Congressional Record, Volume 157 Issue 6 (Tuesday, January 18, 2011)

[Congressional Record Volume 157, Number 6 (Tuesday, January 18, 2011)]
[House]
[Pages H209-H230]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

REPEALING THE JOB-KILLING HEALTH CARE LAW ACT

Mr. RYAN of Wisconsin. Mr. Speaker, pursuant to House Resolution 26,
I call up the bill (H.R. 2) to repeal the job-killing health care law
and health care-related provisions in the Health Care and Education
Reconciliation Act of 2010, and ask for its immediate consideration.
The Clerk read the title of the bill.
The SPEAKER pro tempore. Pursuant to House Resolution 26, the
amendment printed in part A of House Report 112-2 is adopted, and the
bill, as amended, is considered read.
The text of the bill, as amended, is as follows:

H.R. 2

Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Repealing the Job-Killing
Health Care Law Act''.

SEC. 2. REPEAL OF THE JOB-KILLING HEALTH CARE LAW AND HEALTH
CARE-RELATED PROVISIONS IN THE HEALTH CARE AND
EDUCATION RECONCILIATION ACT OF 2010.

(a) Job-Killing Health Care Law.--Effective as of the
enactment of Public Law 111-148, such Act is repealed, and
the provisions of law amended or repealed by such Act are
restored or revived as if such Act had not been enacted.
(b) Health Care-Related Provisions in the Health Care and
Education Reconciliation Act of 2010.--Effective as of the
enactment of the Health Care and Education Reconciliation Act
of 2010 (Public Law 111-152), title I and subtitle B of title
II of such Act are repealed, and the provisions of law
amended or repealed by such title or subtitle, respectively,
are restored or revived as if such title and subtitle had not
been enacted.

SEC. 3. BUDGETARY EFFECTS OF THIS ACT.

(a) The budgetary effects of this Act, for the purpose of
complying with the Statutory Pay-As-You-Go Act of 2010, shall
be determined by reference to the latest statement titled
``Budgetary Effects of PAYGO Legislation'' for this Act,
submitted for printing in the Congressional Record by the
Chairman of the Committee on the Budget of the House of
Representatives, as long as such statement has been submitted
prior to the vote on passage of this Act.

The SPEAKER pro tempore. The resolution shall be debatable for 7
hours, with 30 minutes equally divided and controlled by the majority
leader and minority leader or their designees, 90 minutes equally
divided and controlled by the chair and ranking minority member of the
Committee on Education and the Workforce, 90 minutes equally divided
and controlled by the chair and ranking minority member of the
Committee on Energy and Commerce, 90 minutes equally divided and
controlled by the chair and ranking minority member of the Committee on
Ways and Means, 40 minutes equally divided and controlled by the chair
and ranking minority member of the Committee on the Budget, 40 minutes
equally divided and controlled by the chair and ranking minority member
of the Committee on the Judiciary, and 40 minutes equally divided and
controlled by the chair and ranking minority member of the Committee on
Small Business.
The gentleman from Virginia (Mr. Cantor) and the gentlewoman from
California (Ms. Pelosi) each will control 15 minutes. The gentleman
from Minnesota (Mr. Kline), the gentleman from California (Mr. George
Miller), the gentleman from Michigan (Mr. Upton), the gentleman from
California (Mr. Waxman), the gentleman from Michigan (Mr. Camp), and
the gentleman from Michigan (Mr. Levin) each will control 45 minutes.
The gentleman from Wisconsin (Mr. Ryan), the gentleman from Maryland
(Mr. Van Hollen), the gentleman from Texas (Mr. Smith), the gentleman
from Michigan (Mr. Conyers), the gentleman from Missouri (Mr. Graves),
and the gentlewoman from New York (Ms. Velazquez) each will control 20
minutes.
The Chair recognizes the gentleman from Wisconsin (Mr. Ryan).

General Leave

Mr. RYAN of Wisconsin. Mr. Speaker, I ask unanimous consent that all
Members may have 5 legislative days in which to revise and extend their
remarks and include extraneous material on H.R. 2.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Wisconsin?
There was no objection.
Mr. RYAN of Wisconsin. Mr. Speaker, I yield myself 2 minutes.
Mr. Speaker, I am going to begin by saying why we're doing this, and
I want to get into the accounting of all this at a later time in this
debate. But let me just simply say why we are here.

[[Page H210]]

We are here because we heard the American people in the last
election. We are here because we believe it's really important to do in
office what you said you would do. We said we would have a straight up-
or-down vote to repeal this health care law, and that's precisely what
we are doing here today.
Now, Mr. Speaker, why do we believe this? Because this health care
law, if left in place, will accelerate our country's path toward
bankruptcy. This health care law, if left in place, will do as the
President's own chief actuary says it will do: It will increase health
care costs. We are already seeing premiums go up across the board. We
are already hearing from thousands of employers across the country who
are talking about dropping their employer-sponsored health insurance,
and we are already hearing about the lack of choices that consumers
will get as this new law is put into place. This new law is a fiscal
house of cards, and it is a health care house of cards. It does not
make our health care system better. I would argue it makes it weaker.
There are two ways to attack this problem, and I want to say in the
outset to my friends on the other side of the aisle we agree that
health care needs fixing. We agree that there are so many serious,
legitimate problems in the health care system that need fixing.
Affordable insurance, the uninsured, people with high health care costs
and high health care risks, those need to be addressed. But we can fix
what's not working in health care without breaking what's working in
health care.
With that, Mr. Speaker, I would simply say this: We believe we can
get to the moment of having affordable health care for every American,
regardless of preexisting conditions, without having the government
take it over, without $1 trillion of a combination of Medicare benefit
cuts and tax increases. We believe in this: Let's have health care
reform put the patient in charge, not the government in charge.
The SPEAKER pro tempore. The time of the gentleman has expired.
Mr. RYAN of Wisconsin. I yield myself an additional 20 seconds to
simply say we believe that health care ought to be individually based,
and it ought to be patient centered.
There are two ways to go: Put the government in charge and have the
government put in place rationing mechanisms to tighten the screws and
ration health care; or put the consumer in charge and have providers
compete for our business as patients, hospitals, doctors, and insurers.
That's the system we want.
Mr. Speaker, I reserve the balance of my time.
Mr. VAN HOLLEN. Mr. Speaker, I yield myself 4 minutes.
Mr. Speaker, I hope the tenor and substance of the debate we have in
this House over the next few days will be worthy of the American people
and reflect well on this Congress.
Many of us believe we should focus our efforts here today on measures
to help put people back to work, rather than on a bill that takes away
important patient and consumer protections. And we don't think it makes
a whole lot of sense to debate a bill that, thankfully, will go nowhere
in the Senate and would certainly be vetoed by the President. However,
the Republican majority is entitled to use its time here as it chooses.
And while we believe we should be doing that focused on jobs, perhaps
this debate will clear up many of the myths and misinformation about
the health care law that was signed by President Obama.
I'm interested to hear my colleagues say that they can identify with
all the problems in the health care system. Between the year 2000 and
year 2006, premiums in this country doubled, health insurance company
profits quadrupled, and this Congress did nothing. Why not put your
plan on the table first so everybody can see it before you begin taking
away the important patient protections in this bill taking effect just
since last March? And within that 9-month period, that law has made an
important and positive difference to millions of Americans.
In fact, we wish our Republican colleagues would take a few days,
maybe even just a few hours, to have congressional hearings to listen
to those individuals and families. The new Republican majority said it
wanted to listen to the American people, but it has not invited a
single American outside this Congress to a hearing to testify on the
repeal bill we are debating today.
As a result, we on the other side of the aisle have had to schedule
an unofficial hearing. It's going on right now, not 100 yards from
where we debate, in the Capitol Visitor Center. And I encourage all of
you to drop by, because if you do, you're going to hear some stories.
You're going to hear the stories from moms and dads of young people who
will tell you how they are relieved that their sons and daughters are
no longer kicked off their insurance policies when they turn age 22 or
graduate from college and cannot now stay on their parents' insurance
plan until the age of 26. As a result, if their 20-year-old child gets
sick or hit by an automobile or another terrible accident, they can get
care without the family going bankrupt.
You will hear from moms and dads with kids who have cancer, asthma,
diabetes or other preexisting conditions telling you they're relieved
that finally insurance companies can't deny their children coverage
because of preexisting conditions. And you will hear from senior
citizens who are unable to pay for the huge prescription costs of their
bills, and then as of January 1 of this year, they are getting a 50
percent discount and they can afford to pay for the medicines their
doctors say they need.
You will hear from small businesses. The number of small businesses
using the tax credit has exceeded everyone's expectation. You will hear
from those small businesses saying they can now afford to purchase
affordable coverage for their employees and, as a result, hire more
people. You would hear all that and more.
That is why it is such a mistake, it's an historic mistake, to take
away these patient protections and throw these individuals back over to
the whims and the many abuses of the insurance industry. There's no
doubt that the insurance industry will be popping champagne bottles if
the health care law was ever to be repealed. Let's put the interests of
our constituents, patients and consumers first in this debate.
The SPEAKER pro tempore. The time of the gentleman has expired.
Mr. VAN HOLLEN. I yield myself an additional 30 seconds.
And let's make sure that as we do this, we tackle the deficit and the
debt. I listened to my colleague talk about the debt, but we all know
that the independent, nonpartisan Congressional Budget Office in a
letter to Speaker Boehner dated January 6, 2011, indicated that
repealing this bill will increase the deficit by over $200 billion over
the first 10 years and by another $1.2 trillion over the second 10
years.

{time} 1510

Our colleagues have criticized those findings, but they're the same
people who they applauded when the numbers came back their way.
Mr. Speaker, I reserve the balance of my time.
Mr. RYAN of Wisconsin. Mr. Speaker, I yield 2 minutes to a new member
of the committee but a senior Member of Congress, the gentleman from
California (Mr. Calvert).
Mr. CALVERT. Mr. Speaker, I rise today in support of H.R. 2, a bill
that would repeal the disastrous government takeover of health care.
The more we learn about the new health care law, the more we
understand how devastating it will be to our economy. Already employers
across the country have suffered increases in their health premiums as
a result of the health care law, yet we were told that the law would
bend the health cost curve downward.
We were told that the bill would reduce the deficit by $143 billion
over 10 years. However, we now know that the figures given to the CBO
did not accurately reflect the law's real costs. When you add back the
$115 billion needed to implement the law and subtract the bill's
double-counting of revenue and other budgetary gimmicks, the true cost
is a staggering $700 billion over 10 years.
We were told the bill would protect the uninsured; yet all it does is
roll them onto Medicaid--a low-performing program that has resulted in
more people turning to the ER for their medical needs.

[[Page H211]]

We were told this bill would help seniors; instead, it guts Medicare
Advantage leaving 50 percent of beneficiaries on the verge of losing
their current coverage. What happened to the promise that if you like
your health care plan, you can keep your health care plan?
In addition to all the false promises, the health care bill will
impose $52 billion in new taxes on businesses. Our economy relies on
the ability of businesses to grow, hire, invest and succeed. The new
taxes will devastate our economy and turn the American Dream into a
nightmare.
The bottom line is that we cannot afford this new health care law, no
matter how well intentioned. We must repeal ObamaCare and replace it
with legislation that decreases health care costs, increases
competition in the marketplace, maintains the sanctity of the doctor-
patient relationship and truly helps those without insurance.
I urge my colleagues to vote in favor of H.R. 2.
Mr. VAN HOLLEN. Mr. Speaker, I yield 2\1/2\ minutes to the gentlelady
from Pennsylvania (Ms. Schwartz).
Ms. SCHWARTZ. I rise to speak very forcefully, I hope, about the
importance of proceeding with the health care bill, the health care law
that we had in place and the critical protections that it is providing
to literally millions of Americans in each and every one of our
districts; and each of us, I think, have heard from them.
The new health care law reduces the deficit. We're here talking
about, from the Budget Committee, it is going to reduce the deficit
while promoting more efficient and higher quality care. Reducing the
deficit and slowing the growth of health care costs means real savings
to American families, American businesses and to the Federal
Government. And yet their first major act in the majority,
congressional Republicans want to repeal this law.
Repealing the protections for Americans with preexisting conditions.
We just heard this morning the Washington Post reported on a study that
says that one-half of all Americans under the age of 65 have a
preexisting condition. So this isn't just about a few of us. Really
it's about almost all of us. We all know someone and we may all love
someone who has a preexisting condition. If Republicans got their way--
and they will probably in the House but fortunately not in the Senate--
they would repeal the protections for Americans with preexisting
conditions, or for children who can now already be covered. They will
repeal the new law that says annual limits for coverage if you have
cancer will be repealed. They will repeal the prescription drug
benefits for our seniors, and will repeal tax credits for small
businesses. And in doing so, they will add to the cost for American
taxpayers.
Let's be clear on what this means. Repeal increases the deficit by
$252 billion over 10 years and $1.4 trillion over 20 years. Repeal
reverses progress in getting health care costs under control, causing
families and businesses and, yes, the government--which really means
the taxpayers--to face higher health care costs. It repeals benefits
for millions of Americans, important consumer protections and insurance
reform, such as making sure that the children with preexisting
conditions have coverage.
And the repeal means starting over. We're going to hear it over and
over again, I think, over the next 7 hours. What starting over means is
no consumer protections and months and maybe years of just talk,
possibly no action, while the costs go up for American businesses, go
up for our families and go up for our Nation.
The SPEAKER pro tempore. The time of the gentlewoman has expired.
Mr. VAN HOLLEN. I yield the gentlelady an additional 30 seconds.
Ms. SCHWARTZ. Let's be clear that the new rules allow the Republicans
to do this, but it's going to cost trillions of dollars to our budget
and it's going to cause greater suffering for the American people. So
it's a wrong course of action. Let's not repeal this bill. It will hurt
Americans, it will hurt our economic competitiveness, and it will hurt
the fiscal condition of this nation.
I encourage a ``no'' vote.
Mr. RYAN of Wisconsin. Mr. Speaker, I yield myself 3 minutes to
address some of the charges we've heard.
Number one, they're saying this is a jobs bill. Half a trillion
dollars in tax increases creates jobs? That mandates the taxes, that
creates jobs?
Others have been saying, well, this isn't going to pass the Senate
and the President's not going to sign it, so why bother doing that. If
that's the logic we take on every bill we bring to the floor, then we
ought to just go home. We think it's important to define ourselves with
our actions, and that's why we're acting. We think this law should be
totally repealed, and that's why we're doing this.
Let me speak to the fiscal house of cards as represented by this law.
The minority is saying, This reduces the deficit. Just look at the
letter from CBO to Speaker Boehner. It reduces the deficit by $143
billion over 8 years; $230 billion over 10 years.
It does that if you manipulate the CBO. I've heard charges of Enron
accounting. The only Enron accounting that's been employed here is the
previous majority gave the CBO a bill full of smoke and mirrors and
made them score that.
Well, here's what the CBO says, if you take away the smoke and
mirrors. If you take away the fact that there's $70 billion in CLASS
Act premiums that are being double-counted; $53 billion in Social
Security taxes that are being double-counted; $115 billion in new
appropriations required to hire the bureaucracy that wasn't counted;
$398 billion in Medicare cuts that are being double-counted; and oh,
let's not forget the fact that we're going to do the doctor fix, $208
billion, that we just discounted and ignored.
When you take away the smoke and the mirrors, this thing has a $701
billion deficit. If you don't believe me when I say it that way, how
about this way: The CBO says this raises the debt.
Now, how is that different where they say on one hand the bill lowers
the deficit but on the other hand it raises the debt? Because when the
CBO looks at whether or not a measure raises the debt, they can look at
everything. They look at the interplay of all fiscal policies to
determine its effects on the debt. When they score a particular bill
and its effects on the deficit, they look at what you put in front of
them, all the smoke, all the mirrors, the double-counting, the
noncounting, the discounting, and they give you that answer.
So if this bill actually lowers the deficit, how on Earth can it then
increase the debt? You know why? Because you have to play a phony trick
with all this double-counting to do that. What does this bill
ultimately do when you really look at it all? This bill blows a hole
through the deficit. When you look at the first 10 years, this bill is
a $1.4 trillion increase. That's because you have 10 years of tax
increases and Medicare cuts to pay for 6 years of spending. But when
you actually look at the full 10 years of implementation of this law,
$2.6 trillion in spending. $2.6 trillion.
Mr. Speaker, let me just say this as far as jobs and the effects of
this health care bill. I had a very alarming conversation with a very
large employer in Wisconsin not too long ago, a privately held company
with thousands of employees. She takes good care of her employees.
The SPEAKER pro tempore. The time of the gentleman has expired.
Mr. RYAN of Wisconsin. I yield myself an additional 20 seconds to say
this.
She said to me, I believe it's my obligation to offer health
insurance to my employees, but my two competitors, my publicly traded
competitors, have already said they're dumping their employees. Instead
of paying $17,000 a year for employee health care, they're going to pay
a $2,000 fine. That's a $15,000 difference that her competitor will
have as a competitive advantage against you.
So what did she say? ``I have no choice. I'm dumping my employees
into this exchange.'' And thousands of employers are making the same
decision. This should be repealed.
With that, Mr. Speaker, I reserve the balance of my time.

{time} 1520

Mr. VAN HOLLEN. Mr. Speaker, I yield myself 3 minutes.
Mr. Speaker, it is interesting to hear this attack on the CBO numbers
that came out when many of my colleagues on the other side of the aisle
just 9

[[Page H212]]

months ago, when the CBO was reporting deficit numbers and the cost of
the bill, were singing CBO's high praises. Now let's look at some of
the items that were just mentioned. Let's look at the doctor fix
payment. Let us look at the SGR. We know that has been an issue that
has been with this House for years and years. It has nothing to do with
the health insurance reform bill that was signed by the President. We
are going to have to deal with that issue whether we had health
insurance reform or didn't have health insurance reform. And, Mr.
Speaker, they know that.
We also heard that we front-loaded the revenue in this bill and
disguised the out-year costs. If that were the case, how is it possible
that CBO would say that it actually reduces the deficit by more in the
second 10 years than in the first 10 years?
The fact of the matter is this bill will increase Social Security
revenue as employers provide more of their compensation in the form of
wages that are subject to payroll taxes. Double counting is not the
issue. The fact is it reduces the deficit, and CBO says that.
Now, CBO is the independent referee that we use in this body. They
are like the guy on the football field, the referee, who calls the
plays, calls when there are penalties and no penalties. Sometimes we
like the call and sometimes we don't. But it is an unprecedented step
to say that we are going to totally ignore the decisions and judgment
of the independent CBO and we are going to replace that with our
judgment for the purposes of deficit reduction calculations in
legislation that goes to reducing our debt. That is a recipe for budget
anarchy. It is a recipe for fiscal chaos. We should not go down that
road.
The CBO has been very clear that the fiscally responsible thing to do
is to move forward with the law in its place. We obviously can fix
things as they come up that need to be addressed, specific items. But
to repeal this wholesale will--the folks that we rely on as the
independent, nonpartisan judges here say that repealing this bill as
our colleagues are proposing to do will add $1.4 trillion to the
deficit over 20 years.
I reserve the balance of my time.
Mr. RYAN of Wisconsin. I yield myself 10 seconds simply to say that
if the doc fix should be considered outside, then why did the Democrats
have it in their bill in the beginning?
Secondly, either we are financing this entitlement or raiding the
Social Security and Medicare funds--you can't do both. If you are going
to fund the entitlement with these revenues, then you are consigning to
raid Social Security and Medicare.
I yield 2 minutes to the gentleman from Michigan (Mr. Amash), a new
member of the committee.
Mr. AMASH. Mr. Speaker, the Founders were keenly aware of the threat
a powerful and overbearing Federal Government poses to our liberty.
With this concern in mind, they wrote a Constitution that created a
Federal Government with limited powers. Later they proposed the 10th
Amendment, which reserves to the States or the people powers not
delegated to the Federal Government.
The debate we are having today goes beyond health care, although
there is no doubt health care coverage is an important and difficult
issue. What we are discussing today goes to the core of our
Constitution's design. It asks Members of Congress whether we take
constitutional limits on our power seriously.
We have all witnessed everyday Americans' renewed interest in the
Constitution. As they have asked tough questions about the
constitutionality of this law, the law's proponents have tried to dress
up their answers in constitutional language.
They say Congress's power to tax upholds this law. But when this law
originally was being considered, those same proponents were the first
to claim the bill included no new taxes. They try to find support in
Congress's power to regulate interstate commerce. If forcing Americans
to start commerce is the same as regulating existing commerce, it would
have been news to the Founders.
Finally, grasping at clauses, they claim Congress can do anything
that is in the general welfare of the country. If this law is
constitutional, if Congress has such broad power, our limited Federal
Government will become limitless, and all without changing our
Constitution or the approval of the Americans whom it protects. It is
not just for the courts; it is our duty as a Congress to pay attention
to the Constitution and its limits on our power.
I urge we repeal this unconstitutional law.
Mr. VAN HOLLEN. Mr. Speaker, I yield 1 minute to the gentleman from
Virginia (Mr. Connolly).
Mr. CONNOLLY of Virginia. Mr. Speaker, I rise as a member of the
Budget Committee to oppose this deficit-busting repeal, and I want to
speak today on behalf of Suzanne from Vienna, Virginia.
Suzanne's daughter suffers from a debilitating neurological disease.
Before health care reform, Suzanne and her husband could not get health
insurance for their daughter because, through no fault of her own, she,
like 129 million other Americans, had a preexisting condition.
While many of those Americans wait to see if their insurance company
will deny them, Suzanne, unfortunately, already knew. She was willing
to pay for health insurance to protect her daughter; the insurance
companies said no and wouldn't insure her daughter at any price.
Suzanne had no option until we created high-risk insurance pools under
health care reform. Suzanne's words to me after health insurance reform
passed were, Now at least we have hope for the future.
Voting for this repeal will take away that hope, throwing Suzanne's
daughter off of insurance. I urge my colleagues to remember Suzanne's
daughter and the other 129 million Americans like her and vote against
this repeal. Do not take away their hope.
Mr. RYAN of Wisconsin. Mr. Speaker, I yield 1 minute to the gentleman
from South Carolina (Mr. Mulvaney), a new member of the Budget
Committee.
Mr. MULVANEY. I rise in favor of this bill.
I can't tell you how excited I am to hear the language coming from
the other side of the Chamber this evening. I am hearing discussions
about the importance of cutting deficits and the importance of keeping
spending in line. It makes me wonder, Mr. Speaker, what has been
happening here for the last several years. At least when it comes to
this side of the aisle, I think we have been consistent with that
message over the course of this debate. I don't know where the other
side was when we got the information that said this bill actually cost
trillions of dollars. I don't know where this attitude about being
fiscally responsible was when we got information from the chief actuary
at Medicare and Medicaid who said this bill was unsustainable in its
spending. I don't know where they were with this attitude when we heard
from that same body that this bill actually raised the cost of health
care versus not passing the bill.
But, Mr. Speaker, I am extraordinarily excited to hear this level of
discussion because, as a member of the Budget Committee, I look forward
to this level of debate continuing beyond this bill, beyond the health
care discussion and into the upcoming discussion on the budget because
my guess is if we have this level of discussion on health care, then
the budget will be an easy, easy debate this year, and we will be able
to make dramatic inroads to cutting our spending.
Mr. VAN HOLLEN. Mr. Speaker, I yield 1 minute to the gentleman from
Texas (Mr. Cuellar).
Mr. CUELLAR. Mr. Speaker, in the long rich history of Congress, when
a prior Congress passes a piece of legislation, the prudent step is to
look at that legislation and agree on making the changes on what
doesn't work. I think to come today and just say to repeal and not have
a health plan in place is not a prudent plan to take. We have to see
what works and what doesn't work, and I think that would be the prudent
step to take today.
We have to focus on the deficit and focus on jobs. Deficit is
important. I think we can come together and work in a bipartisan
approach. Jobs, we certainly have to look at. But to just come in and
say this is something that kills jobs is not the right step to take.
If you look at, for example, the FNIB Research Foundation, when they
looked at this piece of legislation, they said that a number of health
care profession jobs would be created by this

[[Page H213]]

legislation. This is something that we need to look at. Again, the
prudent step is to look at what works and what doesn't work. Mr.
Speaker, that is what we need to look at.
Mr. RYAN of Wisconsin. Mr. Speaker, I yield 90 seconds to the
gentleman from Oklahoma (Mr. Cole), a new member of the Budget
Committee.
Mr. COLE. Mr. Speaker, I rise to support H.R. 2, the repeal of last
year's so-called health bill. The American people, quite frankly, have
never liked this bill, as they demonstrated last November. You can't
find a poll where it cracked 50 percent in approval. And those wanting
to repeal it have generally always been above that mark.
The bill itself may be unconstitutional. Over 20 States are now
challenging it in Federal court. It is certainly likely to be
unworkable. The creation of dozens of boards, agencies, and commissions
with rulemaking authority, the fact that hundreds of companies have
already asked for waivers under the legislation, suggest it is going to
be a bureaucratic nightmare.

{time} 1530

Finally and most importantly, the bill itself is fiscally
irresponsible and unsustainable. The idea that we would take hundreds
of billions of dollars out of Medicaid and Social Security and Medicare
at a time when the baby boomer generation is beginning to retire is
simply irresponsible. I am all for saving money in Medicare, but when
we do, those savings are going to be needed to sustain Medicare.
So I urge this House to take the fiscally responsible course--repeal
this bill and start over, and give the American people the health care
bill they deserve and the health care bill they can afford.
Mr. VAN HOLLEN. Mr. Speaker, I yield 2 minutes to the gentlewoman
from Florida (Ms. Wasserman Schultz).
Ms. WASSERMAN SCHULTZ. Mr. Speaker, I rise to oppose the Republican
majority's callous attempts to repeal the Affordable Care Act. Reform
has already made a dramatically positive difference for millions of our
constituents and small businesses while tackling our ballooning
national debt.
We in Congress must continue doing all that we can to support
American families and businesses as we emerge from this recession.
Democrats have pledged to measure all legislation by a proposal's
success at creating jobs, at strengthening the middle class, and at
bringing down the deficit. Unfortunately, the Republican majority's
attempts to repeal the Affordable Care Act fails on all such counts.
Repeal would hurt small businesses, canceling $40 billion worth of
tax credits to help employees afford coverage. Repeal would stall
middle class job growth, as one-third of small business owners told the
small business majority they were more likely to hire new employees as
a result of reform. And of course repeal would deepen our already
exploding deficit, increasing it by $230 billion in the next 10 years
and by more than $1 trillion in the following decade.
Many of my colleagues across the aisle have rebuffed this analysis
from Congress' own budgetary referee, the Congressional Budget Office,
because it doesn't fit the Republican narrative or campaign promise to
tackle the deficit. However, while they may be entitled to their own
opinions, they are not entitled to their own facts.
Health care repeal is the epitome of fiscal irresponsibility, and it
counters our most basic American values: life, liberty, and the pursuit
of happiness. We lose life when insurance companies can freely drop
those who are sick from coverage. We lose liberty when our seniors have
to choose between medications and groceries. And we lose the pursuit of
happiness if we return to the days when only job security guaranteed
health security.
Our fiscal decisions, Mr. Speaker, must be a reflection not only of
our economic future but of the statement of our most central national
values. By ensuring that Americans have vital coverage rather than
cruelly denying it to them, we can live up to the dreams of liberty and
justice for all.
Mr. RYAN of Wisconsin. Mr. Speaker, I yield 1 minute to the gentleman
from Kansas (Mr. Huelskamp), a member of the Budget Committee.
Mr. HUELSKAMP. Mr. Speaker, as a result of this law, employers across
America have discovered that onerous reporting requirements will force
them to file 1099 forms for every vendor with which they do $600 worth
of business. This past weekend, I visited with an accountant in my
district who indicated he would have to expand his staff by 25 percent
to accommodate all the extra redtape and paperwork.
Mr. Speaker, this is not the type of job creation American
envisioned.
Additionally, businesses and labor unions alike have realized that
ObamaCare is a bad deal, and at least 222 have sought waivers from
having to comply with the law. HHS Secretary Kathleen Sebelius has
approved special privilege exemptions for dozens of labor unions and
the half a million union members they cover. Even more troubling is
that Secretary Sebelius has been tardy in responding to a FOIA inquiry
regarding the secretive details of these waiver requests.
Fortunately, rather than selective waivers for the politically
connected, we have a universal remedy--repeal the law.
I urge my colleagues to heed the calls voters made last year during
the debate and at the ballot box.
Mr. VAN HOLLEN. Mr. Speaker, I would remind the gentleman that this
body voted on a majority basis to repeal the 1099 provision.
I yield 2 minutes to the gentleman from Texas (Mr. Doggett).
Mr. DOGGETT. Mr. Speaker, the choice here is whether to give more
money to insurance monopolies or to leave just a little bit in the
pockets of middle class Americans. But for House Republicans, always
putting insurance companies first seems to be a preexisting condition.
This bill isn't repeal and replace; it is repeal and forget--forget
the health care needs of millions of Americans, forget the hundreds of
billions of dollars that with this repeal they add to our Federal debt.
Within a year, Allison, a 23-year-old from Bastrop, Texas, who is
completing her college degree while caring for her mother as her mother
faces another round of breast cancer, would lose her health insurance.
Emily, from Wimberley, who is battling cancer herself, would now face
lifetime limits on what doctor-recommended care her insurer will pay
for. Of course, if her husband loses or changes his job, she won't have
any insurance at all.
Charlotte, an Austin senior, would have to pay more for prescriptions
and preventative health care, while Republicans reduce the solvency of
the Medicare Trust Fund by more than a decade.
Family budgets would be crushed by this bill as health care costs
remain the leading cause of credit card debt and bankruptcy. This same
devastating Republican bill would also hike the Federal debt. That's
why Republicans have rejected pay-as-you-go budgeting and instead will
borrow from the Chinese to pay for this legislation.
Yes, repeal is a priority for the insurance companies and their
apologists, but neither our family budgets nor our Federal budget can
afford it. I believe that every American is entitled to a family
doctor, not to an appointment with a bankruptcy judge because of
soaring health care costs.
Mr. RYAN of Wisconsin. Mr. Speaker, I yield 90 seconds to a member of
the Budget Committee, the gentleman from Oklahoma (Mr. Lankford).
Mr. LANKFORD. Mr. Speaker, I rise today in support of H.R. 2.
A few months ago, I visited with a small business owner in Oklahoma
who has five employees but whose health care costs for 2011 will go up
by 50 percent. When he asked about that, the reason he was given was:
the cost of implementing the new health care law. Another business
owner told me he would not hire new employees until he could figure out
what the cost of health care is going to be, so he will just stop
hiring.
While some in this Chamber talk about universal coverage and cost
controls, many people in my district are frustrated with this so-called
``solution.'' Every person should control his own health care option
and opportunities. Every young student should have the motivation to go
into medical research and the practice of medicine. As our population
ages, every doctor should have greater incentives to take on Medicare
patients.

[[Page H214]]

We need to deal with the root causes of health care costs and not
just move the costs to the States and put in price controls on doctors
and hospitals. Shared pain is not what America was looking for. America
was looking for solutions. The new health care law will create long-
term budget issues in the days to come. From a budget perspective, you
can cook the numbers all you want, but this bill will dramatically
increase our Federal debt again.
We need answers, not bigger problems. This is the United States of
America. I believe we can do better than this. It is time to repeal
this law and start the hard work of solving the cost issues of health
care delivery.
With that, sir, I urge my colleagues to support H.R. 2.
Mr. VAN HOLLEN. Mr. Speaker, if I could inquire as to how much time
remains.
The SPEAKER pro tempore. The gentleman from Maryland has 3\1/2\
minutes remaining, and the gentleman from Wisconsin has 5\1/2\ minutes
remaining.
Mr. VAN HOLLEN. Mr. Speaker, I yield 1 minute to the gentleman from
Kentucky (Mr. Yarmuth).
Mr. YARMUTH. Mr. Speaker, tomorrow we will vote on H.R. 2, the
Republican health care bill. This bill is another example of actions
speaking louder than words.
Now, many of my Republican colleagues have said they support certain
health care reforms: a ban on preexisting condition discrimination,
allowing young adults to stay on their parents' health policies until
age 26, closing the prescription doughnut hole, and eliminating
lifetime limits on coverage.
They could have crafted this bill any way they wanted. They could
have guaranteed any or all of just those important provisions--those
protections--they claim to support, but they didn't. They could have
ensured that, by 2016, annual health care premiums for the average
American wouldn't be $24,000 and that, over the next decade, small
businesses wouldn't lose more than $52 billion in profits.
They could have crafted the bill that way, but they didn't. They can
say whatever they want, but the truth is that the Republican plan is no
care--no matter how desperate or how dire your diagnosis, no matter if
the alternative saves money, saves jobs and saves lives.
Mr. RYAN of Wisconsin. Mr. Speaker, I yield 2 minutes to the
gentleman from New Jersey (Mr. Garrett).
Mr. GARRETT. Mr. Speaker, I rise today in support of repealing this
simply job-destroying health care bill.
What we want to do is replace it with a piece of legislation that
addresses three main tenets: one that will grow our economy, one that
will bring down costs, and one that is basically constitutional.
In the area of jobs, you know, I remember when Minority Leader
Pelosi, then Speaker Pelosi at the time, said this bill would create 4
million jobs and 400,000 of them immediately. All the same, the CBO was
saying, ``It is likely to reduce employment.''

{time} 1540

So instead of encouraging America's leading job creators, this
takeover of health care hurts small businesses with more taxes, more
mandates, and higher health care costs on those small businesses. We
need to do this and work together in a bipartisan manner in a way that
will help our small businesses.
In the area of cost, additionally, this health care bill is deficient
in that it fails to address bringing down costs. As companies have
begun to digest this health care bill, costs have only risen. CBO has
found that this law will actually increase health care premiums by as
much as 10 to 13 percent.
Now, one of the areas that I looked at--and I've heard from a lot of
people in the medical community and I've asked them, What is one major
thing you would have liked for us to put in this bill? And that is tort
reform, but it's missing in this legislation. It is imperative that any
serious reform of the health care system take a very hard look at the
issue of medical liability reform. Unfortunately, this bill fails in
that regard, too.
Finally, in the area of constitutionality, while the Constitution
grants Congress the authority to regulate commerce among the several
States and the Supreme Court has long allowed Congress the ability to
regulate and prohibit all sorts of economic activity, this bill goes
even further because, for the first time in the history of the U.S.
Government, we are regulating inactivity. For the first time, Congress
has mandated that individuals purchase a private good approved by the
government as the price of citizenship.
On the first day of Congress, I introduced a bill, H.R. 21, the
Reclaiming Individual Liberty Act, legislation which would take out
that individual mandate, because, while I believe Congress has the
ability to pass legislation which I believe is bad policy, I do believe
it is wrong to pass unconstitutional legislation.
Mr. VAN HOLLEN. Mr. Speaker, I notice the gentleman mentioned CBO.
What CBO said in that regard was that, because of the exchanges, there
would be some people who would not seek their health care through
employment. They would be liberated to be able to get it through the
exchange. I'm glad the gentleman confirmed the importance of CBO
numbers.
Mr. Speaker, I yield 1 minute to my colleague from Ohio (Mr. Ryan).
Mr. RYAN of Ohio. Mr. Speaker, I was going out to dinner the other
night, and as I was walking in, one of the young folks who was working
there walked up to me and said, Sir, can you tell the new leaders in
Congress about my story?
The story was that he is a 25-year-old kid who is working at a
restaurant and has seizures and could not get any medication, could not
get any health care coverage, but because of the law that was passed
here last year, this young person now can get the medication, can stay
on his parents' health care, and now is a productive member of society.
I know my friends on the other side have said things like, well, this
employer said their insurance was going up 50 percent. That's been
going on for decades now, especially in the last decade. This is going
to fix that. I know my namesake from Wisconsin also said there are some
employers who are going to have to let their people go into the
exchange because their competition is going to let people go into the
exchange. The bottom line is people were dumping workers for a decade
and there wasn't an exchange. Now there is an exchange that these
people will have some remedy and ability to get health care.
Mr. RYAN of Wisconsin. Mr. Speaker, I yield 2 minutes to the
gentleman from California (Mr. McClintock).
Mr. McCLINTOCK. I thank the gentleman for yielding.
Mr. Speaker, the central promises of ObamaCare were that it would
bend health costs down and wouldn't threaten existing plans. We now
know that both of these claims were false.
The CBO warns us that the law will increase average private premiums
by $2,100 within the next 5 years above what they would have been
without ObamaCare. The administration's own actuary admits that the law
bends the cost curve up--not down--by $311 billion over the next 10
years.
We now know that many existing plans are, indeed, jeopardized and
that scores of companies that have been offering their employees basic
plans have either dropped them or are continuing them only with waivers
left to the whims of administration officials. But the most dangerous
provision of this law is the Federal Government's assertion that it now
has the power to force every American to purchase products that the
government believes they should purchase whether or not they want them,
need them, or can afford them. If this President prevails, the Federal
Government will have usurped authority over every aspect of individual
choice in the care of our families and can logically extend that power
to every other commodity in the market.
The tragedy is that every day we continue down this road is a day we
have lost to address the real problems in our health care system: the
spiralling costs of malpractice litigation and defensive medicine, the
loss of the freedom to shop across State lines, the loss of the freedom
to tailor plans to the needs of individuals and families, and the
absence of the tax advantages that families need to afford and choose
their own health plans according to their own needs.
Churchill said all men make mistakes but wise men learn from them.

[[Page H215]]

Mr. Speaker, the American people understand that ObamaCare was a huge
mistake. Let us acknowledge that, learn from it, and move on to enact
the reforms that will reduce health costs and increase health care
choices for American families.
Mr. VAN HOLLEN. Mr. Speaker, I yield 1 minute to the gentlelady from
California (Ms. Loretta Sanchez).
Ms. LORETTA SANCHEZ of California. I thank my colleague from
Maryland.
Mr. Speaker, this past year, around June, I was speaking to a woman
who is a single mother. She has two young children. She is a real
estate agent, and it has been tough in California. But through all of
that, she managed to pay her premium to have health care for herself
and for her two children.
In June, her daughter, for the first time, had an epileptic attack,
and she didn't know what to do. She was scared to death. So she took
her to the hospital and her daughter got better, but of course her
daughter will have more of these. One month later, she found out that
her daughter would not be covered any longer by that health care plan,
and so she has been paying about $1,700 out of her pocket for her
daughter and her medications and all.
She came to me and I said, well, this is what the reform is about.
This is what health care reform is about. It's about taking care of our
children and our families. And I told her that her daughter would now
be covered. If this was your daughter, you would not repeal this health
care reform.
Mr. VAN HOLLEN. May I inquire, Mr. Speaker, how much time remains?
The SPEAKER pro tempore. The gentleman from Maryland has 15 seconds
remaining.
Mr. VAN HOLLEN. Mr. Speaker, all the charts in the world can't wish
away the CBO letter of January 6 of this year which says that the
premiums will go down in the employer market, that people, on average,
will pay less in the individual market, and that this legislation will
reduce the deficit and the debt over the next 20 years. Again, that is
the call from the nonpartisan experts we have. We shouldn't be
substituting our judgment for theirs.
The SPEAKER pro tempore. The time of the gentleman has expired.
Mr. RYAN of Wisconsin. Mr. Speaker, I yield myself the balance of my
time.
Mr. Speaker, I think we have already fairly well established the fact
that when you strip out all the budget gimmicks and all the double
accounting, ObamaCare is a budget buster. But let's take a look at
where we are as a country.
We have a debt crisis coming in America, Mr. Speaker, and the primary
reason why we have this mountain of debt is because of our already
existing health care entitlements which have a massive unfunded
liability. So what did the previous majority do? They just put two new
unfunded, open-ended entitlements on top.
Now, a lot of people on the other side of the aisle said health care
is a right and we are giving it to the people. Well, if we declare such
things as a right to be given to us by government, then it's
government's right to ration these things; it's government's right to
regulate these things; it's government's right to pick and choose
winners and losers. Health care is too important for that. I want to be
in control of my and my family's health care. I want individuals to be
in control of their health care and their destiny.
We have to ask ourselves when we create these new programs how much
of our children's future and our grandchildren's future are we willing
to sacrifice to give them this mountain of debt that is getting worse
by the passage and creation of this law. This, of all reasons, is why
we should vote to repeal.
Mr. Speaker, I yield back the balance of my time.
The SPEAKER pro tempore. The gentleman from Texas (Mr. Smith) and the
gentleman from Michigan (Mr. Conyers) each will control 20 minutes.
The Chair recognizes the gentleman from Texas.

{time} 1550

Mr. SMITH of Texas. Mr. Speaker, I yield myself 2 minutes.
Mr. Speaker, I support this legislation that repeals the Democrats'
job-stifling, cost-increasing, freedom-limiting health care law.
This bill would repeal a requirement that every individual buy a
certain kind of health insurance. The Congressional Research Service
confirms that the Federal Government has never forced all Americans to
buy any good or service--until now.
This mandate violates Congress' powers under the commerce clause if
our Constitution of limited Federal powers means anything. It's a major
reason to repeal the health care bill.
One particularly costly part of our health care system is the
practice of so-called defensive medicine, which occurs when doctors
must conduct tests and prescribe drugs that are not medically required
because of the threat of lawsuits. Taxpayers pay for this wasteful
defensive medicine, which adds to health care costs.
The Democrats' health care law goes exactly the wrong direction.
Incredibly, it contains a provision that prohibits any new limits on
litigation from being enforced because it allows lawyers to opt out of
any system that limits their ability to sue. This is contrary to the
best interests of all Americans--except trial lawyers. The health care
bill can only be read as an invitation to trial lawyers to sue medical
personnel. That's another reason to repeal this health care bill.
The Democrats' health care law will produce more litigation and more
costly health care. Those are two good reasons we should repeal it.
I reserve the balance of my time.
Mr. CONYERS. Mr. Speaker, I yield myself 3 minutes.
Ladies and gentlemen of the House, I am very pleased to defend what
has been not intended as a compliment, but to defend the so-called
ObamaCare bill. President Obama is going to go down in history for
having taken 54 million people, according to the CBO, off the rolls of
the uninsured and given them insurance.
I've been looking over my congressional district over the King
holiday and talking to a lot of people about health care. I haven't
found one parent in the 14th Congressional District that didn't like
the idea of having their children remain on their health care policy
until age 26. Have you found anybody that would like not to have their
children extended until 26? Please see me after this debate, because
we've got so much to be proud of.
And what are we talking about? Preexisting illnesses not being a
basis for being denied insurance or a reason to kick one out of a
health insurance policy. These are good things.
I am amazed by the fact that people say this bill is going to cost
jobs. Well, the CBO says it's going to cost us $230 billion to repeal
the bill. Please, could we be a little more fiscally conservative in
this body as we rush to repeal this bill?
The question of constitutionality is a very interesting one for the
Judiciary Committee, a matter we are going to go into further. But
we've found a very good set of arguments about the ability of this bill
to be totally within the framework of our Constitution. Come on. We
already have Medicare. Who do you think runs that? We already have
Medicaid. What about Social Security?
Mr. Speaker, the issues here are simple.
The health care bill that Republicans attack today ensures that
millions of Americans have access to essential medical care.
It enables businesses to provide health care to their employees--
which protects and creates the jobs we so desperately need.
It protects Americans from notorious insurance company practices like
denying coverage to those with pre-existing conditions and children
with birth defects.
It stops insurance companies from dropping your coverage when you get
sick.
And it takes critical first steps towards getting health care costs
under control, cutting hundreds of billions of dollars from the
deficit. Everyone in America who gets health insurance through their
work has seen premiums and co-pays skyrocket year after year. Those
increases afflict our entire health care economy. Before we passed the
Affordable Care Act, they threatened to engulf the entire federal
budget. Those who would repeal this law are simply not serious about
our debt.

Costs of Repeal

Repealing this bill would undo all these profound public policy
achievements. And towards what end?
Repeal would add 54 million people to the rolls of the uninsured. Is
that what the new majority wants as their first legislative act?
Repeal would permit health insurers to resume discriminating against
those with pre-existing conditions. Does the new majority want

[[Page H216]]

to tell women who have survived breast cancer or children with birth
defects that they are not allowed to buy health care?
Repeal would lead to millions of young people being dropped from
their parents' insurance coverage. In this economy, with work and the
health insurance that comes with it so hard to find, does the new
majority really want to kick these children off the insurance rolls?
And finally, repeal would add more than $230 billion to the near term
federal deficit. Is that what the new majority has in store for the
American taxpayer?
The majority apparently feels that all these costs are acceptable,
because they will ``replace'' the health care bill with something else.
But that is simply not credible.
After all we went through to pass this bill, it obviously would be no
simple thing to draft a replacement. So if the majority is serious
about wanting to improve our health care system, at the least they
should hold off on repealing the current law until their replacement
actually exists. Voting now suggests the true motive here is the
politics of health care, not the policy.
During the health care debate last year, we saw the Republican
approach--and it simply does not improve our health care system.
Indeed, in November of 2009, the Republicans put forward their own plan
which the non-partisan Congressional Budget Office found would cover
only 3 million people. That meant that for the 54 million people left
without the ability to afford insurance, the Republicans' ``No Care''
plan provided exactly that--no care; no hope; no security.

Conclusion

There may be no issue that comes before the Congress that more
clearly demonstrates the different priorities of the parties.
Based on today's proceedings, it is clear that the new Republican
majority stands for protecting insurance companies, exploding the
national debt, and playing to the extremes of their base.
The Democratic minority, on the other hand, stands for affordable
health care for all, holding insurance companies accountable, and
responsibly addressing our long term financial challenges.
I urge all Members to vote against repeal of the landmark health care
reform law.
I reserve the balance of my time.
Mr. SMITH of Texas. Mr. Speaker, I yield 2 minutes to the gentleman
from Wisconsin (Mr. Sensenbrenner), who is the chairman of the Crime
Subcommittee of the Judiciary Committee and also a former chairman of
the Judiciary Committee itself.
Mr. SENSENBRENNER. I thank the gentleman from Texas.
Mr. Speaker, as each of us have traveled back to our districts over
the past several months, we've heard from our constituents--from
seniors to families to small businesses--speaking out convincingly.
They demanded that this new Congress focus on legislation that
encourages job growth, cuts spending, and shrinks the size of
government. What better way to start than by repealing the President's
trillion-dollar health care law, a massive new government intrusion
into Americans' health care which promises to skyrocket costs even
further. Our immediate action today demonstrates that we are listening.
This is not to say that reforms aren't necessary. We must improve our
health care system. We must enact sensible reforms that address the
core problem--the rising cost of health care--without increasing the
size of government. We must enact real medical liability reform, allow
Americans to purchase health coverage across State lines, empower small
businesses with greater purchasing power, ensure access for those with
preexisting conditions, and create new incentives to save for the
future health needs. Republicans want health care reform; however, we
must reform it the right way.
Today, we take a much-needed first step. America deserves legislation
that addresses our health care problems and helps our economy prosper.
This bill is the first step to do that, and I urge my colleagues to
vote in favor of it.
Mr. CONYERS. Mr. Speaker, I am pleased to yield 1\1/2\ minutes to a
senior member of the Judiciary Committee, Ms. Sheila Jackson Lee of
Texas.
Ms. JACKSON LEE of Texas. There is nothing that one can do when
you're debating this bill than to be civil and to respect the American
people, who, many of them, are in the jaws of terrible disease,
rehabilitation, or maybe some have already lost their lives. And the
repeal of this health bill, just a couple of pages, would sentence
people possibly to dying. H.R. 2 talks about jobs when we're talking
about lives.
So I think it is important that we follow what the repeal of this
patient protection and health care bill does--end consumer protection,
patient protection. And I think it is important for us to be able to
hold this Constitution and prove that the Affordable Care Act is
constitutional.
Well, I could say that there are 1.1 million jobs already created,
that the deficit will blow up $143 billion, a trillion over 20 years.
But I really want to refer to the 14th Amendment that allows and
guarantees you equal protection under the law.
If this bill is repealed, Ed Burke, a hemophiliac, will probably have
serious health issues because he would have lifetime caps. Or Mr. Land,
who was on my health care teleconference--where 18,000 people in Harris
County were contacted--maybe he, who is from a family of schizophrenics
and people who have children that have schizophrenia, maybe he would
not be guaranteed the equal protection under the law.
The SPEAKER pro tempore. The time of the gentlewoman has expired.
Mr. CONYERS. I yield the gentlewoman 15 seconds.
Ms. JACKSON LEE of Texas. Thank you so very much.
Maybe they would not be able to withstand this onslaught on their
rights because the Constitution guarantees them equal protection. And
some who have insurance and some who do not would not be treated
equally.
And finally, let me say that in Texas, the Department of Insurance
has said that this bill helps Texans.
I hope my colleague from Texas will vote not to repeal this bill. I
will vote ``no'' on the repeal.

Announcement by the Speaker Pro Tempore

The SPEAKER pro tempore. The Chair will remind all Members to not
traffic the well when another is under recognition.

{time} 1600

Mr. SMITH of Texas. Mr. Speaker, I yield 2 minutes to the gentleman
from Iowa (Mr. King), who is a senior member of Judiciary Committee.
Mr. KING of Iowa. Mr. Speaker, I thank the gentleman from Texas, the
chairman of the Judiciary Committee.
It is a pleasure to serve on this committee and come here and speak
in support of the repeal of ObamaCare. It's something that I have
worked on every day since it passed last March. It's legislation that I
introduced, actually asked for the draft the same day that it passed.
People thought that we couldn't get to this point. We are.
But this is Judiciary Committee subject matter. And the bill didn't
go through the Judiciary Committee. We didn't address the tort reform
that's so essential if we're going to do something to put health care
back on track here in this country. And when I look at this, and
serving on the committee, I believe it was in 2005 we passed
legislation in the House that addressed the lawsuit abuse that drives
up the costs of our health care. It didn't get taken up in the Senate.
And here we are with a huge ObamaCare bill, ready to vote to repeal it,
and part of the discussion needs to be why didn't it have tort reform
in it. We are prepared to take a look at this as we go forward.
When I look at the numbers that are produced in part by the health
insurance underwriters, they and others will tell me that somewhere
between 3.5 and 8.5 percent of the overall cost of our health care goes
because of lawsuit abuse and the defensive medicine that's associated
with it.
I have a friend who is an orthopedic surgeon who tells me that 95
percent of the MRIs that he orders, he knows exactly what he is going
to see when he gets inside to do the surgery, but he has to order them
anyway to protect himself from that 5 percent that might end up being
in litigation. And he said that in his little practice that's an
additional million dollars a year in unnecessary tests. That's just one
small piece of the lawsuit abuse that drives up the costs of health
care that we must address if we're going to have managed costs.
And then the other component that is a Judiciary Committee component
of this ObamaCare legislation that is about to have a vote on repeal
here that we are debating is the components that are unconstitutional.
The individual mandate is the most egregious

[[Page H217]]

component of ObamaCare that compels Americans to buy a policy produced
or approved by the Federal Government.
Mr. CONYERS. Mr. Speaker, I am pleased to yield 1\1/2\ minutes to a
former subcommittee chairman of Judiciary, the gentleman from Georgia,
Hank Johnson, to defend the ObamaCare legislation.
Mr. JOHNSON of Georgia. Thank you, Mr. Ranking Member.
I rise in opposition to the repeal of health reform. Repeal of health
care reform would strip 32 million Americans of health insurance,
including 139,000 residents of my district. Repeal will allow insurers
to discriminate against people with preexisting conditions and reopen
the doughnut hole, which would devastate Joseph Williams, a former
corrections officer in my district who relies on Medicare for his
prescription drugs. I will be voting against repeal, and I urge my
colleagues to do the same.
Mr. SMITH of Texas. Mr. Speaker, I yield 2 minutes to the gentleman
from North Carolina (Mr. Coble), who is also the chairman of the
Courts, Commercial and Administrative Law Subcommittee of the Judiciary
Committee.
Mr. COBLE. I thank the gentleman from Texas (Mr. Smith).
Mr. Speaker, when we debated health care reform during the 111th
Congress, I made the statement that we need to fine-tune the engine,
not overhaul it. I reiterate that theory today.
President Obama, in my opinion, elevated health care to the number
one issue facing America, mistakenly so, in my opinion. I think the
number one issue facing America then and now involves jobs, or more
precisely lack of jobs, and reckless spending. There is agreement from
both sides of the aisle that we need to improve our health care system.
I believe these improvements must enhance the quality and accessibility
of care in a fiscally responsible manner. The law implemented last year
failed to meet these criteria, particularly in the onerous 1099 tax
increase on small businesses. That is just one glaring example.
By repealing ObamaCare, we will have the opportunity to take the more
prudent approach of fine-tuning our health care law to ensure that it
encompasses sound principles.
Mr. Speaker, this will likely be an obvious partisan vote, but it
also serves a purpose. It sends a message to the American people that
we are serious about fixing our broken health care system. Physicians
do this daily. They make a diagnosis and fix the problem. I support the
passage of H.R. 2 because Congress should take the same approach: fix
the problem. Much energy and attention was directed to this matter,
when it probably should have been directed to jobs and reckless
spending. Too late for that now. But we need to address it. And I look
forward to the vote that I guess will be tomorrow.
Mr. CONYERS. Mr. Speaker, I yield 1 minute to Dr. Judy Chu of
California, a very valuable member of Judiciary Committee.
Ms. CHU. The health care repeal act will hurt many people, but
especially seniors. It raises cost for prescriptions and preventive
care. It weakens Medicare. And it takes away your freedom to make your
own decisions, returning your health back to the hands of insurance
companies. At the start of this year, seniors began receiving free
preventive services such as mammograms and an annual exam, while, if
repeal succeeds, good-bye free check-ups and free life-saving tests.
Today, seniors in the Medicare doughnut hole are getting half off
many brand-name drugs; but if repeal passes, your prescription drugs
are going to double. And those who get a $250 check to help cover high
drug costs might even have to pay it back. The original health reform
bill extended Medicare's life until 2029; but if we repeal it, the
Medicare Trust Fund becomes insolvent in 6 short years. The Patients
Rights Repeal Act hurts seniors. It's dangerous for America's health.
Mr. SMITH of Texas. Mr. Speaker, I yield 2 minutes to the gentleman
from Texas (Mr. Poe), who is actually a member of three subcommittees
of the Judiciary Committee.
Mr. POE of Texas. Mr. Speaker, never before in the history of our
great country has a tax been levied on individual Americans by the
Federal Government with the purpose of forcing citizens to do something
the government wants them to do. And never before has the government
self-righteously ordered Americans to buy a product or pay a punitive
fine.
In my opinion, the Constitution does not give the Federal Government,
even well-intentioned government, the authority to make citizens buy
any product, whether it's a car, whether it's health insurance, or even
whether it's a box of chocolates.
The individual mandate provision of the health care bill is
unconstitutional. The author of the Constitution, James Madison, said:
``The powers delegated by the Constitution to the Federal Government
are few and defined. Those that remain to State governments are
numerous and indefinite.'' The health care bill is a theft of the
individual freedom to control one's health to have it now controlled by
omnipotent government.
Big government doesn't mean better solutions. In fact, as someone has
said, ``If you think the problems government creates are bad, just wait
until you see government solutions.'' Government is partially to blame
for the health care crisis, and the nationalized health care bill's
government solution is unworkable and unconstitutional.
And if you like the efficiency of the post office, the competence of
FEMA, and the compassion of the IRS, we will love the nationalized
health care bill. Certainly, what we do here in Congress should be
constitutional. And we should repeal the health care bill and come up
with constitutional solutions for health problems.
And that's just the way it is.
Mr. CONYERS. Mr. Speaker, I want to take this opportunity to
congratulate Lamar Smith on becoming the chairman of the House
Judiciary Committee during the 112th session of Congress.
I turn now to the former chairman of the Constitutional Subcommittee,
Jerry Nadler of New York, and I yield him 2 minutes.

{time} 1610

Mr. NADLER. I thank the gentleman for yielding.
Mr. Speaker, I rise in opposition to the Republican effort to deny 32
million Americans health care, to deny millions of middle class
Americans the ability to get health care insurance if they have
preexisting conditions and to drive up our national debt by an
additional $1.4 trillion over the next 20 years.
The Affordable Care Act will stave off the 55 percent of personal
bankruptcies caused by health care emergencies. By banning rescissions,
banning the preexisting conditions insurance bar, banning annual and
lifetime coverage caps and capping annual out-of-pocket expenses, this
law ensures that nobody will go broke because they get sick.
The bill will save the lives of the approximately 45,000 Americans
who now die every year because they lack health insurance. For
America's seniors, the Affordable Care Act strengthens the Medicare
program. Seniors will no longer pay out of pocket for preventive
services; and the cruel doughnut hole, which forces seniors to choose
between taking their drugs or going without, will be closed.
And owners of small businesses will get billions of dollars in tax
credits to help them provide health coverage to their employees--
unless, of course, the Republicans are successful in enacting a tax
increase on small businesses by repealing the law.
We did all this and more while reducing the deficit by what CBO now
estimates will be $230 billion in the first 10 years and $1.2 trillion
in the next 10 years.
The Republicans say the bill is an unprecedented or unconstitutional
expansion of constitutional power. They are wrong. There is nothing
radical, dangerous, or unconstitutional about the act. We have the
power to enact this comprehensive plan, including its minimum coverage
requirement under the commerce, necessary and proper, and general
welfare clauses of article 1, section 8 of the Constitution. Similar
attacks were levied against the Social Security Act of 1935, saying it
was unconstitutional for the same reasons. Those arguments were unsound
and rejected then and will fare no better today.
Indeed, leading Republican lawmakers championed individual mandates
as part of their Health Equity

[[Page H218]]

and Access Reform Today Act of 1993 introduced by Senator Dole and
Senator Chafee. The requirement of individual participation was valid
then, and it is valid now.
For all of these reasons, I strongly encourage my colleagues to vote
``no'' on this misguided repeal bill.
Mr. Speaker, following is my statement in its entirety:
I rise in opposition to the Republican effort to deny 32 million
Americans health care, to deny millions of middle-class Americans the
ability to get health care insurance if they have pre-existing
conditions, and to drive up our national debt by an additional $1.4
trillion over the next 20 years.
Last March, I had the distinct pleasure and honor of voting for the
Affordable Care Act, which achieves many of the goals I have been
fighting for my entire adult life.
The Affordable Care Act will stave off the 55 percent of personal
bankruptcies caused by health care emergencies. By banning rescissions,
banning the ``pre-existing conditions'' insurance bar, banning annual
and lifetime coverage caps, and capping annual out-of-pocket expenses,
this law ensures that nobody will go broke because they get sick.
When fully implemented more than 32 million additional Americans will
have access to health care coverage. This translates into saving the
lives of the 45,000 Americans, who now die every year because they lack
health insurance.
In addition, the Affordable Care Act extends greater rights and
benefits to women. No longer can insurance companies discriminate
against women by charging women higher rates than men for the same
coverage. No longer will women be denied coverage because insurance
companies consider pregnancy, C-sections, and being the victim of
domestic violence to be pre-existing conditions. No longer will women
go without critical maternity care coverage, access to mammograms, and
other key preventive care services--services that will be available
without co-pays and deductibles. Ending these routine, disgraceful, and
patently unfair practices are a tremendous victory for women and
children.
For America's seniors, the Affordable Care Act strengthens the
Medicare program. Seniors will no longer pay out of pocket for
preventive services, and the cruel donut hole, which forces seniors to
choose between taking their drugs or going without, will be closed. And
by cracking down on fraud and waste, the Act ensures that those who
seek to take advantage of our seniors and steal from the Medicare
program will no longer have a free ride.
The Affordable Care Act also benefits America's young people. Often
without the option of employer-based health insurance, young people now
can stay on their parents' health plans until their 26th birthday.
And owners of small businesses will get billions of dollars in tax
credits to help them provide health coverage to their employees--
unless, of course, the Republicans are successful in enacting a massive
tax increase on small businesses by repealing this law.
We did all this and more while reducing the deficit by what CBO now
estimates will be $230 billion in the first ten years, and $1.2
trillion in the next ten years.
Mr. Speaker, when our predecessors passed similarly historic laws
such as Social Security in 1935 and Medicare and Medicaid in 1965, they
knew the measures would require further consideration. In the years
since those crucially important programs were signed into law, Congress
has made, and will continue to make, improvements to those programs.
And that is the key--to make improvements to the law. Instead of
spending our time looking for ways to build on and perfect the health
care reform law, Republicans want to take a sledgehammer to it, to
throw out everything, without any consideration at all. No matter that
our economy still needs our attention. No matter that millions of
Americans remain out of work.
The Republicans say the bill is an unprecedented or unconstitutional
expansion of Congressional power. They are wrong. There is nothing
radical, dangerous, or unconstitutional about the Act, through which
Congress is regulating the vast interstate health and insurance markets
in a number of ways that protect the American people. We have the power
to enact this comprehensive plan, including its minimum coverage
requirement, under the Commerce, Necessary and Proper, and General
Welfare clauses of Article I, Section 8 of the Constitution. Similar
attacks were levied against the Social Security Act of 1935. They were
unsound and rejected then and will fare no better today.
We require citizens to participate in programs--like Medicare and
Social Security--when necessary to accomplish an objective wholly
within Congressional powers, and there simply is nothing so surprising
or severe in requiring similar participation--by requiring that those
who can obtain insurance do so or pay a tax penalty--in our
comprehensive framework for health care reform. Indeed, leading
Republican lawmakers championed individual mandates as part of their
Health Equity and Access Reform Today Act of 1993. The requirement of
individual participation was valid then, and it is valid now.
For all of these reasons, I strongly encourage my colleagues to vote
NO on this misguided repeal bill, and instead, to say ``yes'' to
guaranteeing health care for 32 million more Americans. To say yes to
enabling millions of Americans with pre-existing conditions to obtain
health insurance. To say yes to ending gender rating and rescissions.
To say yes to allowing parents to cover their adult children on their
health care plans. To say yes to strengthening Medicare for our
seniors. To say yes to growing our economy by supporting small
businesses. To say yes to reducing our deficit.
Mr. SMITH of Texas. Mr. Speaker, I yield 2 minutes to the chairman of
the House Administration Committee, the gentleman from California (Mr.
Daniel E. Lungren).
Mr. DANIEL E. LUNGREN of California. Mr. Speaker, in the scope of the
American constitutional system of governance, the Congress is the body
whose power is defined within the context of enumerated powers, and
this is more than a matter of structural mechanics because it goes to
the heart of the issue of governmental power, or if one prefers the
flip side of the coin, personal freedom and responsibility.
If government has the power to require that you buy item A, it means
that you are less able to buy item B, C, D or anything else.
Now, economists would call this the opportunity cost of foregone
goods or services, but the fundamental question is the question of
freedom to choose how we as individuals will spend the fruits of our
labor.
Certainly the commerce clause lacks the elasticity that would
accommodate a requirement that every American buy health insurance
which conforms to the dictates of the Federal Government, as the
Federal Government would change it on a yearly basis. Such an
interpretation would render the notion articulated by James Madison and
Federalist 45, that is, one of limited government, a nullity.
Now, I know we have smart people here. I know we have those in the
administration who believe that this is totally constitutional; but,
frankly, Mr. Speaker, my bet goes with James Madison.
He did say that the powers delegated by the proposed Constitution of
the Federal Government are few and defined. He did say that the Federal
Government will be exercising their responsibilities principally on
external objects as war, peace, negotiations, and foreign commerce and
the States would do much else.
Then, of course, we have the 10th Amendment, later adopted, which
said, again, that this is a government of limited enumerated powers.
Now, either the 10th Amendment means something, or it means nothing;
and either James Madison knew what he was talking about, or he does
not.
Mr. CONYERS. Mr. Speaker, I am pleased to yield 1 minute, and I
congratulate the ranking member of Government Reform, to the gentleman
from Maryland, Elijah Cummings.
Mr. CUMMINGS. Mr. Speaker, I rise before you in fervent opposition to
the bill we are considering today. I have heard from many of my
constituents and small business owners who are grateful for the
benefits of this law.
Children with preexisting conditions are no longer being denied
access to private health insurance. Maryland small businesses offering
health insurance to their employees are eligible for a 35 percent tax
credit.
Further, as ranking member of the Committee on Oversight and
Government Reform, I note that repealing this law would also eliminate
the new private health plan currently providing coverage for many
uninsured Americans with preexisting conditions.
I find it repugnant that Republicans want to strip Americans of this
law's protections that will save the lives of our fellow citizens.
I urge a ``no'' vote on this bill.
Mr. SMITH of Texas. Mr. Speaker, I yield 2 minutes to the gentleman
from Texas (Mr. Gohmert).
Mr. GOHMERT. Mr. Speaker, lest we forget, this is the disaster that
we are told would be repugnant to repeal.
It started out as an act to amend the Internal Revenue Code of 1986
to modify first-time homebuyers' credit in the

[[Page H219]]

case of members of the Armed Forces. We took a bill that was designed
to help veterans and the Senate stripped it all out and stuck in this
disaster of a health care bill.
Just as we heard in the late 1990s that you can't pass welfare
reform, you will leave women without anything, you heartless, mean
people, it was because people here had hearts and wanted to see single
women with children doing better that welfare reform had to be done. It
was sent to the President; he wouldn't sign it. It was re-sent to the
President; he wouldn't sign it. He finally signed it, and for the first
time since the Great Society legislation came about, after 30 years of
flat line, when adjusted for inflation single women with children,
after welfare reform, began to have increases in income.
We heard all the naysayers then; we are hearing them now. It's
because we want people to have the best health care. It's because we
don't want what the President said when he told the Democratic Caucus,
before it passed. Gee, you go to the doctor now and have five tests,
after this bill you will go and get one test. My mother had to have six
days of tests to find her tumor.
I don't want rationed care. I want health care to be legislated the
way the President promised it would be. And once we get this disaster
out of the way, no matter how many times we have to send it, it will be
time to pass a bill that gets real health care reform.
Mr. CONYERS. Madam Speaker, I yield 1 minute to the gentlewoman from
Birmingham, Alabama, Terri Sewell.
Ms. SEWELL. Madam Speaker, I rise in opposition to this bill that
seeks to repeal the Affordable Care Act, legislation that has helped so
many constituents of mine and Americans all across this Nation.
Nearly 2 weeks ago, I was honored by being sworn in as a
Representative for the Seventh Congressional District of Alabama. On
day one I received numerous calls from my constituents urging me to
oppose this repeal, and this weekend I heard from countless voices that
the health care bill that's currently enacted has begun to help them.
Let me tell the story about Mr. and Mrs. Cheatem in Greene County
from my district. Both are on Medicare. Mr. Cheatem suffered several
heart attacks, and Mrs. Cheatem has a chronic back condition.
Prescription medication alleviates her pain and keeps him alive.
Several provisions in the Affordable Care Act have helped Mr. and
Mrs. Cheatem to get their prescriptions. Now they don't have to choose
between putting food on the table, gas in their cars, or paying for
their medication.
The Affordable Care Act is a first step towards strengthening our
health care system and is already helping to save the lives of many in
my district.
I urge my colleagues to vote ``no'' on this bill.
Mr. SMITH of Texas. Madam Speaker, I yield 2 minutes to the gentleman
from Virginia (Mr. Goodlatte), who is also chairman of the Intellectual
Property, Competition, and Internet Subcommittee of the Judiciary
Committee.
Mr. GOODLATTE. I thank the chairman for yielding.
Madam Speaker, I rise in strong support of this legislation, which
repeals the sweeping health care reform law rammed through Congress
last year. This new law amounts to a Big Government takeover of our
health care system, one that will lead to fewer choices, higher prices,
and rationed care.

{time} 1620

It creates more than 150 new government agencies and programs at a
cost of well over $1.2 trillion. It includes over $560 billion in
devastating new tax increases and cuts Medicare by over $500 billion.
Americans are frustrated by rising health care costs. We must repeal
the new health care law that kills jobs, raises taxes, threatens
seniors' access to care, will cause millions of people to lose the
coverage they have and like, and increases the cost of health care
coverage. Then we must replace it with commonsense reforms that lower
health care costs and empower patients.
For those who argue that somehow this is going to save the taxpayers
money, think of the mandates that are not covered by the Federal
Government. Think of the fact that it is not credible that at a time
when senior citizens, baby boomers, are going to retire in
unprecedented numbers to take over $500 billion out of a Medicare
program. And think of the jobs that are already being lost because the
taxes on this are already being put into place, yet the benefits don't
occur for 4 years. That legislation was smoke and mirrors. This
legislation repeals it. We should support it and then start anew on
commonsense reforms.
Mr. CONYERS. Madam Speaker, I'm pleased to yield 1 minute to the
distinguished gentleman from Iowa (Mr. Braley).
Mr. BRALEY of Iowa. I thank the gentleman for yielding.
Madam Speaker, I want to show the face of the repeal of health care.
This is Tucker Wright from Malcom, Iowa. He is 4 years old. And 2 years
ago, before the Affordable Care Act was passed, Tucker was diagnosed
with liver cancer and had two-thirds of his liver removed. He faces a
long and uncertain medical future. But on January 2 of this year,
because we passed the Affordable Care Act, Tucker's father, Brett, was
able to change jobs because he no longer had to worry about the stigma
of preexisting conditions.
Now, when you talk about repealing this bill, I'll tell you why it is
not a good deal for Tucker Wright. Because even though our friends talk
about wanting to fix some of the problems that they now think are
important, the first thing that's going to happen to Tucker Wright and
his family as soon as this bill is repealed is his family will get a
rescision letter from their insurance company because they will no
longer be required to provide insurance for this young boy because he
has preexisting conditions. That's why this bill is a bad idea, and
that's why I urge you to vote ``no'' and think about Tucker Wright.
Mr. SMITH of Texas. Madam Speaker, may I ask how much time remains on
each side?
The SPEAKER pro tempore (Mrs. Capito). The gentleman from Texas has
5\1/2\ minutes remaining. The gentleman from Michigan has 8\1/2\
minutes remaining.
Mr. SMITH of Texas. I reserve the balance of my time.
Mr. CONYERS. I yield 1 minute to the gentleman from Minnesota (Mr.
Walz).
Mr. WALZ of Minnesota. I thank the gentleman for yielding.
Madam Speaker, I rise today to state my strong opposition to the
repealing of the Affordable Care Act. Repealing this law will eliminate
consumer protections, raise taxes on small business, explode the
deficit, and put insurance company CEOs directly between Americans and
their doctor.
I'm very proud to represent the Mayo Clinic in Rochester, Minnesota.
They're a symbol of what we can achieve when we deliver the world's
highest quality care at the most efficient and effective costs. When we
passed this law last year, they said it was a good first step. And I
agree.
Now is not the time to step backwards. Folks in my district are
already seeing the benefits of this new law. Seniors have received help
paying for their expensive prescription drugs and have better access to
preventative care saving money. And just a few weeks ago, I received a
letter from a dad in my district named Paul. Paul's son Joe is 21,
works part-time and has diabetes. Joe couldn't get the insurance he
needed to pay for the expensive equipment and treatment he needs to
stay healthy and alive. Paul wrote to say thank you for passing the
Affordable Care Act. Because of the new law, Joe got back on his
parents' insurance, and a new insurance card came in the mail on
January 3. A vote to repeal this legislation pulls that card away.
Mr. SMITH of Texas. Madam Speaker, I yield 1 minute to the gentleman
from New York (Mr. Reed), former mayor of Corning and a new member of
the Judiciary Committee.
Mr. REED. Madam Speaker, I rise today in support of the repeal of the
job-killing ObamaCare legislation.
This bill is a whopping 2,500 pages, a monstrosity of new spending
and government bureaucracy, rushed to approval after only 48 hours of
arm-twisting and deal-making. Unfortunately,

[[Page H220]]

just as Republicans predicted, this legislation did absolutely nothing
to address the real problem of health care--its cost.
Republicans have long advocated for tort reform to be included in any
legislation to lower the costs of health care. For just as long, those
who have written this legislation have continually ignored the need for
tort reform. As even as the nonpartisan Congressional Budget Office
estimates, tort reform initiatives could save approximately $54
billion. I will say that the other side attempted to address tort
reform by providing $50 million to States to consider the concept of
tort reform. Here we go again. Another example of what's wrong with
Washington, spending $50 million to figure out how to save money. The
American people recognize Republicans have a better plan, one which
reduces health care costs.
The SPEAKER pro tempore. The time of the gentleman has expired.
Mr. SMITH of Texas. Madam Speaker, I yield the gentleman an
additional 30 seconds.
Mr. REED. The American people recognize Republicans have a better
plan, one which reduces health care costs and gets lawyers and
bureaucrats out of our doctors' and nurses' offices.
Let's repeal this bill, focus on bipartisan initiatives we all agree
on like fixing the doughnut hole, and pass tort reform legislation once
and for all without spending an additional $50 million. Until we do so,
jobs will continue to be lost.
Mr. CONYERS. I yield 1 minute to the gentleman from Missouri, Russ
Carnahan.
Mr. CARNAHAN. Madam Speaker, I rise in strong opposition to this bill
that would hurt small businesses in Missouri who are finally gaining
access to affordable coverage for their employees. Since 2010, the
health care coverage among small firms has increased by more than 12
percent. If this bill passes, those small business owners will lose the
tax credits that are providing up to 50 percent of their health care
costs. Many of them will have to drop the very health insurance they
have just now been able to provide their employees and their families.
These are real people, people like Michelle Barron, who owns an
independent book store in Rock Hill, Missouri. She used to be able to
afford coverage for her employees, but over the years couldn't keep up.
She had to drop her employees and finally drop her own coverage because
of preexisting conditions. Last year when the health care bill was
signed into law, new options opened up for Michelle and countless small
business owners like her.
But if we repeal health care, it will turn back the clock for small
business owners like Michelle. Insurers would be able to go back to
denying coverage for preexisting medical conditions, and small business
owners would lose the tax credits that are helping make health care
coverage affordable. We cannot go back to the bad old days of insurance
company control. This is not the time to step backwards.
Mr. SMITH of Texas. Madam Speaker, I yield 1 minute to the gentleman
from Arizona (Mr. Quayle), who is a member of the Judiciary Committee.
Mr. QUAYLE. I thank the chairman for yielding.
Madam Speaker, I rise today in support of H.R. 2.
Last year, behind closed doors and against the will of the American
people, the Democratic majority of the 111th Congress passed a bill
that fundamentally changes the doctor-patient relationship. They passed
a bill that will increase the cost of health care and explode our
national debt. They passed a bill that expands the scope of government
well beyond the parameters set forth in the Constitution.
The genius of our Constitution is that this document didn't set forth
what the government must do for us, but rather what the government
can't do to us. Requiring every individual to enter into a commercial
contract certainly falls within the realm of what the government can't
do to us.
The people in my district understand this, just as they understand
that our health care system needs sensible, patient-centered reforms
that will reduce costs and increase access. Unfortunately, the health
care bill that was passed will increase costs and increase our national
debt. Yes, those who drafted the bill tried to conceal the true costs
from the American people. But if you look beyond the accounting
gimmicks, that bill increases our debt by $701 billion over the next 10
years.

It is time to get our country back on the right track, and H.R. 2 is
a necessary step to fulfilling that mission.
Mr. CONYERS. Madam Speaker, I yield 2 minutes to the distinguished
gentlewoman from Florida, Debbie Wasserman Schultz.
Ms. WASSERMAN SCHULTZ. Madam Speaker, I think it is important to
address the notion of job killing versus job creating. We've heard a
lot of talk about the title of this bill and the jobs that it
supposedly kills. But let's look at the facts here though. Of the 1.1
million private-sector jobs--documented--that were created last year,
fully 200,000 of those were in the health care sector, or one-fifth.
We've actually had an average of 20,000 jobs per month created in the
health care sector alone over the course of the last 2 years.

{time} 1630

There have been no job losses in the health care sector. None. And I
challenge our colleagues on the other side of the aisle, on the
Republican side of the aisle, who are vociferously advocating the
repeal of health care reform on the premise that it is a job killer to
name one area of health care, one, where there have been job losses. I
would suspect that we would hear crickets chirping, because there are
none. There isn't a single area of health care that there have been job
losses; not before health care reform passed and not since.
Also, I think it is important to address the comments from my
colleague the gentleman from Texas (Mr. Gohmert) who stated that
President Obama told the Democratic Caucus that health care reform
would supposedly allow us to shrink five tests performed on a patient
to one. That is simply not true. That never happened. He never said
that. And at the end of the day we need to make sure that we are
entitled to our opinions but not to our own facts.
I suspect that our colleagues on the other side of the aisle are
making up their own facts because their arguments don't stand on the
strength of their ideas and aren't strong enough to stand on their own.
I thought it was important to clear that up, Madam Speaker.
Mr. SMITH of Texas. Madam Speaker, I yield 1 minute to the gentleman
from Arkansas (Mr. Griffin), who is a member of the Judiciary
Committee.
Mr. GRIFFIN of Arkansas. I thank the gentleman from Texas for his
leadership on this issue and for yielding me this time.
Madam Speaker, I believe we need health care reform badly, but the
law we got isn't what we need. That is why I rise today in support of
H.R. 2 to repeal the current health care law. The health care law
provides for an increased government role and will ultimately lead to
decisions made by the government instead of doctors and patients.
It ignores the issue of cost. It was loaded with gimmicks to make it
seem deficit neutral. But once those are accounted for, we find that it
adds over $700 billion to the deficit in the next 10 years.
The health care law, and especially the unconstitutional mandate,
handicaps our ability to grow jobs. Small businesses will be hit
hardest because they operate on the tightest margins and will have the
toughest time complying with the onerous regulations, many of which are
still not written, creating uncertainty for employers.
We must repeal the law and replace it with one that lowers costs,
preserves the doctor-patient relationship, lets Americans keep the
coverage they have, allows the private sector to create jobs and
follows the Constitution.
Mr. CONYERS. Madam Speaker, I yield 1 minute to the gentleman from
New Jersey, Mr. Rob Andrews.
(Mr. ANDREWS asked and was given permission to revise and extend his
remarks.)
Mr. ANDREWS. Madam Speaker, as we meet this afternoon, there are 15
million unemployed Americans. And no matter where you go in this
country, you hear that the number one concern of our constituents is
creating an environment where businesses and entrepreneurs can put
people back to work.

[[Page H221]]

So what is the House doing this week? Re-litigating, regurgitating,
rearguing a political debate about health care again. I believe the
people of this country want us to work together to get jobs back in the
American economy.
The Republicans offer us a slogan, a job killing health care bill.
What kills jobs is paralysis in Congress. What kills jobs is ignoring
the economic problems of this country. ``No'' is not simply the right
vote on the merits, it's the right vote because this is the wrong bill
at the wrong time.
Mr. SMITH of Texas. Madam Speaker, I only have one more speaker on
this side and I am prepared to close.
Mr. CONYERS. How much time have we remaining, Madam Speaker?
The SPEAKER pro tempore. The gentleman from Michigan has 3\1/2\
minutes remaining, and the gentleman from Texas has 1\3/4\ minutes
remaining.
Mr. CONYERS. Madam Speaker, I yield myself 1 minute.
Because this is the Judiciary Committee and so little has been said
about the constitutionality, I am pleased to quote from the dean of the
law school of the University of California, Erwin Chemerinsky, who said
that opposing health care reform and relying on an argument that it is
unconstitutional is an inadequate way to proceed.
Somebody here must remember that there is Medicare, Medicaid, Social
Security. Please, this is not new that the government would be
intervening in this way. Maybe we need to revise and revisit the
questions of constitutionality.

[From POLITICO, Oct. 23, 2009]

Health Care Reform Is Constitutional

(By Erwin Chemerinsky)

Those opposing health care reform are increasingly relying
on an argument that has no legal merit: that the health care
reform legislation would be unconstitutional. There is, of
course, much to debate about how to best reform America's
health care system. But there is no doubt that bills passed
by House and Senate committees are constitutional.
Some who object to the health care proposals claim that
they are beyond the scope of congressional powers.
Specifically, they argue that Congress lacks the authority to
compel people to purchase health insurance or pay a tax or a
fine.
Congress clearly could do this under its power pursuant to
Article I, Section 8 of the Constitution to regulate commerce
among the states. The Supreme Court has held that this
includes authority to regulate activities that have a
substantial effect on interstate commerce. In the area of
economic activities, ``substantial effect'' can be found
based on the cumulative impact of the activity across the
country. For example, a few years ago, the Supreme Court held
that Congress could use its commerce clause authority to
prohibit individuals from cultivating and possessing small
amounts of marijuana for personal medicinal use because
marijuana is bought and sold in interstate commerce.
The relationship between health care coverage and the
national economy is even stronger and more readily apparent.
In 2007, health care expenditures amounted to $2.2 trillion,
or $7,421 per person, and accounted for 16.2 percent of the
gross domestic product.
Ken Klukowski, writing in POLITICO, argued that ``people
who declined to purchase government-mandated insurance would
not be engaging in commercial activity, so there's no
interstate commerce.'' Klukowski's argument is flawed because
the Supreme Court never has said that the commerce power is
limited to regulating those who are engaged in commercial
activity.
Quite the contrary: The court has said that Congress can
use its commerce power to forbid hotels and restaurants from
discriminating based on race, even though their conduct was
refusing to engage in commercial activity. Likewise, the
court has said that Congress can regulate the growing of
marijuana for personal medicinal use, even if the person
being punished never engaged in any commercial activity.
Under an unbroken line of precedents stretching back 70
years, Congress has the power to regulate activities that,
taken cumulatively, have a substantial effect on interstate
commerce. People not purchasing health insurance
unquestionably has this effect.
There is a substantial likelihood that everyone will need
medical care at some point. A person with a communicable
disease will be treated whether or not he or she is insured.
A person in an automobile accident will be rushed to the
hospital for treatment, whether or not he or she is insured.
Congress would simply be requiring everyone to be insured to
cover their potential costs to the system.
Congress also could justify this as an exercise of its
taxing and spending power. Congress can require the purchase
of health insurance and then tax those who do not do so in
order to pay their costs to the system. This is similar to
Social Security taxes, which everyone pays to cover the costs
of the Social Security system. Since the 1930s, the Supreme
Court has accorded Congress broad powers to tax and spend for
the general welfare and has left it to Congress to determine
this.
Nor is there any basis for arguing that an insurance
requirement violates individual liberties. No
constitutionally protected freedom is infringed. There is no
right to not have insurance. Most states now require
automobile insurance as a condition for driving.
Since the 19th century, the Supreme Court has consistently
held that a tax cannot be challenged as an impermissible take
of private property for public use without just compensation.
All taxes are a taking of private property for public use,
but no tax has ever been invalidated on that basis.
Since the late 1930s, the Supreme Court has ruled that
government economic regulations, including taxes, are to be
upheld as long as they are reasonable. Virtually all economic
regulations and taxes have been found to meet this standard
for more than 70 years. There is thus no realistic chance
that the mandate for health insurance would be invalidated
for denying due process or equal protection.
Those who object to the health care proposals on
constitutional grounds are making an argument that has no
basis in the law. They are invoking the rhetorical power of
the Constitution to support their opposition to health care
reform, but the law is clear that Congress constitutionally
has the power to do so. There is much to argue about in the
debate over health care reform, but constitutionality is not
among the hard questions to consider.

I yield the balance of my time to the gentlewoman from Texas, Ms.
Sheila Jackson Lee, a senior member of the committee.
The SPEAKER pro tempore. The gentlewoman from Texas is recognized for
2\1/2\ minutes.
Ms. JACKSON LEE of Texas. Mr. Chairman, you are absolutely right.
This is a constitutional question that has been raised, and as I came
to the floor earlier, I mentioned my predecessor, Congresswoman Jordan,
who believed in this Constitution without question. I mentioned the
14th Amendment. I now mention the Fifth Amendment.
First of all the commerce clause covers this bill, but the Fifth
Amendment speaks specifically to denying someone their life and liberty
without due process. That is what H.R. 2 does, and I rise in opposition
to it. And I rise in opposition because it is important that we
preserve lives and we recognize that 40 million plus are uninsured.
In my own county, Harris County, this bill will allow some 800,000
uninsured members of Harris County, citizens of Harris County, to be
insured in Texas. In addition, the Texas Department of Insurance, as
many other States, have already begun implementing this bill, the
patient protection bill, gladly so, and saying it will help save lives
and provide for the families of their States.
Can you tell me what is more unconstitutional than taking away from
the people of America their Fifth Amendment rights, their 14th
Amendment rights, and the right to equal protection under the law? I
know that Mr. Land, who suffers from schizophrenia with his family; Ms.
Betty, who had to go to the ER room in Texas because of no insurance;
Mrs. Smith who was on dialysis; or Mrs. Fields whose mother couldn't
get dental care, I know they would question why we're taking away their
rights.
Today we stand before this body, we beg of them to ask themselves
whether this is all about politics or about the American people. I am
prepared to extend a hand of friendship, standing on the Constitution,
to enable us to provide for all of the citizens of this country.
This bill has been vetted, this bill is constitutional, and it
protects the constitutional rights of those who ask the question: Must
I die, must my child die because I am now disallowed from getting
insurance? To our seniors, there are no death panels. This is about
your primary care doctor. This is about closing the doughnut hole that
will allow you to be able to get discounts on your prescription drugs
that some of you have avoided because you have to pay your rent and you
have to buy your food.
Texas, a big State, has already said through a governmental agency,
we need this bill. And we hope that those who come from our State and
many other States will not vote against the protection of patients.
Vote against H.R. 2 and provide yourself with the protection of the
Constitution.

[[Page H222]]

Madam Speaker, I stand in strong opposition to the Patient's Rights
Repeal Act. As a Member of Congress I take seriously my responsibility
and sworn oath to serve my constituents and improve the lives of all
citizens of this country for the better.
The Fourteenth Amendment of the U.S. Constitution states that, ``No
State shall make or enforce any law which shall abridge the privileges
or immunities of citizens of the United States; nor shall any State
deprive any person of life, liberty, or property, without due process
of law; nor deny to any person within its jurisdiction the equal
protection of the laws.''
The last portion of this amendment, commonly called the Equal
Protection Clause, is one of the most important portions of the
Constitution, which was added after the Civil War and was the basis for
most of the civil rights decisions that transformed this country.
Furthermore, many of the legal arguments for demanding medical
treatment have also rested on this clause, which the U.S. Supreme Court
relied on in its Roe v. Wade decision. Repealing the healthcare reform
we enacted last year would be a violation of the Equal Protection
Clause of the 14th Amendment of the U.S. Constitution since it would be
abridging the fundamental right of U.S. citizens to have health care
and would be denying them the equal protection under the law guaranteed
to them by the 14th Amendment.
Furthermore, even the Founding Fathers more than two centuries ago
emphasized the fundamental importance of good health. Thomas Jefferson
stated that, ``Without health there is no happiness. And attention to
health, then, should take the place of every other object . . . The
most uninformed mind, with a healthy body, is happier than the wisest
valetudinarian.''
I urge President Obama that should any repeal of any beneficial
portion of the Patient Protection and Affordable Care Act come to his
desk, he should utilize his presidential prerogative to veto this
legislation which would harm the fundamental rights of Americans.
As health care reform takes a particularly partisan tone, this
Nation, as of January 2011, still has more than 20 million Americans
according to the U.S. Census Bureau who live without health insurance.

To my colleagues across the aisle, have you truly considered what
this repeal would mean and who this would affect? Sadly to say, in my
district, the 18th Congressional District of Houston, Texas, the repeal
would be devastating. To highlight a few major effects of the repeal
for my district, please listen as I explain several devastating changes
to health care coverage that a number of populations throughout the
18th Congressional District of Houston, Texas, will face.
The repeal would increase drug costs for seniors. There are 5,300
Medicare beneficiaries in my district who are expected to benefit from
these provisions. Repeal would increase the average cost of
prescription drugs for these Medicare beneficiaries by over $500 in
2011 and by over $3,000 in 2020.
The repeal would deny seniors new preventive and wellness care
improving primary and coordinated care, and enhancing nursing home
care.
The repeal would eliminate these benefits for 70,000 Medicare
beneficiaries in the district and cause the Medicare trust fund to
become insolvent in just six years.
The repeal would eliminate tax credits for small businesses. The
health reform law provides tax credits to small businesses worth up to
35 percent of the cost of providing health insurance. There are up to
14,600 small businesses in my district, small businesses that are
eligible for this tax credit. This repeal would force these small
businesses to drop coverage or bear the full costs of coverage
themselves.
The repeal would increase retiree health care costs for employers.
The health reform law provides funding to encourage employers to
continue to provide health insurance for their retirees. As many as
5,500 district residents who have retired but are not yet eligible for
Medicare could ultimately benefit from this early retiree assistance.

The repeal would increase costs for employers and jeopardize the
coverage their retirees are receiving. The repeal would increase the
cost of uncompensated care born by hospitals. The Health Reform Law
benefits hospitals by covering more Americans and thereby reducing the
cost of providing care to the uninsured.
The repeal would undo this benefit, increasing the cost of
uncompensated care by $27 million annually for hospitals in my
district.
As evidenced in the recent elections, the public has indicated they
want less spending and a balanced budget. The Congressional Budget
Office estimates the budget will be negatively impacted to the tune of
$230 billion dollars over a 10 year period if healthcare reform is
repealed. Additionally, more than four million small businesses would
lose health insurance tax credits as a result of repeal, and the cost
of offering employer-based health insurance could increase by more than
$3,000 annually, according to the U.S. Public Interest Research Group.
As a Congress we have continued to debate this issue for decades
without resolve. The uninsured, the underserved, vulnerable and
minority communities are particularly at risk. Lest we forget--in 1999
we asked the Institute of Medicine--the independent organization whose
reports are considered the gold standard for health care policymakers--
to investigate disparities in health and health care among racial and
ethnic minorities. The results were damning: the ensuing study, Unequal
Treatment: Confronting Racial and Ethnic Disparities in Health Care,
found that minorities had poorer health and were consistently receiving
lower-quality health care even when factors such as insurance status
and income weren't involved.
As stated by Newsweek, minorities and the underserved were less
likely to get lifesaving heart medications, bypass surgery, dialysis,
or kidney transplants. They were more likely to get their feet and legs
amputated as a treatment for late-stage diabetes.--Mary Carmichael, The
Great Divide, Newsweek, February 15, 2010.

In our current system, most people do not choose to be uninsured but
are priced out of insurance. These people cannot, as free market
proponents often argue, ``pull themselves up by their bootstraps.''
Instead, they and their families are too often cyclically and
systemically trapped in their economic situation. As a result, minority
communities suffer grave health disparities that would otherwise be
limited but for lack of access to affordable and quality care. What is
the price for improving the life expectancy of millions of Americans of
all ages?
In 2007, only 49 percent of African-Americans in comparison to 66
percent of non-Hispanic whites used employer-sponsored health
insurance, according to the Department of Health and Human Services.
During the same year, 19.5 percent of African-Americans in comparison
to 10.4 percent of non-Hispanic whites were uninsured.
Hispanics have the highest uninsured rates of any racial or ethnic
group within the United States. In 2004, the Centers for Disease
Control and Prevention reported that private insurance coverage among
Hispanic subgroups varied as follows: 39.1 percent of Mexicans, 47.3
percent of Puerto Ricans, 57.9 percent of Cubans, and 45.1 percent of
other Hispanic and Latino groups.
Health care reform also is critical to ensure that women have access
to affordable health care coverage. An estimated 64 million women do
not have adequate health insurance coverage. About 1.7 million women
have lost their health insurance coverage since the beginning of the
economic downturn. Nearly two-thirds lost coverage because of their
spouse's job loss. And nearly 39 percent of all low-income women lack
health insurance coverage. Women also are more likely to deplete their
savings accounts paying medical bills than men because they are more
likely to be poor. This bill gives women access to the health care that
they need and deserve.
Health care reform is a critical step in helping to reduce such
health disparities. Are we now telling the American public we will not?
Lower costs for minority families and all Americans should forget
about preventive care for better health.
Racial and ethnic minorities are often less likely to receive
preventive care. Vietnamese women, for example, are half as likely to
receive a pap smear, and twice as likely to die from cervical cancer as
are whites. Obesity rates are also high among certain minority groups.
By ensuring all Americans have access to preventive care and by
investing in public health, health insurance reform will work to create
a system that prevents illness and disease instead of just treating it
when it's too late and costs more. Are we telling the citizens of this
country that we will not?
Make health care accessible to everyone.
African Americans, Hispanics, and Native Americans are roughly twice
as likely to be uninsured as the rest of the population. By providing
health insurance choices to all Americans and providing premium
assistance to make it affordable, health insurance reform significantly
reduces disparities in accessing the best quality for health. We will
you tell your constituents that you will not:
Control chronic disease and promote primary care.
Nearly half of African Americans suffer from a chronic disease,
compared with 40 percent of the general population. Chronic illness is
growing in other minority communities as well. Health insurance reform
is slated to include a number of programs to prevent and control
chronic disease, including incentives to provide medical homes and
chronic disease management pilots in Medicare. By investing in the
primary care workforce (including scholarships and grants to increase
diversity in health professions), health reform will make sure that all
Americans have access to a primary care doctor and strengthen the
system of safety-net hospitals and community health centers to ensure
accessible care.

[[Page H223]]

The people of my home State of Texas, in particular, with 6 million
uninsured persons, and 26 percent uninsured in my district, have been
hit especially hard when it comes to lack of access to quality,
affordable care. Many Americans continue to be forced from their health
care plans due to decisions by insurance companies that consider profit
over people.

So how do the million plus Houston residents without an insurance
company get health care--the emergency room, ER! Emergency rooms have
become the health care providers of last resort for well over 100
million Americans annually.
Will we allow this trend to continue? Over a 10 year period from 1994
to 2004, ER visits on a national level saw an 18 percent jump,
according to the Centers for Disease Control and Prevention. Emergency
rooms in Houston hospitals are routinely overcrowded as overused as
throngs flock seeking care for ailments that may range from a heart
attack or gunshot wound to an ear infection or toothache. ER
overcrowding is so bad in the Houston area, that patients have called
911 from one ER to get to another, according to one report. When the
President signed the health care bill into law, he ensured that
Americans who have been flocking to emergency rooms for primary care
will have another option--affordable and accessible health care.
Repealing the health act is not in the best interest of Americans.
Health is not partisan and we should not treat it as such. Will we tell
the citizens of this great Nation, we will not?
Bar insurance companies from discriminating based on pre-existing
conditions, health status, and gender; create health insurance
exchanges--competitive marketplaces where individuals and small
business can buy affordable health care coverage in a manner similar to
that of big businesses today; offer premium tax credits and cost-
sharing assistance to low and middle income Americans, providing
families and small businesses with the largest tax cut for health care
in history; insure access to immediate relief for uninsured Americans
with pre-existing conditions on the brink of medical bankruptcy; invest
substantially in community health centers to expand access to health
care in communities where it is needed most; empower the Department of
Health and Human Services and State insurance commissioners to conduct
annual reviews of new plans demanding unjustified, egregious premium
increases; expand eligibility for Medicaid to include all non-elderly
Americans with income below 133 percent of the federal poverty level
(FPL); replace the so-called ``cornhusker'' deal with fair assistance
for all States to help cover the costs of these new Medicaid
populations; maintain current funding levels for the Children's Health
Insurance Program (CHIP) for an additional two years, through fiscal
year 2015; and increase payments to primary care doctors in Medicaid.

Increased costs for families and business in the current economy
cannot be best for the Nation. Before we rush headlong toward repeal,
we must consider the consequences and look for solutions that hold down
costs, not increase them. In opposition to H.R. 2, I offered several
amendments to protect the millions of Americans who are at risk of the
legislation that is before the body of Congress today. Specifically, my
amendments would amend the legislation to make no further reduction in
Medicare and Medicaid fraud and would prevent the abuse of activities
below the level that would be provided under Title VI and Subtitle F of
Title X of the Patient Protection and Affordable Care Act and Sections
1106 and Subtitle D of Title I of the Health Care and Education
Reconciliation Act of 2010, Public Law 111-152.
My amendment stated that this repeal shall not take effect unless and
until the Director of Office of Management and Budget in collaboration
with the Director of the Congressional Budget Office certifies to
Congress that this repeal will not result in any decrease in Medicare
and Medicaid fraud and abuse prevention activities below the level
provided in the Patient Protection and Affordable Care Act.
Health care fraud and abuse has been a national problem, prevalent in
Federal, State and private insurance programs, costing this Nation
billions of dollars each year. Fraud can result in improper payments,
but it is not the only cause of wasteful spending in Federal health
care programs. Payments for unnecessary medical services, for claims
with insufficient documentation, for ineligible patients and to
ineligible providers, are examples of improper expenditures that waste
taxpayer dollars and drive up health care costs. Fraud and abuse
account for one-fifth, an estimated $125 to $175 billion of that waste.
This is staggering.
Continuing to uncover fraud and abuse will assist in covering the
costs of health reform, allowing us to keep the services so many
Americans rely upon, while reducing the deficit. The Congressional
Budget Office estimates that every $1 invested to fight fraud yields
approximately $1.75 in savings. Through FY 2009, the Department of
Justice's civil division and U.S. Attorneys' Offices have recovered
nearly $16 billion in matters alleging fraud against government health
care programs.
As we look to make non-partisan decisions that will benefit the
American people and guarantee fair and equitable health care coverage,
the Obama administration has taken steps to significantly improve
oversight of the Medicare Part C and Part D programs. These steps have
sought to tailor interventions towards the areas where fraud and abuse
are the greatest. Efforts have been implemented to invest in critical
data infrastructure, enhanced field operations at Centers for Medicaid
and Medicare Services, the Office of Inspector General, and Department
of Justice, and initiated new efforts to reduce improper payments.
On July 2010, U.S. Health and Human Services Secretary, Kathleen
Sebelius and U.S. Attorney General, Eric Holder launched a series of
regional health care fraud prevention summits. These summits brought
together a range of Federal, State and local partners, beneficiaries,
providers, and other interested parties to discuss innovative ways to
eliminate fraud within our U.S. health care system. Tools contained in
the Affordable Care Act serve to safeguard taxpayer dollars and ensure
health care coverage for seniors, families and children are secure.
The Nation's health care system has been victimized by health care
fraud perpetrators whose objective is to line their pockets at the
expense of the American taxpayer, patients, and private insurers. This
not only drives up costs for everyone in the health care system, it
cripples the long term solvency of Medicare and Medicaid, two programs
upon which millions of Americans depend.
This particular amendment was essential to hold State and local
partners, beneficiaries, providers, and others accountable to their
patients and communities and ensure these new policies are used in an
effective manner to yield the best possible outcome.

Regarding community health centers, I offered an amendment that would
prevent Section 2 of House Bill H.R. 2 from taking effect unless and
until the Director of the Office of Management and Budget, in
consultation with the Director of the Congressional Budget Office,
certifies to Congress that the repeal of the Patient Protection and
Affordable Care Act (Public Law 111-148) will not result in an
elimination of any increased funding to community health centers
provided under the Patient Protection and Affordable Care Act or the
Health Care and Education Reconciliation Act of 2010 and will not
result in any decrease in the number of community health centers, and
will not otherwise disallow further expansions of community healthcare
centers.
It is important to protect the historic healthcare legislation which
we fought so hard to enact in order to provide the accessible,
affordable and quality healthcare that all Americans deserve and so
many Americans receive through community healthcare centers.
Community health centers are poised to play a vital role in the
implementation of the Affordable Care Act and emphasize coordinated
primary and preventive services. These centers also provide preventive
services. Routine health care that includes screenings, check-ups, and
patient counseling to prevent illnesses, disease, or other health
problems.
Offer a medical home to the most vulnerable and medically
underserved--low-income individuals, racial and ethnic minorities,
rural communities and other underserved populations to address and
reduce health disparities.
Community health centers continue to show their ability to manage
patients with multiple health care needs, and implement key quality
improvement practices, including health information technology.
For more than forty years, health centers have delivered quality,
comprehensive preventive and primary care to patients regardless of
their ability to pay. With a proven track record of success, and the
advent of 350 new community health care centers being established in
fiscal year 2011, a repeal of the Affordable Care Act will threaten the
very fabric of this Nation's health care system. Currently, more than
1,100 community health centers operate 7,900 service delivery sites and
provide care to nearly 19 million patients in every state, the District
of Columbia, Puerto Rico, the U.S. Virgin Islands, and the Pacific
Basin.
The Affordable Healthcare Act included enhanced funding for
operations and start-ups of federally qualified health centers in the
Harris County Hospital district, which is in the 18th Congressional
District of Texas, my home district, thereby increasing the
availability of primary health care and preventive health care
services. The Affordable Healthcare Act also provided funding for and
policy direction to increase the number of primary care providers in
the Harris County Hospital district and the state of Texas, inclusive
of physicians and physician extenders (advanced nurse practitioners).

[[Page H224]]

The Affordable Healthcare Act also directed states to increase
provider payment rates to physicians in the Medicaid program. This is
significant in that rates are so low in Texas many physicians are
unwilling to take Medicaid patients.
According to the Texas Health and Human Services Commission Study,
there are currently 1.1 million uninsured in Harris County, Texas. Full
implementation of health care reform would reduce that number to a
little over 390,000. That represents a 65 percent reduction in the
number of uninsured residents. Diminished access to primary and
preventive health care services that in turn will lead to a moreover
use of acute care hospital inpatient services and emergency center
encounters at much higher costs to county taxpayers and higher Medicaid
per capita expenditures for the state and Federal government. Without
reform, cuts to the Medicare and Medicaid program will put a greater
strain on existing safety net providers and local tax payers. Without
expanded care and insurance reforms, people will not have access to
affordable, lower cost health care services.

Specifically, in my Congressional district, the South Central Houston
Community Health Center has been serving the Houston community since
1994 and has locations in the Sunnyside and Third Wards areas of
Houston. By being the oldest, Federally qualified health center in the
city of Houston, the community health center has grown to receive over
1.2 million in annual Federal funds, which is instrumental in providing
quality health care to the medically underserved, uninsured, and
underinsured people of the greater Houston area. The South Central
Houston Community Health Center has made tremendous progress towards
eliminating healthcare disparities and increasing access to healthcare
services to the Houston community.
The Legacy Community Health Center in my Congressional district has
also benefitted greatly from the Affordable Healthcare Act. The Legacy
Community Health Center is a full-service, community health center that
provides comprehensive, primary healthcare services to all Houstonians
in a culturally sensitive, judgment-free and confidential environment.
Legacy has specialized in HIV/AIDS testing, education, treatment and
social services since the early 1980's. They also provide care for
other chronic health conditions like diabetes and high blood pressure
disparately impacting minorities. Generous financial support from
individuals, businesses and charitable foundations allows Legacy to
provide no-cost or low-cost healthcare services to over 30,000 men,
women and children each year.
The Good Neighbor Healthcare Center also in my Congressional district
offers a wide array of services to families living in the greater
Houston area. Services include primary health care, dental care,
optometry, and behavioral health services. Good Neighbor Healthcare
Center has a special mission to the community that goes right to the
heart of providing quality, accessible primary health care and dental
care to those in need. Good Neighbor Healthcare Center serves patients
from virtually every zip code in Harris County, and the diverse staff
is ready to assist patients with all of their health care needs. Good
Neighbor Healthcare Center assists patients in Spanish or English as
needed as well.

Community health centers are an integral part of our communities
providing a source of local employment and economic growth in many
underserved and low-income communities. In 2009, community health
centers across the Nation provided more than $11 billion in operating
expenditures directly into their local economies. Community health
centers employ more than 9,100 physicians and more than 5,700 nurse
practitioners, physician assistants, and certified nurse midwives to
treat patients through culturally competent, quality and integrated
care.
And lastly, I offered an amendment that would be essential to an
unprecedented opportunity to serve more patients, retain existing and
support new jobs, meet the significant increase in demand for primary
health care services among the nation's uninsured and underserved
populations and address essential construction, renovation, and
equipment and health information technology systems needs in community
health centers. I cannot turn my back and shut the door on the
constituents I represent in securing accessible, affordable and quality
healthcare services in my Congressional district.
If the Healthcare Repeal Bill were to pass, this amendment would
ensure that insurance rates do not increase from those rates that would
have applied if the law is left intact.
Health care reform is something that people have fought for fervently
for years, and it would be a great disservice to the American people if
the health care law were repealed as a result of politics. The Patient
Protection and Affordable Care Act insure access to quality, affordable
healthcare for all Americans. It also makes necessary changes that will
make our system of health care more efficient. Children are allowed to
stay on their parents' health insurance until the age of twenty-six.
Patients cannot be refused health insurance coverage because of pre-
existing conditions. Insurance premiums were lowered and mechanisms are
in place to avoid them getting any higher. Repealing health care reform
would reverse all of this good that has been done.

However, if the Patient Protection and Affordable Care Act is
repealed, it is important that certain provisions of the law remain
intact. For aforementioned reasons, I urge my colleagues to reason with
the American people and provide an opportunity for every American in
every state to receive affordable and quality healthcare. If the
Healthcare Law is repealed without the inclusion of my amendment, that
would ensure that insurance rates do not increase from those rates that
would have applied if the law is left intact, we are left great
potential for health insurance rates to rise, much like they did in the
past, to levels which make coverage inaccessible and unaffordable for
many Americans.
Before the Healthcare Reform Bill was signed into law, increasing
healthcare costs were crushing the budgets of families and American
businesses, making us less competitive in the ever growing global
market, placing Medicare and Medicaid in serious danger, damaging our
long-term fiscal stability, and worse of all, causing Americans to
continue to go without basic health care coverage. This broken health
care system was driving up health care costs and weakening our economy.
Minorities in general were more in danger of being uninsured and
falling victim to frequent emergency visits, increasing debt that leads
to bankruptcy, and premature death.
Without healthcare reform, a devastating number of citizens would
have had to continue to live without healthcare. No American citizen
should have to face a decision of whether to buy food or pay healthcare
premiums. Putting a face to healthcare is recognizing Iris Williams
from Houston, Texas.
For many mothers, finding a good doctor for their children can be
quite difficult, especially if they don't have health insurance. When
the child has fears of going to the doctor, the difficulty only
worsens.

Iris Williams first brought her son, Simon, to Legacy Community
Health Services in 2007. As a resident in the surrounding area, Iris
liked the convenience of Legacy's Community Health Center on Lyons
Avenue in the heart of her neighborhood. When she found out Legacy
offered school physicals, even to those without health insurance, she
was thrilled.
``My son had a bad experience with a doctor when he was younger and
did not like going to the doctor,'' Iris sighed. ``But Legacy was able
to schedule a physical for Simon within the week, and I was told it
would only cost $45.''
Now that Iris had an appointment for her son at an affordable cost,
she only had to worry about whether Simon would like the doctor.
``I just love Dr. Levine, he is so kind and wonderful,'' Iris
continued, ``he not only made my son feel at ease but he also treated
him like a young man. That made us both feel really good.''
This past summer Simon hurt his finger at a summer program. Iris had
to take him to the emergency room to get his fingernail removed. For
his follow-up care Iris sought out Legacy to clean the wound and make
sure it was healing properly.
``Again the staff at Legacy was great and the finger is healing
nicely,'' Iris glowed. ``I am so glad Legacy had a doctor to care for
him after the visit to the ER.''
When people in Iris's neighborhood ask her where to go for quality
and affordable healthcare, Iris doesn't hesitate to refer them to
Legacy. She knows they will get great care. Iris stated, ``it gives me
great satisfaction knowing that Legacy is here for all of us and will
take care of our health care needs.'' Madam Speaker, what do you expect
I say to constituents similar to Iris Williams?
Madam Speaker, before the Healthcare Reform Bill passed, the need for
more efficient healthcare was dire, especially within my home State of
Texas. One in four Texans, about 5.7 million people, or 24.5 percent of
the State's population, had no health insurance coverage. An estimated
1,339,550 Texas children--20.2 percent of Texas children--were
uninsured. According to the U.S. Census Bureau, Texas had the Nation's
highest percentage of uninsured residents. This posed consequences for
every person, business, and local government in the State who were
forced to bear extra costs to pay for uncompensated care. If the
Patient Protection and Affordable Care Act is repealed, Texas, like
many other States, runs the risk of a reoccurrence of statistics such
as these.
Over the years, I have had the opportunity to meet with health care
providers who have been on the front lines of health care debates from
day one. It is no surprise that they enthusiastically endorsed
healthcare reform, and many are still holding out hope for progressive
changes to the current healthcare laws as we move forward in this new
Congress. These

[[Page H225]]

health professionals have seen the pain and frustration of hardworking
Americans who faced financial collapse, physical suffering, and
sometimes the loss of their life simply because they did not have
decent health care coverage. The repeal of healthcare reform could lead
our Nation back down a similar path, and I am confident that no health
care professionals, nor I, or any of my colleagues would want to see
situations like that reoccur.
The late Congresswoman Barbara Jordan, who once held the seat that I
so proudly and humbly hold today said, ``What the people want is very
simple. They want an America as good as its promise.'' These words
resonate in our time and the American people only ask for simple
things. Therefore, I and my fellow colleagues are striving to maintain
something we fought for tirelessly for years and were finally able to
secure in the last Congress--the ability to provide all Americans with
affordable and accessible healthcare.
For these reasons, I urge my colleagues to allow their conscious to
recognize the greater need to work across the aisles with one another
and strengthen our healthcare system to one day provide universal
healthcare for all Americans. Again, I am in opposition of H.R. 2.
Mr. SMITH of Texas. I yield myself the balance of my time.
Madam Speaker, the Democrats' health care bill squanders health care
resources and taxpayer money by encouraging wasteful defensive
medicine. It explicitly prevents States from making any effective legal
reforms under its provisions, and expands opportunities for lawyers to
sue doctors who did absolutely nothing wrong. And it limits the supply
of doctors when patients need them most.
In fact, one particularly costly part of our health care system is
the practice of so-called ``defensive medicine,'' which occurs when
doctors are forced by the threat of lawsuits to conduct tests and
prescribe drugs that are not medically required. A survey released last
year found defensive medicine is practiced by virtually all physicians.
Lawsuit abuse does more than make medical care much more expensive.
It drives doctors out of business. Doctors who specialize in inherently
high-risk fields are leaving their practices and hospitals are shutting
down because their high exposure to liability makes lawsuit insurance
unaffordable.

{time} 1640

It can have deadly consequences. Hundreds and even thousands of
patients may die annually for lack of doctors.
Madam Speaker, the Democrats' health care law will produce more
litigation and less effective health care. That is why it should be
repealed.
I yield back the balance of my time.
The SPEAKER pro tempore. The gentleman from Missouri (Mr. Graves) and
the gentlewoman from New York (Ms. Velazquez) each will control 20
minutes.
The Chair recognizes the gentleman from Missouri.
Mr. GRAVES of Missouri. Madam Speaker, I yield myself such time as I
may consume.
I rise today in support of H.R. 2, legislation to repeal the job-
destroying health care law that was rushed through Congress last year.
The American people have repeatedly voiced their frustration over the
way the health care law put the government between patients and their
doctors. They have protested this law's outrageous Federal mandates and
high taxes. They have demanded that reform of our Nation's health care
system focus not on bigger government, not on more bureaucrats, but on
targeted, commonsense changes that encourage competition and better
choices.
But instead of listening to the people, Washington gave them a law
that piles more than $500 billion in tax increases on families and
small businesses. This law will force as much as 80 percent of all
small businesses to give up their current coverage and could cost our
economy 1.6 million jobs, 1 million of which could come from small
businesses.
All of these new regulations and restrictions included in the law
will make it more difficult for small businesses to hire new workers,
expand their operations, and offer competitive wages. With unemployment
still hovering above 9 percent, families and businesses simply cannot
afford more regulations and red tape from Washington. It is going to
make jobs more scarce and further slow our economic recovery.
My Republican colleagues and I repeatedly tried to reach across the
aisle to craft a better bill when this was pushed through. I was
disappointed that rather than listen to their counterparts, the
American people, those in charge when this was pushed through chose to
put a completely partisan, widely unpopular bill through the people's
House.
We now have an opportunity to give the people what they want by
repealing this law and replacing it with meaningful reforms that will
cut costs and increase access without creating big problems for
businesses or piling more unsustainable debt on future generations.
I urge my friends and Members to vote in favor of repeal of this
legislation, and join me in implementing better solutions for improving
our Nation's health care system.
I reserve the balance of my time.
Ms. VELAZQUEZ. Madam Speaker, I yield myself such time as I may
consume.
(Ms. VELAZQUEZ asked and was given permission to revise and extend
her remarks.)
Ms. VELAZQUEZ. Madam Speaker, I rise in opposition to the bill before
us today.
As we begin the 112th Congress, it is unfortunate that one of the
first bills before this body is more about politics than policy. This
bill will not help a single small business secure a loan, open a new
market for its products, or invest back in its operations. By their own
admission, the other side acknowledges this legislation is going
nowhere.
It is ironic this grandstanding occurs when health insurance
continues to be a top challenge facing small businesses. Over the last
decade, small employers have seen their premiums rise by over 114
percent with no sign of relief. It is hard to imagine how repeal will
help small businesses. In fact, it could do significant harm. The bill
before us today imposes a $40 billion tax increase by eliminating
critical small business tax credits. These have already helped reduce
costs and increased coverage rates by nearly 12 percent in the past
year.
Repeal would also eliminate choices for entrepreneurs. Currently, in
the majority of States, the two largest insurers had a combined market
share of 70 percent or more. By doing away with reforms that establish
new health insurance markets, it will limit small businesses' ability
to secure coverage.
Small businesses already pay 20 percent more than their corporate
counterparts, and the loss of new safeguards will compound this
problem. Because of health reform, insurers are no longer able to raise
rates arbitrarily without explaining why. They cannot deny coverage
based on a preexisting condition or because an employee gets sick.
Passage of this bill would also strip new protections that provide
small businesses bargaining power.
We have heard how important reforms were excluded from the original
legislation. They say that for this reason, the House will start from
scratch and enact a new health care law. However, when Republicans were
in control of both Chambers and held the Oval Office, they talked about
these solutions for nearly a decade, and yet nothing happened. In the
meantime, small businesses saw their employees' premiums rise by an
average of $700 every single year. These small businesses now pay
nearly $14,000 for a policy that cost $6,500 in 2000. Why should small
businesses believe they can deliver on a promise this time?
While our economy has added nearly 400,000 jobs over the past 3
months, more must be done. We must continue to confront the problem of
health coverage for small businesses, but voting for today's bill will
not do that.
I urge Members to oppose the bill, and I urge the new leadership to
focus on meaningful ways to address this Nation's economic challenges.
I reserve the balance of my time.
Mr. GRAVES of Missouri. Madam Speaker, I yield 1 minute to the
gentleman from South Carolina (Mr. Mulvaney).
Mr. MULVANEY. Madam Speaker, I rise in favor of H.R. 2.
It is hard to know where to begin when you are talking about how bad
the current health care legislation is for small businesses. The
current health care bill that this Congress passed last year has an
incentive for businesses to go from 50 employees to

[[Page H226]]

49. It has an incentive for businesses to go from 25 employees down to
fewer, and it has a disincentive then for small businesses to grow.
There is a financial incentive to pay your employees less because the
tax credit that we talked so much about last year goes away as you pay
your folks more.
In fact, it is almost as if the folks who wrote this piece of
legislation last year either have no idea how small business works or
they don't care how small business works. Either way, the current
health care legislation is a complete disaster for small business, and
the number one priority for small business this year should be
repealing of the existing health care and passing of H.R. 2.
Ms. VELAZQUEZ. Madam Speaker, in the State of South Carolina as a
result of this repeal legislation, small businesses in the State of
South Carolina will see a tax increase of $540 million.
I yield 2 minutes to the gentleman from Rhode Island (Mr. Cicilline).
Mr. CICILLINE. I thank the gentlelady for yielding.
Madam Speaker, I rise today in strong opposition to H.R. 2.
We know that if we repeal this law, we know the following things will
happen: Children with preexisting conditions will be denied coverage;
adult children under the age of 26 will be denied coverage under their
parents' policy; seniors will pay more for their prescription drugs;
and small businesses will once again go back to paying nearly 20
percent more than their corporate counterparts for providing the same
health care coverage; small businesses would lose the incentive for
providing coverage to their employees and an up to 50 percent tax
credit which has already increased coverage at small firms by more than
10 percent. They would lose the ability to grow their businesses and
create jobs by using that tax credit to hire additional employees.
This law establishes consumer protections, incentivizes wellness
programs, and establishes cost controls and cost-cutting exchanges. For
small businesses, that means driving down the cost of providing health
insurance and providing assistance for small businesses that are
struggling with skyrocketing premiums.
Currently, small businesses pay, on average, 18 percent more than
large businesses for the same coverage, and health insurance premiums
have gone up three times faster than wages in the past 10 years.
The SPEAKER pro tempore. The time of the gentleman has expired.
Ms. VELAZQUEZ. I yield the gentleman an additional 15 seconds.

{time} 1650

Mr. CICILLINE. Small business tax credits are critical to providing
small businesses the opportunity to provide insurance to their
employees. We made a promise to those small businesses to do everything
we can to make it easier for them to thrive in this economy, and this
is a good first step.
I urge my colleagues to vote against this repeal.
Mr. GRAVES of Missouri. Madam Speaker, I yield 1 minute to the
gentleman from Tennessee (Mr. Fleischmann).
Mr. FLEISCHMANN. Madam Speaker, tonight I rise in support of the
repeal of ObamaCare.
This is my first speech on the floor as a Member of Congress, and I
thought it only appropriate that it be on this topic--a topic I
campaigned hard on and a topic I believe strongly in.
We must repeal this health care legislation. As a small business
owner for the past 24 years, I know firsthand the kind of damage this
legislation would do to American small business if it is allowed to be
put in place.
The National Federation of Independent Research Foundation conducted
a study that showed the employer mandate found in ObamaCare could lead
to a loss of 1.6 million jobs throughout the country, and 66 percent of
those lost jobs would come from the small business workforce. That same
study showed ``small businesses would lose, roughly, $113 billion in
real output and account for 56 percent of all real output lost.''
As a member of the Small Business Committee, I promise to use my
personal experience to fight every day for small business owners
everywhere. Starting tonight, we must repeal ObamaCare.
Ms. VELAZQUEZ. Madam Speaker, I yield 2 minutes to the gentleman from
North Carolina (Mr. Miller).
Mr. MILLER of North Carolina. Madam Speaker, I rise today to speak
against this bill.
Even before the recession, my State of North Carolina was losing one
wave of jobs after another in our traditional industries, and we have
needed the energy and the job creation that comes from small business--
from people leaving jobs, whether they jump or are pushed, and starting
their own businesses. Half the American economy, our gross domestic
product, is generated by small business. Even more importantly, small
businesses create 75 percent of new jobs.
By providing access to State high-risk pools and an insurance market
for individuals, the health care reform bill passed last year will make
it possible for American workers to start their own businesses without
worrying they are going to lose health care for themselves or for their
families.
I do know firsthand what it is like as a small business owner to buy
health insurance for employees. It is one of the greatest
frustrations--trying to find something affordable and trying to figure
out what you really bought, and you're not going to know until one of
your employees gets sick or gets hurt.
This bill, the bill passed last year--this legislation--will make it
affordable. It will provide tax credits of 35 percent for small
businesses to provide health insurance, and that is going to go up to
50 percent. That will increase health care coverage by more than 12
percent amongst small business owners. Even more importantly, they're
going to know what they've got. It is going to be insurance that really
covers what it ought to cover. It is not going to be filled with small-
print exceptions of one kind of care after another, one condition after
another. Employees are going to get the care they need.

Reform has freed people who want to start a business to do it without
worrying about what kind of shape it's going to leave them in and their
family members in.
I urge my colleagues to vote against this bill, which will put those
small businesses back into uncertain land.
Mr. GRAVES of Missouri. Madam Speaker, at this time, I yield 1 minute
to another member of the Small Business Committee, the gentlewoman from
Washington (Ms. Herrera Beutler).
Ms. HERRERA BEUTLER. Madam Speaker, I rise in support of this bill,
and I hope this is only a first step in the pursuit of making quality,
affordable health care available to all Americans.
This year we have the chance to correct mistakes made by both
parties. The ObamaCare bill passed by the other party last year was the
wrong approach. It increases the debt and the deficit for future
generations while doing nothing to decrease the inflationary curve of
health care. It was the wrong approach.
No party is perfect. The last time our party had the majority, while
there were many on our side of the aisle who worked diligently to
reform health care, the job was left undone. Getting this right is one
of the reasons the people of southwest Washington sent me to Congress.
Now, the good news is that solutions exist that can fix our health care
system and bring costs down for middle-income families. Today, we hit
``reset'' on health care reform.
I invite my Democratic colleagues to join me in advancing solutions
that help small businesses and middle-income families--solutions like
small business health plans, ending junk lawsuits that drive up the
cost of everyone's care, the expanded use of health savings accounts,
and the ability to purchase health care across State lines.
These are patient-centered solutions that won't grow government, but
are solutions that will make health care more affordable and more
accessible to all Americans. I sincerely hope we vote today to seize
this chance.
Ms. VELAZQUEZ. Madam Speaker, I would like to inquire as to how much
time remains on both sides.
The SPEAKER pro tempore. The gentlewoman from New York has 12\1/4\
minutes remaining. The gentleman from Missouri has 15 minutes
remaining.

[[Page H227]]

Ms. VELAZQUEZ. Madam Speaker, I reserve the balance of my time.
Mr. GRAVES of Missouri. Madam Speaker, I yield 1 minute to the
gentleman from Colorado (Mr. Tipton).
Mr. TIPTON. Madam Speaker, the question before us is: Will we accept
what is, or are we willing to commit to build what could be?
America has always been a land of self-determination. Our
constitutionally guaranteed rights as individuals, as a people, as a
Nation have made us flourish. Innovation, creativity, and freedom are
American hallmarks.
I rise in support of H.R. 2. It does not indite intent, but it does
address outcome. In fact, the deeper we dig into the health care act,
the more we discover that it is stopping job creation, building more
government, and placing tax burdens on American families who are
already struggling. We can and must do better.
Let us commit ourselves to addressing the basic concerns we hold in
common concerning health care--affordability and accessibility. Let us
strive to empower our people to make their own choices about the care
they receive, empower private sector solutions that will lower costs
and increase the quality of care, and eliminate governmental stumbling
blocks and not build bigger government.
Ms. VELAZQUEZ. Madam Speaker, I yield 2\1/2\ minutes to the
gentlewoman from California (Ms. Roybal-Allard).
Ms. ROYBAL-ALLARD. Madam Speaker, today, millions of Americans have
more freedom to choose and control their health care as a result of the
Affordable Care Act.
In my congressional district, nearly 40 percent of my constituents
were uninsured. Thousands more were underinsured and living on the
brink of financial disaster when facing a serious illness or accident.
With health care reform, positive change is taking place for them and
for individuals, families, and small businesses throughout the country.
Young adults are grateful they can remain on their parents' insurance
until age 26; seniors living in fear of not being able to afford their
medications are thankful for discounts on brand-name drugs when
reaching the doughnut hole; families with preexisting conditions are
comforted by the new high-risk insurance pool; and those facing serious
illness are relieved their insurers can no longer drop them when they
need coverage the most.
Small businesses, which abound in my district and which are a
mainstay in our Latino and minority communities, can take advantage of
tax credits to offer health insurance to their employees.
A 2009 study by MIT economist Jonathan Gruber found that, without
reform, over the next decade employers will pay trillions of dollars in
employee health costs; will potentially cut 170,000 small business
jobs; and will lose $51.2 billion in profits. That is why John
Arensmeyer, founder and CEO of the Small Business Majority, supports
health care reform.
Madam Speaker, H.R. 2 will hurt small business. It will repeal the
freedoms and protections Americans now have, and it will return control
of their health care to the insurance companies.
Mr. GRAVES of Missouri. Madam Speaker, I yield 1 minute to the
gentleman from Louisiana (Mr. Landry).
Mr. LANDRY. Madam Speaker, it is with great enthusiasm that I rise to
encourage my colleagues to stand with the American people--the
hardworking families and the small business owners across our country--
and vote for repealing the job-killing health care law.
In March, Members of Congress passed a massive government-run health
care law that will kill jobs, raise taxes, and increase the size of our
Federal Government.

{time} 1700

The bill called for tax increases on American families, wasteful
spending of taxpayer dollars, and new mandates on small businesses.
This is wrong. Voters made it clear in November that ``business as
usual'' must end.
I submitted the necessary paperwork to decline the health care plan
offered to Members of Congress. I rejected this benefit because
Washington must work just like the American people must work. We are
not above them. I hope my actions will energize the efforts to repeal
the government-run health care law.
I encourage my colleagues to vote ``yes'' on this bill and to promote
commonsense solutions of purchasing health insurance across State lines
and pooling small businesses together to leverage purchasing power.
Ms. VELAZQUEZ. Madam Speaker, I reserve the balance of my time.
Mr. GRAVES of Missouri. Madam Speaker, I yield 1 minute to the
gentleman from Illinois (Mr. Walsh).
Mr. WALSH of Illinois. Madam Speaker, I rise today in support of H.R.
2, Repealing the Job-Killing Health Care Act.
I commend the Republican leadership for simplifying this process by
drafting a two-page, stand-alone bill for repeal. It will be very
clear, Madam Speaker, to the American people where we stand on repeal.
During this past campaign, I, like a lot of candidates, spoke to
small businesses every single day. There is a reason why 90 percent of
small business men and women in this country support repeal. From the
billions in taxes, to the needless paperwork, to the burdensome
regulations, to the 1.6 million estimated job loss, small business men
and women are adamant that we need to repeal.
Finally, Madam Speaker, our opposition last year said that if you
like your plan, you can keep it. To date, there are 222 organizations,
including some of ObamaCare's biggest union supporters, who have
received waivers. Why? Why, Madam Speaker, if the law was so worthy,
would there be a need for waivers?
Ms. VELAZQUEZ. Madam Speaker, as a result of this repeal legislation,
small businesses in the State of Illinois will see a tax increase of
$1.7 billion.
Madam Speaker, I yield 2 minutes to the gentleman from Connecticut
(Mr. Murphy).
Mr. MURPHY of Connecticut. Madam Speaker, when I testified against
this repeal before the Rules Committee, I told a story about a family
in my district. The husband lost his job and, therefore, his insurance
because of a debilitating injury. This family faced a choice: They
either had to dip into their savings account, their high school son's
college fund, or they had to sell their house. They chose to first
spend down the college account so that they could keep a roof over
their head.
When I told that story, one Republican on the committee basically
said, Wait, I don't get it. They had money, they had a house, why
should somebody else pay for their health care if they had assets?
Well, that Member was right about one thing: She didn't get it. And
Republicans don't get it. Because in a nation as compassionate as this,
no family should be forced out on the street just because one of their
family members gets sick. There is a moral imperative behind making
sure that we live up to our duty to be our brother's keeper.
But it's more than that. There is a fiscal imperative here. What she
also didn't get was that once that family's savings is gone, once
they're out on the street, we all pick up the cost. Small businesses
pick up the cost. That's why small businesses are paying 18 percent
more than big businesses. That's why about $1,100 of every single
premium for a small business employee goes to cover the uninsured.
There are thousands of small businesses in Connecticut organized
under the auspices of a group called Small Businesses for Health Care
Reform that are crying out for this repeal to be defeated because they
see the $260 billion price tag attached to this bill that is going to
land on their head, as well as the continuation of discriminatory
practices that ask small businesses to pay for the uninsured like that
family that I talked about.
This bill isn't anything more than a political statement, but
families in my district, small businesses in my district need more than
politics. They need answers.
Mr. GRAVES of Missouri. Madam Speaker, I yield 1 minute to the
gentleman from Iowa (Mr. King).
Mr. KING of Iowa. I thank the chairman for yielding time.
I listened to this delivery ahead of me. I spent 28\1/2\ years in
business. I met payroll for over 1,400 consecutive weeks. I never saw a
regulation that

[[Page H228]]

made my job easier or allowed me to make more money. This is 2,400
pages of legislation. It's thousands more pages of regulation. It's
oppressive to small business. It should be called the ``Entrepreneurial
Extinction Act,'' not this health care plan.
This is ObamaCare. It must be pulled out completely by the roots. The
American people know this. That's why there are 87 freshman Republicans
on this side and nine freshman Democrats on this side. The American
people have spoken resoundingly. It is our obligation to go down this
path. It's not symbolic. It's very important. Because without this vote
on this floor, we can't move forward with the rest of the scenario to
eliminate ObamaCare.
The language in the bill is pretty simple, and it concludes with this
language, ``act is repealed, and the provisions of law amended or
repealed by such act are restored or revived as if such act had never
been enacted.''
Ms. VELAZQUEZ. Madam Speaker, I yield 2 minutes to the gentleman from
New Mexico (Mr. Lujan).
Mr. LUJAN. Madam Speaker, during these difficult economic times that
we're facing, it's critical that we make job creation a top priority.
That is why I'm concerned about the impact H.R. 2 will have on small
businesses.
The Republican plan will repeal a 35 percent tax credit for small
businesses that offer health insurance to their employees. It would
allow insurers to deny a business coverage if their employees had
preexisting conditions.
As a result of health insurance reform, New Mexicans no longer face
this discrimination. If this protection is repealed, having cancer or
diabetes or even being a victim of domestic violence could lead to a
denial of insurance. Discrimination for preexisting conditions will be
alive and well. All of that would be dangerous for New Mexicans.
People like Yvonne from Santa Fe would once again have to worry about
losing their health care. Yvonne lost her job when the company she
worked for was shipped overseas. Yvonne was diabetic, and because of
the high cost of COBRA, she was forced to ration her medicine. As a
result, she became gravely ill and had to visit the emergency room.
There, doctors noticed another problem that required further
examination. Yet because Yvonne could not afford COBRA and because
private insurance companies would not insure her because she had
diabetes, the hospital released her. The only option Yvonne had left
was to wait 2 months to be seen at the University of New Mexico
Hospital. After that visit, she was diagnosed with a form of lung
cancer that would have been caught earlier if she had not been kicked
out. Yvonne passed away from complications resulting from the cancer,
having resulted through a system that discriminated against her.
We simply cannot return to the days when people like Yvonne are
forced to suffer because of insurance companies' bad practices. Please,
let's not turn a blind eye on people like Yvonne.
Mr. GRAVES of Missouri. Madam Speaker, I yield 1 minute to the
gentlelady from North Carolina, a nurse and the new chairwoman of the
Subcommittee on Health Care and Technology, Mrs. Ellmers.
(Mrs. ELLMERS asked and was given permission to revise and extend her
remarks.)
Mrs. ELLMERS. Madam Speaker, when I ran for Congress, I vowed to
repeal ObamaCare, and with one of my first votes in the 112th Congress,
I will do so.
As a nurse for 20 years, co-owner of a wound care clinic, and in
practice with my husband in his general surgery practice, we know the
problems that exist for Americans in health care. Instead of being a
remedy to these problems, ObamaCare has already done more harm than
good to both the quality of health care in our country as well as our
economy. As a nurse, I look for pathways to solutions; this is a
problematic pathway undoubtably.
In the face of rising unemployment, unsustainable Federal deficits,
and overwhelming public opposition, it took more than a year to cobble
together an unpopular government takeover of health care so riddled
with provisions that violate right-to-life principles and support
government rationing of care that it cannot simply be patched.
ObamaCare is bad for workers. It's bad for employers and bad for
America.
The SPEAKER pro tempore. The time of the gentlewoman has expired.
Mr. GRAVES of Missouri. Madam Speaker, I yield the gentlelady 30
additional seconds.
Mrs. ELLMERS. Repealing it allows us to start with a clean slate and
look at market-based reforms that will actually lower health care
costs, increase accessibility, let Americans keep the plans they have
and like, and forestall impending drastic changes that have created
uncertainty in the lives of so many Americans and businesses.
To this Congress, I will work with my colleagues on both sides of the
aisle to repeal and replace the law's job-killing regulations and
State-bankrupting mandates. The bill to repeal the so-called
``Affordable Care Act'' is very simple, and my vote will be to overturn
this job-killing law.

{time} 1710

To this Congress, I will work with my colleagues on both sides of the
aisle to repeal and replace the law's job-killing regulations and State
bankrupt mandates.
Ms. VELAZQUEZ. Madam Speaker, I reserve the balance of my time.
Mr. GRAVES of Missouri. Madam Speaker, I yield 1 minute to the
gentlelady from New York (Ms. Hayworth).
Ms. HAYWORTH. I rise today in strong support of this legislation to
repeal the Affordable Care Act.
As a physician with 16 years of practice experience, I can assure you
that the Affordable Care Act will, paradoxically, deprive Americans of
care. It enshrines a third-party payment system that adds to costs;
then, in the name of controlling costs, transfers power from consumers
to the government to make crucial decisions that belong in the hands of
patients and their doctors. It neglects to deal effectively with
reforms in medical liability that are desperately needed to reduce the
unconscionable cost of defensive medicine.
Our vote to repeal is not merely symbolic. It represents the true
will of the American public, and it will pave the way to reform our
health care in a way that will allow our citizens to have the good,
cost-effective health care and affordable, portable health insurance
they need, while maintaining the quality, choice, and innovation that
represents the best of American medicine.
Ms. VELAZQUEZ. Madam Speaker, I continue to reserve the balance of my
time.
Mr. GRAVES of Missouri. Madam Speaker, I yield 1 minute to the
gentleman from Arizona (Mr. Gosar).
Mr. GOSAR. Madam Speaker, America is hurting, but the health care law
passed last year did not fix any problems. It will only make things
worse. Small businesses can barely make ends meet. And now the Federal
Government is imposing more mandates, more taxes, and more red tape?
Enough is enough.
As a health care provider, a small business owner, and a father, I
know that the way to provide health care to more individuals and create
more jobs is not through government bureaucracies, deficit spending,
and higher taxes. Rather, we need to empower businesses--big and
small--to band together to purchase health insurance. We need to open
markets with free competition. We also need to implement real health
care reform that will lower the cost of care and open up access.
Tort reform, red tape reform, preexisting conditions reform: these
are reforms that will work--reforms the current law fails to adequately
address or ignores altogether.
If we are serious about putting our Nation back to work, then we can
start by repealing this onerous health care law and work hand-in-hand
with the American people to implement true health care reform.
Ms. VELAZQUEZ. Madam Speaker, I continue to reserve the balance of my
time.
Mr. GRAVES of Missouri. Madam Speaker, I yield 1 minute to the
gentleman from Pennsylvania (Mr. Fitzpatrick).
Mr. FITZPATRICK. I rise today in support of the repeal and
replacement of the so-called Affordable Care Act of 2010 because the
Affordable Care Act is in fact unaffordable for small businesses and
individuals who purchase their health insurance.

[[Page H229]]

Since the implementation of the act, businesses and individuals
across my home county of Bucks County have seen double-digit premium
increases. The act is unaffordable for States, already billions in the
red, that will be required to shoulder untold millions more in Medicaid
costs. The act is unaffordable for America's seniors who will see a
half-trillion-dollar reduction in Medicare spending over the next 10
years. And, finally, the act is unaffordable for the American taxpayer
who will see a $700 billion increase in the Federal deficit.
We must enact real health care reform, tort reform for doctors to
stop the wasteful practice of defensive medicine, permitting
individuals real competition of purchase across State lines, and
enacting and enhancing health saving accounts.
These are the cornerstones of real health care reform and
affordability and will make health care affordable and accessible for
patients, for seniors, States, and for generations of taxpayers to
come.
Ms. VELAZQUEZ. Madam Speaker, I would like to inquire as to how much
time each side has remaining.
The SPEAKER pro tempore. The gentlewoman from New York has 6 minutes
remaining. The gentleman from Missouri has 6\1/2\ minutes remaining.
Ms. VELAZQUEZ. At this time, I yield 2 minutes to the gentlelady from
California (Ms. Richardson).
Ms. RICHARDSON. Madam Speaker, I rise today in strong opposition to
H.R. 2, the Patient Rights to Appeal of 2010, and I would urge my
colleagues, let's keep true to the tone of civility. This isn't
ObamaCare; it's actually called the Affordable Care Act.
So, Madam Speaker, at a time when Americans finally have a chance to
see a regular doctor, to prevent sitting in hospital rooms in emergency
waiting for desperate care, we finally have a chance.
What does this mean to small businesses? In California and in my own
hometown, 15,100 small businesses have seen a 50 percent tax credit to
provide health care for the first time for their employees. Over 16,000
additional small businesses will now be eligible for health care
exchanges that will make insurance affordable. In my district, these
are real people, like Betty Claire in my district.
Now you're talking about considering something that would prevent
Medicare for 63,000 beneficiaries, extending coverage to 88,000
residents in my district. That's what we're talking about, and also
when you look at guaranteeing 17,000 residents who previously had
preexisting conditions.
My colleagues, I will vote ``no'' on H.R. 2. And I also urge my
colleagues to consider not reversing. It's not time to go back. It's
time to step forward.
Mr. GRAVES of Missouri. Madam Speaker, I yield 1 minute to the
gentleman from Ohio (Mr. Stivers).
Mr. STIVERS. I would like to thank the gentleman from Missouri for
yielding time.
I rise in support of the health care repeal bill because doing
otherwise would be supporting the job-killing status quo, and that's
unacceptable. Whether we start over or we work to fix the current law,
we must act.
Moving forward, I'm committed to working with my colleagues in a
bipartisan manner to support reforms that we agree on, such as helping
people with preexisting conditions get access and allowing young adults
to stay on their parents' plan.
But I'm equally committed to eliminating the job-killing portions of
the current law, such as the burdensome mandate and the 1099
requirement in the legislation.
A small business owner from my district, Cathy, called us the other
day and wanted to talk to me about the burdens of the 1099 provision.
She called it a nightmare. It will increase her burden by 12 times.
The bottom line is we need to work to lower health care costs for
families and allow a more patient-centered approach while not placing
unnecessary burdens on the backs of small business and job creators.
Ms. VELAZQUEZ. I continue to reserve the balance of my time.
Mr. GRAVES of Missouri. Madam Speaker, I yield 1 minute to the
gentleman from Arkansas (Mr. Womack).
Mr. WOMACK. I thank the gentleman from Missouri for the time.
Throughout this debate there's been a lot of talk about jobs. And
there should be. There is little doubt that this law impacts American
workers. Take, for example, Baldor Electric in Fort Smith, Arkansas.
Madam Speaker, this is a company that has 6,000 employees across
America, and the impact of the health care law in the first year alone
is $2.9 million. How does a company like Baldor absorb that cost? By
further automating its processes and through attrition, allowing 50
jobs to disappear.
Eliminating 50 jobs in the first year of this law for a company like
Baldor--not to mention thousands of companies across America similarly
situated--is not my idea of restoring economic prosperity for America.
I urge my colleagues to support H.R. 2 and begin the process of
crafting a meaningful, affordable, and workable solution. That's the
way forward.
Ms. VELAZQUEZ. Madam Speaker, I yield 1\1/2\ minutes to the gentleman
from New York (Mr. Weiner).
Mr. WEINER. I'm curious. Any of the Members who have spoken about the
impact on small business, are any of them in favor of the tax incentive
that is provided on small businesses to provide health care? Of course
they are.
Now, they might not know it's in the bill because to listen to the
rhetoric--and a lot of them can be forgiven; they just came off the
campaign trail. They were used to saying glib things like ``government
takeover,'' ``job killing.'' But I would urge you to read the bill.
Small businesses get a 30 to 50 percent tax incentive to provide health
care for their workers. Small businesses do.

{time} 1720

And do you know what requirements they have to go along with that?
None. No gaudy regulation, no government takeover. And just a word on
this whole government takeover thing. I mean I love you guys, and I
know you are caught up in the rhetoric of the campaign, this is tax
breaks that are going to go to citizens to buy, wait for it, private
insurance policies. Where is the government takeover in that?
Now, some of us believe that Medicare, which of course you refer to
as a government takeover of health care, and I am sure you are opposed
to that as well, some of us believe that, frankly, the insurance
companies aren't providing a lot of value-added here. But they are the
beneficiaries of this plan.
Small businesses today, if the Republicans are successful, will lose
that tax incentive. Think that will create a lot of jobs, guys? It's
not going to. And you think small businesses benefit when they don't
provide health insurance and then people go to hospital emergency rooms
to get their care? Who do you think pays that bill? The bill fairy?
Your taxpayers. Your taxpayers in your States.
Now, what's your solution? Well, they don't have a solution. We know
what they are against. They are against health reform. We don't know
what they are for. Welcome to the Republican majority.

Announcement by the Speaker Pro Tempore

The SPEAKER pro tempore. Members are reminded to address their
remarks to the Chair.
Mr. GRAVES of Missouri. Madam Speaker, I yield 2 minutes to the
gentleman from New York (Mr. Gibson).
(Mr. GIBSON asked and was given permission to revise and extend his
remarks.)
Mr. GIBSON. I thank the gentleman from Missouri for yielding.
I rise today to express the sentiments of my district in upstate New
York. With health care costs continuing to rise at several times the
rate of inflation year after year, clearly we need reform. Health care
costs were 4.7 percent of the GDP in 1960. They are over 17 percent
today. We must drive down costs. But the bill passed last year is not
the answer. We're going to end up with higher costs, higher premiums,
higher taxes, and more burdensome regulation, and more big government
at a time we should be consolidating.
We need to start over again and arrive at a patient-centered bill,
not the government-centered plan we got last year. I believe we can
find solutions that drive down costs and expand access without hurting
small businesses and without stepping on our freedoms.
This bill passed last year dramatically expands the government's
involvement in the delivery of health care, which is already
significantly increasing premiums in my district and

[[Page H230]]

stifling job creation. I believe that both sides of the aisle believe
that we should be focusing on job creation. This is not the way
forward. Indeed, the new taxes and regulations will hurt our small
businesses, including the medical device industry, a sector of the
economy where our region leads the Nation.
Ultimately, the new law, if not repealed, will hurt families across
my district and across America. Moreover, the changes to the Medicaid
program will put additional burdens on States already facing very
difficult challenges.
I plan to vote for repeal. And then later this week, I plan to vote
for House Resolution 9, so that we can instruct committees to report a
replacement bill that includes insurance reform for wider access to
options and choices, and medical liability reform to rein in defensive
medicine practices. I think we should engage in a civil, bipartisan
discussion with our colleagues across the aisle. Our replacement bill
should include coverage for preexisting conditions and ensure that
coverage can't be dropped when you are sick.
Ultimately, I believe the fate of this repeal effort will hinge on
the content and quality of the replacement bill. If we bring forward in
this House a new plan that drives down costs, increases access, while
protecting choices and the patient-doctor relationship, I believe the
American people, evaluating the two respective plans side by side, will
pressure the Senate and the President to repeal and replace, because we
need reform, but the bill last year is not the answer. It's time to
start over.
Ms. VELAZQUEZ. Madam Speaker, may I inquire of the time remaining?
The SPEAKER pro tempore. The gentlewoman from New York has 3 minutes
remaining. The gentleman from Missouri has 2\1/2\ minutes remaining.
Ms. VELAZQUEZ. I would like to inquire through the Chair how many
speakers the gentleman has remaining.
Mr. GRAVES of Missouri. I don't have any more speakers, and I am
prepared to close.
Ms. VELAZQUEZ. I yield 2 minutes to the gentleman from California
(Mr. Garamendi).
Mr. GARAMENDI. Madam Speaker, this is the most remarkable of all
Chambers where discussions take place, because in this Chamber if you
say something that is not true, often enough somebody will believe that
it's actually true. What I have heard today on the floor I am just
going, well, that's a marvelous thing, when in fact our colleagues on
the Republican side want to enact reforms that are already in place.
Already in place is the Patients' Bill of Rights. No rescisions. No
preexisting conditions. Children being able to stay, or young adults
being able to stay on their parents' policies until the age of 26. They
say they want it--it's already the law of America. Wow. What are we
going to repeal? You are going to repeal that?
You want small businesses to be well taken care of? Well, so do we.
That's why, if you employ less than 50 people as a small business you
don't have any requirements at all. But if you want to provide health
insurance to your employees, wow, the government's going to give you a
subsidy, 35 percent now, building to 50 percent in the years ahead.
What's wrong with that? Where's the harm to small business? What in the
world are our colleagues talking about here? I don't get it. It's in
the law already.
Everything I have heard here in the last half hour is the law of
America. So why are you repealing it? So you can have the insurance
companies get another shot at taking over the care of patients, which
is exactly what they do, and exactly what I know because I was the
insurance commissioner for 8 years in California, and I know what the
insurance companies do. They are the ones that make the decisions. We
don't want that to happen. That's why the Patients' Bill of Rights is
the law in America today. The Patients' Bill of Rights would be
repealed by this H.R. 2. Not good for Americans. Not good. Some 30
million people would lose their opportunity for insurance.
Ms. VELAZQUEZ. Madam Speaker, what will small businesses lose if
health care reform is repealed? The small business tax credit of up to
50 percent will be lost. Insurers will be able to continue price
gouging. Insurers will be able to deny small businesses coverage
without any justification. New health insurance options for small
businesses will be eliminated. Small businesses will be unable to pool
resources to purchase coverage. Insurers will be able to delay small
businesses' access to health insurance. New health options for the
self-employed will be abolished.
I urge a ``no'' vote. And I hope that we spend the remainder of this
Congress on measures that truly get small businesses hiring and
creating jobs. What we need is to get this economy back on track. By
repealing health care reform, we will not achieve that.
I yield back the balance of my time.
Mr. GRAVES of Missouri. Madam Speaker, some of my colleagues on the
other side of the aisle continue to claim that the health care law is
actually going to benefit small businesses despite the mountain of
facts that are out there. Specifically, and what was argued earlier, is
that the health care tax credit's going to make it easier for employers
to offset the costs that are being required to provide health
insurance. Unfortunately, this is far from the truth. Any potential
assistance from this tax credit is far outweighed by the tax increases
and paperwork burdens that this law is going to pile on small
businesses.
Madam Speaker, the American people spoke loudly in November. And we
need to make sure that we move away from the health care law that
penalizes our Nation's entrepreneurs and place a renewed focus on
enacting targeted, commonsense reforms that increase access and lowers
costs.
Madam Speaker, with that I would urge my colleagues to vote for H.R.
2, and let's get back on track.
Ms. WATERS. Madam Speaker, I'm proud to join my Democratic colleagues
on the floor this afternoon to state our unequivocal stance against
health care reform repeal.
The landmark health reform law takes a stand against the health care
disparities that exist for low-income Americans, people of color, and
people with pre-existing conditions.
Twenty percent of African-Americans were uninsured in the United
States, and 32 percent of the Hispanic population was uninsured.
Though African-American women are 10 percent less likely to get
breast cancer than white women, we are 34 percent more likely to die
from it. And Hispanic women are twice as likely to die from cervical
cancer as White women.
Both African-American and Mexican-American men are 30 percent more
likely to die from heart disease than White Americans.
Hispanic men were one-and-a-half times as likely to die from diabetes
as White Americans, and African-Americans were 2.2 times as likely to
die from diabetes as compared to White Americans.
Finally, though they comprise 15 percent of the U.S. population,
Hispanics make up 17 percent of new HIV infections. And more
shockingly, though we make up only 12 percent of the U.S. population,
African Americans are 45 percent of new HIV infections.
Many Americans are suffering from a lack of access to health care
because health insurance is simply unaffordable. This problem has
existed for far too long in the most prosperous nation in the world.
Meaningful health care must be available for all Americans regardless
of race, level of income, gender, or the existence of a pre-existing
condition. That's why the health care reform law specifically addresses
these disparities and other pre-existing conditions and makes it
illegal to be denied health care insurance because of them.
So I implore my Republican colleagues to work with us to strengthen
the law, make it better, and provide health care and jobs to millions
of Americans.
Mr. GRAVES of Missouri. I yield back the balance of my time.
The SPEAKER pro tempore. Pursuant to clause 1(c) of rule XIX, further
consideration of this bill is postponed.

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