[Congressional Record Volume 158, Number 102 (Tuesday, July 10, 2012)]
[House]
[Pages H4711-H4724]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PROVIDING FOR CONSIDERATION OF H.R. 6079, REPEAL OF OBAMACARE ACT
Mr. SESSIONS. Madam Speaker, by direction of the Committee on Rules,
I call up House Resolution 724 and ask for its immediate consideration.
The Clerk read the resolution, as follows:
H. Res. 724
Resolved, That upon adoption of this resolution it shall
be in order to consider in the House the bill (H.R. 6079) to
repeal the Patient Protection and Affordable Care Act and
health care-related provisions in the Health Care and
Education Reconciliation Act of 2010. All points of order
against consideration of the bill are waived. The bill shall
be considered as read. All points of order against provisions
in the bill are waived. The previous question shall be
considered as ordered on the bill and any amendment thereto
to final passage without intervening motion except: (1) five
hours of debate, with 30 minutes equally divided and
controlled by the Majority Leader and Minority Leader or
their respective designees, 60 minutes equally divided and
controlled by the chair and ranking minority member of the
Committee on Education and the Workforce, 60 minutes equally
divided and controlled by the chair and ranking minority
member of the Committee on Energy and Commerce, 60 minutes
equally divided and controlled by the chair and ranking
minority member of the Committee on Ways and Means, 30
minutes equally divided and controlled by the chair and
ranking minority member of the Committee on the Budget, 30
minutes equally divided and controlled by the chair and
ranking minority member of the Committee on the Judiciary,
and 30 minutes equally divided and controlled by the chair
and ranking minority member of the Committee on Small
Business; and (2) one motion to recommit.
The SPEAKER pro tempore. The gentleman from Texas is recognized for 1
hour.
Mr. SESSIONS. For the purpose of debate only, I yield the customary
30 minutes to my friend, the gentlewoman from Fairport, New York, and
the ranking member of the Committee on Rules, Ms. Slaughter, pending
which I yield myself such time as I may consume. During consideration
of this resolution, all time yielded is for the purpose of debate only.
General Leave
Mr. SESSIONS. Madam Speaker, I ask unanimous consent that all Members
have 5 legislative days to revise and extend their remarks.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Texas?
There was no objection.
Mr. SESSIONS. House Resolution 724 provides a closed rule for
consideration of H.R. 6079.
Madam Speaker, today I rise in support of this rule and the
underlying bill. H.R. 6079, the Repeal of Obamacare Act of 2012, was
introduced by the Republican majority leader, Eric Cantor, the
gentleman from Virginia. The bill text has been online since last
Thursday, giving Members more than the mandatory 3 days to read and to
understand the language.
[[Page H4712]]
Madam Speaker, on June 28, just 12 days ago, the United States
Supreme Court upheld the individual mandate provisions contained in
ObamaCare, thereby forcing every American to purchase health insurance.
While I may disagree with how they ruled, I respect their decision and
there is nothing we can do to change that. ObamaCare is now the
official law of the land.
However, there is something this body can do to reverse the course
and to prevent the job-destroying aspects of this bill from taking
effect: a complete repeal of the bill that the President asked this
Congress to pass under Speaker Pelosi--and they did. We need to repeal
ObamaCare today. In 2010, Republicans were elected all across this
country because Americans understood the need to stop the tax-and-spend
policies of the other party. H.R. 6079 will do exactly that.
Last night in the Rules Committee, my colleague and friend, the
gentleman from New Jersey (Mr. Andrews), urged us to ``dispassionately
examine the facts.'' I agree with just that sentiment and would like to
take a moment to do just that.
Earlier this year, the Centers for Medicare and Medicaid Services,
CMS, reported that health insurance premiums are expected to rise by
over 44 percent over the next 9 years as a result of ObamaCare. And
since ObamaCare was signed into law, there has been a steady decline in
the number of Americans on private health insurance.
A report from the McKinsey Group found that more than 50 percent of
employers with a high awareness of the law say that they will stop
offering health insurance, confirming what Republicans have been saying
for 3 years, and that is, that ObamaCare is designed to force employers
to drop coverage in an attempt to get Americans to enter the new health
care exchanges.
A Kaiser Family Foundation report found that health insurance
premiums have increased by 9 percent, or $1,200, for the average
American family following passage of the President's health care bill.
According to the 2010 Medicare Trustees Report, as a direct result of
ObamaCare, more than 90 percent of seniors will lose the retiree
prescription drug coverage they have and will see nearly double-digit
premium increases. Seniors will also see reduced access to doctors, as
Medicare officials explained that physicians ``could find it difficult
to remain profitable and might end their participation in the program,
which possibly could jeopardize access to care for beneficiaries.''
According to the President's own budget, the cost of ObamaCare
subsidies have jumped $111 billion in just 1 year. Earlier this year,
during a Ways and Means Committee hearing on February 28, 2012, when
asked why this happened, Health and Human Services Secretary Sebelius
said, ``I really don't know.''
Finally, earlier this year, the nonpartisan Congressional Budget
Office adjusted their long-term outlook of the impact of ObamaCare on
our national debt. The revised figures show ObamaCare will cost
taxpayers $1.8 trillion--twice as much as the President promised in
2010 when the bill was passed.
These are just a few of the facts that I believe should be considered
dispassionately as we debate whether to repeal ObamaCare. If you think
that the facts I just listed are what the country needs, vote to keep
it. However, if you, like me, find these facts unacceptable for our
future, then I urge you to join me in repealing ObamaCare so that we
can focus on patient-centered health care solutions which do not
increase dramatically insurance premiums, do not restrict access to
physicians, and do not mount unsustainable debt onto our children and
grandchildren, as well as harming employers who wish to employ more
Americans.
I urge my colleagues to vote for the rule and the underlying bill,
and I reserve the balance of my time.
[From the Wall Street Journal, June 8, 2011.
Study Sees Cuts to Health Plans
(By Janet Adamy)
A report by McKinsey & Co. has found that 30% of employers
are likely to stop offering workers health insurance after
the bulk of the Obama administration's health overhaul takes
effect in 2014.
The findings come as a growing number of employers are
seeking waivers from an early provision in the overhaul that
requires them to enrich their benefits this year. At the end
of April, the administration had granted 1,372 employers,
unions and insurance companies one-year exemptions from the
law's requirement that they not cap annual benefit payouts
below $750,000 per person a year.
But the law doesn't allow for such waivers starting in
2014, leaving all those entities--and other employers whose
plans don't meet a slate of new requirements--to change their
offerings or drop coverage.
Previous research has suggested the number of employers who
opt to drop coverage altogether in 2014 would be minimal.
But the McKinsey study predicts a more dramatic shift from
employer-sponsored health plans once the new marketplace
takes effect. Starting in 2014, all but the smallest
employers will be required to provide insurance or pay a
fine, while most Americans will have to carry coverage or pay
a different fine. Lower earners will get subsidies to help
them pay for plans.
In surveying 1,300 employers earlier this year, McKinsey
found that 30% said they would ``definitely or probably''
stop offering employer coverage in the years after 2014. That
figure increased to more than 50% among employers with a high
awareness of the overhaul law.
Behind the expected shift is the fact that the law will
give Americans new insurance options outside the workplace,
and carriers will no longer be allowed to deny people
coverage because they have been sick. McKinsey found that
reduced the moral obligation employers may feel to provide
coverage.
The Obama administration says it is working to encourage
employers to retain coverage. An administration official,
Nick Papas, described the McKinsey report as an outlier amid
other research suggesting that employers overwhelmingly would
keep coverage.
``History has shown that reform motivates more businesses
to offer insurance,'' he said. ``When Massachusetts enacted
health reform, the number of individuals with employer-
sponsored insurance increased.''
The nonpartisan Congressional Budget Office, in a March
2010 report, found that by 2019, about six million to seven
million people who otherwise would have had access to
coverage through their job won't have it owing to the new
law. That estimate represents about 4% of the roughly 160
million people projected to have employment-based coverage in
2019.
However, the CBO estimated that the overall number of
Americans with coverage will rise by 32 million because of
new subsidies and other steps.
The law contains a disincentive for employers to drop
coverage. It requires all employers with more than 50
employees to offer health benefits to every full-time worker
or pay a penalty of $2,000 per worker, though it doesn't
apply to the first 30 workers. Health-policy experts have
questioned whether that is high enough to discourage
companies from health coverage.
McKinsey found at least 30% of employers would gain
economically from dropping coverage even if they completely
compensated employees through other benefits or higher
salaries. The study suggests the fallout would be minimal,
with more than 85% of employees remaining in their jobs even
if their employer stopped coverage.
Nearly half the employers said they would consider
alternatives to their current plan after 2014. Besides
dropping coverage, those included weighing a switch to a
defined-contribution model of insurance, in effect offering
coverage only to certain employees.
____
[From the Kaiser Family Foundation and Health Research & Educational
Trust]
Employer Health Benefits: 2011 Summary of Findings
Employer-sponsored insurance is the leading source of
health insurance, covering about 150 million nonelderly
people in America. To provide current information about the
nature of employer-sponsored health benefits, the Kaiser
Family Foundation (Kaiser) and the Health Research &
Educational Trust (HRET) conduct an annual national survey of
nonfederal private and public employers with three or more
workers. This is the thirteenth Kaiser/HRET survey and
reflects health benefit information for 2011.
The key findings from the 2011 survey, conducted from
January through May 2011, include increases in the average
single and family premiums, as well higher enrollment in high
deductible health plans with savings options (HDHP/S0s). The
2011 survey includes new questions on the percentage of firms
with grandfathered health plans, changes in benefits for
preventive care, enrollment of adult children due to the new
health reform law, and the use of stoploss coverage by firms
with self-funded plans.
HEALTH INSURANCE PREMIUMS AND WORKER CONTRIBUTIONS
The average annual premiums for employer-sponsored health
insurance in 2011 are $5,429 for single coverage and $15,073
for family coverage. Compared to 2010, premiums for single
coverage are 8% higher and premiums for family coverage are
9% higher. The 9% growth rate in family premiums for 2011 is
significantly higher than the 3% growth rate in 2010. Since
2001, average premiums for family coverage have increased
113%. Average premiums for family coverage are lower for
workers in small firms (3-199 workers) than for workers in
large firms (200 or more
[[Page H4713]]
workers) ($14,098 vs. $15,520). Average premiums for high-
deductible health plans with a savings option (HDHP/S0s) are
lower than the overall average for all plan types for both
single and family coverage.
There is significant variation around the average annual
premiums as a result of factors such as benefits, cost
sharing, and geographic cost differences. Nineteen percent of
covered workers are in plans with an annual total premium for
family coverage of at least $18,087 (120% of the average
family premium), while 21% of covered workers are in plans
where the family premium is less than $12,058 (80% of the
average premium).
Covered workers contribute on average 18% of the premium
for single coverage and 28% of the premium for family
coverage, similar to the percentages they contributed in
2010. Workers in small firms (3-199 workers) contribute a
significantly lower average percentage for single coverage
compared to workers in larger firms (15% vs. 19%), but a
higher average percentage for family coverage (36% vs. 25%).
As with total premiums, the share of the premium contributed
by workers varies considerably around these averages. For
single coverage, 59% of covered workers are in plans that
require them to pay more than 0% but less than or equal to
25% of the total premium, and 3% are in plans that require
more than 50% of the premium; 16% are in plans that require
them to make no contribution. For family coverage, 47% of
covered workers are in plans that require them to pay more
than 0% but less than or equal to 25% of the total premium,
and 15% are in plans that require more than 50% of the
premium; only 6% are in plans that require no contribution.
Looking at the dollar amounts that workers contribute, the
average annual contributions in 2011 are $921 for single
coverage and $4,129 for family coverage. Neither amount is a
statistically significant increase over the 2010 values.
Workers in small firms (3-199 workers) have lower average
contributions for single coverage than workers in larger
firms ($762 vs, $996), and higher average contributions for
family coverage ($4,946 vs. $3,755). Compared to the overall
average contributions, workers in HDHP/S0s have lower average
contributions for single coverage ($723 vs. $921), while
workers in point of service (POS) plans have higher average
contributions for family coverage ($5,333 vs. $4,129).
PLAN ENROLLMENT
Overall, PPOs are by far the most common plan type,
enrolling 55% of covered workers. Seventeen percent of
covered workers are enrolled in an HMO, 10% are enrolled in a
POS plan, and 1% are enrolled in a conventional plan.
Enrollment in HDHP/S0s continues to rise, with 17% of covered
workers in an HDHP/SO in 2011, up from 13% of covered workers
in 2010, and 8% in 2009. The enrollment distribution varies
by firm size, with PPOs and HMOs relatively more popular
among large firms (200 or more workers) and PPOs and HDHP/S0s
relatively more popular in smaller firms.
EMPLOYEE COST SHARING
Most covered workers face additional costs when they use
health care services. A large share of workers in PPOs (81%)
and POS plans (69%) have a general annual deductible for
single coverage that must be met before all or most services
arc reimbursed by the plan. In contrast, only 29% of workers
in HMOs have a general annual deductible. Many workers with
no general annual deductible still face other types of cost
sharing when they use covered services.
Among workers with a general annual deductible, the average
deductible amount for single coverage is $675 for workers in
PPOs, $911 for workers in HMOs, $928 for workers in POS
plans, and $1,908 for workers in HDHP/S0s (which by
definition have high deductibles). As in recent years.
workers with single coverage in small firms (3-199 workers)
have higher deductibles than workers in large firms (200 or
more workers); for example, the average deductibles for
single coverage in PPOs, the most common plan type, are
$1,202 for workers in small firms (3-199 workers) compared to
$505 for workers in larger firms. Overall, 31% of covered
workers are in a plan with a deductible of at least $1,000
for single coverage, similar to the 27% reported in 2010, but
significantly more than the 22% reported in 2009. Covered
workers in small firms (3-199 workers) remain more likely
than covered workers in larger firms (50% vs. 22%) to be in
plans with deductibles of at least $1,000.
The majority of workers also have to pay a portion of the
cost of physician office visits. About three-in-four covered
workers pay a copayment (a fixed dollar amount) for office
visits with a primary care physician (74%) or a specialist
physician (73%), in addition to any general annual deductible
a plan may have. Smaller shares of workers pay coinsurance (a
percentage of the covered amount) for primary care office
visits (17%) or specialty care visits (18%). Most covered
workers in HMOs, PPOs, and POS plans face copayments, while
covered workers in HDHP/S0s are more likely to have
coinsurance requirements or no cost sharing after the
deductible is met. For in-network office visits, covered
workers with a copayment pay an average of $22 for primary
care and $32 for specialty care. For covered workers with
coinsurance, the average coinsurance is 18% for both primary
care and specialty care. While the survey collects
information on only in-network cost sharing, we note that
out-of-network cost sharing is often higher.
Almost all covered workers (98%) have prescription drug
coverage, and nearly all face cost sharing for their
prescriptions. Over three-quarters (77%) of covered workers
are in plans with three or more tiers of cost sharing.
Copayments are more common than coinsurance for each tier of
cost sharing. Among workers with three- or four-tier plans,
the average copayments in these plans are $10 for first-tier
drugs, $29 for second-tier drugs, $49 for third-tier drugs,
and $91 for fourth-tier drugs. These amounts are not
significantly higher than the amounts reported last year.
HDHP/SOs have a somewhat different cost-sharing pattern for
prescription drugs than other plan types: 57% of covered
workers are enrolled a plan with three or more tiers of cost
sharing while 17% are in plans that pay 100% of prescription
costs once the plan deductible is met. Covered workers in
these plans are also more likely to pay coinsurance than
workers in other plan types.
Most workers also face additional cost sharing for a
hospital admission or an outpatient surgery episode. After
any general annual deductible, 55% of covered workers have
coinsurance and 17% have copayment for hospital admissions.
Lower percentages have per day (per diem) payments (6%), a
separate hospital deductible (3%), or both copayments and
coinsurance (9%). The average coinsurance rate for hospital
admissions is 17%, the average copayment is $246 per hospital
admission, the average per diem charge is $246, and the
average separate hospital deductible is $627. The cost-
sharing provisions for outpatient surgery are similar to
those for hospital admissions, as most covered workers have
either coinsurance (57%) or copayments (18%). For covered
workers with cost sharing for each outpatient surgery
episode, the average coinsurance is 17% and the average
copayment is $145.
Most plans limit the amount of cost sharing workers must
pay each year, generally referred to as an out-of-pocket
maximum. Eighty-three percent of covered workers have an out-
of-pocket maximum for single coverage, but the limits differ
considerably. For example, among covered workers in plans
that have an out-of-pocket maximum for single coverage, 38%
are in plans with an annual out-of-pocket maximum of $3,000
or more, and 14% are in plans with an out-of-pocket maximum
of less than $1,500. Even in plans with a specified out-of-
pocket limit, not all spending is counted towards meeting the
limit. For example, among workers in PPOs with an out-of-
pocket maximum, 77% are in plans that do not count physician
office visit copayments, 35% are in plans that do not count
spending for the general annual deductible, and 84% are in
plans that do not count prescription drug spending when
determining if an enrollee has reached the out-of-pocket
limit.
AVAILABILITY OF EMPLOYER-SPONSORED COVERAGE
Sixty percent of firms offer health benefits to their
workers in 2011--a significant reduction from the 69%
reported in 2010, but much more in line with the levels for
years prior to 2010. The large increase in 2010 was primarily
driven by a significant (12 percentage points) increase in
offering among firms with 3 to 9 workers (from 47% in 2009 to
59% in 2010). This year, 48% of firms with 3 to 9 employees
offer health benefits. a level which is more consistent with
levels from recent years (2010 excluded). These figures
suggest that the 2010 results may be an aberration.
Even in firms that offer health benefits, not all workers
are covered. Some workers are not eligible to enroll as a
result of waiting periods or minimum work-hour rules. Other
workers do not enroll in coverage offered to them because,
for example, of the cost of coverage or because they have
access to coverage through a spouse. Among firms that offer
coverage, an average of 79% of workers are eligible for the
health benefits offered by their employer. Of those eligible.
81% take up their employer's coverage, resulting in 65% of
workers in offering firms having coverage through their
employer. Among both firms that offer and do not offer health
benefits, 58% of workers are covered by health plans offered
by their employer, similar to the percentage in 2010.
HIGH-DEDUCTIBLE HEALTH PLANS WITH SAVINGS OPTION
HDHP/SOs include (1) health plans with a deductible of at
least $1,000 for single coverage and $2,000 for family
coverage offered with an Health Reimbursement Arrangement
(HRA), referred to as ``HDHP/HRAs,'' and (2) high-deductible
health plans that meet the federal legal requirements to
permit an enrollee to establish and contribute to a Health
Savings Account (HSA), referred to as ``HSA-qualified
HDHPs.''
Twenty-three percent of firms offering health benefits
offer an HDHP/SO, up from 15% in 2010. Firms with 1,000 or
more workers are more likely to offer an HDHP/SO than smaller
firms (3-199 workers) (41% vs. 23%). Seventeen percent of
covered workers are enrolled in HDHP/SOs, up from 13% in
2010, and 8% in 2009. Eight percent of covered workers are
enrolled in HDHP/HRAs and 9% are enrolled in an HSA-qualified
HDHP. Twenty-three percent of covered workers in small firms
(3-199 workers) are enrolled in HDHP/SOs, compared to 15% of
workers in large firms (200 or more workers).
The distinguishing aspect of these high deductible plans is
the savings feature available to employees. Workers enrolled
in an
[[Page H4714]]
HDHP/HRA receive an average annual contribution from their
employer of $861 for single coverage and $1,539 for family
coverage. The average HSA annual contribution is $611 for
single coverage and $1,069 for family coverage. In contrast
to HRAs, not all firms contribute to HSAs. Sixty percent of
employers offering single coverage and 57% offering family
coverage through HSA-qualified HDHPs make contributions
towards the HSAs that their workers establish. The average
employer contributions to HSAs in these contributing firms
are $886 for single coverage and $1,559 for family coverage.
The average premiums for single coverage for workers in
HSA-qualified HDHPs and HDHP/HRAs are lower than the average
premiums for workers in plans that are not HDHP/SOs. For
family coverage, the average premium for HSA-qualified HDHPs
is lower than the average family premium for workers in plans
that are not HDHP/SOs. For single and family coverage, the
average worker contributions to HSA-qualified HDHPs are also
lower than the average worker contributions to non-HDHP/SO
plans.
RETIREE COVERAGE
Twenty-six percent of large firms (200 or more workers)
offer retiree health benefits in 2011, which is the same
percentage that offered retiree health benefits in 2010. The
offer rate has fallen slowly over time, with significantly
fewer large employers offering retiree health benefits in
2011 than in 2007 and years prior.
Among large firms (200 or more workers) that offer retiree
health benefits, 91% offer health benefits to early retirees
(workers retiring before age 65) and 71% offer health
benefits to Medicare-age retirees.
HEALTH REFORM
While many of the most significant provisions of the
Patient Protection and Affordable Care Act (ACA) will take
effect in 2014, important provisions became effective in 2010
and others will take effect over the next few years. The 2011
survey asked employers about some of these early provisions.
Grandfathered Health Plans. The ACA exempts
``grandfathered'' health plans from a number of its
provisions, such as the requirements to cover preventive
benefits without cost sharing or to have an external appeal
process. An employer-sponsored health plan can be
grandfathered if it covered a worker when the ACA became law
(March 23, 2010) and if the plan does not make significant
changes that reduce benefits or increase employee costs.
Seventy-two percent of firms had at least one grandfathered
health plan when they were surveyed (January through May of
2011). Small firms (3-199 workers) were more likely than
larger firms to have a grandfathered health plan (72% vs.
61%). Looking at enrollment, 56% of covered workers were in
grandfathered health plans when the survey was conducted. The
percentage of covered workers in grandfathered plans is
higher in small firms (3-199 workers) than in larger firms
(63% vs. 53%).
Firms with plans that were not grandfathered were asked to
respond to a list of potential reasons why each plan is not a
grandfathered plan. Twenty-eight percent of covered workers
are in plans that were not in effect when the ACA was
enacted. Roughly similar percentages of workers are in plans
where the deductibles (37%), employee premium contributions
(35%), or plan benefits (29%) changed more than was permitted
for plans to maintain grandfathered status. The reasons plans
were not grandfathered varied by firm size, with workers in
small firms (3-199 workers) much more likely than workers in
large firms to be in a new plan that was not in effect when
the ACA was enacted (63% vs. 18%) and generally less likely
to be affected by plan changes.
Preventive Benefits. The ACA requires non-grandfathered
plans to provide certain preventive benefits without cost
sharing. Firms were asked whether changes were made to their
cost sharing for preventive services or the services that
were classified as preventive because of health reform.
Twenty-three percent of covered workers are in a plan where
the employer reported changing the cost-sharing requirements
because of health reform. Workers in large firms (200 or more
employees) are more likely than workers in smaller firms to
be in such a plan (28% vs. 13%). Thirty-one percent of
covered workers are in a plan where the employer reported
changing the services that are considered preventive services
because of health reform.
Coverage for Adult Children to Age 26. The ACA requires
firms offering health coverage to extend benefits to children
of covered workers until the child reaches age 26. The child
does not need to be a legal dependent, but until 2014,
grandfathered plans do not have to enroll children of
employees if those children are offered employer-sponsored
health coverage at their own job. The survey asked firms
whether any adult children who would not have been eligible
for the plan prior to the change in law had enrolled in
health coverage under this provision. Nineteen percent of
small firms (3-199 workers) and 70% of larger firms enrolled
at least one adult child under this provision.
The numbers of children who enroll under this provision are
closely related to the number of workers in the firm. Smaller
firms (3-24 workers) on average enroll two adult children due
to the provision, while the largest firms (5,000 or more
workers) enroll an average of 492 adult children. In total,
an estimated 2.3 million adult children were enrolled in
their parent's employer sponsored health plan due to the
Affordable Care Act.
Small Employer Tax Credit. The ACA provides a temporary tax
credit for small employers that offer insurance, have fewer
than 25 full-time equivalent employees, and have average
annual wages of less than $50,000. The survey included
several questions for both offering and non-offering
employers about their awareness of the tax credit and whether
they considered claiming it.
Because our survey gathers information on the total number
of full-time and part-time employees in a firm, we cannot
calculate the number of full-time equivalent employees and
therefore could not limit survey responses only to firms
within the size range eligible for the credit. To ensure that
we included employers that may have a number of part-time or
temporary employees but could still qualify for the tax
credit, we directed these questions to employers with fewer
than 50 total employees. This approach allowed us to capture
some employers with more than 25 employees who would
nonetheless be eligible for the tax credit, but this also
means some employers who are unlikely to be eligible for the
tax credit (because they have more than 25 full-time
equivalent employees) were asked these questions.
Among firms with fewer than 50 employees that offer
coverage, 29% said they have made an attempt to determine if
the firm is eligible for the small employer tax credit. Of
the firms which attempted to determine eligibility, 30% said
that they intend to claim the credit for both 2010 and 2011,
21% said they do not intend to claim the credit for either
year, 41% are not sure, and small percentages said they do
not know if they will claim the credit or they intend to
claim it for only one of the two years. The vast majority of
those saying they do not intend to claim the tax credit
indicated they were not eligible to receive it.
Firms with fewer than 50 workers that do not offer health
insurance were asked if they were aware of the small business
tax credit. One-half (50%) of these firms said they were
aware of the credit, and of those aware, 15% are considering
offering coverage as a result of the credit.
OTHER TOPICS
Stoploss Coverage. Many firms that have self-funded health
plans purchase insurance, often called ``stoploss'' coverage,
to limit the amount they may have to pay in claims either
overall, or for any particular plan enrollee. Fifty-eight
percent of workers in self-funded health plans are enrolled
in plans covered by stoploss insurance. Workers in self-
funded plans in small firms (3-199 workers) are more likely
than workers in self-funded plans in larger firms to be in a
plan with stoploss protection (72% vs. 57%). About four in
five (81%) workers in self-funded plans that have stoploss
protection are in plans where the stoploss insurance limits
the amount the plan spends on each employee. The average per
employee claims cost at which stoploss insurance begins
paying benefits is $78,321 for workers in small firms (3-199
workers) with self-funded plans, and $208,280 for workers in
larger firms with self-funded plans.
High-Performance Networks. Some plans offer tiered or high-
performance networks, which group providers in the network
based on quality, cost, and/or efficiency of the care they
deliver. Plans encourage patients to visit higher performing
providers either by restricting networks to efficient
providers, or by having different copayments or coinsurance
for providers in different tiers in the network. Twenty
percent of firms offering coverage in 2011 include a high-
performance or tiered provider network in their health plan
with the largest enrollment. Small firms (3-199 workers) and
larger firms are equally likely to offer a plan that includes
a high-performance or tiered network.
CONCLUSION
The 2011 survey saw an upturn in premium growth, as the
average premiums for family coverage increased 9% between
2010 and 2011, significantly higher than the 3% increase
between 2009 and 2010. The percentage of workers in HDHP/SOs
continues to rise as employers seek more affordable coverage
options and are potentially seeking to shift increased costs
to workers. In 2011, 17% of covered workers were enrolled in
an HDHP/SO, compared to 13% in 2010 and 8% in 2009.
Changes from the new health reform law are beginning to
have an impact on the marketplace. Significant percentages of
firms made changes in their preventive care benefits and
enrolled adult children in their benefits plans in response
to provisions in the new health reform law. Most employees
with employment-sponsored insurance are in grandfathered
plans that are exempt from some of the law's new provisions,
but this may change over time as firms adjust benefits and
cost sharing or change plan design to incorporate new
features. The survey will continue to monitor employer
responses to health reform as firms adapt to early provisions
in the law and as new provisions take effect.
METHODOLOGY
The Kaiser Family Foundation/Health Research & Educational
Trust 2011 Annual Employer Health Benefits Survey (Kaiser/
HRET) reports findings from a telephone survey of 2,088
randomly selected public and private employers with three or
more workers. Researchers at the Health Research &
Educational Trust, NORC at the University of Chicago, and the
Kaiser Family Foundation designed and analyzed the survey.
National Research, LLC conducted the fieldwork between
January and May 2011. In 2011 our
[[Page H4715]]
overall response rate is 47%, which includes firms that offer
and do not offer health benefits. Among firms that offer
health benefits, the survey's response rate is 47%.
From previous years' experience, we learned that firms that
decline to participate in the study are less likely to offer
health coverage. Therefore, we asked one question to all
firms with which we made phone contact, but the firm declined
to participate. The question was, ``Does your company offer a
health insurance program as a benefit to any of your
employees?'' A total of 3,184 firms responded to this
question (including 2,088 who responded to the full survey
and 1,096 who responded to this one question). Their
responses are included in our estimates of the percentage of
firms offering health coverage. The response rate for this
question was 71%. Since firms are selected randomly, it is
possible to extrapolate from the sample to national,
regional, industry, and firm size estimates using statistical
weights. In calculating weights, we first determined the
basic weight, then applied a nonresponse adjustment, and
finally applied a post-stratification adjustment. We used the
U.S. Census Bureau's Statistics of U.S. Businesses as the
basis for the stratification and the post-stratification
adjustment for firms in the private sector, and we used the
Census of Governments as the basis for post-stratification
for firms in the public sector. This year, we modified the
method used to calculate firm-based weights resulting in
small changes to some current and past results. For more
information on the change consult the Survey Design and
Methods section of the 2011 report. Some exhibits in the
report do not sum up to totals due to rounding effects and,
in a few cases, numbers from distribution exhibits referenced
in the text may not add due to rounding effects. Unless
otherwise noted, differences referred to in the text use the
0.05 confidence level as the threshold for significance.
____
2010 Annual Report of the Boards of Trustees of the Federal Hospital
Insurance and Federal Supplementary Medical Insurance Trust Funds
Each drug plan receives direct subsidies (calculated as the
risk-adjusted plan bid amount minus the plan premium),
prospective reinsurance payments, and low-income cost-sharing
subsidies from Medicare, as well as premiums from the
beneficiaries. At the end of the year, the prospective
reinsurance and low-income cost-subsidy payments are
reconciled to match the plan's actual experience. In
addition, if actual experience differs from the plan's bid
beyond specified risk corridors, Medicare shares in the
plan's experience gain or loss.
Expenditures for this voluntary prescription drug benefit,
which started on January 1, 2006, were determined by
combining estimated Part D enrollment with projections of per
capita spending. Actual Part D spending information for 2009
was used as the projection base.
a. Participation Rates
All individuals enrolled in Medicare Part A or Part B are
eligible to enroll in the voluntary prescription drug
benefit.
(1) Employer-Sponsored Plans
There are several options for employer-sponsored retiree
health plans to benefit from the Part D program. One option
is the retiree drug subsidy (RDS), in which Medicare
subsidizes qualifying employer-sponsored plans a portion of
their qualifying retiree drug expenses (which are determined
without regard to plan reimbursement). About 20 percent of
beneficiaries participating in Part D were covered by this
subsidy in 2009. Effective with 2013 under the Affordable
Care Act, employers will no longer be able to deduct retiree
health plan costs that are reimbursed by the RDS. In
addition, retiree drug claims in the coverage gap will not be
eligible for the 50-percent brand-name drug discount, and the
28-percent RDS subsidy rate will remain constant even though
the coverage gap will be closing over time for other Part D
drug plan participants. As a result of these changes, RDS
program participation is assumed to decline quickly to about
2 percent in 2016 and beyond. It is expected that the
retirees losing drug coverage through qualifying employer
plans will participate in other Part D plans.
{time} 1310
Ms. SLAUGHTER. Madam Speaker, I thank the gentleman for yielding me
the customary 30 minutes and yield myself such time as I may consume.
Madam Speaker, I guess I'd better start by saying that one man's
facts are another woman's folly. I want everybody who is listening
today to clear their minds of what they just heard and also to remind
them that when Medicare and Social Security were also before the
Congress of the United States, Republicans didn't like them either, and
almost all of them voted against it. So to hear people whose plan for
Medicare is to simply do away with it and give vouchers to the Medicare
recipients no matter what their physical condition or their mental
condition to go into the private market and try to buy insurance if
they can with the amount of money that may not even cover it, this
crying about Medicare in this bill, which really strengthens it, is
hard to take.
This is an incredible milestone today, and those of you in the
gallery are here on a very important day. Over the last 2 years, over
30 votes have been taken on this health care bill alone. Today is the
31st. They want to defund or dismantle or do whatever to it. Never in
the history of this Congress, and I feel perfectly secure in saying
this, has anybody voted this many times on a single issue. Why? Because
we don't have anything else to do.
We are here simply killing time because everybody knows the Senate
has already done away with this bill, so we know it's never going to
become law. What it's going to do is, as I said yesterday at the Rules
Committee, we're not trying to make law here, we're making political
points. And that is a shame, because it's not that the country doesn't
need our attention. It isn't as though the unemployment rate isn't so
high and that people's futures are not so grim that they are crying out
for us to get something done, but it has been said that this is the
least productive Congress since the beginning of Congresses, apart from
the Continental Congress.
So here today, no jobs bill has been passed here, and over that time
while everybody is clamoring for it, we do the 31st vote on this
measure which, again, everybody knows is going nowhere. So we have just
months left in the 112th Congress, and yet we vote again on this. We
voted at least nine times on women's reproductive health, which shows
you what are the real issues here that people care about.
Sadly, we're not going to be able to vote this year, the rest of this
term, on creating jobs or rebuilding the infrastructure or even ending
the war in Afghanistan, but we vote for the 31st time on dismantling
historic health care concerns.
I am sure that while time runs out on this Congress to tackle the
major issues that face us, to create jobs and to rebuild our country,
we have failed to answer the call. I shouldn't say ``we'' because
that's the polite way to do it on the floor of the House. But everybody
knows who is wasting time.
This year, thanks to the Affordable Care Act, already more than
360,000 small businesses are expected to receive tax credits that
reduce the cost of health care for their employees. And meanwhile, the
new guarantees, one that ensures that the insurance companies will
spend 85 percent of the cost on health care, of your premium dollar for
the first time in history, 85 cents of that dollar is going to go to
health care, not administrative costs, not being put away to something
or building buildings or whatever else. It will go to health care. That
in itself is going to reduce the cost. This increased efficiency is
very good news not only for small business owners but all the rest of
us who bear the burden of inefficient care.
In addition, more than 3 million young adults are already insured on
their parents' health care, and more than 5 million seniors have
cheaper prescription drugs simply thanks to this health care reform,
and we have not even started. It is not going to go into full effect
until 2014, which I deplore, but nonetheless that's where we are.
Despite these benefits for millions of Americans, the majority wants
to take it all away. Now they talk about repeal and replace. With what?
We've had no plan of replacement. There is no answer to what's going to
happen to the seniors and others who are already benefiting from this
plan. They have offered no solution of their own; and 537 days ago, the
majority passed legislation requiring this Congress to craft a proposal
that would keep popular provisions of the Affordable Care Act, such as
health care for people with preexisting conditions.
I hope everybody understands that your health care, as it is written
now, has a yearly limit and a lifetime limit. If you exceed the
lifetime limit, you are not insurable again in the United States. And
you can do that very easily with, let's say, a serious head wound or
other trauma. But we have waited for a year for this bill that was
promised 537 days ago. I really believe, and I don't want to be
cynical, but I certainly do believe, because I must, that no such bill
will ever come.
So what's going to happen if this bill passes and the Affordable Care
Act is
[[Page H4716]]
repealed? What's going to happen to the millions of women who will,
once again, be charged more money than men for the same health
insurance coverage? Do you know women pay 40 percent more? What will
happen to the millions of seniors who will, once again, face the
financial threat of the doughnut hole? What's going to happen to the
thousands of children who will, once again, be denied health insurance
coverage because they were born with a preexisting condition? And what
will happen to the young people on their parents' health care unable to
find work because Congress is not involved with that--or at least the
majority is not? What will happen to them?
Today's vote will take away health care from women like Nancy
O'Donnell, who is 60 years old and lives in my district in Rochester,
New York. She works four jobs to make ends meet, and not a single one
of them offers health care. Her life changed when she was diagnosed
with cancer and told she would need a mastectomy. With no insurance to
help cover the cost of major surgery, she faced the very real prospect
of suffering with cancer and having no hope of being cured. And if
anybody out there believes that you can be diagnosed with cancer and
not be able to get treatment for it because you have no insurance,
you've got another think coming.
Prior to the Affordable Care Act, there would have been no recourse
for a woman like Nancy. For years, millions of women and men in America
were denied health insurance because cancer was a ``preexisting
condition'' or if they had ever had it and they changed jobs and they
had to get new health care, they probably would not be able to because
they had had cancer. Even patients like Nancy who had insurance--and
she did not, remember--would face lifetime and yearly limits on their
health care, meaning that they would stop providing treatment because
they didn't want her high-cost disease affliction.
Thanks to the Affordable Care Act, these tragic stories are no more.
Thanks to the Affordable Care Act, Nancy was able to access health
insurance at a price she could afford. And with that health insurance
in hand, she was able to access treatment and found out that a
mastectomy was no longer needed. She has now had four clean CAT scans
and no sign of cancer, and we are all delighted for her.
Women like Nancy are the reason I brought the Affordable Care Act
through the Rules Committee to the House floor. Women like Nancy are
the reason I stood up to those who threw a brick through one of my
district office windows and who threatened my family because I wanted
to provide affordable, lifesaving health care to Americans in need.
Health care was costing us 17, going on 18, percent of GDP, and we
could not afford it unless we wanted to become the one industrial
Nation on Earth that was only able to provide health care and do war.
Surely to goodness, we would like to join the community of other
nations. And in addition to that, we have put the burden on our
employers to provide the health care for their employees that none of
their competitors from overseas or Canada have to put up with. This has
been really sad and really the start of the debate for Clinton health
care which came from Lee Iacocca, who said that the cost of health care
forced him to put about $2,000 more for the cost of each automobile he
sold. It was unsupportable. But we're still at it here.
The United States, as I said, is the only one that does not provide
its citizens with safe, secure, and affordable health care. They do it
much cheaper than we do with much better outcomes. Instead, we put the
burden back on the employers. That puts us at a disadvantage with
competitors all around the world. Despite not providing reliable health
care to millions of our citizens, the cost of health care rises. Prior
to the Affordable Care Act, we were on a trajectory to soon be bankrupt
simply through the skyrocketing cost of care.
{time} 1320
Since the Presidency of President Roosevelt--and I'm talking about
Teddy here, we're going way back beyond, ahead of Franklin--numerous
Presidents have tried to provide health care--President Nixon,
President Truman, President Clinton--to the millions of the uninsured
to lower the cost of care.
We, each of us, when we talk about having other people buy health
insurance if they can afford it, and if they can't, we help them, each
family is expected, and has been for some time, paying what is
estimated to be between $1,000 and $1,500 more on your own health care
to cover for the uncompensated cost of people who don't have it.
So why don't we deal with this in a mature and grown-up way? Because
somehow or other we can't. But the reason could be this: yesterday
morning, Politico, one of the newspapers that we have here on the Hill,
reported on the plans of the majority over the next 4 weeks. They had
been talking to members of the majority. In part, they wrote: ``House
Republicans have planned a series of hot-button votes over the next 4
weeks to contrast the party's agenda with that of Democrats and put
President Barack Obama and Democratic candidates on the defensive,'' as
though we are not capable of standing up and defending the votes that
we take. ``The main goal is to boost the party's prospects on Election
Day.''
Madam Speaker, the record is clear: today's vote is nothing more than
a show. It is political theater. It puts political games ahead of the
health of the Nation's citizens.
So, on behalf of the millions of Americans who are already benefiting
from affordable care, I urge my colleagues to change course and
reconsider the legislation before us today. Frankly, we should drop it.
There's no point in taking this vote at all. Too much needs to be done,
from creating jobs to investing in schools, rebuilding our broken
highways and bridges. And we have only been able, in the United States,
to build one airport from the ground up since 1972, in Denver. That
tells you how modernized we are. But we are playing politics with
health care reform instead, and health care is already saving lives.
So I urge my colleagues to oppose today's rule, the underlying
legislation, and I reserve the balance of my time.
Mr. SESSIONS. Madam Speaker, at this time I'd like to yield 3 minutes
to the gentleman from Spring Hill, Florida (Mr. Nugent), the gentleman
from the Rules Committee.
Mr. NUGENT. Madam Speaker, I want to thank the gentleman from Dallas,
my Rules Committee colleague, Pete Sessions, for yielding me the time.
Over the past couple of years, I've met with thousands of people in
Florida's Fifth Congressional District, whether it's businessmen,
people on Medicare, veterans, and they all have the same appeal to me:
Please, please repeal ObamaCare.
It's clear the American people know what our Democratic leaders
still, to this day, don't want to admit: ObamaCare eliminates millions
of American jobs, it cuts hundreds of billions of dollars from
Medicare, and it puts in place 21 tax hikes that are going to cost the
American people more than $800 billion over the next 10 years. And
guess what. It only pays for 6 years of coverage. What a scam.
Everybody knows the health care system is broken and reform is
needed, but ObamaCare is not the answer. Madam Speaker, I think a
number of my colleagues forget that although the Supreme Court upheld
the individual mandate--because it's a tax--it did declare parts of the
bill unconstitutional. The Court explicitly stated the Affordable Care
Act is constitutional in part and unconstitutional in part. And
expansion, they said, of ObamaCare unconstitutionally forces States to
expand Medicaid.
So the vote we take on this rule, H.R. 6097, gives Members of this
body two things: repeal a law that is in part unconstitutional, and
repeal an $800 billion tax increase on the American middle class. I
have to think that if the other side knew that this was a tax increase
back when they first implemented it, that--you know what?--they
probably would rethink their thought on it.
Last night, my colleagues on the other side said that ObamaCare
reduces the deficit, but it's also a tax cut. Only in Washington does
that work--creating a new trillion-dollar health care program means
reducing government spending. Only in Washington is $800 billion in new
taxes a cut. These are numbers I know my colleagues on the
[[Page H4717]]
other side of the aisle know, and, more importantly, the American
people know it.
For all these reasons, I'm grateful to Leader Cantor for introducing
the Repeal of Obamacare Act, and I'm proud to be a cosponsor of this
legislation. I support the rule, I support the underlying legislation,
and I encourage all of my colleagues who want real health care reform
to do the same.
Ms. SLAUGHTER. Madam Speaker, I am pleased to yield 3 minutes to the
gentleman from New Jersey (Mr. Andrews), the ranking member of the
Education and the Workforce Subcommittee on Health.
(Mr. ANDREWS asked and was given permission to revise and extend his
remarks.)
Mr. ANDREWS. I thank my friend from New York. It's great to be with
her on the floor today, and my colleagues on the Republican side as
well.
Today we could be voting on a bill where we work together to cut
taxes for small businesses that put Americans back to work, but we are
not. Today we could be voting on a bill that would help cities and
counties and States around the country rehire police officers and
firefighters and teachers they've had to lay off--over 600,000 of them
the last few years--but we are not. Today we could be voting on a bill
that would say that, if an American company brings jobs back from
overseas, we'll cut their taxes and we'll pay for it by eliminating tax
giveaways and loopholes for companies that outsource their jobs outside
of the United States and take them overseas, but we're not voting on
that. For the 31st time in the last 18 months, we're voting on a bill
to repeal the health care law.
Now, I know there are Americans who feel strongly for and against the
health care law, but almost every person I listen to feels very
strongly we should be working together to help create an environment
where businesses can create jobs for the American people, not voting
for the 31st time on essentially a political argument.
Now, I do agree with my friend from Texas--and I thank him for
mentioning my name; I respect him very much--about the need for facts
in this debate. There is one fact that I think we've got to get to
right away, which is whether or not the law that they are trying to
repeal for the 31st time increases or decreases the Federal deficit.
The Congressional Budget Office, which is our neutral, nonpartisan
auditor, said in January 2011--the first time of the 31 when the other
side tried to repeal this law--that repeal of the law would add $220
billion to the deficit. In other words, if you write the law off the
books, the deficit goes up because of the spending restraints and the
new revenues that are in the bill.
I would want to ask my friend from Texas if he can tell us what the
effect of the repeal of this bill--in other words, if this bill passes,
what will this bill do to the deficit, according to the Congressional
Budget Office?
I yield to the gentleman from Texas.
Mr. SESSIONS. I appreciate the gentleman asking the question.
The gentleman also understands that the Congressional Budget Office
has not, as a result of the Supreme Court, been able to render that
decision.
Mr. ANDREWS. Reclaiming my time, I would then respectfully ask my
friend: Why don't we wait and see what the auditor says the bill will
cost before we vote on it? My understanding is that they're going to do
that probably by the end of this month. Why don't we wait and see what
the auditor says it's going to cost before we vote on this bill?
And I would yield to the gentleman.
Mr. SESSIONS. I appreciate the gentleman engaging me. This really is
of substance to the American people.
The cost of the bill is twice now--we found out a year after it was
passed--twice as expensive as it was originally started.
The SPEAKER pro tempore. The time of the gentleman has expired.
Mr. SESSIONS. Madam Speaker, at this time, I'd like to yield 2
minutes to the gentleman from San Antonio, Texas (Mr. Canseco), from
the Financial Services Committee.
Mr. CANSECO. I thank the gentleman from Texas for yielding this time,
and I rise in support of the rule and the underlying bill to completely
repeal ObamaCare.
Though ObamaCare has been found to be constitutional, it doesn't mean
it is good for our health care nor good for our economy. ObamaCare is
still a government takeover of health care, putting Federal bureaucrats
in charge of decisions that should be made by you and your doctor by
creating 159 different boards, bureaucracies, and programs that will
increase Washington's control over health care, like the Independent
Payment Advisory Board, which is compromised of 15 unelected
bureaucrats that will be empowered to decide what treatments Medicare
will and will not cover.
{time} 1330
ObamaCare also could lead to less access to care and lower quality
health care. I recently visited with several physicians last week in my
district, and they told me that ObamaCare could lead to a large exodus
of physicians from active practice, leaving many Americans with health
care coverage but without health care access.
ObamaCare also cuts over half a trillion dollars from Medicare to pay
for other spending, which could lead physicians to cut back on the
number of American seniors that they will see, negatively impacting
their care by leaving seniors with health care coverage but without
access to care.
Besides being bad for health care, ObamaCare is bad for our economy.
I've visited with numerous small businesses throughout the 23rd
Congressional District of Texas, and almost every one of them has told
me that the biggest factor keeping them from expanding their businesses
and hiring more employees is the uncertainty about health care costs
due to various taxes and mandates contained in ObamaCare.
Given the Supreme Court's ruling, it's now up to the people's elected
representatives in the Congress to provide American families and small
businesses with much-needed relief from the burdens of ObamaCare by
repealing it completely. Only after ObamaCare is repealed can we then
work to implement commonsense reforms to make health care more
affordable and accessible.
Ms. SLAUGHTER. Madam Speaker, I yield 3 minutes to the gentlewoman
from California (Ms. Matsui), a member of the Committee on Energy and
Commerce.
Ms. MATSUI. I thank the gentlelady from New York for yielding me
time.
Madam Speaker, I rise today in strong opposition to this rule and the
underlying legislation. This bill marks the 31st time that the
Republicans attempted to repeal the Affordable Care Act, even though
the Supreme Court of the United States has ruled it constitutional.
Unfortunately, instead of focusing on job creation, here we are
again. The underlying legislation exemplifies the majority's continuous
drumbeat to abolish the ACA, fearful that Americans may have a chance
to fully realize its tremendous benefits.
Instead, the majority has only offered vague phrases and empty
rhetoric, such as ``patient-centered health care,'' while repeatedly
attempting to repeal legislation that will expand access to care for
millions of Americans. Clearly, their idea of ``patient-centered health
care'' refers only to those patients who can afford skyrocketing health
insurance rates and do not have any preexisting conditions. What is the
point of ``patient-centered health care'' when only a small portion of
the public can access the care?
The underlying legislation before us today would deny my constituents
and the American people the consumer protections for which they've been
asking for for years. This legislation would increase costs to
families, small business owners, and seniors across the board. It would
allow insurance companies to deny coverage to Americans with
preexisting conditions, drop coverage when people get sick, re-
institute lifetime limits on coverage, and charge people more based
merely on gender.
The ACA has already created long-lasting benefits for many of my
constituents, including Paula, who, in March of 2010, was diagnosed
with Ewing's sarcoma, a rare children's bone cancer, and given a 15
percent chance of survival. Initially, she was lucky to have health
insurance. But at an average of $60,000 per chemotherapy treatment, she
quickly approached her lifetime benefits cap. These are not burdens
anyone can or should have to bear.
[[Page H4718]]
Because of the ACA, she remained covered and was able to complete her
full treatment plan. And in the future, because of the law, Paula will
not have to fear being denied coverage due to this preexisting
condition.
It is time that we move forward and focus our efforts on job
creation. I urge my colleagues to vote down this rule and vote against
this underlying legislation.
Mr. SESSIONS. Madam Speaker, at this time I yield 1 minute to the
gentlewoman from Dunn, North Carolina (Mrs. Ellmers), a nurse, a health
care professional prior to her service in the United States Congress.
Mrs. ELLMERS. I thank my colleague from Texas for acknowledging me.
Madam Speaker, I'm here today to join my colleagues and call for the
immediate repeal of ObamaCare, with its massive tax increases.
Last month, as we know, the Supreme Court verified that ObamaCare is,
in fact, a tax, one that has increased financial burdens of every
American by over $500 billion, and will go down in history as the most
significant expansion of the Federal Government and its power. This law
has and continues to be bad policy for all Americans and future
generations.
The Supreme Court's decision has sent a direct message to Congress
and policymakers that we have to get back to work to repeal this law
and replace it with effective, efficient reforms. I have begun
circulating a letter that will be sent to Senator Harry Reid, calling
on him to allow for his colleagues in the Senate to have an up-or-down
vote on the repeal. Every American needs to know how his senator feels
about this as well.
We each have an obligation to vote our conscience and carry out the
business of the American people. I am encouraging all of my colleagues
here in the House to sign on to this letter so that each Member of
Congress can decide whether or not they are in favor of raising taxes
on millions of hardworking American taxpayers.
Ms. SLAUGHTER. Madam Speaker, I am pleased to yield 2 minutes to the
gentlewoman from Maryland (Ms. Edwards).
Ms. EDWARDS. Madam Speaker, I thank the gentlelady from New York, and
join her in opposing the rule and the underlying bill.
This is the way it's supposed to work. Passed by the House, passed by
the Senate, signed into law by the President, and upheld by the United
States Supreme Court.
The ruling provided certainty for Americans and businesses all across
the country, knowing that the popular provisions they've already
enjoyed are going to remain in place, and we can continue to implement
the law of the land.
So America, here's what Republicans want to take away from you today.
They want to take away covering 7 million children, young adults who
can remain on their parents health insurance plans until they're 26.
They want to ban insurance companies from denying coverage to 17
million children with preexisting conditions. They want to end tax cuts
that benefit 360,000 businesses that employ 2 million workers, all
provisions that have popular and bipartisan support.
But rather than building on and moving forward from last month's
ruling, nope, the Republicans, not surprisingly, decided to spend yet
another day in Congress considering the repeal of the Affordable Care
Act; 31 times that the House will vote on repeal. What a waste of
America's time.
Thirty times that we haven't voted on jobs bills. Thirty times we
haven't focused on extending tax cuts for the middle class.
For the American people in congressional districts all across the
country, this is also the 31st time that the Republicans have put in
jeopardy their access to quality, affordable, and comprehensive care.
And so 250 million Americans could lose their benefits and protections
with the vote today.
It's a step backward for Marylanders like Doug Masiuk, who watched
the Affordable Care Act because he couldn't afford to keep paying a
third of his income for health care and had started using bags of coins
to pay for his medicines. The Affordable Care Act saves Americans like
him $4 billion.
Families like the Mosbys in my county, in Prince Georges County, who
suffered three traumatic health events and fell behind on their
mortgage, almost lost their home. But the Affordable Care Act saves 105
million Americans who would reach lifetime limits but for the
Affordable Care Act that the Republicans today want to repeal.
It's time to get on with it. It's enough. It's time for Republicans
to move on, approve the settled law of the land, and start to implement
the law.
I urge my colleagues to vote down the rule and to vote against this
repeal.
Mr. SESSIONS. Madam Speaker, at this time I yield 2 minutes to the
gentleman from Brigham City, Utah (Mr. Bishop), a member of the Rules
Committee.
Mr. BISHOP of Utah. Madam Speaker, if, indeed this will be the 31st
time we will vote to repeal what is commonly called ObamaCare, that
number signifies also the number of job-creating bills this House has
passed and sent over to the Senate. It would be nice if the Senate
would actually deal on any of those issues to move us forward on all of
these concerns.
I do want to speak for just 1 minute here, though, about the concept
of the 10th amendment, one of the task forces on which I serve.
Everything that we are talking about, there's nothing wrong with
helping people provide for themselves. The issue always is where should
that decision be made. There's nothing wrong about that at all, but
where should it be made.
The brilliance of our Founding Fathers in coming up with federalism
was simply the idea of choices should be made by people in the areas in
which they can affect themselves.
Massachusetts appears to have a health care system they imposed upon
themselves. They like it. That's fine.
{time} 1340
It won't work in the State of Utah because we are different. We have
far more kids than Massachusetts has. We have a higher percentage of
small business. Our solution is not their solution.
The brilliance of federalism is that the people who live in the
States and the leaders of the States, they care as much as we do. They
also can decide for themselves as much as we do. The other brilliance
of federalism is that States can decide to be wrong if they want to
without impacting the entire Nation. There are some States that may
want to have a robust government involvement and tax themselves to do
it. Allow them to do so. There are other areas that want to have a less
robust government and tax themselves less. Allow them to do it. Only
the States have the ability of becoming efficient, creating justice and
creativity in their approaches.
My State of Utah came up with a legislative exchange program that
better meets the needs of my State, of the demographics of my State. It
is, in my opinion, still a better way of going, but unfortunately, it
is stopped by ObamaCare. That is not what we should be doing. Not all
great decisions have to emanate from this particular body.
Now, the Supreme Court has said this is a tax. Fine. It must be
enforced by the Internal Revenue Service, and we need to realize that
there will be 12,000 to 17,000 new employees of the Internal Revenue
Service to enforce this provision. Will they be outsourced, as the IRS
has done in the past--and does that present problems for it--or will
they be funded in-house, which will cost us again?
Ms. SLAUGHTER. Madam Speaker, I am pleased to yield 3 minutes to the
gentleman from Massachusetts, who knows health care, the distinguished
ranking member of the Committee on Natural Resources, Mr. Markey.
Mr. MARKEY. The Affordable Care Act is now part of our Nation's
fabric of health care laws. Right alongside Social Security and
Medicare now stands the Affordable Care Act. Yet the Republicans keep
trying to take away or to take apart the benefits included in this law
for the 31st time since they took over the House of Representatives.
What we have here, Madam Speaker, is a severe case of Republican
reflux.
Again and again, the Republicans keep coming up with harmful attempts
to destroy all of the protections Americans have gained under this
law--a Groundhog Day Republican reflux attempt to repeal this historic
piece of
[[Page H4719]]
legislation that helps every family in our country. Again and again,
the Republicans keep choosing corporations over consumers. The side
effects of this Republican reflux are serious.
If the Republicans succeed, insurance companies could, once again,
deny coverage because of preexisting conditions. Kids with asthma,
women with breast cancer, all of these protections would just go away,
and the Republicans will replace it with nothing. Americans could, once
again, be forced into bankruptcy just because they got sick. Just
because they got sick, they could go bankrupt if the Republicans'
repeal attempt is successful this afternoon on the House floor. And
what are they going to put in place of that protection against going
bankrupt just because you are sick? Nothing. They have no proposal to
have something replace those protections for American families.
Women could, once again, be discriminated against with higher
insurance premiums. Just being a woman, unfortunately, under existing
law is a condition which has women paying more. What are the
Republicans going to replace this protection for women with, a
protection that is now in the law? Nothing. They have no proposal
they're bringing out here today onto the House floor.
With this Republican reflux, it's the American people who get burned.
All they are doing is bringing out a proposal to repeal protections
that ensure for every American family all of these extra protections
which the Republicans have always denied them. They keep saying: Oh,
no. We care about preexisting conditions. Oh, no. We care about people
going bankrupt. Oh, no. We care about women being discriminated
against. Then you say to them: Well, where is your proposal? Bring it
out here. Let's have a vote on it.
But do you know what? This is about insurance companies over the
consumers of our country. Vote ``no'' on this Republican reflux bill.
Mr. SESSIONS. Madam Speaker, I would like to yield 2 minutes to the
gentleman from Knoxville, Tennessee (Mr. Duncan).
Mr. DUNCAN of Tennessee. I thank the gentleman for yielding.
Madam Speaker, I rise in support of the rule and of the underlying
legislation, the so-called Affordable Care Act, which should be called
the ``Unaffordable Care Act.'' Even if the President's plan were the
best thing since sliced bread, we simply cannot afford it.
Both Medicare and Medicaid now cost many times more than what was
estimated when they were first passed. Already, the estimate for the
President's plan is double what it was just 1 year ago, and most of it
will not be fully implemented until 2014 and some parts until 2016. And
much of it is ``paid for'' by placing millions more onto the Medicaid
rolls. This will cost all the States many billions they do not have.
The nonpartisan Congressional Quarterly estimated these additional
Medicaid costs at $627 billion over the next 10 years. In addition, in
June, the Joint Committee on Taxation estimated that increased taxes
over the next 10 years just to cover the plan would be from $675
billion up to possibly as much as $804 billion. If these are lowball
front-end estimates, as is typical, the health care plan will not work
unless medical care is limited or restricted more and more each year.
In considering their votes on this legislation, on this so-called
Affordable Care Act, I hope that my colleagues will consider these
strong words by Dr. Milton R. Wolf, President Obama's cousin. He wrote
this:
For the first time in the history of our Republic, our
government has demanded that every American, upon the
condition of breathing, be forced to enter a legal contract
with government-approved corporations. Not even King George
III dared impose such control. In truth, if a government can
force you to patronize companies of its choosing, the
fundamental relationship between the government and the
individual is irrevocably changed. If it is allowed to stand,
there will be no part of your life the government cannot
control, and no crony it cannot enrich with your money.
I urge the support for this rule and this underlying legislation.
Ms. SLAUGHTER. Madam Speaker, I yield 2 minutes to my colleague, the
gentlewoman from New York (Mrs. Maloney).
Mrs. MALONEY. I thank the gentlelady for yielding and for her
leadership.
Madam Speaker, today Congress must, once again, spend time in an
empty gesture even as this country waits for real solutions to serious
problems.
Instead of dealing with ways to speed up and expand the creation of
jobs, once again, our colleagues on the other side of the aisle insist
that we pretend like we are going to repeal the Affordable Care Act--
even though that could drop over 6.6 million young adults under the age
of 26 off their parents' health care policies; even though that could
throw 17 million children with preexisting conditions to the mercy of
the marketplace; even though that would drop 5.3 million seniors down
the doughnut hole of Medicare; even though it would just create new
uncertainties for small businesses.
Even though all of this is true and more, you make Congress, once
again, engage in this crude Kabuki, which is totally without meaning
because, if by some dark miracle you are able to pass the bill in the
House and the Senate, do you believe for one second that the President
would sign it? So what are we doing today? We are taking a vote on
repealing the Affordable Care Act for the 31st time. It was a waste of
time the first time, the second time, the third time, and so on and so
on, and it's a waste of time today.
So I would say let's just hurry up. Vote ``no'' on the rule and on
the underlying bill, and let's get back to the business of working to
create jobs for the American people.
{time} 1350
Mr. SESSIONS. At this time, I yield 1\1/2\ minutes to the gentleman
from Savannah, Georgia (Mr. Kingston).
Mr. KINGSTON. Madam Speaker, there are five quick reasons why I think
this bill should be repealed:
Number one, it does not decrease the cost of health care. In fact, it
is estimated that it will increase costs by 13 percent per family and
is already moving toward a $2,100 increase.
Number two, the loss of health care. The nonpartisan Congressional
Budget Office estimates that 20 million people will lose their
employer-based health insurance because of the mandates in ObamaCare.
Number three, it interferes with the patient-doctor relationship. The
law creates 159 new boards, offices, and panels within the Federal
Government to be in charge of people's health care decisions.
Number four, increased government spending at a time where we borrow
40 cents on every dollar we spend and our national debt is 100 percent
of the GDP. ObamaCare is expected to cost over $1.8 trillion over the
next decade. We don't have the money.
Number five, loss of jobs. The nonpartisan Congressional Budget
Office estimates that nearly 800,000 jobs will be lost because of
ObamaCare.
Madam Speaker, we need to repeal ObamaCare and replace it with the
best ideas of Republicans and Democrats, which should include expanded
health savings accounts, ending frivolous lawsuits, association health
plans, across-State-line health care purchases, and State-run high-risk
pools. These ideas will bring America together rather than divide us as
a country over this very important issue.
Madam Speaker, following are my remarks in their entirety:
Rising Health Care Costs--Under the Patient Protection and Affordable
Care Act (PPACA), CBO projects health insurance premiums will increase
by $2,100 per family.
By 2016, health insurance premiums for individuals and families will
increase by 13%.
Loss of Health Care Coverage--CBO estimates 20 million people could
lose their employer-based health insurance because of the mandates
imposed by PPACA.
According to HHS's own assumptions, as high as 80% of small
businesses and 64% of large businesses will discontinue offering health
insurance to its employees.
According to a survey by House Ways and Means, 71 of the nation's
largest employers could save more than $28 billion in 2014 alone and
$422.4 billion over a decade, by deciding to drop health insurance
coverage for their 10.2 million employees and dependents and paying the
$2,000 per-employee penalty instead.
Some colleges have already begun dropping student health insurance
plans for the coming academic year and others are warning students of
premium increases because of a provision in the Obamacare requiring
plans to expand their coverage benefits.
[[Page H4720]]
For example, Bethany College in Kansas is cancelling its health
insurance plan for students rather than face a premium increase of over
350 percent, causing the plans to increase from $445 per year to more
than $2,000 per year.
A mandate in Obamacare requires all child-only health insurance
carriers to guaranty issue plans, which allows individuals to purchase
health insurance on the way to the emergency room. As a result, 17
states including Georgia no longer offer new child-only health
insurance policies.
Interference with Patient-Doctor Relationship--PPACA creates the
Independent Payment Advisory Board (IPAB) consisting of 15 bureaucrats
responsible for making spending and coverage decisions for Medicare.
CBO projects IPAB will have a marginal effect on reducing Medicare
spending.
The law does create 159 new boards, offices and panels within the
federal government in charge of making decisions for people's health
care.
Increased Government Spending--PPACA is expected to cost $1.8
trillion over the next decade, which is nearly double the original
estimate.
Total federal spending on health care will increase from 5.4 percent
of GDP this year to 10.7 percent of GDP in 2037 and 18.3% by 2087.
Loss of Jobs--The CBO estimates nearly 800,000 jobs will be lost
because of passages of PPACA. This is because of the law's misguided
incentives that increase the marginal tax rates discouraging work and
labor supply.
According to a survey by the U.S. Chamber of Commerce, 74 percent of
small businesses stated PPACA makes it harder for firms to hire new
workers.
The same survey found 30% of the businesses surveyed are not hiring
at all thanks to PPACA.
Ms. SLAUGHTER. Madam Speaker, I yield 2 minutes to the gentleman from
Texas, a member of the Committee on Ways and Means, Mr. Doggett, who
also served on the Subcommittee on Health during the health care
debate.
Mr. DOGGETT. ``I have lived through a terminal illness while
struggling to get well and struggling to get and keep my insurance. I
have been denied insurance because of a preexisting condition. I have
lived this. It is very real for me. Today I breathe a little better.
Life is good because now I have hope.''
That was the reaction of my constituent, Erin Foster, to the approval
of the Affordable Health Care Act by the Supreme Court. And today's
legislation ought to be called the Take Away Erin Foster Hope Act,
because that's what it is, replacing the Affordable Health Care Act
with only tax breaks for Tylenol.
In a few days, thousands of Texans will be receiving checks of almost
$200 each, of almost $200 million in rebates from private insurance
companies that overcharged and abused them. This bill should be called
the Return to Sender Act, because it says those abusive health
insurance companies get their money back if this act became law.
There are seniors today who are trying to make use of the flawed
Republican prescription drug act that is now law. They left a giant
gap--sometimes referred to as a ``doughnut hole''--in the coverage of
that act.
Our seniors, as a result of the Affordable Health Care Act, have seen
their prescription costs go down, some of that doughnut hole plugged,
eventually to fill it all, and provide them the protection that they
have earned.
This bill, if enacted, would double the cost of prescription drugs
for those in the doughnut hole. About 2,250,000 Texas seniors would
also no longer receive free preventive services. This act should be
called the Charge Seniors More for Their Prescription Act, because
that's what it does.
You see, the problem is that in their near fanatic determination to
see that President Obama fails on everything, Erin Foster and that
senior and that individual that is counting on one of those rebate
checks, they are just collateral damage to these Republicans.
Mr. SESSIONS. Madam Speaker, at this time, I yield 1 minute to the
gentleman from Laurens, South Carolina (Mr. Duncan), from the Foreign
Affairs Committee, one of the most influential committees we have here
in the House of Representatives.
Mr. DUNCAN of South Carolina. Madam Speaker, Americans know that the
government takeover of health care is wrong. They spoke very loudly
when the other side of the aisle forced this on America in the last
Congress. It was bad policy before the Supreme Court ruled, and it was
bad policy in January when we first passed the repeal bill. It's bad
policy today, and it will be bad policy tomorrow. It takes $500 billion
away from Medicare. It puts government bureaucrats between Americans
and their doctors. It rations care for American seniors. It adds
exponentially to the Nation's debt. It grows government. Specifically,
it grows the Internal Revenue Service to collect the tax, which the
Supreme Court so evidently pointed out that it is a tax that will be
assessed if you fail to meet government's requirement to buy something.
Socialized medicine is wrong for America, and it is time to repeal
the bill.
Ms. SLAUGHTER. I am pleased to yield 2\1/2\ minutes to the gentleman
from New Jersey (Mr. Pascrell).
Mr. PASCRELL. Madam Speaker, Albert Einstein once said the definition
of ``insanity''--and you've heard this before, Madam Speaker--is doing
the same thing over and over and expecting different results. Well,
we've already voted over 30 times to repeal or restrict the Affordable
Care Act, and here we are again, wasting time with politics instead of
putting people back to work.
We're offering you the opportunity to help your constituents right
now, Madam Speaker. You can defeat the previous question and take up
the Bring the Jobs Home Act, which, for the first time, makes sure we
promote insourcing of jobs and stops the corporate welfare for
outsourcing jobs.
In the last decade, we have lost 5.5 million manufacturing jobs and
1.3 million back-office jobs. However, we have seen that the light of
our economic recovery is powered by domestic production, not the
outsourcing of jobs, and we've added over half a million manufacturing
jobs in just the last 2 years.
There are some who think outsourcing is a good policy. In fact, they
have made hundreds of millions doing just that.
I believe that the American Dream starts by creating good jobs right
here in the United States, and that we should not outsource the
American Dream to China or any other country.
This bill is very simple here. We're going to end the tax breaks that
encourage companies to shift their jobs overseas, and use that to pay
for tax credits for patriotic companies that want to bring jobs back
home. That's pretty simple.
With all due respect, Madam Speaker, why are we wasting our time? The
Supreme Court has ruled. The Affordable Care Act is the law of the
land. If the law is repealed, according to a report by the New Jersey
Public Interest Research Group, employers would see health care costs
grow by more than $3,000 a year, and premiums would be increased from
14 percent to 18 percent per year higher to those who want to buy
insurance, and my home State of New Jersey would have 10,000 fewer jobs
by the end of the decade.
The SPEAKER pro tempore. The time of the gentleman has expired.
Ms. SLAUGHTER. I yield an additional 10 seconds to the gentleman from
New Jersey.
Mr. PASCRELL. Despite the rhetoric, the majority is yet to propose a
replacement that will cover all of the people they want to throw off
the health care rolls. And they continue to ignore the number one
priority of the American people: creating jobs.
A week after the Fourth of July, Madam Speaker, I urge my colleagues
to defeat this motion and let the House vote on a patriotic American
bill that will create jobs right here.
Mr. SESSIONS. Madam Speaker, at this time, I yield 2 minutes to the
gentleman who, before he came to Congress, was on the front line of
health care as an anesthesiologist on the eastern shore of Maryland,
Congressman Harris.
Mr. HARRIS. Thank you very much, Mr. Chairman, for yielding the time.
Madam Speaker, my, my, my. Former Speaker Pelosi was so right when
she said Congress had to pass this bill so Americans could just find
out what's in it.
{time} 1400
Well, Americans have learned a lot since we first tried to repeal the
President's health care act last January. We learned that it still
continues to stifle job growth as we learn more and more about it, and
that's why we have to attempt to repeal it once again.
[[Page H4721]]
Earlier this year, Americans discovered that the law creates a new
nationwide mandate for coverage that doesn't allow people to opt out
when they have a religious or moral objection to those covered
services, a violation of the Religious Freedom Restoration Act duly
passed by this Congress and, more importantly, a violation of their
First Amendment rights. These inflexible mandates jeopardize the
ability of institutions and individuals to exercise their rights of
conscience, one of the most basic rights, and, yes, we discovered this
since we voted on the repeal last January.
Mr. Speaker, by now Americans have learned enough about this bill.
They want it repealed, and we should listen to them. We should pass the
rule and pass the bill.
Ms. SLAUGHTER. I reserve the balance of my time.
Mr. SESSIONS. Mr. Speaker, I yield 3 minutes to the Rules Committee
chairman, the gentleman from California (Mr. Dreier).
(Mr. DREIER asked and was given permission to revise and extend his
remarks.)
Mr. DREIER. Mr. Speaker, I would like to express my appreciation to
the distinguished vice chairman of the Committee on Rules, our friend
from Dallas, Mr. Sessions, for his superb management of this rule.
I would like to say that as we look at where we're going, contrary to
arguments that have been propounded here on the floor, it's important
to note that everybody wants to do everything we possibly can to ensure
that our fellow Americans have access to the best quality, affordable
health care in the world. We have the best health care system in the
world; we all know that. We want to make sure that we continue to see
that health care system improve, and we have just come to the
conclusion that the massive expansion of government is not the answer
to the goal of ensuring that people have access to quality health care.
The Supreme Court made their decision. We know what the Supreme
Court's decision was. I think that that decision pointed out a few
things. It's a tax. We were told consistently it wasn't a tax, and,
frankly, if we had known what the Supreme Court told us about it being
a tax, I don't believe that we would have had the passage of that
measure from the House.
That decision has been made, and also the Supreme Court, by virtue of
determining what is constitutional, does not mean that it's good public
policy. In fact, the Chief Justice has made it clear that they are not
casting an opinion as to whether or not this is a right measure.
I think that most of us have come down on the side of saying that we
should have taken an incremental approach in dealing with this. There
are a number of things that if we had done that would have, I believe,
immediately reduced the cost of health insurance and direct health care
costs, Mr. Speaker.
They include things like allowing for the purchase of insurance
across State lines, things like saying that there should be association
health plans, which interestingly enough passed the House and died
because of Democrats blocking it in the Senate when my party was last
in the majority here. Also, things like allowing for real meaningful
lawsuit abuse reform, which the President of the United States said he
advocated when he was here, and I acknowledge pooling to deal with pre-
existing conditions is something that needs to be done.
The fifth point is expanded medical savings accounts, which encourage
people to put some dollars aside with a tax incentive plan for their
health care needs.
If we had done these five things, Mr. Speaker, and these are things
that we as Republicans have put forward and again--as I said when we
were last in the majority, when people on the other side often said
that we did nothing--we passed association health plans, which, again,
allow small business to pool together, come together and work to get
lower rates as large corporations do.
It seems to me, Mr. Speaker, that as we look at the challenges that
we have, we can make this happen. The reason that we are casting the
vote, as we will today to repeal, is that we need to do that so that we
can do this in an open way.
Now, I have got to say some would say this is a closed rule. This is
simply an up-or-down vote on whether or not we should repeal this. When
we last considered this measure that we are voting to repeal today, Mr.
Speaker, I have got to tell you it was done under the most closed
process we have ever had.
The SPEAKER pro tempore (Mr. Poe of Texas). The time of the gentleman
has expired.
Mr. SESSIONS. I yield the gentleman an additional 2 minutes.
Mr. DREIER. Let me just say that when we did this, when we did this
here, it was done under a process that was unprecedented for an issue
of this magnitude.
That closed process, Mr. Speaker, is one of the things that I believe
played a role in seeing the Speaker of the House of Representatives,
then Nancy Pelosi, have to hand the gavel to John Boehner.
The American people understood the fact that things were so closed
around here, and I am very proud and happy that since we have been in
the majority our Rules Committee has reported out bills that have
allowed for a structure that has made more amendments considered in the
first several months of this Congress than have been considered in the
entire last Congress.
So we have tried to work for more openness and, again, a real example
of that closed process was what took place in the last Congress.
Well, we need to take this measure, we need to repeal it. I hope very
much that some of our colleagues in the other body will agree to that.
People always say it's a foregone conclusion what's going to happen.
Well, you know what? I never come to an absolute foregone conclusion.
We have our responsibility, as Members of the House of
Representatives, to step up to the plate and do what we as a body think
is the right thing for us to do, and that's exactly what is going to
take place today.
So if it doesn't happen, I think that there might be a chance for us
next year to do this. Again, Republicans, contrary to what is often
said, do want to take steps to ensure that all of our fellow
Americans--and we listen to these horror stories, and they are terrible
stories of the way people have been treated.
That's why I am a proponent of a structure that will allow for ways
to deal with pre-existing conditions. I believe that we can in a
bipartisan way, since the President advocated it, deal with meaningful
lawsuit abuse reform.
Again, we need to remember that if we want to keep our Nation on the
cutting edge of technological development to find a cure for cancer,
Alzheimer's and these other ailments, we need to make sure that there's
still an incentive for that to take place.
Mr. Speaker, I support the rule, and I support our underlying
measure.
Ms. SLAUGHTER. I continue to reserve the balance of my time.
Mr. SESSIONS. Mr. Speaker, the Republicans today have brought forth
the ideas about why we are repealing the ObamaCare health care bill.
The process that was gone through has been under wide debate, but the
results are factually known and understood.
Mr. Speaker, our economy is in shambles. Our economy is in shambles
because of uncertainty, uncertainty in the marketplace about the rules
and regulations, not just of health care, but about the impact of Big
Government, and this is the big daddy of all of them. The health care
bill is the big daddy that invades every single piece, part of not just
this country and our society, but because of the way it reaches into
individuals and to families, it is very disruptive.
The IRS will be empowered to hire up to 17,000 new IRS agents to make
sure that not only are taxes being paid, but to make sure that the
government has its way with people who, even though they may or may not
choose to get health care, will be required to by this government. We
well understand what the results are of this bill; and as a result of
that, that's why Republicans are on the floor of the House of
Representatives today.
Ms. SLAUGHTER. I continue to reserve the balance of my time.
Mr. SESSIONS. Mr. Speaker, I yield 2 minutes to the gentleman from
New Jersey (Mr. LoBiondo).
Mr. LoBIONDO. I appreciate the chairman for yielding.
[[Page H4722]]
Mr. Speaker, I would like to reemphasize some points that I think
probably have already been made, that health care is not a partisan
issue. Whether we're Republicans or Democrats or Independents, we want
to see health care more affordable and more accessible. Unfortunately,
President Obama's health care bill does not do the job.
The Supreme Court made it completely clear that this is a new tax.
{time} 1410
With a very fragile economy, the last thing we need to do is impose a
new tax on our businesses. In my district, the average unemployment
rate is hovering around 13 percent. I've talked to many of the
businesses. The uncertainty of this legislation is killing their
incentive to hire new people. It's something that we really shouldn't
let happen. And maybe more important, I believe that the sacrosanct
doctor-patient relationship is jeopardized by the 111 new boards and
commissions that will put cost before care.
This is something that we cannot allow to happen. The best way to do
it is for a total repeal, to start over with the points that will make
sense, that most of America can get their arms around, that the medical
community will say will help the doctor-patient relationship and
businesses will have a clear understanding.
Ms. SLAUGHTER. May I inquire of my colleague if he has further
speakers?
Mr. SESSIONS. At this time, I'd inquire of the Speaker how much time
remains on both sides.
The SPEAKER pro tempore. The gentlewoman from New York has 1 minute
50 seconds remaining, and the gentleman from Texas has 3 minutes
remaining.
Mr. SESSIONS. Thank you very much, Mr. Speaker.
I have no further requests for time, and I reserve the balance of my
time.
Ms. SLAUGHTER. Mr. Speaker, Presidents from both sides of the aisle
have tried to do health care in the United States for a hundred years.
Finally, 2 years ago, we were able to achieve the goal. Today, we vote
on a bill that would dismantle that achievement for political points
only, because the 31st time is not going to be the charm here.
We have heard, again, the dire straits of this country. Please ask
your Member of Congress why it is that we're voting on this for the
31st time instead of doing something about jobs, for heaven's sake.
I've not heard anything in that bill or anyplace else that 17,000 IRS
agents are going to be hired. I think that's, again, something that we
really don't know about.
Mr. Speaker, I ask unanimous consent to insert the text of the
amendment Mr. Pascrell talked about, along with the extraneous
material, in the Record immediately prior to the vote on the previous
question.
The SPEAKER pro tempore. Is there objection to the request of the
gentlewoman from New York?
There was no objection.
Ms. SLAUGHTER. I urge my colleagues to vote ``no'' and defeat the
previous question.
I urge a ``no'' vote on the rule, and I yield back the balance of my
time.
Mr. SESSIONS. I appreciate the gentlewoman from New York not only for
her indulgence of this issue the past few days but also for her
professional nature today.
Mr. Speaker, we're on the floor because the health care bill that the
President and House Democrats and Senate Democrats supported costs
twice as much 1 year later as was guesstimated the year before.
The United States is suffering economically, people are suffering
economically, and we are losing our competitiveness with the world. We
are here because the biggest driver of what I would consider to be not
just lack of jobs in this country but also continued uncertainty for
the business community. Someone called them corporations. They're
really employers. Employers across this country are saying to Members
of Congress not just in sworn testimony but in media after media,
newspaper after newspaper, that it is uncertainty related to the health
care bill that is causing them not to move forward on their plans to
grow their business.
We are here today because we need to make sure that we also
understand the cost--the cost that is twice as much in 1 year as was
guesstimated to be in the year before. This cost in doubling, this
would mean that this body either needs to come up with a way to pay for
it, which would mean, following the Democrats' proposal, instead of
taking $500 billion out of Medicare, we would take $1 trillion out of
Medicare. Instead of raising taxes $570 billion, we would have to raise
taxes $1 trillion. Instead of all these things that the bill does that
taxes people, instead of it being exactly the way they said it would
be, including $70 billion for a plan for long-term care that now they
cannot sustain, it would have to be $140 billion.
Mr. Speaker, the American people do understand that health care is
important, and Republicans would insist upon us following, just as we
have in the past, health care bills which would better the marketplace,
and people would have the ability to purchase health care at an
affordable amount and to make sure that we have physicians and patients
that have a close relationship. Please make no mistake: tort reform
would be at the top of our order.
Secondly, buying insurance across State lines would include a healthy
marketplace. Third, 26-year-olds being on their parents' insurance,
that's a bipartisan idea. High-risk pools to help spread out the cost
would become available. We're for those, too. And certainly associated
health care plans that are able to pool their resources so that they
can have a bigger team size in which to purchase health care would be
important. But more importantly, we need to make sure that every single
American gets health care on a pretax basis.
We've made our case today, Mr. Speaker. I am very proud of what we're
doing. I urge my colleagues to vote for the rule and the underlying
bill.
The material previously referred to by Ms. Slaughter is as follows:
An Amendment to H. Res. 724 Offered by Ms. Slaughter of New York
Amendment in nature of substitute:
Strike all after the resolved clause and insert:
That immediately upon adoption of this resolution the
Speaker shall, pursuant to clause 2(b) of rule XVIII, declare
the House resolved into the Committee of the Whole House on
the state of the Union for consideration of the bill (H.R.
5542) to amend the Internal Revenue Code of 1986 to encourage
domestic insourcing and discourage foreign outsourcing. The
first reading of the bill shall be dispensed with. All points
of order against consideration of the bill are waived.
General debate shall be confined to the bill and shall not
exceed one hour equally divided among and controlled by the
chair and ranking minority member of the Committee on Ways
and Means. After general debate the bill shall be considered
for amendment under the five-minute rule. All points of order
against provisions in the bill are waived. At the conclusion
of consideration of the bill for amendment the Committee
shall rise and report the bill to the House with such
amendments as may have been adopted. The previous question
shall be considered as ordered on the bill and amendments
thereto to final passage without intervening motion except
one motion to recommit with or without instructions. If the
Committee of the Whole rises and reports that it has come to
no resolution on the bill, then on the next legislative day
the House shall, immediately after the third daily order of
business under clause 1 of rule XIV, resolve into the
Committee of the Whole for further consideration of the bill.
Sec. 2. Clause 1(c) of rule XIX shall not apply to the
consideration of the bill specified in the first section of
this resolution.
____
The information contained herein was provided by the
Republican Minority on multiple occasions throughout the
110th and 111th Congresses.)
The Vote on the Previous Question: What It Really Means
This vote, the vote on whether to order the previous
question on a special rule, is not merely a procedural vote.
A vote against ordering the previous question is a vote
against the Republican majority agenda and a vote to allow
the opposition, at least for the moment, to offer an
alternative plan. It is a vote about what the House should be
debating.
Mr. Clarence Cannon's Precedents of the House of
Representatives (VI, 308-311), describes the vote on the
previous question on the rule as ``a motion to direct or
control the consideration of the subject before the House
being made by the Member in charge.'' To defeat the previous
question is to give the opposition a chance to decide the
subject before the House. Cannon cites the Speaker's ruling
of January 13, 1920, to the effect that ``the refusal of the
House to sustain the demand for the previous question passes
the
[[Page H4723]]
control of the resolution to the opposition'' in order to
offer an amendment. On March 15, 1909, a member of the
majority party offered a rule resolution. The House defeated
the previous question and a member of the opposition rose to
a parliamentary inquiry, asking who was entitled to
recognition. Speaker Joseph G. Cannon (R-Illinois) said:
``The previous question having been refused, the gentleman
from New York, Mr. Fitzgerald, who had asked the gentleman to
yield to him for an amendment, is entitled to the first
recognition.''
Because the vote today may look bad for the Republican
majority they will say ``the vote on the previous question is
simply a vote on whether to proceed to an immediate vote on
adopting the resolution . . . [and] has no substantive
legislative or policy implications whatsoever.'' But that is
not what they have always said. Listen to the Republican
Leadership Manual on the Legislative Process in the United
States House of Representatives, (6th edition, page 135).
Here's how the Republicans describe the previous question
vote in their own manual: ``Although it is generally not
possible to amend the rule because the majority Member
controlling the time will not yield for the purpose of
offering an amendment, the same result may be achieved by
voting down the previous question on the rule. . . . When the
motion for the previous question is defeated, control of the
time passes to the Member who led the opposition to ordering
the previous question. That Member, because he then controls
the time, may offer an amendment to the rule, or yield for
the purpose of amendment.''
In Deschler's Procedure in the U.S. House of
Representatives, the subchapter titled ``Amending Special
Rules'' states: ``a refusal to order the previous question on
such a rule [a special rule reported from the Committee on
Rules] opens the resolution to amendment and further
debate.'' (Chapter 21, section 21.2) Section 21.3 continues:
``Upon rejection of the motion for the previous question on a
resolution reported from the Committee on Rules, control
shifts to the Member leading the opposition to the previous
question, who may offer a proper amendment or motion and who
controls the time for debate thereon.''
Clearly, the vote on the previous question on a rule does
have substantive policy implications. It is one of the only
available tools for those who oppose the Republican
majority's agenda and allows those with alternative views the
opportunity to offer an alternative plan.
Mr. SESSIONS. I yield back the balance of my time, and I move the
previous question on the resolution.
The SPEAKER pro tempore. The question is on ordering the previous
question.
The question was taken; and the Speaker pro tempore announced that
the ayes appeared to have it.
Ms. SLAUGHTER. Mr. Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 and clause 9 of rule
XX, this 15-minute vote on ordering the previous question will be
followed by 5-minutes votes on adopting the resolution, if ordered; and
agreeing to the Speaker's approval of the Journal.
The vote was taken by electronic device, and there were--yeas 238,
nays 184, not voting 9, as follows:
[Roll No. 456]
YEAS--238
Adams
Aderholt
Alexander
Amash
Amodei
Austria
Bachmann
Bachus
Barletta
Bartlett
Barton (TX)
Bass (NH)
Benishek
Berg
Biggert
Bilbray
Bilirakis
Bishop (UT)
Black
Blackburn
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
Coble
Coffman (CO)
Cole
Conaway
Cravaack
Crawford
Crenshaw
Culberson
Davis (KY)
Denham
Dent
DesJarlais
Diaz-Balart
Dold
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
Huelskamp
Huizenga (MI)
Hultgren
Hunter
Hurt
Issa
Jenkins
Johnson (IL)
Johnson (OH)
Johnson, Sam
Jones
Jordan
Kelly
King (NY)
Kingston
Kinzinger (IL)
Kline
Labrador
Lamborn
Lance
Landry
Lankford
Latham
LaTourette
Latta
Lewis (CA)
LoBiondo
Long
Lucas
Luetkemeyer
Lummis
Lungren, Daniel E.
Mack
Manzullo
Marchant
Marino
McCarthy (CA)
McCaul
McClintock
McHenry
McIntyre
McKeon
McKinley
McMorris Rodgers
Meehan
Mica
Miller (FL)
Miller (MI)
Miller, Gary
Mulvaney
Murphy (PA)
Myrick
Neugebauer
Noem
Nugent
Nunes
Nunnelee
Olson
Palazzo
Paul
Paulsen
Pearce
Pence
Petri
Pitts
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 (FL)
Royce
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)
NAYS--184
Ackerman
Altmire
Andrews
Baca
Baldwin
Barber
Barrow
Bass (CA)
Becerra
Berkley
Berman
Bishop (GA)
Bishop (NY)
Blumenauer
Bonamici
Boswell
Brady (PA)
Braley (IA)
Brown (FL)
Butterfield
Capps
Capuano
Cardoza
Carnahan
Carney
Carson (IN)
Castor (FL)
Chandler
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
Donnelly (IN)
Doyle
Edwards
Ellison
Engel
Eshoo
Farr
Fattah
Filner
Frank (MA)
Fudge
Garamendi
Gonzalez
Green, Al
Green, Gene
Grijalva
Hahn
Hanabusa
Hastings (FL)
Heinrich
Higgins
Himes
Hinchey
Hinojosa
Hochul
Holden
Holt
Honda
Hoyer
Israel
Jackson Lee (TX)
Johnson (GA)
Johnson, E. B.
Kaptur
Keating
Kildee
Kind
Kissell
Kucinich
Langevin
Larsen (WA)
Larson (CT)
Lee (CA)
Levin
Lewis (GA)
Lipinski
Loebsack
Lofgren, Zoe
Lowey
Lujan
Lynch
Maloney
Markey
Matheson
Matsui
McCarthy (NY)
McCollum
McDermott
McGovern
McNerney
Meeks
Michaud
Miller (NC)
Moore
Moran
Murphy (CT)
Nadler
Napolitano
Neal
Olver
Owens
Pallone
Pascrell
Pastor (AZ)
Pelosi
Perlmutter
Peters
Peterson
Pingree (ME)
Polis
Price (NC)
Quigley
Rahall
Rangel
Reyes
Richardson
Richmond
Ross (AR)
Rothman (NJ)
Roybal-Allard
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
NOT VOTING--9
Akin
Bonner
Gutierrez
Hirono
Jackson (IL)
King (IA)
Miller, George
Platts
Sullivan
{time} 1440
Messrs. HASTINGS of Florida, BUTTERFIELD, and KUCINICH, Ms. LORETTA
SANCHEZ of California and Ms. JACKSON LEE of Texas changed their vote
from ``yea'' to ``nay.''
Mr. POSEY changed his vote from ``nay'' to ``yea.''
So the previous question was ordered.
The result of the vote was announced as above recorded.
The SPEAKER pro tempore. The question is on the resolution.
The question was taken; and the Speaker pro tempore announced that
the ayes appeared to have it.
Ms. SLAUGHTER. Mr. Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. This is a 5-minute vote.
The vote was taken by electronic device, and there were--yeas 240,
nays 182, not voting 9, as follows:
[Roll No. 457]
YEAS--240
Adams
Aderholt
Alexander
Amash
Amodei
Austria
Bachmann
Bachus
Barletta
Bartlett
Barton (TX)
Bass (NH)
Benishek
Berg
Biggert
Bilbray
Bilirakis
Bishop (UT)
Black
Blackburn
Bono Mack
Boren
Boustany
Brady (TX)
Brooks
Broun (GA)
Buchanan
Bucshon
Buerkle
Burgess
[[Page H4724]]
Burton (IN)
Calvert
Camp
Campbell
Canseco
Cantor
Capito
Carter
Cassidy
Chabot
Chaffetz
Coble
Coffman (CO)
Cole
Conaway
Cravaack
Crawford
Crenshaw
Culberson
Davis (KY)
Denham
Dent
DesJarlais
Diaz-Balart
Dold
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
Huelskamp
Huizenga (MI)
Hultgren
Hunter
Hurt
Issa
Jenkins
Johnson (IL)
Johnson (OH)
Johnson, Sam
Jones
Jordan
Kelly
King (NY)
Kingston
Kinzinger (IL)
Kissell
Kline
Labrador
Lamborn
Lance
Landry
Lankford
Latham
LaTourette
Latta
Lewis (CA)
LoBiondo
Long
Lucas
Luetkemeyer
Lummis
Lungren, Daniel E.
Mack
Manzullo
Marchant
Marino
McCarthy (CA)
McCaul
McClintock
McHenry
McIntyre
McKeon
McKinley
McMorris Rodgers
Meehan
Mica
Miller (FL)
Miller (MI)
Miller, Gary
Mulvaney
Murphy (PA)
Myrick
Neugebauer
Noem
Nugent
Nunes
Nunnelee
Olson
Palazzo
Paul
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
Schweikert
Scott (SC)
Scott, Austin
Sensenbrenner
Sessions
Shimkus
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
Yoder
Young (AK)
Young (FL)
Young (IN)
NAYS--182
Ackerman
Altmire
Andrews
Baca
Baldwin
Barber
Barrow
Bass (CA)
Becerra
Berkley
Berman
Bishop (GA)
Blumenauer
Bonamici
Boswell
Brady (PA)
Braley (IA)
Brown (FL)
Butterfield
Capps
Capuano
Cardoza
Carnahan
Carney
Carson (IN)
Castor (FL)
Chandler
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
Donnelly (IN)
Doyle
Edwards
Ellison
Engel
Eshoo
Farr
Fattah
Filner
Frank (MA)
Fudge
Garamendi
Gonzalez
Green, Al
Green, Gene
Grijalva
Hahn
Hanabusa
Hastings (FL)
Heinrich
Higgins
Himes
Hinchey
Hinojosa
Hochul
Holden
Holt
Honda
Hoyer
Israel
Jackson Lee (TX)
Johnson (GA)
Johnson, E. B.
Kaptur
Keating
Kildee
Kind
Kucinich
Langevin
Larsen (WA)
Larson (CT)
Lee (CA)
Levin
Lewis (GA)
Lipinski
Loebsack
Lofgren, Zoe
Lowey
Lujan
Lynch
Maloney
Markey
Matheson
Matsui
McCarthy (NY)
McCollum
McDermott
McGovern
McNerney
Meeks
Michaud
Miller (NC)
Moore
Moran
Murphy (CT)
Nadler
Napolitano
Neal
Olver
Owens
Pallone
Pascrell
Pastor (AZ)
Pelosi
Perlmutter
Peters
Peterson
Pingree (ME)
Polis
Price (NC)
Quigley
Rahall
Rangel
Reyes
Richardson
Richmond
Rothman (NJ)
Roybal-Allard
Ruppersberger
Rush
Ryan (OH)
Sanchez, Linda T.
Sanchez, Loretta
Sarbanes
Schakowsky
Schiff
Schrader
Schwartz
Scott (VA)
Scott, David
Serrano
Sewell
Sherman
Shuler
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
NOT VOTING--9
Akin
Bishop (NY)
Bonner
Gutierrez
Hirono
Jackson (IL)
King (IA)
Miller, George
Woodall
Announcement by the Speaker Pro Tempore
The SPEAKER pro tempore (during the vote). There are 2 minutes
remaining.
{time} 1446
So the resolution was agreed to.
The result of the vote was announced as above recorded.
A motion to reconsider was laid on the table.
____________________