Congressional Record, Volume 159 Issue 102 (Wednesday, July 17, 2013)

[Congressional Record Volume 159, Number 102 (Wednesday, July 17, 2013)]
[House]
[Pages H4557-H4573]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

FAIRNESS FOR AMERICAN FAMILIES ACT

Mr. PRICE of Georgia. Mr. Speaker, pursuant to House Resolution 300,
I call up the bill (H.R. 2668) to delay the application of the
individual health insurance mandate, and ask for its immediate
consideration.
The Clerk read the title of the bill.
The SPEAKER pro tempore. Pursuant to House Resolution 300, the bill
is considered read.
The text of the bill is as follows:

H.R. 2668

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

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Fairness for American
Families Act''.

SEC. 2. DELAY IN APPLICATION OF INDIVIDUAL HEALTH INSURANCE
MANDATE.

(a) In General.--Section 5000A(a) of the Internal Revenue
Code of 1986 is amended by striking ``2013'' and inserting
``2014''.
(b) Conforming Amendments.--
(1) Section 5000A(c)(2)(B) of the Internal Revenue Code of
1986 is amended--
(A) by striking ``2014'' in clause (i) and inserting
``2015'', and
(B) by striking ``2015'' in clauses (ii) and (iii) and
inserting ``2016''.
(2) Section 5000A(c)(3)(B) of such Code is amended--
(A) by striking ``2014'' and inserting ``2015'', and
(B) by striking ``2015'' (prior to amendment by
subparagraph (A)) and inserting ``2016''.
(3) Section 5000A(c)(3)(D) of such Code is amended--
(A) by striking ``2016'' and inserting ``2017'', and
(B) by striking ``2015'' and inserting ``2016''.
(4) Section 5000A(e)(1)(D) of such Code is amended--
(A) by striking ``2014'' and inserting ``2015'', and
(B) by striking ``2013'' and inserting ``2014''.
(c) Effective Date.--The amendments made by this section
shall take effect as if included in section 1501 of the
Patient Protection and Affordable Care Act.

The SPEAKER pro tempore. The gentleman from Georgia (Mr. Price) and
the gentleman from Washington (Mr. McDermott) each will control 30
minutes.
The Chair recognizes the gentleman from Georgia.

General Leave

Mr. PRICE of Georgia. Mr. Speaker, I ask unanimous consent that all
Members have 5 legislative days in which to revise and extend their
remarks and to include extraneous material on H.R. 2668.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Georgia?
There was no objection.
Mr. PRICE of Georgia. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, today I rise in strong support of H.R. 2668, the
Fairness for American Families Act. The administration says that they
invited business to come in and explain how the cost and the complexity
of ObamaCare was hurting business and hurting the economy, and they
granted business relief appropriately.
Mr. Speaker, why hasn't the administration invited the American
people into the halls of government?
Why hasn't the White House listened to the concerns of the American
people about the cost and the complexity of ObamaCare for American
families?
Have American families seen a $2,500 premium decrease as promised by
the President?
No. In fact, premiums have gone up.
The American people don't understand this law any better than the
employers, employers who can hire lawyers and consultants and health
benefits experts. In fact, individuals who have no help understand this
law even less than business; yet the administration granted relief only
to business.
Mr. Speaker, it's clear: the President has now admitted it. His law,
ObamaCare, is not ready. Deadlines have been missed. System testing is
not complete. Income verification systems are not in place.
In the words of Senator Baucus, the train wreck is happening.
The law should be repealed, Mr. Speaker. President Obama disagrees
with that, and that's unfortunate. But we all should be able to come
together on the simple principle of fairness. If business gets a 1-year
delay, the American people ought to get a 1-year delay. It's a simple
principle.
If ObamaCare is behind schedule, the American people should not have
to bear the burdens alone. They should get the same delay as business.
I urge my colleagues to come together today and to advance this very
simple principle that this government will treat its citizens fairly
and equally.
I reserve the balance of my time.
Mr. McDERMOTT. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, now we get to the real bill. If the Republicans can't
repeal the Affordable Care Act, they're going to try and rot it from
the inside.
For the last few days, my Republican colleagues have been spinning
this vote as a great populist effort to help the middle class. They
explain that, even with these repeals, we can keep all the things we
like, covering our kids till age 26, prescription drug help, banning
the denial of coverage for those with preexisting conditions.
And legally, they aren't wrong. They're not lying. They're just
confusing the people. These laws will still be in place; but
realistically, in the real world in which we live, it will be hard to
cover your kids and subsidize drugs if the insurance industry no longer
exists in this country.
Without the healthy consumers the mandate guarantees, only the
sickest and the costliest will be left, and prices will skyrocket.
We have a letter from the Congressional Budget Office that says that
if we delay this, you can expect that the prices of insurance will go
up and fewer people will be covered.
The reason you don't see any fur flying is because the insurance
industry knows this isn't going anywhere. This is just a lot of
political theater.
In Washington, we tried this. In 1993, the Democrats put in universal
coverage and guaranteed issue. Everybody had a mandate, and you were
going to get it. The insurance companies couldn't do otherwise. Two
years later, the Republicans repealed the guaranteed mandate, leaving
the insurance industry covering the sickest in the State of Washington.
Within 3 years, there were no individual policies sold in the State of
Washington.
We have run this game once in Washington State, and you are coming
out here today and running it again. It's been tried in other States.
You cannot have universal coverage without a mandate. You cannot have
insurance reform that guarantees everybody insurance.
Now, this isn't prophecy on my part. This has happened. A lot of what
you hear about around here is that people

[[Page H4558]]

are talking, well, gee, we got these terrible insurance rates going up.
They're not going up in Washington in our exchange. They're not going
up in Oregon in the exchange. They're not going up in California in the
exchange. Today, New York reports they're not going up in New York.
Anybody who stands out here and says insurance rates are out of sight
simply is misleading the people.
We ought to vote ``no'' on this bill.
I reserve the balance of my time.

U.S. Congress,

Congressional Budget Office,

Washington, DC, July 16, 2013.
Hon. Dave Camp,
Chairman, Committee on Ways and Means,
House of Representatives, Washington, DC.
Dear Mr. Chairman: CBO and the staff of the Joint Committee
on Taxation (JCT) have begun a review of H.R. 2668, the
Fairness for American Families Act, but we have not yet
completed a cost estimate for the bill. On a preliminary
basis, however, we expect that enacting H.R. 2668 would have
the effect of reducing the deficit in 2014 and over the 2014-
2023 period. That initial conclusion is based on our prior
work on proposals to repeal the individual mandate
established in the Affordable Care Act.
The legislation would delay for one year the requirement
that nearly every resident of the United States have health
insurance coverage by January 1, 2014. The bill also would
shift by one year the schedule of penalties for people who do
not comply with the mandate.
CBO and JCT expect that, during the period of delayed
phase-in of the penalty for failing to comply with the
mandate, health insurance premiums for individually purchased
coverage would be higher under H.R. 2668 than they are
projected to be under current law. In addition, the number of
people with health insurance coverage would be reduced
relative to current law.
I hope you find this preliminary information useful; if you
wish further details, we will be pleased to provide them.
Sincerely,
Douglas W. Elmendorf.
Enclosure.
____

[From Bloomberg News, June 16, 2012]

Health Reform Without a Mandate: Lessons From Washington State

(By Sarah Kliff)

If the Supreme Court overturns the health reform law's
individual mandate--a decision that could come as soon as
Monday--it won't be totally unknown territory. For Washington
state, it would be quite familiar.
Washington state attempted to pursue health insurance
without an individual mandate.
In 1993, Washington also passed a law both guaranteeing all
residents access to private health insurance, regardless of
their health status, and requiring Washingtonians to purchase
coverage.
The state legislature, however, repealed that last
provision two years later. With the guaranteed access
provisions still standing, the state saw premiums rise and
enrollment drop, as residents only purchased coverage when
they needed it. Health insurers fled the state and, by 1999,
it was impossible to buy an individual plan in Washington--no
company was selling.
Washington state is among a handful of states that have
pursued universal access to health insurance. The challenges
they have faced could give some clues about the federal
overhaul's fate should the mandate get struck down. ``There
are seven states that tried this in the mid-1990s and, in
every case, it was a disaster,'' said M.I.T. health care
economist Jonathan Gruber, who worked on both Massachusetts'
reform law and the Affordable Care Act. ``It became pretty
clear that, if you want a market to work, you need a
mandate.''
Washington state began pursuing health reform in 1990, when
the state legislature created a commission to study how best
to provide universal coverage for its 5 million residents.
The commission weighed a single-payer scheme, where state
would create and run its own health plan. It ultimately
settled on a ``managed competition'' model, where the state
would play a greater role in regulating the insurance market.
``There were essentially three goals of the law: To cover
everybody, to reduce the rate of health-care cost growth by
managing competition better and to improve health care
outcomes,'' says Aaron Katz, a University of Washington
health policy professor who served on the commission.
Starting on July 1, 1993, health insurance companies were
required to accept all state residents who applied for
coverage. The new law also barred health plans from charging
sick subscribers more, a practice known as underwriting. The
requirement to purchase coverage, meanwhile, was not slated
to take effect until five years later, in 1998.
That never came to be. After Republicans took control of
the Washington state House in 1994, the state repealed its
individual mandate. The guaranteed issue provision, however,
remained on the books.
``The legislature was loath to repeal the insurance reforms
because those were very popular,'' says Aaron Katz, a health
policy professor at the University of Washington, who advised
the legislature on the issue. ``That put the insurance
companies in a bind.''
The bind they were in was this: The only people buying
health insurance were those who foresaw having high medical
costs. That drove health insurance premiums up. As premiums
went up, and insurance became less affordable, enrollment
decreased significantly.
As one report from the Washington state Insurance
Commissioner's Office described it, the insurance market has
entered a ``death spiral,'' with customers only buying
coverage ``when they needed it.''
Jonathan Hensley, who then served as the president of local
health plan Premera Blue Cross, recalls one letter he got
from a healthy woman cancelling her insurance policy.
``She wrote in her letter that she very much appreciated
our excellent service [and] that she would certainly pick our
plan again when she became pregnant,'' says Hensley, who now
works for another health insurer in Washington, Cambia.
Big premium spikes indicated that many Washingtonians were
making similar decisions: Premera Blue Cross, increased
premiums on its most popular product by 78 percent over the
course of three years.
Health insurance companies, meanwhile, were losing money--
and leaving the state. Between 1993 and 1998, 17 health
insurance carriers had left the state's individual market.
The two remaining plans--Regence Blue Shield and Group
Health, a health maintenance organization--stopped writing
policies in 1999. Washington state's individual market was
essentially dead.
``What effectively happened was you got to this tipping
point, where we couldn't afford to do business, and
individual coverage was simply not available,'' says Hensley.
Hensley, along with other health-care stakeholders, met
with then-Gov. Gary Locke to discuss new legislation to fix
the insurance market. In 2000, the Washington state
legislature significantly modified its guaranteed issue
policy. Insurers would still have to cover most residents,
but those with pre-existing conditions could be required to
wait nine months for the policy to kick in. The very sickest
applicants would, meanwhile, would be eligible for coverage
in a high-risk insurance pool administered by the state.
Washington state's insurance market now has nine companies
selling individual policies, compared to the 19 that
participated in 1993. Thirteen percent of Washington state
residents currently lack health coverage, the same number as
when the health reform experiment started.
Washington state's experience does not make a perfect
analogy for what would happen to the federal law, should its
individual mandate get struck down. The Affordable Care Act
has premium subsidies, for example, that could encourage more
individuals to purchase coverage. It also allows insurance
companies to charge older subscribers three times as much as
young enrollees; in Washington, everyone had to receive the
same rate.
Some, however, do see parallels between the role that the
individual mandate played in Washington state's law--and
could play in the law passed in Washington, D.C.
``Washington state's experience demonstrated that passing
market reforms without requiring broad participation in the
system does not work,'' said Karen Ignagni, President of
America's Health Insurance Plans. ``The linkage is
essential.''
Washington state, for its part, filed an amicus brief with
the Supreme Court on the health reform law, that drew heavily
from its own experience.
``We also know, from Washington state's own experience,
that insurance coverage for pre-existing medical conditions
must go hand in hand with the minimum insurance coverage
requirements,'' Washington Gov. Christine Gregoire, a
Democrat, said in a statement accompanying her filing.

Mr. PRICE of Georgia. Mr. Speaker, I'm pleased to yield 2 minutes to
the gentleman from Indiana (Mr. Young), the author of the bill,
recognizing his wisdom and his diligence in working on this issue and
recognizing that fairness was absolutely vital on this issue.
Mr. YOUNG of Indiana. Mr. Speaker, on July 2, the President announced
the delay of ObamaCare's employer mandate tax. Now, we know this is
great for business, for those businesses that have the resources, the
lobbyists, the accountants and so on to get their message out to
Congress and the administration. But it does little for hardworking
American individuals and families.
A government of the people, by the people, and for the people must be
a government that is fair to all of its citizens. It's simply unfair to
give business a pass, but not to give such treatment to rank-and-file
Americans.
So that's why I introduced H.R. 2668, the Fairness for American
Families Act. The bill gives individuals the same reprieve from
ObamaCare that our President gives to Big Business.
Under current law, individuals must buy insurance on January 1 or pay
a tax. My bill would merely delay implementation of the individual
mandate tax for 1 year as well.

[[Page H4559]]

It's worth noting that the individual tax is just as confusing to
hardworking Americans as the employer tax is to businesses; but
families don't have teams of accountants and lawyers to help them
comply with ObamaCare.
It isn't getting any easier either. On July 5, an additional 145
pages of regulations were promulgated by this administration related to
the individual tax. So how are ordinary Americans supposed to keep up
with all of this?
That's why poll after poll shows that the individual mandate tax is
so unpopular. In fact, only 12 percent of Americans like it.
The White House said they delayed the employer tax because it's too
darn complex for businesses. Well, I hear from my constituents every
day that the individual tax is just as confusing. They want relief.
The President only wants to give relief to some. I think all of our
constituents deserve relief. And with that in mind, I ask my colleagues
from both political parties, let's take off our political blinders for
once. Let's do the right thing here, and let's support the Fairness for
American Families Act.
Let's provide the same relief to America's families that the Obama
administration has granted to Big Business. That's only fair.
Mr. McDERMOTT. Mr. Speaker, I will insert for the Record the report
on the Ninth Indiana District and the people who will benefit from that
bill when it goes into effect on the first of October.

Benefits of the Health Care Reform Law in the 9th Congressional
District of Indiana

Committees on Energy and Commerce, Ways and Means, and Education and
the Workforce, Democratic Staff Report, July 2013

The landmark Affordable Care Act (ACA) began delivering
important new benefits and protections to tens of millions of
American families almost immediately after it was signed into
law by President Obama. But the largest benefits of the law
will become available to consumers on October 1, 2013, when
health insurance marketplaces open in all 50 states. These
marketplaces will offer individuals, families, and small
businesses an efficient, transparent, one-stop shop to
compare health insurance policies, receive financial
assistance, and sign up for high-quality, affordable, and
secure insurance coverage.
This fact sheet summarizes new data on the significant
benefits of the health care reform law in Rep. Young's
district. It also provides the first picture of the impacts
of the law in districts redrawn or newly created following
the 2010 Census. As a result of the law:
8,300 young adults in the district now have health
insurance through their parents' plan.
More than 9,300 seniors in the district received
prescription drug discounts worth $13.7 million, an average
discount of $680 per person in 2011, $720 in 2012, and $700
thus far in 2013.
110,000 seniors in the district are now eligible for
Medicare preventive services without paying any co-pays,
coinsurance, or deductible.
213,000 individuals in the district--including 45,000
children and 86,000 women--now have health insurance that
covers preventive services without any co-pays, coinsurance,
or deductible.
135,000 individuals in the district are saving money due to
ACA provisions that prevent insurance companies from spending
more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 33,800 consumers
in the district received approximately $4.4 million in
insurance company rebates in 2012 and 2011--an average rebate
of $157 per family in 2012 and $99 per family in 2011.
Up to 40,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
255,000 individuals in the district now have insurance that
cannot place lifetime limits on their coverage and will not
face annual limits on coverage starting in 2014.
Up to 91,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition. In addition, the 35,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more secure, higher quality coverage and many will be
eligible for financial assistance.

I yield 2 minutes to the gentleman from North Carolina (Mr.
Butterfield).
Mr. BUTTERFIELD. Let me thank you, Mr. McDermott, for yielding time,
and thank you for you leadership on this issue. I've watched you for
years doing your work, and you are consistent. I thank you so very
much.
Mr. Speaker, I am opposed to this bill. You know, I've kind of lost
track. I think it's 38 times that the Republican-controlled House has
voted to repeal the Affordable Care Act, either in whole or in part.
Why are my colleagues wasting valuable time legislating on what
amounts to nothing more than a talking point and something they know
has no chance, no chance of becoming law?
Why is discrediting this President at the top of their agenda?
Let me remind my colleagues that there is real work to be done here
on this floor on behalf of the American people. Maybe my friends
somehow forget student loan interest rates doubled on July 1. Maybe
they forget that they rammed through a farm bill that, for the first
time since 1973, was without a nutrition title, leaving the door open
for food banks to be closed and for millions of needy Americans to go
hungry.
But, no, they didn't forget. I suggest that many of them just do not
care.
Today, for the 38th time, Mr. Speaker, we vote on a bill that would
delay better health care, delay fixing the problem of uncompensated
care from emergency room visits, and delay access to good, affordable
health care for millions of good Americans.
Therefore, I come to the floor today to urge my colleagues to oppose
H.R. 2668. I ask you to vote ``no'' on this ill-conceived legislation.
Mr. PRICE of Georgia. Mr. Speaker, I would remind my friend that it's
the President who has delayed the employer mandate in this arena. All
we're looking for is fairness and equality for the American people.
I'm pleased to yield 1 minute to the gentleman from Minnesota (Mr.
Paulsen), a member of the Ways and Means Committee.
Mr. PAULSEN. Mr. Speaker, from the beginning, it was clear to many
Americans that ObamaCare was far too burdensome, far too complex, and
far too bureaucratic to be successfully implemented. And now it appears
the Obama administration agrees.
Just a few weeks ago, the administration announces on a blog post a
1-year delay of the employer mandate, admitting that it is unworkable.
Now, I've advised hundreds of businesses in Minnesota and have heard
loud and clear the concerns that Obama's mandates and rules mean
increased costs, higher taxes, fewer hours for workers, lost jobs and
layoffs. But it's not fair that the administration is choosing to let
the individual mandate take effect, letting millions of average
Americans be hit with a mandate and new financial penalties.
Why is the administration only concerned about protecting business,
but not hardworking American taxpayers?
Today we have an opportunity to also delay the individual mandate in
order to protect all Americans. This is an issue of fairness. Average
Americans are struggling under this law and they need relief. They need
protection, and they need real health care reform.
Mr. McDERMOTT. Mr. Speaker, I submit for the Record the report on the
Third Congressional District of Minnesota and the people who will
benefit from this act.

Benefits of the Health Care Reform Law in the 3rd Congressional
District of Minnesota

Committees on Energy and Commerce, Ways and Means, and Education and
the Workforce, Democratic Staff Report, July 2013

[[Page H4560]]

150,000 individuals in the district are saving money due to
ACA provisions that prevent insurance companies from spending
more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 16,600 consumers
in the district received approximately $1.4 million in
insurance company rebates in 2012 and 2011--an average rebate
of $303 per family in 2012 and $160 per family in 2011.
Up to 40,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
282,000 individuals in the district now have insurance that
cannot place lifetime limits on their coverage and will not
face annual limits on coverage starting in 2014.
53,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition. In addition, the 42,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more secure, higher quality coverage and many will be
eligible for financial assistance.

I now yield 3 minutes to the gentleman from Michigan (Mr. Dingell).
He's been here for a number of years, always fighting for health care,
and he is living proof that the price of liberty is eternal vigilance.
He's here today fighting for health care, just like he did the first
day he got here.
(Mr. DINGELL asked and was given permission to revise and extend his
remarks.)
Mr. DINGELL. Mr. Speaker, I thank my good friend for the time; and I
rise in strong opposition to the seriously misnamed H.R. 2668, Fairness
for American Families Act. It's a lot of baloney. This is nothing more
than a sorry political stunt that would undermine the critical portions
of the Affordable Care Act, which is already bringing enormous benefits
to the American people.
Delaying the individual mandate by 1 year will simply undercut ACA
when it is the time that we must be focusing on fully implementing the
law. Just today, we found that the health insurance premiums in New
York are going to fall by an average of 50 percent when the exchanges
are up and running. Other States can do the same thing, and that is the
experience which we're finding across the country. This is happening
elsewhere.

{time} 1645

I would point out that repealing the individual mandate is going to
cost Americans additional health care costs, not decrease them.
Let us move forward with the implementation. I ask my Republicans
colleagues to cooperate with us in that goal. I ask them to work with
us to better the welfare of the American people by seeing to it that
this comes into law. The Congress has spoken and the American people
approve. I say that it is time for us to provide real benefits to the
American people rather than continue playing these sorry and tired
political games.
I say shame on those of us who are wasting the time of this body. Let
us address the problems of the economy. Let us deal with jobs,
employment. Let us deal with student loans, where the interest rate is
doubling. Let us see to it that we implement this law which will do
away with things that are so hurtful to the American people, such as
having Americans unable to get insurance because they have a
preexisting condition or where insurance companies can cancel a policy
because people are getting sick. It is time for us to deal with the
real problems.
Einstein observed that insanity is doing the same thing over and over
again with the full expectation that the results are going to be
different, but getting the same result. I say this country needs better
leadership, better understanding, and a Congress that will work on
behalf of the American people. As I look around, I do not see that on
this floor today.
Again, I say shame. This is a terrible, terrible waste of the
people's money and the people's time. It costs a lot for us to make
this Congress meet and to conduct its business, and we are wasting that
time now with this kind of nonsensical legislation.
Mr. DINGELL. Mr. Speaker, I rise in strong opposition to both H.R.
2667, the Authority for Mandate Delay Act, and H.R. 2668, the Fairness
for American Families Act. Here we are once again taking another cheap
shot at the Affordable Care Act (ACA), rather than working to continue
providing its benefits to the American people. Both pieces of
legislation are political stunts which will not help Americans get
access to quality, affordable health care
There is no need for passage of H.R. 2667 since the President has
already acted to delay by one year the employer responsibility
requirements under ACA. Given the fact that this type of change has
long been sought by my friends on the other side of the aisle and their
allies, you would think they would be praising the President for taking
this action. Instead, they have done nothing but used this as another
opportunity to score cheap political points, which is very telling.
Although I wish the employer responsibility provision would be
implemented on time, the fact of the matter is that this delay will
have very little practical impact. Over ninety six percent of large
employers already offer health coverage to their employees. It is
important that we take our time in getting these new reporting
requirements right, which is exactly what the President is doing. Since
the President has already acted in this manner, H.R. 2667 is
duplicative and unnecessary.
H.R. 2668 also should be rejected by this body. The individual
mandate is the cornerstone of the ACA, and the Supreme Court has
affirmed its constitutionality. Simply put, delaying the implementation
of the individual mandate is just a back door attempt to undermine the
entire law. The Affordable Care Act has already brought many benefits
to the American people. Thanks to the law, 206,000 people in my
district have access to preventative services without a co-pay, and
8,500 young adults have health insurance through their parents' plan.
Adopting this bill today would jeopardize this progress we have made in
recent years.
Today we received news that health insurance premiums will fall by an
average of 50 percent in New York once their exchanges are up and
running in 2014. The individual mandate is a key reason for this. For
years, New York had a prohibition on discriminating against individuals
with a pre-existing condition. However, the State did not require all
individuals to purchase insurance, which caused rates to skyrocket. The
individual mandate, combined with the new health insurance
marketplaces, are in large part responsible for this precipitous
decline in insurance rates in New York. We should ensure that these
results are replicated in my home State of Michigan and across the rest
of the country. Repealing the individual mandate will increase
Americans' health care costs, not decrease them.
I hope we can come together and work in a bipartisan manner to
improve our health care system and provide real benefits to the
American people. Until that day comes, I urge my colleagues to join me
in voting against these two pieces of legislation, as they are nothing
more than political stunts which do nothing to address the problems we
face as a Nation.
Mr. PRICE of Georgia. I am pleased to yield 1 minute to a fellow
physician colleague in the United States House, the gentleman from
Tennessee (Mr. Roe).
Mr. ROE of Tennessee. I thank the gentleman for yielding.
I rise in strong support of the Fairness for American Families Act.
As chairman of the Health, Employment, Labor, and Pension Subcommittee,
I've held three hearings outside the Beltway--one in North Carolina--
where we talked to businesses and individuals about the effect of the
Affordable Care Act on them and their businesses.
Let me just tell you about some people that I heard from. One was a
divorced server in a restaurant that had her hours cut from 40 to 29 so
that the company could stay in business. This woman now is missing an
entire week's worth of hours every single month. She can't pay her
bills unless she gets another job. The same problem for adjunct
professors at the local community college.
And now, the audacity of what we've done is we've forced businesses
to cut these hours, where they make less money, and then penalize you
when you don't buy something. That's wrong. The right thing to do is to
delay this for both individuals and businesses so they can work out the
problems. That was the President's suggestion. I strongly support this
bill.
Mr. McDERMOTT. Mr. Speaker, according to a report on the First
Congressional District of Tennessee, 5,800 young adults have insurance
on their parents' plan, 13,000 seniors receive prescription drug
benefit reductions, and 168,000 seniors are now eligible for preventive
care that's free. And on and on it goes.

Benefits of the Health Care Reform Law in the 1st Congressional
District of Tennessee

committees on energy and commerce, ways and means, and education and
the workforce, democratic staff report, july 2013

The landmark Affordable Care Act (ACA) began delivering
important new benefits and

[[Page H4561]]

protections to tens of millions of American families almost
immediately after it was signed into law by President Obama.
But the largest benefits of the law will become available to
consumers on October 1, 2013, when health insurance
marketplaces open in all 50 states. These marketplaces will
offer individuals, families, and small businesses an
efficient, transparent one-stop shop to compare health
insurance policies, receive financial assistance, and sign up
for high-quality, affordable, and secure insurance coverage.
This fact sheet summarizes new data on the significant
benefits of the health care reform law in Rep. Roe's
district. It also provides the first picture of the impacts
of the law in districts redrawn or newly created following
the 2010 Census. As a result of the law:
5,800 young adults in the district now have health
insurance through their parents' plan.
More than 13,100 seniors in the district received
prescription drug discounts worth $16.9 million, an average
discount of $580 per person in 2011, $630 in 2012, and $680
thus far in 2013.
168,000 seniors in the district are now eligible for
Medicare preventive services without paying any co-pays,
coinsurance, or deductible.
177,000 individuals in the district--including 34,000
children and 75,000 women--now have health insurance that
covers preventive services without any co-pays, coinsurance,
or deductible.
168,000 individuals in the district are saving money due to
ACA provisions that prevent insurance companies from spending
more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 26,000 consumers
in the district received approximately $3.7 million in
insurance company rebates in 2012 and 2011--an average rebate
of $69 per family in 2012 and $201 per family in 2011.
Up to 36,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
190,000 individuals in the district now have insurance that
cannot place lifetime limits on their coverage and will not
face annual limits on coverage starting in 2014.
Up to 103,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition. In addition, the 28,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more secure, higher quality coverage and many will be
eligible for financial assistance.

I yield 1 minute to the leader of the Democratic Party, the
gentlewoman from California (Ms. Pelosi).
Ms. PELOSI. I thank the gentleman for yielding. I thank him also for
his leadership on this health care issue. I've watched him lead this
debate for nearly three decades, and I'm so pleased that you are here
to defend the Affordable Care Act on the floor today, as our Republican
colleagues try for the 38th time to repeal it. It is nothing more than
a waste of time. This matter has been settled in Congress, at the
Supreme Court, and at the ballot box. It is the law of the land.
Mr. Speaker, this bill that is on the floor today is something that
the President has very clearly said he will veto. Yet Republicans still
want to vote for the 38th time to repeal the Affordable Care Act while
we're still waiting for the first time to vote for a jobs bill.
The American people expect and deserve this Congress to work together
to grow the economy, creating jobs, and strengthening the middle class,
the backbone of our democracy. It's been over 6 months since this
Congress took office. It's been over 3 months since the Senate passed a
budget bill. For all of that time, Democrats have proposed a budget
that would reduce taxes on the middle class, strengthen the middle
class, reduce the deficit, create jobs, and grow the economy. And for 6
months the Republicans have said ``no.'' Instead, for 38 times they
have wanted to waste the public's dollar repealing, once again, the
Affordable Care Act.
What does a vote for this bill mean? A vote for this bill means
that--just on the provisions already in place--you are voting so that
children with a preexisting medical condition can now face
discrimination. Because you will eliminate the end of that
discrimination. Right now, children no longer face discrimination on
the basis of a preexisting condition. A vote for the bill eliminates
that.
Right now, young adults are gaining coverage through their parents'
plans. A vote for this bill strikes that down. Right now, seniors are
paying less for prescription drugs and getting better treatment at a
lower cost. A vote for this bill strikes that down. Americans no longer
face lifetime limits on care. A vote for this bill eliminates that.
Families are receiving rebates from insurance companies because of the
medical loss ratio. It's very important in this bill. Insurance
companies were overly profiting at the expense of policyholders. This
is a vote for the insurance companies and against policyholders. Soon,
being a woman will no longer be considered a preexisting medical
condition. The Republicans don't like that.
And when I say don't like, what will also be coming up in the bill is
it will take away access to affordable coverage for 129 million people
with a preexisting medical condition. Just think of it. Do any of you
know anyone with heart disease, cancer, diabetes, or a child born
prematurely? That's a preexisting condition forever--one that also has
lifetime limits on it, if you have your way.
It takes away the guarantee that women pay the same premiums as men
for the same coverage. Women have so much to gain in this bill because
for so long we have been discriminated against on the basis of being a
woman. You want to take that away from us again. It takes away the new
cap on America's out-of-pocket health care costs. The list goes on and
on about what is the law now that will be taken away and what will
become the law in fewer than 6 months that was very helpful for
America's families.
The gentleman told us a story about a small businessman. We always
say the plural of anecdote is not data, but we all have our stories to
tell. They are illustrative. Ninety-six percent of America's businesses
are not affected by this law.
Mr. Speaker, last year, in San Francisco, I met with Julie and Matt,
parents of a little 2-year-old girl, Violet. Violet was born with a
rare and life-threatening form of epilepsy. For Violet and her family,
the Affordable Care Act was life-changing. Before the act, Violet had a
preexisting condition. So she would be discriminated against in terms
of health insurance. Violet had lifetime and annual limits on the
coverage that she could get. A little child with such an early
preexisting condition could possibly exhaust her lifetime limits before
she was in third grade.
Imagine being in their shoes. Imagine Julie and Matt watching this
debate, following the work of Congress, and what it means to them. What
it means to them is the health of their child, the financial security
of their family, and hope for the future. Imagine the fear, the
uncertainty, the frustration they feel when they hear this debate.
Imagine what it would be like to witness it 38 times and the threat
that it is to your family's security.
So there are Violet and other children like her. We hear stories over
and over again. Whatever we're doing, I always like to envision what it
means to children and what it does for our children. This means a great
deal to our children and to their families. It honors the vows of our
Founders of life, liberty, and the pursuit of happiness. A healthy
life, the liberty to pursue your happiness, to be whatever you want--an
artist, be self-employed to start a business, to change jobs. To be
able to follow your passion, not policy. And not to be confined because
there's a preexisting condition in your family or to be confined
because of fear of someone getting ill.
Really, what is important today is what it does or how it damages the
health security of America's families. But it's also the missed
opportunity. When, if ever, do the Republicans intend to bring a bill
to the floor that will create jobs for our country? When are we going
to have a budget that does just that?
You said you wanted the Senate to pass a bill and then we would go to
conference. That's called regular order. The Senate passed a bill 3
months ago. And still, the Republicans resist. What are you afraid of?
Are you afraid that the public will see the contrast between a
Democratic budget, which invests in people, which builds the
infrastructure of America, which has provisions to bring jobs home to
America, and that strengthens the middle class instead of the
exploitation of the middle class that is contained in the Republican
budget?
So all this is a smokescreen. It's just make-work projects. It's just
subterfuge. Let's do anything other than what the American people
expect us to do here. They expect us to work together. They expect us
to compromise.

[[Page H4562]]

They expect us to find solutions. They expect us to get results for
them. They expect us to act the way we used to here and be respectful
of each other's views, instead of having a Republican anti-government,
ideological agenda which says nothing--nothing--is our success, to do
nothing is to succeed, and never is our timetable.
So let's not waste the public's time, and the taxpayers' dollar on
initiatives that are going no place. They're political stunts and an
excuse for a legislative agenda that is not worthy of this House of
Representatives, that is not deserving of the respect of the American
people, and the form of this legislation will not have my support.
Mr. PRICE of Georgia. * * * The fact of the matter is that this bill,
understanding that ObamaCare is a huge, destructive element in job
destruction-- Mr. BECERRA. Mr. Speaker, I ask that the gentleman's
words be taken down.
The SPEAKER pro tempore. The gentleman will suspend. The gentleman
will be seated.
The Clerk will report the words.

{time} 1700

Mr. PRICE of Georgia. Mr. Speaker, I ask unanimous consent to
withdraw my previous statement.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Georgia?
There was no objection.
Mr. PRICE of Georgia. Mr. Speaker, I'm pleased to yield 1 minute to
the gentleman from Virginia (Mr. Hurt).
Mr. HURT. Mr. Speaker, in response to the minority leader's
statement, I would suggest that this is in fact a jobs bill. This is a
bill about health care. It is about the quality of health care. It is
also about preserving jobs for this country.
I rise in support of the Fairness for Families Act, a House
initiative that would delay the enforcement of the individual insurance
mandate, a central element of the President's health care law. This
bill would provide hardworking individuals and families with the same
relief that the Obama administration recently gave to American
employers.
As I travel throughout our district, I consistently hear about the
law's devastating effect it has on our families, our workforce, and our
struggling economy. Whether it's the community college in Danville that
is cutting employee hours because it simply cannot afford to comply
with the law or the family in Charlottesville that is coping with
skyrocketing insurance premiums, there is no question that the people
of Virginia's Fifth District continue to be negatively impacted by this
law.
While the administration continues to praise this legislation, the
American people are left with nothing but broken promises.
At a time when too many across this country are out of work, it only
makes sense that we act to reduce the burden on individuals and
families by suspending this mandate while continuing our efforts to
repeal this flawed law and replace it with market-oriented policies
that will lower costs for all Americans.
Mr. McDERMOTT. Mr. Speaker, I would like to insert letters from
consumer groups opposing the bill--Easter Seals, American Diabetes
Association, American Heart Association, and others.
I also would like to enter into the Record the report on the Fifth
Congressional District of Virginia and those who will benefit from the
Affordable Care Act.

Benefits of the Health Care Reform Law in the 5th Congressional
District of Virginia

committees on energy and commerce, ways and means, and education and
the workforce, democratic staff Report, july 2013

The landmark Affordable Care Act (ACA) began delivering
important new benefits and protections to tens of millions of
American families almost immediately after it was signed into
law by President Obama. But the largest benefits of the law
will become available to consumers on October 1, 2013, when
health insurance marketplaces open in all 50 states. These
marketplaces will offer individuals, families, and small
businesses an efficient, transparent one-stop shop to compare
health insurance policies, receive financial assistance, and
sign up for high-quality, affordable, and secure insurance
coverage.
This fact sheet summarizes new data on the significant
benefits of the health care reform law in Rep. Hurt's
district. It also provides the first picture of the impacts
of the law in districts redrawn or newly created following
the 2010 Census. As a result of the law:
5,900 young adults in the district now have health
insurance through their parents' plan.
More than 11,400 seniors in the district received
prescription drug discounts worth $15.6 million, an average
discount of $590 per person in 2011, $720 in 2012, and $800
thus far in 2013.
165,000 seniors in the district are now eligible for
Medicare preventive services without paying any co-pays,
coinsurance, or deductible.
201,000 individuals in the district--including 37,000
children and 87,000 women--now have health insurance that
covers preventive services without any co-pays, coinsurance,
or deductible.
188,000 individuals in the district are saving money due to
ACA provisions that prevent insurance companies from spending
more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 57,300 consumers
in the district received approximately $4.6 million in
insurance company rebates in 2011 and 2012--an average rebate
of $115 per family in 2011 and $88 per family in 2012.
Up to 37,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
235,000 individuals in the district now have insurance that
cannot place lifetime limits on their coverage and will not
face annual limits on coverage starting in 2014.
Up to 91,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition. In addition, the 51,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more secure, higher quality coverage and many will be
eligible for financial assistance.
____

July 16, 2013.
Hon. John Boehner,
Speaker of the House, U.S. House of Representatives,
Washington, DC.
Hon. Nancy Pelosi,
Minority Leader, U.S. House of Representatives, Washington,
DC.
Dear Speaker Boehner and Minority Leader Pelosi: Today,
millions of Americans face barriers to health insurance
coverage. Many go without insurance because it is simply
unaffordable. Others have life-threatening chronic diseases
such as cancer, diabetes, heart disease or stroke and are
denied insurance due to pre-existing conditions. Starting in
2014, the Affordable Care Act will remove these tough
barriers to health insurance.
New patient protections will require insurers to cover
people with pre-existing conditions, eliminate limits on the
coverage a patient can receive, and ban the practice of
charging women and people with health conditions more for
their coverage. In fewer than 80 days, the doors to new
insurance marketplaces will be open to enroll uninsured
people and the marketplaces, along with tax credit subsidies,
will help more Americans afford life-saving care
However, for these important protections to stay in place
without disrupting the health care market--and driving up
costs for everyone--the insurance market must include a mix
of both healthy and sick people. We already know what a
health care system without a minimum coverage requirement
looks like: many healthy Americans opt not to buy health
coverage until they are ill, and costs skyrocket as insurance
pools fill with people in urgent need of treatment and care.
People with pre-existing conditions are charged exorbitant
rates for health coverage, putting critical care out of reach
for many American families. As a result, many people with a
chronic illness must resort to emergency room care, which
lowers their chances of surviving their illness and drives up
costs system-wide.
We are therefore opposed to H.R. 2668, legislation that
would delay the minimum coverage provision that is
instrumental to the effectiveness of the patient protections.
By ensuring near universal coverage, the new patient
protections help end cherry-picking and cost shifting in the
current health care market, which drives up costs for
everyone. Last year the Supreme Court upheld the
constitutionality of the minimum coverage provision and our
organizations support its scheduled implementation.
We also believe that H.R. 2667 is unnecessary and detracts
from the more critical job we all must undertake to help more
Americans gain access to high quality, affordable, health
insurance.
The undersigned organizations believe that we all have a
duty to spread the word about the new health insurance
options that will allow people to compare prices and shop for
health insurance where they live. That is why our respective
organizations are opposed to votes that hamper the
implementation of the law or wrongly direct attention away
from the important job of informing people about new coverage
options.
We look forward to working with you to help you and your
constituents get information about the new options for
fairer, more comprehensive, and more affordable health care
coverage.
Sincerely,
American Diabetes Association.
American Heart Association.

[[Page H4563]]

Consumers Union.
Families USA.
National Partnership for Women & Families.
National Women's Law Center.
____

American Academy of

Family Physicians,

July 15, 2013.

Insurance Coverage Requirement is Foundation of Improving Access,
Quality and Cost Containment in Health Care

Statement attributable to: Jeff Cain, MD, President, American
Academy of Family Physicians.
The Affordable Care Act's requirement that individuals have
health insurance--either through their employer, a federal or
state health care program, or as an individual purchaser--is
the foundation of improving access to care and vital to
ensuring everyone has health care coverage. For that reason,
the American Academy of Family Physicians strongly supports
the health coverage requirement for individuals. We urge
Congress to preserve this element of health care reform.
The cost of providing care to uninsured patients is a major
driver of skyrocketing costs of health care. Health
professionals struggle with economic losses that result from
providing care to uninsured patients. Individuals whose usual
source of care is the emergency room have no access to
comprehensive, coordinated services that prevent unnecessary
often-uncompensated ER use and hospitalizations. Worse, the
professionals who see these patients for incident-specific
health issues and do not know the patient's medical history
must repeat expensive tests and procedures. The cost of these
fragmented and costly interventions are passed on through
rate increases to the insured, which in turn drives up the
cost for employers, governments, and individuals.
One way to end this increasingly expensive cycle is to
require everyone to have health insurance. The AAFP has
consistently called for ensuring that everyone has access to
health insurance and care provided in a patient-centered
medical home. The Affordable Care Act does just that with its
requirement that individuals who don't get health benefits
through work buy coverage--with appropriate subsidies if
necessary--or receive health care through Medicaid.
If Congress hopes to improve the quality of health care and
rein in escalating costs, it must end the fragmented,
duplicative system that results from lack of health
insurance. Ensuring that all individuals have health care
coverage is not only good health care policy, but it is also
good economic policy. Without a coverage requirement, many
patients will continue to have no coverage, other patients
will see insurance premiums rise due to covering the cost of
uninsured patients, businesses will continue to grapple with
rising health care costs, and health professionals, will have
to absorb significant financial losses due to providing
uncompensated care.
____

National Women's Law Center Critical of House Bills Aimed at Hampering
Health Care Law

Washington, DC.--The House of Representatives is slated to
vote today on H.R. 2667 and H.R. 2688, two bills aimed at
undermining the Affordable Care Act (ACA).
The following statement is from Marcia D. Greenberger, Co-
President of the National Women's Law Center:
``Thanks to the ACA, millions more American women will have
access to affordable health insurance options when enrollment
in health insurance marketplaces begins in October. But
rather than help the American people learn about new coverage
options and their benefits, the House leadership is working
relentlessly to hamper, if not totally prevent implementation
of the law. Their efforts could cost uninsured and
underinsured women and their families dearly, taking away the
critically important health and financial security promised
by the ACA's landmark reforms.
``We urge the House of Representatives to put aside any
attempts to roll back the ACA and get on with the urgently-
needed work of ensuring its success.''
____

National Committee to Preserve

Social Security & Medicare,

Washington, DC, July 16, 2013.
House of Representatives,
Washington, DC.
Dear Representative: On behalf of the millions of members
and supporters of the National Committee to Preserve Social
Security and Medicare, I urge you to vote against H.R. 2668
and any legislation that would delay the individual
responsibility provision to obtain health insurance. The
individual requirement is a critical component of the
Affordable Care Act (ACA). Without it, the intent of the
law--to offer affordable coverage to the uninsured--would be
undermined.
This differs from the Administration's decision to delay
for one year the requirement for large employers to offer
employee health insurance or pay a penalty, made to
accommodate the business community's request for additional
time to prepare for the new system. Currently, the majority
of employers already provide health insurance to recruit and
retain employees, and the employer delay will not change
this. For large employers that do not offer health coverage
or plan to delay providing coverage, such as some retail and
restaurant chains, their employees will be able to purchase a
health plan in one of the subsidized marketplaces. Because
federal subsidies will be available to those with low-to-
moderate incomes to purchase insurance through the exchanges,
some employees may end up with less expensive and more robust
health plans from the exchanges than they would have received
from their employers.
In contrast, delaying the individual requirement to
purchase health insurance will undercut the ability of the
ACA marketplace exchanges to offer affordable health
coverage. Requiring individuals to purchase health insurance
is necessary because it spreads health risks across the
entire population, thus healthier and/or younger individuals
would help keep overall expenditures lower. Younger enrollees
benefit from risk sharing between generations as they age and
require more health care.
According to a recent Kaiser Family Foundation poll, more
than seven in ten young adults stated that it is very
important for them to have health insurance. However, the
high cost of insurance was the biggest barrier for purchasing
insurance. The same poll found that about half of those under
age 65 believe that they or household members have a pre-
existing condition, and a quarter of them were denied health
insurance or paid higher premiums because of it. In order to
reverse these wrongs, the individual insurance requirement is
needed to create a health system that will put affordable
coverage in reach of young and old alike.
We support the Affordable Care Act, and urge you to vote
against H.R. 2668 and any legislation that would delay the
individual responsibility requirement. Millions of American
are counting on it and need affordable health coverage as
soon possible.
Sincerely,
Max Richtman
President and CEO.
____

Service Employees

International Union,

Washington, DC, July 16, 2013.
Dear Representative: On behalf of the more than 2.1 million
members of the Service Employees International Union (SEIU),
including more than 1 million nurses, doctors, lab
technicians, nursing home workers, home care workers and
others, I urge you to oppose the Authority for Mandate Delay
Act (H.R. 2667) and the Fairness for American Families Act
(H.R. 2668). Rather than a productive, bipartisan effort to
ensure successful implementation of the Affordable Care Act,
these bills are yet another misguided political effort to
undermine the law and chip away at the protections the law
provides.
The Affordable Care Act makes healthcare more available and
affordable for millions of Americans. Right now, there are
more than 100 million Americans--of all ages, occupations,
incomes and political parties--who are benefiting from the
Affordable Care Act. Because of this law, insurance companies
are prohibited from rescinding insurance coverage based on a
pre-existing condition, seniors can afford lifesaving
prescriptions, young people can stay on their parents' plans
until age 26, and progress is being made around the country
to give Americans new options to purchase affordable health
coverage.
Sadly, rather than engaging in bipartisan efforts to ensure
successful implementation, some seek to score political
points to undermine support for the law. These bills--like
the dozens of others--serve nothing more than to distract
from the core work SEIU is committed to: making sure people
know about the new options available to them for more
accessible, affordable coverage where they live.
Despite the delay tactics and millions of dollars spent to
derail the Affordable Care Act, the law is moving forward and
new healthcare markets will be ready to offer high-quality,
lower-cost healthcare coverage to middle-class Americans as
of January 1, 2014. SEIU will continue to work together with
organizations from all walks of life--including labor, small
businesses and responsible employers, healthcare providers
and advocates, faith leaders and elected officials--to make
sure Americans are informed when it comes to their healthcare
choices under the law.
H.R. 2667 and H.R. 2668 are part of a concerted strategy to
refight political battles of the past, rather than bipartisan
efforts to continue moving this law forward. We urge you to
oppose these misguided bills. Votes on these bills may be
added to SEIU's Congressional scorecard at www.seiu.org. If
you have any questions, please contact Steph Sterling,
Legislative Director.
Sincerely,
Mary Kay Henry,
International President.
____

American Public Health Association,
Washington, DC, July 16, 2013.
House of Representatives,
Washington, DC.
Dear Representative: On behalf of the American Public
Health Association, a diverse community of public health
professionals who have championed the health of all people
and communities around the world for more than 140 years, I
write in opposition to the Fairness for American Families
Act,

[[Page H4564]]

legislation to delay the individual mandate under the
Affordable Care Act (H.R. 2668).
Implementation of the ACA is critical to addressing the
biggest challenges facing our health system including the
escalating costs associated with our health care system,
uneven quality and deaths due to medical errors,
discriminatory practices by health insurance providers and
the shrinking ranks of the nation's primary care providers.
The ACA is helping to shift our health system from one that
focuses on treating the sick to one that focuses on keeping
people healthy. The individual mandate is central to reducing
the number of uninsured Americans, controlling health care
costs and ensuring the availability of affordable health
insurance coverage. Delaying this key provision will only
undermine our progress in creating a healthier nation.
The ACA will provide an additional 30 million uninsured
individuals with affordable and comprehensive health
insurance coverage. Since its enactment, the law has provided
71 million Americans with access to preventive health care
services such as vaccines, disease screenings, well-child
visits and tobacco cessation counseling without co-pays or
deductibles. More than 34 million seniors have also accessed
preventive services without cost through the Medicare
program. More than 3 million young adults up to age 26 are
able to stay on their parents' health insurance plans and
nearly 18 million children with pre-existing conditions are
protected from insurance coverage denials. In addition, the
ACA provides critical mandatory funding through the
Prevention and Public Health Fund for community-based
prevention and wellness activities including efforts to
control the obesity epidemic, reduce tobacco use and
modernize vaccination systems.
Protecting the ACA and working to effectively implement
this critical law will remain a top priority for APHA and we
will consider including this vote in our 2013 annual
congressional vote record.
We ask you to oppose this and future efforts to delay or
repeal the full implementation of the ACA and we look forward
to working with you to protect and improve the health of the
American people.
Sincerely,

Georges C. Benjamin,

MD, FACP, FACEP (E),
Executive Director.
____

Easter Seals,

Office of Public Affairs,

Washington, DC, July 16, 2013.
Dear Member of Congress: Easter Seals is asking you to
oppose the Authority for Mandate Delay Act (H.R. 2667),
legislation to codify the recent administration-issued delay
in the implementation of the employer mandate included in the
Affordable Care Act, and the Fairness for American Families
Act (H.R. 2668), legislation to delay the implementation date
of the individual mandate, also part of the Affordable Care
Act. The structure of this law allows access to appropriate
and high quality health care services which are essential for
people with disabilities to live, learn and work and play in
their communities.
The goal of the health care reform law is to assure that
all people have access to quality, affordable health care
that meets their individual needs. It is through the types of
changes included in the Affordable Care Act that we can hope
to enable all Americans, including people with disabilities
and chronic conditions, to be healthy, functional, live as
independently as possible and participate in their
communities.
The circumstances facing people without insurance, or those
that are under-insured, have not changed since passage of
this law in March of 2010, even if some might say the
political landscape has become more complex. We strongly urge
you to reject steps to dismantle this tightly-crafted process
before it has had a chance to be put into place. The law, if
given the time and tools to be successful, can make great
strides to provide affordable, quality health care to those
who have difficulty attaining or retaining insurance
coverage.
Easter Seals looks forward to working with you as the
effort to ensure quality health care is available to more
Americans moves forward.
Sincerely,
Katherine Beh Neas,
Vice President, Government Relations.

Mr. McDERMOTT. I now yield 5 minutes to the minority whip, the
gentleman from Maryland (Mr. Hoyer).
Mr. HOYER. I thank the gentleman for yielding.
Mr. Speaker, I rise to speak the truth. This bill and the other bill
are not real; they are purely partisan politics. They have nothing to
do with reality. My friends and Mr. Speaker, the American people ought
to know that is the truth.
These bills take time, with no effect. And everybody in this House--
the majority leader and 434 of the rest of us--know these bills are
going nowhere. They are, in fact, the 38th and 39th effort to repeal
the Affordable Care Act, an attempt which has been made some 37 times
already with no substantive alternative to assure quality, affordable
health care for all Americans. My friends, that is the truth.
This is a game. This is political messaging, nothing more, nothing
less. It is a ``gotcha'' game.
The President has already taken action to make sure that businesses--
some 4 percent of the businesses in America, by the way, are affected
by what the President did and your purported bill--to make sure that
they can do the paperwork properly. The administration took the right
action.
Your first bill is not necessary and you know it. It is a setup so
that your second bill, which takes away the individual mandate--which
America ought to know, Mr. Speaker, would undermine the very benefits
that are today being enjoyed by seniors, by young people, by children
with preexisting conditions, and by so many millions of Americans
enjoying the benefits today. But without the individual mandate, as the
Heritage Foundation pointed out so many years ago--a position they have
now changed, of course--was absolutely essential to make sure that we
could bring costs down. The New York Times of course, today,
ironically, said on its front page that there is a possibility that
premiums are going to be reduced 50 percent.
So, Mr. Speaker, I would tell my friends in the press, in the media,
don't take any of these votes for real. They're ``gotcha'' votes so
that maybe some people will vote ``yes'' to confirm the President's
opinion and then say, But we don't want to undermine the Affordable
Care Act--as all of you who have voted so often have expressed your
willingness and intent to do. But then they will vote ``no'' on the
individual mandate, and you will say, of course, My, my, my; they were
for businesses but against all you individuals. That RNC ad I'm sure is
written already. That's what this is about, ``gotcha'' politics.
Isn't it a shame. Isn't it a shame, when millions of Americans have
no health care, when millions of Americans have no jobs, when people
are being furloughed in the defense sector, undermining the security of
our country--in Virginia and in Maryland--undermining our national
security, that we spend our time here on this floor with ``gotcha''
politics, with no expectation whatsoever that either of these bills
will ever become law.
This is simply messaging. This is simply saying for the people who
have been, for the last 4 years, trying to repeal the Affordable Care
Act. And so many people were absolutely positive that President Obama
was going to go down to defeat on the horns of the dilemma of the
Affordable Health Care Act. It didn't happen. The American people said,
No, we don't buy that argument. We believe providing Americans with
health care is an important objective. We believe in making sure that
kids and individuals with preexisting conditions can get health care,
making sure that seniors won't be driven into poverty by paying for
expensive drugs to keep them alive, making sure that people get
preventive health care and are not disincentivized in doing that by
additional costs.
The SPEAKER pro tempore. The time of the gentleman has expired.
Mr. McDERMOTT. I yield the gentleman an additional 30 seconds.
Mr. HOYER. I thank my friend.
Ladies and gentlemen, we really need to come together and talk about
how we reasonably move forward.
Speaker Boehner said, when the President was reelected, well, the
Affordable Care Act is here. But you continue, you continue this very
day, to pretend you're going to repeal the Affordable Care Act. That's
maybe what your constituents want. That's maybe good politics for you,
but it's lousy substance. That's the truth.
This is a ``gotcha'' vote. The press ought to disregard and
constituents ought to disregard anything other than this is a vote to
end the Affordable Care Act. Reject it. Reject it. Reject this politics
as usual.
Mr. Speaker, today's votes are a sad and unnecessary gimmick.
What Republicans are focusing on with these bills is not real--it's
part of a political game that comes at the cost of spending time on the
actual challenges we face, like creating jobs and replacing the
sequester.
I'm not surprised that Republicans continue to force votes to repeal
the Affordable Care Act, because that's been their position all along.
Today's votes are more of the same--efforts to undermine a law that
has

[[Page H4565]]

been enacted by Congress, upheld by the Supreme Court and reaffirmed
with the reelection of President Obama.
The Administration has already announced they are delaying employer
penalties by one year, while they continue to work with America's
businesses to simplify reporting requirements.
They have already taken the needed steps to give the four percent of
employers impacted by this policy more time to adapt their health
coverage to new requirements--making today's legislation both redundant
and irrelevant.
With respect to the individual responsibility requirement--no delay
is needed.
Consumers will soon be able to use new insurance marketplaces to
purchase insurance products that cover pre-existing conditions, do not
impose arbitrary limits on your coverage, and do not charge women
higher premiums than men for the exact same policy.
Many will be eligible for tax credits to help them cover the cost of
insurance as well.
Today's legislation will only serve to increase both premiums and the
number of uninsured.
It's time Republicans stop playing games with America's health care
and focus the People's House on the issues the people care about:
replacing the sequester and creating jobs.
The SPEAKER pro tempore. The Chair would remind all Members to direct
their remarks to the Chair.
Mr. PRICE of Georgia. Mr. Speaker, I'm pleased to yield 1 minute to
the majority leader of the United States House of Representatives, the
gentleman from Virginia (Mr. Cantor).
Mr. CANTOR. I thank the gentleman from Georgia for his leadership.
Mr. Speaker, I rise today to support the Fairness for American
Families Act.
You know, Mr. Speaker, it's interesting here on the floor to hear the
leadership of the minority continue their cries of objection based on
claims of politics and process. Now we're talking about substance here.
Instead, what we hear are objections about our position, somehow
insinuating that we don't care about people's health care. Well, Mr.
Speaker, I would say it is exactly the opposite. We're talking about
substance and we're talking about ways that we can improve the
prospects for quality health care for Americans.
For several years, Republicans have been warning the American people
about the devastating impact ObamaCare will have on both jobs and
health care, and it now appears that Democrats--and even the President
himself--are beginning to agree. The decision by the administration
earlier this month to delay the employer mandate to 2015 is a clear
signal that even the administration doesn't believe the country is
ready to sustain the painful impact this law will have. Fortunately,
others, including some of the law's most ardent supporters, are
starting to realize the same.
Just this week, Democratic leaders of the House and Senate were sent
a letter from the presidents of three major unions warning that if
changes were not made to the Affordable Care Act, it would ``destroy
the foundation of the 40-hour workweek that is the backbone of the
American middle class.''
Now, Mr. Speaker, to me, that's real. That's not just games. That's
real.
Now, continuing, these union leaders claim that if the Affordable
Care Act was enacted without being modified, it would ``destroy the
very health and well-being of our members, along with millions of other
hardworking Americans.''
These consequences resulting from employees having their hours cut
and their health benefits jeopardized represent what these leaders
described as ``nightmare scenarios.''
Mr. Speaker, I'd submit again, that's real. That's not just games.
It is now explicitly clear to people across political lines that
promises were made and now broken, and ObamaCare is not working. Now,
this is the direction we need to take. This is the common ground. If we
have bipartisan agreement that things just aren't working under
ObamaCare, let's work to improve the situation for Americans.
Why is it that working Americans have to suffer the financial burdens
of an overreaching, government-run health care system while the same
consequences for big business are delayed a year? The White House won't
offer an answer to that because, I believe, they've run out of excuses.
They've run out of ideas, and now they're starting to backpedal.

{time} 1715

The Fairness for American Families Act will extend the delay of these
mandates to all Americans. No family's health, well-being, or
employment should suffer while businesses get a break. I sincerely hope
that my colleagues on the other side of the aisle would join us in this
effort to bring basic fairness to everyone.
I would like to thank Congressman Todd Young from Indiana for his
hard work on this issue, and I urge my colleagues in the House to
support this legislation.
Mr. McDERMOTT. Mr. Speaker, I yield myself 30 seconds to report on
the Seventh Congressional District of Virginia, where the promises have
been kept:
4,500 young adults have health insurance on their parents' plan;
10,000 seniors have received help with their drug costs;
112,000 seniors are now eligible for preventive care at no cost;
288,000 people in the Seventh District now have insurance that does
not have lifetime limits.
The promises have been kept in the Seventh District.

Benefits of the Health Care Reform Law in the 7th Congressional
District of Virginia

committees on energy and commerce, ways and means, and education and
the workforce, democratic staff report, july 2013

The landmark Affordable Care Act (ACA) began delivering
important new benefits and protections to tens of millions of
American families almost immediately after it was signed into
law by President Obama. But the largest benefits of the law
will become available to consumers on October 1, 2013, when
health insurance marketplaces open in all 50 states. These
marketplaces will offer individuals, families, and small
businesses an efficient, transparent one-stop shop to compare
health insurance policies, receive financial assistance, and
sign up for high-quality, affordable, and secure insurance
coverage.
This fact sheet summarizes new data on the significant
benefits of the health care reform law in Rep. Cantor's
district. It also provides the first picture of the impacts
of the law in districts redrawn or newly created following
the 2010 Census. As a result of the law:
4,500 young adults in the district now have health
insurance through their parents' plan.
More than 10,000 seniors in the district received
prescription drug discounts worth $13.6 million, an average
discount of $580 per person in 2011, $730 in 2012, and $800
thus far in 2013.
112,000 seniors in the district are now eligible for
Medicare preventive services without paying any co-pays,
coinsurance, or deductible.
236,000 individuals in the district--including 56,000
children and 95,000 women--now have health insurance that
covers preventive services without any co-pays, coinsurance,
or deductible.
222,000 individuals in the district are saving money due to
ACA provisions that prevent insurance companies from spending
more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 67,300 consumers
in the district received approximately $5.4 million in
insurance company rebates in 2011 and 2012--an average rebate
of $115 per family in 2011 and $88 per family in 2012.
Up to 43,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
288,000 individuals in the district now have insurance that
cannot place lifetime limits on their coverage and will not
face annual limits on coverage starting in 2014.
Up to 74,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition. In addition, the 42,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more secure, higher quality coverage and many will be
eligible for financial assistance.

Mr. Speaker, I now yield 3 minutes to the gentleman from California
(Mr. Becerra).
Mr. BECERRA. Mr. Speaker, ``The Least Productive Congress Ever,''
that's the title of an article in today's Washington Post. Here is how
the article begins:

Congress, in case you have been living on another planet
for the last few years, doesn't do all that much these days.

So we are, debating again--for the 38th time--a bill to repeal all or
part of our Nation's health security law. We've heard this broken
record 37 times before and it sounds the same and it goes nowhere.

[[Page H4566]]

But there is more consequence to this partisan agenda than just
wasting the American people's time and adding to the record of the
least productive Congress ever. Wasting the American people's time 38
times wastes the American taxpayers' money. According to CBS News
reports, this obsession to vote over and over and over 38 times on
these partisan bills has cost the American taxpayers more than $50
million. That's an expensive ticket for political theater.
So what are the facts on this legislation? The Congressional Budget
Office, our country's fiscal watchdog, says this about H.R. 2668:
``Health insurance premiums''--under this legislation--``for
individually purchased coverage would be higher under H.R. 2668. In
addition, the number of people with health insurance coverage would be
reduced.''
Translated, the cost for health insurance and health care for
Americans will go up and the number of Americans with insurance
coverage will go down under this legislation.
Here is today's New York Times--and it says it all on the front page:
``Many New Yorkers Will See Big Savings on Health Plans Under the
Current Law.'' How does it start? The article says:

Individuals buying health insurance on their own will see
their premiums tumble next year in New York State as changes
under the Federal health care law take effect.

The facts: health care insurance costs are going down. But this bill
will repeal all or part of the health care security law.
This Congress is the least productive Congress ever, because instead
of voting on a jobs agenda and growing our economy, this House is
voting for the 38th time to do nothing. This House is out of touch with
the American people. It is time this House caught up with the American
people and work in bipartisanship to get Americans back to work and
provide them more health security, not less.
Mr. PRICE of Georgia. Mr. Speaker, I would now like to insert into
the Record a letter of today from the National Federation of
Independent Business.
NFIB,

The Voice of Small Business,

Washington, DC, July 17, 2013.
Dear Representative: On behalf of the National Federation
of Independent Business (NFIB), the nation's leading small
business advocacy organization, I am writing in strong
support of H.R. 2668, the Fairness for American Families Act
A vote in favor of H.R. 2668 will be considered an NFIB Key
Vote for the 113th Congress
H.R. 2668 would delay the requirement that nearly all
Americans purchase minimum essential health insurance
coverage or pay a tax penalty until 2015. The delay of the
individual mandate is needed due to the administrative delay
of the employer mandate. The delay would alleviate confusion
for small business owners, self-employed individuals and
small-business employees. Delaying problematic provisions
provides temporary relief for individuals and small
businesses, while also validating the underlying problems
inherent in the law and its implementation. Perhaps most
importantly, delay provides Congress additional time to
correct problematic provisions in the law.
In NFIB v. Sabelius NFIB opposed the individual mandate
because we believe the Commerce Clause of the U.S.
Constitution does not give Congress the authority to require
Americans to purchase a product. Unfortunately, the Supreme
Court determined the mandate was proper as a ``tax'' under
Congress'' taxing power. Whether a ``mandate'' or a ``tax''
penalty, this provision requires small-business owners to
spend money--buy health insurance or pay a tax penalty. This
is money they could have used to grow their business and hire
more workers.
Without significant changes, this law will continue to
cause problems for the small-business economy. Small-business
owners support continued efforts to remedy the most harmful
provisions in the law that are already impacting their
businesses and their employees. Some fundamental reforms
include:
H.R. 2575, the Save American Workers Act, which would
change the definition of full-time employee from 30 hours per
week to 40 hours per week;
H.R. 903, the American Job Protection Act, which would
repeal the employer mandate that is already preventing
business expansion and job creation;
H.R. 763, the Jobs and Premium Protection Act, which would
repeal the small business health insurance tax (HIT) that
will increase premiums for the health insurance plans that
self-employed individuals and small businesses purchase.
NFIB is dedicated to working with lawmakers to find
solutions that work for small business and will consider a
vote in favor of H.R. 2668 an NFIB Key Vote for the 113th
Congress.
Sincerely,
Susan Eckerly,
Senior Vice President, Public Policy.

Mr. Speaker, I am pleased to yield 1\1/2\ minutes to the chairwoman
of the Republican Conference, the gentlelady from Washington State
(Mrs. McMorris Rodgers).
Mrs. McMORRIS RODGERS. Mr. Speaker, I rise in strong support of the
Fairness for American Families Act, to protect families and individuals
from a health care law that is unworkable and is making it harder and
worse on our health care system.
I support this bill delaying the individual mandate because it
protects everyday hardworking American families--like my family at home
and yours all across this country--from higher premiums, fewer choices
of doctors, and lower quality of health care.
We see time and time again this President at work picking winners and
losers and ignoring his constitutional duty to uphold the law--even his
signature law. Each time, individuals lose, families lose--America
loses.
The administration's decision to delay the employer mandate is no
different. How is it fair to delay an unworkable law for big businesses
but not for individuals and families--the very people that are going to
have to pay the price because of this unworkable health care law?
The fact is this law is making it worse; worse for health care, worse
for the economy, worse for America.
I urge my colleagues, Republicans and Democrats, support this bill,
do what is fair for the American people and their families.
Mr. McDERMOTT. Mr. Speaker, I yield myself 30 seconds so that I can
inform the body of the effect on the Fifth Congressional District of
the State of Washington:
7,000 adults, young adults, are on their parents' plan;
5,600 seniors have had benefits around their drug costs;
89,000 who have lacked health insurance now have it.
All of this is because of the Affordable Care Act.

Benefits of the Health Care Reform Law in the 5th Congressional
District of Washington

Committees on Energy and Commerce, Ways and Means, and Education and
the Workforce, Democratic Staff Report, July 2013

The landmark Affordable Care Act (ACA) began delivering
important new benefits and protections to tens of millions of
American families almost immediately after it was signed into
law by President Obama. But the largest benefits of the law
will become available to consumers on October 1, 2013, when
health insurance marketplaces open in all 50 states. These
marketplaces will offer individuals, families, and small
businesses an efficient, transparent one-stop shop to compare
health insurance policies, receive financial assistance, and
sign up for high-quality, affordable, and secure insurance
coverage.
This fact sheet summarizes new data on the significant
benefits of the health care reform law in Rep. McMorris
Rodgers's district. It also provides the first picture of the
impacts of the law in districts redrawn or newly created
following the 2010 Census. As a result of the law:
7,900 young adults in the district now have health
insurance through their parents' plan.
More than 5,600 seniors in the district received
prescription drug discounts worth $7.5 million, an average
discount of $620 per person in 2011, $660 in 2012, and $1,070
thus far in 2013.
113,000 seniors in the district are now eligible for
Medicare preventive services without paying any co-pays,
coinsurance, or deductible.
180,000 individuals in the district--including 36,000
children and 75,000 women--now have health insurance that
covers preventive services without any co-pays, coinsurance,
or deductible.
167,000 individuals in the district are saving money due to
ACA provisions that prevent insurance companies from spending
more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 700 consumers in
the district received approximately $100,000 in insurance
company rebates in 2012 and 2011--an average rebate of $512
per family in 2012 and $185 per family in 2011.
Up to 36,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
203,000 individuals in the district now have insurance that
cannot place lifetime limits on their coverage and will not
face annual limits on coverage starting in 2014.
89,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition. In addition, the 45,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more

[[Page H4567]]

secure, higher quality coverage and many will be eligible for
financial assistance.

Mr. Speaker, I now yield 2 minutes to the gentleman from Texas (Mr.
Gene Green).
Mr. GENE GREEN of Texas. Mr. Speaker and Members, I rise in strong
opposition to the further Republican attempts to undermine the
Affordable Care Act.
The administration recently announced that due to logistical issues
they were delaying the employer mandate for a year. I do not support
this measure, but it is within their authority to do it.
However, the decision of the Department of Treasury does not justify
delaying the implementation of other portions of the law. Implementing
this law is too important for America's well-being and their economic
security to delay it. Low-cost, high-quality health care is right
around the corner. If we delay the individual mandate, the risk pools
will be skewed so that the coverage is less affordable for those who
choose to purchase it.
Delaying the employer mandate will have a higher impact on States
like mine that are refusing to expand Medicaid. If an employee makes
between 100 percent and 133 percent of the Federal poverty level, they
will receive no Medicaid, no subsidies, and now employers won't have to
cover them for another year.
I am told that this is a small number, but in a district like ours,
which has the highest rate of working uninsured in the country, this is
a big problem. Up to 260,000 individuals in our district who lack
health insurance will have access to quality, affordable care without
fear of discrimination or higher rates because of a preexisting
condition.
Our country has waited too long for real health care reform--coverage
that our industrial competitors and partners provide. I oppose both
these bills.
Mr. PRICE of Georgia. Mr. Speaker, I would like to enter into the
Record a letter dated July 15, 2013, from Matt Kibbe, the president and
CEO of FreedomWorks in support of H.R. 2668.

FreedomWorks,

Washington, DC, July 15, 2013.

Key Vote YES on Delaying ObamaCare's Individual Mandate

As one of our millions of FreedomWorks members nationwide,
I urge you to contact your Representative and urge him or her
to vote YES on H.R. 2668, the Fairness for American Families
Act. Sponsored by Rep. Todd Young (R-IN), this bill--which
the House is expected to take up this week--would delay
ObamaCare's ``individual mandate.''
Beginning on January 1, 2014, ObamaCare will require most
U.S. citizens to purchase government-controlled health
insurance. This ``individual mandate'' is, by the
Administration's own admission, the ``linchpin'' of the
Washington takeover of health care. If the mandate were to go
away, the whole costly and intrusive scheme would unravel.
The individual mandate is a latter-day ``intolerable act.''
Despite the Supreme Court's erroneous 2012 ruling, Congress
lacks authority under the Constitution to impose such a
mandate on U.S. citizens. And even if it were constitutional,
the mandate is immoral because it violates individual
liberty, is not necessary to ``help the uninsured'' (there
are less coercive and less costly ways to do so), and is
terribly unfair, both in its effects and how it is being
implemented.
The unfairness of the mandate is this: its costly burden
falls most heavily on just one segment of the population:
young adults in their twenties and thirties. They are the
group most likely to be uninsured. Indeed, two-thirds of the
uninsured are in their twenties and thirties. ObamaCare
causes their insurance premiums to rise exponentially, in
some cases doubling or even tripling. These Americans are
uninsured because health insurance costs too much.
ObamaCare's mandate is unfair to them, because it forces them
to buy a product that is already too expensive, relative to
their needs.
But the law is also unfair to everyone, not just
millennials, in terms of how it is being implemented. The
Obama Administration recently made a unilateral (and illegal)
decision to cancel the ``employer mandate'' (which requires
employers with more than 50 employees to offer and heavily
subsidize health insurance to their workers). But it left the
individual mandate in place for the rest of us. The
Administration had already displayed rank unfairness by
granting more than 1,200 waivers from ObamaCare provisions to
its labor union allies and corporate cronies. It has now
given Big Business the ultimate waiver, a complete exemption
from the mandate, while making sure that Big Insurance gets
its own ``ultimate gift'' from Big Government: a compulsory
customer base. No wonder more than 70 percent of Americans
oppose the individual mandate, and just 12 percent support
it.
The only cure for the manifold ailments of ObamaCare is to
immediately defund or repeal it entirely, and to replace it
with patient-centered health care that will actually lower
costs and improve quality and access for all. Until then,
basic fairness demands that individuals be granted the same
favor as the Administration has given to businesses. The
individual mandate must be delayed for as long as possible.
H.R.2668 would delay the mandate for the same length of time
that the Administration claims to be ``delaying'' the
employer mandate: one year. That's a start.
I urge you to call your Representative and ask him or her
to vote YES on H.R. 2668, to delay ObamaCare's individual
mandate. We may count their vote as a KEY VOTE when
calculating the FreedomWorks Economic Freedom Scorecard for
2013. The Scorecard is used to determine eligibility for the
FreedomFighter Award, which recognizes members of Congress
with voting records that support economic freedom.
Sincerely,
Matt Kibbe,
President and CEO.

Mr. Speaker, I am pleased now to yield 2 minutes to the chairwoman of
the House Administration Committee, the gentlelady from the great State
of Michigan, Candice Miller.
Mrs. MILLER of Michigan. Mr. Speaker, it appears that the Obama
administration has finally come to the conclusion that the employer
mandate in ObamaCare is a job killer.
Many have speculated that the Obama administration's decision to
delay the employer mandate until after the 2014 election was due to
fears that job cuts and hour reductions that would result from the
mandate's implementation would negatively impact the President's party
at the polls.
It does seem that those fears are justified. Recently, the Teamsters
and other labor groups wrote to Senate Majority Leader Harry Reid and
House Democrat Leader Nancy Pelosi stating that the implementation of
ObamaCare put at risk the 40-hour workweek, the health care, and the
take-home pay of their members.
Mr. Speaker, I agree with the Teamsters that the employer mandate is
a job killer. Eliminating the employer mandate would not stop the
individual mandate which requires every American to purchase
government-approved insurance that they may not want, that they can't
afford, and may not be provided by their employers or otherwise they
have to pay a penalty. Is that fair to American families?
The legislation, Mr. Speaker, that we are considering today would
give every American--every American--the same 1-year reprieve from
ObamaCare that the President has offered to businesses. Because we
extend this help to all of the American people, the President has
threatened to veto this bill.
Mr. Speaker, the President is not a king. He is the President. He
does not have the authority to change the law and to delay the employer
mandate on his own. Congress must give him that authority.
I would say to the President that we will delay the job-killing
employer mandate, as he has asked, and we will also extend the same
relief to all of the American people.
The President and Members of Congress who vote against this bill will
have to explain to the American people why they heard the concerns of
business but not those of the people. We have heard the people, we
share their concerns, we stand with them, and I would urge all of my
colleagues to stand with them as well and to support this very vital
legislation.
The SPEAKER pro tempore. The Chair would remind all Members to direct
their remarks to the Chair and also to refrain from improper references
toward the President.
Mr. McDERMOTT. Mr. Speaker, I would like to enter into the Record a
report on the effects of the Affordable Care Act on the Tenth District
of Michigan.

Benefits of the Health Care Reform Law in the 10th Congressional
District of Michigan

Committees on Energy and Commerce, Ways and Means, and Education and
the Workforce, Democratic Staff Report, July 2013

[[Page H4568]]

assistance, and sign up for high-quality, affordable, and
secure insurance coverage.
This fact sheet summarizes new data on the significant
benefits of the health care reform law in Rep. Miller's
district. It also provides the first picture of the impacts
of the law in districts redrawn or newly created following
the 2010 Census. As a result of the law:
4,900 young adults in the district now have health
insurance through their parents' plan.
More than 8,900 seniors in the district received
prescription drug discounts worth $11.8 million, an average
discount of $610 per person in 2011, $780 in 2012, and $630
thus far in 2013.
130,000 seniors in the district are now eligible for
Medicare preventive services without paying any co-pays,
coinsurance, or deductible.
210,000 individuals in the district--including 47,000
children and 86,000 women--now have health insurance that
covers preventive services without any co-pays, coinsurance,
or deductible.
177,000 individuals in the district are saving money due to
ACA provisions that prevent insurance companies from spending
more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 17,100 consumers
in the district received approximately $2.5 million in
insurance company rebates in 2012 and 2011--an average rebate
of $138 per family in 2012 and $214 per family in 2011.
Up to 41,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
243,000 individuals in the district now have insurance that
cannot place lifetime limits on their overage and will not
face annual limits on coverage starting in 2014.
Up to 73,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition: In addition, the 39,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more secure, higher quality coverage and many will be
eligible for financial assistance.

Mr. McDERMOTT. Mr. Speaker, I now yield 2 minutes to the gentlewoman
from Illinois (Ms. Schakowsky).
Ms. SCHAKOWSKY. Mr. Speaker, there's a word in Yiddish, ``chutzpah,''
that generally translates to ``nerve.'' It has been described as that
quality enshrined in a man who, having killed his mother and father,
throws himself on the mercy of the court because he's an orphan.
But ``chutzpah'' is also a pretty accurate description of the antics
of the Republican Party today that--after throwing up roadblock after
roadblock, obstruction after obstruction to ObamaCare, is now trying to
delay access to care for millions of Americans on the grounds that
we're not ready.
Despite Republican obstructionism we are going to be ready, we are
ready--and not a day too soon--for those who have been locked out of
coverage, hit by annual benefit limits, or faced preexisting condition
exclusions. Imagine the worry that is lifted off of the shoulders of
Americans that have preexisting conditions that won't exist once we
pass this.
This is just another Republican attempted roadblock to progress,
another obstructionism. It is ``chutzpah.''
Mr. Speaker, it is time for the Republicans to stop efforts that will
prevent Americans from getting the health care they need.
Mr. PRICE of Georgia. Mr. Speaker, how much time remains on each
side?
The SPEAKER pro tempore. The gentleman from Georgia has 18\1/2\
minutes remaining. The gentleman from Washington has 9 minutes
remaining.
Mr. PRICE of Georgia. Mr. Speaker, I am pleased to yield 1 minute to
the chairman of the Judiciary Committee, the gentleman from Virginia
(Mr. Goodlatte).
Mr. GOODLATTE. Mr. Speaker, it is with great pleasure that I
acknowledge the great work of the gentleman from Georgia on this issue
and thank him.
Mr. Speaker, all across the country, Americans are asking one
question: Why wasn't the mandate on them delayed? If the systems aren't
in place for businesses to abide by this law by the deadline, why does
the administration think that the systems will be in place for the
individual mandate? If a delay is good for businesses, why isn't it
good for the families in the 6th District of Virginia and across the
Nation?
When Members refer to ObamaCare as a train wreck, they only quote one
of its chief architects. This announcement proves even the
administration knows ObamaCare is headed towards devastation. Let's get
businesses, as well as American families, off this train headed towards
disaster. We need to delay the employer mandate, we also need to delay
the individual mandate, but most importantly, the American people need
a full repeal of this train wreck legislation.
Mr. McDERMOTT. Mr. Speaker, I yield 3 minutes to the gentleman who
helped write this bill 4 years ago and is here today to defend it, the
gentleman from California (Mr. Miller).

{time} 1730

(Mr. GEORGE MILLER of California asked and was given permission to
revise and extend his remarks.)
Mr. GEORGE MILLER of California. Mr. Speaker, I rise in opposition to
this latest Republican attempt to sabotage our Nation's health reform
law.
If these bills pass today, fortunately, they will not become law. It
is just another waste of this body's time, and Americans are sick of
it. The 38th time will not be the charm--the 38th time that we've
redundantly voted to try to repeal the Affordable Care Act. Rather,
these votes underscore the lengths the Republicans and other opponents
will go to take away the basic health insurance protections of the
American people.
For 3 years, many of the opponents of ObamaCare have invested heavily
in its failure. They've tried to deny funding to agencies to do their
jobs as instructed by Congress. They've spread outright lies and
misinformation to purposely confuse the American people. They've
obstructed education efforts to make sure that their constituents don't
understand the new rights and benefits under the law. But investing in
failure is dangerous. It's dangerous for America's families; it's
dangerous for the Nation's businesses; it's dangerous for the Nation's
economy.
The Affordable Care Act is the law of the land, and it is here to
stay. Early evidence suggests that the health care law is already
having a positive impact on the lives of millions of Americans.
Millions of young adults are getting health insurance through their
parents' policies when, before, they were kicked off arbitrarily by
insurance companies; and now, with the individual mandate, millions of
individual Americans will be able to afford the health insurance that
they can't afford today without this legislation--without the law of
the land, the Affordable Care Act.
Children with preexisting conditions can no longer be denied health
coverage or lifesaving treatment.
Billions more of taxpayer dollars are being recovered through
Medicare fraud.
National health costs have dramatically slowed over the last several
years.
Health premiums as part of the State insurance exchanges are coming
in lower than anyone predicted--most recently reported in New York
State--for individuals, who will get their insurance because of the
individual mandate; and for the first time, it will be affordable to
those individuals since they've been required to have it.
And, in January, the preexisting conditions that determine health
coverage or costs will be banned. No longer will you be able to rule
people out because of their preexisting health conditions.
This is all good news, and it stands in stark contrast to the claims
that we've been hearing from the other side for 3 years.
Why on Earth would any responsible elected official try to hide the
rights and benefits from the American people?
My friends on the other side of the aisle are preoccupied with
dismantling government when it protects the vulnerable or the average
American, but they will move heaven and Earth to protect the most
powerful or to try to score some fleeting political point. It's wrong
and it's irresponsible.
Mr. Speaker, playing politics with the Affordable Care Act has become
something of an Olympic sport for the majority. These votes are nothing
new. They are about sabotaging the law of the land in order to satisfy
a narrow, radical element of the majority's party.
Now is not the time to reverse course. Now is not the time to go back
to the days when insurance companies were in charge--when people were
thrown off their policies, when policies were taken away in the middle
of treatment, when their children were not allowed to participate, and
when individuals could not afford the policies at that time. Today,
they will be able to.

[[Page H4569]]

Mr. PRICE of Georgia. Mr. Speaker, I insert in the Record a notice
from the National Taxpayers Union, dated July 15, 2013, in support of
both H.R. 2667 and H.R. 2668.

National Taxpayers Union,

Alexandria, VA, July 15, 2013.

National Taxpayers Union Vote Alert

NTU urges all Representatives to vote ``YES'' on H.R. 2667,
the ``Authority for Mandate Delay Act'' and H.R. 2668, the
``Fairness for American Families Act.'' These bills would
delay for one year the Affordable Care Act's health insurance
mandates for employers and individuals, respectively. While
the primary goal of Congress ought to be full repeal of the
Affordable Care Act (a.k.a. ``Obamacare''), in the meantime
it is imperative for legislators to recognize and address the
numerous problems associated with the law.
The Obama Administration acknowledged the detrimental
effects that the employer mandate will have on businesses,
workers, and the economy at large when it unilaterally
elected to delay this provision for one year. With the
legality of this move very much in question, the House of
Representatives is wisely moving to codify the change by
passing H.R. 2667. This would greatly assist--albeit only in
the short-term--the many businesses that are already cutting
employee hours or jobs as a result of the law.
At the same time that businesses are making difficult
staffing decisions, individuals are poised to be hit by
Obamacare's requirement to purchase health insurance. In
2014, the penalty for failing to do so is $285 per family or
1 percent of household income, whichever is greater. By 2016,
the penalty jumps to $2,085 per family or 2.5 percent of
household income, whichever is greater. As the Supreme Court
ruled last year, this penalty is a tax. For many families
continuing to struggle due to the weak economy, the burdens
from the individual mandate will become increasingly
difficult to bear. H.R. 2668 would delay the provision for a
year, which would provide much-needed, temporary relief to
these families.
Passage of H.R. 2667 and H.R. 2668 would help alleviate
some of the harmful effects that the Affordable Care Act will
impose on businesses and individuals. Enactment of these
bills would be an important step toward more significant
legislative goals, such as permanent repeal of both mandates
and the Affordable Care Act in its entirety.
Rollcall votes on H.R. 2667 and H.R. 2668 will be included
in our annual rating of Congress and ``yes'' votes will be
considered the pro-taxpayer position.
If you have any questions, please contact NTU Federal
Affairs Manager Nan Swift.

Mr. PRICE of Georgia. Mr. Speaker, I am pleased to yield 2 minutes to
the gentleman from Illinois (Mr. Schock), another member of the Ways
and Means Committee.
Mr. SCHOCK. Mr. Speaker, I thank the gentleman from Georgia.
Wow, I'm sure our listening audience at home wonders who to believe.
We are hearing charges of politics. We are hearing claims of chutzpah.
My friends on the other side of the aisle, this isn't politics--this
is lawmaking.
Has our Republic stooped so low that you would go out and raise
millions of dollars and waste thousands of hours of your volunteer time
to be elected to a body only to see that power which is given by the
Constitution to do that which you were elected to do instead given to
the executive branch--to the President?
If you believe as the President believes, which is that this law is
not ready to be implemented--which is that, for various reasons, HHS
and other agencies are not able to certify that the businesses are able
to comply--then join us in doing what the President wants to do
legally. Join us in giving the power to the President that which he is
already claiming unilaterally, and do what your constituents have
elected you to do, which is to actually do lawmaking.
Mr. Speaker, we heard claims earlier today that women were being
discriminated against, that women's premiums were rising at a faster
rate than men's. Let me tell you what this bill does to young people,
who are really discriminated against because of ObamaCare.
Young people's premiums are going up over 400 percent because of a
community rating provision in this bill. Young people are paying a
disproportionate, growing cost of health care in this country because
of a discrimination factor in this bill called ``community rating.''
Young people who have gone to college, who have busted their tails to
get a degree, don't want to stay on their mom and dad's insurance until
they're 26. That's not why I went to college. I don't think that's why
you went to college. They go to college to get a job, and this
ObamaCare legislation and so many others of the President's policies
are killing jobs in America. It's why half of the people who graduated
from college last May are still unemployed or underemployed.
For so many reasons, this bill needs to be postponed, which is what
this legislation does. I urge its passage and a ``yes'' vote.
Mr. McDERMOTT. I reserve the balance of my time.
Mr. PRICE of Georgia. Mr. Speaker, how much time remains?
The SPEAKER pro tempore. The gentleman from Georgia has 15\1/2\
minutes remaining, and the gentleman from Washington has 6 minutes
remaining.
Mr. PRICE of Georgia. Mr. Speaker, I am pleased to yield 1 minute to
a member of the Energy and Commerce Committee, a fellow physician from
the State of Georgia (Mr. Gingrey).
Mr. GINGREY of Georgia. Mr. Speaker, I thank the gentleman for
yielding.
I have in my hand a pocket Constitution, which says here in Article
I, Section 1:

All legislative powers herein granted shall be vested in a
Congress of the United States, which shall consist of a
Senate and House of Representatives.

It doesn't say anything in there about the President.
Mr. Speaker, if you've noticed a lot of times, the weaker one's
argument, the louder the volume, and I'm hearing a lot of volume from
the other side of the aisle, including from their leadership. They have
a weak argument, Mr. Speaker--there is no question about it--in saying
that the bill has already passed.
If the bill has already passed, what right does the President have to
change the law without coming back to the Congress?
We are giving them the opportunity to do that. Of course, we are also
giving the young people in this country the opportunity to get the same
break that these large Fortune 500 companies may be getting in regard
to delaying the employer mandate for 1 year. Let's do the same thing
for these young people who are no longer 26. They're 26\1/2\; they're
not living in the basement anymore; they have a job. Let's give them
the same 12-month break that we're giving to employers.
Pass this bill. It's a good bill. We have the authority to do it, not
the President.
Mr. McDERMOTT. I yield myself 30 seconds.
There are 8,300 young adults who are still getting insurance on their
parents' plans; more than 8,500 seniors are receiving prescription drug
discounts; 86,000 seniors are now receiving preventative care without
having to pay for it under the Medicare program; 195,000 now have
health insurance that covers preventative care with no co-pays and
insurance; and on and on and on it goes.
I enter into the Record the health care reform law as it affects the
11th Congressional District of Georgia.

Benefits of the Health Care Reform Law in the 11th Congressional
District of Georgia

committees on energy and commerce, ways and means, and education and
the workforce, democratic staff report, july 2013

[[Page H4570]]

more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 19,900 consumers
in the district received approximately $2.8 million in
insurance company rebates in 2012 and 2011--an average rebate
of $82 per family in 2012 and $134 per family in 2011.
Up to 43,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
248,000 individuals in the district now have insurance that
cannot place lifetime limits on their coverage and will not
face annual limits on coverage starting in 2014.
Up to 129,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition. In addition, the 45,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more secure, higher quality coverage and many will be
eligible for financial assistance.

Mr. Speaker, I reserve the balance of my time.
Mr. PRICE of Georgia. Mr. Speaker, I am pleased to yield 2 minutes to
a gentlelady who, prior to coming to Congress, worked as a nurse and
who is a pivotal member of the Ways and Means Committee, the gentlelady
from Tennessee, Diane Black.
Mrs. BLACK. I thank the gentleman for yielding.
Mr. Speaker, the President has previously described his health care
law as ``a new set of rules that treats everybody honestly and treats
everybody fairly.''
Now, according to President Obama, if you're a big financial
institution or a government contractor, you don't have to comply with
ObamaCare's mandate next year; but if you're a Tennessee family who is
trying to make ends meet, you do or you will get taxed. To add insult
to injury, this President now has the audacity to say that he will veto
the House legislation delaying the employer mandate and the individual
mandate that we are considering today.
First of all, the employer mandate delay was proposed by him, so why
would he veto his own idea? Secondly, why would he turn his back on the
American families, who are merely asking for the same relief that he
said he is going to give to Big Business?
President Obama's veto threat is a pathetic excuse for leadership,
and I suggest that we call his bluff and pass this legislation to
protect the American people and their livelihoods from ObamaCare. It is
simply not fair of President Obama to give business an exemption from
his costly health care law without making the same allowances for
individuals and families.
I call on President Obama and congressional Democrats to do the right
thing by supporting the Authority for Mandate Delay Act and the
Fairness for American Families Act in order to protect the American
people and to ensure fairness for all.
Mr. McDERMOTT. Mr. Speaker, I enter into the Record the effect of the
Affordable Care Act on the Sixth Congressional District of Tennessee.

Benefits of the Health Care Reform Law in the 6th Congressional
District of Tennessee

committees on energy and commerce, ways and means, and education and
the workforce, democratic staff report, July 2013

The landmark Affordable Care Act (ACA) began delivering
important new benefits and protections to tens of millions of
American families almost immediately after it was signed into
law by President Obama. But the largest benefits of the law
will become available to consumers on October 1, 2013, when
health insurance marketplaces open in all 50 states. These
marketplaces will offer individuals, families, and small
businesses an efficient, transparent one-stop shop to compare
health insurance policies, receive financial assistance, and
sign up for high-quality, affordable, and secure insurance
coverage.
This fact sheet summarizes new data on the significant
benefits of the health care reform law in Rep. Black's
district. It also provides the first picture of the impacts
of the law in districts redrawn or newly created following
the 2010 Census. As a result of the law:
5,600 young adults in the district now have health
insurance through their parents' plan.
More than 9,800 seniors in the district received
prescription drug discounts worth $12.7 million, an average
discount of $590 per person in 2011, $640 in 2012, and $690
thus far in 2013.
134,000 seniors in the district are now eligible for
Medicare preventive services without paying any co-pays,
coinsurance, or deductible.
184,000 individuals in the district--including 40,000
children and 74,000 women--now have health insurance that
covers preventive services without any co-pays, coinsurance,
or deductible.
188,000 individuals in the district are saving money due to
ACA provisions that prevent insurance companies from spending
more than 20% of their premiums on profits and administrative
overhead. Because of these protections, over 26,900 consumers
in the district received approximately $3.9 million in
insurance company rebates in 2012 and 2011--an average rebate
of $69 per family in 2012 and $201 per family in 2011.
Up to 40,000 children in the district with preexisting
health conditions can no longer be denied coverage by health
insurers.
217,000 individuals in the district now have insurance that
cannot place lifetime limits on their coverage and will not
face annual limits on coverage starting in 2014.
Up to 101,000 individuals in the district who lack health
insurance will have access to quality, affordable coverage
without fear of discrimination or higher rates because of a
preexisting health condition. In addition, the 37,000
individuals who currently purchase private health insurance
on the individual or small group market will have access to
more secure, higher quality coverage and many will be
eligible for financial assistance.

I now yield 1\1/2\ minutes to the gentlelady from Texas (Ms. Jackson
Lee).
Ms. JACKSON LEE. Thank you to the manager--Dr. McDermott, I like to
call him--who has been a mainstay of good health care in this Congress
for a very long time. He is managing as well with the gentleman from
Georgia, who has practiced medicine.
But we can have a disagreement. The vigorous disagreement that we
have, I must say, Mr. Speaker, is with the weight of truth that falls
on what we have done on behalf of ObamaCare, the Affordable Care Act.
I enjoy sledding. I enjoy the snow. When you get on a sled, it rolls
down and you're happy, and you come to a successful end. We've rolled
down, and we keep on rolling because the Affordable Care Act is
allowing young people to have insurance. It's reducing the cost of
prescription drugs for our seniors. It's allowing a State like Texas,
which has the highest number of uninsured--some 121,000-plus in my
district--to now have insurance. It allows about 10 community health
facilities to be able to begin enrollment this coming September and to
be able to outreach to those families, who will now have coverage for
them and their children.
Let me be very clear. How many times do I have to say, no, you cannot
have your way?
The Supreme Court has ruled. This is the law of the land, and there
is no reason whatsoever to go back on a plan that has allowed the New
York insurance rates to go down on health care. There is nothing wrong
with the President engaging business. These are large companies that
have said we just need to look at it so we can streamline it. That's to
make it better. If they undermine the individual mandate, 13 million
Americans will not have insurance.
How many times do I have to say ``no''?
The Affordable Care Act is going well. People are insured and
Americans are healthier. Let's keep the Affordable Care Act. Vote
``no'' on the underlying bills.
When will you ever understand that it's over? It's over.
Mr. PRICE of Georgia. Mr. Speaker, I am pleased to yield 1\1/2\
minutes to the gentleman from Pennsylvania (Mr. Rothfus).
(Mr. ROTHFUS asked and was given permission to revise and extend his
remarks.)
Mr. ROTHFUS. I thank Dr. Price for his work on the Fairness for
American Families Act, and I rise in support of the legislation.
Mr. Speaker, President Obama made many promises when promoting his
health care law. He promised that, if you liked your coverage, you
could keep it; he promised that it would lower the cost of premiums; he
promised that it would create new jobs and promote economic growth.
Unfortunately, western Pennsylvania workers and families are
experiencing just the opposite.
A mom who works at a food service company in Beaver County,
Pennsylvania, called my office last week to talk for an hour about how
the law is impacting her family. She just had her hours cut by almost
half thanks to the employer mandate. Her husband's job security is also
now at risk. The lost hours, income, and job security have made it
difficult for them to afford the necessities of life, and it will make
it almost impossible to send their daughter to college next year.

[[Page H4571]]

President Obama recently postponed the employer mandate. In so doing,
he has conceded that the law is unworkable for businesses. If
businesses deserve a break from ObamaCare, then why don't the rest of
the American people?
We need workable, commonsense, and patient-centered reforms that
increase access to care and reduce costs. Today's legislation is a
necessary first step in achieving the kind of health care reform that
the American people deserve.

{time} 1745

Mr. McDERMOTT. Mr. Speaker, I reserve the balance of my time.
Mr. PRICE of Georgia. Mr. Speaker, I'm pleased to yield 1 minute to
the gentleman from Ohio (Mr. Wenstrup), a gentleman who is engaged in
the health profession.
Mr. WENSTRUP. Mr. Speaker, the unilateral decision by this
administration to delay certain provisions of Federal legislation
undermines the very rule of law. If President Obama can pick and choose
what he wants to enforce within ObamaCare, what prevents him from doing
the same with other legislation? That is my concern.
And while this administration is determined that their signature
piece of legislation is too complicated for businesses, the individual
mandate still stands. Businesses get a break, but individuals get no
relief from the burdens of this law.
Why do hardworking individuals not deserve relief from the hardships
of the Affordable Care Act? If the President and his allies in Congress
stand by their decision to delay one mandate, is it not fair to delay
the other?
Realistically, a permanent delay through the full repeal of ObamaCare
and its mandates is the only workable solution.
Don't Americans deserve equality under the law and fairness for all?
Mr. McDERMOTT. Mr. Speaker, I inquire as to whether the gentleman
from Georgia is prepared to close.
Mr. PRICE of Georgia. As we have no more speakers, I am prepared to
close.
Mr. McDERMOTT. Mr. Speaker, I yield myself such time as I may
consume.
I have in my hand here a letter signed by 30 economists from Harvard,
Yale, MIT, Stanford, Rice, the University of Chicago, and everybody
else, all of whom say we need a mandate. If this mandate were taken out
of the law, the Affordable Care Act would be dead. What they say is
that the individual mandate does not specify what care people receive;
it simply requires people to pay a reasonable amount for any care that
they may ultimately receive.
No less a conservative than Mitt Romney, the Republican nominee for
President, noted when signing the Massachusetts equivalent of the
individual mandate:

Some of my Libertarian friends balk at what looks like an
individual mandate. But remember, someone has to pay for the
health care that must, by law, be provided: either the
individual pays or the taxpayers pay.

Everyone in this body spends $1,000 a year beyond their own health
care costs paying for the uninsured in this country. People walk into
the emergency room and they get taken care of because the hospital
cannot refuse them and the doctor cannot refuse them, and so they're
taken care of and then it's passed on to you and me.
The individual mandate says everybody should pay according to their
ability.
Going on, Mr. Romney said:

A free ride on the government is not libertarianism.

Everywhere they've tried this without subsidies and mandates, it has
failed. They say in the five States that have tried comprehensive
insurance market reform without an individual mandate, healthy people
choose to stay out of insurance, sick people took it up, and the
premiums go up. That's exactly what the CBO says.
So what you are saying, by repealing the individual mandate, is you
want to drive up the costs on the people who now have insurance. That's
a very strange political position to be taking.
I must say, I listened to all these people who don't like the
individual mandate and all this stuff. If you spend 2 years ranting
about the Affordable Care Act and you run a campaign and spend hundreds
of millions of dollars and rant against the Affordable Care Act, it's
not surprising that people may be a little confused.
When I was in medical school in 1963, the American Medical
Association spent 3 or 4 years ranting against Medicare; and when the
people went out to enroll people for Medicare, they got the door
slammed in their face. Old people said, I'm not going to have that kind
of government health care in my house. Well, let me tell you something.
If you tried to take Medicare out now, you would find you have taken on
a really ugly junkyard dog. You're not going to take out Medicare in
this country now.
You can confuse people for a while, but as they see and as I reported
on everybody's district, it is already affecting kids who didn't have
insurance because of a preexisting condition; it's affecting kids who
didn't have insurance from their job and are now on their parents'
insurance; it took away lifetime limits on care; it took away all the
things that people worry about when they want health care security.
They now have it, and you're saying let's take the individual mandate
out and have the whole house come down, because that's what these
economists have said.
I enter this letter into the Record, and I yield back the balance of
my time.

Why We Need the Individual Mandate

The Patient Protection and Affordable Care Act (ACA)
requires people to buy health insurance when they can afford
to do so. This ``individual mandate'' is essential to address
two features of current health insurance markets: the fact
that millions of people cannot afford health insurance
coverage, and the fact that insurance companies frequently
charge high or unaffordable premiums to people who need
insurance most--those suffering from costly illness or
injury.
This mandate is one of three pillars that together support
ACA's private market approach. The first pillar is insurance
market reform--ending the ability of insurance companies to
discriminate against sick or injured people with high medical
costs. Subsidies to help Americans of modest means gain
access to affordable health coverage provide the second
pillar. The individual mandate provides the third pillar. It
requires people to obtain insurance so long as that coverage
is affordable. The mandate expresses a basic obligation of
citizenship as well as an economic reality. Without the
mandate, some people will choose to gamble or to free-ride,
undermining the fairness and financial stability of the
health insurance system.
Few of the uninsured could personally finance medical
treatment for a serious illness or injury. Moreover, this
country embraces the fundamental principal that everyone
should have to minimally decent medical treatment when
needed, without regard to ability to pay. Federal legislation
and the custom and practice of health care providers embody
this principle. A healthy individual's decision to forego
affordable insurance coverage thus imposes real costs on
others, while raising premiums on many people with serious
medical needs who require the most help.
The individual mandate does not specify what care people
receive. It simply requires people to pay a reasonable amount
for any care they may ultimately receive. No less a
conservative than Mitt Romney noted, when signing
Massachusetts' equivalent of the individual mandate: ``Some
of my libertarian friends balk at what looks like an
individual mandate. But remember, someone has to pay for the
health care that must, by law, be provided: Either the
individual pays or the taxpayers pay. A free ride on the
government is not libertarian.''
The ACA's individual mandate is based on Massachusetts's
successful 2006 reforms. That landmark effort covered about
two-thirds of the formerly uninsured, while reducing premiums
for individual purchasers by about 50% relative to national
trends--with strong public support.
In contrast, insurance reform without subsidies and
mandates has consistently failed. In the five states that
have tried comprehensive insurance market reform without an
individual mandate, healthy people chose to stay out of
insurance, sick people took it up, and premiums increased.
Only broad participation in insurance markets can end the
cycle of insecure coverage and high costs.
The Obama Administration's recent decision to delay ACA's
requirement that large- and medium-sized employers sponsor
coverage for their employees or pay a penalty is independent
of the individual mandate. The employer assessment is
designed to bolster the ACA's financing and to ensure equity
between large firms who do and do not provide insurance. This
assessment will have only a very small impact on employers,
since 97% of firms with more than 50 employees already offer
insurance. The individual mandate stands in stark contrast,
as nearly one in five non-elderly Americans is currently
uninsured.
Delaying the employer assessment has almost no effect on
the implementation of the ACA. The only important effect will
be to raise one fewer year of revenue from this

[[Page H4572]]

component of the law. In contrast, delaying the individual
mandate would cut at the core of the vision of private-market
based insurance market reform.
Requests to delay the individual mandate are really
requests to gut the Affordable Care Act. Millions of
Americans face immediate health care needs and financial
challenges addressed by health reform. They cannot wait.
Signers
Henry Aaron, Senior Fellow and Bruce and Virginia
MacLaury Chair in Economic Studies, Brookings
Institution; Kenneth J. Arrow, Professor Emeritus,
Stanford University; Susan Athey, Professor of
Economics, Stanford Graduate School of Business; Linda
J. Blumberg, Senior Fellow, Health Policy Center, The
Urban Institute; Len Burman, Director, Tax Policy
Center, Urban Institute; Amitabh Chandra, Professor of
Public Policy, Harvard University; Philip J. Cook, ITT/
Terry Sanford Professor of Public Policy, Duke
University; David Cutler, Otto Eckstein Professor of
Applied Economics, Harvard University; Claudia Goldin,
Henry Lee Professor of Economics, Harvard University;
Jonathan Gruber, Professor of Economics, Massachusetts
Institute of Technology; Vivian Ho, Baker Institute
Chair in Health Economics, Rice University; John
Holahan, Institute Fellow, Urban Institute; Jill
Horwitz, Professor of Law, University of California at
Los Angeles; Genevieve M. Kenney Co-Director and Senior
Fellow Health Policy Center, Urban Institute, Frank
Levy, Lecturer, Department of Health Care Policy,
Harvard Medical School; Peter H. Lindert, Distinguished
Research Professor of Economics, University of
California at Davis; Eric S. Maskin, Adams University
Professor, Harvard University; Alan C. Monheit, Ph.D.,
Professor of Health Economics, Rutgers University
School of Public Health; Richard Murname, Juliana W.
and William Foss Thompson Professor of Education and
Society, Harvard Graduate School of Education; Joseph
Newhouse, John D. MacArthur Professor of Health Policy
and Management, Harvard Medical School; Harold Pollack,
Helen Ross Professor of Social Service Administration,
University of Chicago; Matthew Rabin, Edward G. and
Nancy S. Jordan Professor of Economics, University of
California at Berkeley; James B. Rebitzer, Professor of
Management, Economics, and Public Policy and Everett V.
Lord Distinguished Faculty Scholar, Boston University
School of Management; Meredith Rosenthal, Professor of
Health Economics and Policy, Harvard School of Public
Health; Christopher Ruhm, Professor of Public Policy
and Economics, University of Virginia; Jonathan
Skinner, James O. Freedman Presidential Professor of
Economics, Professor of Community and Family Medicine,
Dartmouth College; Katherine Swartz, Professor, Harvard
School of Public Health; Paul N. Van de Water, Senior
Fellow, Center on Budget and Policy Priorities; Kenneth
E. Warner, Avedis Donabedian Distinguished University
Professor of Public Health, Dept. of Health Management
& Policy, University of Michigan School of Public
Health; Stephen Zuckerman, Co-Director and Senior
Fellow, Heath Policy Center, The Urban Instituted;

Mr. PRICE of Georgia. Mr. Speaker, I yield myself such time as I may
consume.
There are a lot of folks who've come to the floor on the other side
of the aisle to speak about this piece of legislation. Curiously, there
aren't any individuals who came from those States that have actually
passed legislation to implore Congress not to continue with the
individual mandate--Alabama, Arizona, Missouri, Ohio, individuals from
the other side of the aisle who didn't come down to the floor.
We get asked by folks on the other side about where's the jobs bill?
Well, in addition to all the remarkable pieces of legislation on jobs
that we have indeed passed and sent over to the Senate and it then
gains dust over there, this is a jobs bill. I don't know if our friends
on the other side haven't talked to their employers back home.
Employers large and small, all of them say, Look, this is damaging job
creation. We had one before the committee on Ways and Means that my
friend from Washington and I sit on just last week who said he wasn't
going to be able to expand his business. He couldn't, because of this
bill. So this is a piece of jobs legislation.
We have a number of folks on the other side who say, Look, this is
just about politics. Mr. Speaker, you talk about politics. You've got
the President saying that he's going to delay the reporting
requirements for the employer mandate for a year. And, by the way, that
just happens to be after the 2014 election. You talk about politics.
Then you talk about delay. Some of my friends on the other side, they
act as if this is something that we have indeed supported in the past.
This is delay. This isn't repeal. In fact, we appreciate that the
administration has awakened to the challenge of this piece of
legislation.
They've recognized that it doesn't work for businesses and job
creators because of the uncertainty and fewer jobs being created, so
they have promoted a delay of 1 year for the employer mandate. But that
uncertainty remains for those employers, and they're not going to be
able to hire significant individuals.
And that uncertainty and that oppression of government-run health
care isn't just for business. It's also true for individuals.
Finally, Mr. Speaker, I would say that I just encourage my friends to
read the bill. This is the bill, H.R. 2668. It's very short and easily
read. It simply changes the year requirements for the individual
mandate from 1 year, 2014, to a year's delay in 2015. That's all it
does. It simply equalizes the treatment for individuals as for
businesses.
I know that many of them haven't read the bill. If they did, they
would recognize that this bill has no change in it for preexisting
illnesses or injuries and the rules thereon. It has no change for 26-
year-olds being covered on their parents' health insurance. It has no
change for lifetime limits. It has no change for the medical loss ratio
provision. It has no change for gender equity. It has no change for
out-of-pocket limits, and it has no change for anybody's insurance
being taken away.
All this bill does, Mr. Speaker, is simply say that individuals ought
to be treated fairly and equally, just like businesses, that we ought
to delay the individual mandate for a year.
I call on my colleagues to support and vote for H.R. 2668, and I
yield back the balance of my time.
Mr. TURNER. Mr. Speaker, the administration recently announced that
the Obamacare employer mandate, requiring businesses to provide their
workers with health insurance, will be delayed until 2015. This
decision is proof that even this administration acknowledges that the
Obamacare law has adverse affects on American families and small
businesses.
At a time when the economy is still struggling to recover, we should
be focused on reducing taxes on hardworking Americans and providing
incentives for businesses to grow and create jobs. The Congressional
Budget Office (CBO) estimates that the employer mandate will raise
taxes on American businesses by $117 billion. In addition, the National
Federation of Independent Business (NFIB) estimates that the employer
mandate will result in 125,000 to 249,000 lost jobs as a result of
higher insurance costs.
Unfortunately, the administration is still moving forward with the
implementation of the individual mandate in 2014, which will have
negative effects on the American people. The average individual premium
is expected to increase somewhere between 20 and 30 percent in 2014.
CBO also estimates that the individual mandate will increase taxes on
American families by $55 billion.
Mr. Speaker, I support passage of H.R. 2667, the Authority for
Mandate Delay Act, and H.R. 2668, the Fairness for American Families
Act. At the same time, we must permanently repeal these burdensome
mandates. That is why I authored H.R. 582, the Healthcare Tax Relief
and Mandate Repeal Act, with 97 of my colleagues, to repeal the
Obamacare individual and employer mandates, providing relief for
American families and businesses.
Mr. Speaker, now is not the time to impose extra burdens on American
families and businesses when our economy is struggling to get back on
track. I strongly support repeal of the individual and employer
mandates and I am committed to working with my colleagues to carefully
and thoughtfully implement real healthcare reform.
Ms. EDDIE BERNICE JOHNSON of Texas. Mr. Speaker, I rise today in
opposition to H.R. 2667 and H.R. 2668, two cynical Republican bills
that play politics with Americans' lives. Instead of spending our time
voting on the 38th and 39th Republican attempts to delay, undermine, or
repeal the Affordable Care Act, we should be focused on implementing
the law of the land and supporting real solutions to getting Americans
the health care we all need.
The requirement that individuals have health insurance is the
foundation of the Affordable Care Act's ability to improve access to
quality, affordable health insurance. H.R. 2668 would delay this
requirement, threatening access to affordable health insurance for an
estimated 129 million Americans with pre-existing health conditions.

[[Page H4573]]

The Affordable Care Act has already begun to improve Americans'
access to health care. Insurance companies are now required to cover
children with pre-existing conditions, and in 2014 insurers will be
prohibited from discriminating against adults with pre-existing
conditions as well. An estimated 3.1 million young adults now have
health insurance through their parents' plans because of the Affordable
Care Act, and 6.3 million seniors have saved $6.1 billion on their
prescription drugs.
The patient protections and health system reforms that will go into
effect in 2014 rely on the individual responsibility provision of the
Affordable Care Act. This provision does not apply to those who cannot
access affordable coverage, and it protects all Americans from sharp
increases in health insurance premiums in the health insurance
marketplaces.
H.R. 2667, which would delay the employer health insurance mandate,
is unnecessary and detracts from the important work of ensuring that
more Americans gain access to affordable, quality health insurance.
I urge my colleagues to oppose H.R. 2667 and H.R. 2668 to defend the
advances already made under the Affordable Care Act and the benefits
yet to come. These bills are not intended to help Americans access
affordable health care. They are merely the most recent Republican
efforts to undermine the Affordable Care Act.
The Affordable Care Act is the law of the land, and it is already
helping Americans improve their health. We must come together to
implement the law effectively and ensure that more Americans have the
opportunity to access affordable health insurance and improve their
health.
The SPEAKER pro tempore. All time for debate on H.R. 2668 has
expired.
Pursuant to House Resolution 300, the previous question is ordered.
The question is on the engrossment and third reading of the bill.
The bill was ordered to be engrossed and read a third time, and was
read the third time.
The SPEAKER pro tempore. Pursuant to clause 1(c) of rule XIX, further
consideration of H.R. 2668 is postponed.

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