[Congressional Record Volume 156, Number 61 (Wednesday, April 28, 2010)]
[House]
[Pages H2990-H2997]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         ADDITIONAL FACTS AND FIGURES FROM THE HEALTH CARE BILL

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Missouri (Mr. Akin) is recognized 
for 60 minutes as the designee of the minority leader.
  Mr. AKIN. Madam Speaker, I appreciate being recognized. As we do on 
occasion on Wednesday, after the main part of the House business is 
closed, we have an opportunity to take a look at various topics and 
subjects. Usually we have chosen subjects of significant importance to 
Americans, ones that affect everybody's lives. And it might seem odd in 
that we have already passed the government takeover of health care bill 
that we would go back to that bill, but I think there is continuing 
information that is being released that a lot of people may not have 
known about when the bill was passed, additional facts and figures 
which are, at a minimum, quite disturbing.
  The facts and figures that I thought that would be important to talk 
a little bit about today are the facts and figures that come from the 
President's own people, the Centers for Medicare & Medicaid Services. 
These are people that the administration has chosen. They are a group 
of people who are taking a good look at the bill that was proposed and 
has been passed, what its implications are and some of the financial 
facts.
  So this was something that was actually approved by the Obama 
administration. This was not the House Congressional Budget Office, 
which is viewed as being fairly bipartisan and has its own numbers. But 
these facts have just come out recently. We have to assume the 
President knew them, and the facts are in sharp contradiction, in 
complete disagreement with statements made by the President himself.
  So I think we need to take a look at some of these things. 
Particularly, there was the claim in the health care bill that we have 
to bend the cost curve down because the numbers financially, for our 
Nation, we can't continue to have increasing health care costs.

                              {time}  1615

  Everything was centered on the fact that we are spending too much on 
health care. First of all, of course, the premise of that is a little 
odd. If you are a sick person, maybe you are not spending too much on 
health care. Maybe you spent what you needed to get well. But we are 
looking when that comment is made on what the government is spending on 
health care, particularly Medicare and Medicaid. So we are saying the 
government runs Medicaid and Medicare and they are spending too much, 
so the government needs to take it all over.
  But the whole thing was sold on we are going to bend the cost curve 
down so Medicare and Medicaid, also health care in America, will cost 
less. Here we have Obama's hand-picked Center for Medicare and Medicaid 
Services saying that, in fact, this bill is going to increase the cost 
of health care. Well, that is kind of odd because the whole logic for 
doing it was because we are going to decrease it. And now we are 
hearing it will increase it. We are going to look at some of the 
different promises, quotes, and comments.
  I am joined by a good friend of mine from Pennsylvania, and hopefully 
we will have some other guests on the floor tonight. I will introduce 
things first, and then we will discuss this.
  This was an attempt to try to summarize the 2,000-page bill. They say 
a picture is worth a thousand words. Well, this picture may be a little 
tough. I don't know if it is worth 2,000 pages or not, but it is a 
tough picture. This is a rough idea what the government has to take 
over on the bill we just passed. So obviously it is going to be 
complicated. It shouldn't surprise us when we see this and ask: Is this 
going to save money? The answer now from Obama's own people is, No, 
this is going to cost more money than it is going to save.
  So this is one of those things, just to get a sense of how complex 
the change is, and people are asking our offices all the time: When is 
this going to take place? For instance, those of us in Congress, we 
lose our health care coverage with this bill. So we are asking 
ourselves: When do we no longer have health insurance; and where do we 
have to go to buy it?
  Well, you have to go to an open exchange. And there are a lot of 
questions about how is it that the Federal Government is going to take 
over one-sixth of the U.S. economy and somehow make it more efficient 
than what we have right now. The answer is they are not. They are not. 
The authorities appointed by the Obama administration again say it is 
not going to be more efficient, it is going to be more expensive.
  There were all kinds of promises that we heard about, and I think it 
is important to go back and look at some of those things. Congressman 
Thompson from Pennsylvania may remember some of those quotes.
  First, this is one that the President said: If you are among the 
hundreds of millions of Americans who already have health insurance 
through your job, Medicare or Medicaid or the VA, nothing will require 
your employer to change the coverage with the doctor you have. Try to 
explain that to the Members of Congress who are all losing their health 
insurance. This doesn't even pass the laugh test. This is ridiculous to 
make this statement.
  The proposal that is before us, and you can probably technically say 
first, if you are among those who already have a health insurance 
policy, nothing in this plan will require you or your employer to 
change. Well, for how long? Well, until the bill goes into effect; then 
it will make you change. So this is really something here. Particularly 
the people who are going to be rather cynical when they read this are 
the people who are the Medicare seniors on Medicare Advantage. I don't 
know how many hundreds of thousands of people are in Medicare 
Advantage. You are going to have half a billion dollars taken out, $500 
billion being taken out of Medicare Advantage. And obviously when you 
take that money out, the people on that plan are not going to have that 
same plan. About 50 percent of the seniors in Medicare Advantage are 
not going to have the same thing.
  I want to contrast back and forth, the President says something, but 
yet, it taint necessarily so, as the song goes.
  Mr. THOMPSON of Pennsylvania. I thank my good friend from Missouri 
for leading this discussion. It is such an important discussion as we 
look at the consequences of this health care bill that has been passed.
  Mr. AKIN. Do you think we really know the consequences? I don't think 
people have a clue what the consequences are.
  Mr. THOMPSON of Pennsylvania. That's right. I don't think we do 
either. The original Senate bill was 2,000 pages. We had a manager's 
amendment, and a reconciliation bill on top of that. We are talking 
close to 4,000 pages, and now the bureaucrats have to take that bill 
and put it into regulatory language. We may not know certainly for 
months and maybe years everything that is in here.
  It really comes down to one word, and it is credibility. To say one 
thing, words one way and your actions completely opposite, it lacks 
credibility. We shouldn't be surprised. We saw that going back. Stretch 
our imaginations, we don't have to go that far back, we saw that a 
little over a year ago with the stimulus bill. The President said we 
have to do this stimulus bill. It was his words then that said we have 
to do this stimulus bill because if we don't, unemployment may go over 
8 percent. So we spent $878 billion on the stimulus bill; and in the 
end, what did we get? Well, we are at 10 percent or just under 10 
percent unemployment at this point.
  Mr. AKIN. So we are getting this radical, one statement says one 
thing and yet when you look at it, it is the exact opposite.
  Mr. THOMPSON of Pennsylvania. Actions as we know, speak louder than 
words.
  Mr. AKIN. The promise was if you don't pass the stimulus bill, this 
was a year ago, you could have unemployment above 8 percent. I wish we 
hadn't passed it because our unemployment is now 10 percent.

[[Page H2991]]

  You were on the floor here about a year ago saying it wasn't going to 
work. It wasn't that we were being pessimistic, but we learned from 
history from Henry Morgenthau, FDR's Secretary of the Treasury. He said 
this economic approach of the government spending tons of money doesn't 
fix this problem of unemployment and recession. It just doesn't work. 
After trying it for 8 years, it wasn't that we were rocket scientists, 
it is just we learned a little something from history.
  Yet we get this one promise that if you don't do this, unemployment 
is going to go as high as 8 percent. Instead it went to 10 when we 
spent whatever it was, $700 billion or $800 billion. That is just 
amazing. That is one of the promises. I was thinking about the health 
care promises, but you're right on that.
  Mr. THOMPSON of Pennsylvania. One of the premises that I have always 
led my life by is the best predictor of future performance is past 
performance. I think there is a significant issue, a great divide being 
what is being said, what the President said about the health care and 
some of the promises that were made in order to get this bill pushed 
through Congress and what we see now and what we have now is the 
reality as we take our time to look through this bill.

  Mr. AKIN. Here is one that might be of interest to you. I have a 
couple of examples.
  This is a quote from Senator Barack Obama and it was on 10-4-08. We 
will start--talking about his health care proposal--we will start by 
reducing premiums as much as $2,500 a family. If somebody told me that, 
I am saying I like that. Our expenses, we go through a lot of money 
with a bunch of kids and health care. If you are going to reduce my 
premiums by $2,500 a family, that is a great promise if it is any good. 
And yet after making this promise, now here we go, not only the 
Congressional Budget Office which is our bean counters, Republican and 
Democrat bean counters in the House and Senate, our guys, and this 
Center for Medicare and Medicaid Services which is the 
administration's, it is Obama's bean counters, are saying it is going 
to reduce the premiums by as much as $2,500, both of these offices are 
saying that the insurance premiums will increase under the Obama care, 
not decrease by $2,500, it is going to increase and it is going to 
increase by, I think they are saying--let's see, here it is: Americans 
who buy their own health insurance plans will pay an average of $2,100 
a year more for their policies.
  So if you are somebody going out and buying your health insurance, 
instead of decreasing by $2,500, it is going to increase by $2,100. 
That is a little different story. That is the sort of thing that gets 
people upset.
  We are joined by a doctor with a medical opinion on this subject.
  Mr. ROE of Tennessee. Thank you. One of the things that we are trying 
to do here, and as I go back and think through the last 15 months, and 
remember when this debate first began: What is the problem that we are 
trying to fix? Well, the problem we are trying to fix was we had 40-
plus million uninsured people in America, and that is untenable in this 
country.
  Number two, health care costs were going up faster than inflation. 
That was a problem. There is no question that the uninsured and rising 
health care costs had to be addressed. There are many ways you can 
address this. I brought to the table 17 years experience with a failed 
plan in Tennessee.
  Mr. AKIN. I want to mention that there may be some people joining us 
that are not always here on Wednesday evening. You are not just a 
Member of Congress, you are not just a former doctor, but you are also 
from the State of Tennessee, and the State of Tennessee is one of two 
States that tried this ObamaCare kind of approach to health care. And 
your experience in the State of Tennessee was did it decrease premiums 
and decrease the cost of insurance? That is what was promised by the 
President when he was a Senator. He said we are going to start by 
reducing premiums by as much as $2,500 a family. Did you believe that?
  Mr. ROE of Tennessee. No, I did not. One of the reasons was just the 
practical experience I had for over 16 years has shown that was not in 
the case. Back in the 1990s, we had a lot of uninsured people, and we 
asked for a Medicaid exemption and we got that in Tennessee to form a 
managed care plan. The idea was we were going to have various plans 
compete among each other to hold health care costs down. What actually 
happened was over about a 10-year period of time our costs tripled in 
this particular plan.
  Mr. AKIN. So your costs tripled when you went this route?
  Mr. ROE of Tennessee. Over 10 years they tripled. What happened was a 
lot of people, and I will predict this right here on the House floor 
right now, what is going to happen nationally with this plan is exactly 
what happened with our plan. I have seen this picture before. What will 
happen is you will have people, and we already have a business in west 
Tennessee that is a large plan. And remember, the Federal Government is 
going to determine what is adequate health care coverage in this great 
scheme, not you the individual or you the company, what you can afford, 
but the Federal Government will decide what is adequate health care 
coverage.
  This particular business their coverage that they have now the 
Federal Government says no, this is not adequate coverage. And so it 
will cost this one business $40 million more. Now if they drop their 
coverage, their covered workers into the exchange and they pay the 
$2,000 fine per individual, it will save that company $40 million.
  Mr. AKIN. Let's get this straight. You have a company here and the 
company is being faced with some choices now. Their first choice is 
just take their employees and dump them into, is it the State or the 
Federal?
  Mr. ROE of Tennessee. The Federal exchange.
  Mr. AKIN. You can take your employees and unload them on the Federal 
Government, and if you do that, how much money does it save?
  Mr. ROE of Tennessee. It saves $40 million. It is a large company.
  Mr. AKIN. So if you are a big company, you can make $40 million by 
just dumping your employees onto this plan?
  Mr. ROE of Tennessee. That's correct.
  Mr. AKIN. Why wouldn't somebody do that?
  Mr. ROE of Tennessee. Why wouldn't they do that. Exactly. That is 
exactly what happened in Tennessee. What happened in Tennessee is 
employers saw they could let their employees go to the TennCare plan, 
and 45 percent of the people who got on TennCare had private health 
insurance and those costs were shifted to the State of Tennessee.
  What happened, the little caveat that isn't ever talked about is that 
no Federal plan, including Medicare, pays the actual cost of the care. 
What you are talking about right there in Tennessee, the TennCare plan 
paid about 50 or 60 cents on the dollar. So guess what happened to 
private businesses, those costs got shifted and their premiums not only 
went up at the rate of inflation, but you got those added costs added 
to it.

                              {time}  1630

  So that's where your $2,000 comes as cost shift that we're talking 
about.
  Mr. AKIN. Okay, I'm starting to understand. Doctor, you're great at 
explaining this stuff.
  So what you're saying is you've got a certain number of people that 
are all kicking into the system and paying for medical care. All of a 
sudden you create a government incentive to dump all those people on 
the government. Now the government is having to pick it up, and guess 
who's going to pick up the bill? Well, it's the people who are still 
buying private insurance. So when you take these people out--the 
company is not paying for them anymore--now the private insurance guys, 
their cost goes way up to compensate for these other people because the 
government is not paying enough to cover the insurance.
  So if the government puts in 50 cents on the dollar, somebody's got 
to make up the other 50 cents. Guess who it's going to be? The other 
poor sucker out there who's trying to buy his own health insurance.
  Mr. ROE of Tennessee. And then what's going to happen is going to be, 
in a few years--in our State, it took about 5 or 6 years for us to 
recognize that we had a big problem on our hands. What's going to 
happen is that then, us, the politicians, are going to

[[Page H2992]]

step up and say, see, the private sector failed; we told you it was 
going to fail. This system that we have, Congressman Akin, is designed 
to fail, and it will.
  Mr. AKIN. Oh, so we're designed to fail because if you get the 
private system to fail, guess who's going to end up having to run the 
whole system?
  Mr. ROE of Tennessee. You got it.
  Mr. AKIN. The Federal Government. What a treat.
  Every time we take a look at this thing and we discuss it on the 
floor, no matter which way you poke at it, it seems to me you come to 
the came conclusion. There's one solution to this problem: repeal this 
silly bill that we passed. It's a disaster.
  Congressman Thompson from Pennsylvania, please join us.
  Mr. THOMPSON of Pennsylvania. Well, I thank my good friend from 
Missouri.
  The other part of that is, what they are paying, what my good friend, 
Dr. Roe from Tennessee, talked about how Medicare pays today less in 
costs. Commercial insurance on the average nationally pays 130 percent 
of cost. And there is only one reason--well, there's two reasons for 
that, but it all comes from the government. The government pays 
Medicare 80, 90 cents on the dollar, if we're lucky. Medical 
assistance, which has been expanded tremendously under this bill, only 
pays 40 to 60 cents for every dollar cost.
  The President's own agency, the Centers for Medicare and Medicaid 
Services, in their actuarial report--so that's taking the folks at 
Medicare and taking the brightest and the best in terms of determining 
the economic impact of this bill, the section that talks about how will 
this impact our hospitals? Right in that bill, and I'll quote: 
``Medicare cuts could drive about 15 percent of hospitals and other 
institutional providers into the red'' and ``possibly jeopardizing 
access'' to care for seniors. That's a significant risk.
  My background was working in rehabilitation therapy as a manager 
within rural hospitals. And most rural hospitals--and, frankly, 
underserved urban hospitals--in my experience, if they're having a 
banner year, make a margin of about 1 to 4 percent. And out of that 1 
to 4 percent, we hope that they can give cost-of-living increases 
because we want them to keep the best and the brightest and be able to 
recruit and retain--and that's a challenge when it comes to recruiting 
health care professionals.
  Mr. AKIN. Just interrupting for a minute, from a business standpoint, 
because my background was engineering and business, when a business is 
running at 1 to 4 percent, that's like if you think about somebody that 
has to breathe keeping his lips above the water, you don't have much 
margin there before you go into the red when you're running at 1 to 4 
percent.
  Mr. THOMPSON of Pennsylvania. And you don't. When you're looking at 
difficulty recruiting and retaining health care professionals, 
especially to rural areas and some urban areas, when you look at 
escalating costs of medical liability insurance--which our colleagues 
across the aisle refuse to deal with--they allow $39 billion annually 
to be spent for medical malpractice insurance. That's $39 billion that 
could be reduced out of the cost of providing health care, let alone 
the impacts of defensive medicine practice. So you've got that 1 to 4 
percent. You also have hospitals under pressure to continually invest 
in new technology because we want them to have the technology to save 
lives.
  Mr. AKIN. Let me just cut to the chase for a minute here. Are you 
suggesting that with this new proposal, because of the tremendous 
pressure that's going to be placed on those hospitals, that they're 
basically going to be starting to close?
  Mr. THOMPSON of Pennsylvania. Well, not only am I suggesting that, 
but the President's agency, the Centers for Medicare and Medicaid 
Services, put that in writing.
  Mr. AKIN. So they're saying that this new bill, among other things, 
is going to close hospitals.
  Mr. THOMPSON of Pennsylvania. That is correct. They're estimating up 
to 15 percent.
  Mr. AKIN. Now there's something here that just seems to be ironic to 
an extreme. We passed this massive government takeover of health care, 
and the very people that the President and his administration chose to 
take a look at and study the effect on Medicare and Medicaid of this 
proposal are saying it's going to close hospitals; and yet this bill is 
going to hire 16,000 new IRS agents to try and enforce the plan. You 
would think if you had a medical bill, you would hire more nurses and 
doctors. No, we're going to do 16,000 IRS agents.
  Mr. ROE of Tennessee. Will the gentleman yield?
  Mr. AKIN. Yes.
  Mr. ROE of Tennessee. I want to just comment on that right now before 
I have to go on blood pressure medication.
  Mr. AKIN. Which is brought on by the bill, is my question.
  Mr. ROE of Tennessee. Which is brought on by the bill.
  Here we have something as ridiculous as hiring 16,000 IRS agents to 
check a box to see whether you have bought health insurance, where if 
you took that $10 billion right there, you could solve the uninsured, 
and our TennCare problems in the State of Tennessee could actually 
provide the care. Now, that's absurd when you hire government 
bureaucrats to check a box when you could actually provide care for 
pregnant women, for the elderly on Medicaid, for young people.
  The gentleman from Pennsylvania brings up a great point on rural 
hospitals. Typically, if you look at the demographics--and I live in a 
rural area in Tennessee--if you look at the demographics, they tend to 
be older and less affluent. And those smaller hospitals that don't get 
the more affluent people have a higher percentage of Medicaid and 
Medicare patients, meaning there's more pressure on them. You lower 
those reimbursements and there's a very real chance they will be in 
financial trouble.
  I yield back.
  Mr. AKIN. Wow. Well, we're joined by a good friend of mine who does 
represent a rural area from the great State of Missouri, Blaine 
Luetkemeyer, a gentleman that I have already a tremendous amount of 
respect for, and somebody who is also going to share a couple of his 
ideas on this whole ridiculous situation with this government takeover 
of health care.
  Congressman.
  Mr. LUETKEMEYER. Thank you, Congressman Akin. It's good to be with 
you.
  I've had a number of visitors over the last several days that have 
been talking about the health care bill. It's amazing, people are now 
starting to sit down and look at the bill, trying to figure out what 
kind of implications it has for themselves, their business, their 
families, whatever it may be.
  And to follow up on the gentleman from Pennsylvania's comment, 
yesterday I had a group of rural hospital folks in, and not only is it 
going to affect the hospitals, it's also going to affect the doctors 
from the standpoint that the payment schedule can't be made whole so 
that they can make enough money to keep their doors open. Private 
practices will be a thing of the past. You're looking at them all 
becoming employees of hospitals or the government, whichever one is the 
surviving--I guess the last one standing here. So it's really a 
challenging time for not only the medical professionals, but also for 
the businesses as well.
  Mr. AKIN. I really appreciate you bringing that point up, gentleman, 
because what you're really saying is there are a whole lot of question 
marks out there. It almost seems like to me, coming from our State of 
Missouri, it's almost like maybe you fall off your roof and you land on 
the ground and you know you hit pretty hard--you get to be an old 
geezer like me--and you kind of pick yourself up and say, I wonder if 
anything's broken. You start reaching around to see what's the damage. 
It seems like now people are kind of asking the question, what's the 
damage going to be? You really hit the nail on the head.
  Go ahead, I didn't mean to interrupt you.
  Mr. LUETKEMEYER. And, again, as you talk to the individuals--and each 
individual industry is a little different, but I know the fast food 
industry, I was talking to a gentleman who has 25 fast food franchises 
from Missouri all the way to South Dakota. He said it's going to cost 
him about $20,000 per location. And some of his locations don't

[[Page H2993]]

make $20,000 because they're small towns or smaller locations.
  Before the bill passed, he was looking not only at trying to figure 
out how he could make some more dollars here, but he was looking to 
expand his operation. He was looking to purchase eight other units from 
another fast food franchise owner as well as build four additional 
ones. But now he says, Because of this extra cost, I not only am not 
going to expand my operation, I'm probably going to have to contract 
because I can't afford it.
  At the end of the day, he's looking at half a million dollars in 
additional costs. He did nothing wrong. He didn't change his business 
model, but all of a sudden now, under this bill, he's got another half 
a million dollar bill that he has to figure out how to----
  Mr. AKIN. You're talking about a bill that is actually driving the 
unemployment worse. It's a bill that's going to create unemployment is 
what you're saying. That's what this small business owner says. In 
other words, you're saying he's making enough money as it is now to 
open additional franchises, but with the cost of this bill, it pushes 
him under water, which says, I've got to close some rather than open 
them, and there goes some more jobs. So why in the world are we doing 
this when we've got an unemployment problem?
  Mr. LUETKEMEYER. Well, I think it's pretty obvious, gentleman. I 
think that we're not about preventing health care in this bill. It's 
about a government takeover of one-sixth of our economy. It's about 
control; they want to control that portion of the economy.
  Again, I've got another friend of mine who owns three manufacturing 
plants around the country, looking to open a fourth, but with the 
uncertainty of our economy, with bills like the health care bill, cap-
and-trade, the stimulus package, additional tax increases that are 
sitting on the back burner right now, he says, I'm not going to open 
this business; I'm not going to build a new manufacturing plant.
  To bring another business example here, I had a group of bankers in 
yesterday and I asked them, I said, How is your money supply? Have you 
got plenty of funds to loan out and what is your loan demand? And he 
said, We have the funds to loan out. The demand is sort of lukewarm 
right now, but the last five guys we've had come in who wanted to take 
out business loans were all ready to sign the papers. We had approved 
them, everything was fine. They're good customers, they're good 
business people, they decided at the last minute, we're not going to 
expand. We don't want to do this because we're going to endanger our 
whole operation if we go down this road. So they actually backed off, 
and as a result, look at how many jobs we're not providing or jobs that 
we're killing because of bills like this.
  Mr. AKIN. I would like to underline that point. We just had my good 
friend from Tennessee talking about what happened when Tennessee did 
this crazy harebrained idea and how it really messed up the economy in 
the State of Tennessee. And now you're saying, actually, if I remember 
right, is that today the President is coming to Missouri to some degree 
to assure people that he's concerned with unemployment, and yet what 
you're telling me is you had small business owners going to bankers--I 
think you had a banking background, is that right, gentleman?
  Mr. LUETKEMEYER. That's correct. That's correct.
  Mr. AKIN. They're going to bankers, those loans are all set up, and 
when this thing passes, they go, Forget it, we're not going to expand 
business that way. And so you literally have people you know in the 
banking business in the State where the President is visiting today, 
and they're saying, These people came to us and said we don't want your 
money because we can't make enough profit on it to pay you back because 
we passed this piece--you keep coming to the same conclusion that--and 
I don't mean to beat on this a little bit--the solution to this is 
repeal. We've got to get rid of this thing.
  I am also joined by another good friend of ours, another doctor who 
has been a stalwart on this from Georgia, my good friend, Congressman 
Gingrey.
  We've just been talking about this tremendous gap between statements 
that the President is making, and now the gap between what the 
President is saying and what this Centers for Medicare and Medicaid, 
the center that's collecting the numbers, is saying totally different 
than what the President is saying. I just wanted your thoughts on that 
because you've been very much on top of this bill.
  Mr. GINGREY of Georgia. Madam Speaker, I thank the gentleman for 
yielding.
  I think the truth is finally coming out. I guess it's kind of like 
what Speaker Pelosi said maybe a week or just a matter of days before 
the vote on ObamaCare. They finally did get that passed, as we all 
know, by deem-and-scheme and reconciliation and everything that you can 
think of. It barely passed. But her famous quote was, Well, we need to 
hurry up and do this so that the American people can find out what's in 
it. And, boy, was she prophetic. Nothing could be further from the 
truth--finally.
  And I think the gentleman from Missouri is absolutely right: now all 
of a sudden the true numbers coming out from the Centers for Medicare 
and Medicaid Services, CMS, are showing quite clearly that this pledge 
that the President, then-Senator Obama, made I guess back in as late as 
October of 2008 that if you like what you have you can keep it. 
Certainly, nothing could be further from the truth for those 11 
million, I think, Medicare recipients who get their Medicare coverage 
under the Advantage Plan. That's cut 18 percent a year over the next 10 
years, something like $150 billion. That plan is going to go away, 
certainly.
  Mr. AKIN. If you let me just cut in for a second, Doctor, I've 
actually got that exact quote. Here it is. This is President Obama, 
June 15, 2009: ``If you like your doctor, you will be able to keep your 
doctor. If you like your health care plan, you will be able to keep 
your health care plan. No one will take it away no matter what.'' And 
yet this center is saying that's not true. Go ahead.

                              {time}  1645

  Mr. GINGREY of Georgia. That is the exact quote, and I thank him for 
having that.
  It is exactly what we all predicted on our side of the aisle, and 
that's why no Republicans could vote for this massive takeover of the 
health care system--a sixth of our economy. It's part of a grand 
scheme, of course, and that's why you see people all across this 
country who are upset, certainly not just Republicans, but Independents 
and the grass root activists, be they Tea Party patriots or the 9-12 
Group or Freedom First or the Doctors for Patient Care. All of these 
folks have been coming to the people's House, to the Nation's Capitol, 
over the last year. They are the same folks who were turning out for 
the town hall meetings last August to whom the Democratic majority, 
Madam Speaker, just absolutely turned a deaf ear. They came back, and 
then all they did was change the name and the number of the bill.
  So I thank the gentleman for giving me an opportunity to weigh in as 
a physician Member. There are 10 M.D.'s on our side of the aisle. There 
have been 31 years of experience for me and many, many years of 
experience for my colleagues who practice medicine.
  Mr. AKIN. How many of those doctors voted for this bill? Of those 10 
doctors you just mentioned, how many voted for this bill?
  Mr. GINGREY of Georgia. I thank the gentleman for asking.
  The answer is nada, a big zero. That is also true for the two 
Republican Senators, the only M.D.'s, in fact, in the Senate--Dr. 
Coburn and Dr. Barrasso.
  There is expertise that we had. In the House organization of the 
Doctors Caucus, of the GOP's Doctors Caucus, there are, in fact, 15 of 
us--10 are M.D.'s, and there are others who were health care providers 
in their professional lives. The unfortunate thing is that none of us 
got an opportunity to try to help. Even though we were knocking on that 
door, it was never opened.
  I yield back.
  Mr. AKIN. There was no chance for input or anything else.
  My good friend, Congressman Luetkemeyer, you recently have been 
elected to Congress. You come from an out-State part of Missouri with a 
lot of pretty conservative, but Democrats, in your district.
  Now, what would they have thought if you had voted, first of all, for 
cutting

[[Page H2994]]

Medicare? Next, you've got a brilliant idea for a tax on wheelchairs, 
on medical devices and on something which is going to increase the 
average person's cost to health care and which is going to force the 
person to go to the Federal Government ultimately to get health care.
  What would they have thought of you if you had voted for this thing?
  Mr. LUETKEMEYER. They would have literally rode me out of town on a 
rail. The people in my district are conservatives. Whether Republicans 
or Democrats, they are conservatives, and they don't believe in 
government takeovers. They don't believe in governments solving 
problems that people can solve for themselves. Regardless of party, I 
think they are appalled by what is going on.
  Last night, for instance--and, in fact, today--we have the President 
in my district. He had a closed meeting with some folks versus an open 
meeting where the people could have actually spoken to him and where 
they could have actually listened to what's going on, which is 
concerning to me because, here in D.C., we hear more lecturing than we 
do listening from him, and it's unfortunate, because I think there are 
a lot of people who have a lot of good things to say, and a lot of 
information could be transferred back and forth.
  At the end of the day, I think the folks in my district--and there 
were 1,100 people at a rally last night in a town of 5,000, and they 
weren't supporting what the President was doing. So I think that will 
tell you--and this was in an area that is conservative Democrat by 
nature.
  Mr. AKIN. There were 1,100 people in a town that had 1,000 people?
  Mr. LUETKEMEYER. Well, 5,000 people.
  Mr. AKIN. There were 5,000. So more than one out of five were there.
  Mr. LUETKEMEYER. I think that tells you that there is a lot of 
concern and that there is a lot of frustration. These are people who 
are watching what's going on. They don't approve of it, and they want 
their voices heard.
  I think this is the key--that nobody here in D.C. is listening to 
these folks. They don't perceive what is happening with this 
administration as listening to their voices, as listening to their 
concerns, as listening to them when they point out that there are 
problems with this bill, that there are problems with this thought 
process, that there are problems with this ideology. They are being 
shut out just like we are as minority Members. As a result, they're 
standing up, and they're doing what they can, which is to raise their 
voices even louder.
  So it was exciting to be able to talk to that group last night by 
conference phone. They're energized, and they're going to be very vocal 
come November.
  Mr. AKIN. Well, I'll tell you that I'm going to be talking to one in 
another hour or two not very far from my district. I think they've got 
the same set of concerns. It's at a place where the President has been 
visiting, and they're turning out to say, We're not buying this 
solution.
  My good friend from Pennsylvania, are you getting the same kind of 
sense from your constituents that there is a deep-seated concern for a 
plan that is just going to put 16,000 new IRS agents on the line to try 
and monitor whether you've done the right government thing?
  Mr. THOMPSON of Pennsylvania. Yes, and not just from my constituents.
  When I get home, I am out all over my district. My district is a 
great snapshot of Pennsylvania because it is actually 22 percent of the 
landmass of the commonwealth State, so it is a fairly large piece of 
Pennsylvania, and consistently, people are very conservative. Yet it's 
not just the people. Their State representatives are concerned as well.
  I just received a resolution that is being put forward in the 
Pennsylvania State House by members of that chamber. It is essentially 
expressing their concern over this health care mandate. You know, 
Pennsylvania, with the expanded roles of Medicaid, is expected to have 
a bill of somewhere in excess of $3 billion between 2014 and 2019. 
Three billion dollars.
  I've got to tell you that, financially, Pennsylvania is strapped 
right now. We were the last State to get a budget this past fiscal 
year, and this year's budget is not going to be much better, I don't 
think. These are very, very challenging times for States, for a lot of 
States, not just for Pennsylvania.
  Mr. AKIN. Could I interrupt just for a moment and jump in there? I do 
have specifics on that very point that you've made.
  I don't know if you gentlemen were aware of it, but as of today, 
there are 19 States representing 41 percent of the population--and our 
State of Missouri is not here, but I know they have this on the burner 
to do. As of today, there are 19 States, representing 41 percent of the 
population, which have sued the Federal Government over ObamaCare, 
which has caused Justice Briar to make the statement: ObamaCare, a good 
candidate for review by the Supreme Court of the United States.

  So it's not just Tennessee. It's not just Missouri. It's not just 
Georgia. It's not just Pennsylvania. There are 19 States here that are 
saying something.
  Mr. GINGREY of Georgia. Will the gentleman yield for just a second?
  Mr. AKIN. I do yield to my good friend from Georgia.
  Mr. GINGREY of Georgia. Madam Speaker, I thank the gentleman for 
yielding, and of course I will yield the time back so the gentleman 
from Pennsylvania can continue to make his point.
  He is right on target in regard to what is happening in the States 
and in the Commonwealth of Pennsylvania. In the great State of Georgia, 
we have one more day, tomorrow. We have a 40-day session, and tomorrow 
is the last day.
  They passed a budget for fiscal year 2011, which begins on July 1 in 
the State of Georgia, and it had to cut almost $1 billion. Now, that 
has been extremely painful, and I'm sure it's painful in the State of 
Pennsylvania.
  Though, I want to commend the Governor of the State of Georgia and my 
colleagues in the general assembly--a Republican majority in the House 
and Senate. Madam Speaker, they have made these tough cuts, and most 
States--I think 47 States in the Union--have this balanced budget 
requirement as part of their constitutions. If they can do it, why in 
the world are we sitting here with--what is it?--$12.8 trillion worth 
of debt and with a $700 billion deficit already in this current fiscal 
year?
  I hope my colleagues and anybody who might happen to be listening to 
us here tonight get what I'm trying to say. This is serious business, 
and we're not doing our job up here, quite honestly, and it embarrasses 
me.
  I yield back.
  Mr. AKIN. Maybe we're doing a bad job.
  I want to continue back with my friend from Pennsylvania.
  Mr. THOMPSON of Pennsylvania. Thank you.
  In terms of Medicaid, I think it's an important area for us to look 
at in terms of, again, the credibility of what the President said he 
was going to deliver, of what the Democrats say they are going to 
deliver and what the reality is in the actions that have taken place 
here and that will take place. Now that we have these volumes of pages, 
we will read through them and begin to see what the reality is.
  When it comes to Medicaid, there will be 18 million more people on 
the Medicaid program. Essentially, that means they will have coverage. 
To me, that means they're going to have cards in their wallets or in 
their purses which will say they're eligible for Medicaid insurance, 
which is a form of government insurance. We've already had the 
discussion of the flaws of it. It pays 40 cents to 60 cents for every 
dollar of cost today. I suspect that will probably go down. If you 
include 18 million more people in that program, the pressure that that 
will put on it will be significant.
  We have a problem today. The credibility issue for the Democrats is 
the difference between coverage and access. The fact is, today, there 
are 40 percent of physicians in this country who will accept medical 
assistance patients. That's family practice.
  Mr. ROE of Tennessee. Sixty.
  Mr. THOMPSON of Pennsylvania. Sixty.
  For specialists today, it's 60 percent. It's expected to go to 80 
percent.
  So they may have coverage, but they really don't have access. If you 
don't have a physician who is able to accept you or who will see you, 
then we're not

[[Page H2995]]

really providing them access to quality care.
  Mr. ROE of Tennessee. Will the gentleman yield?
  Mr. THOMPSON of Pennsylvania. I certainly will.
  Mr. ROE of Tennessee. You bring up a very, very pertinent point, 
which is, this year in America, as of the last number I saw, we were 
training a whopping total of 600 primary care physicians.
  Mr. AKIN. You're saying we are training this year 600 primary care 
physicians?
  Mr. ROE of Tennessee. This is for a country with 300 million people 
in it. Also, 15 percent of the practicing physicians in America today 
are over 65, and you know what they're going to do when this ObamaCare 
plan hits.
  I've studied the Massachusetts plan in detail. It's a little 
different than what we did in Tennessee. What they did there was to 
impose the mandates like they have in this plan. The idea was to spread 
the costs over more people. Therefore, we were going to hold the costs 
down, and we'd have fewer people going to the emergency rooms.
  So what's going on in Massachusetts?
  This is the fourth year that they've had it. It was initiated in 
2006, and it's like in Tennessee. You can't spend $8 billion and not 
help some people. You do. There is no question about that. No one is 
arguing that point. In Massachusetts, with the billions of dollars that 
have been spent, you are going to help some folks because they've 
included another 400,000-plus people. What the Governor is now doing is 
recommending that almost all of the private plans' premiums be capped.
  Why are they going up faster than they thought they would?
  Well, they've added more people to the rolls that they're not paying 
the costs of, and the idea was we were going to get people out to 
primary care doctors and that we were going to cut the number of people 
who would be going to the emergency rooms.
  Well, guess what? That didn't happen. Why?
  As the gentleman from Pennsylvania just pointed out, Mr. Thompson, 
who is going to see you? That is the problem with this whole plan. The 
fallacy is: Who is going to see these patients?
  Let me just make one final point.
  Mr. AKIN. I don't want you to make just a final point, but I'd like 
you to answer this question:
  The Democrat Governor of Tennessee, before this bill was passed, 
called this the mother of all unfunded mandates. In other words, one 
thing State legislators hate is when we up here pass some piece of 
legislation which busts their budgets. Then they have to take the 
political hit for the fact that we're fiscally irresponsible and 
legislatively irresponsible.
  Now, is this a budget buster for a State?
  Mr. ROE of Tennessee. There is no question. In Tennessee, it's over 
$1 billion.
  The problem with it is that people from a patient standpoint don't 
understand that, if I've got a card, I've got health insurance 
coverage. Not necessarily. That's what happened with Senator Nelson in 
Nebraska. He exempted Nebraska. Then, of course, the final bill that 
was passed put everybody in, and the States were made whole for the 
first 3 or 4 years of this plan.
  Mr. AKIN. Was that the cornhusker kickback?
  Mr. ROE of Tennessee. That was the kickback. Exactly.
  Eventually what happens is that it will be an unfunded mandate for 
the States. They see it coming. They get it. We have a gubernatorial 
election right now in Tennessee, and it's a hot topic. Who is going to 
pay this unfunded mandate? We've dealt with it for so long.
  You're right. This was a fiscally conservative Democratic Governor 
who understood. He got it. He had to deal with it, and he asked them 
not to do that, not to pass this bill. He was very much against it.
  Mr. AKIN. Wow.
  We've been joined by a good friend of mine, Congressman Lamborn.
  Welcome to the discussion. We're just taking a look at the fact that, 
you know, you'd think logically: What in the world are these 
Congressmen doing, standing on the floor, railing about some bill that 
has already been passed?
  Well, part of the reason is there was some truth in what Speaker 
Pelosi said, which is that you've got to pass the bill to find out 
what's in it. We're still discovering all kinds of surprises. In a way, 
that's what we've been talking about tonight--things that the Obama 
accountants in the Medicare/Medicaid group are analyzing in the bill. 
They're saying, Whoops. It's not going to bend the cost curve down; 
it's going to bend the cost curve up, so it's going to be more 
expensive. Uh-oh, it's going to cost jobs.
  Anyway, please join us.
  Mr. LAMBORN. Well, thank you. This is a great discussion that you all 
are having. Thanks for letting me participate for a few minutes.
  You raised a really good point, which is that this report has shown 
that this is going to be a lot more expensive, that it's going to raise 
taxes, that it's going to raise health insurance premiums, that it's 
going to make people drop out of the existing coverage they have. They 
will be thrown into the government plan. This is a CMS report, the 
Centers for Medicare & Medicaid Services, which is nonpartisan and 
objective.
  What really is outrageous about this report, Representative Akin, is 
that they had it over at DHS before we ever had the final vote on 
ObamaCare. They were sitting on it. Their language now is, Oh, we 
didn't want to influence the debate.
  Isn't that what a report is all about?

                              {time}  1700

  Mr. AKIN. Influence the debate with any facts? My goodness, people 
might not vote for this thing.
  Mr. LAMBORN. These are vital facts to have. It really is a lot more 
expensive. And it is going to raise taxes and throw people out of the 
insurance they have now than what the administration was claiming. So 
if we had known this maybe it wouldn't have passed by the four or five 
votes that it passed by. Maybe it would have failed, and we would have 
been on a whole different trajectory right now if they had been open 
and honest about this report that the American people and us as their 
Representatives should have had access to.
  Mr. AKIN. That is really frustrating, isn't it, to basically give 
people a mushroom treatment. You keep them in the dark, smother them in 
some sort of a fertilizing material, and we tell them these things: if 
you like your doctor, you will be able to keep your doctor, period. If 
you like your health care plan, you will be able to keep your health 
care plan, period. No one will take it away, no matter what. And yet 
the report that you are talking about makes it clear that this just 
flat is not true. So it is a frustrating thing. And in a sense, all of 
these things are falling out now, and it wasn't so obvious before.
  My good friend from Louisiana, Congressman Scalise, please join us.
  Mr. SCALISE. I thank the gentleman from Missouri. And this latest 
smoking gun that's come out is just yet one more example of why the 
American people are so angry about what happened with this government 
takeover of health care, with the way it was rammed through, with all 
the broken promises.
  And you can go back to the very beginning when the President was a 
candidate. He said multiple times all of these hearings would be on C-
SPAN so you could actually have transparency and find out what's going 
on. In fact, none of that transparency happened. None of those meetings 
were held on C-SPAN. And now we see this document that comes out 
conveniently just 2 weeks, 3 weeks after the vote that barely passed by 
three votes that confirms what we were saying, that this would actually 
raise the costs of health care for most American families at a time 
when we should be lowering the cost of health care, like our bill did 
that we filed that actually would have addressed the real problems in 
health care. But in fact their bill does the opposite, and now it's 
confirmed that.
  What I really want to find out is when did the administration know 
about this report? Was this report produced by CMS, a Federal agency, 
before the vote and then covered up, literally held under wraps so that 
this couldn't become public until after the vote, when the American 
people would once again see that yet another promise by this 
administration on health

[[Page H2996]]

care was broken with their government takeover?
  Mr. AKIN. That's an incredible question, isn't it, the control of the 
information, the spin on the whole thing, the promises initially of it 
being a transparent process, it's going to be on C-SPAN, everybody can 
watch it, and in fact everything is closed doors.
  A couple of our doctors have left, but, Dr. Roe, were you invited to 
take part in the drafting and putting this bill together? Were you 
allowed to go into their meetings? I think that's an important 
question.
  Mr. ROE of Tennessee. I am smiling because this actually is kind of 
funny. What happened, the President last July said he would go over 
this line by line with any Congressman that would like to go over this 
bill. So I wrote the President the next day, and then was on Greta Van 
Susteren three or four times. We contacted the White House by email, by 
phone, by letter. I guess I was going to have to try a carrier pigeon 
and smoke signals. But we never did hear one word back.
  And the Physicians Caucus, with over 400 years experience, not one of 
us was consulted in a meaningful way. I practiced medicine, Congressman 
Akin, for 31 years in Johnson City, Tennessee, left my practice and got 
myself elected to Congress to become part of the debate. I was never 
included in any way whatsoever.
  Mr. AKIN. So I guess from what you are saying, a quick summary, 31 
years in medicine, you thought maybe you knew something about medicine, 
decided to take the huge amount of effort to come to Congress so you 
would have something to say about the debate. And in spite of the fact 
that you tried everything other than carrier pigeons and smoke signals, 
the White House refused to honor their promise to let you look at line 
by line what's going on. So the logical conclusion is you are going to 
run for President? Is that where we are going?
  Mr. ROE of Tennessee. No, that's not where we are going. A couple of 
things I want to go over I think that our seniors get, and all of us 
here understand this. One of the things as a physician that bothers me 
about it, and Dr. Gingrey was here a moment ago, our concern is the 
quality of care that our patients are going to get. When you take our 
senior citizens and you cut, the new CMS estimate is, $575 billion out 
of a Medicare plan--and remember, beginning next year, 2011, we begin 
to add the baby boomers at 3 million per year. So in the next 10 years 
we are going to add 35, 36 million more people to the Medicare plan 
with almost $600 billion less money.
  Let me tell you three things that will happen. One, you will have 
decreased access to your doctor. Two, you will have decreased quality 
of care because you can't get to your doctor. Number three, it's going 
to cost you more money. The seniors understand that. I understand that. 
And the American people understand that.
  Mr. AKIN. What you just said is so common sense and straightforward. 
You are going to take how many more people and put them into Medicare?
  Mr. ROE of Tennessee. Thirty-six million in the next 10 years.
  Mr. AKIN. Thirty-six million more people go into Medicare--now, you 
don't have to be too much of a wizard on business--36 million people go 
into Medicare that weren't there before, it's going to cost more money. 
And then you are going to cut $575 billion out of the program. So now 
you are doing two things: one, you are adding millions of people into 
the program, you are taking billions out of the program, and you are 
saying, hey, maybe your quality of health care is going to go down. 
That's pretty straightforward.
  Mr. THOMPSON of Pennsylvania. Will the gentleman yield?
  Mr. AKIN. I yield to my good friend from Pennsylvania.
  Mr. THOMPSON of Pennsylvania. I want to reach back into the past, the 
Balanced Budget Act of 1997, where similar cuts were made to the 
Medicare program, because we have been accused of making this things up 
on this side of the aisle when it comes to rationing of services by our 
Democratic colleagues. And they just don't know how to deal with the 
facts. They don't know how to deal with the reality. The Medicare part 
B cuts have been made. Today in this country we ration health care 
services. But we ration government health care services.
  Medicare part B. My background was rehabilitation services, licensed 
as a nursing home administrator. An older adult that is going in for 
therapy, physical therapy, occupational therapy, speech therapy, you 
are going to an outpatient clinic or into a skilled nursing facility 
because you have had some type of a disease or disability that disabled 
you that you need rehabilitation services, did you know that today the 
Federal Government under Medicare part B rations those services? There 
is a cap that is placed on how much therapy services you can receive on 
an annual basis.

  I know that because, unfortunately, I was the person that was 
responsible in my facilities to track where those patients were in 
terms of that cap. And when they reached that cap, we had to serve them 
notice and their family members notice that they were no longer 
eligible for Medicare, for Medicare part B specifically, for those 
rehabilitation services.
  And you think about the people who wind up in skilled nursing 
facilities, they are the sickest of the sick. These are people who have 
no other place to go for the type of compassion and care that they need 
to receive. Yet there is an example of how we ration already.
  Going forward, I want to read from a report from the actuary on this 
Medicare part B so we have that language. This is according to CMS, the 
Centers for Medicare and Medicaid Services.
  Mr. AKIN. This is part of that same report that we were just talking 
about that has just now been released conveniently after the bill was 
voted on.
  Mr. THOMPSON of Pennsylvania. After the vote.
  Mr. AKIN. Let's get the exact quote.
  Mr. THOMPSON of Pennsylvania. The question is for the President, Mr. 
President, when did you have this report? And why did Congress not have 
it?
  As the actuaries put it:
  ``Therefore, it is reasonable to expect that a significant portion of 
the increased demand for Medicaid would be difficult to meet, 
particularly over the next few years.''
  They continue:
  ``For now, we believe that consideration should be given to the 
potential consequences of a significant increase in demand for health 
care meeting a relatively fixed supply of health care providers and 
services.'' In other words, there will be shortages of both physicians 
and hospitals. That really amounts to having less access to quality 
care.
  Mr. AKIN. Less access or, as you used the word, rationing.
  Mr. ROE of Tennessee. Let me give you just one quick example. You 
talk about rationing of care. In the State of Tennessee this year, what 
we did to get control of our TennCare plan was cut the rolls by 
hundreds of thousands of people. And this year we are going to limit 
doctor access to 10 visits per year, unless something can be done in 
the budget, and a grand total of a hospital pay of $10,000. I don't 
care if you have a massive wreck and your bill is $100,000, the State 
will pay $10,000. And in rehabilitative services, as of July, right 
now, unless something changes before the end of the State legislature, 
there will be no rehabilitative services. If you have a knee 
replacement, you are just going to have to rehabilitate it on your own 
because the State cannot afford to pay for it.
  That is rationing of care going on right now with the government 
plan.
  Mr. AKIN. Wow.
  Mr. ROE of Tennessee. And we just voted to massively expand this 
plan.
  Mr. AKIN. I have not jumped in from a personal point of view because 
you guys are all experts. I am just the poor sucker that receives the 
services. I am a cancer survivor. I happened to have taken a look at 
the cancer survival rates in foreign countries that have socialized 
medicine. You notice the U.K. survival rate of cancer in men is a whole 
lot less than it is in the U.S. Well, why would that be? Is it that the 
cancer technology is different? I don't think so.
  I think the deal on cancer is if you've got it, you want to get 
treated as quick as you can. So what happens in the U.S., you don't 
have the same waiting line. Now, you start putting those waiting lines 
in and it starts to affect your statistics of what's going to happen on 
a disease. That's what we talk about when you all of a sudden hear your 
doctor say, oh, by the way, you're

[[Page H2997]]

doing great, Blaine, but little detail, you have cancer. That kind of 
gets your attention. And you think, I better get that dealt with right 
away. They say, well, that's just fine, but you are going to have to 
wait for, you know, whatever it is. You are going to have to wait 6 
months to get treated. You got melanoma, that's probably not a real 
good idea to be waiting 6 months.
  I have a good friend that's a doctor friend of mine, Steve Smith. He 
has told me that on these kinds of things, you just don't want waiting 
lines. You just don't want socialized medicine. His advice to me is the 
same as the doctor friends we have down here, just repeal this piece of 
junk. That's what he is saying.
  My good friend from Missouri, Congressman Luetkemeyer.
  Mr. LUETKEMEYER. I thank the gentleman.
  I think at the end of the day everybody understands now what's in 
this bill. And it's not something that's good for our country, it's not 
good for our people, it's not good for our business climate. It's 
impacting everybody in a negative way. And I think the only alternative 
is to replace and repeal it. I think that at some point we are going to 
be able to do that. And I think it's imperative that now that we have 
seen what's in it, and again have another report that's come out that 
shows it's going to cost more than anticipated, this thing is a 
boondoggle. It's got to be replaced, it's got to be repealed.
  This can't continue because it's going to lead us over a cliff, as 
the gentleman from Tennessee has talked about TennCare. The 
Massachusetts plan continues to go over a cliff as well. We are headed 
over that cliff with our national health care as well.
  Mr. AKIN. Thank you very much, Mr. Speaker. I appreciate my 
colleagues joining me here tonight and for being a part of an important 
discussion. It is an ongoing story.

                          ____________________