     Kirk
     Kline (MN)
     Kratovil
     Lamborn
     Lance
     Latham
     LaTourette
     Latta
     Lee (NY)
     Lewis (CA)
     Linder
     LoBiondo
     Lucas
     Luetkemeyer
     Lummis
     Lungren, Daniel E.
     Mack
     Manzullo
     Marchant
     Marshall
     McCarthy (CA)
     McCaul
     McClintock
     McCotter
     McHenry
     McKeon
     McMorris Rodgers
     Melancon
     Mica
     Miller (FL)
     Miller (MI)
     Miller, Gary
     Minnick
     Moran (KS)
     Murphy, Tim
     Myrick
     Neugebauer
     Nunes
     Olson
     Paul
     Paulsen
     Pence
     Petri
     Pitts
     Platts
     Poe (TX)
     Posey
     Price (GA)
     Putnam
     Radanovich
     Rehberg
     Reichert
     Roe (TN)
     Rogers (AL)
     Rogers (KY)
     Rogers (MI)
     Rohrabacher
     Rooney
     Ros-Lehtinen
     Roskam
     Royce
     Ryan (WI)
     Sanchez, Loretta
     Scalise
     Schmidt
     Schock
     Sensenbrenner
     Sessions
     Shadegg
     Shimkus
     Shuler
     Shuster
     Simpson
     Skelton
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Souder
     Stearns
     Sullivan
     Taylor
     Terry
     Thompson (PA)
     Thornberry
     Tiahrt
     Tiberi
     Turner
     Upton
     Walden
     Wamp
     Westmoreland
     Whitfield
     Wilson (SC)
     Wittman
     Wolf
     Young (AK)
     Young (FL)

                              {time}  1344

  So the resolution was agreed to.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.

                          ____________________