[Congressional Record (Bound Edition), Volume 156 (2010), Part 3]
[House]
[Pages 4095-4129]
[From the U.S. Government Publishing Office, www.gpo.gov]




PROVIDING FOR CONSIDERATION OF SENATE AMENDMENTS TO H.R. 3590, SERVICE 
MEMBERS HOME OWNERSHIP TAX ACT OF 2009, AND PROVIDING FOR CONSIDERATION 
   OF H.R. 4872, HEALTH CARE AND EDUCATION RECONCILIATION ACT OF 2010

  Ms. SLAUGHTER. Mr. Speaker, by direction of the Committee on Rules, I 
call up House Resolution 1203 and ask for its immediate consideration.
  The Clerk read the resolution, as follows:

                              H. Res. 1203

       Resolved, That upon the adoption of this resolution it 
     shall be in order to debate the topics addressed by the 
     Senate amendments to the bill (H.R. 3590) to amend the 
     Internal Revenue Code of 1986 to modify the first-time 
     homebuyers credit in the case of members of the Armed Forces 
     and certain other Federal employees, and for other purposes, 
     and the topics addressed by the bill (H.R. 4872) to provide 
     for reconciliation pursuant to section 202 of the concurrent 
     resolution on the budget for fiscal year 2010, for two hours 
     equally divided and controlled by the Majority Leader and 
     Minority Leader or their respective designees.
       Sec. 2.  After debate pursuant to the first section of this 
     resolution, it shall be in order to take from the Speaker's 
     table the bill (H.R. 3590) to amend the Internal Revenue Code 
     of 1986 to modify the first-time homebuyers credit in the 
     case of members of the Armed Forces and certain other Federal 
     employees, and for other purposes, with the Senate amendments 
     thereto, and to consider in the House, without intervention 
     of any point of order except those arising under clause 10 of 
     rule XXI, a single motion offered by the Majority Leader or 
     his designee that the House concur in the Senate amendments. 
     The Senate amendments and the motion shall be considered as 
     read. The previous question shall be considered as ordered on 
     the motion to final adoption without intervening motion or 
     demand for division of the question.
       Sec. 3.  If the motion specified in section 2 is adopted, 
     it shall be in order to consider in the House the bill (H.R. 
     4872) to provide for reconciliation pursuant to section 202 
     of the concurrent resolution on the budget for fiscal year 
     2010 if called up by the Majority Leader or his designee. All 
     points of order against consideration of the bill are waived 
     except those arising under clause 10 of rule XXI. The 
     amendment in the nature of a substitute printed in part A of 
     the report of the Committee on Rules accompanying this 
     resolution, modified by the amendment printed in part B of 
     the report of the Committee on Rules, shall be considered as 
     adopted. The bill, as amended, shall be considered as read. 
     All points of order against provisions in the bill, as 
     amended, are waived. The previous question shall be 
     considered as ordered on the bill, as amended, to final 
     passage without intervening motion except one motion to 
     recommit with or without instructions.
       Sec. 4.  Until completion of proceedings enabled by the 
     first three sections of this resolution--
        (a) the Chair may decline to entertain any intervening 
     motion (except as expressly provided herein), resolution, 
     question, or notice;
       (b) the Chair may decline to entertain the question of 
     consideration;
       (c) the Chair may postpone such proceedings to such time as 
     may be designated by the Speaker;

[[Page 4096]]

       (d) the second sentence of clause 1(a) of rule XIX shall 
     not apply; and
       (e) any proposition admissible under the first three 
     sections of this resolution shall be considered as read.
       Sec. 5.  In the engrossment of H.R. 4872, the Clerk shall 
     amend the title so as to read: ``An Act to provide for 
     reconciliation pursuant to Title II of the concurrent 
     resolution on the budget for fiscal year 2010 (S. Con. Res. 
     13).''.

                              {time}  1415


                             Point of Order

  Mr. RYAN of Wisconsin. Mr. Speaker, I raise a point of order against 
H. Res. 1203 because the resolution violates section 426(a) of the 
Congressional Budget Act. The resolution contains a waiver of all 
points of order against consideration of the bill except those arising 
under clause 10 of rule XXI which includes a waiver of section 425 of 
the Congressional Budget Act which causes a violation of section 
426(a).
  The SPEAKER pro tempore. The gentleman from Wisconsin makes a point 
of order that the resolution violates section 426(a) of the 
Congressional Budget Act of 1974. The gentleman has met the threshold 
burden under the rule, and the gentleman from Wisconsin and a Member 
opposed each will control 10 minutes of debate on the question of 
consideration. After the debate, the Chair will put the question of 
consideration.
  The Chair recognizes the gentleman from Wisconsin.
  Mr. RYAN of Wisconsin. Mr. Speaker, let me just quote from a letter 
to the Speaker of the House by the Director of the Congressional Budget 
Office dated yesterday: ``The Congressional Budget Office and the Joint 
Committee on Taxation estimated that the total cost of those mandates 
to State, local and tribal governments and the private sector would 
greatly exceed the annual thresholds established under the Unfunded 
Mandates Reform Act.''
  Mr. Speaker, this bill is the mother of all unfunded mandates. There 
are mandates on States. The new Medicaid mandate is expected to cost, 
according to the CBO, an additional $20 billion on States. Let's start 
with the State mandate, $20 billion on States in Medicaid. Democratic 
Governors have been speaking out against this. Let me quote Governor 
Rendell from Pennsylvania: ``I think it's an unfunded mandate. We just 
don't have the wherewithal to absorb this health care bill without some 
new revenue source.''
  There is an individual mandate. It mandates individuals purchase 
government-approved health insurance or face a fine to be collected by 
the IRS which will need $10 billion additional and 16,500 new IRS 
agents to police and enforce this mandate.
  There is a business mandate. It mandates businesses provide 
government-approved health insurance or face penalties. If you don't 
offer health insurance coverage, you have to pay $2,000 per employee. 
If you do offer health insurance coverage, but one of your employees 
decides to take the Federal subsidy, you have to pay up to $3,000 per 
employee anyway.
  There's a health plan mandate. There are mandates on health plans to 
comply with new Federal benefits, mandates without any funds to meet 
these new requirements. There are new medical loss ratios of 80 and 85 
percent. This hardly jives with the notion, If you like what you have, 
you can keep it, because millions of Americans will exactly lose just 
that.
  There's a provider mandate. This mandates that many health care 
providers must actually provide exactly what Washington says. They're 
forced to take unilateral reimbursement cuts from the new independent 
payment advisory board.
  Mr. Speaker, at this time I want to elaborate quite a bit more, but I 
will reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I claim time in opposition.
  The SPEAKER pro tempore. The gentlewoman from New York is recognized 
for 10 minutes.
  Ms. SLAUGHTER. Mr. Speaker, I yield myself such time as I may 
consume.
  Technically, this point of order is about whether or not to consider 
this rule and, ultimately, the underlying legislation. In reality, it's 
about blocking much-needed health care reform in this Nation. Those who 
oppose the process don't want any debate or votes on health care 
itself. They just want to make reform go away.
  I know my colleagues on our side will vote ``yes'' so we can consider 
this important legislation on its merits and not stop it on a 
procedural motion. Let's stop wasting time on parliamentary loopholes 
because those who oppose the legislation can vote against it on final 
passage. We must consider the rule. We must pass this important 
legislation today.
  I reserve the balance of my time.
  Mr. RYAN of Wisconsin. May I inquire how much time is remaining 
between the two sides, Mr. Speaker.
  The SPEAKER pro tempore. The gentleman from Wisconsin has 8 minutes, 
and the gentlewoman from New York has 9\1/4\ minutes.
  Mr. RYAN of Wisconsin. Mr. Speaker, let's look at the fiscal 
consequences of this bill. I think we're going to hear a lot today how 
this bill reduces the deficit according to the Congressional Budget 
Office. Well, I would simply say, the oldest trick in the book in 
Washington is that you can manipulate a piece of legislation to 
manipulate the final score that comes out.
  But let's take a look at the subsequent analysis by the Congressional 
Budget Office. Let's take a look at the claims being made and the 
reality that we're facing. This bill double-counts billions of dollars. 
It takes $70 billion of premiums from the CLASS Act to spend on this 
new government program, instead of going to the CLASS Act. It takes $53 
billion in Social Security taxes which are reserved for Social Security 
and, instead, spends it on this new program. The Congressional Budget 
Office is telling us that in order to fulfill all the discretionary 
requirements, $71 billion will be required to manage this new 
government-run health care system. They're saying at the Congressional 
Budget Office that Medicare part A trust fund, the trust fund itself 
will be raided to the tune of $398 billion.
  So if we actually count a dollar once, which is how law in math 
works, this bill has a $454 billion deficit. I find it very interesting 
and noteworthy that just 2 days ago, the Speaker of the House said, We 
will be passing legislation in April, doing the so-called doc fix. 
Well, that's $208 billion. And according to the Congressional Budget 
Office, when that will pass, combined with the double-counting and the 
gimmicks and the smoke and mirrors, we will have a $662 billion deficit 
under this bill alone.
  Now, Mr. Speaker, let's think about the economic consequences because 
the economic consequences that will be borne by this bill are truly 
horrific. People are losing jobs in this country. Our unemployment rate 
is near 10 percent. For us to get our unemployment rate back to where 
it was before the economic crisis, back to 5 percent, we will literally 
have to create 250,000 jobs every month for 5 years in this Nation. So 
what does this bill do? It imposes a new tax increase of $569.2 
billion, over half a trillion in new taxes on labor, on capital, on 
families, on small businesses, on work, on jobs.
  And look at what we're looking at. Before even passing this bill, Mr. 
Speaker, we are going into a tidal wave of red ink of debt. The 
interest alone on the national debt that's about to befall us will be 
crushing to our economy. I asked the Congressional Budget Office, what 
would my three children face when they were my age? What we heard from 
the CBO was just alarming. By the time my three kids are my age--I am 
40 and they're 5, 6 and 8 years old--the CBO said that the glide path 
that we are on before passing this bill, the tax rate on that 
generation by the time they're 40 years old will be that the 10 percent 
bracket goes up to 25 percent, middle-income taxpayers will pay an 
income tax rate of 63 percent, and the top rate that the small 
businesses pay will be 88 percent. This is the legacy we are leaving 
the next generation.
  Last year the General Accountability Office said that the unfunded 
liability of the Federal Government--meaning the debt we owe to all the 
promises

[[Page 4097]]

being made--was $62 trillion. You know what they say today, $76 
trillion. And what are we doing here? A $2.4 trillion new unfunded 
entitlement on top all of that. We can't even afford the government 
we've got right now, and we're going to be putting this new unfunded 
entitlement on top of it?
  Mr. Speaker, at the end of the day, though, what's most insidious, 
what's most concerning, what's most troubling about this bill is what 
the future holds. This bill subscribes to the arrogant idea that 
Washington knows best, that Washington can organize and micromanage the 
entire health care sector of this country, 17 percent of our economy, 
one-sixth of our economy.
  Well, let me give you a glimpse into that future, Mr. Speaker. This 
is the Treasury's 2009 financial report. It tells us that we are 
walking into an ocean of red ink, of debt, of deficit, of spending. And 
the only way to get this under control, the only way to stop a debt 
crisis from befalling this country--much like Europe is about to walk 
into--if you have government-run health care, if you have the 
government take the rest of the health care sector over is to deeply 
and systematically ration health care.
  Think about what's in this legislation. We have a new comparative 
effectiveness research board placed in the stimulus legislation that 
decides what treatments are worth paying for. We have a new Medicare 
commission called the Independent Payment Advisory Board that makes 
across-the-board cuts into Medicare whether it's good for patients or 
not based upon cost considerations, bypassing the authority of 
Congress. And we have the new U.S. Preventive Task Force. That's an 
agency that recently said women in their forties don't need to do 
mammograms, that has been given unprecedented power in this legislation 
to make decisions that are normally made by patients and doctors.
  What this bill does is it says this: we are no longer going to trust 
the will, the interest, and the decisions of patients and their 
doctors. They don't know enough. We're going to take the power and the 
money from the citizens and bring it to Washington, and Washington 
knows best. Washington will set up elaborate boards and bureaucracies 
of technocrats who can better micromanage those decisions. And the only 
way to get this debt crisis only control, the only way to get this 
under control is to ration care.
  With that, Mr. Speaker, I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I submit for the Record a 1-page document 
explaining why the requirements in the bill are not unconstitutional.

       Attack: The individual responsibility requirement is 
     unconstitutional.
       Response: The arguments that have been raised against the 
     constitutionality of an individual responsibility requirement 
     are meritless. For over 70 years, the Supreme Court has 
     recognized that Congress has the authority under the Commerce 
     Clause to regulate activities that have a substantial effect 
     on interstate commerce, which includes buying and selling 
     health insurance. The requirement for individuals to 
     contribute to their own health insurance coverage is clearly 
     constitutional.
       Over 70 years of Supreme Court precedent has recognized 
     that, under the Commerce Clause, Congress can regulate 
     activities that have a substantial effect on interstate 
     commerce. A requirement that individuals purchase health 
     insurance is both commercial and economic in nature--indeed, 
     few things are more critical to our nation's economic health.
       The failure of individuals to obtain health insurance has a 
     substantial effect on our national economy. The U.S. spends 
     over $2 trillion dollars on health care each year--more than 
     $7,000 per person and more than 16 percent of our GDP. The 
     economy loses billions of dollars every year because of the 
     costs of treatment for uninsured Americans. And currently, 
     individuals can forego buying insurance, leaving hospitals--
     and ultimately Americans who do buy insurance--on the hook 
     for expensive emergency procedures. That drives up insurance 
     premiums for all Americans.
       Mandating health insurance affects interstate commerce in 
     several ways. Covering more people will reduce the price of 
     insurance by addressing free-riders who rely on emergency 
     care and other services without paying for all the costs, 
     which drives up costs for people with insurance. It will also 
     ensure an insurance pool with a full cross section of healthy 
     and sick subscribers, which will help keep down costs for 
     everyone.
       Even the conservative Supreme Court has recognized that the 
     federal government has broad authority to regulate under the 
     Commerce Clause. In 2005, the Court held that the federal 
     government can prohibit medical marijuana grown at home and 
     consumed personally under the Commerce Clause (Gonzalez v. 
     Raich). Justice Scalia, no fan of expansive claims of 
     Congressional power, even voted to affirm Congress' authority 
     to regulate in that case. Certainly health insurance coverage 
     has a greater effect on the national economy than people 
     growing medical marijuana in their backyard.
       Congress also has authority to impose an individual 
     responsibility requirement under its Power to Tax and Spend 
     for the General Welfare (Article 1, sec. 8, cl. 1) and the 
     Necessary and Proper Clause (Art. 1, sec. 8, cl. 18.).

  Now I am so happy to introduce and yield 2 minutes to Mr. Kennedy, 
the gentleman from Rhode Island, who is not only a valued Member of 
this House but whose father, as we know, devoted his congressional life 
to health care for all Americans.
  Mr. KENNEDY. Notwithstanding this point of order, I urge passage of 
the underlying rule and for us to go forward with the health insurance 
on behalf of the 21 percent of my State's constituents under the age of 
65 who are uninsured because they're either too young to qualify for 
Medicare or they're too middle class to qualify for Medicaid.
  ``No memorial, oration or eulogy could more eloquently honor his 
memory than the earliest possible passage of this bill for which he 
fought so long. His heart and his soul are in this bill.'' While the 
above quote could easily refer to my father, and the context could 
easily describe this health care debate, these words were, in fact, 
spoken by my father as he rose on the Senate floor to honor his brother 
President Kennedy during the debate on the 1964 Civil Rights Act.
  The parallels between the struggle for civil rights and the fight to 
make quality, affordable health care accessible to all Americans are 
significant. It was Dr. Martin Luther King, Jr., who said, Of all forms 
of inequality, injustice in health care is the most shocking and 
inhumane. Health care is not only a civil right, it's a moral issue.
  Thank you, Madam Speaker, for your political and moral leadership in 
helping those to secure more advanced protections and benefits, 
especially in the area of mental health and addiction. Thank you, 
President Obama for delivering on your promise of providing the 
politics of hope rather than the politics of fear.

                              {time}  1430

  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Vermont (Mr. Welch).
  Mr. WELCH. Mr. Speaker, this debate has been long, but it is now 
complete. The arguments have been very contentious, but it is now time 
to decide. The bill before us is long, but the question that we face is 
really very simple.
  Will Congress today choose on behalf of the American people who 
elected us to build a health care system where every American has 
access to health care and where every American shares in the 
responsibility of paying for it.
  Will we today reinvigorate the American dream so that no parent with 
a sick child will wake up wondering if they are going to have access to 
a doctor, so no father who loses health care because he loses his job 
is going to wonder how his family is going to be provided for, so no 
mother who becomes sick will lose the health care she has because she 
is sick.
  Will we today free ourselves from the shackles of a broken status 
quo, one that enriches health care companies but is punishing American 
families, punishing American employers, and punishing American 
taxpayers.
  That's the question, Mr. Speaker, that we face today in this 
Congress. And this Congress has a choice to act like the confident 
Nation we are that faces head-on the challenges that we face. We will 
do so today by voting ``yes'' to move us so that we have a health care 
system in this country where every American is covered and we all help 
pay.
  Mr. RYAN of Wisconsin. I reserve my time.

[[Page 4098]]


  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield 1 minute to the 
gentleman from California (Mr. Farr).
  Mr. FARR. Mr. Speaker, I rise today to enter a letter from my next-
door neighbor born with spina bifida. His parents were told to leave 
him in the hospital because he would be mentally retarded and he would 
never be able to get out of institutional care. His parents loved him 
and got him into school. He went through public high school, went to 
the University of California, graduated and got into Special Olympics. 
He tried to get a job. His coaches told him you will never be able to 
afford a job, you have a preexisting condition, you can't afford the 
insurance. You will have to stay on Medicaid the rest of your life.
  He writes in his letter to me, Dear Congressman, and goes on to say 
in closing, I ask that you please pass this comprehensive health care 
package so that today's kids aren't told the same thing I was told. 
Never again should boys and girls with disabilities hear from their 
mentors, You cannot afford to work.
  Emancipate people into the workforce; allow them to have insurance 
without preexisting conditions.
  I am proud that Ben Spangenberg is here today sitting in that corner. 
I am proud that he is a constituent of this great country.
  Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentlewoman from 
Texas (Ms. Jackson Lee).
  Ms. JACKSON LEE of Texas. Mr. Speaker, let me remind us of a man who 
does not live today, Senator Edward Kennedy told us that he had a 
vision and a resolve that the health care of Americans would no longer 
count on whether or not they were wealthy Americans. And we are 
reminded as well of the words of President John F. Kennedy that said: 
Ask not what your country can do for you, but what you can do for your 
country.
  This is not an unfunded mandate because we know full well that the 
CBO has said that this bill will pay for itself, that the deficit will 
be reduced by $130 billion in the first 10 years, and that the deficit 
will be cut by $1.2 trillion in the second 10 years. It eliminates the 
Medicare doughnut hole, and it insures some 32 million more people. But 
I am standing here today because 45,000 Americans die every year like 
Eric, a 32-year-old lawyer who went to the emergency room not once but 
three times. They sent him away with antibiotics and aspirin, but he 
died. I cannot tolerate that. Today we will heal this land, and we will 
vote for this health care bill. It is not an unfunded mandate. This 
health care reform is fair and must succeed.
  Mr. RYAN of Wisconsin. I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentleman from 
Illinois (Mr. Hare).
  Mr. HARE. Mr. Speaker, I was here last November and I talked about my 
father and my mother. My dad was ill, we lost our house and everything 
we ever had. And when I came home from my sister's wedding, there was a 
deputy sheriff with a notice to evict. My dad thought somehow he had 
let us down. Two days before his death, a death that came way too early 
for somebody at 67, I sat by his bed and he said Phil, just do two 
things for me, two promises: take care of your mother and the girls. 
But the pain that the loss of this house has caused, and the pain this 
family has had to go through, whatever you do, please, do not let 
another family have to go through this.
  Last November I cast my vote in favor of our bill on behalf of my 
dad, my family, and for those people; and tonight, I will cast my vote 
in favor of this bill not just for my dad, but for the people who every 
8 seconds in this Nation file bankruptcy and receive foreclosure 
notices because of health care. It is time to stand up and be counted. 
Tonight I will stand up, and I will be counted among the ``yeses.''
  Mr. RYAN of Wisconsin. I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentleman from 
Wisconsin (Mr. Kagen).
  Mr. KAGEN. Mr. Speaker, today in the House of Representatives, we are 
going to answer the essential question: What kind of Nation are we? 
What kind of Nation would deny 30 million citizens access to health 
care? What kind of Nation would allow a child's illness to cause their 
family to go broke and lose their home? What kind of Nation would turn 
its back on neighbors who are in need, our seniors, our children, and 
millions of unemployed workers who through no fault of their own have 
lost their jobs, and soon, their hope. What kind of Nation are we? And 
what kind of Nation will we become if we do not pass this rule and pass 
essential health care legislation that we need?
  This bill will save lives, and it will save jobs by putting patients 
first, and guaranteeing that Medicare will be there when we need it.
  No longer will a child's illness cause their family to go broke and 
lose their home. Senior citizens will benefit by gaining access to 
prevention services with no copayments, no deductibles.
  This is going to be our time, and I would encourage all of us to stop 
pointing fingers and start joining hands. Pass this essential 
legislation and save our Nation.
  Today, in the House of Representatives, we will answer two essential 
questions: What kind of Nation are we? and Whose side are you on?
  What kind of nation--would deny 32 million citizens access to health 
care? What kind of nation--would allow a child's illness or accident to 
cause families to go broke and lose their home?
  What kind of nation--would turn its back on neighbors who are in 
need? Our senior citizens, our children and millions of unemployed 
workers who through no fault of their own have lost their jobs and need 
our help right here and right now?
  And what kind of nation will we become if we do not take this 
positive step forward today? This bill saves lives and jobs by putting 
patients first, strengthening Medicare, and finally guaranteeing access 
to affordable care for all of us.
  No longer will a child's illness cause their family to go bankrupt 
and lose their home.
  Senior citizens will see a stronger and better Medicare as we begin 
to close the prescription drug program's donut hole.
  Small business owners will soon be able to buy health insurance for 
their employees at the same discounts big corporations do.
  We are beginning to fix what is broken in our heath care system and 
improve on what we already have, at a price we can all afford to pay, 
for this bill is paid for and it reduces our national deficit by 1.2 
trillion dollars over time.
  Today, in the house of Representatives, we must take a positive step 
forward and finally bring an end to all discrimination against any 
citizen because of the way they were born or the illness they may have.
  Today, people across America want to know whose side are you on? Are 
you sitting in the boardroom of a Wall Street run health insurance 
corporation? Or standing with your feet on the factory floor, prepared 
today to stand up for the best interests of your neighbors, by putting 
patients first?
  Well, I am standing up for my patients and will vote yes on this 
bill, because it saves lives and jobs and begins to push insurance 
companies out of my patient's examination room.
  There is much work yet to do to clean up the economic mess we have 
inherited. So, let's stop pointing fingers and start joining hands and 
work together to build a better nation. Join me. Let's take this 
positive step forward today. Join me in this effort and we will finally 
begin to guarantee access to affordable care for all of us--for my 
patients cannot hold their breath any longer.
  Ms. SLAUGHTER. Mr. Speaker, let me yield 45 seconds to the gentleman 
from Pennsylvania (Mr. Fattah).
  Mr. FATTAH. Mr. Speaker, I rise to thank the chairwoman and in 
support of the rule. This Easter season, we are reminded again that if 
we can just hold on past Friday, Sunday will come. Americans have been 
holding on for over 100 years. We have seen bankruptcies, we have seen 
needless deaths. We have seen families denied insurance and children 
denied needed health care, but Sunday has come. This majority and this 
House is going to rise to the occasion. We will beat back this point of 
order, but much more importantly, we are going to beat these insurance 
companies and give the American public a health insurance reform bill 
that we all can be proud of.
  Mr. RYAN of Wisconsin. Mr. Speaker, we can do better. It doesn't have 
to be this way. This is not democracy. This

[[Page 4099]]

is not good government. One of the cornerstone principles of this 
Nation that the Founders created is the principle that we govern by 
consent of the governed. That principle is being turned on its head 
here today.
  More to the point, the shame of all of this is we have been offering 
constructive solutions from the very beginning. We have asked you to 
work with us on a bipartisan basis, step by step, piece by piece, work 
on the uninsured, work on preexisting conditions, work on costs, work 
on prices, work on the deficit. All along the other side said ``no,'' 
we are doing it our way, one-party rule.
  This bill clearly violates the House rules. We shouldn't be waiving 
our own rules and imposing these costly mandates. We are going to hear 
many emotional appeals today. Let me tell you a little bit about my 
own. I have the best mother-in-law a man could ever ask for. She is 5 
years facing stage 3 ovarian cancer, and she is still fighting it 
because of a drug called Avastin that is keeping her alive. Well, if 
she was a British citizen, she wouldn't have it because they deny this 
drug to their cancer patients. We are setting up the identical same 
bureaucracies they have there here.
  This bill explodes the deficit, it explodes the debt, and the only 
way to fix it is to put that kind of rationing in place. That is not 
what our government should be doing. This bill is a fiscal 
Frankenstein. It is a government takeover. It is not democratic.
  Mr. Speaker, my colleagues, it is not too late to get it right. Let's 
start over, let's defeat this bill.
  I yield back the balance of my time.
  Mr. HENSARLING. Mr. Speaker, I rise today in strong opposition to 
this rule and the underlying health care legislation it is attempting 
to impose upon the American people. Despite the claim often made by my 
friends on the other side of the aisle, Republicans agree that we must 
reform health care in America. The current system is unsustainable, and 
simply doing nothing is not an option.
  While I strongly oppose the underlying legislation and the direction 
it proposes to take health care in America, I do not support inaction 
to reform health care. Simply doing nothing is not an option. My vision 
of health care reform will ensure that Americans can get the health 
care that you need, when you need it, and at a price you can afford. I 
want to provide all Americans with access to health care that is 
affordable, portable, accessible, of high quality, and preserves choice 
for Americans.
  In the health care reform debate, I believe it is critical that we 
remember the Hippocratic Oath: first, do no harm. Health care reform 
should also respect the sacredness of the doctor-patient relationship 
and ensure that the federal government does not interfere with the 
ability of patients and their doctors to make decisions about care. 
Health care reform should also lower costs for patients, and bend the 
overall health care cost curve downward. Health care in the United 
States represents one-sixth of our economy, and ultimately affects 
every man, woman, and child. Any health care reforms made will have an 
impact that is far and wide throughout America. It is critical that we 
ensure the reforms we pursue are the right reforms that will improve 
health care, because the wrong reforms could have devastating and long-
lasting consequences for the greatest health care system in the world. 
As important as it is to reform health care quickly, it is more 
important to reform health care correctly.
  I believe five principles should guide any health reform effort. One, 
every American, regardless of health or financial status, should have 
access to affordable health care coverage of their choice. Nobody 
should go bankrupt because they get sick. Two, health care in America 
should be family-focused and patient-centered. It must put patients, in 
consultation with their doctors, in control of their health care. Your 
health care decisions should not be made by your employer, a health 
care plan selected by your employer, or the government. Three, people 
should own and control their health care plan, and it should be 
personal and portable. Four, Americans who are happy with their current 
plan should be allowed to keep it. Five, forcing Americans into a 
government health care program will not solve America's health care 
challenges.
  There are many ideas that I truly believe will help bring down the 
cost of health care for Americans without a government take-over. 
However, the only way to truly lower costs is to empower a competitive 
health care market for health care. Despite what you think we don't 
have a competitive marketplace today. To help spur the creation of one, 
several ideas stand out. First, Congress should pass meaningful medical 
liability reform. I have cosponsored legislation that would provide 
meaningful medical liability reform, the Help Efficient, Accessible, 
Low-cost, Timely Health Care Act (H.R. 1086), and medical liability 
reform was included as part of the Republican substitute I voted for 
when the House debated its health care legislation in November 2009. 
Precious health care resources are wasted because physicians have to 
over-utilize health care and practice defensive medicine when treating 
patients in order to protect themselves from junk lawsuits pursued by 
trial lawyers. Enacting medical liability reforms would lower health 
care costs by cutting down on the practice of defensive medicine. 
Additionally, medical liability reform would help bring doctors back to 
those areas where junk lawsuits and high malpractice insurance has 
chased them away. Since 2003, when Texas enacted medical liability 
reform, the state has been flooded with applications of new physicians 
seeking to practice in Texas. In areas where specialists, such as OB/
GYN physicians, had long ago quit practicing, you now have an OB/GYN 
delivering babies once again.
  Additionally, I believe that Americans should be able to shop across 
state lines to find the health care plan that best suits their needs. 
Why can Americans buy car insurance across state lines, but they can't 
buy health insurance across state lines. By forcing health plan 
providers to compete, not only within their respective states for 
customers, but across the nation, competition will force insurers to 
deliver health care plans at competitive costs or see business go 
elsewhere. I have cosponsored legislation that would permit Americans 
to purchase health insurance across state lines, the Health Care Choice 
Act (H.R. 3217), and this commonsense reform was included in the 
Republican substitute considered during consideration of the House-
passed health care bill.
  To further empower a competitive marketplace, individuals should be 
given the same tax incentive to go out into the marketplace to purchase 
their own health insurance that businesses are to provide health care 
for their employees. This current disparity in our tax laws leaves 
individuals tethered to employer-provided health care plans and the 
jobs that provide them. By empowering individuals to purchase 
individual health coverage and have the same tax-advantaged basis as 
employer-provided coverage, we can free employees to shop around for 
coverage that best suits them, instead of simply taking what their 
employers offer.
  Additionally, I have cosponsored Representative Paul Ryan's Roadmap 
for America's Future Act (H.R. 4529). This sweeping piece of 
legislation takes our nation's toughest fiscal challenges head on and 
solves them. In addition to making both Medicare and Social Security 
solvent for future generations, this legislation would also reform our 
health care system in a patient-centered manner that harnesses the 
power of the marketplace--not government--to provide Americans with 
access to high-quality, affordable health care. It does so without 
raising taxes or inserting a federal bureaucrat between you and your 
doctor.
  When it comes to health care reform, the American people want a tune-
up, they don't want repossession. The massive power grab that the 
underlying health care legislation represents will fundamentally change 
the relationship between the government and its citizens. For example, 
the Senate-passed health care legislation requires all Americans to 
have bureaucrat-approved health insurance or else be subject to 
criminal penalties. I believe such a requirement to be unconstitutional 
to begin with. However, even if it is one day ruled constitutional by 
our nation's judiciary, if the federal government requires you to buy 
health insurance today, what is it going to require you to buy 
tomorrow? Such a provision significantly moves us towards waking up one 
day and finding that the sovereign power in our nation rests not with 
``we the people'' but with ``we the government.''
  I also oppose the underlying health care legislation because of its 
blatant disregard for the sanctity of human life. Despite the fig-leaf 
attempts to cloud the issue, fundamentally, this is the most pro-
abortion piece of legislation to be considered by Congress since the 
tragic Supreme Court decision of Roe v. Wade. The Senate-passed bill 
does nothing more than set up an accounting gimmick for government-
subsidized health care plans that cover elective abortions 
participating in the exchanges. If the legislation truly embodied the 
principle that no federal funds would be used to subsidize elective 
abortions, the Stupak-Pitts amendment that this House approved as part 
of the House-passed health care bill on November 7, 2009 would be in 
the legislation today.

[[Page 4100]]

  To the glaring absence of the Stupak-Pitts language, my friends on 
the other side of the aisle are now pointing to the promise of an 
Executive Order from President Obama. While such an Executive Order may 
seem to be a protection for the unborn, it is nothing of the sort. 
First, the underlying Senate-passed bill that will become law if passed 
by this House and signed into law by President Obama contains 
provisions that specifically set up mechanisms whereby federal taxpayer 
money could be used to subsidize or pay for elective abortions. Supreme 
Court decisions have reaffirmed that an Executive Order cannot override 
a statue in law. Secondly, just as easily as an Executive Order is 
given, an Executive Order can be taken away. Even if you believed that 
President Obama's Executive Order protected the rights of the unborn, 
it would have no lasting permanence. To overturn this Executive Order, 
a future president--or even President Obama himself--need only issue an 
Executive Order canceling it, leaving the protection of the unborn up 
to the stroke of a pen.
  I also oppose the underlying legislation for the provisions that 
threaten the health care of our seniors and the future of Medicare. The 
underlying legislation contains over one-half trillion dollars in 
Medicare cuts. Within those cuts, Medicare Advantage plans are 
particularly hit hard. Medicare Advantage plans are currently providing 
quality health care coverage to millions of American seniors. These 
plans have grown in popularity over the years, demonstrating their 
appeal as seniors have voted with their feet to enroll in them. The 
cuts to Medicare Advantage in the Senate-passed bill would endanger the 
current health care coverage of seniors who have it, breaking a 
fundamental promise made by Democrats throughout this debate that if 
you like your current health care coverage, you could keep it.
  The Medicare cuts are also troubling to me because, instead of being 
reinvested in the Medicare benefit to improve the solvency and future 
of Medicare, they are used to help pay for the new health care 
entitlement created in the underlying legislation. Medicare is already 
on the road to insolvency in the near future. According to the 2009 
Medicare Trustees Report, Medicare has $38 trillion in unfunded 
liabilities--promises made already that we can't pay for--and the 
Medicare Trust Fund will go broke in 2017. Since we will already have 
challenges paying for the Medicare benefits we've already promised, why 
are we taking money from Medicare and spending it elsewhere, instead of 
working to increase the solvency of Medicare to protect it for future 
beneficiaries?
  On top of the reasons I've stated previously, I also oppose this 
legislation because it contains jobs-killing tax increases. The 
underlying legislation also includes approximately one-half trillion 
dollars in tax increases. While I believe that raising taxes is never 
the solution, how can anyone believe that raising taxes during our 
current economic troubles is a good idea? Despite the unprecedented 
spending spree that President Obama and Congressional Democrats 
embarked upon in February 2009, the United States continues to have an 
unemployment rate that is near double digits and the economy continues 
to shed jobs. At the outset of this year, the majority announced that 
jobs were their number one legislative priority. Yet, how can jobs be 
the number one priority when legislation that contains jobs-killing tax 
increases is being brought before us today?
  The final reason that I oppose this rule and the underlying 
legislation is that, simply put, the United States cannot afford this 
new entitlement. Do my friends on the other side of the aisle know that 
our country is going broke? Before President Obama took office, America 
was headed toward a fiscal cliff. However, instead of working to 
improve our fiscal situation, President Obama and Congressional 
Democrats have stepped upon the accelerator hastening the day of fiscal 
reckoning. Overall, under honest accounting standards, this legislation 
will cost $2.6 trillion--or over $22,000 per household. It is a bill 
that is filled with budget gimmicks, and the true cost obfuscated by 
smoke and mirrors accounting that would make Bernie Madoff blush. This 
legislation takes the half-trillion in Medicare cuts and uses them to 
pay for the new spending in the bill. Yet, somehow it also claims to 
use the savings from Medicare to increase Medicare's solvency. How can 
one set of Medicare savings be used twice?
  The underlying legislation also raids the Social Security Trust Fund 
to the tune of $53 billion, taking funds that would be destined to pay 
future Social Security benefits and instead uses them to reduce the 
overall cost of the bill. The benefits those funds were supposed to pay 
for will still have to paid for eventually, requiring taxpayers to make 
up the difference.
  This legislation also creates a new entitlement program known as the 
CLASS Act, which is supposed to be supported by premiums. However, to 
help bring the cost of the underlying legislation down, Democrats take 
the premiums from this program and spend them elsewhere. Thus, premiums 
that should be supporting this program are used elsewhere, leaving 
taxpayers to make up the lost funds in the future. This accounting 
gimmick is so bad, that even Senate Budget Committee Chairman Kent 
Conrad has called this ``a ponzi scheme.''
  This legislation is also fiscally dishonest because it attempts to 
hide its true cost through manipulation of congressional scoring 
procedures. The underlying legislation will collect 10 years of 
revenues to pay for 6 years of spending. By delaying the onset of 
benefits, Democrats are attempting to hide the cost of their health 
care legislation. Do Democrats intend for the health care bill to be 
turned off every decade for 4 years? Certainly not, but this setup is 
not by chance, as its purpose is to get the 10 year cost of the bill 
down.
  In order to draw attention away from the fiscal flaws with this 
legislation, Democrats have been waiving estimates from CBO claiming 
their bill reduces the deficit. The dirty Washington secret is that CBO 
estimates are based on what is put in front of them. If you give CBO 
garbage on one side, garbage comes out the other. For instance, the 
underlying legislation assumes that physicians will receive a 21 
percent Medicare reimbursement cut later this year. However, prior to 
today, Speaker Pelosi has already announced her support for passing 
what Washington calls the ``doc fix.'' Yet, the underlying bill assumes 
a 21 percent physician reimbursement cut. Instead of putting the ``doc 
fix'' in the underlying legislation, it was left out to ensure that the 
overall cost of the bill officially was lower. However, this does 
nothing to lower the overall cost to the American people. In fact, when 
you assume the ``doc fix'' will occur as well, CBO says the deficit 
will actually be increased as a result of passing the underlying 
legislation. In a March 19, 2010 letter to Representative Paul Ryan, 
CBO writes, ``You asked about the total budgetary impact of enacting 
the reconciliation proposal (the amendment to H.R. 4872), the Senate-
passed health bill (H.R. 3590), and the Medicare Physicians Payment 
Reform Act of 2009 (H.R. 3961). CBO estimates that enacting all three 
pieces of legislation would add $59 billion to budget deficits over the 
2010-2019 period.'' Democrats are either going to cut physician 
payments by 21 percent, or they're not going to and increase the 
deficit. They can't have it both ways.
  Despite the protests of my friends across the aisle, the bill before 
us today cannot be mistaken for anything other than what is it is: a 
government take-over of our health care. This legislation takes health 
care in our nation in a fundamentally different direction as it puts a 
federal bureaucrat or politician between you and you doctor by 
empowering the federal government to substitute its decision-making 
regarding your health care decisions in place of that of you and your 
doctor. If you love the way the federal government has run AIG, our 
banks, and our auto companies, you'll love the way they run your health 
care.
  But even more than cost, this is really a debate about who will 
control the health care resources of this Nation and who will control 
the health care decisions of our families. If we pass this bill, we 
will wake up one day only to find that when our loved ones become ill, 
they will wait weeks, perhaps months, to see a mediocre doctor of the 
government's choosing, only to be told by that same doctor that he 
cannot help because his treatment must be limited by the government 
protocol.
  To see what health care in America could look like in the years to 
come, we need only look to those systems in the United Kingdom and 
Canada that the underlying health care legislation before us today 
tries to take us in the direction of. After hearing the stories of how 
those systems provide health care, I can't imagine any American who 
would want our health care experiences to be like those of the British 
and Canadians.
  Would you want you or your loved ones to have the experience of Linda 
O'Boyle from Great Britain? Linda was a 64 year old mother of 3 and 
grandmother of 4 who was fighting cancer. After weeks of chemotherapy, 
doctors told her there wasn't much they could do for her. However, her 
consultant suggested a new drug called Cetuximab, which he applied for 
permission from the National Institute for Health and Clinical 
Excellence (NICE) to treat her with this drug, but was denied. Linda 
and her husband decided to pay for the drug themselves out of their 
savings. However, this was a violation of National Health Service 
policy and Linda was denied the ``free'' treatment by the NHS because 
she had privately paid for a cancer medication that prolonged her life. 
The

[[Page 4101]]

NHS completely withdrew treatment, including chemotherapy. Linda died 
in March 2008. The Southend University Hospital NHS foundation trust, 
where Linda was getting her treatment said in a statement: ``A patient 
can choose whether to continue with the treatment available under the 
NHS or opt to go privately for a different treatment regime. It is 
explained to the patient that they can either have their treatment 
under the NHS or privately, but not both or in parallel.''
  Would you want you or your loved ones to have the experience that 
David Malleau of Canada did? David was a 44 year old truck driver who 
was in a bad car accident in 2004. Doctors were forced to remove a 
fist-piece size of bone from his skull to relieve pressure on his 
brain. After the swelling subsided, he was ready for surgery in March 
2005. He was sent home and placed on a waiting list for surgery to 
replace the removed portion of his skull. Because of the threat of 
something hitting the exposed side of his brain, David was confined to 
his home while waiting on the surgery. Ultimately, he waited nearly a 
year for skull replacement surgery.
  Would you want you or your loved ones to have the experience of 
Lindsay McCreith? Lindsay is a man in his 60s who went to the ER and a 
CT scan showed a large wedge-shaped brain tumor. He was discharged from 
the hospital 4 days later with a diagnosis of a stroke and given anti-
seizure medication. Wanting to see if the tumor was cancerous, Lindsay 
wanted an MRI. He was given an appointment for one 4 months later. Not 
wanting to wait that long, Lindsay came to the United States and paid 
$494.67 for the MRI. He took the results to his Canadian family doctor, 
who referred him to a neurologist. He was examined by the neurologist 
and referred to a neurosurgeon. However, to see the neurosurgeon, 
Lindsay would have to wait 3 months. Not wanting to wait that long to 
determine if he had cancer, Lindsay returned to the US and a biopsy 
found the tumor was malignant, and the tumor was subsequently 
surgically removed.
  My friends on the other side of the aisle think that won't and can't 
happen in America. If the underlying bill becomes law, I hope and pray 
they are right. Unfortunately, I have low expectations that the 
experiences of patients in the United Kingdom and Canada can be avoided 
in the United States if this health care legislation becomes law.
  I think another indication of the future of health care in America 
can be found in career paths that current physicians recommend to their 
own children. Since the health care reform debate began in 2009, I had 
the opportunity to meet with dozens of physicians throughout the Fifth 
Congressional District of Texas, which I have the privilege to 
represent. In my discussions with these physicians, I asked them 
whether or not they would recommend to their children a career in 
medicine as a physician. With very few exceptions, these physicians 
told me that they have encouraged their children to seek careers 
elsewhere, as they believe physicians in the future will not be able to 
provide the care that is right for their patients, but will be limited 
to providing the care that is approved by the government. This 
anecdotal evidence is of great concern to me, because if current 
physicians won't even encourage their own children to practice 
medicine, will Americans continue to see our best and brightest 
students continue to choose medicine? My fear is that we will not, and 
in the future you will be seeing the doctor who was a ``C'' student, 
instead of seeing a doctor who was an ``A'' student, like you can 
today.
  In America, we must never confuse the social safety net with the 
slippery slope to socialism. When it comes to the health care of my 
family, when it comes to the health care of my country, I reject the 
hubris and arrogance of government social engineering, and I embrace 
the affordability and portability that comes by preserving the 
liberties of the American people.
  Mr. Speaker, if this legislation passes and becomes law, Americans 
will not stop being Americans. Each generation of Americans before us 
has passed on a legacy of more freedom and opportunity than the one it 
was left. We owe it to our children and our grandchildren to make their 
pursuit of happiness easier than our own. This legislation takes us in 
the exact opposite direction.
  But despite the obstacles that Washington places along their paths in 
pursuit of their own happiness, Americans will continue to work hard, 
think hard, and employ the exceptionalism that has made our nation the 
beacon of freedom that we are today. Americans will find a way, Madam 
Speaker, to overcome the new taxes, the new spending, and the new 
mandates that are contained in this legislation. They will find a way--
they must find a way--if we are to keep the Republic that we inherited 
from our forefathers.
  Ms. SLAUGHTER. Mr. Speaker, I want to urge my colleagues to vote 
``yes'' on this motion to consider so we can debate and pass the 
important legislation today.
  I yield back the balance of my time.
  The SPEAKER pro tempore. The question is, Will the House now consider 
the resolution?
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. RYAN of Wisconsin. Mr. Speaker, on that I demand the yeas and 
nays.
  The yeas and nays were ordered.
  The vote was taken by electronic device, and there were--yeas 228, 
nays 195, not voting 7, as follows:

                             [Roll No. 159]

                               YEAS--228

     Ackerman
     Altmire
     Andrews
     Baca
     Baird
     Baldwin
     Bean
     Becerra
     Berkley
     Berman
     Berry
     Bishop (GA)
     Bishop (NY)
     Blumenauer
     Boccieri
     Boswell
     Boucher
     Boyd
     Brady (PA)
     Braley (IA)
     Brown, Corrine
     Butterfield
     Capps
     Capuano
     Cardoza
     Carnahan
     Carney
     Carson (IN)
     Castor (FL)
     Chandler
     Chu
     Clarke
     Clay
     Cleaver
     Clyburn
     Cohen
     Connolly (VA)
     Conyers
     Cooper
     Costa
     Costello
     Courtney
     Crowley
     Cuellar
     Cummings
     Dahlkemper
     Davis (CA)
     Davis (IL)
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Dicks
     Dingell
     Doggett
     Donnelly (IN)
     Doyle
     Driehaus
     Edwards (MD)
     Ellison
     Ellsworth
     Engel
     Eshoo
     Etheridge
     Farr
     Fattah
     Filner
     Foster
     Frank (MA)
     Fudge
     Garamendi
     Giffords
     Gonzalez
     Gordon (TN)
     Grayson
     Green, Al
     Green, Gene
     Grijalva
     Hall (NY)
     Halvorson
     Hare
     Harman
     Hastings (FL)
     Heinrich
     Higgins
     Hill
     Himes
     Hinchey
     Hinojosa
     Hirono
     Hodes
     Holt
     Honda
     Hoyer
     Inslee
     Israel
     Jackson (IL)
     Jackson Lee (TX)
     Johnson (GA)
     Johnson, E. B.
     Kagen
     Kanjorski
     Kaptur
     Kennedy
     Kildee
     Kilpatrick (MI)
     Kilroy
     Kind
     Kirkpatrick (AZ)
     Kissell
     Kosmas
     Kucinich
     Langevin
     Larsen (WA)
     Larson (CT)
     Lee (CA)
     Levin
     Lewis (GA)
     Lipinski
     Loebsack
     Lofgren, Zoe
     Lowey
     Lujan
     Lynch
     Maffei
     Maloney
     Markey (CO)
     Markey (MA)
     Matheson
     Matsui
     McCarthy (NY)
     McCollum
     McDermott
     McGovern
     McNerney
     Meek (FL)
     Meeks (NY)
     Michaud
     Miller (NC)
     Miller, George
     Mitchell
     Mollohan
     Moore (KS)
     Moore (WI)
     Moran (VA)
     Murphy (CT)
     Murphy (NY)
     Murphy, Patrick
     Nadler (NY)
     Napolitano
     Neal (MA)
     Oberstar
     Obey
     Olver
     Ortiz
     Owens
     Pallone
     Pascrell
     Pastor (AZ)
     Payne
     Perlmutter
     Perriello
     Peters
     Peterson
     Pingree (ME)
     Polis (CO)
     Pomeroy
     Price (NC)
     Quigley
     Rahall
     Rangel
     Reyes
     Richardson
     Rodriguez
     Rothman (NJ)
     Roybal-Allard
     Ruppersberger
     Rush
     Ryan (OH)
     Salazar
     Sanchez, Linda T.
     Sanchez, Loretta
     Sarbanes
     Schauer
     Schiff
     Schrader
     Schwartz
     Scott (GA)
     Scott (VA)
     Serrano
     Sestak
     Shea-Porter
     Sherman
     Sires
     Skelton
     Slaughter
     Smith (WA)
     Snyder
     Space
     Speier
     Spratt
     Stark
     Stupak
     Sutton
     Tanner
     Teague
     Thompson (CA)
     Thompson (MS)
     Tierney
     Titus
     Tonko
     Towns
     Tsongas
     Van Hollen
     Velazquez
     Visclosky
     Walz
     Wasserman Schultz
     Waters
     Watson
     Watt
     Waxman
     Weiner
     Welch
     Wilson (OH)
     Woolsey
     Wu
     Yarmuth

                               NAYS--195

     Aderholt
     Adler (NJ)
     Akin
     Alexander
     Arcuri
     Austria
     Bachmann
     Bachus
     Barrett (SC)
     Barrow
     Bartlett
     Barton (TX)
     Biggert
     Bilbray
     Bilirakis
     Bishop (UT)
     Blackburn
     Blunt
     Boehner
     Bonner
     Bono Mack
     Boozman
     Boren
     Boustany
     Brady (TX)
     Bright
     Broun (GA)
     Brown (SC)
     Brown-Waite, Ginny
     Buchanan
     Burgess
     Burton (IN)
     Buyer
     Calvert
     Camp
     Campbell
     Cantor
     Cao
     Capito
     Carter
     Cassidy
     Castle
     Chaffetz
     Childers
     Coble
     Coffman (CO)
     Cole
     Conaway
     Crenshaw
     Culberson
     Davis (KY)
     Deal (GA)
     Dent
     Diaz-Balart, L.
     Diaz-Balart, M.
     Dreier
     Duncan
     Edwards (TX)
     Ehlers
     Emerson
     Fallin
     Flake
     Fleming
     Forbes
     Fortenberry
     Foxx
     Franks (AZ)
     Frelinghuysen
     Gallegly
     Garrett (NJ)
     Gerlach
     Gingrey (GA)
     Gohmert
     Goodlatte
     Granger
     Graves
     Griffith
     Guthrie
     Hall (TX)
     Harper
     Hastings (WA)
     Heller
     Hensarling
     Herger
     Herseth Sandlin
     Hoekstra
     Holden
     Hunter
     Inglis
     Issa
     Jenkins
     Johnson (IL)
     Johnson, Sam
     Jones
     Jordan (OH)
     King (IA)
     King (NY)
     Kingston
     Kirk
     Kline (MN)
     Kratovil
     Lamborn
     Lance
     Latham

[[Page 4102]]


     LaTourette
     Latta
     Lee (NY)
     Lewis (CA)
     Linder
     LoBiondo
     Lucas
     Luetkemeyer
     Lummis
     Lungren, Daniel E.
     Mack
     Manzullo
     Marshall
     McCarthy (CA)
     McCaul
     McClintock
     McCotter
     McHenry
     McIntyre
     McKeon
     McMahon
     McMorris Rodgers
     Melancon
     Mica
     Miller (FL)
     Miller (MI)
     Miller, Gary
     Minnick
     Moran (KS)
     Murphy, Tim
     Myrick
     Neugebauer
     Nunes
     Nye
     Olson
     Paul
     Paulsen
     Pence
     Petri
     Pitts
     Platts
     Poe (TX)
     Posey
     Price (GA)
     Putnam
     Radanovich
     Rehberg
     Reichert
     Roe (TN)
     Rogers (KY)
     Rogers (MI)
     Rohrabacher
     Rooney
     Ros-Lehtinen
     Roskam
     Ross
     Royce
     Ryan (WI)
     Scalise
     Schmidt
     Schock
     Sensenbrenner
     Sessions
     Shadegg
     Shimkus
     Shuler
     Shuster
     Simpson
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Souder
     Stearns
     Sullivan
     Taylor
     Terry
     Thompson (PA)
     Thornberry
     Tiahrt
     Tiberi
     Turner
     Upton
     Walden
     Wamp
     Westmoreland
     Whitfield
     Wilson (SC)
     Wittman
     Wolf
     Young (AK)
     Young (FL)

                             NOT VOTING--7

     Davis (AL)
     Davis (TN)
     Gutierrez
     Klein (FL)
     Marchant
     Rogers (AL)
     Schakowsky

                              {time}  1503

  Ms. HARMAN, Messrs. ISRAEL, CHANDLER, and Mrs. McCARTHY of New York 
changed their vote from ``nay'' to ``yea.''
  So the question of consideration was decided in the affirmative.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.


                             Point of Order

  Mr. ISSA. Mr. Speaker, I rise to a point of order.
  The SPEAKER pro tempore. The gentleman will state his point of order.
  Mr. ISSA. Mr. Speaker, I make a point of order against consideration 
of the resolution. The resolution violates clause 9 of rule XXI by 
waiving that rule against consideration of H.R. 4872.
  The SPEAKER pro tempore. The gentleman from California makes a point 
of order that the resolution violates clause 9(c) of rule XXI.
  Under clause 9(c) of rule XXI, the gentleman from California and a 
Member opposed each will control 10 minutes of debate on the question 
of consideration.
  Following that debate, the Chair will put the question of 
consideration.
  The Chair recognizes the gentleman from California.
  Mr. ISSA. Mr. Speaker, my point of order is quite simple. In the last 
2 weeks, both the House Republicans and the House Democrats have passed 
sweeping anti-earmark resolutions. Moreover, the leadership of the 
House has said that they will ensure that earmarks are in the past. 
But, Mr. Speaker, this legislation is filled with earmarks, not the 
least of which is the Louisiana purchase, not the least of which is the 
Bismark provision. Mr. Speaker, the amount of earmarks violating both 
Republican and Democratic House rules against earmarks is beyond the 
counting of any of us. My point of order is intended to stop the bill 
until earmarks can be removed from the bill.
  I might note, Mr. Speaker, last night until late at night, for more 
than 13 hours, Republicans offered 80 amendments, many of which could 
have fixed portions of this bill. None--I repeat, Mr. Speaker, none--
were ruled in order.
  Mr. Speaker, I make a point of order that an earmark is tantamount to 
a bribe. An earmark to receive a vote is clearly a way to get a vote in 
return for something of value.
  Mr. Speaker, this legislation is a vast tax increase and a vast 
increase in the reach of government. It deserves to be considered on 
its merits, not based on promises and bribes for financial gain to 
various Members' districts. Therefore, it is clear we must remove all 
earmarks before this legislation can move forward.
  I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I rise in opposition to the point of 
order.
  The SPEAKER pro tempore (Mr. Jackson of Illinois). The gentlewoman 
from New York is recognized for 10 minutes.
  Ms. SLAUGHTER. Mr. Speaker, I yield myself such time as I may 
consume.
  My friends on the other side of the aisle are attempting to use a 
purely technical violation of the earmark identification rule to try 
and block the House from even considering the rule and the underlying 
legislation. In fact, the Budget Committee did include an earmark 
statement in their committee report.
  However, a minor technical error in that statement made the 
legislation subject to a point of order. The Budget Committee has since 
filed two clarifying earmark statements in the Congressional Record. 
Clearly these statements, as well as the initial statement in the 
committee report, should show that it does not violate the spirit of 
the earmark rule. I have copies of these statements for any Members who 
need clarification.
  The rule and the underlying legislation deserve to be debated on the 
merits, not stopped by purely procedural motions. I urge my colleagues 
to vote ``yes'' so we can consider this important legislation, so 
important to the American people. Let's not waste any more time.
  I reserve the balance of my time.
  Mr. ISSA. Mr. Speaker, I am flabbergasted. Perhaps the gentlelady 
from New York could tell me, does that mean that under the rule that 
the Louisiana purchase, the Cornhusker kickback, the Gator aid, and the 
Bismark bank job will be somehow removed from the legislation after its 
passage?
  Ms. SLAUGHTER. I am happy to tell you that. The final bill will not 
have State-specific provisions. The provisions that are in apply to 
multiple States, and a provision in the education portion of the 
reconciliation bill regarding State-owned banks is being struck by the 
manager's amendment.
  Mr. ISSA. Reclaiming my time, I'm going to simply state for the 
record that our reading is that all of these will go to the President 
in the bill. And, of course, if by some miracle a bribe for one becomes 
a bribe for many States, somehow I don't think the American people will 
find that particularly a happy day for anyone, except perhaps the few 
States who receive for a short time a special consideration.
  With that, I yield 1 minute to the gentleman from Arizona (Mr. 
Flake).
  Mr. FLAKE. I thank the gentleman for yielding.
  We're all aware of the special provisions or earmarks in the bill: 
the Cornhusker kickback, the Louisiana purchase, the Gator aid. These 
earmarks, though, apart from the role they played in greasing the skids 
for this bill, are probably the least offensive part of the 
legislation.
  We desperately need health care reform, reform that lowers costs and 
improves quality through competition and market discipline. But such 
measures, such as allowing the purchase of health care across State 
lines and allowing individuals to purchase insurance with pre-tax 
dollars, are absent from the bill. Instead, the bill contains increases 
in taxes, mandates and bureaucracy that will only serve to further 
shield the health care industry from true competition--competition that 
is so desperately needed.
  Mr. Speaker, without this bill, the fiscal challenges that we face 
are incredibly steep. With this bill, they are almost insurmountable.
  There will come a day that the piper will have to be paid. We have 
shown ourselves unwilling to fess up to the challenges today. We can 
only hope that those elected this November and in the years to come 
will show more courage than we've shown today.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Florida (Ms. Castor).
  Ms. CASTOR of Florida. I thank the chairwoman of the Rules Committee, 
Ms. Slaughter, for yielding the time.
  We're going to fight through these dilatory tactics today and side 
with the American people and side with families all across this great 
country. For families that have health insurance, the insurance 
companies will no longer be able to cancel your coverage if you get 
sick. And if you switch jobs, the insurance companies will not be able 
to bar you from coverage just because you have a preexisting condition, 
like asthma or diabetes or some other disease happens to run in your 
family.

[[Page 4103]]

  As for our parents and our grandparents and our neighbors who rely on 
Medicare, Medicare will get stronger. Not one benefit will be cut. Not 
one. Despite the scare tactics from the other side of the aisle, 
Medicare will be stronger; the prescription drug coverage will improve.
  We're going to focus on prevention because prevention works, it saves 
lives, and it saves money. We're going to pay doctors that serve 
Medicare patients more money so that Medicare patients can keep their 
doctor and we can keep those smart doctors that serve Medicare patients 
working for all of us.
  And for small business owners and families that do not have 
affordable health coverage today, we're going to create a new shopping 
exchange where they can compare plans in a transparent way and also 
provide new tax credits for small business owners and families all 
across America.
  Yes, we're going to side with American families today because we're 
not just Members of Congress, we're daughters and sons and parents. 
We're grandchildren. And once and for all, we're going to ensure that 
all families all across America have what Members of Congress have. 
We're going to side with families against the insurance companies, 
fight through these dilatory tactics, and pass this historic landmark 
legislation.
  Mr. ISSA. Mr. Speaker, I would like to yield 45 seconds to the 
gentleman from Texas (Mr. Poe).
  Mr. POE of Texas. This bill has special deals for special folks. The 
Louisiana purchase, a special deal for Florida, a special deal for two 
States in New England, and a special deal for Connecticut. And as much 
as my friends like to rail on the insurance companies, they give a 
special deal to Michigan Blue Cross so that they don't have to get the 
new tax increases. Why is that? Because it's special deals for special 
folks.
  This bill is unconstitutional. The Texas State Attorney General plus 
30 other Attorneys General will sue the Federal Government if this bill 
passes because of special deals for special folks.
  Also, this bill is unconstitutional because it forces the American 
people to buy a product. Nowhere in the Constitution does the Federal 
Government have the authority to force you to buy anything, whether 
it's insurance, a car, or a box of doughnuts.

                              {time}  1515

  Mr. ISSA. Mr. Speaker, the ranking member needs 15 seconds to enter 
into a colloquy. I would yield the gentleman from California 15 seconds 
for a question.
  Mr. DREIER. Mr. Speaker, I would like to engage in a colloquy, if I 
might, with my distinguished committee Chair if that's possible, if she 
would do that.
  Ms. SLAUGHTER. If we can use your time.
  Mr. DREIER. If we can use my 15 seconds, Madam Chair?
  Ms. SLAUGHTER. Yes.
  Mr. DREIER. Well, let me just say that the one thing that we are 
guaranteed, and please tell me if I am wrong, the one thing that we are 
guaranteed is that the Senate bill, under the rule that has been 
crafted by the Rules Committee, is the only thing that if it passes 
today we know will become public law; is that correct?
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. ISSA. I would yield the gentleman an additional 10 seconds.
  Mr. DREIER. Is that correct, Madam Chair?
  Ms. SLAUGHTER. I am sorry, I couldn't hear.
  Mr. DREIER. Under the rule that was crafted and reported out by the 
Rules Committee just before midnight last night, is it not true that 
the only thing that we are guaranteed to have become public law at the 
end of this day, if the votes are there, is, in fact, the Senate bill?
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Ms. SLAUGHTER. Mr. Speaker, I am happy to yield 1 minute to the 
gentleman from Michigan (Mr. Kildee).
  Mr. KILDEE. Mr. Speaker, I spent 6 years in the Catholic seminary 
studying to be a priest and have always been pro-life. I will be 81 
years old this September. Certainly at this stage of my life I am not 
going to change my mind and support abortion. I am not going to 
jeopardize my eternal salvation.
  I sought counsel from my priest, advice from my family, friends and 
constituents and I have read the Senate abortion prohibition more than 
a dozen times. I am convinced that the original prohibition of the Hyde 
amendment is in the Senate bill. No Federal funds can be used for 
abortion except in the case of rape, incest and to save the life of the 
mother.
  I am a pro-life Member, both for the born and the unborn.


                        Parliamentary Inquiries

  Mr. TIAHRT. Mr. Speaker, parliamentary inquiry.
  The SPEAKER pro tempore. The gentleman from Kansas will state his 
parliamentary inquiry.
  Mr. TIAHRT. Mr. Speaker, it was my understanding that the chairwoman 
of the Rules Committee just said that if the language in the Senate 
bill that was referred to by the gentleman from California is going to 
be changed, would that not mean that the Senate bill would have to go 
back to the Senate for further action in that body?
  Mr. Speaker, in order to keep the American public informed, let me 
restate this so that you can understand.
  Is it true that if the actions to overcome the Cornhusker compromise, 
the Louisiana purchase and those special provisions that have been 
designated in the Senate bill are changed, as was assured by the 
chairwoman of the Rules Committee, then would not that bill have to go 
back to the Senate for further action?
  The SPEAKER pro tempore. The Chair will not interpret the meaning of 
the pending resolution.
  Mr. TIAHRT. Further inquiry, Mr. Speaker.
  The SPEAKER pro tempore. The gentleman will state his inquiry.
  Mr. TIAHRT. Mr. Speaker, I am asking a question that if a bill is 
changed, does it not have to go back to the other body for further 
action, because the gentlewoman from New York has assured the gentleman 
from California that his concerns about specific sections that were 
used to get specific votes is going to be changed by the manager's 
amendment. Would that not then change the underlying Senate bill, which 
would then have to go back to the other body for further action? Is 
that not true?
  The SPEAKER pro tempore. The Chair will not interpret the meaning of 
the pending resolution. That is a matter for debate by Members.
  Mr. TIAHRT. Mr. Speaker, I am a little confused, then. Perhaps you 
could, in a parliamentary inquiry, explain to me that if a bill is 
changed once it comes from the other body, does it not have to return 
to that body for further action?
  The SPEAKER pro tempore. The Chair will not respond to another 
Member's characterization in debate of what the bill's effect is.
  Mr. ISSA. Mr. Speaker, I have a parliamentary inquiry.
  The SPEAKER pro tempore. The gentleman from California will state his 
inquiry.
  Mr. ISSA. Under the rules of the House, if the House is not in order, 
as it was not when the gentlelady from New York said she could not hear 
the question, wouldn't the time not tally until the House is in order, 
thus allowing for her to get the question and be able to answer, 
something that we were denied, even though we gave 25 seconds for that 
process?
  The SPEAKER pro tempore. The Chair recognized the gentleman from 
California for 10 seconds. The gentleman's time expired before the 
gentleman completed his question. The gentlewoman does not have the 
right to request time that she does not control.
  Mr. ISSA. Further parliamentary inquiry.
  If you recall, Mr. Speaker, I yielded 15 seconds and then an 
additional 10 seconds, and the gentlelady from New York repeated that 
she could not hear the question.

[[Page 4104]]

  In fairness to the tally of the time, how can that time run when she 
could not hear? And wouldn't we be entitled to at least the time lost 
in debate because the House was not in order and she could not hear?
  The SPEAKER pro tempore. The Chair may stop the clock while obtaining 
order. However, the Chair recognizes and acknowledges that in the 15 
seconds that was first allotted to the gentleman from California, he 
had not completed his question.
  In the 10 seconds that was subsequently lent to the gentleman from 
California, he still did not finish his question, and at no point in 
time did any Member suggest that they needed order from those who 
controlled the time, which was the gentleman from California.
  Mr. TIAHRT. Parliamentary inquiry, Mr. Speaker.
  Was not the gentleman from California yielded another 10 seconds, and 
he did not get to use it?
  The SPEAKER pro tempore. The Chair is monitoring all time that is 
being used.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield 1 minute to the 
gentlewoman from California (Ms. Lee).
  Ms. LEE of California. I want to thank the gentlewoman for yielding 
and for her wonderful bold leadership. Today we will pass the historic 
vote to improve the health and wellness of millions of Americans who 
suffer because they are uninsured or underinsured and because of 
massive gaps in the Nation's health care system.
  I just want to say on behalf of the Congressional Black Caucus, we 
have to thank Congresswoman Donna Christensen and our health task 
force, Congressman Danny Davis, Congresswoman Donna Edwards, Chairman 
Rangel, Congressman Conyers, our majority whip, Mr. Clyburn, for their 
very stellar leadership.
  We all cast our vote for all of the people who deserve health care 
but simply cannot afford it. We cast our vote for senior citizens who 
will see their prescription drug costs go down. We cast our vote for 
all of those who have no health care and end up in emergency rooms, and 
we cast our vote for our children and our grandchildren so that they 
will live longer and healthier lives. And we cast our vote in memory of 
those people who didn't have preventive health care and died 
prematurely.
  Health care will finally become a right for all.
  Mr. ISSA. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from 
New Jersey (Mr. Smith).
  Mr. SMITH of New Jersey. Mr. Speaker, for those of us who recognize 
abortion as violence against children and the exploitation of women, 
nothing less than a comprehensive prohibition of public funding of 
elective abortion satisfies the demands of social justice.
  Regrettably, the language that emerged from the Senate is weak, 
duplicitous and ineffective, not by accident but by design. It will 
open up the floodgates of public funding for abortion in a myriad of 
programs resulting in more dead babies and more wounded mothers.
  For the first time ever, the Senate-passed bill permits health care 
insurance plans and policies, funded with tax credits, to pay for 
abortion, so long as the issuer of the federally subsidized plan 
collects a new congressionally mandated fee--an abortion surtax--from 
every enrollee in the plan to pay for other people's abortions.
  The Senate-passed bill creates a new community health center fund. 
Hyde amendment protection do not apply. Therefore, either the Obama 
administration or a court is likely to compel funding there as well. 
Also, the bill creates a huge, new program administered by OPM that 
would manage two or more new multistate or regional health plans.
  The legislation says that only one of those multistate plans not pay 
for abortion, which begs the question, what about the other multistate 
plans administered by OPM? Why are those federally administrated plans 
with federally mandated fees permitted to include abortion--this 
represents a radical departure from current policy.
  Abortion isn't health care, Mr. Speaker. It is not preventive health 
care.
  We live in an age of ultrasound imaging, the ultimate window to the 
womb and its occupant. We are in the midst of a fetal healthcare 
revolution, an explosion of benign, innovative interventions designed 
to diagnose, treat and cure illnesses or diseases any unborn child may 
be suffering.
  Let's protect the unborn child and their mother. Obamacare, 
unfortunately, is the biggest increase in abortion funding ever.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Rhode Island (Mr. Langevin).
  Mr. LANGEVIN. Mr. Speaker, tonight we cast a vote to address one of 
our Nation's greatest unsolved challenges, and that is solving our 
Nation's health care crisis.
  This Congress is being given a once-in-a-lifetime opportunity to fix 
a broken health care system that has left millions of families without 
the coverage and care that they deserve or are struggling to keep the 
health care coverage that they do have. If we seize this opportunity 
tonight, we can ensure that tomorrow a working mom in West Warwick, 
Rhode Island, will wake up knowing that she can afford her family's 
health care coverage. A dad in Providence will wake up knowing he can 
take his daughter to the doctor when she gets sick. A small business 
owner in Westerly will be able to wake up knowing he can finally give 
his employees the coverage that he has always intended, and a cancer 
survivor in Narragansett will wake up knowing she won't be denied 
coverage because of a preexisting condition or lose her insurance 
because of a lifetime cap.
  Mr. Speaker, after an injury left me paralyzed almost 30 years ago, 
members of my community rallied behind me and my family at a time that 
I needed it the most. It's that time in my life that inspired me to go 
into public service so that I could give back to a community that gave 
me so much at a time when I needed it the most.
  Tonight I know that with all of my being I am fulfilling that 
promise, and I urge my colleagues to do the same by supporting this 
important piece of legislation and finally give America the kind of 
health care coverage that it deserves.
  Mr. ISSA. Mr. Speaker, I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentlewoman from 
California (Ms. Chu).
  Ms. CHU. Health care reform will make life better for your son, your 
daughter, your mother, your father and the people you see every day. It 
certainly would have made life better for Eric, a young man on my 
staff.
  Eric was only 22 years old when he was diagnosed with cancer of the 
lymph node. He went through 2 years of chemotherapy on his father's 
health insurance. They paid thousands of dollars in copays and traveled 
hundreds of miles to find lower cost care, but at least they had 
insurance.
  The crisis came when he reached the age of 24 and was going to be 
kicked off his parents' insurance. He tried to buy insurance but was 
denied because of a preexisting condition.
  Thank goodness he got a job with us. But with health care reform he 
wouldn't have had to fear for his young life, because children will be 
covered up until their 27th birthday.
  With health care reform, we have a chance to save lives. For the sake 
of young people like Eric, we must pass health care reform.

                              {time}  1530

  Mr. ISSA. Mr. Speaker, can I inquire as to how much time each side 
has remaining?
  The SPEAKER pro tempore. The gentleman from California has 2\1/2\ 
minutes. The gentlewoman from New York has 2\1/4\ minutes.
  Mr. ISSA. Mr. Speaker, I yield 45 seconds to the gentleman from 
Wisconsin (Mr. Sensenbrenner).
  Mr. SENSENBRENNER. Mr. Speaker, the gentleman from New Jersey (Mr. 
Smith) is right on. This bill expands abortion funding to the greatest 
extent in history.
  I have heard that the President is contemplating issuing an Executive

[[Page 4105]]

order to try to limit this. Members should not be fooled. Executive 
orders cannot override the clear intent of a statute.
  Secondly, yesterday everybody in this House voted in favor of the 
TRICARE bill, which preserved the DOD's right to administer this 
program. If an Executive order moves the abortion funding in this bill 
away from where it is now, it will be struck down as unconstitutional 
because Executive orders cannot constitutionally do that.
  Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentleman from 
Georgia (Mr. Scott).
  Mr. SCOTT of Georgia. Mr. Speaker, it is very significant that we are 
having this debate on Sunday, the Lord's day, because this is the day 
of faith, and we are going to have to step forward on faith and 
courage.
  There are many people out here who have been warning and threatening 
us as to, if we vote on this bill, what will happen to us in the 
November elections. Well, that is not the question. The question is not 
what will happen to us in November. The question is, what will happen 
to the American people if we do not vote on this bill? That is why we 
have got to step out on faith, we have got to step out on courage. The 
American people are expecting it.
  Each and every one of us was elected here for some great purpose at 
some great time. Well, that great purpose is for health care for all 
the American people, and the time is now. Vote ``yes'' for this bill 
and make America proud.


                         Parliamentary Inquiry

  Mr. ISSA. Mr. Speaker, point of inquiry.
  Did I just hear an allegation of a threat? Would that be a threat 
against an action on Members of Congress? Is that in fact an allegation 
that we should consider at this time, since that's what I think I 
heard, that Members were being threatened?
  The SPEAKER pro tempore. It is not the role of the Chair to 
characterize remarks used in debate.
  Mr. ISSA. Mr. Speaker, I yield 1 minute to the gentleman from 
California (Mr. Dreier).
  Mr. DREIER. Mr. Speaker, I would like to engage in a colloquy with 
the distinguished Chair of the Committee on Rules and ask the question 
as follows:
  Is it not true that the only thing that we know with absolute 
certainty, if in fact it passes, is that the Senate bill will become 
public law?
  We have heard all about this reconciliation package, and the 
gentlewoman seems to be certain of its passage. But is it not true that 
this rule guarantees that the only thing that will be law for sure is 
the Senate bill, which has the Cornhusker kickback, the Louisiana 
purchase, and those other items?
  Ms. SLAUGHTER. Mr. Dreier, it is absolutely true that the Senate bill 
does contain those things. It has already been passed and requires no 
further action in the Senate.
  What we will do today is pass the bill, which will then be sent to 
the President and become law. We will this afternoon pass the 
reconciliation----
  Mr. DREIER. I would like to reclaim my time.
  Ms. SLAUGHTER. Please let me answer.
  The SPEAKER pro tempore. The gentleman from California controls the 
time.
  Mr. DREIER. Mr. Speaker, we now know with absolute certainty that the 
only thing----
  Ms. SLAUGHTER. No, you don't.
  Mr. DREIER. That we are guaranteed----
  Ms. SLAUGHTER. You don't know that.
  The SPEAKER pro tempore. The gentlewoman from New York will suspend.
  The gentleman from California controls the time.
  Mr. DREIER. Mr. Speaker, I encourage everyone to read the rule. 
Because the only thing that we are guaranteed upon its passage is that 
the Senate bill, with the Cornhusker kickback, Gator aid, Louisiana 
purchase, and all in fact becomes public law.
  Ms. SLAUGHTER. Mr. Speaker, I yield myself 1 minute.
  Yes, the Senate bill will become law today, followed by the 
reconciliation bill which contains the amendments to the law, which 
contains what everybody here wants us to take out. The best way that 
they can achieve their ends of removing the things that are 
objectionable from the Senate bill is to support reconciliation. And 
let's see if you can do it.
  I reserve the balance of my time.


                        Parliamentary Inquiries

  Mr. ISSA. Mr. Speaker, point of parliamentary inquiry.
  Is it not against the rules of the House to urge an action in the 
Senate, such as voting for or assisting in reconciliation?
  The SPEAKER pro tempore. References to the Senate are in order as 
long as they avoid personalities.
  Mr. ISSA. Mr. Speaker, further parliamentary inquiry.
  It is now acceptable to lobby the Senate from the House floor in any 
and all conduct and questions?
  The SPEAKER pro tempore. Remarks must be addressed to the Chair, but 
remarks regarding the Senate are not necessarily out of order.
  Mr. ISSA. I thank the Speaker, and I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I did not address the Senate. I want that 
to be clearly on the record.
  I yield 30 seconds to the gentlewoman from the Virgin Islands, Dr. 
Christensen.
  Mrs. CHRISTENSEN. Mr. Speaker, as a physician and chair of Health for 
the Congressional Black Caucus, someone who has worked long to bring 
quality health care to the underserved in country and inclusion for the 
Virgin Islands and other territories, I thank our President and House 
leadership for the commitment and determination that has brought us to 
the brink of this great victory, not just for some, but for all of the 
people of this great country.
  Today we will make insurance accessible and affordable to 32 million 
Americans, begin to eliminate health disparities, provide our children 
what they need to reach their full potential, and ensure that our 
seniors and disabled have the care they need.
  So let's get on with the rule and to voting ``yes'' on this bill, not 
just for a healthy America, but for a better America.
  Mr. ISSA. Mr. Speaker, could I inquire as to how much time each side 
has remaining?
  The SPEAKER pro tempore. The gentleman from California has 45 seconds 
remaining. The gentlewoman from New York has 15 seconds remaining.
  Mr. ISSA. Mr. Speaker, I will continue to reserve the balance of my 
time.
  Ms. SLAUGHTER. I reserve the right to close, and I will reserve the 
balance of my time unless it is given up on the other side.
  The SPEAKER pro tempore. The gentlewoman from New York has the right 
to close.
  Mr. ISSA. Mr. Speaker, I wanted to inquire as to whether the 
gentlelady had any additional speakers, other than the right to close.
  Ms. SLAUGHTER. Mr. Speaker, I do not.
  Mr. ISSA. Mr. Speaker, at this time I would like to yield 30 seconds 
to the gentleman from Georgia (Mr. Kingston) to give his view of the 
Louisiana kickback and purchase.
  Mr. KINGSTON. I thank the gentleman for yielding.
  I have to ask my friends who have spoken before me: If the bill is as 
good as you say it is, why are any of these bribes in the bill to begin 
with?
  The President said, January 25, ``It is an ugly process, and it looks 
like there are a bunch of backroom deals.''
  And here is something that does not come out in the reconciliation 
process: $7.5 million to Hawaii, page 2,132. Libby, Montana 2,222, 
something about biohazard. Frontier States, $2 billion, page 2,238. And 
it goes on. The Louisiana purchase. None of this comes out in 
reconciliation.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. ISSA. Mr. Speaker, I regret that I have but 15 more seconds to 
give to my colleague.
  Mr. KINGSTON. I thank the gentleman. And I know my friends on this

[[Page 4106]]

side of the aisle feel just the same way. Not one of those things comes 
out in the reconciliation process.
  My question is, if the bill is so good, where has the transparency 
been? Why all the backroom deals? Why this week alone has the President 
had 64 calls and visits to the White House to twist arms? Why the 
sweeteners?
  You know the bill is not as good as advertised. Vote ``no.'' Let's 
work for a bipartisan bill.


                         Parliamentary Inquiry

  Mr. TIAHRT. Mr. Speaker, parliamentary inquiry.
  The SPEAKER pro tempore. The gentleman from Kansas will state his 
parliamentary inquiry.
  Mr. TIAHRT. Mr. Speaker, it was the assumption of the body here that 
all the earmarks that were contained in the Senate bill would be taken 
care of in the reconciliation bill. If it is true that they are not all 
taken into consideration for, do the earmark rules then apply to the 
rest of the bill?
  The SPEAKER pro tempore. Will the gentleman restate his parliamentary 
inquiry.
  Mr. TIAHRT. Yes, Mr. Speaker, I would be glad to.
  It was the impression given the Members and the people of the United 
States that the reconciliation bill would take care of all the earmarks 
in the Senate bill. However, we now know that there are earmarks in the 
Senate bill that are not being taken care of. So do not the House rules 
on earmarks apply to the remainder of the Senate bill?
  The SPEAKER pro tempore. The Chair will make a brief statement about 
the process of entertaining parliamentary inquiries.
  Recognition for parliamentary inquiries is a matter committed to the 
discretion of the Chair. In exercising that discretion, the Chair 
endeavors to apply ordinary jurisprudential principles. A parliamentary 
inquiry should relate in some practical sense to the pending 
proceedings. It should not seek an advisory opinion. The Chair declines 
to respond to hypothetical questions, to questions not yet presented, 
and to requests to place pending proceedings in historical context.
  Members should not expect to engage the Chair in argument. A Member 
seeking to make a point on the merits of an issue--whether it is one of 
policy or one of process--may do so by engaging in debate. But a Member 
should not expect to have the presiding officer affirm or validate such 
a point.
  The Chair appreciates the understanding of Members.
  With that said, the time of the gentleman from California has 
expired.
  The gentlewoman from New York is recognized.
  Mr. TIAHRT. Mr. Speaker, I am asking for an inquiry on the House 
rules. Do the House rules apply or not?
  The SPEAKER pro tempore. The gentlewoman from New York has been 
recognized.
  Mr. TIAHRT. Mr. Speaker, is it not the purpose of your role to make 
sure that the rules of the House are incorporated into our discussions?
  The SPEAKER pro tempore. The gentlewoman from New York has been 
recognized.
  Ms. SLAUGHTER. Mr. Speaker, again I want to urge my colleagues to 
vote ``yes'' on this motion to consider so that we may debate and pass 
this important legislation today.
  Mr. Speaker, I am certain that I heard you say that the gentleman's 
time has expired. Is that not correct?
  The SPEAKER pro tempore. The time of the gentlewoman has expired as 
well.
  Mr. ISSA. Mr. Speaker, a parliamentary inquiry.
  The SPEAKER pro tempore. The gentleman will suspend.
  In response to the earlier inquiry from the gentleman from Kansas, 
the Chair will state that the rules are being applied. The point of 
order under clause 9(c) of rule XXI was made and was being debated.
  All time has expired.
  Mr. TIAHRT. Mr. Speaker, clarification of the point of order.
  The SPEAKER pro tempore. The gentleman from Kansas.
  Mr. TIAHRT. Is it my understanding that you said that the rules will 
apply to the Senate bill on earmarks that were not covered by the 
reconciliation bill?
  The SPEAKER pro tempore. The point of order was raised against the 
pending resolution. The point of order was debated.
  The question is, Will the House now consider the resolution?
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. ISSA. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The vote was taken by electronic device, and there were--yeas 230, 
nays 200, not voting 0, as follows:

                             [Roll No. 160]

                               YEAS--230

     Ackerman
     Altmire
     Andrews
     Baca
     Baird
     Baldwin
     Bean
     Becerra
     Berkley
     Berman
     Berry
     Bishop (GA)
     Bishop (NY)
     Blumenauer
     Boccieri
     Boswell
     Boucher
     Boyd
     Brady (PA)
     Braley (IA)
     Brown, Corrine
     Butterfield
     Capps
     Capuano
     Cardoza
     Carnahan
     Carney
     Carson (IN)
     Castor (FL)
     Chandler
     Chu
     Clarke
     Clay
     Cleaver
     Clyburn
     Cohen
     Connolly (VA)
     Conyers
     Cooper
     Costa
     Costello
     Courtney
     Crowley
     Cuellar
     Cummings
     Dahlkemper
     Davis (CA)
     Davis (IL)
     Davis (TN)
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Dicks
     Dingell
     Doggett
     Donnelly (IN)
     Doyle
     Driehaus
     Edwards (MD)
     Ellison
     Ellsworth
     Engel
     Eshoo
     Etheridge
     Farr
     Fattah
     Filner
     Foster
     Frank (MA)
     Fudge
     Garamendi
     Giffords
     Gonzalez
     Gordon (TN)
     Grayson
     Green, Al
     Green, Gene
     Grijalva
     Gutierrez
     Hall (NY)
     Halvorson
     Hare
     Harman
     Hastings (FL)
     Heinrich
     Higgins
     Hill
     Himes
     Hinchey
     Hinojosa
     Hirono
     Hodes
     Holt
     Honda
     Hoyer
     Inslee
     Israel
     Jackson (IL)
     Jackson Lee (TX)
     Johnson (GA)
     Johnson, E. B.
     Kagen
     Kanjorski
     Kaptur
     Kennedy
     Kildee
     Kilpatrick (MI)
     Kilroy
     Kind
     Kirkpatrick (AZ)
     Kissell
     Klein (FL)
     Kosmas
     Kucinich
     Langevin
     Larsen (WA)
     Larson (CT)
     Lee (CA)
     Levin
     Lewis (GA)
     Loebsack
     Lofgren, Zoe
     Lowey
     Lujan
     Lynch
     Maffei
     Maloney
     Markey (CO)
     Markey (MA)
     Matsui
     McCarthy (NY)
     McCollum
     McDermott
     McGovern
     McNerney
     Meek (FL)
     Meeks (NY)
     Michaud
     Miller (NC)
     Miller, George
     Mitchell
     Mollohan
     Moore (KS)
     Moore (WI)
     Moran (VA)
     Murphy (CT)
     Murphy (NY)
     Murphy, Patrick
     Nadler (NY)
     Napolitano
     Neal (MA)
     Oberstar
     Obey
     Olver
     Ortiz
     Owens
     Pallone
     Pascrell
     Pastor (AZ)
     Payne
     Perlmutter
     Perriello
     Peters
     Peterson
     Pingree (ME)
     Polis (CO)
     Pomeroy
     Price (NC)
     Quigley
     Rahall
     Rangel
     Reyes
     Richardson
     Rodriguez
     Rothman (NJ)
     Roybal-Allard
     Ruppersberger
     Rush
     Ryan (OH)
     Salazar
     Sanchez, Linda T.
     Sanchez, Loretta
     Sarbanes
     Schakowsky
     Schauer
     Schiff
     Schrader
     Schwartz
     Scott (GA)
     Scott (VA)
     Serrano
     Sestak
     Shea-Porter
     Sherman
     Sires
     Skelton
     Slaughter
     Smith (WA)
     Snyder
     Space
     Speier
     Spratt
     Stark
     Stupak
     Sutton
     Tanner
     Teague
     Thompson (CA)
     Thompson (MS)
     Tierney
     Titus
     Tonko
     Towns
     Tsongas
     Van Hollen
     Velazquez
     Visclosky
     Walz
     Wasserman Schultz
     Waters
     Watson
     Watt
     Waxman
     Weiner
     Welch
     Wilson (OH)
     Woolsey
     Wu
     Yarmuth

                               NAYS--200

     Aderholt
     Adler (NJ)
     Akin
     Alexander
     Arcuri
     Austria
     Bachmann
     Bachus
     Barrett (SC)
     Barrow
     Bartlett
     Barton (TX)
     Biggert
     Bilbray
     Bilirakis
     Bishop (UT)
     Blackburn
     Blunt
     Boehner
     Bonner
     Bono Mack
     Boozman
     Boren
     Boustany
     Brady (TX)
     Bright
     Broun (GA)
     Brown (SC)
     Brown-Waite, Ginny
     Buchanan
     Burgess
     Burton (IN)
     Buyer
     Calvert
     Camp
     Campbell
     Cantor
     Cao
     Capito
     Carter
     Cassidy
     Castle
     Chaffetz
     Childers
     Coble
     Coffman (CO)
     Cole
     Conaway
     Crenshaw
     Culberson
     Davis (AL)
     Davis (KY)
     Deal (GA)
     Dent
     Diaz-Balart, L.
     Diaz-Balart, M.
     Dreier
     Duncan
     Edwards (TX)
     Ehlers
     Emerson
     Fallin
     Flake
     Fleming
     Forbes
     Fortenberry
     Foxx
     Franks (AZ)
     Frelinghuysen
     Gallegly
     Garrett (NJ)
     Gerlach
     Gingrey (GA)
     Gohmert
     Goodlatte
     Granger
     Graves
     Griffith
     Guthrie
     Hall (TX)
     Harper
     Hastings (WA)
     Heller
     Hensarling
     Herger
     Herseth Sandlin
     Hoekstra
     Holden
     Hunter
     Inglis
     Issa
     Jenkins
     Johnson (IL)
     Johnson, Sam
     Jones
     Jordan (OH)
     King (IA)
     King (NY)
     Kingston
     Kirk
     Kline (MN)
     Kratovil
     Lamborn
     Lance

[[Page 4107]]


     Latham
     LaTourette
     Latta
     Lee (NY)
     Lewis (CA)
     Linder
     Lipinski
     LoBiondo
     Lucas
     Luetkemeyer
     Lummis
     Lungren, Daniel E.
     Mack
     Manzullo
     Marchant
     Marshall
     Matheson
     McCarthy (CA)
     McCaul
     McClintock
     McCotter
     McHenry
     McIntyre
     McKeon
     McMahon
     McMorris Rodgers
     Melancon
     Mica
     Miller (FL)
     Miller (MI)
     Miller, Gary
     Minnick
     Moran (KS)
     Murphy, Tim
     Myrick
     Neugebauer
     Nunes
     Nye
     Olson
     Paul
     Paulsen
     Pence
     Petri
     Pitts
     Platts
     Poe (TX)
     Posey
     Price (GA)
     Putnam
     Radanovich
     Rehberg
     Reichert
     Roe (TN)
     Rogers (AL)
     Rogers (KY)
     Rogers (MI)
     Rohrabacher
     Rooney
     Ros-Lehtinen
     Roskam
     Ross
     Royce
     Ryan (WI)
     Scalise
     Schmidt
     Schock
     Sensenbrenner
     Sessions
     Shadegg
     Shimkus
     Shuler
     Shuster
     Simpson
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Souder
     Stearns
     Sullivan
     Taylor
     Terry
     Thompson (PA)
     Thornberry
     Tiahrt
     Tiberi
     Turner
     Upton
     Walden
     Wamp
     Westmoreland
     Whitfield
     Wilson (SC)
     Wittman
     Wolf
     Young (AK)
     Young (FL)


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore (during the vote). Two minutes remain in this 
vote.

                              {time}  1606

  Ms. GINNY BROWN-WAITE of Florida changed her vote from ``yea'' to 
``nay.''
  So the question of consideration was decided in the affirmative.
  The result of the vote was announced as above recorded.
  The SPEAKER pro tempore. The gentlewoman from New York is recognized 
for 1 hour.
  Ms. SLAUGHTER. Mr. Speaker, for the purpose of debate only, I yield 
the customary 30 minutes to the gentleman from California (Mr. Dreier), 
and all time yielded during consideration of the rule is for debate 
only.


                             General Leave

  Ms. SLAUGHTER. I ask unanimous consent that all Members have 5 
legislative days within which to revise and extend their remarks and 
insert extraneous material into the Record.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from New York?
  There was no objection.
  Ms. SLAUGHTER. Mr. Speaker, these have been solemn days and not just 
because of the important legislation before us. Yesterday just steps 
away from where we are now standing, a group of protesters engaged in 
dangerous and derogatory behavior toward four of our Members. I believe 
the attacks yesterday were a step back for this country, a stark 
reminder of where we used to be and a reminder of how much further we 
must travel to fulfill the promise of equality.
  It was only 2 weeks ago that my colleague from Georgia, John Lewis, 
marked the 45th anniversary of Bloody Sunday in Selma, Alabama, and yet 
this civil rights icon was accosted yesterday while walking here to 
cast a vote. The use of racist, homophobic and inflammatory rhetoric 
and reports that the protesters who were gathered on our east terrace 
plaza attempted to spit on a Member of Congress is heartbreaking. This 
type of display should alarm every American and encourage us to work 
harder to put aside the hateful divisions and to come together to 
bridge the volatile spirit that is tearing apart our country.
  The anger isn't just contained outside the Capitol. Last week someone 
hurled a brick through the window of my district office in the dark of 
night. We must step back to remind ourselves of why we are here.
  I would like to show an incredible document given to me this week by 
the National Archives from the collection of Franklin Delano 
Roosevelt's original records. As the father of Social Security, 
Roosevelt has an honored place in this battle to create a national 
insurance plan for our country. This message, dated January 23, 1939, 
over 70 years ago, entitled, ``To the United States Congress of the 
United States,'' talks plainly about the need of this government to 
provide health care for its citizens. It was recognized at the time 
that a comprehensive health care program was required as an essential 
link to our national defenses against individual and social insecurity. 
Roosevelt wrote: ``The health of the people is a public concern; ill 
health is a major cause of major suffering, economic loss and 
dependency; good health is essential to the security and progress of 
the Nation.''
  I would like to read directly because I think the familiarity is 
overwhelming: ``I have been concerned by the evidence of inequalities 
that exist among the States as to personnel and facilities for health 
services. There are equally serious inequalities of resources, medical 
facilities and services in different sections and among different 
economic groups. These inequalities create handicaps for parts of the 
country and the groups of our people which most sorely need the 
benefits of modern medical science.
  ``The objective of a national health program is to make available in 
all parts of our country and for all groups of our people the 
scientific knowledge and skill at our command to prevent and care for 
sickness and disability; to safeguard mothers, infants and children; 
and to offset through social insurance the loss of earnings among 
workers who are temporarily or permanently disabled.''
  I will tell you, Mr. Speaker, that reading from that piece of paper 
with his hand notes scribbled on it absolutely takes my breath away, 
but it is a reminder that eyes of history are watching us. Future 
generations will look at what we do today, and it will be a guidepost 
to who we were as a people.
  The effort to reform the health care system goes back to at least 
Theodore Roosevelt, that great President who campaigned in 1912 by 
promising: ``We pledge ourselves to work increasingly in State and 
Nation for protection of home life against the hazards of sickness.''
  Still later, Harry Truman tackled reforms, as did President Clinton, 
during the nineties, a battle that I was here for. Before that, the 
last broad legislative rewrite was led by President Richard Nixon. It's 
remarkable to me that even after all these years, our final bill may 
end up being less progressive than the plan that Nixon would have 
supported, yet still the forces of the other side whip up opposition.
  I want to share a story I heard from a constituent in Buffalo. I will 
be very brief because these heartbreaking stories are nationwide. But 
it is about a young man who moved from New York to California. In 
California, his insurance only allowed him to visit the emergency room 
for seizures. When he got to New York, his insurance did not cover that 
at all except in New York City, so his father has to drive him back and 
forth from Buffalo to New York City. And he said, We are slowly going 
poor.
  Our bill covers an estimated 32 million Americans in a fiscally 
responsible way that improves Medicare benefits, holds insurance 
companies accountable, and helps small business owners with coverage. 
We are finally gaining ground against insurance special interests. 
Small businesses, the backbone of our economy will get tax credits if 
they make health care coverage available for their workers. We offer 
free preventive care for people on Medicare. We help people who have 
retired at 55, 10 years before they are eligible for Medicare. And we 
ban the lifetime and yearly limit on coverage.
  All of these provisions have the potential to transform the way that 
we deliver health care in the country. The fight has been long and 
contentious, and the public has been grievously and purposefully lied 
to. This week the Congressional Budget Office, which is nonpartisan and 
objective and unbiased, estimates that we will cut the deficit by $143 
billion over the next 10 years and $1.2 trillion over the following 10. 
What do our opponents say? That we can't afford this legislation. The 
fact of the matter is we can't not afford to do this legislation. For 
the 100 years we've worked toward this goal and all the obstacles, we 
are here today to do our job. And Harry Truman said, ``If you can't 
stand the heat, get out of the kitchen.''
  Well, I consider the Rules Committee as the kitchen of the of House 
of Representatives, and I am proud to be the cook. And I am proud to 
stand up and

[[Page 4108]]

say that this bill is the right thing to do, and the time to act is 
now. I am delighted to vote ``yes'' today.
  I reserve the balance of my time.

                              {time}  1615

  Mr. DREIER. Mr. Speaker, I thank my good friend, the distinguished 
Chair of the Committee on Rules, for yielding me the customary 30 
minutes, and I yield myself such time as I may consume.
  Mr. Speaker, as the debate on how to reform our health care system 
has proceeded, a great deal of attention has been focused on how 
partisan and divided this House is. And I totally concur with the 
gentlewoman about the horror that took place here yesterday with the 
awful treatment of our colleagues. It is totally unacceptable.
  I will say I am certainly one of those who has lamented the loss of 
bipartisan cooperation and substantive debate on the most important 
issues confronting our country. But I think there is at least one thing 
that we all will agree on, and that is the fact that the measure before 
us will have enormous repercussions for the American people for years 
to come.
  For many of us, the votes that we are to cast today will be among the 
most significant that we have ever cast. Health care represents one-
sixth of our Nation's economy. That fact alone makes any health care 
overhaul a tremendously important issue. But it is a lot more personal 
than that. The care that families receive, the choices that are 
available and the quality of those choices, these issues couldn't be 
more important. For many at some point in their lives, access to 
quality health care will become literally a matter of life or death.
  Now we just heard a story from the distinguished chairwoman of the 
Committee on Rules, and we will hear story after story of tragedies, 
and we all have them that our constituents face. We must all recognize 
what a sobering and weighty matter lies before us today, which is why 
this utterly ill-conceived bill is so dangerous and is such an 
unfortunate, missed opportunity for a good bipartisan conclusion.
  In addition to the divisiveness surrounding this measure, a great 
deal of attention has also been focused on the process by which this 
has been brought to the floor. Speaker Pelosi has argued that the 
American people care far more about the final product than the process 
by which it is considered. Now in a warped and bizarre way, Mr. 
Speaker, she is absolutely right. As egregious as this process has 
been, the American people will suffer the consequences of the substance 
of the bill in an even more significant and lasting way. As much as the 
public was outraged by procedural tactics to avoid a transparent vote 
on the Senate health care bill, the greatest outrage has always been 
reserved for the bill itself.
  This is not a bill that will increase access to care or improve its 
quality. It will not rein in costs.
  What it will do is add an enormous amount of new government 
bureaucracy to our existing system. It will spend $1 trillion at a time 
when our deficit is already $1.4 trillion, and our total national debt 
exceeds $12 trillion. It will cripple the small businesses that are 
already struggling in this economy and will further drive up 
unemployment. It will exponentially increase the waste and the 
potential for fraud and abuse that drive up costs while reducing access 
and quality. It will undoubtedly gut Medicare and potentially threaten 
the benefits and health care choices for nearly 11 million seniors 
enrolled in Medicare Advantage. It gives no guarantee to the more than 
8 million Americans enrolled in health savings accounts that they will 
be able to keep their current coverage if they so choose. And it will 
implement all of the backroom deals that have so outraged the American 
people, and which we have discussed here today--Gator aid, the 
Louisiana purchase, the Cornhusker kickback, and the Bismarck bank job. 
As I said in my exchange with the distinguished chairwoman earlier, 
this is the only bill that has the potential of being the law of the 
land by the end of this day.
  Mr. Speaker, this is a bad bill that grows even more unpopular every 
single day. But while Speaker Pelosi may be right that the substance of 
the bill will be remembered longer than the process, the process has 
been so tainted that we cannot simply gloss over it.
  The Democratic leadership charged forward recklessly all of the past 
week or two with plans to try to avoid a transparent up-or-down vote on 
the Senate's health care bill despite enormous public outrage and harsh 
bipartisan criticism that came from their colleagues of the Democratic 
leadership. For days they ignored the demands of the American people to 
dispense with the Senate health care bill in an accountable way.
  But when Democratic Members began demonstrating their outrage, the 
Democratic leadership had no choice; since the American people got it 
and understood what was taking place here, they had no choice but to 
abandon their plans.
  The rule before us will allow for votes on two questions, Mr. 
Speaker: Will the Senate health care bill become law and will a second 
reconciliation bill be advanced to the Senate for further 
consideration. So again only one measure will become law. While the 
decision to actually hold a vote I have to admit is a welcome one, I 
hope very much that my colleagues will forgive my lack of exuberance 
over this development. I can't quite bring myself to congratulate the 
Democratic leadership for agreeing to uphold the democratic process and 
actually have a vote on their legislation.
  It is a sad commentary on the state of our institution when simply 
holding a vote to make a hopelessly flawed bill the law of the land 
feels like progress. But that's the reality, unfortunately, of where we 
stand today. While the Democratic leadership, as we all know, had no 
choice but to agree to hold a vote on the Senate bill, they have still 
completely closed down the debate.
  Yesterday we had a very rigorous debate in the Rules Committee, where 
countless concerns were raised. Mr. Speaker, none of those concerns 
will be voted on today. We went 13\1/2\ hours yesterday, yet none of 
those concerns will be addressed today.
  While the debate over health care has gone on for over a year, today 
we will be voting on a reconciliation package that was only fully made 
available last night, violating the 72-hour requirement. Yes, we will 
be having an actual vote today. But without open debate, the 
opportunity for amendments, or the chance to fully analyze the 
legislation, we still do not have full transparency or accountability. 
What we do have the opportunity to do today is to answer two different 
questions: One, will the Senate health care bill become the law of the 
land? And will a separate reconciliation package be advanced to the 
Senate for further consideration?
  Mr. Speaker, it is absolutely critical to emphasize this two-track 
process because the Democratic leadership would very much like, as we 
have seen from the exchanges earlier, muddle this crucial fact. If they 
prevail today, Mr. Speaker, the Senate bill and only the Senate bill 
will become public law. The Senate bill, with all of its backroom deals 
and serious problems that are widely recognized by all, that is the 
only thing that will become law.
  The Democratic leadership has tried to claim that the reconciliation 
package will fix all of the problems in the Senate bill. That claim is 
far from accurate. The fundamental approach to health care reform put 
forth by the Senate bill, which is fatally flawed, will remain intact. 
Putting aside that hard truth for just a moment, the more immediate 
issue is that the reconciliation package will not become law today. It 
will merely be sent to our friends, our colleagues in the other body, 
where it will be slowly picked apart like everything else that is sent 
to the other body. Maybe the Senate will amend it and send it back here 
for further action, Mr. Speaker. Maybe it will fail to act at all. No 
matter what anyone says in this institution, Mr. Speaker, no one knows. 
No one has any idea what takes place those many, many miles away, it 
seems, down that hallway. The only thing that can be sent to the 
President for signature

[[Page 4109]]

today is the Senate bill that virtually no one supports.
  Let's cut through all of the misrepresentations and distortions. 
Passage of the underlying measures will ensure one thing and one thing 
only: enactment of the Senate bill. And I challenge anyone to take me 
on on that one. A vote for these measures today is a vote for all of 
those things that I mentioned: the Louisiana purchase; the Cornhusker 
kickback, which even Senator Nelson wants taken out; this Bismarck bank 
job; and the Gator aid. All of these things. It is a vote for new taxes 
and government bureaucracy. It is a vote for a trillion-dollar bill 
that does nothing to improve access or quality in our health care 
system.
  Mr. Speaker, I urge my colleagues to reject this rule. The Democratic 
leadership has demonstrated that when they are left with no other 
option, they can be forced into doing the right thing. Mr. Speaker, 
let's start fresh and find the real solutions for the American people 
that are so critically needed.
  I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield 3 minutes to the 
gentleman from Massachusetts (Mr. McGovern), a member of the Rules 
Committee.
  Mr. McGOVERN. Mr. Speaker, this is a historic day for all of us in 
the House. We have the opportunity to enact real, meaningful health 
insurance reform that will improve the lives of millions of our fellow 
citizens. We can end the most abusive practices of the insurance 
companies. We can provide coverage to millions of hardworking families. 
We can bring down the cost of health care for families and small 
businesses. We can close the doughnut hole in Medicare and extend the 
solvency of that vital program, and we can pass the biggest deficit-
reduction package in 25 years. All we need is the courage to do what is 
right.
  Today is especially meaningful for those of us from Massachusetts. As 
we all know, 7 months ago our friend and mentor, Ted Kennedy, lost his 
battle with brain cancer. When he passed away, I said that while no one 
could ever fill his shoes, we can and we must follow in his footsteps, 
and that is exactly what we are doing today.
  We have already taken important steps in Massachusetts to deal with 
the health care issue. And I am proud to say that my congressional 
district has the highest rate of coverage, over 97 percent, of any 
district in the country. And people back home often ask me, Why do we 
need to pass a Federal bill when we already have insurance here in our 
State? So I would like to talk for a moment about what reform means for 
Massachusetts: 75,000 additional middle class people will receive help 
to pay for their premiums; nearly 180,000 of our seniors will receive a 
50 percent discount on their prescription drugs; 70,000 small 
businesses, the innovators and job creators, will receive credit to 
cover the cost of insuring their workers; our community health centers, 
our hospitals, our medical research centers, all will receive support 
to continue their great work; and we will no longer be forced to 
subsidize through higher premiums and higher Medicare and Medicaid 
costs the uncompensated care of people in other States who do not have 
health insurance.
  If we want to create jobs, then passing this bill is absolutely 
essential. A few weeks ago, I talked to a small business owner in my 
district. Business has picked up lately, and he wanted to hire another 
employee, but then he got his health insurance bill and realized he 
couldn't afford it. He will just have to work harder and spend less 
time with his family. That is who this debate is all about. That is why 
today is so important.
  I regret the fact that my Republican friends are not standing with 
us. I regret the fact that they deliberately try to obstruct this 
process. But you know what? The Republicans opposed Social Security. 
They opposed Medicare. They were on the wrong side of history then, and 
they are on the wrong side of history today. Senator Kennedy said that 
providing access to health care is ``a fundamental principle of justice 
and the character of our country.'' As usual, he was right; and today, 
in this House, the work goes on and the cause endures. I urge my 
colleagues to support this bill.
  Mr. DREIER. Mr. Speaker, at this time I am happy to yield 2 minutes 
to my very hardworking Rules Committee colleague, the gentleman from 
Miami, Florida (Mr. Lincoln Diaz-Balart).
  Mr. LINCOLN DIAZ-BALART of Florida. Mr. Speaker, I truly hope this 
massive bill is not passed by the House today. If it does become law, 
it will constitute a decisive step in the weakening of the United 
States. At precisely the time when we should be implementing necessary 
reforms to strengthen and save Medicare, for example, this legislation 
raids Medicare by more than $500 billion in order to pay for a new, 
massive entitlement.

                              {time}  1630

  At a time when it would still be possible to enact entitlement 
reforms to prevent a Greece-style fiscal catastrophe in the future, 
when genuinely painful economic medicine will be needed, we are 
creating a massive new entitlement.
  We could have avoided the social convulsion and profound pain that 
prolonged fiscal irresponsibility inevitably brings to nations, but 
this President and this Congressional majority went with dogma instead.
  And when the time comes for the United States to have to face 
economic reality, and painful traumatic reforms are implemented by a 
future President and a future Congress, the U.S. military posture, our 
standard of living, the American middle class as we know it, those 
interconnected realities which have been so wonderful in characterizing 
modern America and which this President and this Congressional majority 
apparently seem to take for granted, those realities will be but 
historical memories.
  This legislation is dishonest. It is irresponsible. It should be 
defeated.
  Ms. SLAUGHTER. Mr. Speaker, I yield 3 minutes to the gentleman from 
Florida (Mr. Hastings), a member of Rules.
  Mr. HASTINGS of Florida. Thank you very much, my hero. You have done 
a magnificent job getting us to this point. I thank you for the time.
  I also thank all the wonderful staffers on both sides that have done 
incredible work for us, the police officers that protect us here, the 
clerks, the reporters, and our pages, who are here to see the enormous 
history that we are going to make today.
  I believe all of us want our great Nation to prosper. So today, we 
celebrate the greatest Nation on Earth, and we do so by a visionary 
step in our Nation's future. We are an intense people and we celebrate 
today the immensity of our intensity.
  We all know, based on this harsh winter that just passed, and here on 
a spring-like day with summer soon a coming, that winter will come 
again, and it will ask, What were you doing last summer? I want it to 
be said that I was doing something to try to save the lives of 45,000 
Americans that die every year because they are uninsured.
  I don't want to be with that crowd that could best be described as 
cynics. I picked up today's paper, and a friend of mine, the former 
Speaker of this House, says that what we're about to do is a grand 
social experiment, radical, he said, social experiment.
  Well, in my congressional district, if it is that I am to help 
improve the coverage of 290,000 residents, give tax credits and other 
assistance to 177,000 families and 22,500 small businesses, put me in 
the radical column.
  If it's to improve Medicare beneficiaries, extend coverage to 161,000 
uninsured people in the district I'm privileged to serve, then I'm 
radical.
  If it's going to protect 1,100 families from bankruptcy, radicalize 
me.
  If it's going to allow 60,000 young adults to obtain coverage, in the 
congressional district that I represent, on their parents' insurance 
plans, then Newt, please know that I'm radical.
  As we go forward here today, I guess perhaps it would be good to look 
back on some from yesterday. Ronald Reagan said, There are no easy 
answers, but there are simple answers. We must have the courage to do 
what

[[Page 4110]]

is morally right. That was Ronald Reagan, an icon by all standards.
  Another one said, Each time someone stands up for an ideal or acts to 
improve the lot of others or strikes out against injustice, he sends 
forth a tiny ripple of hope.
  Now, I saw around this Capitol yesterday and around this Nation a lot 
of lack of hope.
  Mr. DREIER. Mr. Speaker, at this time I'm happy to yield such time as 
he may consume to another hardworking member of the Committee on Rules, 
the gentleman from Dallas, Mr. Sessions.
  Mr. SESSIONS. Mr. Speaker, in Texas we have a law that's called the 
deceptive trade practice. And if this were being done in Texas, it 
would be against the law, because this is deceptive, what we are 
talking about here today. What is being sold is deceptive.
  We're hearing about the 35 million Americans that will be covered, 
but the other 23 million that will not be covered, they are not talking 
about.
  And secondly, they are not talking about the $500 trillion worth of 
physician reimbursement that is not included in this bill. And if 
people think you've got insurance or you can change insurance just to 
give everybody coverage, if you don't have a doctor to go to who can be 
paid for, then you won't get time to see the doctor.
  Mr. Speaker, this is deceptive what is being put on the table here 
today.
  The gentleman said call him a radical. I will. He is a radical.
  Ms. SLAUGHTER. Mr. Speaker, I'm delighted to yield 3 minutes to a 
member of the Rules Committee and a gentlewoman from California (Ms. 
Matsui).
  Ms. MATSUI. I would like to thank the gentlewoman from New York for 
yielding me time and for her courageous leadership of the Rules 
Committee.
  Mr. Speaker, I rise today in support of the rule and the underlying 
legislation. I wasn't here 10, 20, or 30 years ago while the debates 
about health care ebbed and flowed, but I am here today. And as an old 
friend said to me today, there are not too many times in politics that 
you get to do something monumental, and this is the day.
  We have the opportunity today to vote for a health insurance reform 
bill to improve the quality of life for millions of American families. 
It will also control costs, improve Medicare, and reduce the deficit.
  If we do nothing, the health care system will continue to work better 
for the insurance companies than it does for the American people. Our 
plan gives people in my hometown of Sacramento more consumer protection 
and puts medical decisions back in the hands of patients and their 
doctors. Insurance companies will be prohibited from denying coverage 
based on preexisting conditions or from rescinding policies from people 
once they're sick.
  I've heard so many personal stories from my constituents who are 
struggling to make ends meet and who are burdened by the current 
insurance market. Tim Sullivan called my office 2 days ago. Tim is a 
small business person who lives day to day in fear of losing his 
insurance because, as someone who has glaucoma, his rates are going up 
and up every single year. Tim called me to ask why the current system 
discouraged entrepreneurs, average Americans with a brilliant idea who 
can't go out on their own because they can't afford their own 
insurance.
  For millions of Americans like Tim, we have created insurance 
exchanges that will help him get the same buying power as big business 
or a Member of Congress.
  Elizabeth Bell recently graduated from college and does not yet have 
a full-time job with benefits. She reached the age where she was 
dropped from her parents' plan and now has to pay expensive monthly 
premiums. Elizabeth wrote to ask, What would I do if I didn't have 
insurance?
  For Elizabeth and millions of Americans like her, our health care 
bill allows young adults to stay on their parents' plans through their 
26th birthday.
  The current system is not working for Tim or Elizabeth or millions 
more Americans in districts throughout our country. And if it is not 
working for them, Mr. Speaker, it is not working for me. And that is 
why I'll be proud to cast my vote for the bill before us today.
  Mr. DREIER. Mr. Speaker, at this time I am happy to yield 2 minutes 
to another dedicated member of the Rules Committee, the gentlewoman 
from Grandfather Community, North Carolina (Ms. Foxx).
  Ms. FOXX. Mr. Speaker, the legislation we're about to vote on 
represents one of the most offensive pieces of social engineering 
legislation in the history of the United States, and the American 
people recognize this simple truth.
  Even the ruling Democrats recognize how unpopular this proposal is 
but have chosen to ignore the overwhelming outcry and convince their 
wavering colleagues that the government and politicians in Washington, 
D.C., know better than their constituents. What arrogance.
  Although this may be shocking to many Americans, this arrogance 
reflects the approach the ruling Democrats have taken since they 
regained the majority in 2007. We will be voting on legislation that 
even the liberal Democrat chairwoman of the Rules Committee said ``Will 
do almost nothing to reform health care,'' and that ``It's time that we 
draw the line on this weak bill and ask the Senate to go back to the 
drawing board. The American people deserve at least that.'' On that, we 
agree.
  This legislation contains taxpayer funding for elective abortion, an 
unprecedented proposal that offends the conscience of American 
taxpayers.
  The legislation we're about to vote on increases the cost of 
insurance, strangles private competition, and ultimately leads to a 
complete Federal takeover of the health care industry.
  Voting ``no'' on this rule and this legislation will give Congress a 
renewed opportunity to do what should have been done from the 
beginning, vote for effective bipartisan legislation that rises to the 
challenge facing so many people seeking reasonable health care reform.
  Ms. SLAUGHTER. Mr. Speaker, I'm pleased to yield 3 minutes to the 
gentleman from California (Mr. Cardoza), a member of the Rules 
Committee.
  Mr. CARDOZA. Mr. Speaker, my wife has been a family doctor for 20 
years and comes home every single night telling me stories about her 
patients who have paid their premiums, but when they get sick and need 
coverage, they're denied the care by the same companies who are trying 
to kill this legislation here today. I have heard her on the phone 
fighting those very insurance company executives to let her practice 
medicine the way she was trained at the University of California at 
Davis Medical School.
  What a concept, to have your doctor write your prescription, not 
someone on the other end of an insurance company authorization line.
  This is not socialized medicine. Far from it. We are making sure that 
the doctor is making the decision, not the insurance company.
  Mr. Speaker, my brother runs a company, a business, a small business 
that has been in my family for 50 years. Two weeks ago he was told his 
premiums are going up by 75 percent. To add insult to injury, on that 
very day, my sister-in-law had had knee replacement surgery and the 
doctor thought she needed a few extra days in the hospital because they 
were afraid that she might get blood clots. She was told by her 
insurance company they couldn't have that time initially because it was 
too expensive.
  There was a little girl in my hometown who had leukemia. The 
insurance company told her she couldn't go to the hospital with the 
best success rate to fix her disease. She had to go to the hospital 
with a much lesser success rate because it was cheaper there. Her 
parents called me and I tried desperately to help get her to the other 
hospital. I failed. She died.
  That is what is happening in America right now. That is what we have 
to deal with today. That is what the American people want fixed, and 
that is precisely what this reform is all about.
  Mr. Speaker, when I was 22 years old, I was an intern here in this 
very Capitol. Mr. Kennedy was holding hearings

[[Page 4111]]

on health care reform for all Americans. I listened to the very same 
arguments by the people trying to kill this bill here today back then. 
They're the same people that were fighting health care. They don't care 
about patients. All they care about is the bottom-line profits for the 
insurance companies.
  We have waited for this day far too long already. If we don't take a 
stand and do the right thing here today, the very same debate will be 
taking place in another 30 years.
  So I'm going to vote for this bill, Mr. Speaker. I am going to vote 
for it proudly because the reform is so desperately needed, and it's 
also desperately long overdue.
  Mr. DREIER. Mr. Speaker, at this time I'm happy to yield 1 minute to 
a former member of the Rules Committee, but always hard working, the 
gentleman from Moore, Oklahoma, Mr. Cole.
  Mr. COLE. Mr. Speaker, I rise today to oppose this rule and the 
underlying legislation. Frankly, this rule sets a deplorable precedent, 
deplorable in terms of limiting Member participation and silencing 
millions of voters whom they represent.
  This bill cuts $523 billion out of Medicare and diverts it to an 
entirely new entitlement. Sixty-five Members filed amendments offering 
new ideas and better approaches. None of those amendments were made in 
order.
  My amendment, Mr. Speaker, would have prohibited cuts in Medicare, 
would have kept the money saved in Medicare in that program. Democrats 
are turning a blind eye to the future unfunded obligations of that 
program just as the baby boomers are retiring by the millions upon 
millions.
  This rule is flawed. This bill is fiscally irresponsible. We should 
vote ``no.'' I urge a ``no'' vote on the rule and the bill.

                              {time}  1645

  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Colorado (Mr. Perlmutter), a member of the Rules Committee.
  Mr. PERLMUTTER. Thank you, Madam Chair.
  This marks a historic time for our country to take necessary steps to 
make quality, reasonably priced health care possible and accessible to 
many more people. The current system is broken, and there is still a 
lot of work to be done. And I am committed to continuing this work. But 
``no'' is not an option. Just say ``no''; just vote ``no'' thats what 
you hear from the other side. The status quo is not an option.
  Today we can improve our health care system by extending coverage to 
people with preexisting conditions like my daughter and 16,800 of my 
constituents in the Seventh Congressional District in Colorado. I've 
talked with my constituents in Seventh Congressional District meetings, 
in the government-at-the-grocery meetings that I have, telephone town 
halls, town halls all across the board, and they know the system is 
broken and something has to be done.
  But for me, this is personal. I have a daughter with epilepsy. She 
didn't ask to get it. It's just part of her chemistry. I dare say 
everybody in this room has somebody in their family, a close friend, a 
neighbor with a preexisting condition, and our system, our health care 
system, discriminates against those people.
  The 14th Amendment to the Constitution guarantees that every American 
has the right to equal protection of the laws. The system that we have 
right now is probably unconstitutional and, I believe, downright 
immoral and must be changed. More and more families and businesses can 
no longer bear the burden of this broken health care system. This issue 
touches every person in their own unique way.
  Because there are millions and millions of people affected by our 
health care system, we have to change this. The status quo will not 
work for us any longer. I'm proud to support this bill. I ask for a 
``yes'' vote on the rule and a vote to change our health care system.
  Mr. DREIER. Mr. Speaker, at this time I'm happy to continue the Rules 
Committee and former Rules Committee lineup by yielding 2 minutes to 
another former Rules Committee member, the gentleman from Marietta, 
Georgia (Mr. Gingrey).
  Mr. GINGREY of Georgia. Mr. Speaker, I thank the gentleman from 
California for yielding.
  I left behind my medical practice of almost 30 years to run for 
Congress. And it's hard to put into words the joy I felt each time I 
helped bring a new life--actually 5,200 new lives--into this world. Yet 
in my heart, I felt strongly in the need to improve health care in this 
country. But, Mr. Speaker, this bill is not the health care reform that 
I had in mind.
  Raiding $500 billion from Medicare is not reform. The Cornhusker 
kickback is not reform. The Louisiana purchase is not reform. Turning 
IRS agents--in fact, 17,000 new ones--into health care czars is not 
reform. And an unconstitutional mandate that will penalize poor 
families is certainly not reform.
  Mr. Speaker, I would say to my moderate and conservative Democratic 
friends who have been told by Speaker Pelosi and by the President, 
``Just vote for this bill. Don't worry about your constituents. We'll 
take care of you,'' there is a Dear Colleague being passed around as I 
speak of pictures of Democratic Members, former Democratic Members, who 
were told the same thing back in 1993 on the issue of the Clinton tax 
increases. None of them who voted ``yes'' are in Congress today.
  Mr. Speaker, let me quote President Obama from his speech yesterday: 
``If you don't think your constituents would be helped by this, then 
vote `no.'''
  I know Americans would not be helped by this bill. I cannot support 
it. I will not support it. I will be voting ``no.''
  Ms. SLAUGHTER. Mr. Speaker, I am delighted to yield 2 minutes to the 
gentlewoman from Maine, a member of the Rules Committee, Ms. Pingree.
  Ms. PINGREE of Maine. I thank the hardworking chair of the Rules 
Committee, Ms. Slaughter, for yielding me the time.
  As we get ready to cast a vote to finally reform our health care 
system and rein in the insurance companies, I want to tell you what I 
hear from my home State of Maine where people are frustrated and 
struggling.
  A woman named Margaret told me about her small business. She said, 
``I own a small business that employs 10 Maine residents. Anthem has 
announced a 23 percent increase in my rates. In 4 years, rates with 
Anthem have almost doubled. I cannot afford to provide health insurance 
for my employees.''
  A man named Mark told me about his latest letter from the insurance 
company. ``My wife has been paying more than one-third of our entire 
income for her health insurance and that doesn't cover the high copays 
and prescription drug costs. She just received notice from her 
insurance company that they are raising her rates another 30 percent. 
It's impossible. We can't do it.''
  And Ron told me about living on the edge. He said, ``I was out of 
work and lost my insurance, for 18 months. I am a cardiac patient and 
have other chronic illnesses that require constant care and constant 
prescription drugs. After 18 months with no insurance, I lost 
everything.''
  These people wrote to me from Maine, but the stories are told every 
day in every State. Americans are denied insurance, have their coverage 
canceled, or find themselves bankrupt just because they got sick.
  Today we will change that with our vote. Today we will start to end 
the worst practices of the insurance companies, like denying coverage 
for preexisting conditions or canceling your policy when you get sick. 
Today we will improve health care for our seniors, strengthening 
Medicare, closing the doughnut hole, reducing prescription drug prices, 
and making sure they don't have to pay to get a checkup or get screened 
for diseases like cancer or diabetes. Today we will make sure that 
Americans don't go bankrupt because of medical bills. And today we will 
make it easier for small businesses and individuals to afford coverage, 
bringing the largest health insurance tax break

[[Page 4112]]

in history for small businesses and individuals.
  We have a chance to truly reform our system. I will be voting 
``yes.''


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore. Members are reminded not to traffic the well 
while another Member is under recognition.
  The gentleman from Massachusetts has 7 minutes remaining. The 
gentleman from California has 13\1/2\ minutes remaining.
  Mr. DREIER. Mr. Speaker, at this time I am happy to yield 1 minute to 
a hardworking new member from Clarence, New York (Mr. Lee).
  Mr. LEE of New York. Since discussions on health care reform began in 
Washington, I've heard from thousands of western New Yorkers opposed to 
this trillion-dollar government-run takeover. One such comment comes 
from a western New Yorker who writes, ``I'm retired Air Force and have 
government health care now. If anyone thinks government run health care 
is a picnic, I invite them to try it.''
  Another western New Yorker wrote she ``strongly believes that we need 
health care reform.'' However, she is ``particularly worried about the 
level of debt that our children and grandchildren will inherit. Like a 
household, the government has to learn to live within its means.'' 
These two constituents summarize well the majority of comments I 
received.
  There are two certainties if this bill were to pass. One, it will 
raise taxes by over $500 billion, and two, it will cut hundreds of 
billions of dollars from existing Medicare programs for seniors all in 
support of another government entitlement program.
  The proposal before us is not what western New Yorkers have asked 
for, not what they can afford, and surely not what they deserve.
  Mr. McGOVERN. Mr. Speaker, at this time I would like to yield 2 
minutes to the gentleman from Colorado, a member of the Rules 
Committee, Mr. Polis.
  Mr. POLIS. This has been a long process writing this bill. I've been 
honored as a new member of Congress to be at the table along the way 
scoring some wins and some losses with regard to the final product and 
where I would like to see it overall.
  I think it's a very strong product. I'm excited that we have the real 
ability to bend the cost curve with a strengthened IMAC over the House 
version. I'm also thrilled that this new version will reduce the 
deficit by over $150 billion. We really can't afford not to do it.
  With regard to taxes and the impact on business, there have also been 
some very positive developments since the House version. The initial 
House version would have raised the tax rate that S Corps and LLCs, 
many small businesses, pay. I'm happy to say that that did not survive 
this process, we were able to get that out of the bill and that this 
bill is extremely beneficial for small businesses to help them save 
money.
  I think there is great potential going forward to reduce the need for 
tax increases and in fact allow tax cuts if we can pass comprehensive 
immigration reform. One of the baseline assumptions in this bill is 
that there will be 50 percent more undocumented immigrants after 10 
years. This Nation can't afford to have 20 million undocumented 
immigrants. This Nation can't afford to have 10 undocumented 
immigrants. This Nation needs to have zero undocumented immigrants. And 
that will have substantial savings within health care and make sure 
that taxpayers are not forced to subsidize the care of an undocumented 
population that should not be here. That's why I'm a proud sponsor of a 
comprehensive immigration reform bill here in the House, and there are 
also efforts underway in the Senate between Senator Graham and Senator 
Schumer that can reap substantial savings for health care, and we can 
return that money right to the American people.
  That's why I'm proud to support this rule and this bill to build the 
momentum with hundreds of thousands of people in town this very week 
advocating comprehensive immigration reform.
  Mr. DREIER. At this time I am happy to yield 1 minute to our very, 
very thoughtful colleague from Athens, Georgia (Mr. Broun).
  Mr. BROUN of Georgia. Mr. Speaker, the simple truth is this health 
care bill is a killer. It kills over 5 million jobs in future job 
creation with $52 billion in mandates and taxes. It kills economic 
freedom and the American entrepreneurial spirit. It kills the family 
budget with over $17 billion in more mandates and taxes primarily aimed 
at the poor and its seniors. It kills our future by allowing taxpayer-
funded abortions.
  Make no mistake about it. If you vote for this bill, you can never 
call yourself pro-life again. No executive order can change this.
  As a family doctor, I know we can have commonsense health care reform 
that provides lower costs without a government takeover and without 
killing our economy. I urge my colleagues to listen to the American 
people and kill this bill.
  Mr. McGOVERN. I reserve the balance of my time, Mr. Speaker.
  Mr. DREIER. Mr. Speaker, may I inquire how much time is remaining on 
each side?
  The SPEAKER pro tempore. The gentleman from California has 11\1/2\ 
minutes remaining. The gentleman from Massachusetts has 5 minutes 
remaining.
  Mr. DREIER. At this time I am happy to yield 1 minute to my very good 
friend from Fort Myers, Florida (Mr. Mack).
  Mr. MACK. Mr. Speaker, the Democrats believe that they can rewrite 
the Constitution. They believe in the power of government, not the 
power of the people. They believe that a better America goes through 
more and more and more government. And it's clear they do not believe 
in the American people.
  Americans have spoken loud and clear. We are saying ``no'' to more 
government control of our lives. We are saying ``no'' to higher taxes 
and deficits. We are saying ``no'' to this takeover of health care. The 
American people want Washington to get its irresponsible hands out of 
their pockets and stop their unconstitutional power grab.
  The American people deserve to be respected. They deserve to be 
listened to. They deserve freedom, they deserve security, and they 
deserve prosperity. The Democrats need to stop and listen to the 
American people.
  And hear me now. You may win this vote today through arm-twisting 
tricks and backroom deals, but let's see who's still here after the 
American people speak loud and clear in November.
  Mr. McGOVERN. Mr. Speaker, I reserve the balance of my time.

                              {time}  1700

  Mr. DREIER. Mr. Speaker at this time I'm happy to yield for the 
purpose of a unanimous consent request to another former Rules 
Committee member, the distinguished ranking member of the Committee on 
Natural Resources, Mr. Hastings.
  Mr. HASTINGS of Washington. Mr. Speaker, I rise in opposition to this 
flawed piece of legislation.
  Mr. DREIER. I yield to the distinguished vice chair of the Republican 
Conference for the purpose of a unanimous consent request, the 
gentlewoman from Washington (Mrs. McMorris Rodgers).
  Ms. McMORRIS RODGERS. Mr. Speaker, I rise in opposition to this 
flawed health care bill.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from South Carolina (Mr. Brown).
  Mr. BROWN of South Carolina. Mr. Speaker, I rise in opposition and 
give note that I am against this flawed health care bill.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the distinguished ranking member of the Committee on Foreign Affairs, 
the gentlewoman from Miami, Ms. Ros-Lehtinen.
  Ms. ROS-LEHTINEN. I rise in opposition to this flawed health care 
bill.
  Everyone deserves health care treatment. Everyone deserves access to 
health care insurance. Everyone deserves both at an affordable cost.

[[Page 4113]]

  However, this health care bill is not the answer. It is the wrong 
approach--one which ignores the concerns and needs of the American 
people, while increasing the financial burden through excessive taxes, 
especially on small businesses.
  It places control in the hands of government bureaucrats rather than 
letting Americans decide for themselves what is best for their 
families.
  We need to promote common-sense solutions that make health care 
easily accessible and affordable to all Americans--solutions like 
preventing denial of coverage due to a pre-existing condition or 
ensuring that your coverage stays with you even when you change jobs.
  We should eliminate health care insurance discrimination based on age 
or gender and encourage real competition in the health care insurance 
market.
  We must enact reforms to prevent frivolous lawsuits so that doctors 
will not be forced to order unnecessary and expensive tests and 
procedures. This will help eliminate costly waste and inefficiency in 
the system. These changes, along with effective prevention, wellness, 
and disease management programs, will help reduce the cost of health 
care.
  This Senate bill makes little sense for seniors. It is a fiscal time 
bomb for future generations, and I do not want to leave this legacy of 
debt to my granddaughter.
  The majority was aware of the cost and impact of this bill. They 
should have worked in an open, bipartisan fashion. Instead, we are left 
with a bill killing tax increases in the middle of a terrible economic 
recession.
  This is a bill with billions of dollars in tax increases. There is a 
tax on anyone who does not purchase bureaucrat-approved health 
insurance. There is a tax on businesses that cannot afford to provide 
their workers with health coverage and another tax for hiring low-wage 
workers.
  In South Florida, the construction industry has a 27 percent industry 
unemployment rate yet this bill taxes those workers especially hard.
  The Congressional Budget Office has stated that all of these taxes 
will be passed on to Americans in higher costs and rising insurance 
premiums.
  This bill makes no effort to control the skyrocketing costs of health 
care. I am disappointed that we have missed an opportunity to tackle a 
huge problem in South Florida and in the Nation: eliminating Medicare 
fraud. It tries to fool the consumer by finding creative ways to hide 
health care costs in new taxes, mandates, and cuts.
  The bill also contains over $523 billion in Medicare cuts, including 
over $202 billion from Medicare Advantage plans that serve tens of 
thousands of my constituents directly.
  Medicare helps so many seniors in our community--seniors like my 
mother, who is 83 and suffers from Alzheimer's--live longer and 
healthier lives. When I see this bill taking benefits away from seniors 
like her, I worry tremendously.
  This bill also includes cuts of millions of dollars to elderly home 
care; millions of dollars cut for Alzheimer's programs; and millions of 
dollars cut to the food-for-seniors program.
  The only way to coerce passage of this bill was through special deals 
for special interests. The Majority has weighed the bill down with 
political handouts such as millions of dollars in Medicaid funding to 
Louisiana, known as the ``Louisiana Purchase.'' Americans are 
rightfully weary of the Majority playing political games with important 
policy initiatives.
  I know that the high cost of health care is an important issue facing 
our nation and I am committed to making high quality, equitable and 
accessible health care affordable to all Americans. This bill is not 
the right answer to the serious issues facing our Nation and our 
families.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the distinguished gentleman from Texas (Mr. Neugebauer).
  Mr. NEUGEBAUER. Mr. Speaker, I rise in opposition to this flawed 
health care bill.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentlewoman from Texas (Ms. Granger).
  Ms. GRANGER. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  My district is a military district. We are a district of men and 
women who served this Nation in all branches of our Armed Forces. We 
are a district that builds the weapons that our war fighters depend on 
in the battlefield.
  Unfortunately, when rushing this legislation through Congress, the 
Democrats failed to exempt 9.2 million military families from being 
forced to pay a penalty under this health care bill the President wants 
on his desk so quickly. Congress was forced to fix this in the eleventh 
hour. But it remains unchanged in the Senate bill.
  Mr. DREIER. Mr. Speaker, I yield for the purpose of a unanimous 
consent request to the gentleman from South Carolina (Mr. Wilson).
  Mr. WILSON of South Carolina. Mr. Speaker, I rise in opposition to 
this flawed health bill.
  Mr. Speaker, I support the principles of Thomas Jefferson who stated 
``I predict future happiness for Americans if they can prevent the 
government from wasting the labors of the people under the pretense of 
taking care of them.''
  I rise today to express my disappointment not only with the 
provisions in the irresponsible health care takeover, but with the 
process that was used to secure votes. Speaker Pelosi promised the most 
ethical and honest Congress in history and the President said eight 
times on the campaign trail that health care negotiations would be 
televised and transparent. Unfortunately we haven't seen anything that 
even remotely resembles this rhetoric.
  It is outrageous that in 2010, with all the new media tools of 
Twitter, Facebook, Youtube, blogging, and Skype that Congress, 
lawmakers and the Administration have at their disposal that the 
American people are still shut out of this debate. This is a bill that 
impacts the health and safety of every American and makes up one sixth 
of our economy--the American people certainly deserve a seat at the 
table.
  But the American people are being ignored. You would think after 
record-breaking town hall meetings, an unprecedented House Call on 
Washington, and the election outcomes in Massachusetts, Virginia, and 
New Jersey, that congressional leaders and the administration would 
wake up and tune in.
  I was grateful to host in South Carolina the largest Congressional 
town halls in history of 1700 in Columbia, 1500 in Lexington, 1500 in 
Beaufort and 1200 at Hilton Head Island along with the first 
Congressional town halls ever for Barnwell, North in Orangeburg, and 
Varnville in Hampton County. 98 percent of attendees opposed government 
takeover.
  The majority of Americans have made it perfectly clear that they do 
not want a health care bill that: Mandates private citizens purchase 
health care, whether they need it or want it; causes millions of 
employers to cancel the health insurance they currently offer; and 
creates a health care czar to impose price controls on private health 
insurance.
  What is even more disconcerting about this bill is that Congress and 
the Administration has decided to plow ahead with this before 
addressing the tragic employment rate that continues to cripple many 
communities across the Nation. Where are the jobs? That is what we 
should be talking about each and every day. Instead of standing down 
here debating a bill full of job-killing taxes and mandates, we should 
be debating ideas that will give employers job creation incentives and 
offer tax relief to hardworking families. The National Federation of 
Independent Business, the voice of America's small business, has 
revealed the takeover will kill 1.6 million jobs.
  As I conclude, I'd like to take this opportunity to speak directly to 
the concerned citizens who fought so hard over the last year to protect 
the doctor-patient relationship and prevent a Federal Government 
takeover of health care. The provisions in the bill and the process 
used to secure passage were both designed to enhanced the power of 
politicians; you should be proud of your efforts to limit such power by 
town halls and tea parties.
  Mr. DREIER. Mr. Speaker, I yield for the purpose of a unanimous 
consent request to the gentleman from Louisiana (Mr. Fleming).
  Mr. FLEMING. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
our soft-spoken colleague from Texas (Mr. Culberson).
  Mr. CULBERSON. Mr. Speaker, I rise in opposition to this flawed 
4,700-page health care bill.


                Announcement by the Speaker pro tempore.

  The SPEAKER pro tempore. As recorded in section 957 of the House 
Rules and Manual, although a unanimous consent request to insert 
remarks in debate may comprise a simple, declarative statement of the 
Member's attitude towards the pending measure, it is improper for a 
Member to embellish such a request with oratory, and it can become an 
imposition on the time of the Member who has yielded for that purpose.
  The Chair will entertain as many requests to insert as many as may be

[[Page 4114]]

necessary to accommodate Members, but the Chair must also ask Members 
to cooperate by confining such requests to the proper form. Further 
embellishments will be charged to the time of the gentleman from 
California.
  Mr. DREIER. Thank you very much, Mr. Speaker. We will certainly 
comply with your directive and appreciate it.
  I yield for the purpose of a unanimous consent request to the former 
mayor of Dayton, Ohio (Mr. Turner).
  Mr. TURNER. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from Houston, Mr. Olson.
  Mr. OLSON. Mr. Speaker, I rise in opposition to this flawed health 
bill.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from Vienna, Virginia (Mr. Wolf).
  Mr. WOLF. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  I do not question the need for Congress to find a way for the 
millions of Americans without health insurance to be assured of 
quality, affordable health care. The majority of my constituents in the 
10th District of Virginia have made clear that they want an open and 
transparent process in which Republicans and Democrats work together to 
pass responsible health care reform that lowers costs and offers 
greater access to affordable health care.
  They told me that they don't want more government spending.
  They don't want government-run health care.
  They don't want a plan that hurts America's seniors, families or 
small businesses.
  What they do want is a plan that fixes what's broken and keeps what's 
working without adding billions of dollars to an already ballooning 
deficit.
  I cannot support today's bill because it will raise over $500 billion 
in new taxes during a recession and times of high unemployment. This 
will especially hit small business employers at a time when the Federal 
Government should be assisting in job creation, not raising taxes.
  This legislation cuts billions of dollars from Medicare, a program 
that our seniors rely on.
  It requires individuals to purchase health insurance. If you don't 
purchase health insurance, the government will fine you a minimum fine 
of $750, up to the maximum penalty of 2 percent of your income. This 
provision has drawn the attention of the citizens of Virginia, with the 
Virginia General Assembly, in a bipartisan vote, becoming the first 
legislature in the Nation to pass legislation opposing this mandate.
  This bill mandates billions of dollars in additional Medicaid 
spending in unfunded mandates for cash-strapped states.
  It breaks a promise to members of our Nation's armed services, their 
families, veterans, and employees, with its failure to protect the 
military's TRICARE system--health care programs provided by the 
Department of Veterans Affairs. This means that, under this 
legislation, unless an individual has TRICARE for Life, additional 
health insurance would have to be purchased.
  Mr. Speaker, I am committed to working with my colleagues to pass 
real health care reform in a cost effective manner. This legislation 
fails that test.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from Kansas (Mr. Tiahrt).
  Mr. TIAHRT. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. Speaker, I rise today on behalf of not only the people of the 
great State of Kansas but also on behalf of the millions of Americans 
whose wishes are not being represented by their own Representatives. 
Kansans, over two-thirds of Americans, and I are strongly opposed to 
the Senate bill and the Reconciliation bill, both of which represent a 
massive government takeover of health care. I cannot and will not 
support this government takeover of our health care system that will 
restrict choice, ration care, increase the cost of health care, greatly 
increase government spending, cut Medicare spending, bankrupt States, 
lead to the destruction of the world's best medical care, and kill jobs 
during one of the worst economic periods in our Nation's history.
  In order to get to the Capitol today, everyone in this body had to 
pass the tens of thousands of Americans from all walks of life who came 
by plane, train and automobile, at their own expense, to petition their 
government not to impose government run health care on them.
  I spent the weekend speaking with many of these patriotic Americans, 
many of whom were turned away by their own Representatives on the other 
side of the aisle. I was struck not only by their personal stories 
(from the great-grandmother with a bad knee who came from Pennsylvania 
and navigated the Metro for the first time to the small business owner 
from Wisconsin who has never gotten involved in politics but bought a 
ticket to come out here because he felt this was so important) but also 
by their determination. The media may have made the prospects for 
killing the bill look grim, but they were not going to let that happen 
without a fight.
  The group was diverse but almost everyone with whom I spoke mentioned 
the same concerns with the bill: government power grab, deficit 
spending, increased taxes, rationing of care, taxpayer funded 
abortions, and especially the restriction of freedom. If government can 
take over one-sixth of the Nation's economy over the will of the 
people, they asked, what separates us from Venezuela and socialized 
nations?


                               Power grab

  We have a one party town; the Democrats control the House, the Senate 
and the White House. They are taking advantage of this situation to 
centralize power in their hands so that they may control every aspect 
of our lives including what cars we can drive, how we educate our 
children, now our health care options. Believe me, the American people 
are opposed to this, as indicated in rock bottom approval ratings for 
Congress and even the President, who less than a year ago had the 
highest approval ratings seen in a long time.
  Patients benefit when their doctors make the decisions as to their 
health care needs, not bureaucrats sitting in an office building in 
Washington, DC. The federal government should not intrude in this 
sacred relationship. The most famous line of the physician's 
Hippocratic Oath is ``I will prescribe regimens for the good of my 
patients according to my ability and my judgment and never do harm to 
anyone.'' Under government-run health care, Washington will override 
their judgment and it will be government bureaucrats, not doctors, who 
prescribe regimens.
  It's not just the bureaucrats at HHS that Americans will have to 
worry about, this bill also greatly expands the power of the IRS and 
hands them the authority to harass and even fine American families and 
job creators for their health care choice. Despite repeated inquiries, 
no one has been able to tell me just how many new bureaucrats will be 
added to the federal payroll to implement government-run health care.
  The unfunded mandates on the States to provide health insurance 
options and oversee the private sector, at a time when they are in dire 
financial straits, are confounding.


                                 Access

  Today over 20 percent of physicians in Kansas already no longer 
accept new Medicare patients because they will be forced into 
bankruptcy trying to care for them with the grossly inadequate 
government reimbursements. Now the new administration wants to compound 
this loss of accessible health care professionals with a loss of access 
to health care treatment. In response, 46 percent of family physicians 
indicated that they would leave the medical profession due to a 
government takeover of health care.


                                  Cost

  This bill will cost well over the $1.2 trillion that CBO has scored. 
That score conveniently does not include the cost of the ``doc fix,'' 
the Medicare prescription drug donut hole fix, the Pell Grant expansion 
inexplicably included in the bill, or many other provisions of the 
bill.
  As if the health provisions weren't enough, the Democrats have used 
this bill as a vehicle to pass education and energy provisions that 
will increase deficit spending by billions and kill even more jobs.
  How are they paying for this? By cutting other areas of our bloated 
federal government? No, they are paying for this on the backs of 
American families and job creators. There is $569.2 billion in new 
taxes included in this bill. Much of that burden will be shouldered by 
the middle class and small businesses.


                             Rationed Care

  My biggest concern with the Democrat proposals is the intended 
rationing of health care. The Obama administration has already begun to 
set the framework for rationed care with comparative effectiveness 
research. This is a very dangerous road to travel down.


                                Freedom

  We pride ourselves on being the home of the free but this bill will 
reduce the United States to the level of every socialized nation in the 
world. If this bill is signed into law, Americans will not have the 
freedom to choose their doctor, their course of treatment, or their 
health plan.
  The federal government has no authority to force Americans to buy 
health insurance or to

[[Page 4115]]

mandate what benefits employers can and cannot provide employees. In 
addition this bill begins to destroy Health Savings Accounts (HSAs). 
HSAs are what we should be promoting as a way to expand choice, give 
patients more control over their medical spending, and reduce health 
care costs.


                           Prevent innovation

  Just this week I met with NTH Director Francis Collins. We spent the 
better part of an hour talking about all of the exciting advances in 
medicine, especially in the area of individualized medicine. It was not 
lost on me that the treatments and cures we were discussing will never 
come to fruition under a government-run health care system that rations 
care and stifles innovation.


                                Seniors

  This bill is a bad deal for our seniors. It expressly cuts $523 
billion from Medicare and doesn't even fix the Medicare prescription 
drug donut hole until 2020. The rationing of care will also 
disproportionately affect seniors who, for obvious reasons, are the 
largest consumers of health care.


                           Pro-Life Concerns

  Finally, the bills before us include abortions paid for with federal 
dollars and do not include conscience protection for medical providers. 
This is in blatant disregard of the House vote just 4 months ago. More 
importantly, it is in blatant disregard of the whopping two-thirds of 
Americans who oppose using federal dollars to pay for abortions. Even 
those individuals and organizations who strongly support government-run 
health care, such as the Catholic Church, do not want such programs to 
pay for abortions or euthanasia.
  I want health care reform and am saddened that this process has 
become so political that we won't see the much needed modernization 
that will ensure Americans have access to the best health care for 
decades to come. I am saddened that states like my home state of Kansas 
are forced to take drastic action to try to protect their citizens from 
being affected by Washington's takeover of health care.
  Republicans have offered better solutions and principles that should 
be included in any health care reform. Those principles should: let 
Americans who like their health coverage keep it, give all Americans 
the freedom to choose the health plan that best meets their needs; 
ensure that medical decisions are made by patients and their doctors, 
not government bureaucrats; and improve Americans' lives through 
effective prevention, wellness, and disease management programs, while 
developing new treatments and cures for life-threatening diseases. CBO 
has declared that the Republican health care plan would lower health 
care costs by at least 10 percent. This is the approach the American 
people want to see passed by Congress, not the destructive bill that is 
instead before us.
  Our constituents have spoken loudly and clearly and it is our duty as 
their representatives to listen to them, not ignore them and use the 
sacred Speaker's gavel to impose personal political goals upon them. 
Therefore, with every breath in my body, on behalf of my constituents, 
I scream ``heck no'' and vote ``nay.''
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from Illinois (Mr. Roskam).
  Mr. ROSKAM. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from Wisconsin (Mr. Petri).
  Mr. PETRI. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. Speaker, I rise in opposition to H.R. 3590 and H.R. 4872. I 
certainly agree that it is time to fix the health care system in the 
United States so that all Americans have access to quality, affordable 
health care. However, the path we are considering takes us in the 
entirely wrong direction. And this reconciliation bill only makes worse 
the Senate amendment considered by the House today. Overall, it will 
break the bank because it is filled with budget gimmicks to hide its 
true cost. It imposes over $500 billion in new taxes as our fragile 
economy struggles towards recovery. It makes significant cuts to 
Medicare, including to Medicare Advantage Plans which will surely 
eliminate or reduce benefits to the 216,000 beneficiaries in Wisconsin. 
It gives the government unprecedented authority over the regulation of 
health insurance, which will lead to increased costs for those who 
currently have health insurance.
  We need the right reforms to eliminate waste throughout the system 
and reward high quality low-cost care. We should be choosing approaches 
which give consumers incentives to use their health care dollars 
wisely. Instead, we are going in the opposite direction by turning 
decisions over to government bureaucrats.
  Instead of getting everybody into the old, dysfunctional system and 
then figuring out how to pay for it, we should emphasize advances in 
efficiency so that more people will be able to afford their health 
care, and the government will be better able to take care of the rest. 
Unfortunately, the majority in Congress has committed us to a path 
which will make the right reforms much harder to achieve.
  Despite the fact that I will vote against both bills, I do want to 
express my support for provisions in H.R. 4872 that make changes to the 
federal student loan program. This bill eliminates the Federal Family 
Education Loan (FFEL) Program and moves the origination of all federal 
student loans to the Direct Loan Program. For over two decades I have 
championed the Direct Loan Program as the most efficient, stable, and 
cost effective federal student loan program. The change to 100 percent 
direct lending marks an important step forward for students, parents, 
and taxpayers.
  Currently we have two federal student loan programs that provide the 
exact same student loans to borrowers, and schools choose to 
participate in either one or the other. The FFEL Program uses private 
capital to fund student loans but receives a federal subsidy to ensure 
a guaranteed rate of return. The federal government also provides a 
guarantee on these loans. Thus, if a student defaults, taxpayers are on 
the hook, not the private lender. The Direct Loan Program uses the 
proceeds from the wholesale auction of Treasury securities to the 
private sector to fund loans to students, and all servicing and bill 
collection is handled by private companies operating through 
performance-based contracts. The loans are delivered to students 
through the same system that universities use to disburse Pell Grants.
  I first became interested in student loan reform in the early 1980s 
when the head of the Wisconsin higher education agency convinced me 
that the FFEL program was wildly costly to the government. I introduced 
the first direct loan proposal in 1983 and almost ten years later won 
approval of a pilot program to test the direct loan program at hundreds 
of schools nationwide, including Marquette University in my state of 
Wisconsin. A year later, I successfully worked with President Clinton 
to authorize the Direct Loan Program.
  Over the years, there has been unanimous agreement about the 
excessive costs of the FFEL program compared to the Direct Loan Program 
when studied by the Congressional Budget Office (CBO), the U.S. 
Government Accountability Office (GAO), and the Office of Management 
and Budget (OMB) and the Treasury Department under both Presidents 
Clinton and Bush. Most recently, the Congressional Budget Office 
reported that a switch to all direct lending would save taxpayers $61 
billion over ten years.
  Besides being more expensive for the taxpayers, the FFEL program has 
also been plagued by fraud and abuse which further illustrates the 
drawbacks of this program for students and taxpayers. For instance, 
last Congress it was found that from 2001 to 2006 nonprofit lenders 
illegally claimed, according to one estimate, over $1 billion in 
improper taxpayers subsidies by knowingly manipulating a loophole in 
the law. And then there was the ``pay for play'' scandal in which it 
was revealed that colleges and administrators received special favors, 
benefits and kickbacks from lenders in exchange for steering students 
to their loans.
  The FFEL program has also been proven to be unreliable. In 2008, 
because of the turmoil in the credit markets, Congress passed emergency 
legislation to temporarily allow lenders access to Treasury funds so 
they could continue to make loans. Between the Direct Loan Program and 
an emergency program, the federal government now funds $8.80 of every 
$10 in federal student lending activity. Over the past year, hundreds 
of schools have switched to the Direct Loan Program. They report smooth 
and easy transitions to the program and satisfaction with the service. 
In fact, according to Student Lending Analytics, only two percent of 
schools surveyed indicated they had not taken the steps necessary to 
originate direct loans.
  By moving to 100 percent direct lending we are not favoring 
government over the private markets, there is no ``takeover'' here. 
Eliminating guaranteed loans in favor of direct loans means replacing a 
wasteful program with one that is more cost effective and in the 
interests of students and taxpayers. So, while I must vote against this 
bill due to the ill-conceived health care provisions, I strongly 
support the switch to 100 percent direct lending.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the next Governor of Oklahoma, Ms. Fallin.
  Ms. FALLIN. Mr. Speaker, I rise in opposition to this flawed health 
care bill.

[[Page 4116]]


  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from Maryland (Mr. Bartlett).
  Mr. BARTLETT. I rise in opposition to this bill.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from Arizona (Mr. Franks).
  Mr. FRANKS of Arizona. Mr. Speaker, I rise in opposition to this 
flawed bill.
  Mr. Speaker, today I resolutely intend to vote against H.R. 3590 and 
H.R. 4872, the imposition of government-run health care on the American 
people.
  It appears that Democrats in this majority are determined to shove 
this bill down the throats of the American people with not even a 
single Republican vote. Never has such sweeping legislation--taking 
over fully one-sixth of our economy--been done with a purely partisan 
vote. Therefore, whatever ill comes from this bill, history should 
record that Democrats alone chose the path of socialism over the 
highway of freedom. Let future generations hold them accountable.
  My first reason for voting against this bill will be the conviction 
in my heart that I will be voting to protect my children, their 
contemporaries, and generations to come from being forced to live under 
the socialist ideal of a bill that will dim the light of freedom and 
suppress many of the hopes they might have otherwise had.
  I vote against this bill because it is my deepest conviction that its 
cost will grow to threaten the entire economy of the United States in 
the years to come. In every corner of the planet, in every corridor of 
history, socialized medicine has always cost more, not less. Every 
government health care program the United States has ever implemented 
has cost many times the amount that was first predicted.
  I am fundamentally convinced that the costs of this bill will so 
overwhelmingly outpace present predictions that Congress will have no 
choice but to drastically alter its provisions in the future.
  I also intend to vote against this bill because of the provisions in 
it that will increase the killing of unborn children in the name of 
health care. Nothing so completely destroys the notion that this bill 
is about compassion than the arrogant and cruel disenfranchisement of 
those helpless unborn children who have no voice in this twisted and 
corrupt process.
  It is also my conviction that this bill will reduce the quality of 
the greatest health care system in the world, and that many of those 
who support it today will be its victims tomorrow.
  Ultimately, this bill is about robbing America of one of its greatest 
distinctives: freedom of the individual. It's about robbing the 
American citizen of power, and putting it in the hands of left-wing 
bureaucrats and elitists who think they know more about running 
people's lives than the people themselves do.
  Finally, I vote against this bill because I believe one day America 
will look back and see what a tragic mistake that it was. It is my hope 
that when that occurs, my children and my children's children will know 
that it was my deepest desire to protect their freedom as faithfully as 
my father protected mine.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the distinguished ranking member of the Transportation and 
Infrastructure Committee, Mr. Mica.
  Mr. MICA. Mr. Speaker, I rise in opposition to this flawed health 
bill.
  Mr. Speaker, I rise in opposition to the Obamacare proposal that is 
before the U.S. House today. Unfortunately for both the American 
Taxpayer and millions of our senior citizens this legislation is a bad 
deal. As crafted this bill will increase taxes by $569 Billion dollars 
and cuts medicare by $523 Billion dollars. Additionally this bill will 
create more than 118 new federal bureaus, agencies and czars. 
Furthermore I am concerned that this legislation will in fact increase 
health care premiums for millions of current policy holders because of 
the taxes and mandates in the 2700 pages of the bill. Also missing is 
any provision for tort or libiablity reform that would actually bring 
down health care costs.
  At a time when our national debt is ballooning out of control passing 
a multi-year multi-trillion dollar spending measure is heading in the 
wrong direction. Yes, I do agree that we need health care reform 
however this bill badly misses the mark. Congress can and must do 
better for the American people.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentlewoman from Ohio (Mrs. Schmidt).
  Mrs. SCHMIDT. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. Speaker, I rise in opposition to both the Patient Protection and 
Affordable Care and the Health Care and Education Reconciliation Acts. 
Most likely, this package of bills will pass tonight without a single 
Republican vote. It did not have to be this way.
  There is bipartisan consensus that our health care system is in need 
of real reform. President Obama is correct when he says that the costs 
associated with our current health care system are unsustainable. Too 
many of my constituents are struggling to provide coverage for their 
families and employees. The ever-rising costs of medical coverage have 
left too many Americans without the means to purchase the health 
insurance that many of us take for granted. Individuals with pre-
existing medical conditions are often unable to purchase insurance at 
all. And, people should not be forced to remain in a job they hate just 
for the health insurance benefits.
  We can begin to right these wrongs and others, as well. But, we do 
not need to destroy a system that has given us the best doctors and 
hospitals in the world and put us on the cutting edge of life-saving 
technology and pharmaceuticals. Unfortunately, the package of bills we 
are considering today, will actually increase premiums and ration care. 
People will be forced out of their current coverage--whether they like 
it or not. The bills will stifle economic growth and cost jobs. They 
actually manage to cut Medicare by a half-trillion dollars, yet make 
our entitlement crisis even more urgent. And, perhaps worst of all, it 
allows federal funding for abortions for the first time in 34 years.
  The President is fond of saying that Americans have been fighting for 
this type of healthcare reform for a hundred years. That might be true 
for some Americans. However, over the last nine months, we have all had 
the opportunity to hear from the vast majority of Americans. We have 
heard from them in a number of different ways--rallies at the Capitol, 
letters, phone calls, and, yes, town hall meetings throughout all of 
our districts. Their message is clear. If you were listening this 
weekend, you would have heard it summed up at rallies at the Capitol--
``Kill the Bill.'' They fear government involvement in their medical 
decisions. They fear a future of higher taxes and debt heaped on their 
children and grandchildren. They fear a bill that rations care. And, 
they are tired of the backroom deals and politics as usual. Worse than 
all of these, they are afraid of a government too arrogant to listen to 
what they have to say.
  The House of Representatives is the people's house. We have a duty to 
listen to what the American people are telling us. There is still time 
to listen and defeat this flawed and dangerous bill.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from Pennsylvania (Mr. Shuster).
  Mr. SHUSTER. Mr. Speaker, I rise in opposition to this flawed health 
bill.
  Mr. Speaker, tonight, the House will vote on legislation that will 
reshape our nation. The Federal Government will take control over one 
sixth of our private economy in order to extend government approved 
health care across America. Never before in our history has such an 
important issue been brought to the floor on a party line vote. In 
fact, the only bipartisan agreement on this bill has been the 
opposition against it.
  No one disputes the need for health care reform in America that 
lowers costs and protects those with pre-existing conditions, but this 
bill is not the answer. The reality is that we cannot even afford the 
government we have today and we cannot afford the disastrous fiscal and 
economic consequences this bill will place on future generations.
  The Democrats' bill will create a $2.4 trillion entitlement when 
fully implemented. Our deficit, already dangerously in the red, will 
grow by $662 billion in 10 years. The bill raids Medicare and Social 
Security to pay for these new entitlements and will require $529 
billion in new taxes while national unemployment hovers around 10 
percent. This health care bill is nothing short of a road map to fiscal 
insolvency.
  One of the cornerstone principles of this nation is that we have a 
government by the consent of the governed. For over a year, the 
President and Congressional Democrats have pushed this health care plan 
over the vocal objections of the American people, my own constituents 
and House Republicans who have offered solutions only to be denied at 
every turn.
  It didn't have to be this way. Health care reform could have been 
achieved through bipartisan cooperation and a sharing of ideas between 
the political parties. The American people deserve better than this.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the

[[Page 4117]]

gentleman from Newport Beach, California (Mr. Campbell).
  Mr. CAMPBELL. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. Speaker, those in favor of this bill often talk about the 30 
million that they say will be covered by this bill. For the sake of 
discussion, let's just assume for the moment that they are correct. 
There are over 300 million Americans in this country right now . . . 
what will this do to the other 270 million Americans? Well the answer 
is that they all will suffer as a result of this legislation. Some will 
lose the health care coverage they have right now, because their 
insurance will be priced out of the market and their employer won't be 
able to afford the fines. Some will lose their jobs as the deluge of 
taxes and mandates begin to take effect, and some will lose out on good 
quality medical care as doctors stop practicing medicine and hospitals 
close because the practice of medicine no longer will be able to pay 
the bills. Everyone will pay for the new taxes whether directly or 
indirectly, and everyone who does not get their insurance from the 
government will have to pay more. It even goes so far as to impact our 
nation's veterans and members of the military because their health care 
coverage does not meet the standards set forth in the bill. This will 
result in fines for our nation's veterans for having veterans coverage, 
and it will result in fines to members of the military and their 
families just for having coverage provided by the military. Mr. 
Speaker, how does this make sense?
  I am strongly opposed to this legislation. It will require more IRS 
agents to be hired in order to process the myriad of new fines, taxes, 
fees, and penalties that this bill creates. And even the President's 
own actuaries say that this bill will raise total health care costs in 
the United States by $222 billion. The very same actuary went on to 
estimate that nearly 20% of all health care providers who accept 
Medicare will become unprofitable and likely go out of business within 
10 years.
  Mr. Speaker, this legislation is a bad deal. It would serve my 
colleagues on the other side of the aisle to listen to the voices of 
the American people. For months, the American people have decried their 
opposition to this government takeover of health care from every state 
in the union, and this weekend they have descended on Washington to 
make one final plea: don't ruin the best parts of the American health 
care system by replacing them with the worst.
  Mr. Speaker, don't pledge to insure 30 million Americans at the 
expense of the other 270 million in this country.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from Dallas, Texas (Mr. Hensarling).
  Mr. HENSARLING. Mr. Speaker, I rise in opposition to this flawed 
health care bill.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from Arizona (Mr. Flake).
  Mr. FLAKE. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
our newest Republican, the gentleman from Alabama (Mr. Griffith).
  Mr. GRIFFITH. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. DREIER. Mr. Speaker, I am happy to yield for a unanimous consent 
request to the gentleman from Ohio (Mr. Latta).
  Mr. LATTA. Mr. Speaker, I rise in opposition to this flawed health 
bill.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from Midland, Texas (Mr. Conaway).
  Mr. CONAWAY. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from Texas (Mr. Poe).
  Mr. POE of Texas. Mr. Speaker, I rise in opposition to this flawed 
health care bill.
  Mr. Speaker, in a new survey of doctors published by The New England 
Journal of Medicine--nearly half of all primary care physicians said 
they may leave the medical profession if Obama-care passes.
  Doctors are getting railroaded out of practice now. Medicare doesn't 
pay the cost to keep their doors open. The new healthcare scheme makes 
it worse. Some doctors who can stay in business won't see Medicare 
patients anymore. They can't afford it.
  More patients and fewer physicians will cause long lines and 
rationing for our senior citizens.
  Government-run Medicare already denies claims twice as much as 
private insurance. But when Medicare denies coverage for a procedure--
you can't pay for it with your own money. The procedure--not the 
coverage--but the procedure is denied under Medicare. That's government 
rationing.
  Passing the healthcare bill would only make those problems worse.
  Government-run healthcare has the competence of FEMA, the efficiency 
of the Post Office, and the compassion of the IRS. It is not fit for a 
free people.
  And that's just the way it is.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from New Jersey (Mr. Garrett).
  Mr. GARRETT of New Jersey. Mr. Speaker, I rise in opposition to this 
unconstitutional health care bill.
  Today the majority seeks to enact its health care reform legislation. 
While, I appreciate the efforts of the majority to reform our health 
care system, it is hard to underestimate what a grave mistake it would 
be to enact this bill. It would fundamentally alter our citizens' 
relationship with their government. It would seriously jeopardize our 
nation's long-term prosperity. It would dampen the vitality of our 
nation's health care innovators. It would restrict choice and access to 
medical care for millions of our nation's elderly and poor. It would 
tax hundreds of billions of dollars out of the economy in the midst of 
one of the most serious economic downturns in our nation's history. And 
for all this--for all of these thousands of pages and hundreds of new 
bureaus, boards, and bureaucracies--it won't make America any 
healthier. And perhaps more fundamentally this legislation does not 
solve the most pressing problem facing our health care sector; namely 
its upwardly spiraling cost growth. If the majority is successful in 
passing this bill, they will, at best, celebrate a narrow political 
victory at the expense of the American public, and at worst, send our 
nation further down the path towards financial catastrophe.
  For the most part, Republicans and Democrats agree on the problems 
our health care system faces. Even though Americans spend more on 
health care than any other country in the world, current projections 
assume that this level of spending will rise indefinitely. As this 
spending increases, it is consuming a greater and greater share of 
workers paychecks. Health insurance is too expensive, and some people 
with chronic illness struggle to access health care services. We agree 
on the problems.
  But it is rare that a single piece of legislation can so crystallize 
the differences in governing philosophy between our two political 
parties. As a solution to these problems in our health care system, the 
Democrats would propose a massive increase in government involvement--
expanding current government run health programs, and creating new 
ones. Provisions in this legislation would restrict choice, and place 
greater control of health care in the hands of the federal government. 
For example, under the bill's terms, no longer would we exercise a 
number of freedoms that we now take for granted, such as whether to 
purchase health insurance or what medical benefits we feel are 
necessary. Under this bill, this is now a matter for the government to 
decide.
  This is far, far removed from what our nation's founders envisioned. 
And indeed, I submit that, fundamentally, this legislation violates the 
Constitution and will be found unconstitutional when it is inevitably 
litigated through our judicial system. This legislation would require 
individuals to purchase private health insurance--health insurance that 
has been approved by the federal government--or pay a fine. While 
Congress is granted the authority to ``regulate commerce . . . among 
the several states,'' and the Supreme Court has long allowed Congress 
to regulate and prohibit all sorts of ``economic'' activities that are 
not, strictly speaking, commerce, this is the first time in our 
nation's history that Congress would seek to regulate inactivity. And 
for the first time, Congress would mandate that individuals purchase a 
private good, approved by the government, as the price of citizenship. 
This requirement is plainly unconstitutional, and would violate the 
commerce clause. I have been speaking out on the unconstitutionality of 
this individual mandate on the House floor, in Budget Committee and 
through the Constitutional Caucus, of which I am the chair. If we allow 
that Congress has this authority under the Constitution, then there is 
virtually no limit on its authority to compel our nation's citizens to 
comply with the whims of a Congressional majority. If future Congresses 
feel that we don't eat enough vegetables, they could simply mandate 
that we purchase government approved salads. Or if future Congresses 
feel that our domestic auto industry

[[Page 4118]]

needs a boost, they could mandate that we purchase a car from General 
Motors.
  However, even if we allow that this bill is constitutional, it should 
still be rejected because it further deteriorates our nation's 
financial standing. In Congress, I have the pleasure of serving on the 
Budget Committee. Ever since I first arrived in Congress, witness after 
witness--Republican or Democrat, liberal or conservative--who have 
appeared before the Committee have all noted the serious long-term 
funding issues that our country faces. Quite simply, we are running out 
of money to pay for an ever growing government. According to the Peter 
G. Peterson Foundation, America's three biggest entitlement programs, 
Medicare, Medicaid, and Social Security, are projected to consume over 
80 percent of the federal budget within a generation. And the single 
biggest driver of this increased cost is health care inflation. 
Medicare alone has a $36.3 trillion unfunded liability. This past week, 
three members of my staff were blessed with the birth of a child. As 
soon as those children took their first breath, they each assumed a 
health care debt of $121,000.
  The majority claims that this bill would actually reduce the deficit, 
but this rests on a number of assumptions that are wildly unrealistic. 
The budget gimmicks in the bill have been well documented, but among 
the highlights are that it would: pay for 6 years of benefits with 10 
years of taxes; raid the Social Security trust fund of $53 billion; 
double count the savings in Medicare to pay for a new entitlement; 
disregard the increased administrative costs of running these new 
programs; double count $70 billion in premiums for a new long-term care 
entitlement which would later have to be used to pay for benefits; and 
rely on unrealistic Medicare cuts.
  This last point is perhaps the most important one. The chief actuary 
of the Department of Health and Human Services wrote, in a letter to 
Congress, that the Medicare cuts proposed in this bill are 
``unrealistic'' and could ``jeopardize access to care'' for seniors. 
Independent analysis says that many hospitals and health care providers 
would simply leave Medicare altogether if these cuts are implemented. 
So, under the terms of this legislation, future Congresses would have 
to do something it has thus far shown no appetite for: limiting access 
to vital medical care for our nation's seniors.
  Another major assumption made by the majority is that this 
legislation would enact a tough ``Cadillac tax'' on generous employer 
provided insurance plans. But this tax's implementation date has been 
pushed back to 2018; well after President Obama leaves office. For 
years, Congress has assumed in its revenue projections that millions of 
middle class tax filers should pay the Alternative Minimum Tax (AMT) 
each year. But every year, Congress has stepped in and passed 
legislation to prevent this from happening. Similarly, we should assume 
that a tax that is so unpopular that it must be pushed out 8 years 
before being implemented is a tax that may never realistically happen.
  So this gargantuan health care entitlement, once fully implemented, 
would end up costing us approximately $200 billion per year, and then 
increasing at a rate of 8 percent per year. But we can not afford our 
current entitlements! How will we be able to afford this when the bill 
comes due? I worry that this bill is a fiscal disaster of the first 
order.
  It should not have been this way. We had an opportunity to enact real 
health care reform--reform that would have set our nation on a prudent 
fiscal path, and one that would not have violated our Constitution. I 
and my Republican colleagues have proposed a series of reforms, such as 
enacting real medical liability reform; allowing individuals to 
purchase insurance across state lines; allowing individuals to purchase 
insurance through groups and trade associations the same way unions 
can; allowing small businesses to band together to purchase insurance; 
and eliminating the discrimination in the tax code against purchasing 
insurance through the individual market by allowing individuals to 
deduct insurance premiums the same way their employers can. While these 
proposals are not the final word on health care reform, they certainly 
would have served as a good starting point for bipartisan reform.
  Instead we are left with this bill which, I am afraid, will do much 
harm but provide little benefit. I strongly urge that this bill be 
defeated, so that we can go back to the drawing board and find true 
bipartisan solutions to the problems facing our health care system.
  The SPEAKER pro tempore. The gentleman will be charged.
  Mr. DREIER. Mr. Speaker, I yield for the purpose of a unanimous 
consent request to the gentleman from Virginia (Mr. Wittman).
  Mr. WITTMAN. Mr. Speaker, I rise in opposition to this flawed health 
bill.
  Mr. Speaker, I rise today to share my outrage about the lack of 
protection for health programs provided to veterans, servicemembers or 
their families in the health reform bill under consideration by the 
House of Representatives.
  This bill is deeply flawed. It covers TRICARE For Life but leaves out 
the other TRICARE programs that serve 9.2 million beneficiaries.
  Any health care reform legislation must explicitly protect TRICARE 
and all other Defense or Veterans Department health plans by including 
them in the definition of ``acceptable'' or ``minimum essential 
coverage.''
  If the health care reform package under consideration today by the 
House of Representatives passes, millions of servicemembers, veterans, 
and their dependents across the Nation will be at risk of having their 
insurance plan being deemed ``unacceptable'' and therefore have to 
purchase supplemental insurance or obtain a new plan altogether.
  The tens of thousands of servicemembers, veterans, and their 
dependents in the first congressional district of Virginia have made 
great sacrifices for our Nation.
  I have long held the belief that the benefits afforded our men and 
women in uniform have been earned through sacrifice and hardship.
  The TRICARE and Veterans (VA) health care systems are unique and are 
designed to fulfill certain requirements that are not shared by the 
private sector. We must respect the unique identity and role of the 
military TRICARE and VA health delivery systems.
  Now is not the time to change either the terms under which our 
service members defend our country or the means by which we continue to 
care for those that have served.
  I cannot support legislation that does not uphold this Nation's 
commitment to our men and women in uniform, our veterans, and their 
families.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from Texas (Mr. Thornberry).
  Mr. THORNBERRY. Mr. Speaker, I rise in opposition to this flawed 
health care bill.
  Mr. Speaker, this is unprecedented. It is an unprecedented intrusion 
of government into one of the most personal areas of our lives.
  It is unprecedented procedures to force through a bill of this 
significance with two hours of debate and no amendments or alternatives 
even considered.
  It is unprecedented to pass a measure of this magnitude against the 
strong, clear opinion of a majority of the American people.
  I believe we need to reform health care, particularly the way that it 
is paid for in this country. We can do that without upending the whole 
system. Real health care reform would protect the nearly 85 percent of 
Americans who currently have health insurance and want to keep it. It 
would protect Medicare for those seniors currently enrolled in the 
program and for those who will be enrolled in the future. It would make 
health insurance more affordable for everyone, including those who do 
not have coverage today. And it would keep government from interfering 
in the doctor-patient decision relationship.
  The bill before us does none of these things. It cuts more than $500 
billion from Medicare and increases taxes over $550 billion dollars. It 
fines individuals and businesses that do not sign up for the 
government-approved insurance. It multiplies government bureaucracy by 
adding a mind-boggling number of new commissions, commissioners, 
committees, centers, and administrations. It empowers the IRS to 
determine whether or not your personal health insurance is adequate in 
the eyes of Washington bureaucrats. And it is filled with special deals 
to attract support it could not get on its own merit.
  I believe that this bill will not only fail to stem the growing cost 
of health insurance; it will actually make it cost more. How could the 
combination of increased taxes, expensive mandates, and new federal 
regulations not increase the cost of health care for most Americans?
  Mr. Speaker, common sense tells us that when the government spends 
more money, it does not usually cost taxpayers less. Yet, the Majority 
claims that this bill, which spends at least $1 trillion, will somehow 
reduce our deficit. It cannot be true.
  The vast majority of citizens in the 13th district of Texas who have 
contacted me have been clear and consistent in their opposition to 
reform that leads to more government, less choice, cuts in Medicare, 
and increased taxes. The same sentiments have been echoed across the 
country.
  Unfortunately, the version the Democratic majority is trying to pass 
includes new restrictions and more government intrusion. It is over

[[Page 4119]]

2,700 pages of big government that we don't need or want.
  Mr. Speaker, President John Adams once said, ``Facts are stubborn 
things; and whatever may be our wishes, our inclinations, or the 
dictates of our passion, they cannot alter the state of facts and 
evidence.'' The facts here are plain and simple: this bill includes 
massive government involvement in health care, higher taxes, and 
hundreds of billions in Medicare cuts. I know it, most people who serve 
in this House know it, and the American people know it. It is wrong for 
our country and for its future.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from Florida (Mr. Posey).
  Mr. POSEY. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. Speaker, I rise to express my strong objections to the health 
care legislation, H.R. 3590, and the unprecedented, process through 
which it is being considered. The overwhelming majority of Americans 
are telling Washington through their letters, calls and every poll that 
they don't want this bill. Nearly eight in ten of my constituents who 
have contacted me on this issue have asked that I vote against the 
bill.
  Social Security is already unsustainable. Medicare is unsustainable. 
Medicaid is unsustainable and reimbursements are already so low that 
few doctors will even see Medicaid patients. These programs have tens 
of trillions of dollars in unfunded liabilities. Rather than fix these 
problems, the bill before us makes them worse. This bill takes over 
$500 billion out of Medicare and spends it on this new health care 
plan. It adds millions of new enrollees to Medicaid--already one of the 
fastest growing federal and state budget line items. H.R. 3590 takes 
over $53 billion out of the Social Security Trust Fund and spends it on 
this new health care plan. And, they say that this bill will save the 
taxpayers money.
  The American people have figured it out and that is why they want 
this particular piece of legislation stopped. It's not that they don't 
want health care reform; it's just that they don't want this particular 
bill. No one is suggesting that the status quo is acceptable. In fact, 
I have cosponsored more than a dozen health care bills aimed at fixing 
the problems with our current system. I suggested in a meeting with the 
Secretary of Health and Human Services Kathleen Sebelius, that we move 
forward with those things upon which we can reach agreement--like 
addressing preexisting conditions and ending the practice of insurance 
companies dropping coverage for someone when they get sick. 
Unfortunately, she rejected that offer.
  I want to talk just briefly about the cost of this bill. On Thursday, 
a preliminary Congressional Budget Office, CBO, cost estimate of the 
bill was released. But that budget included a number of gimmicks that 
hide the real costs of health care reform legislation. I believe the 
American people want and deserve honest budgeting because once the 
smoke and mirrors are removed, they will have to pay the costs of this 
bill.
  Let's look at why we have the differences. It is important to 
remember that the CBO can only estimate the costs of the specific 
language that is presented to them. An analysis of the costs of the 
bill that was released by the Senate Budget Committee found that after 
you remove the budget gimmicks, this bill increases the budget deficit 
by nearly $600 billion in the first 10 years and $1.6 trillion over the 
second 10 years. This is a far cry from the preliminary budget estimate 
from the CBO, which put the net effect of the bill at reducing the 
deficit by $118 billion over 10 years. So, what causes this 
discrepancy?
  What are some of the reasons for the differences? CBO does not 
include in its calculation the $53 billion that is borrowed from Social 
Security to pay for H.R. 3590. CBO assumes these monies will not have 
to be repaid to the Social Security Trust Fund.
  Likewise, the bill includes over $500 billion in cuts to Medicare 
program and assumes that future Congresses will allow these cuts to be 
fully implemented. Anyone remotely familiar with Congress knows that 
time and again Congress has stepped in to stop such Medicare cuts and 
may well do so again in the future. Thus to assume that Medicare will 
be cut by nearly $500 billion is simply not realistic. Furthermore, 
rather than take these Medicare savings and spend them elsewhere, these 
funds could have been used to help secure the long-term solvency of 
Medicare.
  This bill creates a new long-term care entitlement benefit, known as 
the CLASS Act. This bill collects $70 billion more in premiums than it 
will pay out in benefits over the first 10 years of the program. Rather 
than keep this $70 billion in the Trust Fund to pay future benefits, 
H.R. 3590 takes the money out of this trust fund and uses it to pay the 
costs of H.R. 3590.
  H.R. 3590 creates dozens of new programs; however, the CB0 cost 
estimate does not include any costs associated with these programs. The 
Senate Budget Committee estimates the 10-year costs of these programs 
at $114 billion.
  Medicare also faces more than a $200 billion shortfall in the amount 
of funding needed to pay physicians. It would have been appropriate to 
use the Medicare savings in H.R. 3590 to fix this problem. However, 
H.R. 3590 leaves in place the 21 percent cut in payments to doctors. 
Speaker Pelosi has said that we can expect another bill to come to the 
House floor in a few weeks that fixes this shortfall. The cost of that 
bill will simply be added to the deficit and no one will have to pay 
for it.
  So, rather than saving $118 billion over 10 years as CBO estimates, 
the real costs will be hundreds of billions of dollars in deficit 
spending in just the first 10 years. Between 2020 and 2029 the debt 
rises even more.
  Our nation has lost millions of jobs since January of 2008. To 
restore these jobs, our nation would have to create 250,000 jobs per 
month for each of the next 5 years. Hundreds of billions of dollars in 
new taxes on small business and new costly mandates included in H.R. 
3590 will only result in the loss of additional jobs and it will make 
it harder for businesses to hire new employees. In fact, it is 
estimated that this bill may result in the loss of more than 2 million 
additional jobs.
  Not only does this bill have a costly impact on businesses, but it 
imposes tens of billions of dollars in unfunded mandates on the states. 
Our state budgets are already stretched thin and governors and state 
legislatures are cutting tens of billions of dollars just to balance 
their budgets--something many states are required to do, but not 
Washington. This bill makes that task harder for the states and will 
ultimately result in higher taxes on individuals and businesses.
  H.R. 3590 lacks sufficient protections to ensure that American 
taxpayers are not forced to pay for the health care of millions of 
illegal immigrants.
  I am further concerned that this bill fails to include protections, 
passed earlier this year in the House, that would ensure that taxpayer 
money is not used to pay for elective abortions. This bill also lacks 
sufficient conscience protections to ensure that health care providers, 
doctors, nurses, hospitals, and health plans are not required to 
participate or in any way support elective abortions.
  Never before has Congress considered a bill that so fundamentally 
changes the relationship between the people and the government.
  This bill gives the federal government unprecedented powers. H.R. 
3590 empowers government panels to make coverage determinations. It 
also creates the Independent Medicare Advisory Board, IMAB, which is 
given broad authority to make cuts in Medicare.
  Over 4,000 times in this bill, the word ``shall'' appears, and 
``shall'' indicates a federal mandate. In more than a dozen places, the 
bill provides that there will be ``no administrative or judicial 
review'' of a federal bureaucrat's decision.
  It has been said that: ``A democracy cannot exist as a permanent form 
of government . . . It can only exist until the voters discover they 
can vote themselves largess from the public treasury. From that moment 
on, the majority usually votes for the candidates promising them the 
most benefits. Therefore the average age of the world's greatest 
civilizations has been about 200 years. These nations have progressed 
through this sequence: From bondage to spiritual faith; from spiritual 
faith to great courage; from courage to liberty; from liberty to 
abundance; from abundance to selfishness; from selfishness to apathy; 
from apathy to dependence; from dependency back again into bondage.''
  This bill vastly expands the powers of the Internal Revenue Service, 
IRS. If this bill becomes law, the IRS may have to hire up to 16,500 
additional employees just to enforce all the new taxes and penalties. 
The bill empowers the IRS to: (1) verify that Americans have 
government-approved health care coverage; (2) fine Americans up to 
$2,085 or 2 percent of income (whichever 'is greater) for the failure 
to purchase a government-approved plan; (3) confiscate tax refunds; and 
(4) increase audits.
  Finally, I would be remiss if I did not express my deep 
disappointment with the process that has characterized this debate and 
the manner in which this legislation has been written. I come from the 
sunshine state, where we have very strict laws about transparency and 
openness in government--a process that is seriously lacking in 
Washington.
  The House considered a bill in three committees last summer. A 
handful of Republican amendments were adopted in those committees. 
Unfortunately, when the bill was rewritten

[[Page 4120]]

behind closed doors before coming to the House floor in November; those 
amendments were removed from the bill. When the House considered this 
bill in November 2009, over 200 amendments were filed to be offered, 
but the leaders in the majority allowed only one amendment to be voted 
on.
  Likewise the Senate bill was written behind closed doors and no 
amendments were allowed to be offered when it was considered in the 
Senate in December 2009. It includes special earmarks meant to secure 
the votes of particular Senators. Now we are debating that bill today, 
and once again no amendments are allowed to be offered.
  We are also debating a new bill drafted by the majority in the House 
that purports to make changes to the Senate bill. Again, this bill was 
drafted behind closed doors over the last few days and includes yet 
again more special provisions intended to secure particular votes. 
Yesterday, at the House Rules Committee, Republicans presented over 80 
amendments that they wanted to offer to this bill, but not a single one 
allowed an up or down vote.
  Mr. Speaker, is it any wonder that the American people have so much 
disdain for Washington and this body? This is a sad day characterized 
by a lack of openness and transparency. The American people deserve 
better.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from Virginia (Mr. Goodlatte).
  Mr. GOODLATTE. Mr. Speaker, I rise in opposition to this flawed 
health care bill.
  Mr. Speaker, nearly two months ago President Obama stood here before 
the Members of the House of Representatives, the Senate, the Supreme 
Court Justices, his own Cabinet Members and millions of Americans who 
were watching on television to deliver his first State of the Union 
address. In that speech he declared that as economic uncertainty 
continues to plague our Nation the government must focus on policies 
that promote economic growth and job creation. My how things have 
changed in just two short months.
  Congress should be working to reduce the tax and regulatory burdens 
that hinder small businesses and ultimately overall economic growth and 
job creation. Instead, over the loud objections of a majority of 
Americans, the Majority continues to advance their health care reform 
proposal which sets the tone for a Washington takeover of the health 
care system. This legislation which contains a multitude of new federal 
regulations, mandates, new big government programs, and a significant 
increase in federal spending and debt, will be extremely detrimental to 
American businesses and particularly our small businesses, which will 
make job losses even worse.
  The legislation includes over $569 billion in tax increases and over 
$523 billion in Medicare cuts. This includes $52 billion in new taxes 
on employers, including small businesses, that cannot afford to provide 
health coverage or that don't offer coverage. The effect of this type 
of tax, similar to a payroll tax increase, would ultimately fall 
squarely on workers in the form of lower wages or reduced employment. 
Additionally, the legislation includes $17 billion in new taxes on 
Americans who do not comply with the individual insurance mandate which 
is sure to further stifle economic growth.
  In fact, 130 economists from all across the country sent President 
Obama a letter explaining how this legislation is a job-killer. In 
their letter, the economists stated that the insurance mandate and the 
tax increases, among other things, will ``constrict economic growth and 
reduce employment'' while ``increasing spending on health care and 
increasing the cost of health coverage''.
  That is why I strongly support an alternative proposal which allows 
for the purchase of health insurance across state lines, allows 
individuals and small businesses to join large pools to get more 
competitive rates, provides tort reform to cut down the high cost of 
defensive medicine, allows full tax deductibility of health insurance 
premiums, portability of health insurance and protection against pre-
existing condition exclusions. In addition, I support health insurance 
tax credits for individuals and families who don't have access to 
employer-based health insurance, increasing the number of community 
health centers, and encouraging the use of health information 
technology to achieve greater efficiencies.
  Congress should not be pushing this government takeover of health 
care that will inflict even more harm on our Nation's economy, making 
job losses even worse. Instead Congress must focus on strategies that 
help Americans obtain the best quality health care at the least cost, 
and ensure that the government fosters increased access to quality care 
based on individual choice, not by taking away choices from people on 
the grounds that government knows best.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from California (Mr. Calvert).
  Mr. CALVERT. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. Speaker, I ask unanimous consent to revise and extend my remarks 
against this flawed health care bill.
  Mr. Speaker, I rise today in opposition to the Democrat health reform 
legislation that imposes billions of dollars in new job killing taxes 
on American small business owners and families. Make no mistake about 
it, at a time when the unemployment in the United States is over 10 
percent, over 14 percent in some parts of my district, this Congress is 
choosing to take up a health reform bill that is a job killer.
  Small business owners struggling to make ends meet who cannot afford 
to buy government approved insurance for their employees will be 
subject to a $2,000 dollar per employee tax. When employers realize 
they can afford neither the government mandated insurance nor this 
egregious new tax they will have no choice but to lay off more 
employees.
  For employers who can afford to provide health insurance to their 
employees, this bill contains billions of new taxes and mandates that 
will raise their premiums. These will drive up the cost of insurance, 
forcing many employers and private individuals to reduce or drop their 
coverage.
  In addition, this bill imposes a never before seen Medicare tax that 
would, for the very first time, apply to capital gains, dividends, 
interest, rents, royalties, and other investment income of singles 
earning over $200,000 and couples earning over $250,000. Currently, 
capital gains and dividends are taxed at a top rate of 15 percent, but 
those rates are already scheduled to rise in 2011 to 20 percent and 
39.6 percent, respectively. When the expansion of the Medicare tax is 
coupled with the already scheduled capital gains rate increase, long-
term capital gains rates would rise by from 15 percent to 23.8 percent 
and the top tax rate on dividends would nearly triple from 15 percent 
to 43.4 percent.
  At a time when Congress should be focusing on incentivizing 
investment in America and putting people back to work we are instead 
here today to levy over $560 billion dollars in new taxes on the 
American public and approve over $938 billion dollars in new 
entitlement spending. I urge my colleagues to stop this massive 
government expansion and focus on America's most pressing issue, 
putting our citizens back to work.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from California (Mr. McClintock).
  Mr. McCLINTOCK. Mr. Speaker, I rise in opposition to this flawed 
health care bill.
  Mr. Speaker, I rise in opposition to this flawed health care bill. 
Under the provisions of this bill, Americans will be required by 
federal law to purchase health insurance policies that include every 
mandate imposed by the new federal health czar and will face federal 
fines and even imprisonment if they refuse. And they will pay for them 
through a combination of higher taxes, higher premiums or lower wages.
  The proposition that Congress has the power to order Americans to 
purchase insurance--or any other product--is contrary to the 
fundamental concept of individual liberty and antithetical to the 
takings clause of the Fifth Amendment. If this precedent were to be 
upheld, the federal government will have assumed authority over every 
aspect of individual choice in the care of ourselves and our families 
and can logically be extended to what foods we choose or to what 
physical activities we engage in. Nor is this brave new doctrine 
limited to health care. Once the precedent is established that 
government may usurp individual decisions in the marketplace, what 
limitation remains on its power to order any other of our decisions as 
consumers?
  Fortunately, the Constitution still protects our freedom from such 
usurpations. It will fall to the Supreme Court to hold this act 
accountable to the Constitution and it will fall to ``We the People'' 
to hold those responsible for it accountable at the polls.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from Ohio (Mr. Jordan).
  Mr. JORDAN of Ohio. Mr. Speaker, I rise in opposition to this flawed 
health bill.
  Mr. DREIER. I yield for the purpose of a unanimous consent request to 
the gentleman from Florida (Mr. Miller).
  Mr. MILLER of Florida. Mr. Speaker, I rise in opposition to this 
flawed health care bill.

[[Page 4121]]


  Mr. DREIER. Mr. Speaker, was there any time consumed?
  The SPEAKER pro tempore. You were charged once.
  Mr. DREIER. For what, half a second?
  The SPEAKER pro tempore. The gentleman was charged 5 seconds.
  Mr. DREIER. Five seconds. Is there any way we can try and get that 
back, Mr. Speaker?
  I reserve the balance of my time.
  Mr. McGOVERN. Can you tell me how much time is remaining on both 
sides.
  The SPEAKER pro tempore. The gentleman from Massachusetts has 5 
minutes remaining, and the gentleman from California has 10 minutes and 
25 seconds.
  Mr. DREIER. Mr. Speaker, at this time I yield for the purpose of a 
unanimous consent request to my friend, the former sheriff from 
Washington (Mr. Reichert).
  Mr. REICHERT. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. DREIER. Mr. Speaker, I yield for the purpose of a unanimous 
consent request to my friend from San Diego, California (Mr. Issa).
  Mr. ISSA. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. McGOVERN. I continue to reserve the balance of my time, Mr. 
Speaker.
  Mr. DREIER. Mr. Speaker, at this time I am happy to yield 1 full 
minute to our friend from Gold River, California (Mr. Daniel E. 
Lungren).
  Mr. DANIEL E. LUNGREN of California. I thank the gentleman for 
yielding.
  Mr. Speaker, in the famous play, ``A Man for All Seasons,'' there is 
a tremendous scene there where Sir Thomas More looks out and sees 
Richard Rich, who used to be a supporter of his, who was giving 
testimony against him. And he notices that he has a medallion on him 
designating that he happens to be the new attorney general for Wales.
  And, in response, Mr. Thomas More says, Richard, it profits a man 
nothing to give his soul for the whole world. But for Wales?
  Mr. Speaker, for those of us who have worked so hard in the pro-life 
movement for years and years and years, and who understand the 
importance of the historic effort made by our former colleague, Mr. 
Hyde, I beg those who have joined us over these years to understand 
what they are doing if they sign off on an executive order. An 
executive order is not law.
  The reason we have had to have the Hyde amendment over the years is 
that the courts have said that there is a statutory mandate to provide 
abortion unless we say it does not exist. Therefore, an executive order 
does not take precedence over the law. People should know where they 
are. Don't be like Richard Rich of Wales.
  The SPEAKER pro tempore. The gentleman's time has expired.
  Mr. McGOVERN. Mr. Speaker, I yield to the gentleman from American 
Samoa (Mr. Faleomavaega) for the purpose of a unanimous consent 
request.
  Mr. FALEOMAVAEGA. Mr. Speaker, I rise in total opposition to all my 
friends who oppose the legislation on the other side of the aisle, but 
in full support of this most historical bill.
  Mr. Speaker, I rise in strong support of the ``Health Care and 
Education Affordability Reconciliation Act of 2010.''
  Mr. Speaker, we stand today at the threshold of a momentous occasion 
in the history of this great Nation. It is momentous in the sense that 
this long-overdue, comprehensive overhaul of our national Healthcare 
system is desperately needed to address rising medical costs and to 
extend coverage to our fellow Americans that are often left to fend for 
themselves.
  I want to thank Speaker Nancy Pelosi for her leadership and for 
bringing this important issue to the Floor for consideration.
  I also want to express my gratitude to President Obama and the 
Democratic House and Senate leadership for their willingness to work 
hand-in-hand with the Congressional Delegates to resolve our concerns 
and reduce the health disparity facing the Territories.
  On the House side, I want to particularly thank both Chairman Henry 
Waxman of the Committee on Energy and Commerce and Chairman Charles 
Rangel of the Committee on Ways and Means for their unwavering support 
in addressing the concerns put forward by the Congressional Delegates. 
On the Senate side, I also want to thank Senator Chris Dodd and Senator 
Charles Schumer for their assistance.
  Most of all, I wish to recognize my fellow Congressional Delegates, 
Donna Christensen of the Virgin Islands for her work in the House 
Committee on Energy and Commerce, Gregorio Sablan of the Commonwealth 
of the Northern Marianas and Pedro Pierluisi of Puerto Rico for their 
advocacy in the House Committee on Education and Labor, and Madeleine 
Bordallo of Guam for her leadership as the Chairwoman of the 
Congressional Asian Pacific American Caucus Healthcare Task Force. 
Together, we worked relentlessly to bring about change for those we 
represent.
  This entire Healthcare overhaul would not have been possible without 
the support of the Congressional Hispanic Caucus, the Congressional 
Black Caucus, and the Congressional Asian Pacific American Caucus 
(CAPAC), and I want to especially recognize the efforts of Congressman 
Mike Honda, Chairman of CAPAC.
  While the bill we have before us today is far from ideal and not the 
perfect solution to all our health care issues, it is imperative and 
also the constitutional responsibility of the Members of this Chamber 
to act in the best interest of those who are suffering, particularly in 
light of the heart-wrenching stories told of people dying, parents 
worrying and families living in fear because they have no health 
insurance. Just last year, it was estimated that 625 Americans lost 
their health insurance every hour.
  So even though we may not agree on how to make this right, we can 
agree that to do nothing is not an acceptable course of action. Our 
fellow Americans deserve our help.
  The some 4.4 million Americans living in the Territories also deserve 
to be recognized and this is why I am pleased that this bill 
acknowledges that we are part of the American family. Although much 
remains to be desired, this bill is a step towards bringing the 
Territories to parity with the States. Under Section 1204, the 
Territories--Puerto Rico, the U.S. Virgin Islands, Guam, American 
Samoa, and the Commonwealth of the Northern Marianas Islands--will 
receive an additional $6.3 billion over a 9 year period in federal 
funding for Medicaid costs.
  American Samoa will receive $285.5 million in total Medicaid spending 
for the next 9 years, or an increase of over $180 million.
  This legislation also provides $1 billion for the Territories to 
participate in the Health Insurance Exchange program, the centerpiece 
of this Healthcare Reform Legislation. Each of the Territories will be 
afforded the option to participate or transfer their allocation to 
their Medicaid program. If American Samoa chooses not to participate in 
the Exchange, the Territory will receive an additional $18.75 million 
for its Medicaid program.
  With the historic passage of this legislation and the increased 
federal funding it will provide, I am hopeful that the American Samoa 
Government and Legislature will do all it can to provide quality and 
affordable health care for the people of American Samoa.
  In 2005, the findings of the American Samoa Health Survey estimated 
that only 25 percent of the population had insurance and, with the 
rising cost of health care, it is highly likely that the number of 
insured in American Samoa has declined drastically since that time.
  But now, with a significant increase in federal funding, ASG has the 
tools it needs to improve healthcare and health coverage for the 
residents of the Territory and to meet the challenges which have been 
exacerbated by the Territory's remote location and the exponential rate 
of chronic diseases.
  In light of the current political environment surrounding healthcare 
reform, President Obama's own testimony in Ohio last week best 
summarizes the necessity and the very reason why Congress must pass 
this legislation today. The President said, ``I'm here because of my 
own mother's story. She died of cancer, and in the last six months of 
her life, she was on the phone in her hospital room arguing with 
insurance companies instead of focusing on getting well and spending 
time with her family.''
  Millions of Americans share the same story, and passage of this 
legislation is critical for the welfare of all Americans. This 
legislation is not only about saving money and reducing the deficit or 
addressing the billions wasted in Medicare. Passage of this legislation 
is about providing for those who cannot provide for themselves. It is 
about the fundamental right of healthcare for all.
  As Martin Luther King once said, ``Of all the forms of inequality, 
injustice in health care is the most shocking and inhumane.''

[[Page 4122]]

  At its best, this bill is a step toward equality and justice for all 
Americans and, for this reason, I urge my colleagues to support this 
historic legislation.
  The SPEAKER pro tempore. The gentleman will be charged.
  Mr. McGOVERN. I reserve the balance of my time, Mr. Speaker.
  Mr. DREIER. Mr. Speaker, my colleagues are very curious as to whether 
or not any time was taken from the other side.
  The SPEAKER pro tempore. The gentleman was charged.
  Mr. DREIER. I just wanted to make sure. I just wanted to make sure in 
the name of fairness here. I appreciate your fairness, Mr. Speaker.
  At this time I yield 1 minute to the distinguished ranking member of 
the Financial Services Committee, the gentleman from Vestavia Hills, 
Alabama (Mr. Bachus).
  Mr. BACHUS. Mr. Speaker, in our Declaration of Independence, our 
forefathers declared that we are endowed by our Creator with certain 
inalienable rights. The first was life, yet this bill would permit the 
public funding of abortions in a number of programs that would take an 
innocent life formed by that Creator within a matter of months, if not 
weeks or days.
  The very first act of our government on this innocent and defenseless 
life would be to end it. Our forefathers could not comprehend such an 
outrageous act.
  Let me close by saying that on this very day, March 21, exactly 61 
years ago, Chaplain Peter Marshall prayed on the floor of the Senate: 
Lord, our God, help us to stand up for the inalienable rights of 
mankind, knowing that Thy power and Thy blessings will be upon us only 
when we do what is right.
  May we so speak, vote and live as to merit thy blessing.
  Mr. DREIER. Mr. Speaker, at this time I am happy to yield 1 minute to 
my friend from Lincoln, Nebraska (Mr. Fortenberry).
  Mr. FORTENBERRY. Mr. Speaker, let's just imagine for a moment that 
this health care bill before us today failed. Let's just imagine that 
we all awoke tomorrow and could say to one another now we have a chance 
to get health care reform right, health care reform that is fair to 
everyone, reduces costs and truly improves outcomes, instead of just 
shifting costs to more unsustainable government spending and eroding 
health care liberties.
  Mr. Speaker, the debate has become very passionate, and I fear that 
we sometimes lose sight of the fact that our actions have consequences 
and can even affect little children. The other day a 9-year-old boy 
approached me and he said, Congressman, I have a question. He said, if 
the government gets so bad, which country should we move to? And I put 
my hand on his shoulder and I looked at him and I said, America is 
still a good country, we just have to make it better.
  Mr. Speaker, I am not here to help manage the decline of America. 
None of us are. We can do better. We must do better.
  Mr. McGOVERN. Mr. Speaker, I yield 1 minute to the gentleman from 
North Carolina (Mr. Butterfield).
  Mr. BUTTERFIELD. I thank the gentleman for yielding the time and for 
the hard work of the Rules Committee.
  Mr. Speaker, I come to the well of the House today to support the 
rule and to commend President Obama and the Democratic leadership for 
their willingness to stand up for America's families and for their 
willingness to be strong and steadfast in the face of political 
opposition. My North Carolina district is the fourth poorest district 
in America: 100,000 uninsured, seniors unable to afford prescription 
drugs, rural hospitals in the red, insurance premiums increasing while 
insurance company profits are multiplying.
  My constituents need health insurance reform, and they need it now. 
The time for debate is over. We are poised to deliver on the Democratic 
promise of health insurance reform.
  I am confident, Mr. Speaker, that one day historians will write that 
the passage of this bill took America to a higher level, to a higher 
place, and restored confidence with the American people that Congress 
is responding to the needs of America's families.

                              {time}  1715

  The SPEAKER pro tempore. The gentlewoman from New York has 3 minutes 
and 55 seconds remaining. The gentleman from California has 7 minutes 
and 25 seconds remaining.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request I yield to 
the gentleman from Georgia (Mr. Westmoreland).
  Mr. WESTMORELAND. Mr. Speaker, I rise in opposition to this flawed 
health bill.
  Mr. Speaker, there's no such thing as a free lunch and there's no 
such thing as free health care. Yet, the Democrats ramming this 
legislation through the House against the will of the American people 
would have you believe that we're going to extend coverage to 32 
million and subsidize millions of others, and it's not going to cost 
average Americans a thing. Somehow, they say, this will all be covered 
by big businesses and high-income earners, and it won't have any effect 
whatsoever on average Americans. It's the mysterious ``them'' who will 
pick up the tab, not ``us.''
  The truth is that we're all going to pay, and we will pay big. This 
legislation will raise taxes by $569 billion, it will raise the 
insurance premiums of all Americans, it will place a huge new tax on 
jobs and it will put expensive mandates on individuals and employers.
  There will be $52 billion in new taxes on employers who can't afford 
to provide health insurance. So what's going to happen when you 
drastically hike up the cost of jobs? We'll have fewer jobs. This 
Congress is recklessly destroying jobs at time when unemployment is at 
nearly 10 percent. At a moment when unemployed Americans are looking 
for work to provide for their families, at a time when many more are 
underemployed or working part time, at a time when businesses are 
unable to get the loans they need to expand, the Democratic Congress is 
taking us backwards. We will make a bad situation worse.
  For the next 4 years, in fact, we'll implement the taxes but not the 
coverage. We keep hearing Democrats say that 45,000 Americans die each 
year because they don't have health insurance. According to the 
Democrats' own rhetoric--as faulty as it may be--they're ignoring 
180,000 needless deaths over the next 4 years.
  Mr. Speaker, there is no free lunch. It is our duty, first and 
foremost, to render tough decisions. We have to prioritize. Our 
priority in today's climate should be creating and saving jobs, and 
therefore, helping more Americans gain employer-provided coverage. 
Then, we can focus our attention on bringing down the cost of health 
care and expanding access without adding on a new entitlement that we 
can't afford.
  You know, Mr. Speaker, it's remarkable to me that for a President who 
campaigned on reaching across the aisle and bridging the partisan 
divide, the only bipartisanship on his signature issue is in 
opposition. Democrats and Republicans are joined together in opposing 
this government takeover of health care. There are 25,000 Americans 
protesting this legislation outside these walls. There are 39 state 
legislatures threatening to fight this law in court. Large majorities 
of American citizens are begging their Member of Congress to vote 
``no''.
  Mr. DREIER. Mr. Speaker, I yield for a unanimous consent to the 
gentleman from Illinois (Mr. Manzullo).
  Mr. MANZULLO. Mr. Speaker, I rise in opposition to this flawed health 
bill.
  Mr. Speaker, the President's $1 trillion health care bill is a job-
killing disaster that will slap Americans with massive tax increases 
and Medicare cuts immediately while delaying the bulk of the health 
care benefits until 2014. This is not health care reform; this is an 
unprecedented and unnecessary government takeover employing some of the 
highest and cruelest tax increases and perhaps the broadest expansion 
of the power of the federal government in history. It didn't have to be 
this way. I do support health care reform. Bipartisan alternatives 
exist that would make health care more affordable and accessible for 
the uninsured without having to wait four years for benefits.
  Here are just a few of the most egregious policies within the 
President's massive government takeover of health care. H.R. 3590 would 
increase taxes on Americans by $569 billion, including a new $210 
billion 2.9 percent ``Medicare'' tax on investment income; cut Medicare 
benefits for seniors by $530 billion; increase Americans' health 
insurance premiums $2,100 by 2014, according to the non-partisan 
Congressional Budget Office; put another 3 to 5 million Americans on 
the unemployment lines due to the heavy mandates that require employers 
to provide health care

[[Page 4123]]

coverage to their employees and families whether they can afford it or 
not; require the Internal Revenue Service (IRS) to hire up to 16,500 
additional workers to enforce all the new tax penalties on Americans 
who can not afford to purchase health insurance; and puts another 16 
million Americans on Medicaid, a struggling program that pays such low 
reimbursement rates that 121 Walgreens stores in Washington announced 
last week they would no longer accept Medicaid for prescriptions. This 
bill will burden states with additional Medicaid share costs. The State 
of Illinois, already facing a $12 billion budget deficit with plans to 
cut $1.3 billion from local school funding, would have to pay at least 
$1.8 billion in additional Medicaid sharing costs to cover the 
additional enrollments. To add insult to injury, this bill makes 
Americans wait until 2014 to receive the bulk of the benefits. In fact, 
the ban on preexisting conditions does not kick in until 2014 for 
adults.
  This bill implements tax increases and Medicare cuts immediately, but 
delays most of the benefit provisions for four years. However, when you 
look at the first 10 years of benefits, the estimated true cost will be 
$2.6 trillion. And that does not even include the nearly $1 trillion of 
additional spending that was either pulled out of the bill to be dealt 
with later or the result of correcting double counting cuts in 
unrelated programs.
  Plus, H.R. 3590 would not have a true firewall of protection to 
prevent federal tax dollars from paying for abortions. According to a 
Quinnipiac University survey released on December 22, 2009, 72 percent 
of Americans said they oppose allowing abortions to be paid for with 
public funds under any new health care system created by the 
government. Thus, because a ``reconciliation'' bill cannot solve this 
particular issue due to the fact that it is not directly a budget 
issue, the President has promised to issue an executive order to ban 
federal funding of abortion. However, an Executive Order cannot trump 
the language in this bill that would become law, if passed. In 1952, 
the Supreme Court struck down President Truman's executive order during 
the Korean War that assumed federal control of certain domestic steel 
mills due to labor unrest because it was an unconstitutional exercise 
of lawmaking authority reserved to Congress. In 1996, the District of 
Columbia Court of Appeals struck down an executive order issued by 
President Clinton which authorized sanctions on federal contractors 
that permanently replaced workers who went on strike because it 
superseded existing law guaranteeing the right of employers the right 
to hire permanent replacement workers. Finally, the Supreme Court 
struck down an executive order issued by President G.W. Bush because 
Congress, in enacting a statutory military commissions system, had 
impliedly prohibited the President's invocation of military commission 
jurisdiction over a terrorist detainee.
  I also want to expand upon what I believe to be one of the cruelest 
elements of this bill. As if raising taxes on struggling families and 
their employers, cutting benefits for seniors, growing the IRS 
enforcement police by thousands, and further jeopardizing the budgets 
of all states in the union was not cruel enough, this bill creates a 
new 2.9 percent tax on life-saving medical devices like the titanium 
brace that was inserted into the spine of my wife after a cancerous 
tumor shattered one of her vertebrae. That medical device saved my wife 
from the wheelchair. The authors of this bill believe that life-saving 
medical devices should be nearly three percent more expensive. I fail 
to understand how we make health care more affordable by pursuing 
policies that intentionally make health care more expensive.
  As the former Chairman of the House Small Business Committee, I have 
long supported legislation that would help small employers purchase 
health insurance for their employees and their families. Of the 47 
million uninsured Americans, 57 percent work for small employers who 
cannot afford to offer them health insurance. I support two bipartisan 
solutions that would go a long way to reduce the number of uninsured in 
America. First, Congress should pass H.R. 2360, the Small Business 
Health Options Program Act of 2009 (SHOP Act) as a stand-alone bill. 
H.R. 2360 would allow small employers to purchase health insurance at 
reduced group rates through national associations while still following 
state rules. I am one of 60 bipartisan cosponsors of H.R. 2360, which 
also enjoys support from the liberal Service Employees International 
Union (SEIU), the AARP, and the conservative National Federation of 
Independent Business (NFIB). A companion bill in the Senate was 
authored by my fellow Illinoisan, Senator Dick Durbin, and enjoys 
similar bipartisan support.
  Second, Congress should also pass H.R. 1470, the Equity for Our 
Nation's Self-Employed Act of 2009. This bill would let small employers 
pay for their health insurance before they pay their Social Security 
and Medicare tax liabilities, giving them the same deduction as large 
employers. The self-employed pay on average $12,106 annually for family 
health care coverage, and H.R. 1470 would save them $1,852 a year, 
according to the Kaiser Foundation. I am one of 48 bipartisan co-
sponsors of H.R. 1470.
  These bills would dramatically reduce the costs of health insurance 
for small employers so they can better afford to provide coverage for 
their employees and their families. And they will reduce the rolls of 
the uninsured without increasing taxes, killing jobs, forcing Americans 
into a government-run program, and burdening our children and 
grandchildren with even more debt.
  Mr. Speaker, I also support making the following four changes to 
America's health care system. First, we need to reform our out-of-
control medical liability system. Medical malpractice insurance 
continues to surge, skyrocketing health care costs and forcing doctors 
and other medical professionals to practice ``defensive medicine,'' 
which entails ordering costly and often unnecessary tests to cover all 
the bases from lawsuits. I am a cosponsor of the HEALTH Act (H.R. 1086) 
that would fully compensate victims for medical injuries but place 
reasonable caps on punitive and non-economic damages that often inflate 
the awards and contribute to out-of-control liability and health care 
costs.
  Second, we need to expand tax-free availability to Health Savings 
Accounts (HSAs). HSAs allow small business owners to offer more 
affordable high-deductible health insurance plans to their employees 
and make tax-deductible contributions to employee savings accounts to 
allow their employees to build equity and assume personal control of 
their health care needs. Congress should increase the tax deductibility 
for these insurance plans.
  Third, we need to preserve high-quality health care through America's 
community health centers. I am a strong supporter of continued funding 
of our community health center system, which provides high-quality 
health care to America's low-income families. The district I am 
privileged to represent has one of the model community health centers 
in America, the Crusader Clinic in Rockford, which serves more than 
40,000 needy patients in northern Illinois each year.
  Finally, we need to create refundable tax credits to help low-income 
Americans purchase health insurance. Low-income children are already 
covered through the federal State Children's Health Insurance Program 
(SCHIP), and I support refundable tax credits to help low-income adults 
purchase health insurance.
  Mr. Speaker, this bill today will increase taxes, cut Medicare, raise 
health care premiums, and put millions more Americans on the 
unemployment lines. And amazingly, most of the benefits--including the 
ban on pre-existing conditions for adults--will not be available for 
another four years. We should instead be pursuing the bipartisan 
reforms that would make health care more affordable and accessible to 
Americans now, and not make them wait four years for assistance. This 
bill is certainly not the type of health care reform Americans deserve.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request I yield to 
the gentleman from Peoria, Illinois (Mr. Schock).
  Mr. SCHOCK. Mr. Speaker, I rise in opposition to this flawed health 
bill.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request, I yield to 
my friend from New Jersey (Mr. LoBiondo).
  Mr. LoBIONDO. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request, I yield to 
the gentleman from Arkansas (Mr. Boozman).
  Mr. BOOZMAN. Mr. Speaker, I rise in opposition to this flawed health 
bill.
  Mr. DREIER. Mr. Speaker, for a unanimous consent, I yield to my 
California colleague, Mr. Herger.
  Mr. HERGER. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. Speaker, the ``Reconciliation Act of 2010,'' written behind 
closed doors and published just a few days ago, does nothing to improve 
the Senate health care bill. It is simply more of the same: higher 
taxes on investment and job creation, more cuts to Medicare to pay for 
the new government health care program, and more special backroom deals 
reflecting the Majority's determination to pass this bill by any means 
necessary.
  The reconciliation bill raises the Medicare payroll tax and, for the 
first time in history, applies it to unearned income. This tax hike is

[[Page 4124]]

aimed squarely at small businesses and is sure to result in the loss of 
even more jobs. Even worse, Congress is once again raiding the Medicare 
and Social Security Trust Funds to pay for other programs.
  The reconciliation bill also contains higher cuts to Medicare 
Advantage--over $200 billion in all. If this passes, it is the end of 
Medicare Advantage as we know it. Senior citizens in many parts of the 
country will no longer be able to choose their Medicare plan. Once 
again, these cuts have nothing to do with solving Medicare's long-term 
budget problems. They are greasing the skids for the new government 
health care program.
  Not only does the reconciliation bill leave in place many of the 
backroom deals included in the Senate bill, it adds several new ones, 
including a special tax exemption for union multiemployer health plans 
and extra Medicare money for hospitals and physicians in certain parts 
of the country. The American people have repeatedly expressed outrage 
at the special deals that are being made behind closed doors, yet the 
Democratic Majority still refuses to listen.
  One of the most serious concerns I have heard from my constituents is 
that the Senate government health care bill will lead to rationing. 
Unfortunately, the Rules Committee refused to make in order my 
amendment to ensure that the new comparative effectiveness research 
board established by the Senate bill cannot be used as a basis for 
cost-based coverage denials. The Majority has repeatedly refused to 
include an ironclad guarantee that Medicare will not start rationing 
access to life-saving treatments because of their cost. The 
reconciliation bill also leaves intact a new Independent Payment 
Advisory Board of unelected bureaucrats that will have the power to 
change Medicare payment policies without congressional approval, and 
that cannot be repealed without a supermajority vote of the House and 
Senate. This board is charged not only with issuing recommendations, 
but also implementing Medicare policy. It is the ultimate embodiment of 
government-run health care where decisions about access to innovative 
new drugs, treatments and therapies are decided not by patients and 
doctors and a functioning marketplace, but by unresponsive and 
unaccountable bureaucrats working to contain costs.
  In a final touch of irony for a Majority that has repeatedly insisted 
that they are not aiming for a government takeover of health care, this 
reconciliation bill incorporates a complete government takeover of the 
private student loan industry. The Majority's rationale for this policy 
is that the current policy of government subsidies for private 
businesses is not controlling costs and has become too expensive. The 
Congressional Budget Office has already told us that the Senate health 
care bill will cause individual private insurance premiums to rise 
faster than they would under current law. It is difficult to imagine 
that a government-industry cartel will be any more efficient for health 
insurance than it was for student loans. After a few years of this 
policy, will Democrats again conclude that costs are out of control and 
the government must take over?
  The House should reject both the Senate government health care bill 
and this reconciliation bill that only makes things worse.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request, I yield to 
the gentleman from Florida (Mr. Bilirakis).
  Mr. BILIRAKIS. Mr. Speaker, I rise in opposition to this flawed 
health care bill.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request, I yield to 
my friend from Alabama (Mr. Bonner).
  Mr. BONNER. Mr. Speaker, I rise in opposition to this flawed health 
bill.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request, I yield to 
my friend from St. Louis, Missouri (Mr. Akin).
  Mr. AKIN. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request, I yield to 
my friend from Pennsylvania (Mr. Thompson).
  Mr. THOMPSON of Pennsylvania. Mr. Speaker, I rise in opposition to 
this flawed health care bill.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request, I yield to 
the gentleman from Texas (Mr. Carter).
  Mr. CARTER. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request, I yield to 
the gentleman from Iowa (Mr. Latham).
  Mr. LATHAM. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request, I yield to 
the gentleman from Florida (Mr. Mario Diaz-Balart).
  Mr. MARIO DIAZ-BALART of Florida. Mr. Speaker, I rise in opposition 
to this flawed health bill.
  Mr. Speaker, I rise today to express my strong opposition to the 
eventual government takeover of health care that took place on the 
floor of the House today.
  Though I strongly believe that America needs health care reform, I 
cannot in good conscience cast a vote for a bill that will take our 
country down the path of bankruptcy.
  This deeply flawed legislation raids Medicare, which faces insolvency 
in 2017, by over half a trillion dollars in order to create a massive 
new entitlement program. It raises taxes on our families and small 
businesses by over half a trillion dollars. It will lead to increases 
in insurance premiums, increase overall spending on health care by over 
$200 billion and will result in job losses. This bill will also 
increase the national debt and deficit, leaving our children and 
grandchildren to pay the price.
  Today Democrat leadership abused and manipulated the legislative 
process for political gain, in an effort to force an eventual 
government takeover of health care that the American people do not 
want. This legislation was drafted in secret and is loaded with 
backroom deals for certain Members of Congress and special interests. 
The American people need, demand and deserve health care reform that 
will increase access, improve quality and lower costs. What the 
American people do not want is this ill-conceived legislation that will 
bankrupt our country and leave a lasting negative impact on generations 
to come.
  Nothing is more sacred in this country then our freedom and 
democracy. These are the fundamental principles that make America the 
greatest country in the world, and I cannot and will not vote for 
legislation that jeopardizes the freedom, democracy, prosperity and 
opportunity of future generations of Americans.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request, I yield to 
the gentlewoman from Minnesota (Mrs. Bachmann).
  Mrs. BACHMANN. Mr. Speaker, I rise in opposition to this dangerous 
health care bill.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request, I yield to 
the gentleman from Colorado (Mr. Coffman).
  Mr. COFFMAN of Colorado. Mr. Speaker, I rise in opposition to this 
flawed health bill.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request, I yield to 
the gentleman from Michigan (Mr. Hoekstra).
  Mr. HOEKSTRA. Mr. Speaker, I rise in opposition to this flawed health 
bill.
  Mr. Speaker, I rise today to vehemently object to the government 
takeover of health care.
  It is bad social policy, bad public policy and bad fiscal policy for 
the United States.
  The health care bills we will vote on today are estimated to cost 
more than $1 trillion, will expand government bureaucracy, permit 
taxpayer-funded abortions, increase taxes and cut Medicare. 
Additionally, it includes egregious sweetheart deals such as the 
``Cornhusker Kickback'' for Nebraska, ``Gator Aid'' for Florida and the 
``Louisiana Purchase.''
  My home state of Michigan alone will be forced to pay $710 million 
annually for new Medicaid enrollees, money the state does not have to 
spare. It is verging on denying the state's ability to regulate health 
care programs and insurance and encroach on its sovereignty in doing 
so.
  Every American is personally impacted by health care. As such over 
the last year Michigan residents and all Americans have voiced their 
opposition with the health care proposals in Congress. It is 
disheartening to see that Congress is blatantly ignoring the voice of 
the public.
  The U.S. health care system remains the best in the world, but still 
needs reform. Reform can be achieved by targeted measures such as 
allowing insurance competition across state lines and creating high-
risk pools of money for states to support those with pre-existing 
conditions.
  I had hoped that we could work in a bipartisan manner to achieve 
reform of health care, but Republicans were not allowed a seat at the 
table.
  We do not need the federal government to take over one-sixth of the 
American economy, and saddle states like Michigan with mandates, tax 
increases and debt.
  Mr. Speaker, in Michigan a situation has developed in which home 
health car providers have been forced to pay union dues to state 
because they accept federal dollars.

[[Page 4125]]

  How can we be sure that the same will not happen to medical 
practitioners who will be forced into a government-run system?
  Additionally, I am concerned that the reconciliation bill that we 
will vote upon today will completely federalize student lending, 
leading to lost jobs, tax increases and the elimination of choice.
  Mr. Speaker, I will be voting against the bills, and I respectfully 
submit my remarks for the Record.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request, I yield to 
the gentleman from Iowa (Mr. King).
  Mr. KING of Iowa. Mr. Speaker, I rise in opposition to this flawed 
health care bill.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request, I yield to 
our friend from Indianapolis (Mr. Burton).
  Mr. BURTON of Indiana. Mr. Speaker, I rise in opposition to this 
flawed health care bill.


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore. The Chair will remind Members not to 
frequent the well when another Member is speaking.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request, I yield to 
the gentleman from Texas (Mr. Gohmert).
  Mr. GOHMERT. Mr. Speaker, I rise in opposition to this government 
takeover of health care in this so-called health care bill.
  The SPEAKER pro tempore. The gentleman will be charged.
  Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentleman from 
Virginia (Mr. Connolly).
  Mr. CONNOLLY of Virginia. Mr. Speaker, I thank the gentlelady.
  We have reached a historic crossroads in our Nation's history. We can 
choose to set our Nation on the path to improving the access to quality 
health insurance for millions of Americans and finally containing the 
cost of that care, or we can continue on the road of the status quo, 
threatening to leave more families without basic care and bankrupting 
the engine of our economy.
  This bill in front of us today, this historic bill meets the four 
tests my constituents set for it:
  Will it bring down premium costs for families and small businesses? 
Yes, it will.
  Will it reduce the deficit? Yes, it will. Now and in the future.
  Will it protect their choice of plan and doctor? Yes, it will.
  Will it improve access to care? Yes, it will.
  We have heard a lot of fear, we have heard a lot of disinformation. 
But I quote today on the Sabbath 2 Timothy 1:7, ``For God did not give 
us a spirit of timidity, but a spirit of power, of love.''
  Let us not be timid. Let us pass this historic piece of legislation.
  Mr. DREIER. Mr. Speaker, at this time I am happy to yield 1 minute to 
my very good friend from Sarasota, Florida (Mr. Buchanan).
  Mr. BUCHANAN. I want to thank the gentleman from California.
  Mr. Speaker, I oppose this bill. It does nothing to lower costs or 
little to lower costs, it raises taxes $540 billion, and it cuts 
Medicare.
  Being in business and signing the front of payroll checks, I can tell 
you that one of the biggest concerns with small businesses is the 
escalation of health care. It is $10,000 to $12,000 today for a small 
business in a family. CEO Roundtable is saying if we do nothing about 
it--and this bill does nothing about it--it will go to $28,000 in the 
next 10 years.
  It also increases taxes $540 billion. A lot of those taxes are passed 
through to small businesses, the LLCs and sole proprietorships. It 
passes through to them, it hurts working families, and it will not 
increase jobs.
  The other thing, as someone that represents an area that has the most 
seniors in the country, we have real cuts, not just waste, fraud, and 
abuse, of $500 billion. This will really hurt seniors. I had a senior 
the other day say, ``All I have is my Social Security and Medicare. It 
is not perfect, but don't mess with my Medicare.''
  Ms. SLAUGHTER. Mr. Speaker, may I inquire how much time remains?
  The SPEAKER pro tempore. The gentlewoman has 2 minutes, 55 seconds 
remaining. The gentleman from California has 6 minutes, 20 seconds 
remaining.
  Ms. SLAUGHTER. I reserve the balance of my time.
  Mr. DREIER. Mr. Speaker, at this time I am happy to yield for a 
unanimous consent to the gentleman from Idaho (Mr. Simpson).
  Mr. SIMPSON. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. DREIER. Mr. Speaker, at this time I am happy to yield 1 minute to 
the distinguished gentleman from Springfield, Missouri (Mr. Blunt).
  Mr. BLUNT. Mr. Speaker, I thank the gentleman for yielding.
  Mr. Speaker, I was able to chair our Health Care Solutions group on 
our side, and we had lots of ideas. In fact, many of those ideas were 
included in the 80 amendments that went to the Rules Committee 
yesterday, none of which were allowed.
  This could be a bill, Mr. Speaker, about medical liability reform, 
about small business health plans, buying across State lines, lots of 
things that aren't there.
  I don't think, Mr. Speaker, this bill improves what works and fixes 
what is broken, which should be our goal. But that is not the main 
reason, Mr. Speaker, we should not be proceeding today. The main reason 
is not that it is not the best bill or a bill that I approve of. The 
main reason is that it costs too much, Mr. Speaker.
  This is a bill where the proponents say we are going to collect $1 
trillion in either new taxes or Medicare cuts. We are going to 
accumulate $1 trillion over 10 years, and we are going to spend it in 6 
years. In fact, Mr. Speaker, by year 8, by year 9, by year 10, we are 
spending $200 billion a year. When I checked with the Congressional 
Budget Office, what about year 11? They said $200 billion as well.
  Mr. Speaker, this will cost jobs. It doesn't head the country in the 
right direction. I oppose the rule and will oppose the bill.
  Ms. SLAUGHTER. Mr. Speaker, I continue to reserve the balance of my 
time.
  Mr. DREIER. Mr. Speaker, I yield myself 15 seconds to urge my 
colleagues to defeat the previous question. I will be offering an 
amendment to the rule. The amendment will require the Speaker to direct 
the Clerk to call the roll on the final votes on the Senate health care 
bill and the reconciliation bill.
  As the Republican leader has said repeatedly, it is time for the 
Members of this House to stand up and be counted.
  I ask unanimous consent that the text of the amendment and 
explanatory material appear in the Record immediately prior to the vote 
on the previous question.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Mr. DREIER. Mr. Speaker, at this time I yield 1 minute to my good 
friend from Monticello, Indiana (Mr. Buyer).
  Mr. BUYER. I rise in opposition to the rule.
  Why would the VFW National Commander state that he is furious? 
Because Congress is moving a flawed bill that does not protect 
America's military, dependents, veterans, widows, nor orphans.
  The VFW stated, ``The President and the Democrat leadership are 
betraying America's veterans.''
  The VFW is asking for a ``no'' vote on this bill because it breaks 
the promises the President made to veterans at their national 
convention. This flawed bill covers neither our military and dependents 
under TRICARE, nor VA programs for widows and orphans, nor the program 
for children of Korea and Vietnam veterans with spina bifida. None of 
these programs are considered minimum essential coverage. And where are 
the protections for the Secretaries of DOD and the VA to preserve the 
integrity of their health care systems? Absent from the bill.
  Buck McKeon and I and others tried to fix this bill, but were denied 
by this rule and our suspension efforts, even though Mr. Levin and I 
tried to have

[[Page 4126]]

an agreement. Many veterans groups support efforts to correct these 
errors. Vote ``no.''

                            [Mar. 21, 2010]

               National Healthcare Bill Betrays Veterans

       Washington.--The national commander of the nation's oldest 
     and largest combat veterans' organization is furious that 
     Congress is moving ahead with a flawed healthcare bill that 
     does not protect the health programs provided to veterans, 
     servicemembers or their families.
       ``The president and the Democratic leadership are betraying 
     America's veterans,'' said Thomas J. Tradewell Sr., a combat-
     wounded Vietnam veteran from Sussex, Wis., who leads the 2.1 
     million-member Veterans of Foreign Wars of the U.S. and its 
     Auxiliaries.
       ``And what makes matters worse is the leadership and the 
     president knows the bill is flawed, yet they are pushing for 
     passage today like it's a do-or-die situation. This nation 
     deserves the best from their elected officials, and the rush 
     to pass legislation of this magnitude is not it.''
       At issue is H.R. 4872 does not fully protect the healthcare 
     programs provided by the Department of Veterans Affairs and 
     the military's Tricare system. Specifically, the bill covers 
     Tricare For Life but not the other Tricare programs that 
     serve millions of beneficiaries; it does not cover children 
     suffering from spina bifida as a result of a parent's 
     exposure to Agent Orange; and it does not cover dependents, 
     widows and orphans who are served by CHAMPVA, the Civilian 
     Health and Medical Program of the Department of Veterans 
     Affairs.
       ``The president was very clear at our VFW national 
     convention last year when he said he was going to protect 
     these programs, as did the Democratic leadership in the House 
     and Senate repeatedly throughout the year. Now we have this 
     flawed package that everyone is trying to rush through that 
     blatantly omits any protections of the healthcare programs 
     our nation provides to millions of veterans, military 
     personnel, military retirees, and their families or 
     survivors.
       ``This is Washington doubletalk at its very worse, and the 
     uproar is going to be huge in America's military and 
     veterans' communities,'' said Tradewell, who wants Congress 
     to vote against H.R. 4872 today.
       The issue surfaced publicly Friday when House Armed Service 
     Committee Chairman Ike Skelton (D-Mo.) introduced legislation 
     to explicitly protect Tricare and other Defense Department 
     nonappropriated fund health plans from any health reforms 
     currently under consideration by Congress.
       Yesterday, Reps. Steve Buyer (R-Ind.) and Buck McKeon (R-
     Calif.) tried to introduce an amendment to H.R. 4872 to 
     protect the integrity and independence of the VA and Defense 
     Department healthcare systems. Buyer is the ranking member of 
     the House Veterans Affairs Committee and McKeon is the 
     ranking member of the House Armed Services Committee.
       ``The VFW salutes the congressmen and their supporters,'' 
     said Tradewell, ``and I hope their messages were heard loudly 
     and clearly throughout Congress. Healthcare is important, but 
     so is protecting the programs that were promised to our 
     nation's veterans, military and their families,'' he said.
       ``Those serving in Iraq and Afghanistan should not have to 
     worry about their dependents' healthcare programs, but they 
     are today, and so are millions of military retirees, 
     veterans, survivors and children.
       ``Military service is based on the fundamental principle of 
     trust, and once lost, it is virtually impossible to regain,'' 
     said Tradewell. ``That is why I am urging the House to vote 
     `no' today, then go back and fix the bill with the language 
     proposed by Skelton, Buyer and McKeon, and then come back and 
     vote your conscience. Let's not rush to pass flawed 
     legislation that could tremendously impact our nation's true 
     heroes.''
                                  ____



                                   Disabled American Veterans,

                                   Washington, DC, March 20, 2010.
     Hon. Steve Buyer,
     Ranking Member, Committee on Veterans' Affairs, Cannon House 
         Office Building, Washington, DC.
     Hon. Buck McKeon,
     Ranking Member, Committee on Armed Services, Rayburn House 
         Office Building, Washington, DC.
       Dear Ranking Members Buyer and McKeon: On behalf of the 1.2 
     million members of the Disabled American Veterans (DAV), I am 
     writing to express our support for your amendment no. 31 to 
     H.R. 4872, the Reconciliation Act of 2010, and its associated 
     proposed legislation, H.R. 4894, ``to amend the Patient 
     Protection and Affordable Care Act to ensure appropriate 
     treatment of Department of Veterans Affairs and Department of 
     Defense health programs.'' You recently proposed these 
     measures to maintain the integrity of the health care systems 
     of the Department of Veterans Affairs (VA) and the Department 
     of Defense (DoD), and to ensure that the circumstances of all 
     persons covered by the VA or DoD health care systems meet any 
     minimum coverage requirements mandated by national health 
     insurance reform legislation now pending before Congress.
       As you know, over six million veterans, and particularly 
     war-disabled veterans, have come to rely on the Department of 
     Veterans Affairs (VA) health care system--a system 
     acknowledged by independent evaluators as one of the best 
     health care systems in America. Since national health 
     insurance reform legislation is under consideration in 
     Congress today, it is of vital importance to DAV and our 
     membership that the VA retain its autonomy to manage our 
     system to continue addressing the unique and specialized 
     needs of sick and disabled veterans. For this reason, we 
     support Congressional approval of the unambiguous language in 
     your amendment, that nothing in the health insurance reform 
     proposal, if adopted, could be ``. . . construed as affecting 
     . . . any authority under title 38, United States Code.''
       We also appreciate the proposed clarifying language related 
     to the bill's minimum insurance requirements. Under the 
     legislation that earlier passed both Congressional chambers, 
     persons covered by VA health care under Chapter 17 of title 
     38, United States Code, were deemed to have met the 
     individual requirement to possess acceptable health insurance 
     coverage. However, as you pointed out, additional VA health 
     care authorities are extant that are not a part of Chapter 
     17, including children of Vietnam and Korean war veterans who 
     contracted spina bifida, the benefits and care for whom are 
     authorized within Chapter 18; additionally, Chapter 31, title 
     38, United States Code--an authority that governs VA's 
     crucial vocational rehabilitation programs for service-
     disabled veterans, may be affected unless your language is 
     adopted by Congress. For these reasons, and to avoid other 
     potential problems that may be unintended but occur because 
     of the complexity of this reform legislation, we strongly 
     support your amendment as well as H.R. 4894, your bill to 
     clarify that ``minimum essential coverage'' includes all 
     persons covered under any part, chapter, or section of title 
     38, United States Code.
       Thank you for your continued efforts to ensure that the 
     rights of sick and disabled veterans are fully protected as 
     national health insurance reform legislation is considered by 
     the Congress.
           Sincerely,
                                                  David W. Gorman,
     Executive Director, Washington Headquarters.
                                  ____



                                          The American Legion,

                                   Washington, DC, March 20, 2010.
     Hon. Steve Buyer,
     Ranking Member, Committee on Veterans' Affairs, Cannon House 
         Office Building, House of Representatives, Washington, 
         DC.
       Dear Representative Buyer: The American Legion offers its 
     full support to the Buyer/McKeon Amendment to H.R. 4872.
       As the nation's largest veterans' service organization, The 
     American Legion is extremely concerned about the impact 
     health care reform will have on the Department of Veterans 
     Affairs (VA) and the Department of Defense (DoD) health care 
     systems. Throughout the discussion of national health care 
     reform, The American Legion and others in the military and 
     veterans' communities were reassured by both the 
     Administration and congressional leadership that both VA and 
     DoD beneficiaries would be exempted in any national health 
     care reform legislation.
       Both VA and DoD provide quality health care services and 
     should be considered earned benefits by virtue of honorable 
     military service. Therefore, the insurance premiums have been 
     paid in full, especially by those who are service-connected 
     veterans and military retirees. Moreover, it would be an 
     unfair hardship for any of these heroes to have to purchase 
     additional coverage because they do not meet the definition 
     for the minimum essential coverage that is in the current 
     legislation.
       Once again, The American Legion fully supports this 
     amendment and we appreciate your leadership in addressing 
     this critical issue that is important to America's service 
     members, veterans and their families.
           Sincerely,
                                                 Clarence E. Hill,
                                               National Commander.

  Ms. SLAUGHTER. Mr. Speaker, I yield myself 30 seconds.
  Democrats understand the importance of providing health care to 
veterans. We started it. The House passed a bill yesterday affirming 
our commitment to TRICARE and TRICARE for Life. And, in addition, the 
VA Secretary has stated that this health bill will not undermine 
veterans health care.
  I submit for the Record a letter from five committee chairs and a 
statement from Veterans Affairs Secretary Eric Shinseki.

                                Congress of the United States,

                                   Washington, DC, March 21, 2010.
     Hon. Louise Slaughter,
     Committee on Rules, The Capitol, Washington, DC.
       Dear Chairwoman Slaughter: The House Democratic leadership 
     asked our committees to review H.R. 3590 and H.R. 4872 to 
     assess the impact of the bills on the health care

[[Page 4127]]

     provided by the Department of Defense and the Department of 
     Veterans Affairs. Our reviews of H.R. 3590 and H.R. 4872 lead 
     us to believe that the intent of the bills was never to 
     undermine or change the Department of Defense and Department 
     of Veterans Affairs operation of their health care programs 
     or interfere with the care that our service members receive 
     under TRICARE. However, we commit to look into this issue 
     further to ensure that no unintended consequences may arise 
     and to take any legislative action that may be necessary.
       H.R. 3590, as drafted, does not specifically mention that 
     TRICARE coverage meets the individual responsibility 
     requirement, but such coverage would satisfy the requirements 
     of this bill. To affirm that this is the case, the U.S. House 
     of Representatives unanimously passed H.R. 4887, the TRICARE 
     Affirmation Act, which provides assurances to the American 
     people that care provided to those in the military and their 
     families, as well as military retirees under age 65 and their 
     families, would indeed meet the requirement for coverage.
       The members of our nation's military sacrifice much to 
     defend us all. We commit to these dedicated service members 
     and their families as well as our veterans that we will 
     protect the quality healthcare they receive.
           Sincerely,
     Bob Filner,
       Chairman, Committee on Veterans' Affairs.
     Ike Skelton,
       Chairman, Committee on Armed Services.
     George Miller,
       Chairman, Committee on Education and Labor.
     Sander Levin,
       Chairman, Committee on Ways and Means.
     Henry Waxman,
       Chairman, Committee on Energy and Commerce.
                                  ____


              Statement From VA Secretary Eric K. Shinseki

       As Secretary of Veterans Affairs, I accepted the solemn 
     responsibility to uphold our sacred trust with our nation's 
     Veterans. Fears that Veterans health care and TRICARE will be 
     undermined by the health reform legislation are unfounded. I 
     am confident that the legislation being voted on today will 
     provide the protections afforded our nation's Veterans and 
     the health care they have earned through their service. The 
     President and I stand firm in our commitment to those who 
     serve and have served in our armed forces. We pledge to 
     continue to provide the men and women in uniform and our 
     Veterans the high quality health care they have earned.
       President Obama has strongly supported Veterans and their 
     needs, specifically health care needs, on every major issue 
     for these past 14 months--advance appropriations, new GI Bill 
     implementation, new Agent Orange presumptions for three 
     additional diseases, new Gulf War Illness presumptions for 
     nine additional diseases, and a 16% budget increase in 2010 
     for the Department of Veterans Affairs, that is the largest 
     in over 30 years, and which has been followed by a 2011 VA 
     budget request that increases that record budget by an 
     additional 7.6%.
       To give our Veterans further assurance that health reform 
     legislation will not affect their health care systems, the 
     Chairmen of five House committees, including Veterans Affairs 
     Chairman Bob Filner and Armed Services Chairman Ike Skelton, 
     have just issued a joint letter reaffirming that the health 
     reform legislation as written would protect those receiving 
     care through all TRICARE and Department of Veterans Affairs 
     programs.

  I reserve the balance of my time.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request I yield to 
the gentlewoman from Kansas (Ms. Jenkins).
  Ms. JENKINS. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. Speaker, I rise today in opposition to the Motion to Concur in 
the Senate Amendments to H.R. 3590 and to H.R. 4872--Reconciliation Act 
of 2010. Over the past year, I have worked on and supported a health 
care reform plan that would bring down costs for families, address the 
issue of pre-existing conditions and improve availability of care 
without destroying what works in our current system. Today, it appears 
the Democrat majority will take an entirely different approach and I 
will not support that plan. A plan that increases taxes by nearly $570 
billion, a plan that cuts Medicare by more than $520 billion, a plan 
that increases premium costs for Kansas families by more than $2,100 
annually, and a plan that, according to the national commander of the 
Veterans of Foreign Wars, is ``betraying America's veterans.'' The 
American people want healthcare reform, but they do not want this bill. 
Kansans, and all Americans don't deserve this. They deserve much 
better. So, today, I pledge that as long as I am here, I will listen 
and fight for what Kansans want. Not the special interests. Not a 
President or a Speaker looking to create a legacy. Just Kansans.
  Mr. DREIER. Mr. Speaker, I yield 1 minute to the gentleman from 
Louisiana (Mr. Cassidy).
  Mr. CASSIDY. Mr. Speaker, I have been listening to my colleagues' 
comments. I have actually found some things to agree with.
  Ms. Slaughter mentioned that the American people have been lied to. I 
agree. They have been told that a policy which raises taxes for 10 
years to pay for 6 years of government programs is fiscally sound.
  I was struck, Mr. Speaker, that Mr. McGovern spoke of the small 
business owner in Massachusetts who couldn't afford his premiums. What 
he neglected to say is that Massachusetts has the same plan that we are 
about to implement. In fact, the Democratic treasurer of Massachusetts 
says that, ``If we implement this plan, we go bankrupt in 4 years.''
  I was struck, Mr. Speaker, by Mr. Hastings, who spoke how the people 
outside have lost hope. They have lost hope that Congress is listening. 
They are tired of being told, ``You are not smart enough to understand 
our wisdom. We, the Democratic leaders, will tell you how to live. And, 
after we pass this vote, you will love us all the more.''
  I am struck that Mr. Cardoza endorsed this, even though his State is 
going bankrupt from Medicaid and this program expands Medicaid.
  Mr. Speaker, I ask my colleagues to listen to the wisdom of the 
American people. Vote for their constituents, not for their leaders.
  Ms. SLAUGHTER. Mr. Speaker, I continue to reserve the balance of my 
time.
  Mr. DREIER. Mr. Speaker, may I inquire of the distinguished 
gentlewoman from New York how many speakers she has remaining?
  Ms. SLAUGHTER. Mr. Speaker, I have two speakers left.
  Mr. DREIER. Then I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield 1 minute to the 
gentleman from New York (Mr. Nadler).

                              {time}  1730

  Mr. NADLER of New York. This health insurance package, despite real 
inadequacies, deals with three basic problems:
  First, 45,000 Americans a year die because they lack health 
insurance. By extending health insurance to 32 million more Americans, 
this bill will save these lives. A vote for this bill is a vote to save 
45,000 lives a year. A ``no'' vote is a vote to acquiesce in these 
deaths.
  Second, 55 percent of all personal bankruptcies are caused by health 
care emergencies and 75 percent of people who file for bankruptcy 
because of a health emergency have insurance that proves inadequate 
when they get an expensive illness. By banning rescissions, banning the 
preexisting conditions insurance bar, banning annual lifetime caps, and 
by capping out-of-pocket expenses in new plans at $6,200 per year for 
an individual and $12,300 for a family, with lower caps for low-income 
families, this bill will ensure nobody goes broke because they get 
sick.
  Third, the Congressional Budget Office tells us this bill will reduce 
the deficit by $138 billion in the first 10 years and by $1.2 trillion 
in the next 10 years.
  Mr. Speaker, this bill is historic progress. We should embrace it.
  Mr. Speaker, make no mistake about it: the bill before us today is 
far from perfect. Like many of my colleagues in the House, I have 
outlined numerous concerns with the Senate-passed health insurance 
bill. And with good reason. The Senate-passed bill failed to include a 
public option, the best available way to refocus our misguided health 
care approach so that patients and doctors are put ahead of corporate 
bottom lines. It contained draconian provisions on so-called ``do-
gooder'' states like my home state of New York. It imposed a new 
restriction on a woman's access to safe, legal reproductive health 
care. And it included a disastrous excise tax that would have done more 
to cost people health coverage than it would to lower the cost of 
health insurance.
  After considerable struggle and intense negotiation, my colleagues 
and I were able to

[[Page 4128]]

ensure that ``do-gooder'' states like New York are not punished merely 
for taking a more progressive stance in the Medicaid system, turning 
what would have been a nearly $800 million loss in revenue to the State 
under the Senate-passed bill into a $2.1 billion net savings.
  We were also able to reduce the effect of the misguided excise tax, 
to remove special deals for specific states, to increase affordability 
credits, to close the Medicare Part D donut hole that ensnares 
thousands of seniors, and to include numerous consumer protections.
  And, even with these improvements, Mr. Speaker, the package before us 
today is not perfect. But I am reminded that, when our predecessors 
cast their votes in favor of Social Security in 1935, they passed an 
imperfect bill. And when they passed Medicare and Medicaid in 1965, 
they passed an imperfect bill. And in the years since those crucially 
important programs were signed into law, Members of Congress who have 
come after them have made--and will continue to make--vast improvements 
to those programs.
  Despite my concerns with the bill, our votes today mean something. 
Our votes today mean that 32 million more Americans will have access to 
health care coverage. Our votes mean that 45,000 Americans won't lose 
their lives each year because they are too poor to have health 
insurance or because their illnesses are too expensive. Our votes mean 
that the Medicare program will continue to provide important benefits 
to our seniors. And our votes mean that we will take a giant leap 
forward in our quest to ensure that all Americans have access to health 
care that they can afford.
  Mr. Speaker, I have spent much of my adult life fighting for 
universal health coverage. Today's vote doesn't end that fight. But we 
simply can't lose sight of how historic this moment is. That's why I am 
proud to cast my vote in favor of the Health Care and Education 
Affordability Reconciliation Act, a bill that will have immeasurable 
benefits for the American people for years to come.
  Mr. DREIER. Mr. Speaker, at this time I'm happy to yield for 
unanimous consent to the gentleman from Mississippi (Mr. Harper).
  Mr. HARPER. Mr. Speaker, I rise in opposition to this flawed health 
care bill.
  Mr. DREIER. Mr. Speaker, at this time I'm happy to yield for a 
unanimous consent request to the distinguished gentleman from Wisconsin 
(Mr. Sensenbrenner).
  Mr. SENSENBRENNER. Mr. Speaker, I rise in opposition to this flawed 
health bill.
  Mr. DREIER. Mr. Speaker, at this time I'm happy to yield for a 
unanimous consent request to the gentleman from South Carolina (Mr. 
Inglis).
  Mr. INGLIS. Mr. Speaker, I rise against this flawed health care bill.
   Mr. Speaker, the people of the Fourth District of South Carolina are 
sending a message to Washington. They do not want a ``cram down'' of 
this health care bill.
  Last week I received over 3,000 letters from my constituents stating 
their opposition to using reconciliation to pass health care reform. 
They spoke loud and clear to me during town hall meetings last August.
  I don't want this bill. The Fourth District does not want this bill. 
The American people don't want this bill. And many of my Democratic 
colleagues don't want this bill either.
  We need health care reform and we can work on a step by step 
approach. The American people want us to focus on creating jobs and 
fixing the economy, not implementing a massive new federal entitlement 
program. Mr. Speaker, let's throw out this bill and start working to 
grow the economy.
  Mr. DREIER. Mr. Speaker, may I inquire of the gentlewoman if she has 
any remaining speakers?
  Ms. SLAUGHTER. Yes, Mr. Speaker. I have one, and then time for me to 
close.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request, I'm happy 
to yield to my very good friend from California (Mr. Lewis).
  Mr. LEWIS of California. Mr. Speaker, I rise in opposition to this 
flawed health care bill.
  Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the last speaker on 
our side, except for closing, a valued Member--new Member of the 
House--the gentleman from Ohio (Mr. Boccieri).
  Mr. BOCCIERI. Her story took me to a place I hadn't been in a long 
time. I'm talking about Natoma Canfield, the face of this debate, who's 
sitting in a hospital room at the Cleveland Clinic right now, with no 
insurance, getting blood transfusions for the next 30 days. She doesn't 
have health care insurance because, in 2009, her rates increased 25 
percent. In 2010, her rates went up another 40 percent. Finally, she 
just couldn't take it as a single mom, so she dropped her health care 
insurance because she couldn't afford it.
  I remember as a young boy standing at my mom's bedside when she told 
me she had breast cancer. Luckily, my mom had good health care 
insurance. She survived and is alive today. But how many people do not 
have health care insurance and how would my life have changed if she 
did not make it? Where would I be? Would I have been able to go to 
college? Would we have been able to afford her treatment?
  Nearly 40,000 people in the 16th District do not have health care 
insurance, and 9,800 people live with preexisting conditions.
  I'll remind my friends on the other side who voted to send Tommy 
Thompson to Iraq with billion-dollar checks in hand to make sure that 
every man, woman, and child in Iraq had universal health care coverage: 
If it's good enough for Iraqis, it's good enough for Americans. Who are 
you going to stand with today; the insurance industry or Americans like 
Natoma?


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore. The gentleman is reminded to address his 
remarks to the Chair.
  Mr. DREIER. Mr. Speaker, for a unanimous consent request, I yield to 
the gentlewoman from Michigan (Mrs. Miller.
  Mrs. MILLER of Michigan. Mr. Speaker, I rise in opposition to this 
failed health care bill.
  Mr. DREIER. May I inquire of the distinguished gentlewoman from New 
York if she has any remaining speakers?
  Ms. SLAUGHTER. Absolutely not. Just for myself to close.
  Mr. DREIER. I yield myself the balance of my time.
  Mr. Speaker, we have obviously heard many, many, many stories of 
tragic situations--and we all have them--from our constituents across 
this great country, and it is absolutely essential for us to recognize 
that every single Member of this institution does, in fact, want to 
ensure that every American has access to quality, affordable health 
insurance. The contemporary writer and commentator, Dennis Prager, has 
said that the bigger the government grows, the smaller the individual 
becomes.
  Now, Mr. Speaker, it seems to me absolutely essential that we look at 
what it is that is before us. It is a $1.2 trillion bill that has 
$569.2 billion in job-killing tax increases. It has provisions that 
will hire 18,000--18,000--new Internal Revenue Service agents to police 
every one of the 300 million Americans--every one of the 300 million 
Americans--to ensure that they comply with the new mandate that is 
imposed by this measure.
  Now, Mr. Speaker, we have, as has been said, a plan that will have 
taxes and regulations for 4 years, and maybe--maybe--some benefits in 
the last 5 years of the decade. We believe that we can work in a 
bipartisan way to do a number of things that will immediately--
immediately, Mr. Speaker--reduce the cost of health insurance to ensure 
that every single American will have a better opportunity to have 
access to quality health insurance.
  We believe very fervently--and Mr. Cassidy has worked on this--that 
expanding health savings accounts will go a long way towards increasing 
access to quality health insurance. We know very well that pooling to 
deal with preexisting conditions is something that will play a role to 
ensure that those with preexisting conditions have their needs met.
  We know that we can drive costs down if we expand--expand--on 
associated health plans so that small businesses can come together and 
bring their rates down. And we know--we know, Mr. Speaker--that if we 
allow for the purchase of health insurance across State lines, we will 
create greater competition, ensuring that immediately our constituents 
will have access to quality, affordable health insurance.

[[Page 4129]]

  And, Mr. Speaker, we know, item number five, something we've sent to 
the other body but the Democrats blocked, and that is something the 
President also said he supported when he addressed the joint session of 
Congress, meaningful lawsuit abuse reform so that medical doctors do 
not have to engage in defensive medicine.
  Mr. Speaker, these are five commonsense proposals that we could 
address in a bipartisan way, I would hope, that will immediately--
immediately--bring the cost of health insurance down and not force 
every American to wait 4 years before they may have a benefit.
  Mr. Speaker, I urge my colleagues to vote ``no'' on the previous 
question and ``no'' on this rule and, if we get beyond it, vote ``no'' 
on the bill itself.
  I yield back the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, the question couldn't be more clear. You 
either believe in insurance reform, which will give a decent chance for 
health care for every American, or you simply believe in insurance 
companies.
  I urge a ``yes'' vote on the previous question and on the rule.
  Mr. HOLT. Mr. Speaker, I rise today to support the rule and the 
health reform package we are debating today.
  I am reminded of a previous time we voted on a Sunday: March 20, 
2005, when our colleagues on the other side of the aisle forced an 
extraordinary vote to intervene in the case of Terri Schiavo.
  Now, that is what a real government takeover of medicine looks like. 
That midnight vote was a grotesque legislative travesty. For 215 years 
it had been a solid principle of this country that Congress not get 
involved in life-and-death issues like the tragic case of Ms. Schiavo. 
Yet, on that Sunday, Congress broke with tradition and inserted its own 
judgment. On that Sunday, our colleagues on the other side of the aisle 
sent the message that it knew better than families, doctors, and 
hospital chaplains.
  The health reform package we debate today is not a government 
takeover; it is legislation that helps real people with real problems. 
It gives them more choice, more control, and more access to health 
care. One person this will help is a woman from Pennington, New Jersey. 
She called me yesterday to let me know her concerns that she would lose 
her job because of state budget cuts in New Jersey, which would mean 
that she would lose her health coverage as well. She told me her 
worries about finding affordable coverage while she looks for a new job 
and tries to keep food on her table. To complicate her situation, she 
has a pre-existing condition. This means that even if she could afford 
health care, it is possible she could be denied due to her pre-existing 
condition.
  I will vote for health reform to help middle-class Americans like 
her, who play by the rules and still find health coverage unreliable or 
totally out of reach.
  I urge my colleagues to vote in favor of this health reform package 
to give families and small businesses more control over their own 
health care.
  Mr. HONDA. Mr. Speaker, today I rise in support of health care 
reform. The other side of the aisle would have us believe that we need 
to wait longer to make health reform a reality. They don't want to make 
the sweeping changes that the American people KNOW we need to make.
  I cannot, we cannot, stand by and let this historic opportunity pass 
us by; the people of my district deserve more and better from this 
Congress.
  I say yes to tax credits and other assistance to 86,000 families and 
14,900 small businesses in my district. I say yes to coverage for 
22,500 uninsured residents. I say yes to protecting 800 families from 
bankruptcy due to unaffordable health care costs.
  I say yes to reform.
  All the other side is saying is no--to reining in health costs, 
controlling insurance companies who have proven over and over that they 
are willing to put profit over people's lives, to ending the confusing 
morass of paperwork and lack of transparency that drives doctors, 
patients, and hospitals to distraction and negatively impacts the 
quality of patient care.
  The opponents of this reform had their time--health reform was 
defeated in 1994 and they had a decade to change the system. People are 
still dying because they can't afford care. Doctors are still dealing 
with ever more complicated paperwork rather than healing people. Our 
public hospitals are reeling, and the number of uninsured continues to 
grow.
  We needed to act this weekend to step forward into the 21st century, 
make the hard choices, take the tough vote, and act in the best 
interests of our country. I am proud to vote in favor of health care 
reform.
  The material previously referred to by Mr. Dreier is as follows:

     Amendment to H. Res. 1183 Offered by Mr. Dreier of California

       At the end of the resolution, add the following new 
     section:
       Sec. 6. With respect to any demand for a record vote on the 
     motion to adopt H.R. 3590 or on final passage of H.R. 4872, 
     the Speaker shall use her authority under clause 3 of rule XX 
     to direct the Clerk to call the roll.
                                  ____

       (The information contained herein was provided by 
     Democratic Minority on multiple occasions throughout the 
     109th Congress.)

        The Vote on the Previous Question: What It Really Means

       This vote, the vote on whether to order the previous 
     question on a special rule, is not merely a procedural vote. 
     A vote against ordering the previous question is a vote 
     against the Democratic majority agenda and a vote to allow 
     the opposition, at least for the moment, to offer an 
     alternative plan. It is a vote about what the House should be 
     debating.
       Mr. Clarence Cannon's Precedents of the House of 
     Representatives, (VI, 308-311), describes the vote on the 
     previous question on the rule as ``a motion to direct or 
     control the consideration of the subject before the House 
     being made by the Member in charge.'' To defeat the previous 
     question is to give the opposition a chance to decide the 
     subject before the House. Cannon cites the Speaker's ruling 
     of January 13, 1920, to the effect that ``the refusal of the 
     House to sustain the demand for the previous question passes 
     the control of the resolution to the opposition'' in order to 
     offer an amendment. On March 15, 1909, a member of the 
     majority party offered a rule resolution. The House defeated 
     the previous question and a member of the opposition rose to 
     a parliamentary inquiry, asking who was entitled to 
     recognition. Speaker Joseph G. Cannon (R-Illinois) said: 
     ``The previous question having been refused, the gentleman 
     from New York, Mr. Fitzgerald, who had asked the gentleman to 
     yield to him for an amendment, is entitled to the first 
     recognition.''
       Because the vote today may look bad for the Democratic 
     majority they will say ``the vote on the previous question is 
     simply a vote on whether to proceed to an immediate vote on 
     adopting the resolution . . . [and] has no substantive 
     legislative or policy implications whatsoever.'' But that is 
     not what they have always said. Listen to the definition of 
     the previous question used in the Floor Procedures Manual 
     published by the Rules Committee in the 109th Congress, (page 
     56). Here's how the Rules Committee described the rule using 
     information from Congressional Quarterly's ``American 
     Congressional Dictionary'': ``If the previous question is 
     defeated, control of debate shifts to the leading opposition 
     member (usually the minority Floor Manager) who then manages 
     an hour of debate and may offer a germane amendment to the 
     pending business.''
       Deschler's Procedure in the U.S. House of Representatives, 
     the subchapter titled ``Amending Special Rules'' states: ``a 
     refusal to order the previous question on such a rule [a 
     special rule reported from the Committee on Rules] opens the 
     resolution to amendment and further debate.'' (Chapter 21, 
     section 212) Section 21.3 continues: ``Upon rejection of the 
     motion for the previous question on a resolution reported 
     from the Committee on Rules, control shifts to the Member 
     leading the opposition to the previous question, who may 
     offer a proper amendment or motion and who controls the time 
     for debate thereon.''
       Clearly, the vote on the previous question on a rule does 
     have substantive policy implications. It is one of the only 
     available tools for those who oppose the Democratic 
     majority's agenda and allows those with alternative views the 
     opportunity to offer an alternative plan.

  Ms. SLAUGHTER. I yield back the balance of my time and move the 
previous question.
  The SPEAKER pro tempore. The question is on ordering the previous 
question on the resolution.
  The question was taken; and the Speaker pro tempore announced that 
the noes appeared to have it.
  Ms. SLAUGHTER. Mr. Speaker, I demand a recorded vote.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this question will be postponed.

                          ____________________