[Congressional Record Volume 161, Number 97 (Wednesday, June 17, 2015)]
[House]
[Pages H4472-H4478]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 PROTECT MEDICAL INNOVATION ACT OF 2015

  Mr. RYAN of Wisconsin. Mr. Speaker, pursuant to House Resolution 319, 
I call up the bill (H.R. 160) to amend the Internal Revenue Code of 
1986 to repeal the excise tax on medical devices, and ask for its 
immediate consideration in the House.
  The Clerk read the title of the bill.
  The SPEAKER pro tempore. Pursuant to House Resolution 319, the 
amendment in the nature of a substitute recommended by the Committee on 
Ways and Means, printed in the bill, modified by the amendment printed 
in part A of House Report 114-157, is adopted and the bill, as amended, 
is considered read.
  The text of the bill, as amended, is as follows:

                                H.R. 160

       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 ``Protect Medical Innovation 
     Act of 2015''.

     SEC. 2. REPEAL OF MEDICAL DEVICE EXCISE TAX.

       (a) In General.--Chapter 32 of the Internal Revenue Code of 
     1986 is amended by striking subchapter E.
       (b) Conforming Amendments.--
       (1) Subsection (a) of section 4221 of such Code is amended 
     by striking the last sentence.
       (2) Paragraph (2) of section 6416(b) of such Code is 
     amended by striking the last sentence.
       (c) Clerical Amendment.--The table of subchapters for 
     chapter 32 of such Code is amended by striking the item 
     relating to subchapter E.
       (d) Effective Date.--The amendments made by this section 
     shall apply to sales in calendar quarters beginning after the 
     date of the enactment of this Act.

     SEC. 3. BUDGETARY EFFECTS.

       The budgetary effects of this Act shall not be entered on 
     either PAYGO scorecard maintained pursuant to section 4(d) of 
     the Statutory Pay-As-You-Go Act of 2010.

  The SPEAKER pro tempore. The gentleman from Wisconsin (Mr. Ryan) and 
the gentleman from Michigan (Mr. Levin) each will control 30 minutes.
  The Chair recognizes the gentleman from Wisconsin.
  Mr. RYAN of Wisconsin. Mr. Speaker, I ask unanimous consent that the 
gentleman from Minnesota (Mr. Paulsen), the author of this legislation, 
be permitted to control the time.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Wisconsin?
  There was no objection.
  Mr. PAULSEN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker and Members, defibrillators, operating room monitors, 
insulin pumps, pacemakers, heart valves, artificial hips, x ray 
machines, ventilators, and ultrasound machines, these are life-
improving and lifesaving technologies that have reduced costs for the 
improved health of millions of Americans.
  Unfortunately, the President's healthcare law implemented a new tax 
on all of these innovative devices, a tax on medical devices. Only in 
Washington, Mr. Speaker, would you impose a tax on lifesaving medical 
technology and think you will actually reduce healthcare costs. This is 
bad tax policy, and it needs to be repealed.
  The medical device industry is truly an American success story, 
employing more than 400,000 people. In my State of Minnesota, 35,000 
people are employed in this industry, 400 companies alone in the State 
of Minnesota; 80 percent of device manufacturers are small businesses 
with less than 50 employees; 98 percent of all these companies have 
less than 500 employees.
  It can take these small startups 10 to 15 years to even achieve 
profitability or earn one penny of profit because they rely on 
investment and the promise of a future of earnings to survive.
  The device industry is a net exporter. We have a trade surplus with 
our exports. Most importantly, these companies are producing lifesaving 
and life-improving devices for millions of our patients across the 
world.
  Medical advancements have helped add 5 years to U.S. life expectancy 
in the last two decades. It has helped slash the death rate from heart 
disease by a stunning 50 percent and cut the death rate from stroke by 
30 percent.
  Devices have contributed to a 16 percent decrease in mortality rates 
and an astounding 25 percent decline in elderly disability rates in 
just the last 20 years of innovation. Medical innovation is leading and 
will continue to lead the way we improve lives for our seniors who have 
chronic disease.
  Despite all the benefits that this industry provides, a 2014 Harvard 
Business Review article recently found that the device industry now 
faces one of the most uncertain competitive environments in the entire 
country. Instead of hurting this industry, we should be empowering this 
industry, creating more jobs, producing more innovation, and helping 
more patients.
  We often hear that America needs to start making things again to help

[[Page H4473]]

jump-start the economy, and one of the best ways to protect American 
manufacturing and spur innovation is to repeal this harmful medical 
device tax because here is what the tax is doing: it is costing us 
jobs.
  One company that I spoke with said they have never laid off any 
employees in the last 22 years of their history of business, but they 
laid off 25 employees, and they refrained from hiring another 15 
employees because of the tax.
  If you take it to a bigger, larger picture, up to 39,000 jobs have 
been lost because of the tax since it has been imposed. These are high-
paying jobs, Mr. Speaker, that pay nearly $20,000 more than the 
national average.

                              {time}  1630

  And the 2.3 percent excise tax, it may not sound like much, but 
here's the problem: it is taxing revenue; it is not taxing profit.
  A small device manufacturer, they may not be making any money, but 
they still have to pay that tax. One company I spoke to, they have 20 
employees. They recently said they are borrowing $100,000 a month from 
the bank just to pay the tax. That doesn't make any sense.
  Mr. Speaker, it is also raising tax rates. Medical device companies 
now have to pay one of the highest effective tax rates of any industry 
in the world. Recent testimony in the Joint Economic Committee, there 
was a small company from Minnesota that now says because of the tax, 
they have a 79 percent effective tax rate. Who here can justify that?
  It is also harming innovation because instead of investing in the 
next generation of innovative devices that can literally save people's 
lives, companies are spending money on compliance and accountants 
instead of on research and development, which is the lifeblood of this 
industry.
  Members should know that this is separate from the debate about how 
we reform health care. This is about a bipartisan effort today on the 
floor to promote American innovation to protect and promote American 
manufacturing and research and development jobs because Democrats and 
Republicans, conservatives and liberals in both parties, in the House 
and the Senate, favor repealing this tax. It is a bad tax policy that 
is killing jobs. It is hurting our seniors, and it is harming 
innovation.
  Mr. Speaker, it is time to protect our American seniors, American 
patients, and American innovation and repeal this destructive tax.
  With that, I reserve the balance of my time, Mr. Speaker.
  Mr. LEVIN. Mr. Speaker, I yield myself such time as I shall consume.
  There are certain basic facts here. One is this industry participated 
in the creation of healthcare reform. They, like other providers, were 
involved; and like other providers, they said that they would 
participate in helping to pay for it. That is a fact. Now they want 
out.
  Another fact is that they have benefited from it. According to a 
recent analysis by Ernst & Young, the industry's revenue increased by 
$8 billion in the year the tax took effect.
  Also, there has been a reference to R&D. R&D, according to that 
report, spending by the industry, also increased by 6 percent in the 
same year.
  There has also been reference to employment. The analysis of Ernst & 
Young also says that, in that year, employment increased, and the 
overall employment has increased by 23,500. There has been a 23,500 
increase in employment.
  So those are the facts.
  There is another aspect. If people vote for this industry to 
essentially go back on its commitment to participate, other providers 
are going to ask for the same treatment. So in that respect, what the 
Republicans are aiming to do is to unravel ACA.
  Another fact is this is unpaid for. So when you add this unpaid-for 
provision, you get, all together, well over $610 billion that the 
Republicans have passed in permanent tax cuts without paying for one 
dime.
  Another factor is that this applies to imports as well as to those 
that are produced in this country and not at all to exports. So look at 
the equities. Look at how this industry has benefited. Look at the 
irrationality and irresponsibility and coming forth to this body and 
saying let's repeal and not pay for at all from a party that talks 
about fiscal responsibility.
  So let me just read from the Statement of Administration Policy. That 
is another fact. If this were ever to pass the House and the Senate, it 
would be vetoed. So here is the Statement of Administration Policy:
  ``The Affordable Care Act has improved the American health care 
system, on which Americans can rely throughout life. After more than 
five years under this law, 16.4 million Americans have gained health 
coverage. Up to 129 million people who could have otherwise been denied 
or faced discrimination now have access to coverage. And health care 
prices have risen at the slowest rate in nearly 50 years. As we work to 
make the system even better, we are open to ideas that improve the 
accessibility, affordability, and quality of health care, and help 
middle-class Americans.''
  And it concludes:
  ``In sum, H.R. 160 would increase the deficit to finance a permanent 
and costly tax break for industry without improving the health system 
or helping middle-class Americans. If the President were presented with 
H.R. 160, his senior advisors would recommend that he veto the bill.''
  So I close with this. You know, people can be provincial in the sense 
that they respond to one pressure point or another, and I understand 
that. What you have to do is to look at an entire system, an entire 
structure, and what it means for Americans throughout this country.
  This industry, as I said, participated in helping to pay for 
healthcare reform. They have benefited from it, and now, essentially, 
they are coming forth and saying: Just take us out of it; separate us 
out.
  That is unfair, unwise, irresponsible, and sets a pattern that will 
do what Republicans really want to do, and that is to pick apart and 
tear apart this reform that has been 75 years in coming. So I urge 
everybody to look at the broader interests of the people of this 
country and to vote ``no.''
  I reserve the balance of my time.


                             General Leave

  Mr. PAULSEN. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous material on H.R. 160, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Minnesota?
  There was no objection.
  Mr. PAULSEN. Mr. Speaker, I yield myself 15 seconds.
  Mr. Speaker, just in response to the report that was just mentioned, 
the Ernst & Young report, it is true that companies have been hiring 
and growing in certain cases, but all of that growth from the report is 
outside of the United States. So if you want to continue to promote 
more jobs outside of the United States, don't vote for the repeal, and 
we will continue to see jobs move overseas.
  Mr. Speaker, I yield 1 minute to the gentleman from Pennsylvania (Mr. 
Meehan), a member of the Ways and Means Committee.
  Mr. MEEHAN. Mr. Speaker, let me begin by dispelling the premise that 
somehow this whole thing was devised so that we can allow the medical 
device companies to flourish. The thing we want to flourish is research 
and development that is producing the kinds of things that are helping 
the American people, and that is the essence of what the medical device 
R&D innovation is doing, and this is stifling.
  At the precise moment where breakthrough opportunities, oftentimes, 
in small businesses--I see them, Mr. Speaker; I visit them in my 
district--and at the time that it is the most fragile for them, they 
are being hit with this 2.4 percent tax which touches them at the time 
when it is not on profits. These are the very dollars that are being 
used to be invested into R&D, whether they sell that product or not. We 
are killing our innovation right in the cradle.
  I strongly encourage my colleagues to support the repeal of the 
medical device tax.
  Mr. LEVIN. I yield 4 minutes to the gentleman from Washington (Mr. 
McDermott), the ranking member on the Health Subcommittee.
  (Mr. McDERMOTT asked and was given permission to revise and extend 
his remarks.)

[[Page H4474]]

  Mr. McDERMOTT. Mr. Speaker, Mr. Levin was correct. When we were 
designing the Affordable Care Act, everyone was expected to share in 
the cost as we work for the American people.
  The medical device industry initially opposed 5 percent. They said: 
How about 2.3 percent? We will go for that.
  They agreed to it. Here they are today asking for us to give them 
nothing, no taxes; they don't have to pay anything no matter how they 
benefit from it.
  Now, repealing this tax, which the nonpartisan analysts have shown 
has no negative effect on jobs, will add $24.4 billion to the deficit. 
It would eliminate an important source of revenue simply to appease an 
industry that has benefited directly and greatly from the expansion of 
the coverage of ACA.
  On top of that, the bill is a distraction from a more important issue 
that the Congress needs to address in the context of medical devices. 
They would not let us vote on an amendment in the committee to bring up 
the institution of unique device identifiers.
  An essential tool of improving patient safety is the UDI. A UDI is a 
number associated with a medical device right on the device. They 
contain important information about where, when, and by whom the device 
was made. They provide for post-market surveillance to identify 
problems and notify patients when objects that they put in their bodies 
are faulty or dangerous. This has dramatic impacts for safety.
  In 2010, a massive recall of breast implants in France impacted tens 
of thousands of women. Many cancer patients undergo reconstructive 
surgery following mastectomy, and their lives are threatened when 
faulty implants leak dangerous contaminants into their bodies. In 
situations like this, it is essential that we know who has given the 
faulty device so that recall efforts can save as many lives as 
possible.
  Unfortunately, even when the FDA finishes its new UDI regulations in 
the coming years, we will lack important tools, including devices, in 
the agency's postmarket safety checking system, the Sentinel 
Initiative. The primary source of information for the Sentinel is 
insurance claims forms, yet, unlike pharmaceuticals, CMS does not 
currently require UDIs to be listed on Medicare claims. That makes it 
all but impossible to apply the Sentinel Initiative to the device 
context.
  Furthermore, additional gaps exist in the FDA's rulemaking on UDIs. 
For example, there is no requirement that UDIs be affixed directly to 
the implantable devices.
  As we look forward, I encourage my colleagues to look beyond efforts 
to undermine the ACA and to look for opportunities to enhance safety 
and improve the system for patients, not just the device industry.
  I urge Members to vote ``no'' on this and come back with a bill--if 
you want to take the tax off, that is one thing, but at least make them 
identify the name and the place and the number of where it came from 
so, if somebody you know gets impacted by one of these devices going 
bad, we will have a way to trace it.
  Mr. PAULSEN. Mr. Speaker, I yield 2 minutes to gentleman from Indiana 
(Mr. Young), a leader on the Ways and Means Committee, who is also 
concerned about the impact of this tax on his home State of Indiana.
  Mr. YOUNG of Indiana. Mr. Speaker, ObamaCare's medical device tax has 
already been devastating to innovation, patient care, and job creation, 
especially in my home State of Indiana.
  Up north, we have Warsaw, which is known around the world as the 
orthopedics capital of the world. In central Indiana, we have a 
burgeoning life sciences industry centered around the Indianapolis 
area. Further south, we have Bloomington, which is home to Cook 
Medical, the largest privately held medical device manufacturer in the 
world.
  Medical device startups dot Indiana's landscape from Lake Michigan 
down to the Ohio River. Indiana's world-class medical device companies 
like Biomet, Boston Scientific, Hill-Rom, Zimmer, and dozens more don't 
just create and produce lifesaving technology. They also employ tens of 
thousands of Hoosiers, and these jobs pay well.
  At a time when factories have closed and jobs in rust belt States 
have been sent overseas, medical device manufacturing jobs have been a 
lifeline for hard-working Hoosiers and their families.

                              {time}  1645

  Every day this tax remains in effect, we continue to slow 
advancements in lifesaving and life-improving technologies, and we 
hinder patient care. This day is long overdue. It is time to support 
H.R. 160 and finally repeal this harmful, ill-advised tax.
  Mr. LEVIN. It is now my pleasure to yield 4 minutes to the gentleman 
from New Jersey (Mr. Pascrell), a member of our committee.
  Mr. PASCRELL. Mr. Speaker, I am sorry the gentleman from Indiana is 
leaving the floor right now because one of the companies he mentioned--
one of the companies, there are others--was brought before the Justice 
Department because of their behavior not long ago. So my friend from 
Indiana talks about Zimmer Holdings. That is one of the reasons why I 
am asking you to review your support of this legislation. Because let 
me tell you what happened to Zimmer and Stryker in the State of New 
Jersey not that many years ago when the U.S. Attorney looked at these 
two companies and many others.
  Here is what they were brought to heel about: bribing doctors to 
recommend their prosthetic to senior citizens under Medicare. Dante 
said, what place in hell will they be? These guys should be in the 
deepest place in hell--the deepest. You check the record. You can't 
make this stuff up.
  Mr. Speaker, I oppose this legislation. When the Affordable Care Act 
was being negotiated, these companies were at the table. They agreed to 
this. You can't deny that. Because of the ACA, the health care market 
includes millions of newly insured Americans, more business for these 
companies, by the way, driving up the demand for medical devices and 
other health care services--increased demand, capitalism, you know 
about that.
  However, the device industry wants it both ways. They want new 
businesses, and they want new business under the ACA, that the ACA has 
created, and since the law was passed, they have been lobbying for 
repeal of what they agreed to. I swear you can't make it up.
  Mr. Speaker, I support the ACA and its goals. You don't. And it needs 
to be funded. It is the law of the land, as the Speaker once said. You 
can't support the goals of the ACA and then start stripping out the 
pieces of the law that fund the realization of the goals.
  Oh, but you can. And you have tried 56 different times to repeal this 
legislation, and you failed every time, even though you are in the 
majority.
  This legislation would add $24.4 billion to the deficit--through the 
Speaker to my good friend from Pennsylvania--and it is not paid for. 
Despite industry claims of job loss and economic hardship, medical 
device companies have seen a 7 percent growth in employment since the 
ACA. Furthermore, I remain concerned about some of the behavior we have 
seen in this industry.
  The SPEAKER pro tempore. The Chair would like to remind the gentleman 
to address his remarks to the Chair.
  Mr. PASCRELL. Sure, Mr. Speaker.
  Mr. Speaker, I became highly involved in the medical device issues 
since 2007 when a number of device manufacturers entered into 
controversial deferred prosecution agreements for providing doctors 
with kickbacks for using their knee and hip replacement devices. A 
number of these products ended up being recalled. That is the record.
  As a result, on the justice side, I have worked to put an end to 
deferred prosecution agreements that don't hold the bad actors 
accountable. There are many good companies providing medical devices, 
but the facts are the facts, and the history is the history, and the 
culture of this industry needs to be known. I have also worked to 
improve the safety of medical devices for patients by encouraging the 
use of clinical data registries.
  Repealing the device tax is not good policy, Mr. Speaker, and it is 
not good for our budget--another $24.5 billion added to the deficit. I 
think if you would ask our ranking member, Mr. Levin, he would give you 
a precise

[[Page H4475]]

number as to how much you have increased the deficit in legislation you 
have provided over the last 6 months.
  Mr. Speaker, I urge my colleagues to oppose this legislation.
  Mr. PAULSEN. Mr. Speaker, I yield 2 minutes to the gentleman from 
Pennsylvania (Mr. Dent).
  Mr. DENT. Mr. Speaker, I just want to address something that was 
stated by one of the previous speakers from Washington State who made a 
comment to the effect that the medical device industry supported that 
tax. Well, that is a statement that is simply not based in fact. In 
fact, what happened, as I recall, Senator Baucus helped impose the tax 
on the industry because he felt that they were not providing enough at 
the table in terms of concessions for the ACA. In fact, since they 
weren't doing enough at the table, the medical device industry was 
placed on the menu. They fought this tax vigorously. There is no letter 
to indicate they had any support for this tax.
  Mr. Speaker, I rise in strong support of this legislation to repeal 
the medical device tax. However you feel about the 2010 health care law 
on the whole, we can all agree that the legislation has its flaws. 
Again, one of the most glaring deficiencies in the law is the medical 
device tax, designed to extract $26 billion from the industry over 10 
years. This new law is already stifling critical innovation and 
threatening high quality jobs in my district.
  More importantly, it is increasing costs for consumers on products 
which are an absolute necessity of life for those who rely on them, 
such as prosthetics, pacemakers, and artificial hearts. Costs are also 
being passed on to consumers at all levels through increased insurance 
premiums and bills from medical providers.
  The medical device industry currently supports over 75,000 jobs in 
the Commonwealth of Pennsylvania. Several of the companies affected by 
the new tax are located in my district, including OraSure Technologies, 
Olympus, Boas Surgical, and B. Braun. In fact, B. Braun CFO Bruce 
Heugel recently testified before the Senate Finance Subcommittee on 
Health Care that his company has been forced to drastically reduce 
investments in research and development and also has had job losses as 
a result of the medical device tax. In fact, they are not building a 
new headquarters because of this tax. These are good paying, 21st 
century jobs, and this Congress should not support policies that will 
kill them or send them overseas.
  Mr. Speaker, the medical device tax is a punitive tax, and it is 
creating disincentives for companies looking to stay competitive, hire 
domestically, and create lifesaving new technologies. It is past time 
that Congress repeal this onerous new tax, and I urge my colleagues to 
support the Protect Medical Innovation Act. Let's get rid of this thing 
once and for all. Let's excise the excise tax.
  Mr. LEVIN. Mr. Speaker, I reserve the balance of my time.
  Mr. PAULSEN. Mr. Speaker, I yield 1 minute to the gentleman from 
Indiana (Mr. Rokita). Since he was first elected in 2010, he has been a 
leader on this, organizing freshman Members, recognizing the importance 
of repealing this disastrous tax.
  Mr. ROKITA. Mr. Speaker, I thank the gentleman from Minnesota for 
yielding the time. He has been the leader on this from day one, and I 
am happy to join him. I also thank Chairman Ryan of the Ways and Means 
Committee for allowing this to come to the floor the way it has. I 
think it is very important. Most of America thinks this is very 
important, and to have it stand alone here where it can be debated, 
hopefully honestly, I think speaks well to the process, I think it 
speaks well to the leadership of Chairman Ryan and Member Paulsen and 
others who are behind this.

  Mr. Speaker, I am privileged to be back on the floor to support this. 
It is long overdue. It needs to happen. There is an old adage, Mr. 
Speaker, and that is, if you want less of something, tax it. The same 
is true here. If you want less jobs in this area, like the 56,000 jobs 
in Indiana alone, tax the devices that those jobs produce. If you want 
less innovation, tax these medical devices. If you want America to be 
less of a leader in the world when it comes to this industry, tax it. 
That is all their argument, Mr. Speaker, is saying, and our bill 
corrects that. Let the free market work, and let innovation work. Let's 
keep us a leader in the world in this area.
  Mr. LEVIN. Mr. Speaker, I reserve the balance of my time.
  Mr. PAULSEN. Mr. Speaker, I yield 1 minute to the gentlewoman from 
Indiana (Mrs. Brooks) who has also been a leader as part of the Indiana 
delegation on the issue.
  Mrs. BROOKS of Indiana. Mr. Speaker, I would like to commend my 
colleague from Minnesota for leading this effort since I came to 
Congress in 2013.
  I rise today joining my fellow Hoosiers seeking greater opportunity 
for all Americans, and I rise today to call for a swift end to a tax 
that is standing in the way of that opportunity.
  Back home, I hear from countless Hoosiers about the restrictions the 
medical device tax is placing on our life sciences industry, not only 
in Indiana but across the country. This tax takes away the 
opportunities to innovate, to hire more people, and most importantly to 
improve the patient access to critical technology.
  In Indiana the life sciences industry is vitally important. It has a 
$59 billion impact on our economy and employs more than 56,000 people. 
In fact, we are second--Indiana is second only to California in exports 
of life sciences products.
  Mr. Speaker, my colleagues on both sides of the aisle know that the 
unfair medical device tax jeopardizes our competitive edge, it stunts 
our workforce opportunities, but most importantly, it is decreasing 
access to lifesaving technology for people.
  Mr. Speaker, I want to stand for jobs, stand for improving people's 
health, and stand for more opportunity. I urge my colleagues to repeal 
the medical device tax.
  Mr. LEVIN. Mr. Speaker, I reserve the balance of my time.
  Mr. PAULSEN. Mr. Speaker, I yield 1 minute to the gentlewoman from 
New York (Ms. Stefanik) who has also been doing an awesome job of 
organizing a lot of the freshman Members and recognizing the importance 
of this issue to the State of New York.
  Ms. STEFANIK. Mr. Speaker, I strongly support H.R. 160, the Protect 
Medical Innovation Act introduced by Mr. Paulsen, and in March I was 
proud to lead a bipartisan letter by 43 freshman lawmakers to Speaker 
Boehner calling for a vote to repeal the medical device tax.
  According to a 2014 industry survey, the tax resulted in employment 
reductions of 14,000 industry workers in 2013 and years prior to 
implementation of this tax, with approximately an additional 4,500 jobs 
lost in 2014. Furthermore, if we don't repeal this tax, the industry 
will forgo hiring of nearly 20,500 employees over the next 5 years.
  Mr. Speaker, this important bipartisan legislation will repeal the 
Affordable Care Act's medical device tax that is limiting access to 
health care devices that North Country families need and undermining 
the medical device industry that is so important to our local economy.
  Repealing the medical device tax will help our small businesses 
create jobs for North Country families and protect employees who are 
currently at risk from this job-killing tax. This an extremely 
important issue for my district, especially in Warren County, home of 
what is called ``catheter valley'' because of the numerous catheter 
manufacturers.
  I commend the House for bringing this important legislation to the 
floor, and I urge all Members to support this measure.
  Mr. LEVIN. Mr. Speaker, I reserve the balance of my time.
  Mr. PAULSEN. Mr. Speaker, I yield 1 minute to the gentleman from 
Indiana (Mr. Stutzman), someone I traveled with in the State of Indiana 
who showed me firsthand the impact this device tax had in Indiana.
  Mr. STUTZMAN. Mr. Speaker, I rise in support of H.R. 160, the Protect 
Medical Innovation Act, and I appreciate the work that Congressman 
Paulsen has done on this very important issue that has affected my 
district dramatically.
  As a sitting U.S. Congressman of Warsaw, Indiana, known as the 
Orthopedic Capital of the World, the burdensome medical device tax hits 
very close to home for my constituents. In fact, Mr. Speaker, the 
Hoosier State as a

[[Page H4476]]

whole is second in the Nation in exports of life science products, and 
across the State over 20,000 Hoosiers are directly employed by this 
industry. The impact on our communities and our neighbors is one of the 
reasons I have fought so long and hard alongside Mr. Paulsen and my 
colleagues to repeal this very destructive tax.
  Mr. Speaker, back home in Indiana, Hoosiers know that taxation does 
not create jobs; it kills them. In fact, a recent study has shown that 
the medical device tax, implemented to fund ObamaCare, has cost more 
than 33,000 jobs nationally so far. Mr. Speaker, repealing this medical 
device tax is a simple, commonsense reform, and I urge my colleagues to 
support this legislation.
  Mr. LEVIN. Mr. Speaker, I continue to reserve the balance of my time.

                              {time}  1700

  Mr. PAULSEN. Mr. Speaker, I yield 1 minute to the gentleman from 
Pennsylvania (Mr. Costello), who knows the importance of this issue.
  Mr. COSTELLO of Pennsylvania. Mr. Speaker, the cost of health care 
continues to increase in this country.
  As a philosophical matter, I do not believe inserting more government 
between a patient and their doctor will reduce costs. In fact, to the 
contrary. But there are things government can do.
  That is why we in the House of Representatives are putting more money 
into NIH funding. It is why 21st Century Cures has been introduced--to 
streamline approval processes at the FDA and make sure that various 
stakeholders involved in finding cures are all working together.
  Yet what remains as a contradiction at the heart of ObamaCare is the 
policy that taxes those who seek to innovate and improve public health 
outcomes through pioneering medical device equipment. We are taxing 
those who are trying to help improve, and who have improved, public 
health outcomes. It just doesn't make sense.
  Simply put, it is a disincentive to invest capital in precisely the 
industry that has proven itself to be the single most important in the 
history of civilization to improve public health--our life sciences 
industry here in this country.
  Mr. LEVIN. Mr. Speaker, I reserve the balance of my time.
  Mr. PAULSEN. Mr. Speaker, I yield 1 minute to the gentleman from West 
Virginia (Mr. Mooney) to speak on this issue.
  Mr. MOONEY of West Virginia. Mr. Speaker, I am a proud cosponsor of 
H.R. 160, the Protect Medical Innovation Act of 2015, also known as the 
medical device tax repeal.
  This bill would repeal the tax on medical device manufacturers that 
was put into place under ObamaCare. The medical device tax rate is 2.3 
percent, and this is in addition to the State sales tax on common 
medical devices such as pacemakers, hearing aids, and insulin pumps.
  This tax hurts the very same Americans we should be helping. For 
example, 13 percent of West Virginians--the State I am blessed to 
represent--have diabetes. This 2.3 percent tax makes it more difficult 
for struggling taxpayers in West Virginia and around the country to 
access critical healthcare devices like insulin pumps.
  If gone unchecked, this tax will continue to weaken the industry's 
ability to grow and help people in need. It will also continue to 
hinder the development of lifesaving treatments and devices.
  I hope my colleagues will join me tomorrow in voting for the repeal 
of the ill-advised medical device tax.
  Mr. LEVIN. Mr. Speaker, I continue to reserve the balance of my time.
  Mr. PAULSEN. Mr. Speaker, I yield 1 minute to the gentleman from 
Michigan (Mr. Benishek), a physician who works with patients each and 
every day and understands the importance of repealing this tax.
  Mr. BENISHEK. Mr. Speaker, I rise today to urge my colleagues to 
support H.R. 160, the Protect Medical Innovation Act.
  H.R. 160 will permanently repeal the misguided excise tax on medical 
devices that was imposed by the President's healthcare law.
  I am a cosponsor of this important legislation, along with over 280 
Members of this House of Representatives. In the 113th Congress, the 
Senate endorsed getting rid of this burdensome tax by an overwhelming 
margin. It is clearly time for this tax to go.
  The medical device tax discourages innovation, lowers the quality of 
medical care available to the American people, and cuts jobs while 
driving production overseas.
  Companies like RTI Surgical, based in my district, are being harmed 
by this burdensome tax. Instead of hamstringing these manufacturers, we 
should be allowing them to produce new medical devices and create jobs.
  I am a doctor who treated patients in northern Michigan for 30 years. 
I know how important medical devices are for providing quality health 
care, and I believe that getting rid of this tax will improve our 
Nation's healthcare system.
  I hope all my colleagues will join me in supporting this commonsense 
and long overdue fix for the train wreck that is the President's 
healthcare law.
  Mr. LEVIN. Mr. Speaker, I continue to reserve the balance of my time.
  Mr. PAULSEN. Mr. Speaker, I yield 2 minutes to the gentleman from 
California (Mr. Rohrabacher), a State that has been a leader in 
developing new medical technologies.
  Mr. ROHRABACHER. Mr. Speaker, I rise in support of this effort to 
prevent this very destructive tax from having the harmful impact that 
we know it will have. This medical device tax is perhaps the most 
odious of any tax that has ever been loaded upon the shoulders of the 
American people in the history of our Republic.
  Our first Chief Justice of the Supreme Court, John Marshall, once 
pointed out: ``The power to tax is the power to destroy.'' Well, who is 
being destroyed and who is being hurt by this medical device tax? It is 
the American people who are suffering maladies and health challenges, 
and we are putting them as the people who are going to be basically 
paying the bill or doing without their medical devices.
  I would like to give a personal example of this. I know it is very 
painful for me to do so, but I think I need to share this with my 
colleagues.
  Two and a half years ago, I was notified that my daughter, who was at 
that time 9 years old, had leukemia. It was a horror story for my 
family, a horror story, just like it is for families across America. We 
came out of that. We went through it. It was a tough, tough road for a 
year. Last week, she had her last cancer treatment and, last week, she 
was declared cancer free.
  The SPEAKER pro tempore (Mr. Fitzpatrick). The time of the gentleman 
has expired.
  Mr. PAULSEN. I yield an additional 1 minute to the gentleman from 
California.
  Mr. ROHRABACHER. Ninety percent of the kids who get leukemia today 
are cured from leukemia after a period of time. They actually will live 
through this. Only 40 years ago, 90 percent of the kids who got 
leukemia died.
  We have had different advances in medicine that have actually 
achieved this goal. But in my daughter's case, I could see very easily 
a medical device was put under her skin, a portal, so that she did not 
have to take the chemotherapy into her arms, which resulted in younger 
kids decades ago with their veins collapsing because of the 
chemotherapy being shot into their arm.
  The people who devised that medical device saved my daughter's life, 
and now we want to make them the most heavily taxed people in our 
country. That is ridiculous. We want to encourage people to build these 
types of devices that will save our children and help those people who 
are suffering.
  This medical device tax is odious, it is wrong, and it was 
wrongheaded from the very beginning. In the name of saving future 
children from things that we might be able to cure with a proper 
medical device, we need to make sure we eliminate this tax and keep 
faith with future generations, as well as those people who are 
suffering today.
  I ask my colleagues to join me in getting rid of this tax on medical 
devices.
  Mr. LEVIN. Mr. Speaker, I continue to reserve the balance of my time.
  Mr. PAULSEN. Mr. Speaker, may I inquire the amount of time remaining?
  The SPEAKER pro tempore. The gentleman from Minnesota has 11 minutes 
remaining. The gentleman from Michigan has 16\1/2\ minutes remaining.
  Mr. PAULSEN. Mr. Speaker, I yield 1 minute to the gentleman from 
Pennsylvania (Mr. Thompson).

[[Page H4477]]

  Mr. THOMPSON of Pennsylvania. Mr. Speaker, I thank my colleague from 
Minnesota.
  I rise today as a 30-year health care professional and a proud 
cosponsor of H.R. 160, the Protect Medical Innovation Act of 2015.
  This bill would repeal the Affordable Care Act's 2.3 percent tax on 
medical devices. These are medical devices that save and improve lives 
for millions of Americans. These devices include pacemakers, artificial 
joints, CAT scan machines, and many, many more.
  Mr. Speaker, the medical device tax is a terrible policy that is 
stifling innovation and United States competitiveness and is hurting 
small businesses all across the Nation, and certainly in the 
Pennsylvania Fifth Congressional District.
  This legislation, which has strong bipartisan support, will help to 
protect American jobs, keep America at the cutting edge of 
technological medical advances, and preserve a patient's access to 
affordable, lifesaving devices.
  Having served in a nonprofit healthcare setting for three decades, I 
rise today and ask my colleagues to join me in voting to repeal this 
unnecessary and very harmful tax.
  Mr. LEVIN. Mr. Speaker, I yield myself the balance of my time.
  There is no one that questions the importance of this industry--no 
one. This country has been in the forefront in terms of creating 
medical devices. There has been innovation and there has been 
enterprise, and it has impacted the lives of millions of people. That 
is not the issue here.
  The issue is this. A number of industries and a number of providers 
participated in creating the Health Care Reform Act. Essentially, I am 
not sure it is the industry as much as some Members are essentially 
coming here and saying: Give this industry a free ride in terms of 
their participation, while others are doing their part.
  That isn't fair; it isn't workable; and it is also fiscally 
irresponsible. I would like to talk to the CEOs of any of these 
companies and ask them if they think it is fiscally responsible to 
repeal this provision costing well over $20 billion, unpaid for, made 
permanent.
  Indeed, this is industry joined with others in the healthcare world 
in this country in a letter of May 11, 2009, to the President:

       Dear Mr. President,
       We believe that all Americans should have access to 
     affordable, high-quality healthcare services. Thus, we 
     applaud your strong commitment to reforming our Nation's 
     healthcare system. The times demand and the Nation expects 
     that we, as healthcare leaders, work with you to reform the 
     healthcare system.

  And it concludes with this paragraph:

       We, as stakeholder representatives, are committed to doing 
     our part to make reform a reality in order to make the system 
     more affordable and effective for patients and purchasers. We 
     stand ready to work with you to accomplish this goal.

  And it was signed by a number of representatives--the AMA; America's 
Health Insurance Plans, their leadership; the Pharmaceutical Research 
and Manufacturers; et cetera, and also signed by the president and CEO 
of the Advanced Medical Technology Association.
  So now people are coming here and saying what was essentially 
committed to in 2009 should essentially be ripped out of ACA in 2015.
  I just want to read from a report by the National Center for Health 
Research. And I refer, for example, to the chart on the number of 
employees at the 12 largest U.S.-based device companies. All of them 
show an increase in employment of the 12 largest, except two, and in 
one case, the reduction was from 10,800 to 10,500. One company did have 
a larger loss, but it wasn't anything close to catastrophic.
  Then the number of employees at the small, publicly traded device 
companies--one, two, three, four, five, six, seven, eight, nine--of 
those, only seven show a reduction in the number of employees from 2012 
to 2014. In one of them, there was a reduction of one, and the other, a 
reduction of four employees. And then there is another with a reduction 
of four, and another, a reduction of six. The others had increases in 
their employment, and two of them, one went from 230 to 320, and 
another from 244 to 303. These are the smallest.

                              {time}  1715

  Let me also refer in this document to stock prices for the 12 largest 
U.S.-based device companies.
  When you look down at the profit margin, all of their profits went up 
except one, which had a reduction of 1.6 percent from the close of 
January 2, 2013, to the close of January 2, 2015. That reduction was 
tiny. The others had a very substantial reduction, some in the 
twenties, one in the thirties, and the average was a 13.8 percent 
increase in the profit margin.
  Also, this report reads:

       Similarly, the report on 2013 employment, released by a 
     financial analysis news service, EP Vantage, showed that 11 
     of the top 15 device makers expanded their workforce after 
     the device tax went into effect.

  I think what is happening here is that a few of my colleagues are 
coming here and are using a few examples--and I don't deny, in a 
capitalist system, there are some losers as well as winners.
  Everybody isn't necessarily a winner, and there was a recession in 
this country during some of these years, but to come here and to use 
those examples that really are refuted by the overall data, I think, is 
essentially saying that we ought to begin, on this point, to rip apart 
the ACA because, in every case, there hasn't been an improvement for 
every company. In terms of research and development, the Ernst & Young 
report makes it very clear that spending by the industry increased by 6 
percent in the same year.
  I am just asking everybody who cares about healthcare reform and who 
cares about the overall picture here in the United States to resist the 
temptation to take several examples, perhaps, from their own districts, 
to draw conclusions about what really has happened in the medical 
device industry and to, essentially, come forth because of those 
relatively few examples and say that we should now, essentially, repeal 
this provision, costing well over $20 billion--unpaid for--permanently.
  That is not only contrary to the letter I read, but it is contrary to 
fairness within the healthcare industry, and it is really unfair to the 
millions of people who have benefited from the ACA when the motive, 
really, of so many of the Republicans who come here is not to simply 
repeal this tax, but it is part of an effort to, essentially, repeal 
the ACA altogether. We should resist that.
  The people of this country do not want that repeal, so let's vote 
``no''--and a resounding ``no''--on this proposal.

                                                     May 11, 2009.
     The President,
     The White House,
     Washington, DC.
       Dear Mr. President: We believe that all Americans should 
     have access to affordable, high quality health care services. 
     Thus, we applaud your strong commitment to reforming our 
     nation's health care system. The times demand and the nation 
     expects that we, as health care leaders, work with you to 
     reform the health care system.
       The annual growth in national health expenditures--
     including public and private spending--is projected by 
     government actuaries to average 6.2% through the next decade. 
     At that rate, the percent of gross domestic product spent on 
     health care would increase from 17.6% this year to 20.3% in 
     2018--higher than any other country in the world.
       We are determined to work together to provide quality, 
     affordable coverage and access for every American. It is 
     critical, however, that health reform also enhance quality, 
     improve the overall health of the population, and reduce cost 
     growth. We believe that the proper approach to achieve and 
     sustain reduced cost growth is one that will: improve the 
     population's health; continuously improve quality; encourage 
     the advancement of medical treatments, approaches, and 
     science; streamline administration; and encourage efficient 
     care delivery based on evidence and best practice.
       To achieve all of these goals, we have joined together in 
     an unprecedented effort, as private sector stakeholders--
     physicians, hospitals, other health care workers, payors, 
     suppliers, manufacturers, and organized labor--to offer 
     concrete initiatives that will transform the health care 
     system. As restructuring takes hold and the population's 
     health improves over the coming decade, we will do our part 
     to achieve your Administration's goal of decreasing by 1.5 
     percentage points the annual health care spending growth 
     rate--saving $2 trillion or more. This represents more than a 
     20% reduction in the projected rate of growth. We believe 
     this approach can be highly successful and can help the 
     nation to achieve the reform goals we all share.
       To respond to this challenge, we are developing consensus 
     proposals to reduce the rate of increase in future health and 
     insurance costs through changes made in all sectors of the 
     health care system. We are committed to taking action in 
     public-private partnership

[[Page H4478]]

     to create a more stable and sustainable health care system 
     that will achieve billions in savings through:
       Implementing proposals in all sectors of the health care 
     system, focusing on administrative simplification, 
     standardization, and transparency that supports effective 
     markets;
       Reducing over-use and under-use of health care by aligning 
     quality and efficiency incentives among providers across the 
     continuum of care so that physicians, hospitals, and other 
     health care providers are encouraged and enabled to work 
     together towards the highest standards of quality and 
     efficiency;
       Encouraging coordinated care, both in the public and 
     private sectors, and adherence to evidence-based best 
     practices and therapies that reduce hospitalization, manage 
     chronic disease more efficiently and effectively, and 
     implement proven clinical prevention strategies; and,
       Reducing the cost of doing business by addressing cost 
     drivers in each sector and through common sense improvements 
     in care delivery models, health information technology, 
     workforce deployment and development, and regulatory reforms.
       These and other reforms will make our health care system 
     stronger and more sustainable. However, there are many 
     important factors driving health care costs that are beyond 
     the control of the delivery system alone. Billions in savings 
     can be achieved through a large-scale national effort of 
     health promotion and disease prevention to reduce the 
     prevalence of chronic disease and poor health status, which 
     leads to unnecessary sickness and higher health costs. Reform 
     should include a specific focus on obesity prevention 
     commensurate with the scale of the problem. These initiatives 
     are crucial to transform health care in America and to 
     achieve our goal of reducing the rate of growth in health 
     costs.
       We, as stakeholder representatives, are committed to doing 
     our part to make reform a reality in order to make the system 
     more affordable and effective for patients and purchasers. We 
     stand ready to work with you to accomplish this goal.
           Sincerely,
     Stephen J. Ubl,
       President and CEO, Advanced Medical Technology Association.
     Karen Ignagni,
       President and CEO, America's Health Insurance Plans.
     Rich Umbdenstock,
       President and CEO, American Hospital Association.
     J. James Rohack, MD,
       President-elect American Medical Association.
     Billy Tauzin,
       President and CEO, Pharmaceutical Research and 
     Manufacturers of America.
     Dennis Rivera,
       Chair, SEIU Healthcare, Service Employees International 
     Union.

  Mr. LEVIN. I yield back the balance of my time.
  Mr. PAULSEN. Mr. Speaker, I yield myself the balance of my time.
  I have a couple of points right off the bat. My friend from Michigan 
claims that the tax hasn't necessarily impacted jobs, that there are 
only certain stories. I would just point out that, in his home State, 
there is a company named Stryker--now, it is a larger company--that 
laid off 1,000 employees back in November of 2011 to provide 
efficiencies and realign resources in advance of the new medical device 
excise tax.
  As to a lot of data that was mentioned earlier, those figures that 
are talking about how well the industry is doing and as to the growth 
and the sales numbers are global data. These are companies that have 
global awareness and a global presence. Those are not U.S. jobs. We 
want those jobs in the United States. If we can repeal this tax, we can 
make sure that job growth is here in the U.S. instead of outside of the 
United States.
  Mr. Speaker, this is not smart tax policy. It is hurting our 
innovators, and it is costing us jobs. This industry is an American 
success story. We all know the names of the larger companies because 
some of those were mentioned here in debate on the floor today, but 
there are thousands of these companies--the vast majority--because, 
again, 98 percent have fewer than 500 employees, and over 80 percent 
have fewer than 50 employees.
  These are companies you have never heard of, but there is a doctor or 
an engineer or an entrepreneur who has started or who has come up with 
an idea to create a company in the backyard or in the garage to help 
improve lives or to save lives. That is what we are trying to protect 
here, Mr. Speaker.
  These are not technicians in some white lab coats who are trying to 
improve widgets or to build a widget faster. These are, literally, 
small businesses that are on missions to save lives. If you think about 
it, what could be more entrepreneurially worthwhile than that?
  We in Congress have a responsibility to give America's innovators the 
best shot, the best opportunity possible, by removing any obstructions 
to those inventions that are going to bring us all a better quality of 
life. We have the ability to help create a new age of American 
innovation, and we can help kick-start that process this week--today, 
tomorrow, with a vote--by repealing the destructive medical device tax.
  It was mentioned as a part of the debate also that the industry came 
forward and that there was vast support for the Affordable Care Act, 
and they agreed to the tax. Mr. Speaker, there are no letters from the 
industry whatsoever that support their buy-in for a 2.3 percent excise 
tax--a tax on revenue, not on profit.
  It is true that there were letters that were put out that said they 
were committed to healthcare reform and that they wanted to see that 
process move forward, but then they were very vocal when this excise 
tax idea was floated as a part of the new healthcare law and even after 
the law passed. It has been continuous, this awareness about their 
opposition in their knowing of the detrimental effects that it would 
have.
  Mr. Speaker, this is also not about the Affordable Care Act because 
we have had many votes on that--to repeal it, to change it, to move in 
a different direction. This is about a tax that is going into the 
general fund, that is not going into some special account to fund 
ObamaCare. That is not what this tax is doing. This is going into the 
general fund.
  That Affordable Care Act discussion will come up at another time with 
the Court case coming up in the near future. This is more of an 
opportunity to stand up with a bipartisan voice to declare our support 
for American manufacturing, for American jobs, and for protecting our 
patients, including our seniors.
  I just want to remind my friends that the President has said that he 
has been open to any ideas that will improve accessibility, that will 
improve affordability, and the quality of health care. That is exactly 
what this bill does. It is about protecting access to those devices.
  It is also important to point out the 281 cosponsors. The bipartisan 
support is deep, and it is broad. If you think back to the sustainable 
growth rate debate we had just a little over a month ago, that is 
important to bring up. Why? It is because there was broad, bipartisan 
support and a belief that the policy was harming patient care and 
innovation.
  This is good policy now if we can repeal this tax. It is about doing 
the right thing for our constituents, which outweighs the concerns of 
the offsets.
  Mr. Speaker, I urge support for this legislation, and I yield back 
the balance of my time.
  The SPEAKER pro tempore. All time for debate has expired.
  Pursuant to House Resolution 319, the previous question is ordered on 
the bill, as amended.
  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. The question is on the passage of the bill.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. LEVIN. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this question will be postponed.

                          ____________________