[Congressional Record Volume 158, Number 16 (Wednesday, February 1, 2012)]
[House]
[Pages H322-H354]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
FISCAL RESPONSIBILITY AND RETIREMENT SECURITY ACT OF 2011
Mr. GINGREY of Georgia. Madam Speaker, I ask unanimous consent that
all Members may have 5 legislative days in which to revise and extend
their remarks on H.R. 1173 and insert any extraneous material on the
bill.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Georgia?
There was no objection.
The SPEAKER pro tempore (Mr. Boustany). Pursuant to House Resolution
522 and rule XVIII, the Chair declares the House in the Committee of
the Whole House on the state of the Union for the consideration of the
bill, H.R. 1173.
{time} 1425
In the Committee of the Whole
Accordingly, the House resolved itself into the Committee of the
Whole House on the state of the Union for the consideration of the bill
(H.R. 1173) to repeal the CLASS program, with Mrs. Miller of Michigan
in the chair.
The Clerk read the title of the bill.
The CHAIR. Pursuant to the rule, the bill is considered read the
first time.
General debate shall be confined to the bill and shall not exceed 1
hour, with 40 minutes equally divided and controlled by the chair and
ranking minority member of the Committee on Energy and Commerce, and 20
minutes equally divided and controlled by the chair and ranking
minority member of the Committee on Ways and Means.
The gentleman from Georgia (Mr. Gingrey) and the gentleman from New
Jersey (Mr. Pallone) each will control 20 minutes. The gentleman from
Louisiana (Mr. Boustany) and the gentleman from California (Mr. Stark)
each will control 10 minutes.
The Chair recognizes the gentleman from Georgia.
Mr. GINGREY of Georgia. Madam Chair, I yield myself such time as I
may consume.
Madam Chair, it has been more than 2 years since the CLASS Act was
first debated as part of the President's health care takeover debate.
We knew then that the program was flawed and unworkable; yet the
Democratic-controlled Congress ignored these concerns and instead
rushed the CLASS program through as part of the President's health care
law.
Now, 2 years and more than $800 billion later, we have finally heard
from the President and his administration that while they have wasted
taxpayer dollars, this program is in fact not implementable. Surprised?
Well, you shouldn't be.
The truth is that unbiased analysts such as the American Academy of
Actuaries had raised concerns with the program as early as July of
2009, some 5 months before the President's plan was even considered on
the Senate floor. Members from both sides of the aisle also raised
concerns about the program's long-term sustainability during this
debate. Most disturbing is what we came to find in a bicameral
investigation last year that revealed concerns from within HHS were
rampant during PPACA debate, but they were never brought to light by
the Democratic leadership or the Obama administration. Yet the program
was rushed through so that we can, as then-Speaker Pelosi noted, ``find
out what's in it.''
On October 14, 2011, Secretary Sebelius announced what honest
accounting told us was inevitable: the Obama administration finally
admitted there was no viable path forward and, therefore, was halting
any further efforts of implementing the CLASS program.
The failure of Health and Human Services to implement the CLASS
program certainly is not a surprise. However, it is a catastrophic
consequence of what happens when Congress rushes to enact costly
policies and dismisses warnings from independent experts. Most
troubling are the budget gimmicks used to sell the CLASS program and,
indeed, the entire law.
The Congressional Budget Office, CBO, estimated the CLASS program
would save money by collecting premiums from enrollees, premiums that
will now never be collected in light of a failed implementation.
We knew, Madam Chair, the savings estimates for the President's
health care plan were wrong. It defied common sense that such a massive
spending expansion would have no cost. Now the President will have to
explain to the American people why the health care law--ObamaCare,
PPACA, Patient Protection, Affordable Care Act, Unaffordable Care Act--
he'll now have to explain to the American people why this health care
law will cost them $80-plus billion more than what they were told.
{time} 1430
That is more than $80 billion on top of the trillions the President
has added to the books since he took office in January of 2009.
Today, we will have the opportunity to start over on long-term care
reform, an issue that's important to all of us as we hear from
constituents regularly about the growing cost of long-term care
services. The market has not even been penetrated 10 percent, Madam
Chair. We will now begin that process. But first, we must take this
section out of the health care bill known as CLASS. We must take it off
the books.
I urge my colleagues to support just what this bill does, remove
CLASS from the statute, H.R. 1173, repeal the failed CLASS program so
that we can now move forward with reforms that do work.
With that, Madam Chairman, I reserve the balance of my time.
[[Page H323]]
Mr. PALLONE. Madam Chair, I yield myself such time as I may consume.
Madam Chair, there are millions of Americans currently in need of a
long-term care program and many more that will require these services
in the future. Despite the great achievements of our country, the U.S.
lacks an affordable and ethical system of financing long-term care
services. The CLASS program is a significant step towards finding a
realistic solution to this problem. However, many of my Republican
colleagues have taken a stance against CLASS without proposing any real
solutions for long-term care access in America, and I strongly oppose
H.R. 1173 and consider it to be a blatant disregard of a growing crisis
in this country.
Madam Chair, Republicans continue to propose repeal of various
aspects of the Affordable Care Act. We heard my colleague from Georgia
today. And how many other times how many on the other side have said,
well, let's just repeal the Affordable Care Act, let's repeal pieces of
the Affordable Care Act? But they never come up with any meaningful
alternatives. And the same is true today. They're talking about
outright repeal of CLASS without any meaningful suggestion of an
alternative.
My message to my colleagues on the other side of the aisle is that we
should mend the CLASS Act and not end it. This country is already
facing a long-term care crisis, but the problem is only going to get
worse. As our population continues to age, an estimated 15 million
people are expected to need some sort of long-term care support by
2020. If we don't solve the need for affordable long-term care in this
country soon, we will also jeopardize our entitlement programs.
Currently, Medicaid pays 50 percent of the cost of long-term services,
and that price tag is quickly rising every year. The CLASS program was
designed to allow people to stay at home and prevent the cost of
nursing home care that burdened Medicaid.
Now, I want to correct one thing. I know in the Rules Committee some
of my colleagues talk about the administration's position on this bill.
The administration made it quite clear in a hearing that we had on this
bill that they're opposed to repeal of the CLASS Act. They acknowledge
that there are workable solutions under the CLASS program, but didn't
feel that they have the legal authority--I stress legal authority--to
implement them. So the Department of Health and Human Services has more
work to do, and I have suggested on numerous occasions that the CLASS
Advisory Council, which is organized under the legislation, be convened
in order to offer their expertise.
The CLASS program is a framework that will facilitate a solution to
our long-term care crisis. However, all I continue to hear from my
colleagues on the other side of the aisle is that Congress can't do
anything. It's this negative attitude, the idea that Congress can't
address any problem. And I just sincerely hope that my colleagues, when
they come to the table, come up with a workable solution. Don't just
tell me we have to repeal things, we can't do anything, and the
government can't do anything. Cowardly running away from the problem
through repeal is simply not the answer.
Overall, the CLASS Act promotes personal responsibility and
independence. Those are the values that you talk about a lot. It allows
the government to put choice in the hands of consumers while saving
Medicaid dollars. American families have too few long-term care
options, and they need our help. Rather than repeal CLASS, we need to
continue the dialog in the development of a viable plan forward.
Again, let's mend it, not end it. Moving forward with H.R. 1173 shuts
the door on a problem that simply cannot be ignored.
I reserve the balance of my time.
Mr. PITTS. Madam Chair, I yield 1 minute to the gentleman from New
Jersey (Mr. Lance), a very valued member of the Subcommittee on Health.
Mr. LANCE. Madam Chair, I rise today in support of repealing the
CLASS Act.
In hearings before the Energy and Commerce Committee, my colleagues
and I learned that the CLASS program was a ticking time bomb fiscally,
a new entitlement program that Health and Human Services Secretary
Kathleen Sebelius has said is ``totally unsustainable'' financially.
Richard Foster, chief actuary of the Centers for Medicare and Medicaid
Services, wrote in 2009: ``Thirty-six years of actuarial experience
lead me to believe that this program would collapse in short order and
require significant Federal subsidies to continue.'' And Senate Budget
Committee Chairman Kent Conrad has called the CLASS program ``a Ponzi
scheme of the first order.'' To her credit, Secretary Sebelius in
October called for an end of the CLASS program, adding that there was
not ``a viable path forward for CLASS implementation at this time.''
Madam Chair, we have a serious long-term care problem that is driving
patients into bankruptcy and weighing down an overburdened Medicaid
program. But before we can develop bipartisan solutions to address this
important issue, we must first repeal the misguided CLASS program. Only
then can we begin anew and properly address the long-term health care
problem.
Mr. PALLONE. Madam Chair, I yield such time as he may consume to the
ranking member of the full committee, Mr. Waxman.
Mr. WAXMAN. Thank you for yielding that time to me, Mr. Pallone.
Madam Chair, I rise today in strong opposition to H.R. 1173. This
bill is another Republican attempt to tear down and dismantle programs
that provide health care in the United States. Now we have Medicare,
and the Republican alternative to Medicare is to just shift more costs
on to seniors, give them a voucher and let them pay more if they want
more than that voucher will provide, and that voucher is not going to
provide much over time.
On Medicaid, they just want to shift the costs on to the States so
the States can tell a lot of very poor people, I'm sorry, we don't have
enough money to take care of you, but we're not required to under
Federal law. They said that they didn't want the Affordable Care Act;
they wanted to repeal it. But they haven't told us what they want to
put in its place. They said that this was going to be repeal and
replace. They have proposed a repeal, but we have no proposal to
replace it.
Republicans now want to take a part of the Affordable Care Act, the
CLASS program, that is the one and only significant new initiative to
put in place to deal with our country's long-term care crisis. Those
who are supporting this bill say that the CLASS Act is not the right
solution to our long-term care problem. Well, I don't think it's
perfect, either. But the solution is to amend the program, to make it
work, not just repeal it and leave nothing in its place.
If we leave nothing in its place, we have the status quo. And what
does the status quo mean? The status quo means that for some who are on
Medicare, they will have a minimal amount of coverage for their long-
term care services. And to get any other help, people will have to go
through the indignity of impoverishing themselves. A system that is in
place for the very poor would be called upon then, the Medicaid system,
to cover their long-term care needs, especially if they had to go to a
nursing home. Well, many elderly and disabled individuals will be
forced to leave their families and community of friends for
institutionalization because that's all that some States will cover.
Families will have to do what they call ``spend down.'' They have to
spend their money until they're in poverty. So they lose their dignity
along the way in order to qualify for Medicaid assistance. The CLASS
Act was trying to take some of the burden off Medicaid, some of the
indignity away from seniors. Medicaid expenditures for the most part
are paying for long-term care, and that will escalate even further. In
2010 alone, Medicaid spending for these services cost some $120
billion.
{time} 1440
And we have a baby boomer population that is continuing to age. The
number of Americans in need of long-term care assistance will grow,
compounding each of these problems.
So what is the Republican answer to this problem? Nothing. Just
repeal the program that attempts to give some effort to deal with these
costs for people who need long-term care.
[[Page H324]]
Let's not lose this incremental piece. Let's figure out how to add on
to it, how to change it, but don't repeal it.
I urge my colleagues to reject H.R. 1173.
Mr. PITTS. Madam Chair, I just want to remind everyone that under the
CLASS Act there's not one person in the United States who would receive
long-term care benefits under that act because it doesn't work.
At this time I yield 2 minutes to the gentleman from West Virginia
(Mr. McKinley).
Mr. McKINLEY. Madam Chair, I rise today in favor of H.R. 1173. This
bill would save hardworking taxpayer dollars and eliminate a costly and
flawed ObamaCare provision known as the CLASS Act.
This program was sold as a self-sustaining program, one that would
reduce Federal spending. However, the program was problematic from the
start. The President and the Democrat leadership in the Congress knew
this fact over 2\1/2\ years ago and still included the CLASS program in
the health care bill.
During an investigation, it was revealed that Obama administration
officials and Senate Democrats were very much aware that this was not
going to work and that Department officials warned for a year before
passage that the CLASS program would be a fiscal disaster. As far back
as May of 2009, the CMS Chief Actuary sent an email that warned
officials that the program doesn't look workable. These 200 pages of
exhibits from the investigation show that Department officials were
voicing concern to Senate leadership all the way up until passage in
December of 2009. This was all concealed from Congress and the American
public.
After enactment, the concerns continued. On February of 2011,
Secretary Sebelius testified before the Senate Finance Committee that
the CLASS program is totally unsustainable in its present form. And
finally, this past October, the Department announced that the program
was still not financially feasible. What we are seeing now is that, as
well intended as it is, the CLASS program is unworkable.
The objective of providing long-term health care is laudable and
should be a priority of Congress. Therefore, we must identify a long-
term, commonsense solution for our health care. That is why last week I
asked GAO to conduct a study of the Medicaid Long-Term Care Partnership
Program and survey States on how to improve the partnership program so
that more Americans can properly plan for their long-term care needs.
This public-private partnership between States and long-term care
insurance plans was designed to reduce Medicaid expenditures by
lessening the need for some people to rely on Medicaid to pay for long-
term health care services.
The partnership program is not the only solution to our long-term
health care, but it is a helpful tool to help Americans plan for their
health care long-term needs, unlike the unsustainable and costly CLASS
Act embedded in ObamaCare.
The repeal of the CLASS Act marks a small victory. Let's not try to
force this costly program on the backs of hardworking American
taxpayers without fully investigating how we can improve existing
programs or how we can create an affordable, sustainable, long-term
care program.
I urge my colleagues to vote ``yes'' on H.R. 1173.
Mr. PALLONE. Madam Chair, I yield 2 minutes to the champion for
senior citizens, the gentlewoman from Illinois (Ms. Schakowsky).
Ms. SCHAKOWSKY. I thank the gentleman.
You know, there's a lot of areas of agreement. We all agree that
we're in the midst of a long-term care crisis. We agree that today
there are 10 million Americans in need of long-term care services and
support. By 2020, that number will grow to 15 million, and by 2050, the
number of seniors who need long-term care will reach 26 million.
The costs associated with long-term care are high. We agree on that.
Nursing homes can cost over $70,000 a year, and 20 hours a week of home
care can cost nearly $20,000. But repealing the CLASS Act does nothing
to address the glaring need for adequate coverage of long-term care
services and support. The CLASS Act addressed a number of critical
needs, including providing a way for persons with disabilities to
remain independent in their community and bringing private dollars into
the long-term services system to reduce reliance on Medicaid without
impoverishing individuals and families. We agree that the CLASS Act is
far from perfect, but it does provide a framework to begin to deal with
the problem.
So it seems to me if we all agree on the need, not only the need for
long-term care but the need to do better, then instead of repealing the
CLASS Act and passing H.R. 1173 with no effective alternative, we
could, right now today, sit down and work together to repair this
program. Ignoring it or even postponing this long-term care crisis
simply is not going to make it go away.
Mr. PITTS. Madam Chair, I yield myself such time as I may consume.
Madam Chair, I'd like to speak to H.R. 1173, the Fiscal
Responsibility and Retirement Security Act of 2011, which repeals the
CLASS program which was rushed into law in the President's health
reform bill.
Last February, HHS Secretary Kathleen Sebelius publicly admitted that
the more than $80 billion CLASS Act was ``totally unsustainable.'' But
it was not until 8 months later, on October 14, that the Department of
Health and Human Services announced it was not moving forward with the
implementation of the CLASS program ``at this time.''
On October 26, 2011, Assistant Secretary Kathy Greenlee testified
before our subcommittee that the Department had spent $5 million in
2010 and 2011 trying to implement the program. The Secretary's
conclusion that the CLASS program could not meet the law's 75-year
solvency requirement and was not sustainable was not a surprise to
anyone who had been following the issue. Even before its inclusion in
the President's health care law, PPACA, in March of 2010, we were
warned by the administration's own actuary, the American Academy of
Actuaries; Members of Congress from both parties; and outside experts
that the program would not be fiscally sustainable. On July 9, 2009,
approximately 8 months before PPACA was signed into law, CMS's own
actuary, Richard Foster, wrote ``36 years of actuarial experience lead
me to believe that this program would collapse in short order and
require significant Federal subsidies to continue.''
I support the intent behind the CLASS program to help Americans
purchase long-term care policies that most of us will end up needing at
some point, but only about 9 million Americans actually purchase. Long-
term care costs are frighteningly high, and many Americans face
bankruptcy or ending up on Medicaid, or both, in order to get the care
they need.
But while the goals of the program were worthy, good intentions do
not make up for fundamentally flawed, actuarially unsound policies
designed to show the illusion of savings. The President has left us
with a budget hole of more than $80 billion. The irresponsible nature
of the CLASS program's inclusion in the health care law is just a
sample of the budget gimmicks used to pass the health care law in the
dark of the night nearly 2 years ago. The President will have to
explain why, years later, the taxpayers are left with a failed program
that will cost this Nation at least $80 billion. That is more than 150
Solyndra scandals.
{time} 1600
Shelving this failed program is not enough. As long as it is on the
books, it will continue to create substantial uncertainty in the
private sector about what the government's role in long-term care
insurance will be. Let's repeal the CLASS program, not try to tinker
around the edges of a fundamentally flawed model, and take up real
solutions to this problem instead.
I urge my colleagues to support H.R. 1173, to repeal the failed CLASS
program so that we can move forward with reforms that work.
And with that, I reserve the balance of my time.
Mr. PALLONE. I yield, Madam Chair, 2 minutes to the gentlewoman from
California (Mrs. Capps).
Mrs. CAPPS. I thank my colleague from New Jersey for yielding.
Madam Chair, I rise today in opposition to this bill. We all know
that we have a long-term care crisis in this
[[Page H325]]
country. What we have now is an unsustainable patchwork approach, with
wealthy people having access to private plans, while almost everyone
else finds the costs incredibly prohibitive.
These are the folks who fall through the cracks every day, spending
down all their assets until there's nothing left, and then relying on
our strained Medicaid program for care. This is what the CLASS program
tries to avoid. It should provide a modest, but meaningful, benefit to
individuals who need support to stay out of costly nursing homes,
benefits they've already paid into.
We can all agree that the CLASS program, as currently written in the
statute, is not perfect, but few things are. We can use it as a
framework upon which to fix and implement this program, one that would
be amended, improved and made sustainable, rather than destroyed.
Repealing the CLASS Act does not remove the Nation's need for long-
term care. Rather, it makes the path to sustainable solutions much more
difficult. Moreover, in the majority's rush to repeal, they have
overlooked a vital component that will also be affected by this bill,
the National Clearinghouse for Long Term Care.
The clearinghouse, which was established with close-to-unanimous
Republican support, is the only dedicated place for individuals to
learn about their long-term care options. However, a vote for this bill
is a vote to strip funding from this vital public resource. In fact,
the original bill abolished the program altogether until I fought to
save it in our committee.
And while the authorization has been saved, we all know that a
program without any funding is not much of a program. So the result is
yet one more obstacle for American families trying to care for their
loved ones. These are the people who will lose out, and definitely lose
out by this repeal.
So I strongly urge my colleagues to vote against this bill.
Mr. PITTS. Madam Chair, I yield 1 minute to the gentleman from
Illinois (Mr. Lipinski).
Mr. LIPINSKI. I rise today in support of fiscal responsibility and in
support of H.R. 1173. The CLASS program was created with a good
intention, relieving the crushing burden of long-term care. But we have
known from the beginning that this program would not be able to sustain
itself without a massive bailout from taxpayers. The CBO said so.
Medicare's Chief Actuary said so; and, more recently, Secretary
Sebelius concluded the CLASS Act was totally unsustainable and decided
not to implement it; and for this, I give her credit.
But the program is still in law. And given the trillion-dollar
deficits that we face, the only option right now is to make sure that
the taxpayers are not left with an unsustainable program in a big bill.
This debate should not be about the health care law in general. It
should be about this program. It should be about doing what is fiscally
responsible, and that is eliminating the CLASS program and getting to
work right now in a bipartisan manner on a solution to long-term care.
Mr. PALLONE. Madam Chair, can I inquire how much time remains on each
side.
The Acting CHAIR (Mrs. Emerson). The gentleman from New Jersey has 9
minutes remaining. The gentleman from Pennsylvania has 7\1/2\ minutes
remaining.
Mr. PALLONE. Madam Chair, at this time I yield 1\1/2\ minutes to the
gentleman from Illinois (Mr. Davis).
Mr. DAVIS of Illinois. I thank the gentleman from New Jersey for
yielding.
H.R. 1173 would eliminate the potential for many of our citizens to
be able to afford long-term care that provides services and other
supports. This effort to remove support services is not the solution,
but instead a faulty and irresponsible policy initiative which would
burden people in our health systems. Regardless of when individuals may
need these services, there is a lack of financing options to help them
pay for the services they need to maintain their health, independence,
and dignity when they lose the capacity to perform basic daily
activities without assistance.
Medicare does provide limited pay for long-term care services.
Medicaid does cover, but pays only for services for people with very
limited means. Many private long-term care insurance plans are costly
and difficult to acquire. I say that the real answer is to retain
services that we are currently poised to provide.
I oppose H.R. 1173.
Mr. PITTS. Madam Chair, I yield 1 minute to the gentleman from
Kentucky (Mr. Guthrie).
Mr. GUTHRIE. I thank the gentleman for yielding.
I rise today in support of H.R. 1173, to repeal the CLASS Act
established in the Patient Protection Affordable Care Act.
The CLASS Act was unsustainable and unworkable from the time it was
enacted. Even at the time the health care bill was passed, it was
evident that the health care program was completely unworkable. The
CLASS Act is such an egregious budget gimmick that even Health and
Human Services Secretary Kathleen Sebelius has admitted the program is
unsustainable.
Repeal of the CLASS Act isn't as scary as those on the other side
would have you think it would be. In fact, the Obama administration has
already acknowledged the program is unworkable in its current form and
has halted efforts to establish the program. However, the CLASS Act
remains on the books.
I strongly support ensuring Americans have access to long-term care.
In order to move forward with a new plan, we need to get the CLASS Act
off the books.
I urge my colleagues to support this bill.
Mr. PALLONE. Madam Chair, I yield 1\1/2\ minutes to the gentlewoman
from Connecticut (Ms. DeLauro).
Ms. DeLAURO. I rise in strong opposition to the repeal of the CLASS
Act.
We are at another start of another session of the Congress, and this
majority is following the same playbook as last year. The American
people are waiting for this institution to do something--anything--to
create jobs and restore our economic prosperity instead of putting
forward ideological bills that have nothing to do with jobs and that
are intended to roll back health care and senior care in America. Right
now, less than 10 percent of Americans over 50 have long-term health
care insurance, even though a large percentage of individuals will need
long-term care services at some point.
Some studies indicate that up to two-thirds of Americans that live
beyond 65 will need long-term care. The CLASS Act, a bipartisan
addition to the 2010 health reform, seeks to help provide access to
quality, affordable insurance for long-term care. The program must be
actuarially sound and legally solid.
Why would we repeal this bill? It is time for the majority to stop
playing games and to get serious about fixing the economy. America
needs more jobs, not less health care.
I urge my colleagues to stand up for seniors and oppose this repeal.
Mr. PITTS. I reserve the balance of my time.
Mr. PALLONE. Madam Chair, I yield 2 minutes to the gentleman from
Texas (Mr. Doggett).
Mr. DOGGETT. Is it just too much to ask that seniors that are
struggling in a nursing home after a lifetime of work get a little
economic security, that they get a little dignity? Is it too much to
bring just a little peace of mind to a family that is burdened with a
parent that is suffering from Alzheimer's or some other debilitating
condition? Sadly, this does appear to be too much to ask from some
here.
One year ago, the House Republican majority's first major action,
once they gained control of Congress, was to repeal health insurance
reform. At the time they did that, they said they were for ``repeal and
replace.'' But the only replacement they offered for their repeal was a
little flimsy 1\1/2\-page bill that I call ``the 12 platitudes.''
{time} 1500
They proved to be only platitudes because during the intervening
months, they've done nothing about long-term health care or any other
kind of health care for the American people.
Today, they continue to deny Americans actual solutions to health
care problems, and once again, they have a flimsy 1\1/2\ page bill.
They don't have ``repeal and replace,'' they have ``repeal and deny.''
They're in a state of
[[Page H326]]
denial that there is a problem with long-term care, and they continue
to deny meaningful relief to families that are struggling with health
care bills, and particularly, long-term health care bills.
There is a 75 percent chance that some American who reaches age 65
will find themselves in need of long-term care. Paying for that care
can bankrupt a family and the children of a parent who needs that kind
of care. An average cost for nursing home services, for example, of
$70,000 can surely and quickly sink a lifetime of savings.
The CLASS Act is far from perfect. It needs to be changed. But
instead of repealing it, we ought to be focusing on necessary changes.
Where is the commitment to doing something about long-term care? There
haven't even been hearings on how to resolve this problem.
The Acting CHAIR. The time of the gentleman has expired.
Mr. PALLONE. I yield the gentleman another 30 seconds.
Mr. DOGGETT. There was a legendary Texas House Speaker of this body,
Sam Rayburn, who said that it takes a master carpenter to build a barn
but any mule, I think he said, can tear one down.
Well, it's time that we get together to build a solution for long-
term health care, not just tear it down.
Mr. PITTS. It is unconscionable to promise something to people when
you know it won't be there.
Your own administration admits the CLASS Act doesn't work. Zero
people will be enrolled in the CLASS Act. They have a program that does
not work, a program they know that does not work. That is building a
false sense of security in people instead of working on the real
policy.
I yield 2 minutes at this time to the gentleman from Texas (Mr.
Hensarling), our conference chair.
Mr. HENSARLING. Madam Chair, it is clear that the President's
policies have failed. One in seven now have to rely on food stamps.
Half of America now is either classified as low income or in poverty,
and millions remain unemployed.
Yesterday, the Congressional Budget Office announced one more of the
President's failures, and that is, he is on track to deliver his fourth
trillion dollar-plus deficit in a row.
Somebody needs to tell the President we've got to quit spending money
we don't have for jobs we never get.
One more failure, Madam Chair, is the President's health care
program. Not a week goes by that I don't hear from hardworking, small
business people in the Fifth District of Texas.
I heard from a furniture businessman in Garland, Texas, who told me:
I could start two companies and hire multiple people, but based on this
administration and the lack of facts with ObamaCare, I'll continue to
sit and wait.
I heard from a gentleman who ran a music business in Palestine,
Texas: Our business is hampered by the uncertainty of tax policy,
regulations, and ObamaCare.
I had one in Dallas, Texas, after having to lay off 24 people in the
last 2 years, who wrote to me and said: You know what? We're going to
have to terminate one more in February due almost entirely to the
impact on my business of the health care reform we have. We are
stymied.
There is no doubt that the President's health care plan is killing
jobs. House Republicans have repealed it in its totality. It has been
blocked by the President, by Democrats. So if we can't do it in its
totality, we'll do it piecemeal.
We need to start out by repealing the CLASS Act, which Secretary
Sebelius has said is totally unsustainable. Democrat Senate Budget
Committee Chairman Kent Conrad called it a Ponzi scheme of the first
order.
The President's policies have failed. It's time to enact the House
Republican Plan for America's Job Creators. It's time to repeal the
CLASS Act.
Mr. PALLONE. Madam Chair, I yield 2 minutes to the gentleman from New
Jersey (Mr. Pascrell).
Mr. PASCRELL. Madam Chair, I'm tired of hearing the President is a
failure. I'm tired. You can smirk all you want. There's no perfection
on this floor. There's no perfection down the street. You didn't give
these speeches in 2008 when we were losing 500, 600, 700,000 jobs a
month. Not one of you came to the floor. Shame on you.
Now what we want to do, we want to turn our backs on those 10 million
Americans currently who need long-term care. We have no alternative.
We all agree that there needs to be change in the present system that
has yet to work. We have to find a way to make long-term care both
accessible and affordable. These problems will not simply disappear.
They're not going to go away.
This bill certainly does not fix these problems. The bill does not
even provide an alternative. All it does is attack the progress made in
the Affordable Care Act. You've tried to wean it down. You've tried to
bevel it. You've tried to covet. You tried to take all the money away
that's going into it in order to have a system in this country that was
not sustainable in the first place.
Sixty-two percent of small businesses over the last 5 years went
under because they couldn't pay their health care bills, and you stand
there with no alternative whatsoever. Whatever happened to the
``replace'' part of the ``repeal and replace?'' Remember that? That
nonsense we heard last year?
Without the CLASS Act or an alternative, people who struggle the most
with daily tasks due to illness will be the ones to suffer. You know
that. You know there are millions of people out there suffering, yet we
have not come up with an alternative plan. Yet you condemn this, yet
you accuse everybody of failing, but you don't have a plan yourself.
Where is your heart for the middle class? Have you no heart?
Announcement by the Acting Chair
The Acting CHAIR. Members should remember that all remarks must be
addressed to the Chair and not to one another in the second person.
Mr. PITTS. I continue to reserve the balance of my time.
The Acting CHAIR. The gentleman from New Jersey has 2 minutes
remaining. The gentleman from Pennsylvania has 4 minutes remaining.
Mr. PALLONE. I suggest that you go next because I only have myself,
and then we're going to move to Ways and Means.
Mr. PITTS. Madam Chair, I believe we have the right to close, and we
have just one speaker.
I reserve the balance of my time.
Mr. PALLONE. I yield myself the balance of the time.
Madam Chair, I just want to stress again, you know, I hear from the
other side of the aisle over the years how people should take personal
responsibility. The idea of the CLASS Act is that people pay into the
trust fund, and then when they become disabled, they take the money out
to pay for services so that they can stay in their home and don't have
to go to a nursing home.
Now, when they do that, they save the government money because this
is their own money that is being spent to keep them in their home, to
keep them in the community so they don't have to spend down and then
eventually become a ward of the State, essentially, because Medicaid
ends up paying for their nursing home care.
So this is a solution to a long-term care problem. Not a complete
solution, but certainly a partial solution.
I agree with Mr. Pascrell, which is that when I listen to the other
side of the aisle, the gentleman from Texas was quite clear: Let's
repeal the entire Affordable Care Act. If we can't repeal the whole
thing, then we'll repeal it piecemeal piece by piece, which is what's
going on here today. Well, again, it's not a very responsible position
unless you come up with an alternative.
We're in the Energy and Commerce Committee. We've had hearings on
this. I've yet to hear anyone come up on the Republican side with an
alternative. All they keep saying is let's just repeal this and we'll
figure something out down the line.
The problem with that is that Mr. Pascrell said there are 10 million
Americans who need long-term care. Soon it will be 15 or eventually 20
million. So every day that goes by there is not a solution for these
people, and the disabled community and the senior citizen community are
crying out for some kind of relief.
So all I say to my colleagues on the other side of the aisle is,
don't just keep talking about repeal. I'll use the term ``mend it,
don't end it.'' Let's not
[[Page H327]]
end today the effort to try to find long-term care solutions for
America's seniors and for the disabled.
{time} 1510
It simply isn't fair to come here on the floor repeatedly and say
``repeal, repeal, repeal'' and not have an answer. At any time, I am
more than willing to sit down with the chairman of the subcommittee or
with any other Member and come up with a bipartisan solution, but I
haven't heard it yet.
The Acting CHAIR. The gentleman's time has expired.
Mr. PITTS. Madam Chair, to close on our side, I yield such time as he
may consume to a distinguished member of the Health Subcommittee, the
gentleman from Georgia, Dr. Gingrey.
The Acting CHAIR. The gentleman from Georgia is recognized for 4
minutes.
Mr. GINGREY of Georgia. Madam Chairman, as the co-lead sponsor of
this bill, I rise in strong support of H.R. 1173. I commend Dr.
Boustany and Chairman Pitts for their leadership on this issue, and I
thank Mr. Lipinski on the Democratic side.
In response to a question I put to him in March of last year, CBO
Director Douglas Elmendorf wrote: ``The Secretary of Health and Human
Services has now concluded that the CLASS program cannot be operated
without mandatory participation so as to ensure its solvency.'' HHS
Secretary Kathleen Sebelius called the program insolvent, and
Democratic Senator Kent Conrad, chairman of the Senate Budget
Committee, called the program in 2009 a Ponzi scheme. In fact, he went
on to say that it would make Bernie Madoff proud.
Madam Chair, during its consideration in 2009, CMS Actuary Richard
Foster told the Obama administration staff: ``Thirty-six years of
actuarial experience lead me to believe that this program would
collapse in short order and require significant Federal subsidies to
continue.'' He was ignored. In fact, he was eventually cut out of the
email loop. The Health Committee on the Senate side and the staff of
Senator Kennedy didn't want to hear any more from him.
Subsequently, in December of 2010, the President's fiscal commission
recommended Congress reform or repeal--not amend--the CLASS Act. The
commission report stated: ``Absent reform, the CLASS program is . . .
likely to require large general revenue transfers or else collapse
under its own weight. The commission advises the CLASS Act be reformed
in a way that makes it credibly sustainable over the long term. To the
extent this is not possible, we advise it be repealed.''
In February of 2011, Secretary Sebelius testified before a Senate
Finance Committee hearing that the CLASS program was ``totally
insolvent'' as structured and needed to be reformed in order to work.
Then, in October of 2011, the Secretary released a report on the CLASS
Act that essentially found the Obama administration could not make the
program actuarially sound or credibly sustainable, to quote the
President's fiscal commission, over a 75-year period.
Thank God for Senator Judd Gregg for putting that amendment in on the
Senate side that called for fiscal sustainability and the certification
by the Secretary over a 75-year period of time or it could not go
forward, and that's exactly what happened.
Based on the evidence the CLASS program is not simply flawed--it is
broken. As currently written, it poses a clear danger to the fiscal
health of our budget and to the American taxpayer. In defending this
broken program, some of my colleagues have told me that there is no
need to repeal CLASS because the Secretary has already abandoned it.
Yet every day that we delay in repealing CLASS, we prevent Congress
from passing meaningful, true long-term care reform. All sides admit
that CLASS does not work, so the prudent step is to repeal it.
In closing, I urge all of my colleagues to support this legislation
so that we can get to the meaningful reform of long-term care and have
the marketplace work its magic in regard to this so that the
penetration is greater than the current penetration, which is less than
10 percent.
With that, Madam Chairman, I would urge all of my colleagues to
support the repeal of a broken, failed program, the CLASS Act.
The Acting CHAIR. The time of the gentleman has expired.
Mr. BOUSTANY. Madam Chair, I yield myself such time as I may consume.
As a physician, I know firsthand of this really dire need to solve
the problem for many families across this country who are struggling
with their long-term care needs. I am the oldest of 10 children, and my
father was a physician. He died 3 years ago from a lengthy illness, and
required a lot of care at home. He did not have long-term care, but we
gladly bore that burden and were able to provide for him even though it
was somewhat of a strain.
This is a serious problem facing every single family in this country.
Yet what we've seen now is a program that was created in ObamaCare, a
program that is clearly unsustainable by the administration's own
admission. After almost a year now of wrangling about this, they've
finally come to the conclusion that we knew before the bill even
passed: that this was unsustainable, that it was unworkable, that it
was fatally flawed.
As a physician, I know the worst thing you can do for someone is to
create false hope, and that's what this has done. As long as this stays
on the books, on the statute books, we're not going to get anything
done on this. We're not going to solve it. Now, there are many good
ideas on both sides of the aisle, and we've discussed some of them in
the Ways and Means Committee. There are bills on both sides of the
aisle on which I believe we could work together in a true bipartisan
fashion to solve this problem--but the CLASS program is clearly not the
answer.
Washington should learn three lessons from this debacle, ObamaCare's
failed government-run program:
First, don't ignore reality. Democrats ignored the expert actuarial
warnings when they used CLASS as a budget gimmick in ObamaCare.
President Obama cannot create a self-funded sustainable program that
prohibits underwriting unless he intends to force healthy Americans to
participate. What does that mean? Madam Chair, that means an individual
mandate, another individual mandate.
Many constitutional scholars think that this is unconstitutional. We
don't need another individual mandate. In fact, Senator Harkin said
that the problem with CLASS is that it's voluntary. I think he
basically put the cards on the table and showed that what they want to
do to fix CLASS is to give us another individual mandate. Most
enrollees in CLASS will be high-risk, causing premiums to skyrocket
under the current program, making CLASS even less appealing to average
American families. The premiums will be unsustainable, and it will
require subsidies from the taxpayer.
So, the first lesson: Don't ignore reality.
The second lesson: Don't break the law.
The administration planned to break the law by excluding Americans
made eligible by the statute. When the Congressional Research Service
attorneys warned of lawsuits, I sent letters to Secretary Sebelius for
her legal authority to make this change. She then subsequently
suspended the program, but this doesn't correct the bad law. Unless we
repeal CLASS, the Department of Health and Human Services will break
the law when it misses the deadline in October and again in 2014.
That's not a very good example to set for the American people to have
the administration breaking the law.
So, first, don't ignore reality.
Second, don't break the law.
Third, don't compound our Nation's long-term fiscal problems.
A Democrat under the Clinton administration, former Congressional
Budget Office Director Alice Rivlin, wrote: Since the CLASS program is
a new unfunded entitlement, it should be repealed because it will
increase the deficit over the long term. In fact, the President's own
deficit commission agrees that our grandchildren simply cannot afford a
new budget-busting entitlement.
We can do better than this, Madam Chair, and we can work together to
solve this problem. I urge my colleagues on both sides of the aisle to
support this CLASS repeal, to support
[[Page H328]]
H.R. 1173. Beyond this, we will have the impetus to actually do some
real work to create a real program that works for the American people.
We can make it easier for disabled Americans to save for future needs;
we can expand access to affordable, private long-term care coverage;
and we can better educate Americans on the need for retirement
planning.
Congress of the United States,
Washington, DC, January 31, 2012.
Hon. Kathleen Sebelius,
U.S. Department of Health & Human Services, Independence
Ave., SW., Washington, DC.
Dear Secretary Sebelius: We write this as a follow up to
our unanswered November 2011 letter to President Obama
regarding the failed CLASS program. In the letter, we asked
whether the Administration has a legal obligation to
implement the program.
Last year, you announced you could not find ``a viable path
forward for CLASS implementation at this time.'' Legal
experts at the Congressional Research Service (CRS) say you
do ``not appear to have discretion to decide whether or not
to designate a plan by October 1, 2012.'' If the deadline
expires, they say you will be ``committing a facial
violation'' of the 2010 health law. Finally, ``the CLASS Act
does not preclude judicial review'' and ``a failure by the
Secretary to designate a CLASS benefit plan by October 1,
2012 . . . would appear to be a final agency action from
which `legal consequences will flow.' ''
In light of the findings by the CRS, does the Obama
Administration intend to openly violate the law as the 2012
and 2014 deadlines for CLASS expire? If not, when do you
intend to resume implementation of CLASS? What justifications
can the Administration provide to Congress and the American
people in the event that the Secretary's failure to adhere to
the law results in a costly court battle, effectively
delaying meaningful long-term care reform in the process?
Please expedite a written response to these questions.
Democrat and former Congressional Budget Office Director
Alice Rivlin wrote: ``Since the CLASS program is a new
unfunded entitlement, it should be repealed because it will
increase the deficit over the long term.''
Our grandchildren simply cannot afford a new budget-busting
entitlement. We urge you to join us in support of CLASS
repeal, and to support bipartisan efforts to expand access to
affordable private long-term care coverage.
We appreciate your attention to this matter.
Sincerely,
Charles W. Boustany, Jr., MD,
Member of Congress.
Phil Gingrey, MD,
Member of Congress.
I reserve the balance of my time.
{time} 1520
Mr. STARK. Madam Chair, I yield myself such time as I may consume
I'd like to point out that the last time I watched television, they
told me that we still have troops in Afghanistan who should be brought
home. And we've not addressed the Medicare physician payment cuts, the
payroll tax cut extension, unemployment insurance extension. Roads,
bridges, and public transit systems are falling apart, and Congress
hasn't brought forth legislation to invest in the infrastructure to
repair those vital structures. And we continue to have an imbalanced
Tax Code that lets Members of Congress get richer at the expense of
working families, and we've done nothing to change that.
Yet rather than tackle any serious problems, the Republicans are
using the very little time that they permit Congress to be in session
to debate repealing the law that the President has already made clear
will not be implemented. In other words, we should repeal a law that
isn't going to happen. Now, that's a vital use of our time. He's
clearly stated, the President has, that the CLASS Act, as part of the
Affordable Care Act, can't meet the tests put in the statute.
Now, remember that Republicans probably would like to repeal all of
ObamaCare, and I'm not sure exactly which part they want mostly to
repeal. In other words, I assume that the 2.5 million youngsters who
now get health insurance, the Republicans would like to kick them off
the rolls and let them go to work or earn their own way to health
insurance.
It's lowered prescription drug costs, ObamaCare has, for millions of
seniors, for a bill that the Republicans wrote that was too costly. I
presume the Republicans would like to raise the cost of pharmaceuticals
for seniors. Republicans generally like to do anything that the
pharmaceutical obviously asks them to do, and I'm surprised they
haven't brought that up yet.
I understand that my good friend, Dr. Boustany, actually has the
makings of a bill that would help long-term care. And I also understand
that the only reason he hasn't introduced it--I'd be glad to make it an
amendment if it's ready to go right now--is that the health insurance
industry doesn't like it. Well, if the health insurance industry
doesn't like it, it must be spectacular, and I hope we'll see it. Maybe
you'll tell us a little bit about it, and I'd like to applaud it
because he has done some great work in this area, and we need to do
this.
The fully implemented ObamaCare, health care, whatever you want to
call it, by 2014 will extend affordable, quality medical care to 32
million uninsured Americans. That's a plan. Maybe we could change it.
Maybe we could make it quicker. Maybe we would extend it to more
people. Maybe we could save some money. But that has to come from the
other the other side of the aisle.
We oppose this, and I'd like to think that our Republican friends
would work with us to improve it and move us in that direction.
I'd like to highlight a letter of opposition to repealing the CLASS
Act that is signed by more than 70 organizations representing millions
of senior citizens, people with disabilities, and people suffering from
various diseases. These groups include: AARP, the Autism National
Committee, the AFL-CIO, and Easter Seals, and United Cerebral Palsy.
They urge Congress to ``reject H.R. 1173, and instead focus on a
constructive path forward.''
I ask that this letter be inserted into the Congressional Record as
part of this debate.
January 31, 2012.
Hon. John Boehner,
Speaker of the House, House of Representatives, U.S. Capitol,
Washington, DC.
Hon. Nancy Pelosi,
Democratic Leader, House of Representatives, U.S. Capitol,
Washington, DC.
Dear Speaker Boehner and Democratic Leader Pelosi: The
undersigned organizations write to oppose legislation, H.R.
1173, to repeal the Community Living Assistance Services and
Supports (CLASS) program and respectfully urge members to
reject such legislation.
In 2008, 21 million people had a condition that caused them
to need help with their health and personal care. Medicare
does not cover long-term services and supports (LTSS), yet
about 70 percent of people over age 65 will require some type
of LTSS at some point during their lifetime. As our
population ages, the need for these services will only grow.
In addition, about 40 percent of the individuals who need
LTSS are under age 65 and LTSS can enable individuals to work
and be productive citizens.
Regardless of when individuals may need these services,
there is a lack of financing options to help them plan and
pay for the services they need to help them live
independently in their homes and communities where they want
to be. Family caregivers are on the frontlines. They provided
care valued at $450 billion in 2009--more than the total
spending on Medicaid that year. Private long-term care
insurance helps some people pay for the cost of services, but
it is not affordable for most, and some people are not even
able to qualify for it. Too often, the cost of services wipes
out personal and retirement savings and assets that are often
already insufficient--as a result, formerly middle class
individuals are forced to rely on Medicaid to pay for the
costs of LTSS. There are few options for individuals to help
them pay for the services they need that could help them
delay or prevent their need to rely on Medicaid, the largest
payer of LTSS.
That's why we support the CLASS program--to give millions
of working Americans a new option to take personal
responsibility and help plan and pay for these essential
services. CLASS could also take some financial pressure off
Medicaid at the state and federal levels--paid for by
voluntary premiums, not taxpayer funds. For us, this is about
the financially devastating impact that the need for LTSS has
on families across this country every day and the essential,
compelling and urgent need to address this issue. Every
American family faces the reality that an accident or illness
requiring long-term care could devastate them financially.
This issue affects the constituents of every U.S.
Representative. CLASS is an effort to be part of the
solution. The CLASS actuarial report established that CLASS
can still be designed to be a ``value proposition,'' although
development work was still needed. The actuarial report also
noted that federal actuaries ``. . . agreed that certain
plans, designed to mitigate the adverse selection risk . . .
can be actuarially sound and attractive to the consumers.''
Rather than repeal CLASS, we urge continued dialogue and
development of a viable path forward. The need to address
LTSS and how these services will be paid for in a way that
is affordable to individuals and society as a whole will
not go away.
Families will continue to need a workable LTSS option to
protect themselves; and a
[[Page H329]]
path forward is essential because the need for these services
will only continue to grow. We appreciate your consideration
of our views that are based on the experiences of millions of
families across this country. We urge you to reject H.R.
1173, and instead focus on a constructive path forward.
Sincerely,
AAPD; AARP; ACCSES; AFL-CIO; AFSCME; Alliance for Retired
Americans; Alzheimer's Foundation of America; American
Association on Health and Disability; American Counseling
Association; American Dance Therapy Association; American
Geriatrics Society; American Music Therapy Association;
American Network of Community Options and Resources; American
Society on Aging; The Arc of the United States; Association
of Assistive Technology Act Programs; Association of
University Centers on Disabilities (AUCD); Autism National
Committee; Autistic Self Advocacy Network; Bazelon Center for
Mental Health Law; Brain Injury Association of America
(BIAA).
California Foundation for Independent Living Centers; Cape
Organization for Rights of the Disabled (CORD); Center for
Independence of Individuals with Disabilities; Center for
Independent Living of South Florida; Inc.; Children and
Adults with Attention-Deficit/Hyperactivity Disorder (CHADD);
Coalition of Geriatric Nursing Organizations; Council for
Exceptional Children; The Council on Social Work Education;
Direct Care Alliance; Disability Rights Education & Defense
Fund; Easter Seals; Epilepsy Foundation; Health & Disability
Advocates; Inter-National Association of Business; Industry
and Rehabilitation; LeadingAge; Lutheran Services in America;
Mental Health America; The National Alliance for Caregiving;
National Alliance on Mental Illness (NAMI); National
Association of Area Agencies on Aging (n4a).
National Association of County Behavioral Health and
Developmental Disability Directors (NACBHDD); National
Association of the Deaf; National Association for Geriatric
Education (NAGE); National Association for Home Care &
Hospice; National Association of Councils on Developmental
Disabilities; National Association of Nutrition and Aging
Services Programs (NANASP); National Association of
Professional Geriatric Care Managers; National Association of
Social Workers; National Association of State Directors of
Special Education (NASDE); National Association of State Head
Injury Administrators; National Center on Caregiving; Family
Caregiver Alliance; The National Center for Learning
Disabilities; National Committee to Preserve Social Security
and Medicare; The National Consumer Voice for Quality Long-
Term Care (formerly NCCNHR); National Council on Aging;
National Council for Community Behavioral Healthcare;
National Council on Independent Living; National Disability
Rights Network; National Down Syndrome Congress.
National Multiple Sclerosis Society; The National
Rehabilitation Association; National Respite Coalition NISH;
Paralyzed Veterans of America; PHI-Quality Care through
Quality Jobs; Physician-Parent Caregivers SEIU; Self-
Reliance; Inc.; Services and Advocacy for GLBT Elders (SAGE);
Social Work Leadership Institute/The New York Academy of
Medicine; United Cerebral Palsy; United Spinal Association;
Volunteers of America.
____
Leadership Council of
Aging Organizations,
January 30, 2012.
Dear Member of Congress: The Leadership Council of Aging
Organizations, (LCAO) strongly opposes H.R. 1173, legislation
to repeal the Community Living Assistance Services and
Supports (CLASS) program. Please do not support this bill
when it comes to the House floor this week.
The Leadership Council of Aging Organizations (LCAO) is a
coalition of 66 national nonprofit organizations concerned
with the well-being of America's older population and
committed to representing their interests in the policy-
making arena.
We support the CLASS program as a promising means of
effectively financing the long-term services and supports
that thousands of Americans come to need as they age or
develop a disability. Every family faces these potential
costs. CLASS gives families a framework for responsibly
planning for their own long-term services and supports needs.
Our currently fragmented system of paying for long-term
services and supports is in danger of crumbling under the
weight of the baby boom generation. Already an estimated 10
million Americans need long-term services and supports, and
this number is projected to increase to 26 million by 2050.
Acknowledging the growing demand for services, the law also
created the Personal Care Attendants Workforce Advisory
Panel, work which must move forward if we are to build the
strong workforce that America needs to provide personal care
services.
CLASS was developed to provide a coordinated, national
public-private system for delivering long-term services and
supports. Nearly half of all funding for these services is
now provided through Medicaid, which is a growing burden on
states and requires individuals to become and remain poor to
receive the help they need. There is also an institutional
bias in Medicaid whereby approximately two-thirds of all
spending is directed towards nursing homes and other
institutions instead of preferred community-based services
and supports.
CLASS is a promising approach to effectively meeting the
costs of long-term services and supports. Thousands of
Americans do not qualify for private long-term care insurance
due to underwriting practices, and this kind of insurance is
unaffordable for many more. Reverse mortgages assume home
ownership with substantial equity, which excludes thousands
more individuals and families.
There is no effective and affordable alternative to CLASS
at this time. We urge you to vote against H.R. 1173 when it
comes to a vote this week in the House.
Sincerely,
William L. Minnix, Jr.,
President and CEO,
Chair, LCAO.
____
American Federation of State, County and Municipal
Employees, AFL-CIO,
Washington, DC, January 24, 2012.
Dear Representative: On behalf of the 1.6 million members
of the American Federation of State, County and Municipal
Employees (AFSCME), I write to urge you to oppose H.R. 1173,
the misnamed Fiscal Responsibility and Retirement Security
Act of 2011. The bill repeals the Community Living Assistance
Services and Supports (CLASS) program, which was designed to
be a voluntary insurance program to help American workers pay
for long-term care services and supports that they may need
in the future.
The need for the CLASS program is huge and growing. Nearly
70% of people turning 65 today will need, at some point in
their lives, help with basic daily living activities, such as
bathing, feeding and dressing. Repealing the CLASS program
and replacing it with absolutely nothing offers no help to
millions of Americans who want to maintain their health,
independence, and dignity when they lose the capacity to
perform basic daily activities without assistance.
Medicare does not cover long-term care services. Medicaid
does cover long-term care but Medicaid pays only for services
for people with very limited financial means. Private long-
term care insurance can be costly and difficult to purchase,
especially if an individual has a pre-existing condition.
Indeed, only about one-in-ten Americans age 55 and older has
long-term care insurance.
The CLASS program is not perfect and may need
modifications, but now is not the time to accept the status
quo for the financing of long-term services and supports,
which relies by default almost exclusively on Medicaid.
Repealing the CLASS program is not a solution and promotes a
fiscal default policy of increasing Medicaid costs and
requiring middle-class Americans to impoverish themselves in
order to obtain long-term care. We urge you to oppose H.R.
1173.
Sincerely,
Charles M. Loveless,
Director of Legislation.
____
LeadingAge,
Washington, DC, January 17, 2012.
Dear Ways and Means Committee Member: I understand that the
Ways and Means Committee will vote January 18 on H.R. 1173,
legislation to repeal the Community Living Assistance
Services and Supports (CLASS) program.
I strongly urge you oppose this bill. American families
need the CLASS program to effectively plan for the costs of
long-term services and supports.
These costs now are covered primarily by Medicaid, an
entitlement program that is a growing and unsustainable
burden on both federal and state budgets. Currently Medicaid
covers 49% of the total cost of paid long-term services and
supports, making it the predominant source of financing in
this field.
These costs will not disappear if the CLASS program is
repealed, and there is no effective alternative to cover
them. All but the wealthiest Americans have insufficient
income and savings to cover the cost of long-term nursing
home care or even extensive services provided in a home- and
community-based setting. Private long-term care insurance,
for which there already are tax incentives, covers only a
small fraction of long-term services and supports. Reverse
mortgages are becoming less useful as a source of long-term
services and supports financing due to the current state of
the real estate market.
Without CLASS, people who need help with the most basic
activities of daily living will continue to be thrown onto
the Medicaid rolls. The federal and state governments will
have to continue paying for needed long-term services and
supports, but without the revenues that the CLASS program
would generate.
Over the last several decades, policymakers, health
economists and other experts have given much thought and
debate to the issue of financing long-term services and
supports. CLASS developed out of all of this deliberation as
the proposal with the most promise for establishing a
healthy, ethical and affordable system of financing these
costs. This program can give families an affordable means of
planning for their futures and for the long-term services and
supports needs that inevitably arise.
I hope you and members of your family will never come to
need the kinds of services for which CLASS was designed to
pay. But if you ever do, you will understand fully why the
CLASS program has attracted such broad support.
Repealing CLASS would undo years of work toward an
effective means of financing long-term services and supports
needed and
[[Page H330]]
used by thousands of Americans and their families. What other
option addresses these needs?
Please oppose H.R. 1173 when it comes before the Ways and
Means Committee.
Sincerely,
William L. Minnix, Jr.,
President and CEO.
Madam Chair, how much time do I have remaining?
The Acting CHAIR. The gentleman from California has 7\1/2\ minutes
remaining.
Mr. STARK. I yield 2 minutes to the gentleman from Wisconsin (Mr.
Kind).
Mr. KIND. I thank my friend from California for yielding me this
time.
Madam Chair, I rise in support of the resolution. I do so because I
believed at the time when the CLASS Act was inserted in the Affordable
Care Act it wasn't a sustainable program. And sure enough, when
Secretary Sebelius and those at the Department of Health and Human
Services had a chance to analyze it and try to implement it, they
reached the same conclusion.
I just hope that today my Republican colleagues don't take too much
glee or delight over the fact that this resolution will pass and it
repeals yet another small section of the Affordable Care Act, because
just by repealing it without replacing it doesn't solve the problem
with the rising long-term health care costs that our Nation faces.
I know my friend Dr. Boustany shares his interest in trying to find a
fix to this situation, and I hope that the parties are able to come
together and address one of the paramount challenges that we're still
facing in health care: How do you incent young, healthy people to
invest in their long-term health care needs? It's difficult to do.
And I appreciate the work by those who supported CLASS, recognizing
the challenge that we faced and trying to come up with a solution. This
just wasn't the answer.
And to my Democratic colleagues, I never believed that passage of the
Affordable Care Act--which I did support--was the end-all, be-all for
health care reform. In fact, the great potential of the Affordable Care
Act was the vast experimentation that needs to take place in reforming
the health care delivery system and the payment system to learn what's
working and what isn't working and then drive the system to greater
efficiency, better quality outcomes, and a better bang for our buck.
That, to me, is what health care reform is going to look like in the
years to come. It's going to be an ongoing effort trying to determine
what is working and what isn't. The CLASS Act, clearly, the way it was
structured, was something that wasn't going to work.
So I agree with the resolution today that we should repeal it. It's
the same conclusion the administration, having a chance to look at it,
reached themselves. But it doesn't leave us off the hook of trying to
find a solution to one of the great challenges of long-term health care
in this country.
So I would encourage my Republican colleagues--and I know many of
them share this sentiment, that this does not end the work that has to
go on. We've got to figure out a way to start talking to each other,
listening, trusting each other to come up with some solutions. This
isn't that solution today.
Mr. BOUSTANY. Madam Chair, I yield 2 minutes to the gentleman from
California (Mr. Herger), the distinguished chairman of the Health
Subcommittee on the House Ways and Means Committee.
Mr. HERGER. Madam Chair, I rise in strong support of H.R. 1173, the
Fiscal Responsibility and Retirement Security Act.
It's now clear that long before the Democrats' health care overhaul
was passed, the Obama administration knew that the CLASS Act was a
seriously flawed program that could not be implemented. For example,
Medicare actuary Rick Foster said way back in June of 2009: ``Thirty-
six years of actuarial experience lead me to believe that this program
would collapse in short order and require significant Federal subsidies
to continue.''
Yet these warnings went unheeded and the CLASS Act remained in the
health care bill 9 months later because it created an illusion of
budget savings, an illusion based entirely on the fact that it was
designed to collect premiums for a full 5 years before it would have to
start paying benefits. Yesterday the Congressional Budget Office
estimated that the cost of Federal health care entitlement programs
will more than double over the next decade.
Madam Chairman, for the sake of our Nation's future, we must get
these costs under control. The CLASS Act is an unsustainable program
that, if it ever begins operating, would inevitably need a major
taxpayer bailout. By repealing it today, Congress can send a clear
message that we are going to start finding solutions to rising health
care costs instead of making the problem worse.
Mr. STARK. I reserve the balance of my time.
Mr. BOUSTANY. Madam Chair, may I ask how much time remains?
The Acting CHAIR. The gentleman from Louisiana has 3\1/2\ minutes
remaining, and the gentleman from California has 5\1/2\ minutes
remaining.
Mr. BOUSTANY. I yield 1\1/2\ minutes to the gentlewoman from Kansas
(Ms. Jenkins), a member of the House Ways and Means Committee.
{time} 1530
Ms. JENKINS. I thank the gentleman for yielding.
There aren't many areas where the former Kansas Governor and current
Secretary of Health and Human Services, Kathleen Sebelius, and I agree,
but one thing that we do agree on is that the CLASS Act portion of the
President's health care package is completely unviable and needs to be
stopped.
That's why I was glad to hear the Secretary backtrack on her prior
support and pull the plug on the program, and it's why I support a
statutory repeal of the CLASS Act today. This act was designed as a new
national entitlement for purchasing community-living assistance
services, and it was used by this administration as a pay for to
substantiate their faulty claim that ObamaCare was going to reduce the
deficit.
However, as I and many others pointed out at the time, the deficit
reduction claim was bogus and based on budget gimmicks that proved
false when HHS began implementation. You see, the CBO can only project
the cost of bills in a 10-year budget window, so the Obama
administration used a budget trick by setting up the CLASS Act to begin
collecting premiums in 2012 but not paying out benefits until 2017.
Great for years 1 through 10, but very bad for years 5 through 15 or
later.
This gimmick led CBO to report that the program would reduce the
deficit, but it certainly doesn't take a CPA to realize that these
initial savings can't be sustained over time. While we anxiously await
the Supreme Court's decision on the constitutionality of ObamaCare's
individual mandate, I urge my colleagues to support the repeal of this
failed portion of the bill today so we can get this budget gimmick off
the government's books.
Mr. STARK. I reserve the balance of my time.
Mr. BOUSTANY. Madam Chair, I'm pleased to yield 1 minute to the
gentlewoman from Tennessee (Mrs. Black), a member of the Ways and Means
Committee.
Mrs. BLACK. I thank the gentleman for yielding.
Madam Chair, I rise today in support of my colleague from Louisiana's
legislation repealing this unsustainable budget gimmick created to make
the health care law look less expensive.
The CLASS Act was a long-term entitlement that was plagued with
problems from the very beginning. From day one, concerns were raised
about the CLASS program's unsustainable cost structure, and the
administration ignored it.
I have a chart that was presented to us in our Ways and Means
Committee in the markup of this bill, and from the very beginning there
were six different occasions, and up until March 20 when it was passed,
of experts who said this was unsustainable, and they've already been
referenced by prior speakers.
Since that time of passage there were four others, including
Secretary Sebelius in October of 2011, who also said: ``I do not see a
viable path forward for the CLASS implementation.''
This program, again, has been unsustainable from the very beginning.
I think what is so sad is we continue to put our head in the sand and
make the American people believe that this program is somehow workable.
This needs to be removed from our law so we can
[[Page H331]]
start again. This is a nonpartisan issue, and we all need to work
together in a bipartisan way. As a nurse for over 40 years working with
the elderly, I recognize the need for long-term care.
The Acting CHAIR. The gentleman from Louisiana has 1 minute remaining
and the right to close. The gentleman from California has 5\1/2\
minutes remaining.
Mr. STARK. Madam Chair, in closing, I repeat that there are real
problems in this country of much more urgency than trying to repeal a
bill that doesn't do anything, that won't work, that the President has
said won't be effective. I urge my colleagues to join me in voting
``no'' on this Republican agenda to tear down our health system. It's
mugwumpish. It just sticks your head in the sand and says let's repeal
things and let's not go about fixing it.
As I said before, I'm sure Dr. Boustany has a great bill, and I'm
hoping that he'll bring it to us and we can proceed to deal with the
problem of long-term care for our senior citizens.
I have seven children who would like to see that done very quickly
and get me off their hands, thank you very much. And so anything we can
do together, I look forward to working with the distinguished
gentleman.
With that, I yield back the balance of my time.
Mr. BOUSTANY. Madam Chair, I'm pleased to yield my remaining time to
the gentleman from Minnesota (Mr. Paulsen), a distinguished member of
the Ways and Means Committee.
The Acting CHAIR. The gentleman from Minnesota is recognized for 1
minute.
Mr. PAULSEN. Madam Chairman, I also want to rise in strong support of
repealing this misguided CLASS Act. We knew from the start that the
CLASS Act was fiscally unsustainable. But the President and those who
supported the new health care law used this and inserted it as a budget
gimmick to help pass the law. This new program was an illusion, an
illusion that was crafted so government would start collecting funds
long before it would pay anything out, making it seem as if it would
raise revenue and save money. But in the long run it was obvious and it
was clear the program would have disastrous effects.
The CMS Chief Actuary himself said that if implemented, the program
would collapse. And after months of failed attempts, even the
administration has finally admitted that the program was unworkable.
Madam Chair, Minnesota families and small businesses are tired of the
smoke and mirrors coming out of Washington. Let's do the right thing
today and repeal this terrible program, and let's focus on what's
really important: putting Americans back to work. I want to thank my
colleague on the Ways and Means Committee from Louisiana. He's a
doctor, he's a physician, he's a leader in health care. Let's do the
right thing and repeal this legislation.
Mr. STEARNS. Madam Chair, we need to repeal this bad legislation. As
Chairman of the Oversight and Investigations Subcommittee, we looked
into the CLASS Act and the actions of HHS. We issued a bicameral report
on the failures of this fiscally reckless program.
Some Senate Democrats expressed that they ``had grave concerns that
the real effect of the [CLASS Act] would be to create a new federal
entitlement with large, long-term spending increase that far exceed
revenues.''
Perhaps the most damning indictment came from the Senate Budget
Chairman who characterized CLASS Act as ``a ponzi scheme of the first
order, the kind of thing that Bernie Madoff would have been proud of.''
This legislation is so fiscally unsound that even the Secretary of
HHS has announced that she does ``not see a viable path forward for
CLASS implementation at this time.'' This despite all her statements in
support of CLASS when the Democrats were ramming Obamacare down our
throat.
Under CBO rules, the CLASS failure will cost American taxpayers $86
billion--the most recent CBO project of the supposed savings from the
CLASS Act. However, if CLASS had gone into effect, it would have
increased our deficit by the third decade.
We need to repeal this fiscally unsound entitlement. We need to stop
wasteful spending. We need to bring our country back to the path of
fiscal responsibility and repealing CLASS is an important first step.
Ms. JACKSON LEE of Texas. Madam Chair, I rise in opposition to H.R.
1173, ``The Fiscal Responsibility and Retirement Security Act of
2011.'' This bill would repeal title VIII of the Patient Protection and
Affordable Care Act and Supports, CLASS, Program--a national, voluntary
long-term care insurance program for purchasing community living
assistance services and supports. Title VIII also authorized and
appropriated funding through 2015 for the National Clearinghouse for
Long-Term Care Information, clearing house. H.R. 1173 would rescind any
unobligated balances appropriated to the National Clearinghouse for
Long-Term Care Information.
The CLASS Act was designed to provide an affordable long-term care
option for the 10 million Americans in need of long-term care now and
the projected 15 million Americans that will need long-term care by
2020.
The CLASS program would allow the disabled to be treated with respect
and class. Yet, once again, instead of focusing on creating jobs,
instead of finding means to reduce our deficit, instead of addressing
the most pressing needs of our nation today, my Republican colleagues
have put forth a measure that targets the aging and the disabled. They
are supporting a measure that literally lacks class. This measure is a
blatant attempt to repeal the Affordable Health Care Act one title at a
time.
Like many Members of this body, I am disappointed that the Department
of Health and Human Services, DHHS, has not been able to implement the
CLASS provision of the Affordable Health Care Act. Although the CLASS
program is not perfect, I cannot in good conscience support repealing
it at a time when we have no viable alternative for affordable long-
term care.
We have a growing aging population some of whom will require long-
term care. CLASS provides the aging and the disabled with a solution
that is self-sustaining, at no cost to tax payers.
As the estimated 76 million baby boomers born between 1946 and 1964
become elderly, Medicare, Medicaid, and Social Security will nearly
double as a share of the economy by 2035.
With each generation, Americans have been fortunate to live longer
lives; we continue to plan on how to meet the needs of the aging and
the disabled. It is reasonable to assume that over time the aging of
baby boomers will increase the demand for long-term care. Estimates
suggest that in the upcoming years the number of disabled elderly who
cannot perform basic activities of daily living without assistance may
be double today's level.
Repealing the CLASS program does nothing to address the fact that
private long-term care insurance options are limited and the costs are
too high for many American families, including many in my Houston
district, to afford.
In 2000, spending from public and private sources associated on long-
term care amounted to an estimated $137 billion, for persons of all
ages. By 2005, this number has risen to $206.6 billion.
Unless we act now, the costs associated with long-term care will
continue to rise. As it stands, families are bearing the brunt of these
costs. Less than a decade ago those who needed long-term care spent
nearly $37.4 billion in out-of-pocket expenses. This is not sustainable
for the majority of families; less than a decade ago we were not
recovering from a recession.
The issue before us today is how we intend to treat our aging and
disabled at a time when they are in need of assistance that will have a
direct impact on their quality of life.
CLASS comes into effect when a person is at his most vulnerable. For
example, when individuals are unable to clothe or bathe themselves.
CLASS would allow some individuals to remain in their home. It gives
the aging, the disabled and their families a viable option. Long-term
care encompasses a wide range of services for people who need regular
assistance because of chronic illness or physical or mental
disabilities.
Although long-term care might include some skilled nursing care it
consists primarily of help with basic activities of daily living, such
as bathing, eating, and dressing, and with tasks necessary for
independent living such as shopping, cooking, and housework, in essence
helping people who need help.
Traditionally, most long-term care is provided informally by family
members and friends. Some people with disabilities receive assistance
at home from paid helpers, including skilled nurses and home care
aides. Nursing homes are increasingly viewed as a last resort for
people who are too disabled to live in the community, due to a number
of factors, cost being one.
Madam Chair, I believe that we must leave the framework that exists
in place and work with seniors, families, industry, HHS and others to
find a way to make the CLASS Act or an alternative long-term care
program work. We cannot and we must not allow Medicaid to continue to
be the only affordable long-term care service available to Americans.
American families should not have to spend down their savings or assets
to access long-term care. We must not forget that this is an issue we
must address. As of January 1, 2011, baby
[[Page H332]]
boomers will begin to celebrate their 65th birthdays for that day on
10,000 people will turn 65 every day and this will continue for the
next 20 years
My career in Congress has been dedicated to expanding access to
affordable, quality health care for the residents of the state of
Texas, Houstonians, and all Americans, and the CLASS Act furthers that
goal. It is clear that the CLASS Act is not perfect, and almost no
piece of legislation can ever be, but that's why we rely on the
professionals in federal agencies to work on implementation of the law.
I strongly believe that we can find a way to make this program work
and I hope my colleagues on the other side of the aisle will work with
me to ensure that affordable long-term care is available for anyone who
needs it.
American families spend almost twice as much on health care through
premiums, paycheck deductions, and out-of-pocket expenses as families
in any other countries. In exchange, we receive quality specialty care
in many areas that is the envy of many. Yet, they do not receive
significantly better care than countries that spend far less.
Considering the amount that we spend on health care, it is surprising
that Americans do not live as long as people in Canada, Japan, and most
of Western Europe. Our health care system was in need of an overhaul.
The landmark bill signed by President Obama in 2010 is designed to
provide coverage to millions of people who currently lack it.
Under the Affordable Health Care law more than 32 million additional
Americans are expected to get insurance, either through an extension of
Medicaid or through exchanges where low and moderate income individuals
and families will be able to purchase private insurance with federal
subsidies.
A key part of the new health law also encourages the development of
``accountable care organizations'' that would allow doctors to team up
with each other and with hospitals, in new ways, to provide medical
services. There are dozens of good provisions in the Act that will
ultimately benefit the public, if they are not repealed one title at a
time. The CLASS Act is a good provision too--I stand by that notion--
but just improperly designed.
At this stage, any change is difficult and change especially during a
recession is extremely difficult. It is not possible to change a system
as large and as hugely flawed, as ours without some disruptions. We are
using fresh thinking and innovation to make sure everyone benefits--our
citizens, our health care providers, small businesses, large
corporations. I think the public is starting to slowly accept it. Over
the course of several years and as more beneficial provisions take
effect, this law will be more accepted, popular and possibly expanded.
Unfortunately, some in this Congress seems intent on not just undoing
the CLASS Act, but the entire Affordable Health Care law. Everyone
should have equal access to affordable health care and affordable
health care service. Repealing a program that is intended to assist the
aging and the disabled is not where this Congress should be spending
its energy. We should be focused on legislation, like the one I
proposed that would reduce the deficit, boast our nation's energy
production, and create jobs. It appears as though my Republican
colleagues seem more focused on putting forth bills that would cut
taxes, cut services to the aging and disabled, and cut discretionary
spending. Our priority should be to focus on legislation that will
create jobs.
Mr. VAN HOLLEN. Madam Chair, H.R. 1173 exemplifies the GOP agenda in
the 112th Congress: to reject constructive Democratic ideas, and fail
to introduce any practical solutions to our nation's problems.
I think we are all in agreement that the Community Living Assistance
Services and Supports, CLASS, Program--in its current form--needs work.
However, simply repealing it conveniently ignores that we have a long-
term care crisis in this country. Private long-term care insurance is
too costly for most Americans and the alternative, spending down their
assets in order to qualify for Medicaid, is financially devastating.
Medicaid now accounts for nearly half of all long-term care spending,
and as the nation's baby boomers age, federal and state budgets will
face further strain. The CLASS program is intended to lessen the
burden, providing working families a national, voluntary, and premium-
financed insurance program that enables them to responsibly plan for
long-term care.
Secretary Sebelius made the right decision to delay implementation of
program because, under existing parameters, it could not be done in a
financially solvent way. The Congressional Budget Office, CBO,
estimated that the program would run surpluses through approximately
2029 but would begin adding to the budget deficit after that. We need
to fix that. But let's try to mend it, not end it. Let's exhaust all of
our options, confer with experts and beneficiaries, and see if we can
find a viable path forward for the CLASS program. We must make every
effort to make it solvent before we leave seniors and disabled
individuals to the status quo for the foreseeable future.
Mr. CONNOLLY of Virginia. Madam Chair, we are not prepared, either as
families or as a society, to pay for the long-term care supports and
services most of us will need before we die.
Today 10 million Americans require some level of long-term assisted
care, and that number is on pace to triple as the Baby Boom generation
ages. Annual costs top more than $200 billion, and that doesn't count
the time and energy of family caregivers. The growing demand and costs
for long term care cannot be ignored, yet that is precisely what this
legislation does.
Not only does this legislation repeal the voluntary, self-supporting
long-term care insurance program created by the Affordable Care Act,
but it also repeals funding for the national clearinghouse of
information on long-term care services that helps seniors, their
families and caregivers navigate the maze of options.
HHS said it could not implement the CLASS Act as written. It did not
say such a program should not be implemented at all. In fact, HHS said
that 15 million Americans will require some form of long-term care in
2020, yet fewer than 3 percent will have long-term insurance coverage.
It went on to say that allowing that to persist will only increase the
burden on taxpayers at a time when we're working to reduce such federal
health care costs.
Madam Chair, this is nothing more than an ideologically-driven
attempt to undermine the President's signature initiative and score
political points at the expense of our seniors. I urge my colleagues to
reject this bill, so we can pursue a workable solution to this mounting
challenge that threatens the safety and security of our seniors and our
economy.
Mr. HOLT. Madam Chair, I rise today in opposition to the so called
``Fiscal Responsibility and Retirement Security Act of 2011'', H.R.
1173.
H.R. 1173 would repeal the Community Living Assistance Services and
Supports (CLASS) Act, which was included in health reform.
The CLASS Act would make it easier for people to save for long-term
care services. This program would give working adults the opportunity
to plan for long-term care needs by providing cash benefits that can be
used to purchase non-medical services and supports like home health
care. The Congressional Budget Office estimates that the CLASS Act
would reduce the federal deficit and Medicaid spending.
Our nation is facing a long-term care crisis and repealing the CLASS
Act does not help. Over ninety percent of Americans do not have long-
term health insurance coverage. This crisis becomes more serious over
the next two decades, when the number of Americans 65 and older will be
71 million--making up around 20 percent of the U.S. population. Long-
term care is expensive: nursing homes can costs over $70,000 a year and
home health care costs hundreds of dollars a day.
Instead of debating how to help Americans pay for long-term care, we
are spending our time repealing the only program that is trying to
help.
I oppose H.R. 1173 and urge my colleagues to vote no on this piece of
legislation.
Mr. DINGELL. Madam Chjair, I rise today in opposition of H.R. 1173.
This bill is yet another in a long list of efforts by the Republicans
to dismantle and repeal the Affordable Care Act piece by piece. Despite
the fact that my colleagues on the other side of the aisle sit in
Committee hearing rooms and profess to support addressing our long term
care crisis, one of their first pieces of legislation on the floor this
session is a bill that will repeal one option to address this crisis.
H.R. 1173 does nothing to protect the security of our country's
retirees. Repealing the CLASS Act does not protect the 70 percent of
today's 65 year olds who will need some sort of health or personal care
in the future. Nor does repealing the CLASS Act do anything for the 40
percent of long term care users between the ages of 18-64.
While I recognize that the CLASS Act is not fiscally feasible in its
current form, I also recognize that a lack of a long term care
initiative is not financially feasible for Americans. The average cost
of a nursing home is currently a staggering $78,000 per year while in-
home long term care averages $21,600 per year. We must continue to try
and solve the problem of our nation's lack of adequate long term care
options, and I call on my Republican friends to come to the table and
work with us to do so.
Instead of wasting valuable floor time, my Republican friends should
take this opportunity to work with Democrats as well as the Department
of Health and Human Services to find a solution to this critical issue.
We all must continue to champion the effort to create a safe and secure
future for our nation's citizens.
It is my concern that if the CLASS Act is repealed, the impetus to
implement a crucial
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long term care act will fall by the wayside. If my friends across the
aisle wish to repeal this provision, it is vital they work
expeditiously to implement a substitute for CLASS.
In 2008, 21 million Americans utilized some form of long term care.
That number is only going to continue to increase, and it is our duty
to protect the quality of life of our fellow Americans. I urge my
colleagues to vote against H.R. 1173 until we have a viable long term
care program to replace the CLASS Act.
Ms. EDDIE BERNICE JOHNSON of Texas. Madam Chair, I rise today in
opposition of H.R. 1173, legislation to repeal the Community Living
Assistance Services and Supports program. America has a long-term care
crisis, and it is only getting worse. Currently, there are over 10
million Americans who require long-term care, and this number is
expected to grow to 15 million by 2020.
Long-term care places a huge burden on family budgets. CLASS makes
long-term care more affordable and accessible by providing a national,
voluntary, self-sustaining insurance program for the purchase of long-
term care services and supports.
While CLASS may need to be tweaked, it should not be repealed without
the existence of a viable alternative. Rather than repeal this bill
today, Republicans and Democrats need to work together to identify ways
to strengthen CLASS so that it becomes a sustainable long-term care
program. Our nation's seniors are counting on us, and we must not let
them down.
As our population ages, the need for long-term care services will
only grow. Repealing the CLASS Act, without providing a viable
alternative, will result in millions of seniors exhausting their
retirement savings and personal assets. I cannot support H.R. 1173, as
it undermines the personal dignity of our seniors.
Mr. GOODLATTE. Madam Chair, today I rise in strong support of the
Fiscal Responsibility and Retirement Security Act. This important
legislation repeals the failed government-run long-term care insurance
program, known as the CLASS Act, which was included in the President's
Health Care Law, PPACA.
Nearly two years ago, with total disregard for the will of the
American people, Congress passed and President Obama signed the health
care reform overhaul into law. This law, which I voted against, is
defined by federal regulations, mandates, a myriad of new big
government programs, and a significant increase in federal spending and
debt at a cost to our country too high to bear.
The CLASS program is a prime example of the inherent problems with
this new law. In fact, the Obama Administration announced in October
that they would halt implementation of the CLASS program, recognizing
that the program was unsustainable despite claims that it would save as
much as $80 billion over 10 years.
Today the House has an opportunity to pass the Fiscal Responsibility
and Retirement Security Act, which is an important piece to dismantling
the President's Health Care Law and allows Congress to consider new
long-term care reform proposals that work for the American people
without busting the federal budget.
Madam Chair, I intend to continue working to repeal and defund 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. While we
can all agree that our current health care system needs to be reformed,
the new health care law was not the right way to do it. Instead we must
focus on a positive, patient-centered strategy that puts patients,
families and doctors, not Washington bureaucrats, in control of
personal health care decisions.
The Acting CHAIR. All time for general debate has expired.
Pursuant to the rule, the bill shall be considered for amendment
under the 5-minute rule for a period not to exceed 3 hours.
The amendment in the nature of a substitute recommended by the
Committee on Energy and Commerce printed in the bill shall be
considered as an original bill for the purpose of amendment under the
5-minute rule and shall be considered read.
The text of the committee amendment in the nature of a substitute is
as follows:
H.R. 1173
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 ``Fiscal Responsibility and
Retirement Security Act of 2011''.
SEC. 2. REPEAL OF CLASS PROGRAM.
(a) Repeal.--Title XXXII of the Public Health Service Act
(42 U.S.C. 300ll et seq.; relating to the CLASS program) is
repealed.
(b) Conforming Changes.--
(1)(A) Title VIII of the Patient Protection and Affordable
Care Act (Public Law 111-148; 124 Stat. 119, 846-847) is
repealed.
(B) The table of contents contained in section 1(b) of such
Act is amended by striking the items relating to title VIII.
(2) Section 1902(a) of the Social Security Act (42 U.S.C.
1396a(a)) is amended--
(A) by striking paragraphs (81) and (82);
(B) in paragraph (80), by inserting ``and'' at the end; and
(C) by redesignating paragraph (83) as paragraph (81).
(3) Section 6021(d) of the Deficit Reduction Act of 2005
(42 U.S.C. 1396p note) is amended--
(A) in paragraph (2)(A)(iv)--
(i) by inserting ``not'' before ``include''; and
(ii) by striking ``and information'' and inserting ``or
information''; and
(B) in paragraph (3)--
(i) in the heading, by striking ``Appropriation'' and
inserting ``Funding'';
(ii) by striking ``2015'' and inserting ``2012''; and
(iii) by adding at the end the following new sentence:
``There is authorized to be appropriated to carry out this
subsection $3,000,000 for each of fiscal years 2013 through
2015.''.
The Acting CHAIR. No amendment to the committee amendment in the
nature of a substitute shall be in order except those received for
printing in the Congressional Record designated for that purpose in a
daily issue dated January 31, 2012, or earlier and except pro forma
amendments for the purpose of debate. Each amendment so received may be
offered only by the Member who causes it to be printed or a designee
and shall be considered read if printed.
Are there any amendments to the bill?
Amendment No. 2 Offered by Ms. Jackson Lee of Texas
Ms. JACKSON LEE of Texas. I have an amendment at the desk.
The Acting CHAIR. The Clerk will designate the amendment.
The text of the amendment is as follows:
Page 5, after line 19, add the following:
SEC. 3. STUDY ON THE IMPACT OF NOT HAVING LONG-TERM CARE
INSURANCE ON THE FEDERAL, STATE, AND LOCAL
GOVERNMENTS.
(a) Studies.--Section 2 shall not take effect until--
(1) the Director of the Congressional Budget Office
completes a macroeconomic study and submits a report to the
Congress on the impact on the Federal, State, and local
governments of not having long-term care insurance; and
(2) the Secretary of Health and Human Services completes a
study and submits a report to the Congress on the best
practices necessary to have a viable, financially secure, and
solvent long-term care insurance program.
(b) Exception.--Notwithstanding subsection (a), section
2(b)(3)(B) shall take effect upon the enactment of this Act.
The Acting CHAIR. The gentlewoman from Texas is recognized for 5
minutes.
Ms. JACKSON LEE of Texas. Madam Chair, first of all, let me say that
I was on the floor yesterday regarding the CLASS Act and my approach to
the CLASS Act. And I recognize that we have had some difficulty with
putting together the right balance, the right financial structure for a
very large program. But it does not mean that it does not have purpose.
The CLASS program deals with long-term care. In my readings I've
determined that private families and loved ones have given in essence
$450 billion in private care, meaning that they have taken care of
their loved ones on their own; $101 billion has been spent by the
Medicaid program. And I said yesterday that I've had the experience of
taking care of a dear mother who I lost in 2010, and right now an aunt
who I am taking care of in 2012. And I've seen a number of friends and
others who need long-term care. And so the idea of disposing of it to
me seems incomplete, without projecting back to Health and Human
Services how can we get this done.
My amendment would not repeal the CLASS Act until the completion of a
macroeconomic study.
{time} 1540
We must determine the cost of not having long-term care insurance on
the Federal, State and local governments before we repeal any programs
like CLASS that are self-sustaining. CLASS is not taxpayer funded. The
lack of affordable care is a very serious problem which, if not
addressed, will only add to our growing national debt. H.R. 1173 would
repeal the CLASS Act in its totality, and I believe that that is the
wrong direction to go. And so I would be offering my amendment to help
26 million Americans who need long-term care services in the near
future.
The CLASS Act is a positive intent, and it deals with the fact that
we all must have balance of burden and benefit. We have to recognize
that there
[[Page H334]]
are those whom we have to help. My amendment would ask for that study
to be engaged and to ask for the Secretary to come back with an
analysis of how devastating the impact would be and how high the
deficit would grow. As the former executive director for the National
Governors Association noted, failure to reform the underfunded,
uncoordinated patchwork of long-term care supports and services is a
failure to truly reforming health care.
Long-term care is not just for the elderly. It's for those who have
had catastrophic illnesses, maybe the injured football player or the
injured skier or a major accident when our loved ones need our
attention. And, oh, how much can be done with long-term care. How do I
know it? My mother went into a nursing home and could not walk--but she
walked out.
Yes, there is value to helping people restore their lives. And baby
boomers are already turning 65; 10,000 people will turn 65 every day as
of January 1, 2011, over the next 25 years. And I'm grateful that
because of health care and the Affordable Care Act, they will be living
longer. Therefore, I'm asking that we not throw the baby out with the
bath water. Allow the Secretary to do this study and to do this study
that will be helpful to all of us. By 2050, the number of individuals
using long-term care will increase.
I would like to reserve the balance of my time.
The Acting CHAIR. The gentlewoman may not reserve the balance of her
time.
Ms. JACKSON LEE of Texas. Let me just say, Madam Chair, to my
disappointment, I wanted to reserve to engage with my friend. But let
me just say this: that care involves home residential care, skilled-
nursing facilities, and it will likely double from the 10 million
services in 2000 to, as I said earlier, 26 million people.
So it makes sense to accept my amendment that would allow this
macroeconomic study to look closely at the benefit and the burden of
not having long-term care. I can assure you that we will be better
informed to be able to have those instructions, and I would ask my
colleagues to support this amendment.
Madam Chair, I rise today in support of my amendment #2, to H.R.
1173, ``The Fiscal Responsibility and Retirement Security Act of
2011.'' My amendment would delay the repeal of the CLASS PROGRAM until
the completion of a macroeconomic study. We must determine the costs of
not having long-term care insurance on the federal, state, and local
governments before we repeal programs, like CLASS, that are self
sustaining. CLASS is not tax payer funded! The lack of affordable care
is a very serious problem which, if not addressed, will only add to our
growing national debt.
H.R. 1173 would repeal Title VIII of the Patient Protection and
Affordable Care Act and Supports (CLASS) Program--a national, voluntary
long-term care insurance program for purchasing community living
assistance services and supports. Title VIII also authorized and
appropriated funding through 2015 for the National Clearinghouse for
Long-Term Care Information (clearing house). H.R. 1173 would rescind
any unobligated balances appropriated to the National Clearinghouse for
Long-Term Care Information.
I ask my colleagues to ensure that the 26 million Americans, who will
need long term care services in the near future, will be able to
purchase this care at reasonable prices.
The CLASS Act is a noble and notable attempt to legislate this issue
but when the Administration realized that the legislation did not do
what we thought it would they came forth and did the right thing and
deemed it to be unsustainable.
Policy won out over politics because it would be easy to obfuscate
and forge ahead with implementation even in the face of an obviously
problematic bill. This indeed was a bold act of integrity for the
Department of Health and Human Services.
The inclusion of the long term care infrastructure (CLASS) in health
care reform was a signature issue for one of the foremost advocates in
this bicameral body, the late Senator Ted Kennedy who worked tirelessly
to achieve its enactment.
As Raymond Scheppach, former Executive Director for National
Governors' Association noted, ``failure to reform the under-funded,
uncoordinated patchwork of long-term care supports and services is a
failure to truly reforming health care.'' This failure defines the
revolving door of our health care system.
An estimated 10 million Americans currently need long term care
services, and that number is projected to reach 26 million by 2050.
Nearly half of all funding for these services is now provided through
Medicaid, which is an ever-growing and inexorable burden on states and
requires individuals to ``spend down'' or, become and stay poor to
receive the help they need.
This spend-down activity runs contrary to the American notion of
putting something away for a rainy day, or to allow for passing on to
your heirs so that they can see a better day than you.
Estimates suggest that in the upcoming years the number of disabled
elderly who cannot perform basic activities of daily living without
assistance may double today's level. CLASS provides the aging and the
disabled with a solution that is self sustaining, at no cost to tax
payers.
As the estimated 76 million baby boomers born between 1946 and 1964
become elderly, Medicare, Medicaid, and Social Security will nearly
double as a share of the economy by 2035.
Baby boomers are already turning 65. As of January 1, 2011, 10,000
people will turn 65 every day and this will continue for the next 20
years. It is reasonable to assume that over time the aging of baby
boomers will increase the demand for long-term care.
In addition, individuals 85 years and older are one of the fastest
growing segments of the population. In 2005, there are an estimated 5
million people 85+ in the United States; this figure is expected to
increase to 19.4 million by 2050. This means that there could be an
increase from 1.6 million to 6.2 million people age 85 or over with
severe or moderate memory impairment in 2050.
Repealing the CLASS program does nothing to address the fact that
private long-term care insurance options are limited and the costs are
too high for many American families, including many in my Houston
district, to afford.
An estimated 10 million Americans needed long-term care in 2000. Most
but not all persons in need of long-term care are elderly.
Approximately 63% are persons aged 65 and older (6.3 million); the
remaining 37% are 64 years of age and younger (3.7 million).
The lifetime probability of becoming disabled in at least two
activities of daily living or of being cognitively impaired is 68% for
people age 65 and older.
By 2050, the number of individuals using paid long-term care services
in any setting (e.g., at home, residential care such as assisted
living, or skilled nursing facilities) will likely double from the 10
million using services in 2000, to 26 million people. This estimate is
influenced by growth in the population of older people in need of care.
Of the older population with long-term care needs in the community,
about 30% (1.5 million persons) have substantial long-term care needs--
three or more activities of daily living limitations. Of these, about
25% are 85 and older and 70% report they are in fair to poor health.
40% of the older population with long-term care needs are poor or near
poor (with incomes below 150% of the federal poverty level).
Between 1984 and 1994, the number of older persons receiving long-
term care remained about the same at 5.5 million people, while the
prevalence of long-term care use declined from 19.7% to 16.7% of the
65+ population. In comparison, 2.1%, or over 3.3 million, of the
population aged 18-64 received long-term care in the community in 1994.
Mr. PITTS. Madam Chair, I rise in opposition to the amendment.
The Acting CHAIR. The gentleman from Pennsylvania is recognized for 5
minutes.
Mr. PITTS. Madam Chair, again, this amendment continues to ignore the
reality around the CLASS program.
The CLASS program has been reviewed by outside analysts, by the HHS
actuary and the Congressional Budget Office; and just last year the
Obama administration finally admitted what so many already knew, the
CLASS program is not workable. In fact, the Congressional Budget Office
has certified that not a single person would ever receive benefits from
the CLASS program. Any effort to preserve a failed program on the books
simply delays any real attempt to ensure every American has access to
affordable long-term care coverage.
From the start, the CLASS program was a Big Government idea that
independent analysts believed was flawed and unworkable. The American
Academy of Actuaries, the Congressional Budget Office and even
officials at the Department of Health and Human Services run by
Secretary Sebelius had grave concerns about the workability of this
program. It has been studied. It does not work. If you would have done
this study before you passed it, we would not have wasted millions of
taxpayer dollars on a program that was
[[Page H335]]
doomed from the start. Perhaps we should visit what the failed
implementation of the CLASS program has done, rather than spend
millions on a study of what its removal would do.
I begin by reminding my colleagues that the CLASS program has done
nothing to help reduce Federal or State spending. In fact, the
Department spent at least $5 million to implement a failed program and
an $80 billion hole in the Federal budget. I would also remind my
colleague that the CLASS program has done nothing for consumers who are
left with a failed program that was overpromised to the public as part
of the President's monstrous health care law.
We must move to take the CLASS program off the books so that we can
move forward with solutions that work with the private market that are
affordable for consumers and don't place additional strain on the
Federal and State budgets.
Mr. PALLONE. Madam Chair, I move to strike the last word.
The Acting CHAIR. The gentleman from New Jersey is recognized for 5
minutes.
Mr. PALLONE. I yield to the gentlewoman from Texas.
Ms. JACKSON LEE of Texas. I thank the gentleman. Madam Chair, first
of all, I want to make sure that my amendment is amendment No. 2 to
H.R. 1173, and I have another amendment which is amendment No. 1.
But I do want to respond to the gentleman and just indicate that best
practices have not been assessed. The point of my amendment is to get
us focusing on what the numbers need to be to increase the viability of
life and care for those needing long-term care, juxtaposed against the
enormous debt and deficit that will occur if no one has long-term care
or we continue to have to utilize Medicaid, which is at $101 billion,
private insurance is only at $14.5 billion, and then the burden on
family members, aging family members, their care. They have put in
their pound of support at $450 billion. We can at least pay attention
to new numbers by asking for best practices to be assessed.
I believe if we do that, we will have the opportunity to do the right
thing by the American people; and we will be, in essence, being
productive. No one can deny the fact that having insurance that has
people being eliminated from insurance for preexisting conditions is
not good. No one can say that having children on your insurance to 26
is not good. No one can say that not being kicked out of a hospital bed
because you have flat-lined on your insurance is not good. It is good.
We recognize that coming together in a bipartisan manner, we can, in
fact, make this right, and we can find a way to help those families
right now. Alzheimer's, where families are taking care of that loved
one, they need support; and they need it in a structure that can help
provide them with resources for long-term care.
I ask my colleagues to support a thoughtful amendment that deals with
providing additional information. I thank the gentleman for his time. I
ask my colleagues to support the Jackson Lee No. 2 amendment on a
macroeconomic study on the benefits and burdens of repealing the CLASS
Act.
The Acting CHAIR. The question is on the amendment offered by the
gentlewoman from Texas (Ms. Jackson Lee).
The question was taken; and the Acting Chair announced that the noes
appeared to have it.
Ms. JACKSON LEE of Texas. I demand a recorded vote.
The Acting CHAIR. Pursuant to clause 6 of rule XVIII, further
proceedings on the amendment offered by the gentlewoman from Texas will
be postponed.
Amendment No. 1 Offered by Ms. Jackson Lee of Texas
Ms. JACKSON LEE of Texas. I have an amendment, No. 1 I believe.
The Acting CHAIR. The Clerk will designate the amendment.
The text of the amendment is as follows:
H.R. 1173
At the end of the bill, add the following:
SEC. 3. ENSURING MARKET PENETRATION FOR PRIVATE LONG-TERM
CARE INSURANCE.
(a) In General.--Section 2 shall not take effect until such
date as the Secretary of Health and Human Services certifies
to the Congress that at least 60 percent of individuals in
the United States who are 25 years of age or older have
private long-term care insurance.
(b) Exception.--Notwithstanding subsection (a), section
2(b)(3)(B) shall take effect upon the enactment of this Act.
The Acting CHAIR. The gentlewoman from Texas is recognized for 5
minutes.
Ms. JACKSON LEE of Texas. Madam Chair, I rise with great concern
about H.R. 1173. And, again, I want to make it very clear that in all
the course of traveling throughout my district when the Affordable Care
Act was passed in 2010, there was a great deal of emotion and
celebration. I take, for example, those senior citizens who were
continuously falling through the hole on Medicare part D. This
particular legislation helped close the doughnut hole where seniors'
prescription drugs did not skyrocket, so they would not have to make a
decision among their drug prescriptions or their rent or what they ate.
{time} 1550
This amendment is very clear. It simply states Congress resolves that
health care is necessary for a healthy population, humane treatment of
impoverished citizens, and to help reduce the budget deficit, and that
long-term care insurance represents one-third of Federal and State
spending on Medicaid. It's a simple statement of fact, Madam
Chairwoman, and I would ask that this simple statement of fact be added
to this legislation. I think it will be a positive statement. It will
give us the connectedness to say that we have got to get back to the
drawing boards and make sure that we have, in fact, the right kind of
insurance for people in need.
I can't imagine why we would want to abandon those who need long-term
care. As I've indicated, it may be a young person who faces a
catastrophic illness or accident; it may be a child suffering from a
chronic disease; it may be some of our friends who suffer from issues
dealing with mental health. In my own community, just recently, one of
our major hospitals with mental health beds was closed down, 148 beds.
Who knows what will happen to those patients, some of whom actually
stayed in that facility for a period of time. We know we don't have
enough mental health beds and beds for those who need long-term care,
suffering from conditions dealing with their mental health.
My amendment is recognition of the fact that the issue of long-term
care services is not going away. The enormous cost of not providing the
rainy-day umbrella, the cushion for families and those who are
suffering from devastating disease just cannot happen. It cannot be
swept under the rug. The cost curb is steep and growing, and we cannot
continue to kick the can down the road. Long-term care, again, is
fundamental. And so, this particular legislation acknowledges that.
Forty percent of long-term care users today are between the ages of
18 and 64, as I said. While most people who need long-term care are in
their seventies and eighties, as I said, many younger people are facing
the horror of disability or a disability without any way of paying for
it, without giving relief to their family members. Long-term care is
expensive and can quickly wipe out hardworking families' savings, which
gives many families a Hobson's choice: spend down and wipe out years of
hardworking services to qualify for Medicaid.
For those of you who don't know how Medicaid works, because we want
to be responsible with Federal tax dollars, you have to be down to
zero--your house has to be sold, your car has to be sold, any assets
have to be sold, and everything you have goes back into the system.
Well, I know there are people who believe that they want to pay part
of this burden, but there are others who understand that, in addition
to paying, why should they be made completely indigent? Why can't that
person remain in their home, even with care--which is another part of
long-term care. It gives the opportunity for families to be together
and for that individual who is injured to be able to be taken care of
inside their home with a loving family but yet having the long-term
care providers.
This is a simple statement. I hope my colleagues will not oppose the
idea that long-term care is important and that we have to respond to it
by way of ensuring that we don't grow the deficit.
[[Page H336]]
The average lifetime long-term care spending for a 65-year-old is
$47,000; 16 percent will spend $100,000 and 5 percent will spend
$250,000.
There's no doubt that we need relief. Nationwide, the median annual
cost of a nursing home in 2010 was $75,000, room and board, in an
assisted living facility. This is a crisis that will impact the debt;
and, therefore, I would argue that repealing the CLASS Act without a
positive statement, Madam Chair, of how important it is is tragic.
I ask my colleagues to support the Jackson Lee amendment. Stand up
and be counted for the value of long-term care support here in America.
Madam Chair, I rise today in support of my amendment #1 to H.R. 1173,
``The Fiscal Responsibility and Retirement Security Act of 2011.'' My
amendment states, ``Congress resolves that health care is necessary for
a healthy population, humane treatment of impoverished citizens, and to
help reduce the budget deficit; and that long-term care insurance
represents one-third of federal and state spending on Medicaid.''
H.R. 1173 would repeal Title VIII of the Patient Protection and
Affordable Care Act and Supports (CLASS) Program--a national, voluntary
long-term care insurance program for purchasing community living
assistance services and supports. Title VIII also authorized and
appropriated funding through 2015 for the National Clearinghouse for
Long-Term Care Information (clearing house). H.R. 1173 would rescind
any unobligated balances appropriated to the National Clearinghouse for
Long-Term Care Information.
My amendment is recognition of the fact that the issue of long-term
care services is not going away. It cannot be swept under the rug. The
cost-curve is steep and growing. We cannot continue to kick the can
down the road: long-term care is fundamental.
As our nation's population ages, there is an increasingly urgent need
to find effective ways to help Americans prepare for their individual
long-term care needs. Almost seven out of ten people turning age 65
today will need some help with their activities of daily living at some
point in their remaining years.
Forty percent of long-term care users today are between the ages of
18 and 64. While most people who need long-term care are in their 70s
and 80s, many younger people, particularly those living with a
significant disability, also may need assistance.
Long-term care is expensive, and can quickly wipe out hardworking
families' savings, which gives many families a Hobson's choice: spend-
down and wipe out years of hard-earned savings to qualify for Medicaid.
While costs for nursing home care can vary widely, they average about
$6,500 a month, or anywhere from $70,000 to $80,000 a year. And these
costs are only becoming more expensive.
People who receive long-term care at home spend an average of $1,800
a month. The average lifetime long-term care spending for a 65 year old
is $47,000; 16 percent will spend $100,000 and 5 percent will spend
$250,000. And many of these people have other expenses as well.
Nationwide, the median annual cost of a nursing home in 2010 was
$75,000; room and board in an assisted living facility, with no
additional help, was $37,500; an attendant that provides home care and
no medical tasks, like the dispensing of medication, is paid
approximately $19 an hour.
These expenses are left to America's seniors and people with
disabilities (and their adult children) to pay for out of pocket until
their pockets are all but empty. As this body knows well, Medicare only
covers short-term and limited long-term care services, and the Medicaid
safety net is only available to those who have depleted virtually all
of their resources as a result of being frail or suffering from
dementia. Many people are left in dire situations and are truly at
society's mercy.
Today, there are many Americans with disabilities who want to and are
able to work and thereby maintain independence and contribute
financially to their families. However, if they depend upon an
attendant to drive them to their job or help them shop, use the toilet,
or bathe, they must have enough additional financial resources to pay
for such assistance, or have low enough incomes to qualify for
Medicaid.
Long-term care insurance is the most popular of the private options
available, but less than 3-percent of the American people have long-
term care insurance, meaning there is a wide gap and acute lack of
awareness. The CLASS Act sought to bridge this gap and has come up a
little short. However we cannot, as a Congress, pretend the problem is
going away.
My amendment recognizes that long-term care must be addressed as
millions of baby boomers have already begun turning 65. The aging
population and the disabled need viable options for their care. Taking
away a program that is intended to meet the future needs of our aging
is the wrong approach. We should be focused on ways to boost our
economy, providing increased access to affordable care to seniors, low
income, and the disabled, and job creation. We should not be
eliminating programs that aim to sustain our aging population.
Mr. PITTS. Madam Chair, I rise in opposition to the amendment.
The Acting CHAIR. The gentleman from Pennsylvania is recognized for 5
minutes.
Mr. PITTS. Madam Chair, this amendment continues to ignore the
reality. The CLASS program is simply not workable. Keeping the CLASS
program and pretending that it will ever work does absolutely nothing
and offers no help to millions of Americans who want to maintain their
health. Any effort to preserve a failed program on the books simply
delays any real attempt to ensure every American has access to
affordable, long-term care coverage.
From the start, the CLASS program was a Big Government idea that
independent analysts believed was flawed and unworkable. In fact, the
Obama administration officials pointed out serious concerns with the
CLASS program as early as the beginning of 2009. While those concerns
went ignored by the administration until earlier this fall, now is not
the time to stall its repeal.
Yesterday, Senator Harkin told reporters that the only way to make
CLASS work is to make it mandatory. Are the supporters of the CLASS Act
really advocating another mandate? Keeping CLASS on the books is a step
in that direction.
Keeping the CLASS program on the books also further threatens the
private market and the nearly 8 million Americans who have private
long-term care insurance today. You cannot have a functioning long-term
care insurance market if there is a continued threat of a government
takeover of that market.
We need long-term care reform that builds on what the private market
provides, not destroys it. I hope that those on the other side of the
aisle have the courage to admit their mistake, repeal this law, and
begin to work on a real, workable long-term care policy.
I urge Members to oppose this amendment.
Madam Chairman, I yield back the balance of my time.
Mrs. BLACKBURN. Madam Chairman, I move to strike the last word.
The Acting CHAIR. The gentlewoman from Tennessee is recognized for 5
minutes.
Mrs. BLACKBURN. Madam Chairman, I oppose the amendment, and I stand
here today in support of repealing the CLASS Act.
You know, it's been almost 2 years since we sought passage of the
ObamaCare bill in this Chamber, and it is something that we have worked
since taking the majority to repeal this and get it off the books; and,
indeed, what we are seeing is a need to get this CLASS Act off the
books.
Despite the Federal Government's best efforts, there is no way to
show that this is going to save money. Indeed, in a budget gimmick, as
we were discussing this bill in committee a couple of years ago, what
they did was to come in and say, Oh, this will save $80 billion. Oh,
let's add title 8 to the bill, let's add sections 8001 and 8002 to this
legislation, and let's create this little pool here where we're going
to have near-term expenses that are supposed to yield us some long-term
savings. The problem is all the new math you wanted to put to work on
this, Madam Chair, there was no way to show that it was ever going to
save money. And, indeed, Secretary Sebelius, who is the Health and
Human Services Secretary, was forced to admit last October that there
was no path forward for this program.
So what we need to do is to say this was a mistake. It doesn't save
money. It is not going to address a problem. It is something that needs
to come off the books. It is a way we can step forward and we can take
a program off the books. And I encourage my colleagues to support
ending the CLASS Act, getting it off the books.
I yield back the balance of my time.
The Acting CHAIR. The question is on the amendment offered by the
gentlewoman from Texas (Ms. Jackson Lee).
The question was taken; and the Acting Chair announced that the noes
appeared to have it.
[[Page H337]]
Ms. JACKSON LEE of Texas. I demand a recorded vote.
The Acting CHAIR. Pursuant to clause 6 of rule XVIII, further
proceedings on the amendment offered by the gentlewoman from Texas will
be postponed.
{time} 1600
Amendment No. 4 Offered by Mr. Deutch
Mr. DEUTCH. Madam Chair, I have an amendment at the desk.
The Acting CHAIR. The Clerk will designate the amendment.
The text of the amendment is as follows:
At the end of the bill, add the following new section:
SEC. 3. PREVENTING AN INCREASE IN MEDICAID SPENDING.
Section 2 (other than subsection (b)(3)(B) of such section)
shall not take effect until 90 days after the date on which
the Comptroller General of the United States certifies to
Congress that failure to implement the CLASS program
established under title XXXII of the Public Health Service
Act will not increase State and Federal spending for long-
term care under the Medicaid program under title XIX of the
Social Security Act.
The Acting CHAIR. The gentleman from Florida is recognized for 5
minutes.
Mr. DEUTCH. Madam Chair, although I regret that this Congress is
considering the full repeal of a promising effort to address the
looming long-term care crisis in our country, I have to admit I'm not
surprised. This is the action of a Congress deserving of America's low
opinion of us.
We know the facts. A vote against this amendment is a vote for
increased Medicaid spending.
No one is immune from becoming disabled or growing old, yet just 10
percent of Americans over age 50 can afford long-term care insurance.
As a result, a staggering 90 percent of Americans rely on long-term
care provided by Medicaid. It is no wonder that over a third of
Medicaid spending is on long-term care, not on checkups for
impoverished children, not on prenatal care for poor, expectant
mothers. No, it is the expensive, institutionalized long-term care
funded by Medicaid.
The goals of the CLASS program represented an alternative to this
system on which we all could have agreed, a fully solvent, affordable,
premium-financed, long-term care program. It emphasizes personal
responsibility, lessens the burden on taxpayers, and reduces
unnecessary Medicaid spending.
Sometimes, as things happen here, Congress passes imperfect
legislation. But rather than address these imperfections, the
legislation before this House today gives up on our grappling with this
long-term care crisis altogether.
We've overcome challenges like this before. In the early 1980s,
Social Security faced a crisis. So what happened? Did my Republican
friends, concerned about having an imperfect law on the books,
castigate what they called ``RooseveltCare'' and bring to the floor a
two-page bill to revoke the Social Security Act? That's not,
thankfully, what happened. What did happen was that Democrats and
Republicans worked together, with President Reagan, and strengthened
Social Security. As a result, Social Security continues to keep
millions out of poverty, ensuring against the universal risk of old
age, disability, or death of a breadwinner.
The amendment I offer today would prevent repeal of the CLASS Act
from taking place if failure to implement the CLASS program would
increase State and Federal Medicaid spending.
Greater reliance on the safety net has led many to conclude that
Medicaid has become unaffordable. Instead of cutting basic health care
for our most vulnerable--the elderly, the disabled, poor children--we
ought to reduce Medicaid spending. We ought to put more Americans back
to work. We ought to make private health insurance more affordable.
There are many prescriptions for reducing Medicaid spending; but
let's be clear, repeal of the CLASS Act and upholding our long-term
care crisis is not among them. The Congressional Budget Office
estimates that even the imperfect CLASS bill that passed would reduce
Medicaid spending by at least $2 billion.
If more older Americans had access to affordable long-term care
insurance, middle class seniors could secure a less costly, more
independent lifestyle in their own homes instead of spending down into
poverty to receive expensive, institutionalized care.
What message is Congress sending by repealing CLASS? We are
proclaiming that the current system, which incentivizes elder poverty
and forces seniors to blow through their life savings, is just fine.
Save nothing. Pass what you do have on to your children before you get
sick. Own little property, and don't purchase long-term care insurance.
Follow this plan and you'll be eligible for expensive,
institutionalized care through Medicaid. If CLASS is repealed, it is
exactly the children and grandchildren that my friends on the other
side say they worry about who will pay the cost.
A premium-financed long-term care program would shift people from
reliance on Medicaid. This should be our shared goal. We ought to work
together to fix a program that represents the first real path toward
making affordable long-term care available to middle class families who
want to secure themselves against possible poverty.
I respectfully ask my colleagues to support this amendment, because
reducing Medicaid spending while improving the lives of seniors and
persons with disabilities is a conversation worthy of this office.
And with that, I yield back the balance of my time.
Mr. PITTS. Mr. Chairman, I rise in opposition to the amendment.
The Acting CHAIR (Mr. Yoder). The gentleman from Pennsylvania is
recognized for 5 minutes.
Mr. PITTS. Mr. Chairman, this amendment would simply ignore the
millions of dollars that have been spent by this administration to
reach the same conclusion that so many unbiased analysts had said for
years: The CLASS program is unworkable, causing a liability for the
potential beneficiary and the taxpayers alike.
This amendment would promote reckless governing that maintains a
failed program for further meddling. The CLASS program has done nothing
to decrease Medicaid spending, and its inclusion in the Patient
Protection and Affordable Care Act was a budget gimmick, a budget
gimmick that will cost the American taxpayers $80 billion over the next
10 years.
Alternative policies, such as the Long-Term Care Partnership Program,
which was signed into law by President Bush, have decreased Medicaid
spending and deterred Americans from making Medicaid their primary
payer of long-term care services. That program alone has done more for
Medicaid spending than CLASS ever will.
We can and should do more to decrease Medicaid spending and ensure
Americans have the access they need to affordable long-term care
coverage, but government intrusion into the market is not the way to
go. However, we cannot move forward in thinking about better long-term
care policies with this failed program hanging over us.
Yesterday, Senator Harkin made it clear that the problem with the
CLASS program was that it was voluntary. A vote in favor of this
amendment is a vote in favor of another mandate on the American people.
Enough is enough. We must get this failed program off the books so
that we can move forward in establishing long-term care policies that
work for the American taxpayers, not those that further bankrupt this
country.
With that, I yield back the balance of my time.
The Acting CHAIR. The question is on the amendment offered by the
gentleman from Florida (Mr. Deutch).
The question was taken; and the Acting Chair announced that the noes
appeared to have it.
Mr. DEUTCH. Mr. Chair, I demand a recorded vote.
The Acting CHAIR. Pursuant to clause 6 of rule XVIII, further
proceedings on the amendment offered by the gentleman from Florida will
be postponed.
Amendment No. 5 Offered by Mr. Deutch
Mr. DEUTCH. Mr. Chairman, I have an amendment at the desk.
The Acting CHAIR. The Clerk will designate the amendment.
The text of the amendment is as follows:
At the end of the bill, add the following new section:
SEC. 3. CLASS PROGRAM FLEXIBILITY.
(a) In General.--Subject to subsection (b), section 2
(other than subsection (b)(3)(B) of
[[Page H338]]
such section) shall not take effect until such date on which
each of the following has been satisfied:
(1) The Secretary of Health and Human Services submits to
Congress a report including a determination made by the
Secretary on whether or not the Secretary has the authority
to implement the CLASS program under title XXXII of the
Public Health Service Act and develop and implement the
benefit plans described in subsection (c).
(2) In the case the Secretary determines the Secretary does
not have the authority described in paragraph (1), the
Secretary includes in the report described in such paragraph
recommendations for statutory changes needed, and a
recommended list of statutory provisions that would need to
be waived, to provide the Secretary with such authority.
(3) In the case the Secretary determines the Secretary does
not have the authority described in paragraph (1), not later
than 90 days after the submission of such report and
recommendations, Congress has considered and rejected such
recommendations.
(b) Exceptions.--
(1) Section 2 (other than subsection (b)(3)(B) of such
section) shall not take effect if the Secretary of Health and
Human Services determines under subsection (a)(1) that the
Secretary has the authority described in such subsection and
the Secretary develops the 3 benefit plans described in
subsection (c).
(2) In the case the Secretary determines under subsection
(a)(1) that the Secretary does not have the authority
described in such subsection and Congress has not considered
and rejected the recommendations described in subsection
(a)(2) by the deadline described in subsection (a)(3),
section 2 (other than subsection (b)(3)(B) of such section)
shall not take effect and the Secretary shall have the
authority to waive the provisions recommended by the
Secretary to be waived under the report described in
subsection (a)(2).
(c) Actuarially Sound Benefit Plans.--Not later than 180
days after the date of the enactment of this Act, the
Secretary of Health and Human Services shall develop 3
actuarially sound benefit plans as alternatives for
consideration for designation as the CLASS Independence
Benefit Plan described in section 3203 of the Public Health
Service Act that address adverse selection and have market
appeal, regardless of whether such plans satisfy the
requirements described in subsection (a)(1) of such section.
The Acting CHAIR. The gentleman from Florida is recognized for 5
minutes.
Mr. DEUTCH. Mr. Chairman, this amendment reads, ``The Secretary shall
develop three actuarially sound benefit plans.''
This amendment's small fix gives the administration the ability to
implement a program that enjoys the support of two-thirds of all
Americans, including, I should add, over half of Republicans. The
stipulation for moving forward, however, is that CLASS is implemented
on an actuarially sound basis.
The distinguished gentleman from Louisiana and author of the
underlying bill has expressed some opposition to my amendment,
suggesting that it will waive the solvency requirement. I respect the
gentleman's work and service, but I regret that the claim is simply
untrue.
This amendment gives the Secretary waiver authority only after three
requirements are met. The plan must be actuarially sound, must address
adverse selection, and must have market appeal.
The deliberate obfuscation of this amendment's intention is a
textbook example of why American's are fed up with Washington. I would
work with anyone in any party to protect the financial security of
middle class and near-retirees. But when attempts to improve the
existing law in a fiscally responsible way are treated in this manner,
it is no wonder why we can't get things done.
The bill's proponents say, Trust us. We'll replace this.
Unfortunately, over a year ago they said the same thing about the
Affordable Care Act. Instead we had repeal and replace, minus the
replace.
As we all know, the CLASS program, as drafted, is facing challenges
of implementation. Critics have focused on fiscal sustainability. The
good news is that there is a fiscally sustainable path forward. With
greater flexibility, a program could be designed that addresses adverse
selection and improves market appeal.
{time} 1610
We must remember that even with implementation, CLASS would only be a
start addressing a very serious long-term care crisis.
Looking back on our history would serve us well today. In the infancy
of Social Security, Senator William H. King, a Democrat from Utah,
supported the Clark amendment which would have undercut the Social
Security program. He was concerned that Social Security would crowd out
private pensions and conditioned his support of Social Security upon a
guarantee that the Clark amendment would later be taken up.
When Congress returned, Senator King was asked about the amendment.
He said, You can forget about the amendment. The passage of the Social
Security Act has got everybody talking about pension plans. You can
forget it forever.
Americans ought to be talking about long-term care. We should all be
lucky enough to grow older. We should all be lucky enough to retire in
south Florida.
However, no one is immune from the frailty of old age, and no one is
exempt from disability.
I can't help but think of a very impressive man from south Florida, a
good friend named Alan Brown, who, on January 2, 1988, at the age of
20, was hit by a strong wave at the beach that caused a catastrophic
spinal cord injury that leaves him a quadriplegic to this day.
Mr. Brown has an endless list of expenses from his wheelchair and
medication, to disability through accessible transportation, and long-
term care. Even while holding two jobs, he struggles to support his
family in the face of rising health care costs.
As lawmakers, it is our responsibility to remember that those who are
young and healthy may not always remain so and act on the fact that
long-term care is out of reach for the majority of Americans. Any one
of us could experience an unpredictable accident like Mr. Brown. If
that is not compelling enough, the inevitability of aging should be.
What message is this Congress sending when our response to the long-
term care crisis is ``just say no''? Why should Americans be thinking
about long-term care if their leaders in Congress answer a complicated
and systemic problem with a politically charged two-page bill?
If the Secretary were given the flexibility in my amendment, the
CLASS program would remain the furthest thing from an entitlement, as
it would remain fully financed by premiums. This fix to CLASS is true
fiscal responsibility, an individual retirement security; and I
respectfully urge my colleagues to support it.
Mr. GINGREY of Georgia. Mr. Chairman, I rise in opposition to the
amendment.
The Acting CHAIR. The gentleman is recognized for 5 minutes.
Mr. GINGREY of Georgia. Mr. Chairman, the amendment No. 5, or Deutch
2, is an amendment essentially that the Secretary of Health and Human
Services has already looked at, some of these provisions, in eight
different ways in trying to come up with some possibility of certifying
the fiscal solvency of this CLASS Act within the 75-year budget window,
the out-years.
Thank goodness, Mr. Chairman, for the wisdom of Senator Judd Gregg on
the Senate side when that amendment was accepted in the health
committee. I don't know whether it was unanimously accepted by the
Democrats, but I think it was. Again, the prescience and the wisdom of
Senator Gregg is something the American people should be, and I think
will be, eternally grateful for.
The Secretary looked at the possibility of saying that we'll make
this fiscally solvent if we eliminate eligibility for anybody with a
preexisting condition. Then they said, Well, no, that's not going to
work. So let's say, how about a 15-year waiting period for someone with
preexisting conditions. Finally, ultimately, looked at the possibility
of yet again making this part of ObamaCare, the CLASS program, a
mandatory participation. How has that worked out for them thus far in
regard to the exchange in young people being forced, under the ruse of
the Constitution, of the commerce clause, to do that under the penalty
of law, increase taxes or penalties, or whatever they want to call it?
Well, the Supreme Court will ultimately make that decision.
Mr. Chair, the Secretary had every opportunity to look at this. We
are
[[Page H339]]
talking about, I say to the gentleman from Florida, over an 18-month
period of time, and they absolutely could not certify it.
You can delay and delay and delay, but what part of ``no'' does the
gentleman not understand? No, this will not work. This amendment is
unnecessary. We know that this program will not work.
My colleagues on the other side of the aisle, they want to leave the
provision in the bill. They want to let it stand there so they can
somehow maybe with the next administration or with the next chairman of
the Energy and Commerce Committee or whomever on their side of the
aisle might want to resurrect Freddy Krueger one more time on the backs
of the American taxpayer. This is a fiscal train wreck.
Mr. Chairman, the bill actually calls for the provision of a plan at
a date certain, October of 2012. I'm an OB/GYN physician. That's less
than 9 months. That goes quickly. I know that about 9 months.
When you get there, folks that are looking and counting on the CLASS
program long-term care insurance, they want to sign up for it. And the
Federal Government says, I know it's on the books, I know it's still
part of the law, I know we are obligated to have a program for you to
choose from by October 1, 2012; but we decided not to go forward with
it. What's to prevent them from suing the Federal Government? While
these lawsuits are pending and going on and on and on--as an attorney
jobs bill, it would have some merit. In the meantime, the private
market for long-term care insurance, they are not innovative. They are
not going to do anything until the legality of that is cleared up.
We feel very strongly that this would be a bad amendment, and I
strongly oppose it.
Mr. Chairman, I yield back the balance of my time.
The Acting CHAIR. The question is on the amendment offered by the
gentleman from Florida (Mr. Deutch).
The question was taken; and the Acting Chair announced that the noes
appeared to have it.
Mr. DEUTCH. Mr. Chair, I demand a recorded vote.
The Acting CHAIR. Pursuant to clause 6 of rule XVIII, further
proceedings on the amendment offered by the gentleman from Florida will
be postponed.
Ms. MOORE. Mr. Chair, I move to strike the last word.
The Acting CHAIR. The gentlewoman from Wisconsin is recognized for 5
minutes.
Ms. MOORE. Here we are again, ladies and gentlemen. The lights are
up, the music is playing and my Republican colleagues are doing the
same old song and dance for the American people. The Republicans have
spread out their sand, and they're doing their best soft-shoe routine,
trying to convince the American people that the repeal of this bill is
in their best interest. As the saying goes, if it ain't broke, don't
fix it. Yet we find ourselves here debating the repeal of a law that
would have sought to address the long-term crisis burgeoning in this
country.
Mr. Chairman, to most people, finding a solution to the long-term
care insurance crisis in this country seems like a good law. It must be
if 56 national groups, including AARP and SEIU, are against repealing
the CLASS Act.
Once again, my Republican colleagues are trying their best to
distract the American people from their not seeking a solution with
this repeal-the-bill sideshow.
As we debate this repeal, I have heard so many of our colleagues
refer to the President needing to come and apologize for introducing
this provision in the Affordable Care Act. It occurs to me that the
effort to embarrass the President, to harass him, to defy him, that
that is more important than finding a solution to the growing challenge
of the aging population. Indeed, it is an emerging burgeoning problem.
{time} 1620
Ten million Americans need long-term care. Over the next decade,
another 5 million Americans will require this care, bringing the total
to 15 million people. The problem is only becoming more challenging
with estimates that nearly 70 percent of people--the baby boomers--will
need some level of long-term care after turning 65. An additional issue
is that this is a heavy burden on family budgets.
This law was seeking to provide a national, voluntary, and self-
sustaining insurance program for assistance services to aid elderly and
disabled people. It would allow individuals to live independently at
home and in the community for as long as possible without impoverishing
themselves.
It seems that my Republican colleagues are content to defer the
dreams of millions of Americans to live with some sort of dignity as
they age. As we enjoy this Black History Month, it reminds me of one of
my favorite poets, an African American poet who would be 110 years old
today, Langston Hughes:
What happens to a dream deferred? Does it dry up like a
raisin in the Sun? Or fester like a sore--and then run? Does
it stink like rotten meat? Or crust and sugar over--like a
syrupy sweet? Maybe it just sags like a heavy load. Or does
it explode?
Republicans want to put one man out of a job and would defer the
dreams of millions of Americans. Yet, while they continue their song
and dance, Mr. Chair, denying seniors the long-term care that they
deserve and putting more and more Americans out of work, I hope the
American people recognize who is really on their side before we see the
American Dream of living and retiring in dignity explode.
With that, I yield back the balance of my time.
Ms. LEE of California. Mr. Chairman, I move to strike the last word.
The Acting CHAIR. The gentlewoman is recognized for 5 minutes.
Ms. LEE of California. Let me first thank Congresswoman Gwen Moore
for her very passionate and very clear statement. I thank both she and
Congressman Ellison for their unwavering leadership and conviction on
the real issues facing the American people today.
As a former cochair of the Congressional Progressive Caucus and as a
cofounder of the Congressional Out of Poverty Caucus, I rise in strong
opposition to this bill.
Mr. Chairman, members of the Progressive Caucus are here because,
once again, the Republican leadership would rather attack the President
than help the millions of struggling seniors, people with disabilities
and their families who are faced with a system that fails to meet their
very basic needs. This should really be a nonpartisan issue, but we are
here today because Republicans are more focused on ending Medicare and
repealing a long-term care program than they are on creating jobs to
put Americans back to work.
Last year, the Republicans' first order of business was to
eliminate--mind you, eliminate--the Medicare guarantee for America's
seniors under the Ryan budget proposal. This year, it's the same old
story. Instead of focusing on jobs or on extending middle class tax
cuts, unemployment assistance, or fixing the Medicare physician pay
rate, this Tea Party Congress continues to waste time on pointless
bills just to score political points.
Repealing the CLASS program will do nothing--nothing--to address the
long-term crisis for the 10 million Americans who need care now and the
5 million more who will require it over the next 10 years. Killing this
program without offering any alternative is, frankly, irresponsible.
The law may not be perfect, but repealing the bill does not make the
problem go away. We should be doing everything we can to ensure that
senior citizens and the disabled also have a shot at the American
Dream. We should not destroy this for them just because of their ages
or their disabilities. Why in the world would the Republican Tea Party
want to throw them under the bus?
We should work to find a real solution that meets the needs of the
millions of baby boomers who are retiring now, of the senior citizens
and the disabled, and we should work to ensure that they get the long-
term care over the next decade that they will need. Rather than repeal
this bill today, we need to give experts time to identify changes that
would make the CLASS program stronger, and Congress needs to focus on
the real priorities of the day, which are jobs and the economy.
We have work to do, and we don't have a minute to waste. Let's not
waste another year without a jobs bill
[[Page H340]]
and without extending vital unemployment benefits and payroll tax
reductions to millions of Americans while our economy continues to
recover. It is time for the Republican Tea Party to stop walking away
from our senior citizens and the disabled and to work with us to
continue middle class tax cuts, unemployment assistance, and to ensure
that seniors can keep seeing their doctors.
We need to come together now to enact bold programs and policies that
provide equal opportunity and equal access for every single American no
matter their race, no matter their employment status, no matter their
humble beginnings, no matter their ages, no matter their disabilities.
Americans can't wait. This Congress should not wait. We need to really
figure out a way to do the right thing on behalf of our senior citizens
and the disabled, but I have to say that today, unfortunately, this
bill moves us in the wrong direction.
I yield back the balance of my time.
Ms. HAHN. I move to strike the last word.
The Acting CHAIR. The gentlewoman from California is recognized for 5
minutes.
Ms. HAHN. Mr. Chairman, I rise today in strong opposition to H.R.
1173, the Republican legislation to repeal the CLASS program.
CLASS was designed to be the first Federal voluntary long-term care
program, making long-term care more accessible and affordable for
millions of Americans. The idea behind the CLASS program is to provide
Americans, especially our seniors, with peace of mind if they suffer
from an unexpected long-term illness or injury.
We have a long-term care crisis in this country. According to
Secretary Sebelius, ``an estimated 15 million Americans will need some
kind of long-term care, and fewer than 3 percent have a long-term care
policy.'' Because Medicare and other existing programs do not cover
these services, we must work together to find a solution. As my
Republican friends know, however, the CLASS program as enacted will not
be implemented. Secretary Sebelius informed Congress last October that
she did not ``see a viable path forward for CLASS implementation at
this time.'' In other words, this legislation we are debating today is
not needed.
Instead of legislation to create jobs and grow our economy, our
Republican friends are focused on repealing a program that has already
been suspended. I want to encourage my friends on the other side of the
aisle to take a step back and focus on the things we could be doing
together to make long-term care more affordable and accessible.
I have encountered in my own life the issue of providing long-term
care. My dear, sweet mother, before she passed away last summer,
received long-term care services for years, and I will always remember
the warmth and affection her caregivers showed her and my family day in
and day out. What we should be doing today is ensuring that the
hardworking men and women who provide care for our seniors in their own
homes earn a living wage, because these jobs are the jobs that make a
difference and that bring happiness to those who need their help the
most.
With robust job growth predicted in the health care sector over the
next decade, it is imperative that we support long-term care services
and those who provide those services. This is a win-win for the
American economy. Not only do long-term care services provide jobs, but
we know, if our seniors can be taken care of in their own homes, it can
save Americans money in the long run. I fear, however, that this
legislation is meant as a step towards dismantling the health care
reform law that Congress passed and that the President signed, a law
that will help millions of Americans obtain better and more affordable
health care coverage over the next decade.
Thanks to the Affordable Care Act, insurance companies cannot deny
coverage to people with preexisting conditions. Thanks to the
Affordable Care Act, Americans now have access to free preventative
care services. Thanks to the Affordable Care Act, small businesses can
receive tax credits to provide their employees with health coverage.
Thanks to the Affordable Care Act, children can stay on their parents'
insurance until they're 26. We just hope they don't move back home.
To my colleagues on the other side, let's not work to strip these
provisions, putting power back in the hands of for-profit insurance
companies. We do not need this legislation. Instead of repealing a
program that is not moving forward, why don't we work on replacing it
with a better long-term care program. The Affordable Care Act is not a
perfect law. That's why we should be working together to fix the
problems, not just to repeal them. Those problems will remain even if
we repeal this part of the law. Mr. Chairman, I urge my colleagues to
stop this needless debate and legislation and get to work on the real
issues at hand.
{time} 1630
Mr. JOHNSON of Georgia. Mr. Chair, I move to strike the last word.
The Acting CHAIR. The gentleman is recognized for 5 minutes.
Mr. JOHNSON of Georgia. Mr. Chairman, I rise in opposition to
repealing the CLASS Act.
You know, we all get old, or hopefully we will all get old and reach
an elderly status, and we will then perhaps become physically unable to
get around a whole lot and we may need to have some long-term care. Tea
Partiers will need it. Occupy Wall Streeters will need it. Mitt Romney
and his group of 15 percent taxpayers will need it. The only question
is whether or not the 99ers and the Tea Partiers will be able to afford
it. That is the only question. We're in the same boat.
The CLASS Act was included in the health care law in order to help
elderly and functionally disabled Americans purchase the services they
need, which would enable them to continue living in their communities,
as opposed to being forced into expensive private care which most of us
can afford.
So I understand that HHS had determined that the CLASS Act cannot be
implemented as written based on financial considerations; but, ladies
and gentlemen, that's no reason to throw out or to repeal this
worthwhile initiative. We certainly need to improve it, but there's no
need to repeal it.
No matter what side of the political aisle you sit on, you cannot
ignore that we need to improve access to long-term care. Approximately
10 million Americans are in need of long-term care, and this number is
expected to increase to 15 million over the next decade. America is
aging.
In 2009, an estimated 62 million unpaid family caregivers provided
$450 billion in care. At what cost to their jobs, to their family life
with their children?
In 2011, the average annual cost of a nursing home was $70,000. Who
can afford that?
The cost of long-term care is an unsustainable burden on family
members who, while also holding a job and raising a family, struggled
to provide their disabled or elderly relatives with the care that they
need to continue living within their own communities.
The CLASS Act is a voluntary program. It's no mandate. Don't get it
twisted. There is no mandate, individual mandate for the CLASS Act.
It's a voluntary program that relies on free market principles of
responsibility and competition that my colleagues in the Republican
Party claim to revere. There's no mandate in this program. It would
allow families of all means to plan for a secure future where a long
life or a disability does not lead to financial ruin.
Take, for instance, one of my constituents, Linda Rawlins. Linda was
the primary caregiver for her elderly mother until her recent passing.
Linda told me that she supports the CLASS Act because millions of
Americans just like her feel overwhelmed or face financial distress due
to their roles as family caregivers who cannot receive any kind of
assistance.
Although Linda's mother received long-term care through a local
senior assistance program that enabled her to continue living at home,
Linda knows that not everyone is so lucky. Having access to long-term
care services enabled Linda's mother to live independently with grace
and with dignity. It allowed Linda to keep her job and helped relieve
the emotional and financial strains placed on her and her family as she
oversaw her mother's care.
Linda and I feel like everyone should have that kind of support, and
the CLASS Act is a good place to start. Repealing the CLASS Act without
any attempt to improve it is a rash political
[[Page H341]]
move, and I urge my colleagues to oppose the bill.
I yield back the balance of my time.
Mr. GINGREY of Georgia. Mr. Chairman, I move to strike the requisite
number of words.
The Acting CHAIR. The gentleman is recognized for 5 minutes.
Mr. GINGREY of Georgia. My good friend, my very good friend from
Georgia, the gentleman from DeKalb, made the statement about what is
the reason; there is really no reason to strike this; why not leave it
on the books. And I think that's the argument we have heard all
afternoon in regard to the position of the Democratic side.
But let me just read a few passages from a report that we requested
from the Congressional Research Service as to why, in response to my
friend from DeKalb and my good colleague from Georgia:
Judicial review assumes that the Secretary takes no further action to
comply with the CLASS Act's statutory mandate to designate a benefit
plan by October 1, 2012.
The Secretary would appear to be committing a facial violation of the
statutory requirement to designate such plan. Her failure to take such
action conceivably could be challenged in court under the
Administrative Procedure Act, APA, which defines agency action to
include the failure to act.
They go on to say:
The CLASS Act does not preclude judicial review and the Secretary's
designation of a benefit plan is a mandatory, as opposed to a
discretionary requirement.
So judicial review does not appear to be precluded. Therefore, if the
Secretary fails to perform the action required by the statute, that
inaction would appear to be reviewable.
I continue:
A failure by the Secretary to designate a CLASS benefit plan by
October 1, 2012, presumably predicated upon a determination by her--
that is not possible to develop three actuarially sound benefit plans
that meet all the requirements of the act--would appear to be a final
agency action from which ``legal consequences will flow.''
Inaction by the Secretary in designating a plan by the deadline could
be found by a reviewing court to constitute noncompliance with a
statutory mandate. Thus, after October 1, 2012, the Secretary's failure
to take an action legally required of her would appear to meet the
standard for judicial review of agency inaction unlawfully withheld
under the APA, Administrative Procedure Act, provision prescribing the
scope of judicial review of agency action.
I asked one of my colleagues a few minutes ago, What part of ``no''
do you not understand?
Mr. JOHNSON of Georgia. Would the gentleman yield?
Mr. GINGREY of Georgia. I yield to the gentleman.
Mr. JOHNSON of Georgia. Thank you, my friend from Georgia.
What you've just said is that it's essentially a failure to act, to
publish regulations or to promulgate regulations that would lead to the
enactment of this CLASS Act, becomes a final agency action. In other
words, failure to act becomes a final agency action which then enables
an appeal or judicial review, the review being for the purposes, I
suppose, of failing to follow the law, which would, of course, be in
support of the underlying legislation, the CLASS Act.
{time} 1640
So I would argue that the regulation that you cite would actually
enhance the ability of us to come to a reasonable way of financing this
voluntary program.
Mr. GINGREY of Georgia. Reclaiming my time from the gentleman, look,
Mr. Chairman, the gentleman is an attorney. I'm just an old country
doctor. But, you know, this is plain language, and I'll be happy to
provide his office with a copy of this Congressional Research Service
report. I'm not going to get deep into the weeds of the legal argument
back and forth, but this is about as plain as the nose on your face.
With that, Mr. Chairman, I yield back the balance of my time.
Mr. ELLISON. Mr. Chairman, I move to strike the last word.
The Acting CHAIR. The gentleman from Minnesota is recognized for 5
minutes.
Mr. ELLISON. Mr. Chairman, I tell you what's as plain as the nose on
your face, what's as plain as the nose on your face is that the
Republicans are getting rid of a plan for long-term care without
offering any alternative plan in its place. They're just stripping
what's there without saying here's what we're going to do.
But I have a memory, Mr. Chairman. What I remember is that for long
stretches of time in the last decade, Republicans had both houses and
the Presidency, didn't do anything on health care other than do a big
giveaway to Big Pharma. When the Democrats get in, we do a plan. We
pass the Affordable Care Act. Does it need tinkering? Probably so, like
all bills do. But instead of trying to work with us and do something
good for the American people, Republicans say we're just going to strip
the Democratic plan for long-term care. And this is too bad, because it
seems to me that long-term care, Mr. Chairman, is a legitimate issue
for us to work together on. But we're not working together. One side
passes a bill; the other side just tries to get rid of it. I think it
is high time that we start trying to work together, but we don't have a
cooperative partner. Washington Republicans have proven once again that
they would rather try to embarrass President Obama than help American
seniors.
Last year, Republicans' first order of business was to eliminate the
Medicare guarantee for America's seniors. This year it's the same old
story, Mr. Chairman. No health care, no Medicare, no long-term care for
millions of Americans.
Instead of a plan to create jobs or to extend middle class tax cuts
or to address unemployment assistance or to fix the Medicare physician
pay rate, Republicans are wasting time on divisive and pointless bills.
I do respect the gentleman's desire to have me yield, but I must
very, very respectfully decline to yield because I have limited time.
But if I have any extra time, I will be happy to yield to the
gentleman, but it will have to be when I'm done.
Today, we could be dealing with the real issue--fixing the long-term
care crisis. And I'm sure that everyone in this whole body, Republican
and Democrat, ought to be concerned about it because all of us, no
matter what our ideological beliefs may be, have people who need long-
term care. So we've got to be about this business.
You know what, Mr. Chairman? Ten million Americans currently need
long-term care, and the problem is only getting worse. The number of
Americans 62 years and older is 20 percent higher than it was 10 years
ago. Long-term care is a huge burden on families. An estimated 62
million--let me say that one more time, Mr. Chairman--62 million unpaid
family caregivers provided care valued at $450 billion in 2009, more
than the total spending in Medicare that year.
But Republicans are offering no solution to the long-term care
crisis. They may say anything that they want, but they're not coming
here with a bill that we can debate. They're just attacking what has
already been done, which is so easy to do. Way better to be a critic
than to be someone who produces solutions.
So, Mr. Chairman, I want to tell you a little bit about somebody in
my district, Mary. Mary says: My mother is 90 and seriously ill and now
in a nursing home. Her bill is over $6,500 a month. Mary goes on to say
she will soon run out of money, referring to her mom. Why do people
have to become indigent before they receive help?
That's a good question, I think. That's a question warranting our
attention, but our Republican friends have no plan to protect families
like Mary's. They're not here with a plan. They just want to strip and
rip and take down what Democrats have already done. And people are in
need of help.
So, Mr. Chairman, repealing the CLASS Act will not help Mary's
family. We need to make the CLASS program stronger, not get rid of it.
We need to amend it, not end it. We need to improve it. And that's why
56 national groups wrote to Congress saying please don't repeal the
CLASS Act, including AARP, SEIU, and the National Council on Aging,
people who really know what they're talking about when it comes to
long-term care.
So I urge our Republican friends on both sides of the aisle to come
together
[[Page H342]]
with us to make a strong long-term program for seniors rather than just
tearing down and stripping down. It's as plain as the nose on your
face, Mr. Chairman: Americans need long-term care.
I yield back the balance of my time.
Mr. WELCH. Mr. Chairman, I move to strike the last word.
The Acting CHAIR. The gentleman from Vermont is recognized for 5
minutes.
Mr. WELCH. We have a serious challenge here. We have people who need
long-term care. We have very serious fiscal constraints. And the
question before us really is, do we repeal the program altogether when
there is a serious long-term program, as if by legislative magic a
repeal suddenly makes the serious and acute problem vanish altogether.
We know that doesn't happen. It may address a fiscal issue, but it
doesn't solve the fiscal issue and enormous emotional pain that
individuals who are trying to take care of their senior parents will
face. So the problem doesn't go away if this legislation is passed. It
simply means the pain will continue and probably intensify.
So the real challenge for Congress is that when there is a problem
that we acknowledge is real and rising for the American people, and the
folks who need long-term care are in red States and blue States,
they're in your district and they're in mine, the real question is
whether we address that as actively and as aggressively as we can,
taking responsible steps to make certain that we can pay for what we
promise.
The worst thing that we can do in my view is pass legislation that
has almost as its predicate the notion that by repealing the commitment
that this Congress made 2 years ago, the problem doesn't exist. It
does, and we all know that. You've heard the statistics--10 million
Americans currently need long-term care. That is a tough challenge for
those families. Over the next decade, that is going to rise to 15
million. It is a rising challenge, and the longer we defer, the more
difficult it will be for us to address it. Sixty-two million Americans,
good Americans, generous Americans, serve as unpaid caregivers to
elderly family members. How long can that be sustained?
While nearly 70 percent of Americans will need some level of long-
term care in their lifetime, only 8 percent are able to buy long-term
care insurance. That's where we do need a public policy program that's
going to match the resources required with the need that's rising.
The CLASS Act was designed to make progress, giving older Americans
and their families some sense of security. It's not perfect. The most
vigorous proponents of that legislation acknowledge it's not perfect.
But what that we pass on the Republican side or the Democratic side can
any of us claim is perfect?
What we have to do together is try to make an imperfect bill better.
But what we can't do is abandon the very serious challenge that those
10 million Americans in need of long-term care have.
I yield back the balance of my time.
{time} 1650
Ms. WATERS. Mr. Chairman, I move to strike the last word.
The Acting CHAIR. The gentlewoman from California is recognized for 5
minutes.
Ms. WATERS. Mr. Chairman and Members, this bill is just another
attempt to dismantle health care reform. Last year, House Republicans
passed H.R. 2 to repeal the entire Affordable Care Act. The landmark
health care reform law that was enacted almost 2 years ago is what I'm
referring to.
The Affordable Care Act has already made a difference in the lives of
millions of Americans. Let me just recount for the Members of this
House what the Affordable Care Act has done and is doing.
It prevents insurance companies from dropping people because they get
sick. It prevents insurance companies from denying coverage to children
with preexisting conditions. It allows young adults to remain on their
parents' health insurance until they turn 26. It provides free
preventive care to seniors under Medicare. It is phasing out the
``doughnut hole'' and helping seniors obtain affordable prescription
drugs. Finally, it provides tax credits to help small businesses
purchase health insurance for their employees.
When H.R. 2 failed to move in the Senate, House Republicans began
passing bills to dismantle the Affordable Care Act piece by piece and
inch by inch. They passed H.R. 1213, which repeals funding for the
organization of health benefit exchanges, marketplaces where American
families will be able to choose an affordable health care plan. They
passed H.R. 1214, which repeals funding for the construction of school-
based health clinics. They passed H.R. 1216, which repeals funding for
the training of primary care physicians.
Now they're trying to repeal the CLASS Act. The CLASS Act is the
Community Living Assistance Services and Supports Act, and it
establishes a program to facilitate access to long-term health care
services. Who can be against that? The CLASS Act is a voluntary program
to provide participants with a cash benefit that can be used to
purchase a variety of long-term care services, such as home
modifications, accessible transportation, personal assistance services,
homemaker services, respite care, home health aids, and nursing
support. The program would be funded entirely by the premiums paid by
those who choose to participate.
House Republicans' CLASS Act repeal also repeals funding for the
National Clearinghouse for Long-Term Health Information. The
clearinghouse provides online information about long-term care costs
and planning options.
Our Nation is indeed facing a long-term health crisis. People are
living longer. As a result, there's a growing need for long-term care
for elderly and disabled Americans. There are 10 million people who
need long-term care in the United States today. That number is expected
to grow to 15 million in the year 2020. There are an estimated 52
million unpaid caregivers providing long-term care services in American
homes today. American families are paying more than $50 billion every
year on out-of-pocket expenses for long-term care. These families need
options, and they need our support.
The CLASS Act does not need to be repealed. If House Republicans
believe this program should be fixed, then they should try to fix it.
However, they have not even attempted to improve this program or
develop other options to make long-term care services available to
American families who need them.
It is long past due for House Republicans to stop trying to dismantle
health care reform and start working with us in a constructive,
bipartisan manner to improve our Nation's health system. I would urge
my colleagues to oppose this bill and support solutions to America's
long-term care crisis. Ladies and gentlemen, what we are discussing
today is precisely what Occupy Wall Street was all about. It's about
what are we going to do to deal with that 99 percent out there who
simply need some safety nets that their government could easily assist
with.
Health care is a problem in this country. Not everyone can afford it,
and I would ask my colleagues to take the politics out of this issue.
The American public needs this health care reform. And the Occupy Wall
Street people who are out there simply sent a message to say, okay,
America, stop being simply on the side of the 1 percent, look at the 99
percent. I would urge my colleagues to do that.
I yield back the balance of my time.
Mr. NADLER. Mr. Speaker, I move to strike the last word.
The Acting CHAIR. The gentleman from New York is recognized for 5
minutes.
Mr. NADLER. Mr. Speaker, I rise in opposition to this bill to repeal
the CLASS Act. Last year, we watched as Republicans implemented a
slash-and-burn offensive against almost every and any Federal program
that helps people. No matter that the program helps women or children
or seniors or sick people; let's get rid of it.
Apparently, this year is no different. With this bill, Republicans
have set their eyes on the CLASS Act, which when implemented, will help
provide some relief to aging Americans as well as to those who love and
care for them. The CLASS program was designed to combat the rapidly
increasing cost of long-term care, costs that currently account for
nearly half of all health care spending in this country, by helping
enrollees in this program to afford a variety of long-term care
services,
[[Page H343]]
such as home modifications, assistive technology, accessible
transportation, respite care, home health care aids and nursing
support.
Currently, long-term care facilities cost on average $70,000 per
year, and home health care aides can cost $25 per hour in some areas.
How many middle class families can afford that?
I understand the concerns that my Republican colleagues have voiced.
As currently structured, the Congressional Budget Office estimates that
the program will not be solvent beyond about 2029, about 20 years from
now. But what is the Republicans' knee-jerk solution to all budget
issues? To trash a program, a necessary program, that will provide
much-needed support for seniors today and in the future.
This is completely wrong-headed. We should not destroy this program
and ignore the problem. People will still grow older, hopefully, and
they will need assisted living, they will need home health care, and
they will need accessible transportation. At some point, we are going
to have to face this issue.
The current situation, where Medicaid will pay for this but only
after the family has impoverished itself and eliminated all their
assets, it's not a long-term solution, it's not a tolerable solution.
Why should middle class families who have worked all their lives have
to impoverish themselves if an elderly relative needs home health care
or assisted living or a nursing home?
Our job here is to make people's lives better, to identify problems
and to find solutions. We have certainly identified a problem. There is
simply no denying that only the wealthiest among us can possibly afford
to pay $70,000 a year for a nursing home.
So let's do our jobs. Let's roll up our sleeves and work to make this
program better. Let's work to make it solvent, not simply eliminate it.
Let's not simply abandon middle class Americans who are scared to death
that after working their entire lives and playing by the rules, they
will have to bankrupt their children and grandchildren just to have any
sense of dignity as they grow older.
This is not the American Dream. We don't want to tell our old people,
get lost, get out of sight, go into the poorhouses and the almshouses
we had before Social Security. We don't want to tell our seniors, you
can't have the health care, the home assisted living, the home health
care aides that you need. We don't want to tell our families that you
must impoverish yourselves, sell off all your assets because your
mother or your grandmother is sick or can no longer live independently.
This is why we have government, to solve problems for all of us that
we cannot solve for ourselves individually. That is the reason for
government, to provide for the common welfare, as the Constitution
says. We know we have this problem. We know as the population ages the
problem is going to get worse and more intense, not better. We know the
problem is not going to go away. So let's deal with it.
After many, many years, Congress in the Affordable Care Act finally
passed the CLASS Act program to start dealing with this. There are
problems with it. Yes, the financing that was brought into that program
is only sufficient for about 20 years.
{time} 1700
That gives us only 20 years to fix the program.
Now, the sooner we fix it, the sooner we amend the financing, the
easier it will be to do it. The longer we wait, the harder.
So what do the Republicans want to do? Kill the whole program, put
our heads in the sand, ignore the problem, and to heck with the senior
citizens and to heck with their children who worry about how they're
going to have their parents live their last years in dignity. That is
not the American Dream. It is not right.
I urge my Republican colleagues to rethink this. Withdraw this bill.
This program is not being implemented immediately. Figure out how to
finance it better. Figure out how to deal with this problem. Don't
simply say let's ignore the problem and to hell with our senior
citizens. That is not the American Dream. We simply must do better.
We've made a start. Let us continue that start. Let us build on it.
Let us not destroy the beginnings that we have made.
I yield back the balance of my time.
Mr. McDERMOTT. Mr. Chairman, I move to strike the last word.
The Acting CHAIR. The gentleman from Washington is recognized for 5
minutes.
Mr. McDERMOTT. Well, Mr. Chairman, tomorrow is Groundhog Day. We've
been in session this year for 1 month. And this is the 1st day of the
2nd month, and we've had 2 legislative days and haven't done one single
thing for the working Americans in this country.
Now, this bill is the whole reason why the Occupy Wall Street
movement is out there and why the opinion of the performance of the
Congress is so low. This bill has absolutely nothing to do with
creating jobs, training the unemployed, helping businesses grow, or
moving the country forward. It is about the ninth time we've brought a
piece of so-called ObamaCare--Obama does care, you know. They brought
it out here, and they keep trying to repeal it, which is not what the
people want us working on. Instead, the Republicans are giving us just
a bunch of press releases. I can see them going out of the offices now
to the Tea Party all over the country--rile up the base, rile up the
base, oh, yeah, and nothing is being done for the people.
The second problem is that the Republicans aren't being straight with
the American people. This bill does more than the Republicans are
saying. The Republicans aren't just repealing the CLASS Act. The
Republicans are trying to kill another important and inexpensive
program that seniors and families depend on. They're defunding the
National Clearinghouse for Long-Term Care Information, an important and
useful government Web site that seniors and their families use to take
an active role in understanding, planning, and financing their long-
term needs. Remember, these are the most frail people in our society,
and they rely on this information to plan for their futures.
Mr. Chairman, two-thirds of personal bankruptcies in this country are
caused by medical bills, and a lot of those astronomical bills are
caused by the debilitating costs of long-term care. And the Republicans
aren't trying to solve the problem. Instead, the Republicans want to
repeal the first ever Federal law creating a stand-alone long-term care
program. Bill Frist, the Republican leader in the Senate some years ago
said, Don't repeal it; fix it. But the Republicans can't figure out how
to fix it because they don't care about seniors.
Granted, this CLASS Act needs to be fixed. It's not a perfect bill.
We know that. And that's what we should be doing so that the country
stops allowing long-term health care costs to bankrupt families. That
the Republicans don't care enough to do anything about chronic
bankruptcies caused by long-term care is bad enough, but the Republican
wrecking ball goes even further. The Republicans are trying to get a
scalp. They want to please their base by repealing a part of ObamaCare,
that law that insures 31 million more Americans and saves taxpayers
money--so-called ObamaCare, that law that already is driving down
health care costs and getting Americans better service for less money.
In 40 years of legislating, I've seen State houses shift parties,
Congress shift parties, but I've never, ever seen a legislative body
that failed as badly as this one. This is the most unproductive
Congress I've ever seen. And if you think this bill is going to go out
of here and go over to the Senate, even the Republican leader, Mitch
McConnell, wouldn't want this brought up as the bill that we deal with.
The Republicans are running their demonize everything and do-nothing
agenda, and it's having the predictable results. It gets the base
whipped up and angry, but it accomplishes nothing for jobs, nothing for
health care, nothing for the deficit, nothing for the economy. The
American people need the CLASS Act fixed. They need to be able to
continue to rely on the Clearinghouse for Long-Term Care Information.
As the Republicans put out their plan for wasting this entire year of
2012 not serving the American people, the voters should look very
carefully at what they actually are doing. When they put out their
platform, you know, it's going to say, What did you do? Well, I
[[Page H344]]
voted ``no.'' I voted ``no.'' I voted ``no.'' I voted ``no.'' They will
have nothing positive to put on that agenda. What did you do? Well, I
tried to get rid of the EPA. I didn't want clean air. I didn't want
clean water. And I didn't want labor unions. And, and, ``no,'' ``no,''
``no.''
This is a terrible piece of legislation. It should be fixed. There's
none of us who would stand up here and say it's a perfect piece of
legislation, but I urge my colleagues to vote ``no.''
The Acting CHAIR. The time of the gentleman has expired.
Mr. FINCHER. Mr. Chairman, I move to strike the last word.
The Acting CHAIR. The gentleman from Tennessee is recognized for 5
minutes.
Mr. FINCHER. I yield to my colleague from Georgia (Mr. Gingrey).
Mr. GINGREY of Georgia. I thank the gentleman for yielding.
I appreciate the opportunity to respond to my good friend and the
good doctor, my colleague from the State of Washington, who made
reference to, I think, Groundhog Day.
Now, my name, Mr. Chairman, is Phil Gingrey, but as I sat here over
the last couple of hours listening to the argument on the other side of
the aisle, I feel like Phil Connors, and that was the weatherman. Bill
Murray, if you recall, played that role, the weatherman at
Punxsutawney, Pennsylvania, covering Groundhog Day. And believe me, we
have been listening to Groundhog Day from my colleagues on the other
side over and over and over again, and it is indeed getting just a
little bit tiring.
My friend also said, the gentleman, the doctor from the State of
Washington, Mr. Chairman, and I quote him: ``I've never seen a Congress
that has failed as much as this one.'' Well, I'm going to tell you, I
have never seen a provision of law in a bill that has failed as much as
the CLASS Act. And they can beat this to death--and I think they have
done that, Mr. Chairman--but I have in my hand here a summary sheet of
the HHS analysis of the CLASS Act over an 18-month period of time.
And they have tried to model eight different options to make this
fiscally solvent, and required by the law--thank goodness, thank
goodness for the amendment from the Senator from Rhode Island, the
Honorable Judd Gregg, at the time chairman or ranking member of the
Budget Committee. The eight options, none of them work. I mean, there
are things like a work requirement. There are things like not allowing
anybody with a preexisting condition to be in the program, allowing
people with preexisting conditions to be in the program but only
eligible for a benefit for 15 years, and on and on and on. Actually,
the one option that's not on this printout, I guess, is option number
nine, and that would be the option, Mr. Chairman, of requiring every
individual to sign up for the long-term program under the CLASS Act.
Now, the question on all of these options was: Does the Secretary
have legal authority? And in most of the eight: Not completely; HHS
vulnerable to legal challenge. Not completely; vulnerable to legal
challenge. Not completely--again, vulnerable. No authority. No
authority. No authority. No authority.
Well, number nine, individual mandate, making everybody sign up for
it, yes, got the authority to do that. She could have done that. But
I'm sure that my colleagues and her advisors and the administration
probably--and I state this rhetorically. Do you want another mandate to
which the American people can rail against us in the next election? And
she is smart enough to know that option number nine was not
unacceptable.
So, again, we could go on and on. We could do this for another couple
of hours and continue this Groundhog Day ruse, but, as I said earlier,
Mr. Chairman, what part of ``no'' do they not understand?
{time} 1710
Now, look, when this amendment was added at the last moment back in
2009 by the chairman of the Subcommittee on Health, Mr. Pallone, during
the Energy and Commerce Committee debate on the CLASS Act, Chairman
Pallone stated, and I quote him: ``I can't stress enough that we are
not actually setting this up. We are simply suggesting.'' That was the
end of the quote. In fact, Chairman Pallone asserted that the program
would not take effect until subsequent legislation was passed.
Well, Mr. Barton, who, at the time, was the ranking member of the
overall Committee of Energy and Commerce, said this: ``Well, reclaiming
my time, I am going to support the Pallone amendment without binding
anybody on my side to support it, with the understanding that if this
moves forward, there will be a hearing on this in this committee, and
there will be bipartisan efforts to flesh it out. Do I have that
assurance from the chairman?'' And Mr. Pallone responded, ``You
certainly have my assurance.''
And then the chairman, Henry Waxman, overall chairman of the
committee said, fine with me, but he is the subcommittee chairman.
We never had one hearing. We never had an opportunity to flesh it
out.
Defeat this amendment.
The Acting CHAIR. The time of the gentleman from Tennessee has
expired.
Ms. JACKSON LEE of Texas. Mr. Chairman, I move to strike the last
word.
The Acting CHAIR. The gentlewoman is recognized for 5 minutes.
Ms. JACKSON LEE of Texas. My good friend from Georgia, some things
bear repeating. I love February 2. It happens to be my daughter,
Erica's, birthday. Some call it Groundhog Day. I call it a day of great
celebration for a bit of joy that came into our lives.
So it's a day for many that is happy. It's a day that many humorously
look forward to great weather. Some remember our good friend, Bill
Murray, and it is a day that symbolizes repetition.
Sometimes the pain of Americans deserves to be repeated over and over
again. And I'd like to answer my good friend, not speaking for Mr.
Pallone, but, in actuality, we have the opportunity now to have
bipartisan hearings. Nothing is precluded. Mr. Pallone's statement was
accurate. He was not writing the structure of long-term care. He was
indicating that, for Americans, it was vital.
What is disappointing is that my friends on the other side of the
aisle are willing to give up so easily. I don't understand that.
Where's the American genius?
Of course, they will cite HHS; but they know that Congress directs
HHS. They know that the repeal of this legislation for long-term care
will simply kill the opportunity for Americans to find relief.
As we look to the future, we are just a month away until taxes go up
on middle class families, and Americans looking for work lose their
unemployment insurance, and seniors face losing access to their
doctors. We could be working on that, move the conference committee a
little faster. But we're now adding an extra burden. Let's repeal the
CLASS Act.
It doesn't disturb me that HHS has made several tries, and in a time
frame has not found a cure yet. But knowing research and knowing
science and being near and in the community of the Texas Medical
Center, I know how long it takes to get a good answer in health care.
But what I do want to stress to my friends, can they deny that 82
percent of Americans say that taking care of relatives who are aging or
ill is demanding? Eighty-two percent of them say that; 72 percent
indicate that taking care of them is overwhelming; 56 percent said that
as they are taking care of their sick relatives, they are getting ill.
Yet we want to abandon the discussion on long-term care when I've
already said on the floor of the House that $450 billion of that long-
term care is already in private hands. It's in families. It's through
their labor. They are overwhelmed.
Only $14 billion is in the private industry sector. See how much
they're standing up to the bar, and $101 billion in Medicaid.
We have to find a solution that balances benefit and burden. Listen
to a constituent from Texas who took care of her son after he was
seriously injured in a roadside bombing while patrolling in Iraq. She
did not return home 7 years in order to be with her son.
Debbie initially took a leave of absence from her job, but ended up
resigning to become a full-time caregiver
[[Page H345]]
for her son. Because she no longer had a paid job, and her husband was
the only one working, they had to start using their retirement savings
to survive. Her son is now better, great news, and active in the
community. And she continues her work. But the catastrophic impact to
the family continues on.
Rhonda has gone from a part-time, visiting caregiver to her elderly
parents to a live-in, full-time caregiver. Even after the death of her
own 23-year-old daughter in a car accident, and her only brother
becoming disabled after an illness, before 2001 she was a full-time
working mother of two.
Where is the relief for these humans, these individuals, these people
in need? Where is it? It's in the amendment I offered that indicated
that it is important to note that long-term care is important, and a
study should engender to be able to determine that.
But more importantly, let's, again, look at this in a way that we
take our time and look at the macroeconomics and take into
consideration how we can best configure this. But let me tell you very
clearly that if we repeal this CLASS Act, the burden will fall on local
and State governments and the millions of caregivers who already,
through their own effort and their own toil, with love, I will tell you
with love, expend $450 billion that we don't compensate them for, lose
their jobs, raise the deficit, add to the debt because they are not
able to take care of themselves.
And as we see, some 76 million baby boomers, Mr. Chairman, going
forward. Let me just say, don't repeal this bill. It bears repeating.
Help those who need your help.
Mr. Chair, I move to strike the last word. Today, I am joined by
Members of the Congressional Progressive Caucus, to call attention to
the grievous threats posed by to H.R. 1173, ``The Fiscal Responsibility
and Retirement Security Act of 2011'', to key provisions in the
Affordable Health Care Act.
H.R. 1173 bill would repeal title VIII of the Patient Protection and
Affordable Care Act and Supports (CLASS) Program--a national, voluntary
long-term care insurance program for purchasing community living
assistance services and supports.
This piece of legislation is yet another example of the Republican
Majority failing to act on the top priorities of the American people.
At a time when we should be focused on building our economy; advancing
underserved and underrepresented communities, addressing the needs of
our Nation's seniors; and focusing on the deficit, as well as,
unemployment insurance. Instead of generating bold new ideas to help
small businesses hire more Americans, to aid in the revitalization
efforts of our manufacturing industry, to advance the cause for energy
independence, to address the needs of families hurt the most by this
economic down turn.
Instead, The Republicans have brought forward a bill to repeal a self
sustaining program for the aging and the disabled. The CLASS program is
meant to help someone who is unable to bath, cloth, or conduct basic
life actives. We should not be attacking programs that are designed to
address issues of long term care.
Title VIII also authorized and appropriated funding through 2015 for
the National Clearinghouse for Long-Term Care Information (clearing
house). H.R. 1173 would rescind any unobligated balances appropriated
to the National Clearinghouse for Long-Term Care Information.
The CLASS Act was designed to provide an affordable long-term care
option for the 10 million Americans in need of long-term care now and
the projected 15 million Americans that will need long-term care by
2020.
Individuals need long-term care when a chronic condition, trauma, or
illness limits their ability to carry out basic self-care tasks, called
activities of daily living (ADLs), (such as bathing, dressing or
eating), or instrumental activities of daily living (IADLs) (such as
household chores, meal preparation, or managing money).
Long-term care often involves the most intimate aspects of people's
lives--what and when they eat, personal hygiene, getting dressed, using
the bathroom. Other less severe long-term care needs may involve
household tasks such as preparing meals or using the telephone.
Estimates suggest that in the upcoming years the number of disabled
elderly who cannot perform basic activities of daily living without
assistance may be double today's level.
CLASS provides the aging and the disabled with a solution that is
self sustaining, at no cost to taxpayers.
As the estimated 76 million baby boomers born between 1946 and 1964
become elderly, Medicare, Medicaid, and Social Security will nearly
double as a share of the economy by 2035.
Baby boomers are already turning 65. As of January 1, 2011, baby
boomers have begun to celebrate their 65th birthdays for that day on
10,000 people will turn 65 every day and this will continue for the
next 20 years.
It is reasonable to assume that over time the aging of baby boomers
will increase the demand for long-term care.
Repealing the CLASS program does nothing to address the fact that
private long-term care insurance options are limited and the costs are
too high for many American families, including many in my Houston
district, to afford.
In 2000, spending from public and private sources associated on long-
term care amounted to an estimated $137 billion (for persons of all
ages). By 2005, this number has risen to $206.6 billion.
Individuals 85 years and older, the oldest old, are one of the
fastest growing segments of the population. In 2005, there are an
estimated 5 million people 85+ in the United States. This figure is
expected to increase to 19.4 million by 2050. This means that there
could be an increase from 1.6 million to 6.2 million people age 85 or
over with severe or moderate memory impairment in 2050.
An estimated 10 million Americans needed long-term care in 2000. Most
but not all persons in need of long-term care are elderly.
Approximately 63 percent are persons aged 65 and older (6.3 million);
the remaining 37 percent are 64 years of age and younger (3.7 million).
The lifetime probability of becoming disabled in at least two
activities of daily living or of being cognitively impaired is 68
percent for people age 65 and older.
By 2050, the number of individuals using paid long-term care services
in any setting (e.g., at home, residential care such as assisted
living, or skilled nursing facilities) will likely double from the 13
million using services in 2000, to 27 million people. This estimate is
influenced by growth in the population of older people in need of care.
Of the older population with long-term care needs in the community,
about 30 percent (1.5 million persons) have substantial long-term care
needs--three or more activities of daily living limitations. Of these,
about 25 percent are 85 and older and 70 percent report they are in
fair to poor health.
Forty percent of the older population with long-term care needs are
poor or near poor (with incomes below 150 percent of the Federal
poverty level).
Between 1984 and 1994, the number of older persons receiving long-
term care remained about the same at 5.5 million people, while the
prevalence of long-term care use declined from 19.7 percent to 16.7
percent of the 65+ population. In comparison, 2.1 percent, or over 3.3
million, of the population aged 18-64 received long-term care in the
community in 1994.
While there was a decline in the proportion (i.e., prevalence) of the
older population receiving long-term care, the level of disability and
cognitive impairment among those who received assistance with daily
tasks rose sharply. The proportion receiving help with three to six
ADLs increased from 35.4 percent to 42.9 percent between 1984 and 1994.
The proportion of cognitive impairment among the 65+ population rose
from 34 percent to 40 percent.
INFORMAL CARE GIVERS AND FAMILY
Informal caregiver and family caregiver are terms used to refer to
unpaid individuals such as family members, partners, friends and
neighbors who provide care.
Informal caregivers and family can be primary or secondary
caregivers, full time or part time, and can live with the person being
cared for or live separately.
Estimates vary on the number of family and informal caregivers in the
United States, depending on the definitions however:
52 million informal and family caregivers provide care to someone
aged 20+ who is ill or disabled.
44.4 million caregivers (or one out of every five households ) are
involved in care giving to persons aged 18 or over.
34 million caregivers provide care for someone age 50+.
27.3 million family caregivers provide personal assistance to adults
(aged 15+) with a disability or chronic illness.
5.8 to 7 million people (family, friends and neighbors) provide care
to a person (65+) who needs assistance with everyday activities
8.9 million informal caregivers provide care to someone aged 50+ with
dementia. By the year 2007, the number of care giving households in the
U.S. for persons aged 50+ could reach 39 million.
Over three-quarters (78 percent) of adults living in the community
and in need of long-term care depend on family and friends (i.e.,
informal caregivers) as their only source of help; 14 percent receive a
combination of informal and formal care (i.e., paid help); only 8
percent used formal care or paid help only.
[[Page H346]]
Even among the most severely disabled older persons living in the
community, about two-thirds rely solely on family members and other
informal help, often resulting in great strain for the family
caregivers.
The use of informal care as the only type of assistance by older
Americans aged 65 and over increased from 57 percent in 1994 to 66
percent in 1999. The growth in reliance upon informal care between 1994
and 1999 is accompanied by a decline in the use of a combination of
informal and formal care from 36 percent in 1994 to 26 percent in 1999.
30 percent of persons caring for elderly long-term care users were
themselves aged 65 or over; another 15 percent were between the age of
45-54.
For the family caregiver forced to give up work to care for a family
member or friend, the cost in lost wages and benefits is estimated to
be $109 per day.
Home and Community-Based Care
Most people--nearly 79 percent--who need Long-Term Care live at home
or in community settings, not in institutions.
More than 13.2 million adults (over half younger than 65) living in
the community received an average of 31.4 hours of personal assistance
per week in 1995.
Only 16 percent of the total hours were paid care (about $32
billion), leaving 84 percent of hours to be provided (unpaid labor) by
informal caregivers.
The trend towards community-based services as opposed to nursing home
placement was formalized with the Olmstead Decision (July, 1999)--a
court case in which the Supreme Court upheld the right of individuals
to receive care in the community as opposed to an institution whenever
possible.
The proportion of Americans aged 65 and over with disabilities who
rely entirely on formal care for their personal assistance needs has
increased to 9 percent in 1999 from 5 percent in 1984.
Between 2000 and 2002, the number of licensed assisted living and
board and care facilities increased from 32,886 to 36,399 nationally,
reflecting the trend towards community-based care as opposed to nursing
homes. Most assisted living facilities, however, are unlicensed.
Most assisted living facilities (ALFs) discharge residents whose
cognitive impairments become moderate or severe or who need help with
transfers (e.g. moving from a wheelchair to a bed). This limits the
ability of these populations to find appropriate services outside of
nursing homes or other institutions.
Nursing Home Care
The risk of nursing home placement increases with age--31 percent of
those who are severely impaired and between the ages of 65 and 70
receive care in a nursing home compared to 61 percent of those age 85
and older.
In 2002, there were 1,458,000 people in nursing homes nationally.
Older individuals living in nursing homes require and receive greater
levels of care and assistance. In 1999, over three-quarters of
individuals in nursing homes received assistance with four to six ADLs.
Of the population aged 65 and over in 1999, 52 percent of the nursing
home population was aged 85 or older compared to 35 percent aged 75-84,
and 13 percent aged 65-74. Between 1985 and 1999 the number of adults
65 and older living in nursing homes increased from 1.3 million to 1.5
million. In 1999, almost three-quarters (1.1 million) of these older
residents were women.
The issue before us today, is how we intend to treat our aging and
disabled at a time when they are in need of assistance that will have a
direct impact on their quality of life.
Traditionally, most long-term care is provided informally by family
members and friends. Some people with disabilities receive assistance
at home from paid helpers, including skilled nurses and home care
aides.
Nursing homes are increasingly viewed as a last resort for people who
are too disabled to live in the community, due to a number of factors,
cost being one.
Mr. Chair, I believe that we must leave the framework that exists in
place and work with seniors, families, industry, HHS and others to find
a way to make the CLASS Act or an alternative long-term care program
work.
We cannot and we must not allow Medicaid to continue to be the only
affordable long-term care service available to Americans. American
families should not have to spend down their savings or assets to
access long-term care.
American families spend almost twice as much on health care through
premiums, paycheck deductions, and out-of-pocket expenses as families
in any other countries.
Considering the amount that we spend on health care, it is surprising
that Americans do not live as long as people in Canada, Japan, and most
of Western Europe. Our health care system was in need of an overhaul.
Under the Affordable Health Care Act, signed into law in 2010 more
than 32 million additional Americans are expected to get insurance,
either through an extension of Medicaid or through exchanges where low
and moderate income individuals and families will be able to purchase
private insurance with Federal subsidies.
A key part of the new health law also encourages the development of
``accountable care organizations'' that would allow doctors to team up
with each other and with hospitals, in new ways, to provide medical
services. There are dozens of good provisions in the Affordable Health
Care Law that will ultimately benefit the public, if they are not
repealed one title at a time. The CLASS Act is a good provision too--I
stand by that notion--but just improperly designed.
While family caregiving can be a very satisfying job, those who
become primary caretakers for their senior loved ones must understand
that doing so will touch many aspects of their lives--including work,
home and family. This data was developed from the responses of more
than 8,000 family caregivers who visited the caregiverstress.com Web
site since 2005. The results demonstrate the impact stress can have on
family caregivers and they illustrate why it's important to tap into
resources that can provide help or support.
I yield back the balance of my time.
Ms. WOOLSEY. Mr. Chairman, I move to strike the last word.
The Acting CHAIR. The gentlewoman from California is recognized for 5
minutes.
Ms. WOOLSEY. Mr. Chairman, across the United States, anguished
families are sitting down at their kitchen table. They're reviewing
their financial situation. Many are trying to figure out how in the
world they're going to afford their personal long-term care needs or
that of a loved one or another family member.
People who've worked hard their whole lives, who are already coping
with a sluggish economy, are being crushed under the weight of long-
term care costs, depleting their savings and sometimes spending
themselves into bankruptcy.
As we know, Mr. Chairman, long-term care is not covered in most
health care plans. If you're already old and sick, you probably can't
qualify for a separate long-term care policy; and if you can, it's
likely to be insanely expensive. Medicare pays only for the first 100
days of nursing-home care, and Medicaid is only available to the very
poor. But you don't have to be poor to be overwhelmed by nursing-home
costs that average $72,000 a year.
We can't forget that we live in an aging society. As our largest
generation, the baby boomers, move into their retirement years, and
while advances in science and technology have, thankfully, allowed us
to live longer, it means that many of us will require more extended,
more expensive care. All this has created a perfect storm in which the
long-term care crisis will get even worse, not better.
In the coming years, Mr. Chairman, we're going to find ourselves in
turmoil over long-term care. So why aren't we putting our heads
together on both sides of the aisle and coming up with ideas to solve
this dilemma? After all, we're all going to be old.
Instead, we're here today because the majority appears to want to
repeal the one modest attempt to help Americans cope with long-term
care costs. If the program needs improvement, I ask them, then let's
fix it. That's what taxpayers are paying us to do, not throw up our
hands and walk away from this problem.
{time} 1720
But my friends in the majority seem to have a different version and
vision of public service. It seems that instead of providing service to
the public, they view it as their job to dismantle and disembowel any
government investment that improves the lives of regular people.
Nothing seems to drive them to distraction like the commonsense reforms
of the Affordable Care Act. They have no innovative health care ideas
of their own. They're simply nostalgic for the cruel and unfair health
care system that we have finally begun to leave behind us.
So we need to be building on health care reform. We do not need to be
whittling away at it. Vote ``no,'' my colleagues, on the repeal of the
CLASS Act.
I yield back the balance of my time.
Mrs. CHRISTENSEN. I move to strike the last word.
The Acting CHAIR. The gentlewoman from the Virgin Islands is
recognized for 5 minutes.
Mrs. CHRISTENSEN. As I come to the floor today to speak against this
[[Page H347]]
repeal, I cannot help but remember the faces of the individuals with
disabilities, individuals with very serious long-term care needs,
sitting through the long markup a couple months ago only to, at the end
of the day, see the committee majority vote to repeal the CLASS Act. If
an expression could convey a thousand words, theirs did that day. I
know because I had the same expression, and I felt the exact same way:
disappointed and frustrated, saddened at the very real possibility that
they and our seniors would be left out in the cold when they are at
their most vulnerable.
I'm sure that they and millions of other people with special needs
and seniors are watching this now, and they, like all of us here now,
know that repealing the CLASS Act will not make 10 million Americans'
long-term care needs disappear, and it certainly will not make them
suddenly affordable for the overwhelming majority of most families.
The Secretary did the responsible thing. She put the implementation
on hold because the actuarial studies did not show that the program, as
designed, was sustainable. None of us who supported and voted for the
Affordable Care Act thought that everything in it was perfect. Much of
it was well put together, well-planned, well-designed. But there were
some that we thought might need to be tweaked or even revised in bigger
ways, but we needed to take that first big important step in the right
direction to make sure that the health care needs of our fellow
Americans would be met.
The Secretary in her letter to the Speaker said that the report
reflected ``The development of information that will ultimately advance
the cause of finding affordable and sustainable long-term care
options.''
So what we should be doing is looking at those options or charging an
institute like the Institute of Medicine to look at them and recommend
a way forward.
Everyone knows that we have a long-term care crisis in the United
States. There are 10 million vulnerable men, women, and children who
need this care, and we know that over the next decade that number will
grow to 15 million. We also know that there are grave racial, ethnic,
as well as geographic disparities that exist across the 10 million
Americans with unmet long-term health care needs.
We also know that long-term health care burdens family budgets, as
well as Medicaid programs in the States that administer them across our
Nation. Only about 8 percent of Americans buy long-term care insurance
because the premiums are too expensive in many cases for most
individuals to afford.
Despite these facts, and these are indeed facts, and as we have seen
time and time again, rather than identify and support a medically,
economically, and socially responsible solution to this critically
important problem, in their zeal to attack the Affordable Care Act and
undermine the provisions that have already begun to help all of our
constituents, our friends on the other side of the aisle would rather
slam that door shut and not continue to work with us to find ways to
meet this critical need.
We need to have a plan to ensure access to affordable long-term care,
and repealing and dismantling the CLASS Act with no safeguard or
stopgap in place first is definitely not the right way to go.
I, like everyone here, Republican and Democrat, have 10 million
reasons to take a stand and to fight for those who cannot fight for
themselves, to provide a voice for the voiceless and to remind our
colleagues and those watching that this fight cannot be over and that
we cannot stop until our long-term care crisis is addressed and those
who need it, as many of us, Republican and Democrat will, address it in
a manner that meets the high ideals of this country.
Mr. Chairman, I yield back the balance of my time.
Mr. AL GREEN of Texas. I move to strike the last word.
The Acting CHAIR. The gentleman is recognized for 5 minutes.
Mr. AL GREEN of Texas. Mr. Chairman, when it comes to health care and
those who need it and can't afford it, I constantly remind myself that
but for the grace of God, there go I. You don't believe in God? But for
the grace of chance and circumstance, but for the goodness of luck,
there go I.
The question we have to ask ourselves is what kind of country are we
going to be? Are we going to be a country wherein health care becomes
wealth care? Where only the wealthy can afford what is available? The
technology's available. The pharmaceuticals are available. But only the
wealthy can afford that which is available in the richest country in
the world.
Are we going to be a country wherein pregnancy is a preexisting
condition; if you are pregnant and you don't have insurance, you cannot
get it? Is that the kind of country we are going to be? Are we going to
be a country wherein senior citizens who are in need of pharmaceuticals
cannot get them because they can't afford them, but if you're wealthy,
you can. But for the grace of God, there go I.
No one deserves the status in life to which he or she is born. Born
wealthy? You didn't earn it. Born poor? You don't deserve it.
The question is whether we will understand that it can happen to any
one of us and that we are a country that can afford to make a
difference in the lives of those who are sick and cannot take care of
themselves.
So the issue today has not been whether we can afford it or whether
we can do it. The question is, do we have the will? We can find the
way.
I would yield to my colleague from Georgia, whom I have great respect
for and for whom I hold no animus. I just would like to ask you, is it
not true, my dear friend, that we can work this out and find a way to
get it done? Is it not true? Can we not find a way to get this done?
Mr. GINGREY of Georgia. Well, here again, when Mr. Barton, the
ranking member of the committee, asked very specifically, Mr. Chairman,
when he asked very specifically in the markup on the House side back in
2009, if I vote ``yes'' for that, will we have hearings to--I think it
was ``to flesh this out.'' He was assured, of course, by the chairman
at the time of the Health Subcommittee, Mr. Pallone, and also the
chairman of the overall committee, Mr. Waxman of California, said, Hey,
it's okay with me. No hearings were held.
So this business of can't we work this out, but yet we were reaching
out, and it never happened.
I yield back to my friend.
Mr. AL GREEN of Texas. If I may reclaim my time.
I do welcome comments about the past, my dear friend.
But I'm asking you, given that you do have some degree of influence
given that you're in the majority, why can we not do now what was not
done? I'm not privy to all of what wasn't done and should have been
done. But why can we not do now what wasn't done? Why can we not now
work to mend, rather then end, something that can benefit persons who
cannot help themselves? Why can we not do it now? What prevents us?
I yield to the gentleman.
Mr. GINGREY of Georgia. Mr. Chairman, the gentleman asked me a
specific question, and I want to respond to my friend.
You know, the point I will make to him is that we can work together.
We absolutely can.
Mr. Chairman, we have discussed this with Mr. Pallone. I have done so
personally, as I know my physician colleague on Energy and Commerce,
Mr. Burgess, has had a conversation with Mr. Pallone.
{time} 1730
We can work together, but we have to remove this failed program first
because of that looming deadline of October 1, 2012, where we'll get
sued if we don't have a program. So I'd be glad to work with the
gentleman.
The Acting CHAIR. The time of the gentleman has expired.
Mr. AL GREEN of Texas. Mr. Chairman, I ask that I be extended the
courtesy that the gentleman from Georgia received when he received an
additional 5 minutes. I don't need an additional 5 minutes. I would
just like to continue this dialogue that we have had, and he did
receive an additional 5 minutes earlier.
The Acting CHAIR. Is the gentleman requesting unanimous consent for
an additional 5 minutes?
Mr. AL GREEN of Texas. I ask unanimous consent to continue briefly
this dialogue with the gentleman.
[[Page H348]]
Mr. GINGREY of Georgia. Point of order, Mr. Chairman.
The Acting CHAIR. The Chair recognizes the gentleman from Georgia.
Mr. GINGREY of Georgia. In regard to you yielding an additional 5
minutes to me, in fact, that is not true.
Mr. Chairman, as you know, the gentleman from Tennessee,
Representative Fincher, moved to strike the last word and was afforded
the 5 minutes, as we all are, and he yielded to me.
I certainly would oppose the gentleman's unanimous consent request
for you to--I don't think you have the authority to do that quite
honestly.
The Acting CHAIR. Objection is heard.
Mr. AL GREEN of Texas. I would ask the Chair for a ruling first as to
whether the Chair has the authority to do it. Then, if I am incorrect,
let the record always reflect that I will extend an apology when I have
made a mistake. So if I have made a mistake, I will do so; but I do ask
that the Chair give a ruling as to whether or not we can have the
unanimous consent request granted.
Ms. NORTON. Mr. Chairman, could I make a parliamentary inquiry?
The Acting CHAIR. The Chair will first respond to the inquiry of the
gentleman from Texas.
The time of the gentleman may be extended in the Committee of the
Whole only by unanimous consent.
Ms. NORTON. Mr. Chairman, could I make an inquiry at this time?
The Acting CHAIR. Does the gentleman have a futher inquiry?
Mr. AL GREEN of Texas. Before I leave the podium, if I may, I would
like to prevail upon my friend whom I am having a colloquy with to show
some sense of desire to continue this and reach some sort of----
The Acting CHAIR. The gentleman from Texas will suspend.
The time of the gentleman from Texas has expired.
Mr. AL GREEN of Texas. May I ask for the unanimous consent now, Mr.
Chairman?
The Acting CHAIR. The gentleman has requested unanimous consent to
extend his time. There has been an objection to that request.
Does the gentlewoman from the District of Columbia seek recognition?
Ms. NORTON. I ask the Chair: Is it true that there will be no more
Members heard on this issue after 5:40?
Mr. GINGREY of Georgia. Mr. Speaker, I'm going to have to insist on
regular order here.
The Acting CHAIR. In answer to the gentlewoman's parliamentary
inquiry, there is a 3-hour time limit for consideration of amendments
that has not yet been reached.
Ms. SCHAKOWSKY. I move to strike the last word.
The Acting CHAIR. The gentlewoman from Illinois is recognized for 5
minutes.
Ms. SCHAKOWSKY. Mr. Chairman, roughly 70 percent of us at some point
are going to have difficulty taking care of ourselves independently,
and we're going to need some sort of long-term care or support. So as
the population ages, of course the need for these services only
increases.
I've been listening to this debate. On the substance, or at least as
we identify the problem, there is an enormous amount of agreement. We
all know that the costs associated with long-term care are very high,
that nursing homes can cost over $70,000 a year, and that just 20 hours
a week of home care costs nearly $20,000 a year. For working families,
there are few practical options in order to plan and pay for long-term
care and support services. Only about 3 percent have a private policy
covering long-term care while the majority is forced to spend its way
into poverty to qualify for the Medicare safety net coverage of those
costs.
We know this. We all agree on this.
What the CLASS Act did was to address a number of critical needs,
including providing a way for persons with disabilities to remain
independent and in their communities by bringing private dollars into
the long-term care services system in order to reduce the reliance on
Medicaid without impoverishing individuals and their families.
Mr. Chair, here is how: if a person must go into a nursing home--and
those are the potential long-term people, Americans--if such Americans
must go into a nursing home, first they spend down their resources, and
then they go into a nursing home at a cost of about $80,000 a year.
We all agree that the CLASS Act is far from perfect, but it provides
a beginning framework to begin to deal with the problem.
I got a letter from Jonathan Lavin, CEO of AgeOptions in Oak Brook,
Illinois, a service provider. He emailed me, actually, to say:
Please do not vote to repeal the CLASS Act. Such a vote
will reverse the hope of millions of Americans that one day
they may collectively insure themselves for the eventuality
of a debilitating disability. When we see a young former
Congresswoman gunned down and a healthy vibrant Illinois
Senator struck by a stroke, we realize that any of us may
suffer from a disability.
A broad-based, effective insurance program will assist
those who face such life-altering challenges. We understand
why the CLASS Act is delayed in implementation since the
economic situation is so dire, but we cannot understand
deliberately acting to eliminate the potential for such
legislation to do so much good after the economy recovers.
Every American faces the reality that an accident or illness
requiring long-term care could devastate them financially.
While this issue affects everyone, I want to focus on the importance
of the CLASS Act for women in this country.
Long-term care is very much a women's health issue. Women live longer
than men. Their life expectancy exceeds those of men by some 5 years.
Because they live longer, women are at greater risk of needing long-
term care services to help them when they become disabled or too sick
or frail to care for themselves. Women tend to need more resources for
long-term care. Women tend to be ill for longer periods of time, and
women are less likely to have a family member to care for them.
Over 70 percent of nursing home residents and nearly two-thirds of
home-care users are women. Because women, far more than men, take on
the role of caregiver, women are the ones who end up staying at home,
sometimes giving up careers to provide care for a sick or disabled
family member, adults and children alike. Indeed, women make up three-
fourths of the home-care workforce.
CLASS would help make these challenges easier. It would help provide
the care women may require if and when they need long-term care or
supports for themselves. It would help provide relief or a break, if
you will, for those women who spend all day every day at home taking
care of others in need of long-term care.
To take away this program is to take away the first real opportunity
that the women of this country have to deal with the long-term care
challenges they face day in and day out both as patients and as
caregivers. Like so many other Republican assaults on the Affordable
Care Act, H.R. 1173 is, in fact, an attack on women and women's health.
Like all those other assaults, we should push back and reject this
one. CLASS is just one of the many advancements for women's health that
is included in the Affordable Care Act. As you have heard many times
today, let's fix it, not repeal it, so it can work for women and all
Americans as intended.
Instead of passing H.R. 1173 and repealing the CLASS Act with no
effective alternative in place, we can and should work together to
repair this program. Ignoring the long-term care crisis won't make it
go away.
I yield back the balance of my time.
Ms. NORTON. Mr. Chair, I move to strike the last word.
The Acting CHAIR. The gentlewoman from the District of Columbia is
recognized for 5 minutes.
Ms. NORTON. Mr. Speaker, we have here one for the books. The
Democrats offer a 100 percent private-sector solution to the most
costly health care crisis affecting the American people, and
Republicans want to repeal it. This is going to go down in history.
The Obama administration is a victim of its own honesty. It, in good
faith, put the CLASS Act into the health care bill knowing that we
can't do without it. Then the administration looked carefully at the
cost factors, and it did the right thing. It informed the Congress that
it was suspending implementation of the CLASS Act. It certainly did not
repeal it or ask for its repeal, nor should we. Here is why: the
Medicare crisis before us, as I speak, is dwarfed by the long-term care
crisis.
[[Page H349]]
We know it because that crisis, the CLASS crisis if you will, is
already here.
{time} 1740
That crisis, my friends, is long-term care. Who pays for it? We pay
for it. We, the taxpayers, because Medicaid pays for it. They're coming
at an increasing clip because the fact is that the number of Americans
who are living longer, who don't have the resources themselves, grows
exponentially. Government is now paying 100 percent.
Let's look at the CLASS Act. That is a 100 percent privately financed
plan. It means that we should all, not wait for long-term care to be
needed when we would have to ask the government, through Medicaid, to
pay for nursing home care. We should begin now to take care of our own
long-term needs.
What are you going to do if we don't have the CLASS Act--pass off the
elderly who are in the nursing homes? To where? To whom?
Clearly, the CLASS Act is the only solution, unless you want the
Federal Government to continue to pick up the loss for those who need
long-term care, and that is what people in nursing homes are there for.
Only 8 percent of Americans buy long-term care insurance.
I bought long-term care insurance, and then I was a little concerned
to read that people who have bought long-term care insurance find they
are not going to get what they thought they paid for.
I think this House ought to be having hearings on what is out there
now if we want to encourage people to buy their own long-term care
insurance. We are doing none of that. We are not encouraging people to
do what the CLASS Act would encourage them to do. Instead, we are
saying repeal this private sector solution.
That makes no sense, because when the crisis comes, the elderly are
going to come to us. They are going to say they have no long-term care;
they want what the last generation had. You spend down your resources
and then Medicaid picks it up. That's the solution on the table now. If
you want a private solution, this is golden. It is in law.
We should grab it, keep it, have hearings on it. How can we make it
feasible? Thank the administration for deciding not to implement it.
They had an alternative. They could have allowed it to lie dormant,
gone on with the rest of the health care bill. Instead, they told the
truth.
Now we are here trying to repeal it, knowing full well that when the
crisis is upon us, we will never be able to put forward a private, 100
percent private solution because it will be too late.
Take this for what it's worth. You have a bird in hand.
I yield back the balance of my time.
Mr. PITTS. Mr. Chairman, I move to strike the last word.
The Acting CHAIR. The gentleman from Pennsylvania is recognized for 5
minutes.
Mr. PITTS. Mr. Chairman, to summarize briefly, first of all, there is
no CLASS program. The gentlelady was right; this is a woman issue.
Women have been promised something that they'll never get with the
CLASS Act. Zero people will be enrolled in the CLASS Act. They have a
program that doesn't work, they know it won't work, and it's a false
sense of hope to say that it will.
HHS studied for 18 months eight different scenarios to fix the CLASS
Act from $391 a month premium to $3,000 a month premium. They concluded
the same result: The CLASS Act is not fixable. Short of a mandate,
there's no way to fix the CLASS Act.
Now, our friends on the other side have had several opportunities to
offer amendments to fix the CLASS Act. First of all, H.R. 1173 was
marked up in the Energy and Commerce Health Subcommittee, and they
didn't offer an amendment. At full committee, the Democrats didn't
offer a comprehensive plan to fix the program. And now, with nearly 4
hours of debate, still no amendments to fix the program. Without a
mandate, there's no way to fix it.
Mr. Chairman, we must get this program off the books and start over.
It was wrong when it was passed. It's simply a liability in our budget,
and the American taxpayers who would reject any further attempt by the
Federal Government to require something upon them, that is another
mandate.
I urge a vote for H.R. 1173 to repeal this CLASS Act. Let's start
over again.
I yield back the balance of my time.
Announcement by the Acting Chair
The Acting CHAIR. Pursuant to clause 6 of rule XVIII, proceedings
will now resume on those amendments printed in the Congressional Record
on which further proceedings were postponed, in the following order:
Amendment No. 2 by Ms. Jackson Lee of Texas.
Amendment No. 1 by Ms. Jackson Lee of Texas.
Amendment No. 4 by Mr. Deutch of Florida.
Amendment No. 5 by Mr. Deutch of Florida.
The Chair will reduce to 2 minutes the minimum time for any
electronic vote after the first vote in this series.
Amendment No. 2 Offered by Ms. Jackson Lee of Texas
The Acting CHAIR. The unfinished business is the demand for a
recorded vote on the amendment offered by the gentlewoman from Texas
(Ms. Jackson Lee) on which further proceedings were postponed and on
which the noes prevailed by voice vote.
The Clerk will redesignate the amendment.
The Clerk redesignated the amendment.
Recorded Vote
The Acting CHAIR. A recorded vote has been demanded.
A recorded vote was ordered.
The vote was taken by electronic device, and there were--ayes 161,
noes 263, not voting 8, as follows:
[Roll No. 13]
AYES--161
Ackerman
Altmire
Andrews
Baca
Baldwin
Bass (CA)
Becerra
Berman
Bishop (GA)
Bishop (NY)
Blumenauer
Boswell
Brady (PA)
Brown (FL)
Butterfield
Capps
Capuano
Carnahan
Carney
Chu
Cicilline
Clarke (MI)
Clarke (NY)
Clay
Cleaver
Clyburn
Cohen
Connolly (VA)
Conyers
Cooper
Costello
Courtney
Critz
Crowley
Cuellar
Cummings
Davis (IL)
DeGette
DeLauro
Deutch
Dicks
Dingell
Doggett
Doyle
Edwards
Ellison
Engel
Fattah
Frank (MA)
Fudge
Garamendi
Gonzalez
Green, Al
Green, Gene
Grijalva
Gutierrez
Hahn
Hanabusa
Hastings (FL)
Heinrich
Higgins
Hinojosa
Hirono
Hochul
Holden
Holt
Honda
Hoyer
Inslee
Israel
Jackson (IL)
Jackson Lee (TX)
Johnson (GA)
Johnson, E. B.
Kaptur
Keating
Kildee
Kissell
Kucinich
Langevin
Larsen (WA)
Larson (CT)
Lee (CA)
Levin
Lewis (GA)
Loebsack
Lowey
Lujan
Lynch
Maloney
Markey
Matsui
McCollum
McDermott
McGovern
McNerney
Meeks
Michaud
Miller (NC)
Miller, George
Moore
Moran
Nadler
Napolitano
Neal
Olver
Owens
Pallone
Pascrell
Pastor (AZ)
Payne
Pelosi
Peters
Pingree (ME)
Polis
Price (NC)
Quigley
Rahall
Rangel
Reyes
Richardson
Richmond
Rothman (NJ)
Ruppersberger
Rush
Ryan (OH)
Sanchez, Linda T.
Sanchez, Loretta
Sarbanes
Schakowsky
Schiff
Schwartz
Scott (VA)
Scott, David
Serrano
Sewell
Sherman
Sires
Slaughter
Smith (NJ)
Smith (WA)
Stark
Sutton
Thompson (CA)
Thompson (MS)
Tierney
Tonko
Towns
Tsongas
Van Hollen
Velazquez
Visclosky
Walz (MN)
Wasserman Schultz
Waters
Watt
Waxman
Welch
Wilson (FL)
Woolsey
Yarmuth
NOES--263
Adams
Aderholt
Akin
Alexander
Amash
Amodei
Austria
Bachmann
Bachus
Barletta
Barrow
Bartlett
Barton (TX)
Bass (NH)
Benishek
Berg
Berkley
Biggert
Bilbray
Bilirakis
Bishop (UT)
Black
Blackburn
Bonner
Bono Mack
Boren
Boustany
Brady (TX)
Braley (IA)
Brooks
Broun (GA)
Buchanan
Bucshon
Buerkle
Burgess
Burton (IN)
Calvert
Camp
Campbell
Canseco
Cantor
Capito
Cardoza
Carter
Cassidy
Castor (FL)
Chabot
Chaffetz
Chandler
Coble
Coffman (CO)
Cole
Conaway
Costa
Cravaack
Crawford
Crenshaw
Culberson
Davis (CA)
Davis (KY)
DeFazio
Denham
Dent
DesJarlais
Diaz-Balart
Dold
Donnelly (IN)
Dreier
Duffy
Duncan (SC)
Duncan (TN)
Ellmers
Emerson
Eshoo
Farenthold
Farr
Fincher
Fitzpatrick
Flake
Fleischmann
Fleming
Flores
Forbes
Fortenberry
Foxx
Franks (AZ)
Frelinghuysen
Gallegly
Gardner
Garrett
Gerlach
Gibbs
Gibson
Gingrey (GA)
Gohmert
Goodlatte
Gosar
Gowdy
Granger
Graves (GA)
Graves (MO)
Griffin (AR)
[[Page H350]]
Griffith (VA)
Grimm
Guinta
Guthrie
Hall
Hanna
Harper
Harris
Hartzler
Hastings (WA)
Hayworth
Heck
Hensarling
Herger
Herrera Beutler
Himes
Huelskamp
Huizenga (MI)
Hultgren
Hunter
Hurt
Issa
Jenkins
Johnson (IL)
Johnson (OH)
Johnson, Sam
Jones
Jordan
Kelly
Kind
King (IA)
King (NY)
Kingston
Kinzinger (IL)
Kline
Labrador
Lamborn
Lance
Landry
Lankford
Latham
Latta
Lewis (CA)
Lipinski
LoBiondo
Lofgren, Zoe
Long
Lucas
Luetkemeyer
Lummis
Lungren, Daniel E.
Manzullo
Marchant
Marino
Matheson
McCarthy (CA)
McCarthy (NY)
McCaul
McClintock
McCotter
McHenry
McIntyre
McKeon
McKinley
McMorris Rodgers
Meehan
Mica
Miller (FL)
Miller (MI)
Miller, Gary
Mulvaney
Murphy (CT)
Murphy (PA)
Myrick
Neugebauer
Noem
Nugent
Nunes
Nunnelee
Olson
Palazzo
Paulsen
Pearce
Pence
Perlmutter
Peterson
Petri
Pitts
Platts
Poe (TX)
Pompeo
Posey
Price (GA)
Quayle
Reed
Rehberg
Reichert
Renacci
Ribble
Rigell
Rivera
Roby
Roe (TN)
Rogers (AL)
Rogers (KY)
Rogers (MI)
Rokita
Rooney
Ros-Lehtinen
Roskam
Ross (AR)
Ross (FL)
Royce
Runyan
Ryan (WI)
Scalise
Schilling
Schmidt
Schock
Schrader
Schweikert
Scott (SC)
Scott, Austin
Sensenbrenner
Sessions
Shimkus
Shuler
Shuster
Simpson
Smith (NE)
Smith (TX)
Southerland
Speier
Stearns
Stivers
Stutzman
Sullivan
Terry
Thompson (PA)
Thornberry
Tiberi
Tipton
Turner (NY)
Turner (OH)
Upton
Walberg
Walden
Walsh (IL)
Webster
West
Westmoreland
Whitfield
Wilson (SC)
Wittman
Wolf
Womack
Woodall
Yoder
Young (AK)
Young (FL)
Young (IN)
NOT VOTING--8
Carson (IN)
Filner
Hinchey
LaTourette
Mack
Paul
Rohrabacher
Roybal-Allard
{time} 1815
Messrs. POMPEO, LANDRY, POSEY, WILSON of South Carolina, MURPHY of
Pennsylvania, CALVERT, ROKITA, BURGESS, Ms. BERKLEY, and Ms. SPEIER
changed their vote from ``aye'' to ``no.''
Messrs. COOPER, CARNEY, OWENS, and Ms. HOCHUL changed their vote from
``no'' to ``aye.''
So the amendment was rejected.
The result of the vote was announced as above recorded.
Stated for:
Mr. FILNER. Mr. Speaker, on rollcall 13, I was away from the Capitol
due to prior commitments to my constituents. Had I been present, I
would have voted ``aye.''
Stated against:
Mr. SMITH of New Jersey. Mr. Chair, on rollcall No. 13, I
inadvertently voted ``yes'' when I intended to vote ``no.''
Amendment No. 1 Offered by Ms. Jackson Lee of Texas
The Acting CHAIR. The unfinished business is the demand for a
recorded vote on the amendment offered by the gentlewoman from Texas
(Ms. Jackson Lee) on which further proceedings were postponed and on
which the noes prevailed by voice vote.
The Clerk will redesignate the amendment.
The Clerk redesignated the amendment.
Recorded Vote
The Acting CHAIR. A recorded vote has been demanded.
A recorded vote was ordered.
The Acting CHAIR. This will be a 2-minute vote.
The vote was taken by electronic device, and there were--ayes 157,
noes 264, not voting 11, as follows:
[Roll No. 14]
AYES--157
Ackerman
Andrews
Baca
Baldwin
Bass (CA)
Becerra
Berman
Bishop (GA)
Blumenauer
Boswell
Brady (PA)
Braley (IA)
Brown (FL)
Butterfield
Capps
Capuano
Carnahan
Castor (FL)
Chu
Cicilline
Clarke (MI)
Clarke (NY)
Clay
Clyburn
Cohen
Connolly (VA)
Conyers
Costello
Courtney
Critz
Crowley
Cummings
Davis (IL)
DeFazio
DeGette
DeLauro
Deutch
Dicks
Dingell
Doggett
Doyle
Edwards
Ellison
Engel
Eshoo
Farr
Fattah
Frank (MA)
Fudge
Garamendi
Gonzalez
Green, Al
Grijalva
Gutierrez
Hahn
Hanabusa
Hastings (FL)
Heinrich
Higgins
Hinojosa
Hirono
Holden
Holt
Honda
Hoyer
Inslee
Israel
Jackson (IL)
Jackson Lee (TX)
Johnson (GA)
Johnson, E. B.
Kaptur
Keating
Kildee
Kissell
Kucinich
Langevin
Larson (CT)
Lee (CA)
Levin
Lewis (GA)
Loebsack
Lofgren, Zoe
Lowey
Lujan
Maloney
Markey
Matsui
McCarthy (NY)
McCollum
McDermott
McGovern
McNerney
Meeks
Michaud
Miller (NC)
Miller, George
Moore
Moran
Nadler
Napolitano
Neal
Olver
Pallone
Pascrell
Pastor (AZ)
Payne
Peters
Pingree (ME)
Polis
Price (NC)
Quigley
Rahall
Rangel
Reyes
Richardson
Richmond
Rothman (NJ)
Ruppersberger
Rush
Ryan (OH)
Sanchez, Linda T.
Sanchez, Loretta
Sarbanes
Schakowsky
Schiff
Schrader
Schwartz
Scott (VA)
Scott, David
Serrano
Sewell
Sherman
Sires
Slaughter
Smith (WA)
Speier
Stark
Sutton
Thompson (CA)
Thompson (MS)
Tierney
Tonko
Towns
Tsongas
Van Hollen
Velazquez
Visclosky
Walz (MN)
Wasserman Schultz
Waters
Watt
Waxman
Welch
Wilson (FL)
Woolsey
Yarmuth
NOES--264
Adams
Aderholt
Akin
Alexander
Altmire
Amash
Amodei
Austria
Bachmann
Bachus
Barletta
Barrow
Bartlett
Barton (TX)
Bass (NH)
Benishek
Berg
Berkley
Biggert
Bilbray
Bilirakis
Bishop (NY)
Bishop (UT)
Black
Blackburn
Bonner
Bono Mack
Boren
Boustany
Brady (TX)
Brooks
Broun (GA)
Buchanan
Bucshon
Buerkle
Burgess
Burton (IN)
Calvert
Camp
Campbell
Canseco
Cantor
Capito
Cardoza
Carney
Carter
Cassidy
Chabot
Chaffetz
Chandler
Cleaver
Coble
Coffman (CO)
Cole
Conaway
Cooper
Costa
Cravaack
Crawford
Crenshaw
Cuellar
Culberson
Davis (CA)
Davis (KY)
Denham
Dent
DesJarlais
Diaz-Balart
Dold
Donnelly (IN)
Dreier
Duffy
Duncan (SC)
Duncan (TN)
Ellmers
Emerson
Farenthold
Fincher
Fitzpatrick
Flake
Fleischmann
Fleming
Forbes
Fortenberry
Foxx
Franks (AZ)
Frelinghuysen
Gallegly
Gardner
Garrett
Gerlach
Gibbs
Gibson
Gingrey (GA)
Gohmert
Goodlatte
Gosar
Gowdy
Granger
Graves (GA)
Graves (MO)
Green, Gene
Griffin (AR)
Griffith (VA)
Grimm
Guinta
Guthrie
Hall
Hanna
Harper
Harris
Hartzler
Hastings (WA)
Hayworth
Heck
Hensarling
Herger
Herrera Beutler
Himes
Hochul
Huelskamp
Huizenga (MI)
Hultgren
Hunter
Hurt
Jenkins
Johnson (IL)
Johnson (OH)
Johnson, Sam
Jones
Jordan
Kelly
Kind
King (IA)
King (NY)
Kingston
Kinzinger (IL)
Kline
Labrador
Lamborn
Lance
Landry
Lankford
Larsen (WA)
Latham
LaTourette
Latta
Lewis (CA)
Lipinski
LoBiondo
Long
Lucas
Luetkemeyer
Lummis
Lungren, Daniel E.
Lynch
Manzullo
Marchant
Marino
Matheson
McCarthy (CA)
McCaul
McClintock
McCotter
McHenry
McIntyre
McKeon
McKinley
McMorris Rodgers
Meehan
Mica
Miller (FL)
Miller (MI)
Miller, Gary
Mulvaney
Murphy (CT)
Murphy (PA)
Myrick
Neugebauer
Noem
Nugent
Nunes
Nunnelee
Olson
Owens
Palazzo
Paulsen
Pearce
Pence
Perlmutter
Peterson
Petri
Pitts
Platts
Poe (TX)
Pompeo
Posey
Price (GA)
Quayle
Reed
Rehberg
Reichert
Renacci
Ribble
Rigell
Rivera
Roby
Roe (TN)
Rogers (AL)
Rogers (KY)
Rogers (MI)
Rohrabacher
Rokita
Rooney
Ros-Lehtinen
Roskam
Ross (AR)
Ross (FL)
Runyan
Ryan (WI)
Scalise
Schilling
Schmidt
Schock
Schweikert
Scott (SC)
Scott, Austin
Sensenbrenner
Sessions
Shimkus
Shuler
Shuster
Simpson
Smith (NE)
Smith (NJ)
Smith (TX)
Southerland
Stearns
Stivers
Stutzman
Terry
Thompson (PA)
Thornberry
Tiberi
Tipton
Turner (NY)
Turner (OH)
Upton
Walberg
Walden
Walsh (IL)
Webster
West
Westmoreland
Whitfield
Wilson (SC)
Wittman
Wolf
Womack
Woodall
Yoder
Young (AK)
Young (FL)
Young (IN)
NOT VOTING--11
Carson (IN)
Filner
Flores
Hinchey
Issa
Mack
Paul
Pelosi
Roybal-Allard
Royce
Sullivan
ANNOUNCEMENT BY THE ACTING CHAIR
The Acting CHAIR (during the vote). There is 1 minute remaining.
{time} 1819
So the amendment was rejected.
The result of the vote was announced as above recorded.
Stated for:
Mr. FILNER. Mr. Speaker, on rollcall 14, I was away from the Capitol
due to prior commitments to my constituents. Had I been present, I
would have voted ``aye.''
Amendment No. 4 Offered by Mr. Deutch
The Acting CHAIR. The unfinished business is the demand for a
recorded vote on the amendment offered by the gentleman from Florida
(Mr. Deutch) on which further proceedings were postponed and on which
the noes prevailed by voice vote.
[[Page H351]]
The Clerk will redesignate the amendment.
The Clerk redesignated the amendment.
Recorded Vote
The Acting CHAIR. A recorded vote has been demanded.
A recorded vote was ordered.
The Acting CHAIR. This will be a 2-minute vote.
The vote was taken by electronic device, and there were--ayes 164,
noes 260, not voting 8, as follows:
[Roll No. 15]
AYES--164
Ackerman
Altmire
Andrews
Baca
Baldwin
Bass (CA)
Becerra
Berman
Bishop (GA)
Blumenauer
Boswell
Brady (PA)
Braley (IA)
Brown (FL)
Butterfield
Capps
Capuano
Cardoza
Carnahan
Castor (FL)
Chu
Cicilline
Clarke (MI)
Clarke (NY)
Clay
Cleaver
Clyburn
Cohen
Connolly (VA)
Conyers
Costello
Courtney
Critz
Crowley
Cummings
Davis (CA)
Davis (IL)
DeGette
DeLauro
Deutch
Dicks
Dingell
Doggett
Doyle
Edwards
Ellison
Engel
Eshoo
Farr
Fattah
Frank (MA)
Fudge
Garamendi
Gonzalez
Green, Al
Green, Gene
Grijalva
Gutierrez
Hahn
Hanabusa
Hastings (FL)
Heinrich
Higgins
Hinojosa
Hirono
Holden
Holt
Honda
Hoyer
Inslee
Israel
Jackson (IL)
Jackson Lee (TX)
Johnson (GA)
Johnson, E. B.
Kaptur
Keating
Kildee
Kissell
Kucinich
Langevin
Larsen (WA)
Larson (CT)
Lee (CA)
Levin
Lewis (GA)
Loebsack
Lofgren, Zoe
Lowey
Lujan
Lynch
Maloney
Markey
Matsui
McCarthy (NY)
McCollum
McDermott
McGovern
McNerney
Meeks
Michaud
Miller (NC)
Miller, George
Moore
Moran
Nadler
Napolitano
Neal
Olver
Pallone
Pascrell
Pastor (AZ)
Payne
Pelosi
Perlmutter
Peters
Pingree (ME)
Polis
Price (NC)
Quigley
Rahall
Rangel
Reyes
Richardson
Richmond
Rothman (NJ)
Ruppersberger
Rush
Ryan (OH)
Sanchez, Linda T.
Sanchez, Loretta
Sarbanes
Schakowsky
Schiff
Schwartz
Scott (VA)
Scott, David
Serrano
Sewell
Sherman
Sires
Slaughter
Smith (WA)
Speier
Stark
Sutton
Thompson (CA)
Thompson (MS)
Tierney
Tonko
Towns
Tsongas
Van Hollen
Velazquez
Visclosky
Walz (MN)
Wasserman Schultz
Waters
Watt
Waxman
Welch
Wilson (FL)
Woolsey
Yarmuth
NOES--260
Adams
Aderholt
Akin
Alexander
Amash
Amodei
Austria
Bachmann
Bachus
Barletta
Barrow
Bartlett
Barton (TX)
Bass (NH)
Benishek
Berg
Berkley
Biggert
Bilbray
Bilirakis
Bishop (NY)
Bishop (UT)
Black
Blackburn
Bonner
Bono Mack
Boren
Boustany
Brady (TX)
Brooks
Broun (GA)
Buchanan
Bucshon
Buerkle
Burgess
Burton (IN)
Calvert
Camp
Campbell
Canseco
Cantor
Capito
Carney
Carter
Cassidy
Chabot
Chaffetz
Chandler
Coble
Coffman (CO)
Cole
Conaway
Cooper
Costa
Cravaack
Crawford
Crenshaw
Cuellar
Culberson
Davis (KY)
DeFazio
Denham
Dent
DesJarlais
Diaz-Balart
Dold
Donnelly (IN)
Dreier
Duffy
Duncan (SC)
Duncan (TN)
Ellmers
Emerson
Farenthold
Fincher
Fitzpatrick
Flake
Fleischmann
Fleming
Flores
Forbes
Fortenberry
Foxx
Frelinghuysen
Gallegly
Gardner
Garrett
Gerlach
Gibbs
Gibson
Gingrey (GA)
Gohmert
Goodlatte
Gosar
Gowdy
Granger
Graves (GA)
Graves (MO)
Griffin (AR)
Griffith (VA)
Grimm
Guinta
Guthrie
Hall
Hanna
Harper
Harris
Hartzler
Hastings (WA)
Hayworth
Heck
Hensarling
Herger
Herrera Beutler
Himes
Hochul
Huelskamp
Huizenga (MI)
Hultgren
Hunter
Hurt
Issa
Jenkins
Johnson (IL)
Johnson (OH)
Johnson, Sam
Jones
Jordan
Kelly
Kind
King (IA)
King (NY)
Kingston
Kinzinger (IL)
Kline
Labrador
Lamborn
Lance
Landry
Lankford
Latham
Latta
Lewis (CA)
Lipinski
LoBiondo
Long
Lucas
Luetkemeyer
Lummis
Lungren, Daniel E.
Manzullo
Marchant
Marino
Matheson
McCarthy (CA)
McCaul
McClintock
McCotter
McHenry
McIntyre
McKeon
McKinley
McMorris Rodgers
Meehan
Mica
Miller (FL)
Miller (MI)
Miller, Gary
Mulvaney
Murphy (CT)
Murphy (PA)
Myrick
Neugebauer
Noem
Nugent
Nunes
Nunnelee
Olson
Owens
Palazzo
Paulsen
Pearce
Pence
Peterson
Petri
Pitts
Platts
Poe (TX)
Pompeo
Posey
Price (GA)
Quayle
Reed
Rehberg
Reichert
Renacci
Ribble
Rigell
Rivera
Roby
Roe (TN)
Rogers (AL)
Rogers (KY)
Rogers (MI)
Rohrabacher
Rokita
Rooney
Ros-Lehtinen
Roskam
Ross (AR)
Ross (FL)
Royce
Runyan
Ryan (WI)
Scalise
Schilling
Schmidt
Schock
Schrader
Schweikert
Scott (SC)
Scott, Austin
Sensenbrenner
Sessions
Shimkus
Shuler
Shuster
Simpson
Smith (NE)
Smith (NJ)
Smith (TX)
Southerland
Stearns
Stivers
Stutzman
Sullivan
Terry
Thompson (PA)
Thornberry
Tiberi
Tipton
Turner (NY)
Turner (OH)
Upton
Walberg
Walden
Walsh (IL)
Webster
West
Westmoreland
Whitfield
Wilson (SC)
Wittman
Wolf
Womack
Woodall
Yoder
Young (AK)
Young (FL)
Young (IN)
NOT VOTING--8
Carson (IN)
Filner
Franks (AZ)
Hinchey
LaTourette
Mack
Paul
Roybal-Allard
{time} 1824
So the amendment was rejected.
The result of the vote was announced as above recorded.
Stated for:
Mr. FILNER. Mr. Speaker, on rollcall 15, I was away from the Capitol
due to prior commitments to my constituents. Had I been present, I
would have voted ``aye.''
Stated against:
Mr. FRANKS of Arizona. Mr. Chair, on rollcall No. 15, I was
unavoidably detained. Had I been present, I would have voted ``no.''
Amendment No. 5 Offered by Mr. Deutch
The Acting CHAIR. The unfinished business is the demand for a
recorded vote on the amendment offered by the gentleman from Florida
(Mr. Deutch) on which further proceedings were postponed and on which
the noes prevailed by voice vote.
The Clerk will redesignate the amendment.
The Clerk redesignated the amendment.
Recorded Vote
The Acting CHAIR. A recorded vote has been demanded.
A recorded vote was ordered.
The Acting CHAIR. This will be a 2-minute vote.
The vote was taken by electronic device, and there were--ayes 160,
noes 264, not voting 8, as follows:
[Roll No. 16]
AYES--160
Ackerman
Altmire
Andrews
Baca
Baldwin
Bass (CA)
Becerra
Berman
Bishop (GA)
Bishop (NY)
Blumenauer
Boswell
Brady (PA)
Braley (IA)
Brown (FL)
Butterfield
Capps
Capuano
Cardoza
Carnahan
Castor (FL)
Chu
Cicilline
Clarke (MI)
Clarke (NY)
Clay
Cleaver
Clyburn
Cohen
Connolly (VA)
Conyers
Costello
Courtney
Critz
Crowley
Cuellar
Cummings
Davis (CA)
Davis (IL)
DeGette
DeLauro
Deutch
Dicks
Dingell
Doggett
Doyle
Edwards
Ellison
Engel
Eshoo
Farr
Fattah
Frank (MA)
Fudge
Garamendi
Green, Al
Green, Gene
Grijalva
Hahn
Hanabusa
Hastings (FL)
Heinrich
Higgins
Hinojosa
Hirono
Holden
Holt
Honda
Inslee
Israel
Jackson (IL)
Jackson Lee (TX)
Johnson (GA)
Johnson, E. B.
Kaptur
Keating
Kildee
Kissell
Kucinich
Langevin
Larson (CT)
Lee (CA)
Levin
Lewis (GA)
Loebsack
Lofgren, Zoe
Lowey
Lujan
Maloney
Markey
Matsui
McCarthy (NY)
McCollum
McDermott
McGovern
McNerney
Meeks
Michaud
Miller (NC)
Miller, George
Moore
Moran
Nadler
Napolitano
Neal
Olver
Pallone
Pascrell
Pastor (AZ)
Payne
Pelosi
Peters
Pingree (ME)
Polis
Price (NC)
Quigley
Rahall
Rangel
Reyes
Richardson
Richmond
Rothman (NJ)
Ruppersberger
Rush
Ryan (OH)
Sanchez, Linda T.
Sanchez, Loretta
Sarbanes
Schakowsky
Schiff
Schwartz
Scott (VA)
Scott, David
Serrano
Sewell
Sherman
Sires
Slaughter
Smith (WA)
Speier
Stark
Sutton
Thompson (CA)
Thompson (MS)
Tierney
Tonko
Towns
Tsongas
Van Hollen
Velazquez
Visclosky
Walz (MN)
Wasserman Schultz
Waters
Watt
Waxman
Welch
Wilson (FL)
Woolsey
Yarmuth
NOES--264
Adams
Aderholt
Akin
Alexander
Amash
Amodei
Austria
Bachmann
Bachus
Barletta
Barrow
Bartlett
Barton (TX)
Bass (NH)
Benishek
Berg
Berkley
Biggert
Bilbray
Bilirakis
Bishop (UT)
Black
Blackburn
Bonner
Bono Mack
Boren
Boustany
Brady (TX)
Brooks
Broun (GA)
Buchanan
Bucshon
Buerkle
Burgess
Burton (IN)
Calvert
Camp
Campbell
Canseco
Cantor
Capito
Carney
Carter
Cassidy
Chabot
Chaffetz
Chandler
Coble
Coffman (CO)
Cole
Conaway
Cooper
Costa
Cravaack
Crawford
Crenshaw
Culberson
Davis (KY)
DeFazio
Denham
Dent
DesJarlais
Diaz-Balart
Dold
Donnelly (IN)
Dreier
[[Page H352]]
Duffy
Duncan (SC)
Duncan (TN)
Ellmers
Emerson
Farenthold
Fincher
Fitzpatrick
Flake
Fleischmann
Fleming
Flores
Forbes
Fortenberry
Foxx
Franks (AZ)
Frelinghuysen
Gallegly
Gardner
Garrett
Gerlach
Gibbs
Gibson
Gingrey (GA)
Gohmert
Goodlatte
Gosar
Gowdy
Granger
Graves (GA)
Graves (MO)
Griffin (AR)
Griffith (VA)
Grimm
Guinta
Guthrie
Hall
Hanna
Harper
Harris
Hartzler
Hastings (WA)
Hayworth
Heck
Hensarling
Herger
Herrera Beutler
Himes
Hochul
Hoyer
Huelskamp
Huizenga (MI)
Hultgren
Hunter
Hurt
Issa
Jenkins
Johnson (IL)
Johnson (OH)
Johnson, Sam
Jones
Jordan
Kelly
Kind
King (IA)
King (NY)
Kingston
Kinzinger (IL)
Kline
Labrador
Lamborn
Lance
Landry
Lankford
Larsen (WA)
Latham
LaTourette
Latta
Lewis (CA)
Lipinski
LoBiondo
Long
Lucas
Luetkemeyer
Lummis
Lungren, Daniel E.
Lynch
Manzullo
Marchant
Marino
Matheson
McCarthy (CA)
McCaul
McClintock
McCotter
McHenry
McIntyre
McKeon
McKinley
McMorris Rodgers
Meehan
Mica
Miller (FL)
Miller (MI)
Miller, Gary
Mulvaney
Murphy (CT)
Murphy (PA)
Myrick
Neugebauer
Noem
Nugent
Nunes
Nunnelee
Olson
Owens
Palazzo
Paulsen
Pearce
Pence
Perlmutter
Peterson
Petri
Pitts
Platts
Poe (TX)
Pompeo
Posey
Price (GA)
Quayle
Reed
Rehberg
Reichert
Renacci
Ribble
Rigell
Rivera
Roby
Roe (TN)
Rogers (AL)
Rogers (KY)
Rogers (MI)
Rohrabacher
Rokita
Rooney
Ros-Lehtinen
Roskam
Ross (AR)
Ross (FL)
Royce
Runyan
Ryan (WI)
Scalise
Schilling
Schmidt
Schock
Schrader
Schweikert
Scott (SC)
Scott, Austin
Sensenbrenner
Sessions
Shimkus
Shuler
Shuster
Simpson
Smith (NE)
Smith (NJ)
Smith (TX)
Southerland
Stearns
Stivers
Stutzman
Sullivan
Terry
Thompson (PA)
Thornberry
Tiberi
Tipton
Turner (NY)
Turner (OH)
Upton
Walberg
Walden
Walsh (IL)
Webster
West
Westmoreland
Whitfield
Wilson (SC)
Wittman
Wolf
Womack
Woodall
Yoder
Young (AK)
Young (FL)
Young (IN)
NOT VOTING--8
Carson (IN)
Filner
Gonzalez
Gutierrez
Hinchey
Mack
Paul
Roybal-Allard
{time} 1829
So the amendment was rejected.
The result of the vote was announced as above recorded.
Stated for:
Mr. FILNER. Mr. Speaker, on rollcall 16, I was away from the Capitol
due to prior commitments to my constituents. Had I been present, I
would have voted ``aye.''
The Acting CHAIR (Mr. Dold). The question is on the committee
amendment in the nature of a substitute.
The amendment was agreed to.
The Acting CHAIR. Under the rule, the Committee rises.
Accordingly, the Committee rose; and the Speaker pro tempore (Mr.
Yoder) having assumed the chair, Mr. Dold, Acting Chair of the
Committee of the Whole House on the state of the Union, reported that
that Committee, having had under consideration the bill (H.R. 1173) to
repeal the CLASS Program, and, pursuant to House Resolution 522,
reported the bill back to the House with an amendment adopted in the
Committee of the Whole.
The SPEAKER pro tempore. Under the rule, the previous question is
ordered.
The question is on the committee amendment in the nature of a
substitute.
The amendment was agreed to.
The SPEAKER pro tempore. The question is on the engrossment and third
reading of the bill.
The bill was ordered to be engrossed and read a third time, and was
read the third time.
{time} 1830
Motion to Recommit
Mr. GARAMENDI. Mr. Speaker, I have a motion to recommit at the desk.
The SPEAKER pro tempore. Is the gentleman opposed to the bill?
Mr. GARAMENDI. I am in its present form.
The SPEAKER pro tempore. The Clerk will report the motion to
recommit.
The Clerk read as follows:
Mr. Garamendi moves to recommit the bill H.R. 1173 to the
Committee on Energy and Commerce with instructions to report
the same back to the House forthwith, with the following
amendment:
At the end of the bill, add the following:
SEC. 3. ENSURING LONG-TERM CARE SERVICES FOR SENIORS WITH
ALZHEIMER'S DISEASE AND OTHER DISABLED
INDIVIDUALS.
(a) In General.--Section 2 shall not take effect until such
date as the Secretary of Health and Human Services certifies
that a national voluntary insurance program is in effect for
purchasing community living assistance services and supports
for individuals who--
(1) have--
(A) Alzheimer's disease or other cognitive impairment;
(B) chronic diabetes, heart disease, or advanced stages of
cancer;
(C) a disability or traumatic injury; or
(D) any other serious disease or health condition; and
(2) require assistance with two or more activities of daily
living (such as eating, bathing, dressing, and toileting).
(b) Exception.--Notwithstanding subsection (a), section
2(b)(3)(B) shall take effect upon the enactment of this Act.
The SPEAKER pro tempore. The gentleman from California is recognized
for 5 minutes.
Mr. GARAMENDI. Mr. Speaker, I want all Members to pause for a moment
and think about your family, think about your community, and the people
you represent. I want you to put in your mind Alzheimer's and the
effect that it has on the individuals and families. Now are you
envisioning the effect of Alzheimer's, not only on the individual but
on the family?
I want you to put in your mind that terrible auto accident that left
that young child totally disabled. I want you to put in your mind the
diabetic, think about the diabetic, long-term diabetes, and the effect
that it has.
Now, the point of my amendment is not to kill this bill but rather to
amend it in such a way that it can be taken up on the floor with all of
us supporting this.
Long-term care is a major challenge for families, for individuals,
and for this Nation. Today 5.4 million Americans have Alzheimer's, and
at the end of this decade, it's expected to double, more than 10
million.
Keep that vision of the Alzheimer's patient in mind. It may be
someone in your family or in your circle. Twenty-four million Americans
have diabetes, 26 million have heart disease. Think of that stroke
victim. You know that person. They've been our colleagues, disabled,
and in many cases, totally disabled.
What this amendment does is to deal with a profound problem in
America. How do we care for those who are disabled, unable to care for
themselves for a lengthy period of time? How do we do that? There is no
effective way to do it today until that individual and family is flat
broke.
There is no mechanism today to deal with this problem unless you have
become totally bankrupt, no assets, and then you get to go on the
Medicaid program, a burden on our general fund and on every State's
general fund.
This amendment offers a solution. This amendment says that we will
keep the CLASS Act in effect but seek a national voluntary insurance
program. Now, I happen to know insurance, and I happen to know that all
of the long-term insurance programs out there have failed to work
because they are narrow, because they've been unable to reach across
the broad spectrum of America to provide a broad base of risk. You need
a very, very large pool to deal with this very large and very expensive
problem.
If my amendment is adopted, we will be able to go forward and to
repair the CLASS Act into a voluntary insurance program that would
involve the entire Nation and thereby provide a premium that is
affordable. The present programs do not.
As we know from the CLASS Act itself and the work done by the
Department of Health and Human Services, it too is flawed. But the
problem remains. The problem has not disappeared. It is in fact in
every one of our families and, quite possibly, with us as individuals.
We need a solution. Whether you're a Democrat or a Republican, we
have to find a solution to this problem because now it falls back. When
all other resources are gone for the individual and the family, it
falls back onto the general fund of the State and the Federal
Government. Not a good solution at all.
So I ask for your support on this. If you adopt this amendment, we
will immediately vote on the CLASS Act itself, and it will be repealed,
but not real. It will be maintained as we work
[[Page H353]]
forward towards a solution. That's our task here. That's our task as
Members of Congress. Find solutions for the real problems that face
every American.
Mr. Speaker, I yield back the balance of my time.
Mr. GINGREY of Georgia. Mr. Speaker, I claim the time in opposition
to the motion.
The SPEAKER pro tempore. The gentleman is recognized for 5 minutes.
Mr. GINGREY of Georgia. Mr. Speaker, the gentleman from California in
mentioning these categories of suffering seniors, people with
Alzheimer's disease, chronic diabetes, heart disease, advanced stages
of cancer, disability, or traumatic injury, I'd like to tell the
gentleman and my colleagues on the other side of the aisle, Mr.
Speaker, that we on this side of the aisle always have these victims in
our mind, in our heart, in our prayers. But we have the compassion and
the honesty not to promote and present a ruse and false hope. That's
what this so-called CLASS Act non-program does to these suffering
individuals that suffer from these chronic medical conditions and
disabilities.
H.R. 1173 is an opportunity for this Congress to reverse one of the
most costly coverups--yes, coverups--this administration has imposed
upon the American taxpayer. The failure of this administration to
implement the CLASS program came as no surprise to the many of us who
had actually listened to the concerns from the unbiased actuaries--even
the administration's own chief health actuary, Richard Foster, from
CMS--about the certain failure of the CLASS program.
The concerns, Mr. Speaker, were bipartisan during debate on the
President's health care law, and even the President's own fiscal
commission called for the program's repeal.
So today we have the opportunity to finally get this failed program
off of the books. This administration has spent millions of dollars
and, yes, eight ways of Sunday, here they are, colleagues, eight ways,
short of having yet another mandate that all people have coverage.
{time} 1840
They have tried to implement a program that never had a chance of
being implemented, and today we're faced with an $80 billion hole in
the budget that this administration claims would be filled by the
implementation of the CLASS program.
Listen, colleagues, key Senate Democrats, like Senator Harkin,
believe that there is still one last option worth considering: another
unconstitutional mandate on every American. In fact, in comments to
reporters yesterday, Senator Harkin made the claim that the problem
with the current CLASS program is that it is voluntary. In the opinion
of the esteemed Senator, it needs to be mandatory.
The need for long-term care reform is an important issue, and I am
confident that solutions can be accomplished and that we can do this in
a bipartisan way as they have been done before on this issue. We
cannot, however, continue to deny the fact that the CLASS program is an
abject failure and that its repeal is necessary today.
I say to my Democrat colleagues, admit your failure. You rushed this
provision into the health care law. I understand your compassion toward
the late Senator Kennedy and your wanting this to be a legacy for him,
but it was his staff that maybe misled the committee and the Democrat
majority. Admit your failure. Get over it. Vote to repeal this failed
CLASS Act, and live to fight another day.
I recommend that we vote down this motion to recommit and for the
bill to be repealed.
I yield back the balance of my time.
The SPEAKER pro tempore. Without objection, the previous question is
ordered on the motion to recommit.
There was no objection.
The SPEAKER pro tempore. The question is on the motion to recommit.
The question was taken; and the Speaker pro tempore announced that
the noes appeared to have it.
Recorded Vote
Mr. GARAMENDI. Mr. Speaker, I demand a recorded vote.
A recorded vote was ordered.
The SPEAKER pro tempore. Pursuant to clause 8 and clause 9 of rule
XX, this 15-minute vote on the motion to recommit will be followed by
5-minute votes on passage of H.R. 1173, if ordered, and motions to
suspend the rules on H.R. 3835 and H.R. 3567.
The vote was taken by electronic device, and there were--ayes 175,
noes 247, not voting 10, as follows:
[Roll No. 17]
AYES--175
Ackerman
Altmire
Andrews
Baca
Baldwin
Bass (CA)
Becerra
Berkley
Berman
Bishop (GA)
Bishop (NY)
Blumenauer
Boswell
Brady (PA)
Braley (IA)
Brown (FL)
Butterfield
Capps
Capuano
Cardoza
Carnahan
Carney
Castor (FL)
Chu
Cicilline
Clarke (MI)
Clarke (NY)
Clay
Cleaver
Clyburn
Cohen
Connolly (VA)
Conyers
Cooper
Costa
Costello
Courtney
Critz
Crowley
Cuellar
Cummings
Davis (CA)
Davis (IL)
DeFazio
DeGette
DeLauro
Deutch
Dicks
Dingell
Doggett
Doyle
Edwards
Ellison
Engel
Eshoo
Farr
Fattah
Frank (MA)
Fudge
Garamendi
Gonzalez
Green, Al
Green, Gene
Grijalva
Gutierrez
Hahn
Hanabusa
Hastings (FL)
Heinrich
Higgins
Himes
Hinojosa
Hirono
Holden
Holt
Honda
Hoyer
Inslee
Israel
Jackson (IL)
Jackson Lee (TX)
Johnson (GA)
Johnson, E. B.
Kaptur
Keating
Kildee
Kind
Kissell
Kucinich
Langevin
Larsen (WA)
Larson (CT)
Lee (CA)
Levin
Lewis (GA)
Loebsack
Lofgren, Zoe
Lowey
Lujan
Lynch
Maloney
Markey
Matsui
McCarthy (NY)
McCollum
McDermott
McGovern
McIntyre
McNerney
Meeks
Michaud
Miller (NC)
Miller, George
Moore
Moran
Murphy (CT)
Nadler
Napolitano
Neal
Olver
Pallone
Pascrell
Pastor (AZ)
Payne
Pelosi
Perlmutter
Peters
Peterson
Pingree (ME)
Polis
Price (NC)
Quigley
Rahall
Rangel
Reyes
Richardson
Richmond
Rothman (NJ)
Ruppersberger
Rush
Ryan (OH)
Sanchez, Linda T.
Sanchez, Loretta
Sarbanes
Schakowsky
Schiff
Schwartz
Scott (VA)
Scott, David
Serrano
Sewell
Sherman
Sires
Slaughter
Smith (WA)
Stark
Sutton
Thompson (CA)
Thompson (MS)
Tierney
Tonko
Towns
Tsongas
Van Hollen
Velazquez
Visclosky
Walz (MN)
Wasserman Schultz
Waters
Watt
Waxman
Welch
Wilson (FL)
Woolsey
Yarmuth
NOES--247
Adams
Akin
Alexander
Amash
Amodei
Austria
Bachmann
Bachus
Barletta
Barrow
Bartlett
Barton (TX)
Bass (NH)
Benishek
Berg
Biggert
Bilbray
Bilirakis
Bishop (UT)
Black
Blackburn
Bonner
Bono Mack
Boren
Boustany
Brady (TX)
Brooks
Broun (GA)
Buchanan
Bucshon
Buerkle
Burgess
Burton (IN)
Calvert
Camp
Campbell
Canseco
Cantor
Capito
Carter
Cassidy
Chabot
Chaffetz
Chandler
Coble
Coffman (CO)
Cole
Conaway
Cravaack
Crawford
Crenshaw
Culberson
Davis (KY)
Denham
Dent
DesJarlais
Diaz-Balart
Dold
Donnelly (IN)
Dreier
Duffy
Duncan (SC)
Duncan (TN)
Ellmers
Emerson
Farenthold
Fincher
Fitzpatrick
Flake
Fleischmann
Fleming
Flores
Forbes
Fortenberry
Foxx
Franks (AZ)
Frelinghuysen
Gallegly
Gardner
Garrett
Gerlach
Gibbs
Gibson
Gingrey (GA)
Gohmert
Goodlatte
Gosar
Gowdy
Granger
Graves (GA)
Graves (MO)
Griffin (AR)
Griffith (VA)
Grimm
Guinta
Guthrie
Hall
Hanna
Harper
Harris
Hartzler
Hastings (WA)
Hayworth
Heck
Hensarling
Herger
Herrera Beutler
Hochul
Huelskamp
Huizenga (MI)
Hultgren
Hunter
Hurt
Issa
Jenkins
Johnson (IL)
Johnson (OH)
Johnson, Sam
Jones
Jordan
Kelly
King (IA)
King (NY)
Kingston
Kinzinger (IL)
Kline
Labrador
Lamborn
Lance
Landry
Latham
LaTourette
Latta
Lewis (CA)
Lipinski
LoBiondo
Long
Lucas
Luetkemeyer
Lummis
Lungren, Daniel E.
Manzullo
Marchant
Marino
Matheson
McCarthy (CA)
McCaul
McClintock
McCotter
McHenry
McKeon
McKinley
McMorris Rodgers
Meehan
Mica
Miller (FL)
Miller (MI)
Miller, Gary
Mulvaney
Murphy (PA)
Myrick
Neugebauer
Noem
Nugent
Nunes
Nunnelee
Olson
Owens
Palazzo
Paulsen
Pearce
Pence
Petri
Pitts
Platts
Poe (TX)
Pompeo
Posey
Price (GA)
Quayle
Reed
Rehberg
Reichert
Renacci
Ribble
Rigell
Rivera
Roby
Roe (TN)
Rogers (AL)
Rogers (KY)
Rogers (MI)
Rohrabacher
Rokita
Rooney
Ros-Lehtinen
Roskam
Ross (AR)
Ross (FL)
Royce
Runyan
Ryan (WI)
Scalise
Schilling
Schmidt
Schock
Schrader
Schweikert
Scott (SC)
Scott, Austin
Sensenbrenner
Sessions
Shimkus
Shuler
Shuster
Simpson
Smith (NE)
Smith (NJ)
Smith (TX)
Southerland
Stearns
Stivers
Stutzman
[[Page H354]]
Sullivan
Terry
Thompson (PA)
Thornberry
Tiberi
Tipton
Turner (NY)
Turner (OH)
Upton
Walberg
Walden
Webster
West
Westmoreland
Whitfield
Wilson (SC)
Wittman
Wolf
Womack
Woodall
Yoder
Young (AK)
Young (FL)
Young (IN)
NOT VOTING--10
Aderholt
Carson (IN)
Filner
Hinchey
Lankford
Mack
Paul
Roybal-Allard
Speier
Walsh (IL)
{time} 1859
So the motion to recommit was rejected.
The result of the vote was announced as above recorded.
Stated for:
Mr. FILNER. Mr. Speaker, on rollcall 17, I was away from the Capitol
due to prior commitments to my constituents. Had I been present, I
would have voted ``aye.''
The SPEAKER pro tempore. The question is on the passage of the bill.
The question was taken; and the Speaker pro tempore announced that
the ayes appeared to have it.
Recorded Vote
Mr. PALLONE. Mr. Speaker, I demand a recorded vote.
A recorded vote was ordered.
The SPEAKER pro tempore. This will be a 5-minute vote.
The vote was taken by electronic device, and there were--ayes 267,
noes 159, not voting 6, as follows:
[Roll No. 18]
AYES--267
Adams
Aderholt
Akin
Alexander
Amash
Amodei
Austria
Bachmann
Bachus
Barletta
Barrow
Bartlett
Barton (TX)
Bass (NH)
Benishek
Berg
Berkley
Biggert
Bilbray
Bilirakis
Bishop (NY)
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NOES--159
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Yarmuth
NOT VOTING--6
Carson (IN)
Filner
Hinchey
Mack
Paul
Roybal-Allard
{time} 1906
So the bill was passed.
The result of the vote was announced as above recorded.
A motion to reconsider was laid on the table.
Stated against:
Mr. FILNER. Mr. Speaker, on rollcall 18, I was away from the Capitol
due to prior commitments to my constituents. Had I been present, I
would have voted ``no.''
____________________