[Congressional Record Volume 166, Number 195 (Tuesday, November 17, 2020)]
[House]
[Pages H5863-H5865]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              {time}  1800
                 MAINTAINING EXPANSION OF TELEMEDICINE

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 3, 2019, the gentleman from Arizona (Mr. Schweikert) is 
recognized for 60 minutes as the designee of the minority leader.
  Mr. SCHWEIKERT. Madam Speaker, with all the chaos and the activity 
going on around us, as we all know, we are all organizing our 
conferences. I wanted to touch on a couple of pieces of legislation 
that are out there right now that I am hoping, if we do some packages 
between now and the end of the year, we will all consider. And I love 
using the little boards because I think it sort of helps concentrate.
  One of the things, if there is any positive of what we have gone 
through in the pandemic, is the skepticism that was this body about 
telemedicine I hope is over, if you see the adoption rate of what has 
happened with, particularly, our seniors in embracing, having positive 
experiences, and actually even demanding telemedicine services.
  My understanding is now that there is open enrollment in Medicare 
part D, that is actually now one of the common requests: What type of 
telemedicine services do you provide and offer?
  If we understand, as a body, that the access for our seniors to use 
telemedicine functionally--the expansion of the reimbursements, the 
rules--expires when the pandemic is declared over, I am desperately 
hoping that our brothers and sisters around here on the right and the 
left hear that and understand if the community has embraced the price 
efficiency, the additional access to healthcare--that is, the 
telemedicine--let's make sure we don't let it expire when the vaccine 
and those come onto the market, are widely adopted, and we start to see 
the declaration that the pandemic is over. So, this is just sort of the 
benchmark of starting.
  Now, if I am making the argument that telemedicine has expanded 
access, and we are seeing the opportunity for some real cost 
efficiency--because, as we know, it is always hard to talk about, but 
Medicare is one of the greatest drivers of U.S. debt. As a matter of 
fact, it is the greatest driver of U.S. debt.
  It is demographics. Our brothers and sisters who are 65 years and 
older--and I am going to be there soon--earn this benefit. But the fact 
of the matter is, the unfunded liabilities, the substantial portion of 
it, come out of the general fund. It is a major driver.
  We should be excited that we had a proof of concept during this sort 
of miserable several months, that it expanded access. We are seeing the 
price efficiency.

[[Page H5864]]

  And the skepticism that seniors were going to have discomfort on 
using FaceTime and other things on their electronic devices, the 
arrogance of this place was wrong. We underestimated our fellow 
Americans in their ability to use the technology.
  Now, the next wave of what else we can be doing to actually expand, 
we have something that we have introduced called the Safe Testing at 
Residence Telehealth, because we had to come up with a title that would 
create the word ``START,'' as we often do around here.
  As you all saw, about 2 months ago, there were some home COVID tests 
that received approval. If we would tie those home COVID tests with 
telemedicine, those who are vulnerable in our communities could 
actually not have to risk getting in their cars, being part of the 
vulnerable population going to a clinic or the drive-through, or other 
things where there is testing. They can do it at home with these home 
test kits that are approved. We think that is part of the concept of 
the expansion of what is telemedicine.
  If we like this, I can expand the thought experiment: Americans who 
want to do their COVID tests at home and then use telemedicine as part 
of the experience, should that be allowed? Of course, it should.
  Why wouldn't you also go a little bit further? I don't have a board 
on this next one, but we have talked about it here, the ability to use 
technology also to help us be part of that expansion of telemedicine. 
This could be everything from the oxygen patch to the portable EKG.
  My understanding is that there is an American company coming up with 
a smartwatch that is going to do your oxygen, your temperature, your 
pulse rate, even your blood pressure. It turns out those things, put 
into an algorithm, can do some pretty amazing things to help you manage 
your healthcare.
  That is, in many ways, the future of telemedicine. It is not just 
talking to a healthcare professional. It is the ability to use 
technology to watch yourself, to keep yourself healthy, to diagnose if 
you are catching something, and then use that information with your 
healthcare professional.
  These are pieces of legislation that have demonstrated they are here. 
Adoption, particularly with seniors, I am hoping that the body thinks 
about it. If we do any type of stimulus or COVID package between now 
and the end of the year, that we think about telemedicine and keeping 
it permanently with us, the expansion.
  Let's walk through a couple of other things.
  Another piece of legislation we have is, if many of us have seen the 
economic, emotional, you know, future income, the damage we did by 
shutting down so much of our society, economically, in trying to slow 
down the spread of COVID, how do we help businesses stay operating, 
keep their doors open, but also know they are providing a safe 
workplace? We have a tax credit that would help those businesses 
provide testing but also get that partial reimbursement, that partial 
credit, quickly.
  We came up with a quirky idea. Every couple of weeks or every month, 
most businesses have to contribute on the payroll tax. Put the credit 
there so the cash comes back in very, very quickly, or the credit comes 
in very quickly.
  We have a workplace testing tax credit piece of legislation. If we 
are going to move forward with a package, something like that should be 
there because if we are trying to keep our communities open but keep 
them healthy, we need that testing at the small business level. This 
makes it affordable.

  Another thing I would like us to think about, and this is more 
global, the White House, the administration, those of us in this body, 
the resources we put forward months ago, and then the management of 
Operation Warp Speed, other than the stock market, I thought we would 
see more collective joy on how quickly we are moving to a vaccine. If 
it is true that there is a vaccine out there that was--what?--94.5 
percent effective in its first statistical abstract, this is wonderful. 
We have done something that has never been done before, bringing this 
type of vaccine and heading toward approval and emergency 
authorization.
  If this is our benchmark, that we know we have light at the end of 
this tunnel, then we need to also now step up and do the things that 
spur the economic expansion once again. Americans deserve to live in a 
healthy, prosperous country. If the vaccine, Operation Warp Speed, is 
working, which now we know we have multiple vaccines that are on the 
cusp of being here with amazing efficacy, it is time to do some other 
things that make the economy grow.
  The first one I want to give is just a simple thought. When we did 
tax reform, we stopped something that was part of the ObamaCare 
financing. The ACA had a mechanism where your ability to deduct your 
healthcare expenses was going to go up. You didn't get to deduct 
anything until your healthcare expenses were over 10 percent of your 
income. That was one of the mechanisms that kicked a lot of seniors, 
particularly, in the teeth, and that was part of the ACA financing.
  When we did tax reform at the end of 2017, we held it for a couple 
more years at 7.5 percent. If you had $100 of income and $7.50, the 
next portion of that, you get to deduct. If you are under that, you 
don't get to take it off your taxes, if that helps explain it.
  We have a piece of legislation that for the next 2 years would make 
it that you only have to hit 5 percent. Then every incremental dollar 
above that, you could deduct.
  Considering how many folks in the United States this year, and 
potentially into next year, are going to have some unusual healthcare 
expenses, why wouldn't we do this as part of the package?
  The other part is: Then, let's hold it at the 7.5 percent for 
perpetuity. Let's make that permanent.
  I know that it will offend some folks who wanted to raise it because 
that was one of the financing mechanisms of the ACA, ObamaCare, to 
raise those functionally--take away that tax benefit to folks who had 
high medical expenses. But I think that we could all agree, with what 
we have been through, this would be a healthy thing, particularly for 
those who have had some difficulty this year and into next year.
  The last one I want to give you is--in some ways, it is a little bit 
of a quirky idea, but I want to beg of the body to think about what we 
can do to spur economic expansion, to spur the animal spirits, the 
investment in our society, in our country, and into our communities but 
without piling on the debt.
  We all know a number of the things we did this year were necessary. 
These were unprecedented times. But we are going to have to start 
paying for this. The amount of interest costs, the Federal Reserve 
creating liquidity, eventually, that does dial back. We will have to, 
in the future, pay for these times. So, what do you do to spur the 
economy?
  We have a quirky idea that would say: If you would be willing to buy 
an asset, make investments in plant and equipment, do those sorts of 
things that, in today's world, I am buying this hoping I get 
traditional capital gains in the future--but the problem with capital 
gains tax holidays, from a conceptual standpoint, is you are often 
being given a discounted tax rate on gains you have already produced. 
How about you get those people who are willing to invest around the 
country to invest money in the hope that what they buy today will go up 
in value in the future? It is not guaranteed.
  The idea is if we are seeing with the Federal Reserve and the Beige 
Book, and many of these other things, that there are stunning amounts 
of cash sitting in bank accounts all around this country that we need 
circulating, that we need that velocity back into our society and our 
communities, something that might be a fun incentive is saying: If you 
will buy assets, if you will invest in plant and equipment, if you will 
take a risk today, we don't know, we can't guarantee it, but a couple 
of years from now, if that value goes up and you sell, you will get a 
discounted capital gains tax rate because you invested during this 
window when we needed to functionally goose the economy along.
  We wanted to make sure that the curve that we are seeing, where our 
brothers and sisters have work opportunities, and the number of small 
businesses that disappeared permanently,

[[Page H5865]]

that those small business owners who now have lost their businesses 
have access to investors who are willing to give them another chance.
  The beauty of this is it doesn't require a large check from the 
Treasury today. We are sort of saying: Take a risk on the American 
people. Take a risk on our economy today. A couple of years from now, 
if it worked, you get a benefit.
  We need to be looking more for ideas, I believe, like this that we 
can demonstrate a stimulus into our society and our communities without 
immediately putting ourselves more into debt.

                              {time}  1815

  So these are just a handful of ideas that, if the body--and being in 
the minority, you know, sometimes we have to sort of persuade by 
hopefully having good ideas and just getting here on the floor and 
telling everyone about them. But there are ideas like this, whether it 
is the permanency of telemedicine, expanding the definition of such, 
providing individuals that ability to do testing at home, ideas like 
this or the previous one, and ideas of allowing small businesses to be 
able to get a tax credit for providing testing to their employees to 
keep them healthy.
  But I think this one is sort of how a reverse capital gains tax 
holiday actually works. It is creative, and we can put in some turning 
rules so someone doesn't take an asset and sell it and then immediately 
buy it again. Those things actually already exist in the IRS Code.
  But these are ideas that I am hoping the body will step up, move 
forward, and say we can get this economy roaring again, we can get back 
to the economic miracle that 2018 and 2019 were, using creativity like 
this.
  And that is my pitch for this evening.
  Madam Speaker, I thank the Chair for allowing me to tell our story, 
and I yield back the balance of my time.

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