[Congressional Record (Bound Edition), Volume 157 (2011), Part 1]
[House]
[Pages 180-183]
[From the U.S. Government Publishing Office, www.gpo.gov]




                         REPEALING HEALTH CARE

  The SPEAKER pro tempore (Mr. Fleischmann). Under the Speaker's 
announced policy of January 5, 2011, the gentleman from Kentucky (Mr. 
Yarmuth) is recognized for 30 minutes.
  Mr. YARMUTH. Thank you, Mr. Speaker, and congratulations on your 
election.
  It's a great pleasure to be here today. I could spend the next half 
hour responding to my colleague from Iowa. I think it's fascinating 
just that one comment, that he talks about reading the Constitution and 
then talks about how this is an unconstitutional bill. Well, obviously, 
he apparently stopped at article II and didn't get to article III, 
which stipulates that the judiciary and the Supreme Court ultimately 
decide what is constitutional in this country, not Members of Congress.
  The Constitution was read today. I'm glad it was. It's always good to 
remind ourselves of this great foundational document that we all 
respect, that all of us--all 435 Members of the House--swore to protect 
and defend yesterday.

                              {time}  1700

  In the Constitution, in article I, section 5, it says each House may 
determine the rules of its proceedings. Yesterday, the Republican 
majority in the House put forth a group of rules changes that will 
determine how this Congress will operate over the next 2 years.
  It was fascinating, in light of our discussion about health care, in 
light of our discussion about the costs of health care, that one of the 
things it did, these rules changes that Republicans passed, was 
basically to vest extraordinary power on one Member of the House of 
Representatives to determine essentially what the cost, what the 
deficit or the debt, the budget implications on a particular piece of 
legislation might be, and the relevance of this to the debate we are in 
now about the Republicans' proposal to take away all of the privileges 
of rights and benefits granted by the Affordable Care Act that we 
passed in the 111th Congress and that I was proud to support.
  One of the things that it said was, if there is a vote to repeal the 
health care bill, the Affordable Care Act that we passed last year, 
that we basically decide that we don't have to abide by PAYGO rules--in 
other words, saying that, just because the Congressional Budget Office 
determined that the Affordable Care Act will save the taxpayers $230 
billion over the next 6, 7 or 8 years and then another $1 trillion in 
the following 10 years, we don't have to make the same kind of 
adjustments that we do for other kinds of additional expenditures. The 
Republican philosophy is, if you reduce revenues in any way to the 
government, that's fine; and it doesn't affect the deficit.
  Now, a lot of the debate we had in the last Congress over the health 
care act I heard time, after time, after time, and we heard this with 
tax cuts and many other things: oh, a business can't operate like this. 
A family can't operate like this. Well, in fact, I think, in this 
particular case, that analogy is really relevant because, if I have a 
family, a two-income family, and all of a sudden one of us loses our 
job and loses our income, it's really interesting that we could take 
the position that, oh, it didn't affect our budget, and it didn't 
affect the family deficit. Just that loss of revenue didn't matter. All 
we're concerned about is how much we spent. All we're concerned about 
is the expense side.
  What the Republicans have basically done under this new regime, with 
this new set of rules that they passed yesterday, is to say that there 
are two separate ledgers--one dealing with expenditures, one dealing 
with revenue--and that they don't affect each other. It is an 
astounding philosophy of operation that we are about to embark on.
  Under this new rule, when the Bush tax cuts for the very wealthy 
expire in 2 years, we would not have to account for that loss in 
revenue to the Federal deficit even though, when we start writing 
checks and we start trying to borrow money to pay for the deficit, we 
are going to have to come up with that money. They say, no, it doesn't 
affect the deficit.
  If we repeal the Affordable Care Act, which the CBO says will save 
$1.3 trillion over the next two decades, that's money that we aren't 
going to have to borrow from somebody else. They say, oh, that's not 
part of the budget. We don't have to compensate for that.
  So it's fascinating that they basically set up these two sets of 
books, and now they give the power to the chairman of the Budget 
Committee, who in this case is Mr. Ryan of Wisconsin--a very 
thoughtful, honest man. You give him the power, however, to make a 
decision that whatever the CBO says doesn't matter. He can deem, or 
decide, exactly what the impact of any provision or any act of Congress 
is on the budget. One person.
  Now, I come from Kentucky. We're a big basketball State. Last week, 
we had a game, a big-game rivalry. Kentucky and Louisville played. It 
didn't come out the way I would have liked it to. But I had to think, 
when we set up these rules, that would be like Louisville and Kentucky 
playing and saying to Coach Pitino of Louisville or Coach Calipari from 
Kentucky, You get to make all the calls in this game. Our players are 
going to play. They're going to compete hard, but Coach Pitino, we're 
taking the refs off the field. You're the one who's going to call 
fouls. You're going to make all the decisions.
  That's basically what the Republicans have done.
  What they also said and decided in this process is that the health 
care reform bill--changing it, repealing it--will have no impact on the 
deficit, no impact on the budget. That's fascinating because, for the 
last year and a half, when we debated the Affordable Care Act, they 
kept talking about how this was going to balloon the deficit, how it 
was going to explode the deficit. Trillions of dollars it was going to 
cost the American taxpayer. Well, now they say, No, it has no impact at 
all on the deficit because you have to understand, if it costs nothing 
to repeal it, then there was no cost to passing it.
  So one has to question who has been honest in this debate. Who has 
been honest in this debate?
  I understand that finding referees as to who is right and who is 
wrong and what facts are salient and which facts are accurate has been 
a difficult process. My colleague Mr. King said that, you know, all of 
a sudden, we keep talking about this, and expect a liberal light to go 
on in people's heads. Well, we need some light on this subject because 
there have been billions and billions of dollars spent to create 
darkness about the impact of this bill, and that process proceeds 
today.
  So I think, as we debate this proposal of the Republicans to do away 
with many of the benefits which we are so proud of and which millions 
of Americans are beginning to feel now, we should have the kind of 
discussion that is honest, that is open, and that sheds light on the 
subject. No one can do that better than my colleague from the great 
State of Maryland, Donna Edwards.
  Ms. EDWARDS. Thank you for yielding, Mr. Yarmuth.
  You know, as I listened to this discussion, I thought, I wonder what 
taxpayers are thinking about with this discussion. I wonder about those 
taxpayers who go to work every day but who, through no fault of their 
own,

[[Page 181]]

can't afford to buy health insurance even though they work every day 
and they pay taxes every day.
  I thought, well, under the Affordable Care Act, indeed, for those 
people, we get to, you know, put a little bottom under them so they can 
be covered, so they can, you know, go to work and take care of their 
families and can also have the security of knowing that their families 
are going to be covered with health care.
  I thought about the discussion earlier on this floor where our 
colleagues on the other side of the aisle talked, you know, somewhat 
disparagingly of the young people who maybe finish college or trade 
school and go to get jobs, but there is a gap in health care coverage 
because they've turned 22 or 23 years old. They're working for a 
living, doing what they need to do. They've gone to school. They've 
gotten trades, maybe, and they can't afford health care coverage. So 
their parents get to say, You know what? For all of our peace of mind 
and for your security, we're going to, you know, pay for that health 
care coverage under our plan.
  Mr. Speaker, as I stand here today, I think about my son, who has 
just gotten a job. There was this period, and I remember when I 
received that notice from our health insurance company. That notice, 
you know, was a shocker to me because it basically said, You're done.
  Had we not had this provision in the Affordable Care Act that enables 
parents like me and other parents around the country to have the peace 
of mind of being able to keep our children, our young people, our young 
working people on our health care plans, I don't know what working 
families would do out there.
  Mr. Speaker, I thought also about a conversation that I'm going to 
share with you, a conversation with some seniors that I had, as I was 
spending New Year's Eve with friends. One of the seniors said to me, as 
we were talking about health care, You know, I have a medical 
condition. I'm spending thousands of dollars, and I've fallen into the 
doughnut hole, and it is really taking a chunk out of our pocket.
  I had the privilege on December 31 of saying to this family, Do you 
know that, as of January 1, as of the next day, in 2011, your 
prescription drug that has fallen into that doughnut hole will actually 
receive a 50 percent discount?

                              {time}  1710

  They had no idea. I was glad to be able to share it with them. 
They're not my constituents. They live in somebody else's State, but 
it's great to be able to share that with them. And that's the 
experience many of our seniors all across the country are having right 
now as they realize that they won't have to bear the burden of out-of-
pocket costs for prescription drugs that fall through a doughnut hole 
because they can't afford it anymore. Their young people will be able 
to be covered until they're 26. If you experience domestic violence in 
a handful of States, that's a preexisting condition. Guess what? 
Insurance companies will no longer, as we move into the implementation 
of our health care reform bill, be able to call that a preexisting 
condition.
  And so I will close and allow you some additional opportunity in your 
time, but I do want to say that it was really compelling to read the 
Constitution here on the floor of the House of Representatives today, 
and again, a very important reminder of our obligation as elected 
officials to look out for the general welfare of the people, and I can 
think of no better way to do that than making sure that we protect the 
health insurance, the health care that Americans have been guaranteed 
because of what we were able to accomplish with the Affordable Care 
Act.
  Mr. YARMUTH. I thank the distinguished Congresswoman from Maryland 
for her comments, and I'm actually kind of glad that Congressman King 
brought up these major benefits which are now helping families across 
this country.
  Ms. Edwards talked about the benefit of adding your son or daughter 
under 26 to your policy, and Mr. King basically pooh-poohed that--I 
don't know if that's exactly a good legislative term, but kind of 
ridiculed that. And then he talked about lifetime limits and how 
lifetime limits were not necessarily something that we should worry 
about in spite of the fact that almost a million Americans a year, 
historically, over the last few years, have gone bankrupt because they 
either had no insurance or their insurance was inadequate and they lost 
everything they had because of health care costs, because of a cancer 
diagnosis or serious accident. These are real-life stories. These are 
not abstractions.
  And I understand that we have many colleagues on the other side of 
the aisle who believe, with almost a religious zeal, in certain things 
like the perfection of the marketplace, in spite of the fact that we've 
seen time after time after time in this country, not too long ago with 
the financial system, how our markets often fail, how we have created 
or allowed to be created enormous sources of power and concentrations 
of economic power in this country that have basically distorted the 
marketplaces, and that is very, very true in the area of health 
insurance.
  We have many, many States in which one company, one company, one 
insurer will dominate the insurance market, 85, 90 percent of the 
insurance in that State sold through one insurance company. That is not 
something that the drafters of the Constitution envisioned. So it's 
nice to believe in free market principles--and I think Democrats 
believe in free market principles as well as Republicans do--but the 
fact is, in real life, not in a history philosophy book or political 
science philosophy book, in real life markets fail, markets get 
distorted, and that is when the government is responsible for 
protecting the general welfare of the population as the Constitution 
says.
  Because we've been joined by another colleague, we want to return to 
this issue of rules because, again, the budgetary rules that the 
Republicans have set up to govern this next Congress are creating some 
incredibly difficult situations for our States, our localities, and our 
people. And one of those areas in which this has been particularly 
true--and I know I've been contacted by transportation officials in 
Kentucky about how dangerous they think these new rules may be, and Joe 
Courtney from Connecticut has joined us to talk about that implication 
of the new rules that we are going to be operating under.
  So I yield to gentleman from Connecticut.
  Mr. COURTNEY. Thank you, Mr. Yarmuth, and I appreciate the fact that 
you are putting the spotlight on this issue which is really 
extraordinary in terms of what's just happened in the last 24 hours.
  As you know and as Congresswoman Edwards knows, the real workhorse 
infrastructure transportation funding in this country is the highway 
trust fund. That is a mechanism which was set up by the Congress. It 
has a dedicated revenue source, gas taxes, and since 1998, there has 
been a rule which the Congress has operated under which says that the 
5-year transportation plan authorized by the Congress cannot be 
tampered with by a bill that's brought to floor of the House. If it is, 
then that bill is ruled out of order. And the purpose of that is to 
make sure that the transportation plan, which is done on a 5-year 
increment, has sanctity, has consistency so that State DOT's like yours 
in Kentucky or Maryland or Connecticut can actually move forward on 
multiyear projects which, of course, most road construction, bridge 
construction falls into that timeline.
  Well, you know, this has been the operating rules of the House since 
1998. Yesterday, the Republican rule which was adopted astonishingly 
rescinded that protection in terms of procedure for the transportation 
trust fund, again, the mechanism which ensures that States get 
appropriate funding for highways.
  So a coalition grew up over the last 3 days, including Laborers' 
International Union, Ironworkers, the U.S. Chamber of Commerce, the 
American Trucking Association, the Motorcycle Riders of America, people 
who actually care about making sure that our roads

[[Page 182]]

and bridges have the adequate support to make sure that, again, as a 
growing country we are going to be able to move people and goods from 
one place to the other in appropriate fashion.
  By the way, our competitors around the world are moving past us at 
Mach speed in terms of their transportation infrastructure investment.
  Nonetheless, this coalition warned the new majority that this new 
rule was going to upset, again, the consistency which transportation 
funding requires. The new majority went ahead with that rule, adopted 
it, claims that they, in fact, were not doing that to the 
transportation trust fund, but interestingly, the markets say 
otherwise.
  UBS-PaineWebber issued a downgrade to transportation construction 
companies on the Wall Street stock exchanges, and their stocks declined 
yesterday in the wake of the adoption of this rule. And again I, 
earlier today, submitted press accounts that describe, in fact, the 
sequence of what actually happened.
  We are talking here about a sector of the U.S. economy that's not in 
a recession; it's in a depression. The construction trades right now 
are looking at unemployment rates of 25 percent. Rather than shrinking 
and inhibiting the transportation and infrastructure of this country, 
we should be investing in it. And let's be very clear here. There is 
not going to be any private investment that's going to fill the gap 
that's being created by undercutting the sanctity of the highway trust 
fund.
  The fact of the matter is this is done through public dollars, and 
every generation going back to, really, Jefferson has understood that 
this is essential to have an economy that can actually thrive and grow. 
And as I said, we have now left the highway funding of this country 
subject to the whims of the annual appropriations process. That is not 
the type of horizon in which planning can actually take place at State 
DOTs, and it doesn't surprise me that the folks in Kentucky have 
contacted you. The people at DOT in Connecticut have certainly done the 
same, and all across the country. Again, management, labor, public 
sector groups that care about highways, they are just incredulous, 
particularly at this time with the weakness of this economy, that this 
House has adopted that type of rule.
  Mr. YARMUTH. I thank the gentleman.
  And reclaiming my time, the analogy I used earlier was with families, 
and we all know we're in a difficult budgetary situation. We know we're 
running huge deficits right now, and we know that the money that we are 
spending, a large portion of it we are borrowing because tax revenues 
can't support it. This Republican majority now has basically taken the 
position that they're going to strangle this government and put a cap 
on expenditures. And certainly I understand that's part of their 
honestly held philosophy, but if you're a family and you've got two 
kids high school age and two income earners, one of them loses their 
job, are you going to then say under no circumstances am I going to 
borrow money to help pay for the college education of my two teenagers 
so they can have a better life and they can be prepared to meet the 
demands of the future; I'm just going to keep cutting expenses?

                              {time}  1720

  And that analogy seems to be working here, particularly with regard 
to transportation as well and the investment that we have to make.
  Mr. COURTNEY. That's right. And families make that decision to make 
capital investments along exactly the same lines, whether it's to fix a 
roof, you know, put a new driveway in, buy a house. Again, that's done 
through financing, debt financing. And it's, again, the way that 
particularly the middle class kind of deals with those challenges. But 
there's no question that in terms of our own country's history, going 
back in time, again, even to the beginning of our government, even 
during the Civil War when the finances of this country were completely 
going from almost day to day, Abraham Lincoln did not pull back in 
terms of the need for us to invest in rail, land-grant colleges.
  Again, this was in the middle of the worst conflict in the history of 
this country, but yet he still saw the need for us, as a Nation, to 
still continue to invest in the future, and we borrowed funds. Because 
those types of investments, investing in people through education or 
investing in infrastructure comes back to benefit the economy long 
term, and the multiplier effect is much higher than the actual pricetag 
of those initial investments.
  Mr. YARMUTH. I thank the gentleman. Again, I go back to these rules 
that have been adopted now in the House, and they basically give 
extraordinary unprecedented power to one person to set these budget 
limits to decide the budgetary impact of an investment in 
infrastructure or a health care law, the repeal of a health care law 
or, for instance, the repeal of many of the advances we made in terms 
of education funding during the 111th Congress.
  And it seems to me that, as I read through the Constitution, the 
Founding Fathers probably didn't anticipate that we would basically 
disenfranchise 434 Members of Congress in making these incredibly 
important decisions about how we raise revenue, which is specifically a 
power that has been given for initiation to the House of 
Representatives, or to spend tax revenue, that that kind of power would 
vest in one person and that you would set up a set of rules that sets 
up two sets of books and say, If you drop revenue, if you cut taxes, if 
you have a loss in revenue, that has no budget implications; but 
everything you spend has to be offset somewhere along the line.
  And I think in terms of not just investment in infrastructure but 
also investment in research, medical research which probably is the 
real answer to our long-term health care financing costs. If we can 
control or cure diabetes and cancer and make an impact on heart 
disease, these are the things that are really going to help us in the 
future. But to set up these kind of rules which basically, again, 
disenfranchise not just 434 Members of Congress but, in the process, 
virtually every American citizen from the process of deciding what 
money should be spent and invested in some very, very important aspects 
of the general welfare.
  And I would like to yield to the gentlewoman from Maryland, Donna 
Edwards.
  Ms. EDWARDS. I thank the gentleman for yielding. And it occurred to 
me as we heard this discussion--and thank you to Mr. Courtney for 
raising these issues with us, Mr. Speaker. Because it occurred to me 
that while we should be spending our time focused on job creation--and 
we know that a core for job creation for the 21st century for this 
country is in our investment in our transportation infrastructure, 
really putting people back to work. And instead, we are relitigating 
what the American people thought we had finished with--health care.
  So here we are with a rule that then says to us, Even as the 
bipartisan debt commission has said that we need to invest in the 
Nation's infrastructure--those are investments that create jobs, jobs 
where taxpayers are paying into the system so that we have revenue, so 
that we can invest in our infrastructure--that we are going to be 
constrained from doing it. And I am reminded that in the last Congress, 
in the 111th Congress, every Member, I believe, of our Transportation 
and Infrastructure Committee wrote to the President of the United 
States saying, We need to do a long-term transportation and 
infrastructure bill so that our States can begin to really put people 
back to work. And here we are in the 112th Congress, led by the 
Republicans who have put forth a rules package that will constrain our 
ability to create jobs in this country.
  Mr. YARMUTH. I thank you for that contribution. And we've also been 
joined by the gentleman from Tennessee, Congressman Cohen, and I would 
like to yield to him.
  Mr. COHEN. Thank you, Mr. Yarmuth.
  Indeed, the issues that Mr. Courtney brought forward in his 1 minute 
today

[[Page 183]]

were alarming to me because my hometown of Memphis depends upon 
transportation. That's what makes it America's distribution center, the 
roads, the rivers, the runways, and the rails. And if we don't have 
moneys to go into helping our airports--where Federal Express is 
located in my district, and in your district, Mr. Yarmuth, UPS--because 
that's how we move products all over the world. From those hubs, we 
move commerce. And that is why it's so important that we have an FAA 
Reauthorization Act passed, a lot of which would be expenses to 
modernize the structure and the transportation bills that Mr. Oberstar, 
who was one of the great Members of this House but is no longer a 
Member, tried to get passed last year to both stimulate the economy in 
the short run and in the long run, as Mr. Courtney said, with that 
multiplier effect by creating jobs. It's roads that take goods to 
market, that move commerce, that move raw materials. And I was hoping 
and do hope that we will have bipartisan efforts to have 
transportation, FAA reauthorization bills pass that will move this 
economy forward.
  The economy is still in a difficult spot, and we can't really see 
that the economy is improving if we continue to cut spending, 
particularly in places such as transportation, infrastructure, and the 
airport infrastructures. That's so important. So it was distressing 
news to see this happen.
  It is difficult to see how we can get ourselves out of this near 
depression that was caused by the Bush administration with cutting 
spending. I know Paul Krugman has people who don't think he is correct 
all the time. I happen to think he is correct most of the time. And the 
Nobel Prize people aren't always correct. But when they gave him the 
Nobel Prize for economics, some of the brighter people in the world 
thought he was pretty good on economics. And it's his belief that we 
need to do more spending, and I concur with him. I would hate to see us 
lead this economy--it's about to get out of the ditch--put it back in 
the ditch.
  Mr. YARMUTH. I thank you for that.
  As we wind down, pursuing the analogy with families and also with 
small businesses, I mean, people legitimately borrow money, and 
businesses legitimately borrow money for two reasons. One is for 
survival, to eat, to pay salaries if you are a small business. And they 
borrow money for investments. We have plenty of investments that we can 
make in this country that are desperately needed. Infrastructure being 
one, education being another, medical research being a third category.
  And we basically have been told by the Republicans that there is no 
basis, no justification for spending any more money. And because we're 
in a deficit situation, borrowing more money--except when it comes to 
giving tax breaks for very, very wealthy Americans, millionaires, 
billionaires hedge fund managers, and the like, that's okay. We can do 
that, and we can balloon the national debt to do that, but we can't do 
it to help people, to provide people's health care, to invest in needed 
infrastructure, to invest in the things that will make this American 
economy the kind of economy that we will all be proud of, that will 
work for everyone, that will truly live up to the ambitions of the 
Founding Fathers when they wrote the Constitution that we read today, 
to create a more perfect union. That's what we are all about. And we'll 
continue, as Democrats and now as Members of the loyal opposition in 
this body, anyway, to fight for the kind of balanced and intelligent 
investment and restraint of spending that will get us to the world that 
we all envision.
  So I thank my colleagues for joining me today.

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