[Congressional Record Volume 167, Number 211 (Tuesday, December 7, 2021)]
[House]
[Pages H6928-H6933]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


          DR. LORNA BREEN HEALTH CARE PROVIDER PROTECTION ACT

  Mr. HORSFORD. Madam Speaker, pursuant to House Resolution 838, I call 
up the bill (S. 610) to address behavioral health and well-being among

[[Page H6929]]

health care professionals, and ask for its immediate consideration in 
the House.
  The Clerk read the title of the bill.
  The SPEAKER pro tempore (Mrs. Hayes). Pursuant to House Resolution 
838, an amendment in the nature of a substitute consisting of the text 
of Rules Committee Print 117-22 is adopted and the bill, as amended, is 
considered read.
  The text of the bill, as amended, is as follows:

                                 S. 610

       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 ``Protecting Medicare and 
     American Farmers from Sequester Cuts Act''.

     SEC. 2. ADJUSTMENTS TO MEDICARE SEQUESTRATION REDUCTIONS.

       (a) Extension of Temporary Suspension Through March 2022--
       (1) In general.--Section 3709(a) of division a of the CARES 
     Act (2 U.S,C. 901a note) is amended--
       (A) in the subsection header by inserting ``AND 
     ADJUSTMENT'' after ``Suspension''; and
       (B) by striking ``December 31, 2021'' and inserting ``March 
     31, 2022''.
       (2) Effective date.--The amendments made by paragraph (1) 
     shall take effect as if enacted as part of the CARES Act 
     (Public Law 116-136).
       (b) Adjustments to Medicare Program Sequestration Reduction 
     With Respect to Fiscal Years 2022 and 2030.--Section 251A(6) 
     of the Balanced Budget and Emergency Deficit Control Act of 
     1985 (2 U.S.C. 901a(6)) is amended--
       (1) by redesignating subparagraph (C) as subparagraph (E); 
     and
       (2) by inserting after subparagraph (B) the following new 
     subparagraphs:
       ``(C) Notwithstanding the 2 percent limit specified in 
     subparagraph (A) for payments for the Medicare programs 
     specified in section 256(d), the sequestration order of the 
     President under such subparagraph for fiscal year 2022 shall 
     be applied to such payments so that with respect to the 
     period beginning April 1, 2022, and ending on June 30, 2022, 
     the payment reduction shall be 1.0 percent.
       ``(D) Notwithstanding the 2 percent limit specified in 
     subparagraph (A) for payments for the Medicare programs 
     specified in section 256(d), the sequestration order of the 
     President under such subparagraph for fiscal year 2080 shall 
     be applied to such payments so that--
       ``(i) with respect to the first 6 months in which such 
     order is effective for such fiscal year, the payment 
     reduction shall be 2.25 percent; and
       ``(ii) with respect to the second 6 months in which such 
     order is so effective for such fiscal yvar, the payment 
     reduction shall be 3 percent.''.

     SEC. 3. EXTENSION OF SUPPORT FOR PHYSICIANS AND OTHER 
                   PROFESSIONALS IN ADJUSTING TO MEDICARE PAYMENT 
                   CHANGES.

       (a) In general--Section 1848 of the Social Security Act (42 
     U.S.C. 1395w-4) is amended--
       (1) in subsection (c)(2)(B)(iv)(V), by striking ``2021'' 
     and inserting ``2021 or 2022''; and
       (2) in subsection (t)--
       (A) in the subsection header, by striking ``2021'' and 
     inserting ``2021 and 2022'';
       (B) in paragraph (1)--
       (i) by striking ``during 2021'' and inserting ``during 2021 
     and 2022''; and
       (ii) by striking ``for such services furnished on or after 
     January 1, 2021, and before January 1, 2022, by 3.75 
     percent.'' and inserting ``for--
       ``(A) such services furnished on or after January 1, 2021, 
     and before January 1, 2022, by 3.75 percent, and
       ``(B) such services furnished on or after January 1, 2022, 
     and before January 1, 2023, by 3.0 percent.''; and
       (C) in paragraph (2)(C)--
       (i) in the subparagraph header, by striking ``2021'' and 
     inserting ``2021 and 2022''
       (ii) hy inserting ``for services furnished in 2021 or 
     2022'' after ``under this subsection''; and
       (iii) by inserting ``or 2022, respectively'' before the 
     period at the end.
       (b) Report.--Section 101(c) of division N of the 
     Consolidated Appropriations Act, 2021 (Public Law 116-260) is 
     amended--
       (1) in the first sentence--
       (A) by striking ``April 1, 2022'' and inserting ``each of 
     April 1, 2022, and April 1, 2023''; and
       (B) by striking ``, as added by subsection (a)'' and 
     inserting ``furnished during 2021 or 2022, respectively''; 
     and
       (2) in the second scntence--
       (A) by striking ``Such report'' and inserting ``Each such 
     report''; and
       (B) by inserting ``with respect to 2021 or 2022, as 
     applicable'' after ``under such section''.

     SEC. 4. PRESERVING PATIENT ACCESS TO CRITICAL CLINICAL LAB 
                   SERVICES.

       (a) Revised Phase-in of Reduction From Private Payor Rate 
     Implementation.--Section 1834A(b)(3) of the Social Security 
     Act (42 U.S.C. 1395m-1(b)(3)) is amended--
       (1) in subparagraph (A), by striking ``through 2024'' and 
     inserting ``through 2025''; and
       (2) in subparagraph (B)--
       (A) in clause (ii), by striking ``for 2021'' and inserting 
     ``for each of 2021 and 2022''; and
       (B) in clause (iii), by striking ``2022 through 2024'' and 
     inserting ``2023 through 2025''.
       (b) Revised Reporting Period for Reporting of Private 
     Sector Payment Rates for Establishment of Medicare Payment 
     Rates.--Section 1834A(a)(1)(B) of the Social Security Act (42 
     U.S.C. 1395m-1(a)(1)(B)) is amended--
       (1) in clause (i), by striking ``December 31, 2021'' and 
     inserting ``December 31, 2022''; and
       (2) in clause (ii)--
       (A) by striking ``January 1, 2022'' and inserting ``January 
     1, 2023''; and
       (B) by striking ``March 31, 2022'' and inserting ``March 
     31, 2023''.

     SEC. 5. DELAY TO THE IMPLEMENTATION OF THE RADIATION ONCOLOGY 
                   MODEL UNDER THE MEDICARE PROGRAM.

       Section 133 of Division CC of the Consolidated 
     Appropriations Act, 2021 (Public Law 116-260) is amended by 
     striking ``January 1, 2022'' and inserting ``January 1, 
     2023''.

     SEC. 6. MEDICARE IMPROVEMENT FUND.

       Section 1898(b)(1) of the Social Security Act (42 U.S.C. 
     1395iii(b)(l)) is amended by striking ``fiscal year 2021'' 
     and all that follows through the period at the end and 
     inserting ``fiscal year 2021, $101,000,000.''.

     SEC. 7. PAYGO ANNUAL REPORT.

       For the purposes of the annual report issued pursuant to 
     section 5 of the Statutory Pay-As-You-Go Act of 2010 (2 
     U.S.C. 934) after adjournment of the first session of the 
     117th Congress, and for determining whether a sequestration 
     order is necessary under such section, the debit for the 
     budget year on the 5-year scorecard, if any, and the 10-year 
     scorecard, if any, shall be deducted from such scorecard 2022 
     and added to such scorecard in 2023.

     SEC. 8. EXPEDITED PROCEDURES FOR CONSIDERING AN INCREASE IN 
                   THE DEBT LIMIT.

       (a) Definition--In this section, the term ``joint 
     resolution'' means a joint resolution--
       (1) that is introduced by the Majority Leader of the 
     Senate, or a designce, during the period beginning on the 
     date of enactment of this Act and ending December 31, 2021;
       (2) which does not have a preamble;
       (3) the title of which is as follows: ``Joint resolution 
     relating to increasing the debt limit.''; and
       (4) the matter after the resolving clause of which is as 
     follows: ``That the limitation under section 3101(b) of title 
     31, U11itecl States Code, as most recently increased by 
     Public Law 117-50 (31 U.S.C. 3101 note), is increased by $--
     ------------'', the blank space' being appropriately filled 
     in with the dollar amount of the increase.
       (b) Expedited Consideration in Senate.--
       (1) Placement on calendar.--Upon introduction in the 
     Senate, the joint resolution shall be placed immediately on 
     the calendar.
       (2) Proceeding to consideration.--
       (A) In general.--Notwithstanding rule XXII of the Standing 
     Rules of the Senate, it is in order, not later than January 
     15, 2022 (even though a previous motion to the same effect 
     has been disagreed to) to move to proceed to the 
     consideration of the joint resolution.
       (B) Procedure.--For a motion to proceed to the 
     consideration of the joint resolution--
       (i) all points of order against the motion are waived;
       (ii) the motion is not debatable;
       (iii) the motion is not subject to a motion to postpone;
       (iv) a motion to reconsider the vote by which the motion is 
     agreed to or disagreed to shall not be in order, and
       (v) if the motion is agreed to, the joint resolution shall 
     remain the unfinished business until disposed of.
       (3) Floor consideration.--
       (A) In general.--If the Senate proceeds to considerntion of 
     the joint resolution--
       (i) all points of order against tile joint resolution (and 
     against consideration of the joint resolution) are waived;
       (ii) debate on the joint resolution, and all debatable 
     motions and appeals in connection therewith, shall be limited 
     to not more than 10 hours, which shall be divided equally 
     between the Chairman and Ranking Member of the Committee on 
     Finance;
       (iii) an amendment to the joint resolution is not in order;
       (iv) a motion to postpone or a motion to commit the joint 
     resolution is not in order; and
       (v) a motion to proceed to the consideration of other 
     business is not in order.
       (B) Vote on passage.--The vote on passage shall occur 
     immediately following the conclusion of the debate on the 
     joint resolution and a single quorum call if requested in 
     accordance with the rules of the Senate.
       (C) Rulings of the chair on procedure.--Appeals from the 
     decisions of the Chair relating to the application of this 
     paragraph or the rules of the Senate, as the ease may be, to 
     the procedure relating to the joint resolution shall be 
     decided without debate.
       (D) Single measure authorized.--It shall not be in order to 
     consider more than 1 joint resolution under the procedures 
     under this paragraph.
       (E) Sunset.--It shall not be in order to consider a joint 
     resolution under the procedures under this paragraph after 
     January l6, 2022.
       (4) Rules of the senate.--This subsection is enacted by 
     Congress--
       (A) as an exercise of the rulemaking power of the Senate, 
     and as such is deemed a part

[[Page H6930]]

     of the rules of the Senate, but applicable only with respect 
     to the procedure to be followed in the Senate in the case of 
     a joint resolution, and supersede other rules only to the 
     extent that they are inconsistent with such rules; and
       (B) with full recognition of the constitutional right of 
     the Senate to change the rules (so far as relating to the 
     procedure of the Senate) at any time, in the same manner, and 
     to the same extent as in the case of any other rule of the 
     Senate.''

  The SPEAKER pro tempore. The bill, as amended, shall be debatable for 
60 minutes equally divided and controlled by the chair and ranking 
minority member of the Committee on Ways and Means or their respective 
designees.
  The gentleman from Nevada (Mr. Horsford) and the gentleman from Texas 
(Mr. Brady) each will control 30 minutes.
  The Chair recognizes the gentleman from Nevada.

                              {time}  1930


                             General Leave

  Mr. HORSFORD. Madam Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and to insert extraneous material on S. 610.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Nevada?
  There was no objection.
  Mr. HORSFORD. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, I rise in support of S. 610, the Protecting Medicare 
and American Farmers from Sequester Cuts Act, which will, among other 
things, extend additional relief to Medicare providers in 2022 to 
support providers during the COVID-19 public health emergency.
  In 2019, the Centers for Medicare and Medicaid Services made changes 
to how different physician services were valued relative to one another 
in the Medicare payment system. While physicians performing many 
primary care services saw an increase in payments as a result of these 
changes, other providers saw fairly substantial reductions which were 
not phased in.
  That is why last year, Congress provided a 3.75 percent increase in 
the Medicare conversion factor, as a transition to the providers that 
were most affected.
  This legislation continues that glidepath, with a 3 percent 1-year 
increase in the Medicare conversion factor, providing a bump in 
payments. With the new COVID variant emerging here in the United 
States, this will be important support for our frontline workers.
  This legislation also eliminates the Medicare sequester, the 2 
percent cut slated to take effect in January, and instead provides a 
glidepath by fully eliminating the cut in the first quarter and phasing 
it down to 1 percent in the second quarter.
  Lastly, the legislation imposes a 1-year delay on clinical laboratory 
reductions and a radiation oncology payment model to provide additional 
time to adjust to these new policies. These commonsense provisions were 
also included in the legislation that I am proud to have introduced 
earlier today, along with my colleague, Congresswoman Schrier. These 
provisions have strong support from the medical community, physicians, 
and hospitals, because those in the healthcare field recognize that we 
must ensure providers have the support they need to care for patients 
as we continue to battle the COVID-19 pandemic. A letter from 20 
surgical groups notes: ``We urge Congress to pass the Protecting 
Medicare and American Farmers from Sequester Funds Act to mitigate the 
2022 Medicare payment cuts.''
  This legislation will also provide a procedure for the Senate to 
raise the debt ceiling. This deal was struck by Senate Republican 
Leader McConnell.
  As much as my colleagues across the aisle may claim, this is not 
about new spending. Increasing the debt ceiling will prevent us from 
defaulting on debt we already owe.
  It is about investments that Congress previously approved. In fact, 
97 percent of the current debt was accumulated before President Biden 
assumed office. This vote is about protecting the full faith and credit 
of the United States of America.
  A default would spell disaster. Nearly 50 million seniors could stop 
receiving Social Security checks for a period of time. Troops could go 
unpaid. Millions of families who rely on the monthly child tax credit, 
a tax cut, could see delays. Our current economic recovery could 
reverse into recession, with billions of dollars of growth and millions 
of jobs lost. According to an analysis by Moody's Analytics chief 
economist, Mark Zandi, the recession could wipe out as many as 6 
million jobs and erase $15 trillion in household wealth.
  I am proud to stand in strong support of this bipartisan agreement 
that will end the specter of default looming over the American economy 
and the American people.
  Madam Speaker, I urge my colleagues to support this responsible 
measure, and I reserve the balance of my time.
  Mr. BRADY. Madam Speaker, I yield myself such time as I may consume.
  Madam Speaker, today ought to be a rare day for bipartisanship on 
behalf of patients and healthcare providers across America. Sadly, it 
is another day for Democrats' partisanship.
  Providing needed funding for Medicare providers, our local doctors 
and hospitals, especially as we recover from the pandemic, is just 
common sense. We should be on the same page. In fact, we were, as early 
as a few hours ago, when Republicans also introduced legislation to 
help our healthcare providers.
  Instead, Democrats have decided to push a very partisan agenda that 
has led to crisis after crisis, including the one we addressed today.
  Our border communities are overwhelmed. Bidenflation is robbing 
American paychecks. The President has mishandled the economy so badly, 
he is already nearly a million jobs short of his promises from his last 
$2 trillion spending binge.
  Now, patients and doctors are being held hostage to pave the way for 
trillions of more reckless spending that most Americans don't even 
want.
  Regrettably, Democrats are politicizing needed funding for Americans' 
healthcare with a poison pill that provides a process for lifting the 
debt ceiling, absolutely unrelated, and using patients and access to 
local doctors as leverage to increase the national debt on our children 
and grandchildren.
  Last month, knowing this was coming, Republicans on the Ways and 
Means Committee called for a hearing, a bipartisan hearing, to address 
the issues around our doctors and our healthcare providers and 
reimbursement.
  In a letter, we wrote to our Democrat colleagues, who we believed 
shared the same concerns, and said: ``If the stability of healthcare 
providers is, in fact, still a priority for you,'' let's hold a hearing 
so that we can discuss a legislative solution going forward to maintain 
patient access to our local providers.
  Instead, once again, my Democrat colleagues are choosing to go it 
alone because seemingly they are obsessed with spending taxpayer 
dollars wastefully.
  We know there is bipartisan support for doctors. We should do a 
standalone bill. But the truth is, House Republicans can't support 
using patients and access to local doctors as leverage to increase the 
national debt on our children.
  We know there is bipartisan support for providers, and we know this 
could stand alone as a bill. Unfortunately, this is not the path the 
Democrats have chosen.
  Make no mistake: This debt ceiling is being lifted to pay for 
trillions of wasteful socialist spending. This debt ceiling limit is 
increased until 2023, all to accommodate trillions of wasteful 
spending, and Americans know it.
  The Committee for a Responsible Federal Budget has noted that 
President Biden's Build Back Better bill would cost nearly $5 trillion, 
while the President and others continue to claim falsely that this 
costs zero dollars.
  Unfortunately for the President and the taxpayers who will have to 
foot the bill, The Washington Post fact checker found this claim false 
and misleading. They said it ``would take some dubious gimmicks that 
help disguise the true cost of President Biden's agenda,'' and these 
gimmicks are just to justify paying for absolute waste.
  Democrats give away hundreds of billions of dollars to special 
interests and the wealthy, literally sending government checks to the 
top 1 percent and the biggest corporations.

[[Page H6931]]

  Democrats protect so-called green companies from their new minimum 
tax. Wealthy individuals with up to $500,000 in income every year enjoy 
their own green welfare, including a $12,500 check from single moms and 
working Americans so they can buy the wealthy a luxury electric 
vehicle.
  Democrats force the 90 percent of Americans who don't join a union to 
subsidize the few who do. Democrats provide loopholes and tax cuts for 
special interests like trial lawyers.
  Democrats would increase the $10,000 SALT cap, providing wealthy 
taxpayers with a windfall of a quarter of a trillion dollars to help 
the wealthy.
  Two out of three millionaires get a tax cut. One out of three middle-
class families get a tax hike. Where are their priorities?
  Democrats' tax and spending spree will more than double Americans' 
chances of being audited as it targets lower- and middle-income earners 
to make sure they pay their ``fair share.''
  This proposal and that proposal will lead to an additional 1.2 
million IRS audits each year focused on the middle class, and we will 
see $200 billion of new taxes on our Main Street small businesses.
  What does it mean for Americans? More than double the chance of being 
audited, and not just for the rich.
  Americans ought to take a step back and see what we are doing tonight 
as shameful. That is exactly what it is.
  Democrats are threatening to hold up payments for our local doctors 
and healthcare providers, as they fight out of the pandemic, so 
Democrats can pay for measures they claim we need because of the 
pandemic.
  We have gone from never letting a crisis go to waste to never letting 
a crisis get in the way of waste.
  This debt ceiling crisis didn't have to happen this way. House 
Democrats have known this day was coming for 2 years, but they never 
bothered to pass a budget, never passed appropriations bills, and 
failed to have any bipartisan discussion. Here we are at the last 
minute.
  Madam Speaker, commonsense Americans will not let their doctors and 
healthcare providers be held hostage to this debt ceiling crisis. We 
strongly urge a ``no'' vote on this bill.
  Madam Speaker, I reserve the balance of my time.
  Mr. HORSFORD. Madam Speaker, I yield 2 minutes to the gentleman from 
New Jersey (Mr. Pallone), the distinguished chair of the Energy and 
Commerce Committee.
  Mr. PALLONE. Madam Speaker, I rise in strong support of this 
bipartisan legislation that will continue to guarantee access to 
healthcare providers as we confront the COVID-19 pandemic.
  Nothing could be more important to our seniors than making sure that 
they have access to doctors during this time.
  I heard what my colleague on the Republican side said, but I just 
want to assure everyone that what we are really talking about here is 
making sure that our seniors can access a doctor, that there are 
doctors available to help them during the COVID-19 pandemic.
  Since the beginning of the pandemic, Congress has provided relief to 
Medicare providers by waiving a 2 percent cut in payments that was 
created as part of sequestration. This legislation will continue 
waiving those cuts. It also protects Medicare and other 
Federal programs by preventing any cuts from occurring as a result of 
paygo rules.

  The legislation provides additional relief to healthcare providers by 
increasing payments under Medicare's physician fee schedule next year 
and preventing cuts to Medicare payments for lab and oncology services.
  We have to understand that providers have to keep their doors open. 
Labs have to be open. During these difficult times, when providers are 
being stretched to the limit, and labs, oncology services, and 
everything is being stretched to the limit, if Congress does not take 
action now and pass this bill, then some healthcare providers will face 
significant reductions in payments, and that has an impact on our 
seniors and their ability to get services.
  This legislation is important for the seniors, and it is important 
for our constituents. It has bipartisan and bicameral support, and I 
urge my colleagues to join me in supporting it tonight.
  Mr. BRADY. Madam Speaker, I yield 1 minute to the gentleman from 
Nebraska (Mr. Smith), the Republican leader of the Select Revenue 
Measures Subcommittee.
  Mr. SMITH of Nebraska. Madam Speaker, here we are again, late at 
night, debating last-minute legislation to fix problems the current 
majority created.
  When considered alongside the ongoing COVID pandemic, widespread 
workforce concerns, and the cloud of uncertainty created by unnecessary 
vaccine mandates, it is clear the combined effects of upcoming Medicare 
reimbursement cuts represent a critical threat to our healthcare 
system.
  While I commend the efforts that have been made over the last few 
days to draft solutions which address the concerns of our healthcare 
providers, instead of coming together to pass a bipartisan compromise, 
we again find the majority attaching controversial, unrelated material 
to this bill.
  Tonight, the majority has chosen to jeopardize urgent relief for 
healthcare providers with political gimmicks relating to the debt 
ceiling and paygo issues we saw coming from miles away.
  I am disappointed to see yet another erosion of the rules and 
precedents of Congress. I urge all members to oppose this bill.
  Mr. HORSFORD. Madam Speaker, I reserve the balance of my time.

                              {time}  1945

  Mr. BRADY. Madam Speaker, I yield 4 minutes to the gentleman from 
Missouri (Mr. Smith), the Republican leader of the Budget Committee and 
a member of the Ways and Means Committee.
  Mr. SMITH of Missouri. Madam Speaker, what a mess. Truly, what a 
mess.
  Just about 9 months ago, I stood on this floor when we were debating 
the Biden bailout bill, and I warned the gentleman from Nevada how much 
the seniors in his State were going to lose in Medicare cuts. I said it 
State by State for everyone who spoke. You know what? Everyone on that 
side of the aisle, Madam Speaker, acted like it wouldn't happen. They 
still wanted to spend $2 trillion.
  But guess what? Reality has set in, and we are here. Unless you try 
to wipe away the scorecard for your reckless spending, seniors are 
going to have cuts. Why? Because of a law that Democrats passed in 
2010, the Pay-As-You-Go Act.
  Nancy Pelosi loved the act then. President Obama signed that act into 
law, Madam Speaker. You guys just want to wipe the slate clean.
  Madam Speaker, we are here today for two reasons. First, because 
Democrats blew up a bipartisan agreement this afternoon--this 
afternoon--and second is because there are looming cuts to seniors and 
farmers and to programs that millions of Americans rely on because of 
reckless Democrat spending.
  Republicans have warned since March that these cuts would happen. In 
fact, the $2 trillion Biden bailout bill that Democrats rammed through 
Congress is what triggered a sizable portion of these cuts in the first 
place under the Pay-As-You-Go Act.
  Their bailout bill is the largest tranche of spending ever added to a 
paygo scorecard in the history of Congress--in the history of 
Congress--the $2 trillion expenditure back in March.
  Speaker Pelosi said in 2009 that pay-as-you-go budgeting ``will help 
return our Nation to sound fiscal health.'' It was President Obama who 
signed paygo into law, as I stated. But now the Democrat deficit 
spending is forcing cuts, and they are singing a much different tune.
  In fact, just today--just today--the chairman of the House Budget 
Committee said about paygo: It ``has never been an effective tool of 
fiscal policy.''
  The fact is, Democrats should be working in a bipartisan way to 
protect seniors from these cuts, including those stemming from the 
Budget Control Act sequester and the Medicare physician fee schedule. 
But in typical fashion, Democrats have decided to abandon 
bipartisanship and just kick the can down the road over and over again.
  We can stop these cuts, but we should do it in a responsible way, one 
that addresses wasteful spending and puts in place some commonsense 
reforms.

[[Page H6932]]

  How about rescinding money from the Biden bailout bill that is 
fueling inflation? Maybe Congress could tighten up our laws so Federal 
benefits and payments aren't flowing to illegal immigrants instead of 
American citizens, or put commonsense work requirements in place for 
Federal programs so American businesses can reopen.
  Legislation I have introduced today does just that, and I would hope 
my colleagues across the aisle would support this effort to save 
seniors and others from cuts.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. BRADY. Madam Speaker, I yield an additional 1 minute to the 
gentleman from Missouri (Mr. Smith).
  Mr. SMITH of Missouri. This includes those cuts Democrats have 
directly caused with their reckless spending this year. Since the 
beginning of this Congress, House Democrats have passed $7 trillion--$7 
trillion--in new spending.
  We have an inflation crisis, a border crisis, an energy crisis, and 
Democrats also chose to create a debt limit crisis that they want 
Republicans to help solve. One party, one rule, this is what you get.
  We have been clear from the beginning: If Democrats are going to 
pursue a partisan agenda that adds trillions to the debt, they can find 
the votes to raise the debt limit themselves. Republicans will not 
cosign a loan to enact a radical socialist agenda.
  The SPEAKER pro tempore. Members are reminded to address their 
remarks to the Chair.
  Mr. HORSFORD. Madam Speaker, I just remind the gentleman, when we 
talk about bipartisanship, this side of the aisle worked in a 
bipartisan way to pass a bipartisan Infrastructure Investment and Jobs 
Act that only 13 Republicans voted in favor of and more than 200 
Republicans voted against.
  Tonight, we are providing a solution to protect the healthcare 
providers in my home State of Nevada, in States all across the country, 
including in the prior speaker's home State of Missouri. If he won't 
vote to fix that problem, I will, because this is about solving a 
problem, not creating another one.
  Madam Speaker, I reserve the balance of my time.
  Mr. BRADY. Madam Speaker, I yield 2 minutes to the gentleman from 
Texas (Mr. Burgess), leader of the Republican Doctors Caucus who worked 
to put these solutions together.
  Mr. BURGESS. Madam Speaker, I am on the Energy and Commerce 
Committee; I am on the Budget Committee; and I am on the Rules 
Committee. But I am also a co-chair of the House Republican Doctors 
Caucus, and last week, the Surgeon General of the United States, Vivek 
Murthy, asked if he could come talk to us. We made that a bipartisan 
meeting. We included Democrats who are physicians as well in that 
meeting.
  Dr. Murthy was concerned primarily about physician burnout, and he 
has encountered a lot of it since he has reassumed his role as the 
Surgeon General, the Nation's top doctor.
  We shared with the Surgeon General one of the principal drivers. Yes, 
the pandemic has been a problem. Yes, cutting down elective surgeries 
early in the pandemic and clobbering the cash flow in offices was a 
problem. But one of the real drivers of physician burnout today is 
constant, constant haggling and no solution over these cuts.

  A year ago, we were here on this floor talking about a 9.4 percent 
cut in Medicare reimbursement rates. Now, at the last minute, God came 
out of the machine and saved the Nation's doctors, but here we are 
again.
  The thing is, we all knew this was coming. It wasn't a mystery. We 
could have had hearings, as Ranking Member Brady has pointed out. We 
could have had hearings in our committee, but we chose not to.
  We chose to squander that time, and now the Surgeon General is 
concerned about burnout in the Nation's physician corps. Here is the 
problem: They are burned out because we won't answer their calls. We 
won't solve their problems.
  We had an opportunity to do it. I asked in the Rules Committee for an 
amendment to divide the question. We don't have to do the debt limit 
and the doc fix at the same blow. Let's divide the question. Let 
Members have the freedom to vote on this issue and vote their 
conscience, and let doctors all over this country know who stands with 
them and who is against them.
  Mr. HORSFORD. Madam Speaker, I reserve the balance of my time.
  Mr. BRADY. Madam Speaker, may I ask, is the gentleman prepared to 
close?
  Mr. HORSFORD. I have one additional speaker.
  Mr. BRADY. Madam Speaker, I reserve the balance of my time.
  Mr. HORSFORD. Madam Speaker, I yield 1 minute to the gentlewoman from 
the great State of Texas (Ms. Jackson Lee).
  Ms. JACKSON LEE. Madam Speaker, if there is one thing that we have 
heard so often, it is doctors who have sacrificed during this period of 
the pandemic, who have maintained their offices. We often hear in 
public settings and private settings about the cuts that they are 
expecting and how much it will undermine the work that they do, their 
offices' expenses.
  I am very glad that, rather than talking, the Democrats are working 
together to ensure that the Medicare sequester payments will not occur 
and that we will protect against that, as we will do for the farmers.
  But here is the point: The pandemic continues. Doctors in private 
practice are trying to survive. This is a crucial decision and relief 
that is long overdue.
  I want to be able to say to my physicians that Democrats care. And I 
hope my colleagues on the other side of the aisle will do as much 
acting on doctors and medicine and healthcare as they will talking.
  Tonight, we need to act to provide the safety net for these 
physicians. I support this legislation, supporting the healthcare 
providers during this COVID-19 pandemic.
  Mr. BRADY. Madam Speaker, I yield myself the balance of my time to 
close.
  The claim we just heard, that only Democrats want to prevent these 
cuts to our local doctors and hospitals, is just nonsense. Democrats 
and Republicans have worked hard together to extend the moratorium on 
the sequester cuts on our providers, our doctors and hospitals; to 
provide a 3 percent payment increase for our physicians; to make sure, 
in the administration's proposals, to help increase reimbursement for 
primary care physicians. You don't cut the payment for specialty 
doctors, many of whom were hurt so hard during COVID.
  We also worked with our Democrat colleagues to delay for a year the 
proposed cuts by this administration on our labs and our oncologists, 
and we worked together to make sure other cuts didn't occur.
  All that bipartisanship was all on track up until a few hours ago 
when my Democrat colleagues decided they would hold this hostage, hold 
the healthcare reimbursements for doctors and hospitals hostage for 
their debt ceiling crisis that they created.
  It really is, I think, in a day and age where we have seen this one-
party rule for an entire year, the arrogance of this power going to 
their heads. It is unfortunate that they couldn't continue to work just 
a few hours longer together with Republicans to provide help to our 
physicians, hospitals, and providers.

  This bill ought to be a stand-alone bill. We should never hold them 
hostage for our colleagues' spending spree and socialist agenda. 
Unfortunately, that is what our Democrat colleagues have done today.
  We have introduced legislation as Republicans that mirrors our 
Democrat colleagues because we believe so strongly together. 
Unfortunately, one-party rule tore this apart.
  That is why the American public is going to return the majority of 
this House to Republicans in the next election and why President 
Biden's approval ratings are at a terribly low rate, a disapproval rate 
of 57 percent. It is unfortunate. We ought to be working together on 
that.
  Ms. JACKSON LEE. Will the gentleman yield?
  Mr. BRADY. I would be glad to yield 15 seconds to the gentlewoman.
  Ms. JACKSON LEE. I thank my good friend. I will take 15 seconds. You 
can't provide for the doctors if you don't provide an increase in the 
debt ceiling. You know that.
  We have to pay our bills, and paying the doctors and making sure that 
they are protected includes doing the action that we are doing. Join us 
in doing that.

[[Page H6933]]

  

  Mr. BRADY. Madam Speaker, reclaiming my time. Our colleagues have 
known for 2 years this debt ceiling was here, never passed a budget, 
never passed an appropriations bill. They let this crisis occur and 
built it time after time after time when we could easily have come 
together.
  By the way, our Democrat colleagues hold the House; they hold the 
Senate; they hold the White House. They have the power to pass the debt 
ceiling, and they have had that for the entire year.
  To my Democrat friends, you can try to sell this snake oil all you 
want, but the truth of the matter is, you wrecked a bipartisan 
agreement for your debt ceiling crisis. That is what we are voting on 
today.
  Republicans support help for healthcare providers. We will not allow 
them to be held hostage to this debt ceiling crisis.
  Madam Speaker, I urge strong opposition to this bill and urge my 
Democrat colleagues to someday work with us. Let's work together on 
these issues. I yield back the balance of my time.

                              {time}  2000

  Mr. HORSFORD. Madam Speaker, I yield myself the balance of my time.
  I will close by stating that, yes, Democrats are delivering. We are 
delivering for the American people. We are delivering in the time of a 
pandemic. We are delivering to restore public confidence in our public 
institutions and to help our economy recover. This bill is about 
important and responsible measures to deliver for the American people.
  When the Republicans had the majority in the House, the Senate, and 
the White House, they chose to spend their time giving tax cuts to the 
very wealthy, to big corporations that provided little benefit to 
average Americans and to small businesses.
  Now with Democrats in charge, we are delivering for the American 
people.
  I urge my colleagues to support this important and responsible 
measure, and I yield back the balance of my time.
  The SPEAKER pro tempore (Ms. McCollum). All time for debate has 
expired.
  Pursuant to House Resolution 838, the previous question is ordered on 
the bill, as amended.
  The question is on the third reading of the bill.
  The bill was ordered to be read a third time, and was read the third 
time.
  The SPEAKER pro tempore. The question is on passage of the bill.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. BRADY. Madam Speaker, on that I demand the yeas and nays.
  The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution 
8, the yeas and nays are ordered.
  Pursuant to clause 8 of rule XX, further proceedings on this question 
are postponed.

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