[Congressional Record (Bound Edition), Volume 157 (2011), Part 4]
[House]
[Pages 5906-5912]
[From the U.S. Government Publishing Office, www.gpo.gov]




                 THE BUDGET AND THE AFFORDABLE CARE ACT

  The SPEAKER pro tempore (Mr. Schweikert). Under the Speaker's 
announced policy of January 5, 2011, the gentleman from California (Mr. 
Garamendi) is recognized for 60 minutes as the designee of the minority 
leader.
  Mr. GARAMENDI. Mr. Speaker, today we have seen a remarkable event 
here on floor of the House. During this discussion that's so critically 
important to this Nation about the deficit and how we are going to deal 
with our budget, this House passed a bill that will actually increase 
the deficit, a bill passed today with the support of the Republicans to 
repeal a provision in the Affordable Health Care Act that will keep 
Americans healthy.
  Healthy Americans don't need medical care, and I suppose the idea of 
the Republicans here is that they ought to get sick. You take a look at 
the wellness issue, part of the Affordable Care Act, it provided for 
numerous activities specifically designed to keep Americans healthy: 
blood pressure screening for adults, programs for children to avoid 
obesity, public health programs for vaccination so that our children 
and, indeed, our adults don't get sick. All of these programs in the 
wellness portion of the Affordable Care Act would be repealed by the 
action that the Republicans just voted on not more than a half-hour 
ago.
  What in the world is going on here? What's this all about? Is it some 
sort of ideological spiritual thing to do what is not very smart?
  The Affordable Health Care Act, which they like to call ObamaCare, 
has many, many provisions in it specifically designed to reduce the 
cost of medical care in America. If you are going to deal with the 
deficit, and we all talk about it here, you have got to deal with the 
cost of Medicare.
  How do you deal with the cost of Medicare? Well, you deal with it by 
reducing the likelihood that seniors will get sick. You deal with it by 
reducing high blood pressure in seniors so they don't have strokes. One 
of the most expensive things that the senior population will endure is 
a stroke. It's not

[[Page 5907]]

just the immediate medical care; it's the long-term effect of a stroke. 
So when we go out and we try to have seniors and those soon to be 
seniors have blood pressure checks, we reduce the cost of medical care 
in America. But I guess the Republicans don't see it that way.
  They also see it in another way, and that is somehow they believe 
that we can reduce the cost of medical care in the Federal budget by 
terminating Medicare. It is unbelievable that the Republican budget 
would terminate medical care for seniors by terminating Medicare, a 
program that was started in 1964 to deal with the specific problem that 
seniors had at that period, and that was the inability to afford 
medical services. They would literally be into bankruptcy and poverty 
because they couldn't pay for their medical care.
  So, in 1964, Lyndon Baines Johnson and the Democrats in this House 
and the Senate passed Medicare, one of the foundations of support for 
the senior population in this Nation. And yet in the Republican budget 
that will be on this floor later this week is the repeal of Medicare, 
the termination of it.
  So I suppose this is the new way we ought to look at this issue. It's 
a tombstone. And what it is, it said, Medicare, 1965 to 2011, created 
by LBJ, destroyed by the GOP. Unbelievable.
  Fortunately, today, when President Obama spoke to the Nation, he 
addressed this issue, and I will paraphrase what he said. He says it 
more as a professor. I guess I will just say it as a street fighter 
from California: No way, no how will, in his Presidency, Medicare be 
terminated.
  Are you listening my friends on the Republican side? The President 
said ``no.'' We are not going down the path of terminating Medicare.
  And I know that my caucus, the Democratic Caucus, will stand there 
with the President. We will fight any attempt any time, anyplace, 
anywhere that you or anybody else will put before this House a proposal 
to terminate Medicare. We will not allow it, and thankfully the 
President has the veto pen. He ought to go back and pull out the pen 
that LBJ used to sign the Medicare law in 1965 and put it to paper 
should, somehow, the Republican budget arrive on his desk with the 
termination of Medicare in it. It should not happen. It cannot happen. 
We cannot subject our seniors to the kind of poverty that existed prior 
to the implementation of Medicare in the 1960s. This is something that 
we will stand and fight on.
  The President had also said today, as he laid out his solution for a 
$4 trillion reduction in the deficit, do not terminate Medicare and 
don't privatize Social Security. Laying it down. Not a line in the 
sand, but clearly a mark on the concrete. Social Security will not be 
privatized during his watch.
  Thank you, Mr. President. And you know this, that the Democratic 
Caucus in this House will stand firmly with you, and we will fight 
every, every bill, every proposal to privatize Social Security.
  Now, we know there is a budget problem. We know that there is a 
deficit problem here in the United States, and we know that it has to 
be addressed. The President has laid out two chapters in the Democratic 
proposal to deal with the deficit.
  In his State of the Union speech, he made it clear that Federal 
expenditures needed to be frozen over the next 5 years, and today he 
took another step recommending specific reductions in various Federal 
programs, all to the good, and we will stand there with him and we will 
work on reducing those Federal expenditures.
  For me, I have got one in mind, about $120 billion a year that we 
could save, $120 billion a year. Now, that's four times, three and a 
half times what is in the Republican continuing resolution that will be 
on floor this week.
  How do you find $120 billion a year? End the war in Afghanistan. End 
the war in Afghanistan. Bring the troops home. Bring the money home. 
Balance our budget. Use that to solve the deficit, or spend that money 
on building those roads, those facilities here in the United States.

                              {time}  1800

  Let's talk about the deficit for a moment. Oh, yes. If you're going 
to talk about the deficit, you really ought to understand where the 
deficit came from. It didn't just come out of the blue this year. It 
didn't just appear during the Obama administration. The deficit is 
something that has built up over a long period of time here in the 
United States. When they say the deficit is $14 trillion and is going 
to increase, well, it's not if the President and the Democrats get 
their way. It will actually be reduced by $4 trillion.
  However, as to the current deficit, where did it come from? From 
where did it magically appear? Who left us with huge deficits?
  Let's take a look. Here are the facts.
  This fellow over here, you may recognize him. He is Ronald Reagan. At 
the end of every year, the Congressional Budget Office makes an 
estimate of what is going to happen over the next 10 years. At the end 
of the Ronald Reagan period, his last year in office, the Congressional 
Budget Office, the nonpartisan Congressional Budget Office, made an 
estimate of the Federal budget situation. Where's the deficit? They 
estimated that, in the next 10 years, Ronald Reagan's budget and the 
programs that were put into effect during his period would create a 
$1.4 trillion deficit.
  Now, those of you who are familiar with the history of the United 
States would know that George H. W. Bush--the senior--followed Ronald 
Reagan. At the end of his 4 years in office, again, the Congressional 
Budget Office made an estimate. It estimated, should the Bush-Reagan 
policies go forward, the deficit would be $3.3 trillion in the out 
years.
  Then along came Bill Clinton. In the first 4 years of his 
administration, Bill Clinton put in place, if extended forward, 
policies that would deal with the deficit, such things as PAYGO--a word 
that's common in Washington, but I'm sure, out there in the great 
American public, people have no idea what ``PAYGO'' is. ``PAYGO'' was 
the law during the Clinton administration. It required that any bill 
passed by Congress had to be paid for with either higher taxes or cuts 
in some other program. In other words, it could not create a deficit. 
It could not add to the deficit.
  There were other programs put in place, part of which I was 
responsible for implementing, and that was the reinventing of 
government. I was the Deputy Secretary at the Department of the 
Interior during those years, and we were told by the Clinton 
administration's Office of Management and Budget that you will reduce 
the expenditures of the Department of the Interior, and you will 
continue to do the same things. Only, you will do them better. 
Effective and efficient government. We reduced the number of employees 
in the Department of the Interior during those first 4\1/2\ to 5 years 
by some 15,000 people--from 90,000 to 75,000 people. We performed all 
of the previous services as well and, in many cases, better. So it is 
possible to be efficient and effective in this process.
  Anyway, Bill Clinton is now President, and he puts all of these 
policies in place. At the end of his Presidency, the Congressional 
Budget Office did what it always does, which is to produce an estimate 
of what would happen in the next 10 years if the same policies were to 
continue. Guess what would happen. What would happen is a $5.6 trillion 
surplus, enough to wipe out all of the American debt--no debt, no 
interest payments, everything paid off.
  However, Bill Clinton was followed by George W. Bush, and 
immediately, in the very first year of the Bush administration, the 
Clinton-period policies, some of which were voted on by Republicans as 
well as Democrats, were terminated. Massive tax cuts were put in place 
not only in year one but in year two. Two wars were started--the 
Afghanistan war and the Iraq war--neither of which were paid for. It 
was the first time in American history that wars were not paid for but 
were, rather, borrowed. Who did we borrow the money from? China. From 
other foreign countries? Yes.
  Anyway, you now had two massive tax cuts, two wars, and then the 
Medicare drug program, which was about

[[Page 5908]]

$700 billion a year--not paid for but, rather, borrowed, not for 1 year 
but for every year on into the future.
  Thirdly, there was a whole set of policies where the government 
simply stepped back and let Wall Street do whatever it wanted to do. 
What it wanted to do was to engage in reckless profiteering, resulting 
in 2007 and 2008 with the crash of the American economy, with the Wall 
Street crash of 2008, bringing the American economy to its knees, to 
the greatest recession since the Great Depression. Those policies added 
up to this rather massive red zone here of $11.5 trillion of deficit, 
estimated by the Congressional Budget Office, the nonpartisan 
Congressional Budget Office, which projected in the next 10 years, if 
the same policies continued, an $11.5 trillion deficit.
  President Obama came into office in January of 2009. The day he 
arrived in office, the budget had a $1.3 trillion hole in it. He didn't 
create it, but he had to deal with it--a $1.3 trillion deficit handed 
to him by George W. Bush and his policies.
  That's the history. Now we're trying to dig ourselves out of that 
hole. Properly said, when you're in a hole, stop digging. A wise 
policy. The President couldn't do that, and this Congress couldn't do 
that in the face of the most serious financial and economic crisis this 
Nation had faced since the Great Depression. So the stimulus bill was 
enacted, some $750 billion, and it worked. Despite all the rhetoric, 
the economists looking at that today, in the cool memory of the 
stimulus bill, said it worked; it saved this economy; it saved this 
Nation.
  Every other industrialized country in the world did the exact same 
thing--stimulated their economies. Together, the American and the 
international economies were stabilized, and we began to slowly grow 
out of that great recession. We're not out of it yet. We've got to put 
in place policies that end the deficit, and that's precisely what the 
President talked about today.
  The Republicans have put a proposal before us, and we'll vote on it 
this week, but it is not a proposal that will help America retain its 
eminence as the most dynamic, the most creative, the most innovative, 
and the most successful economy in the world, because of the policies 
that are in it. It will terminate Medicare, and it will significantly 
reduce those programs that create future economic growth.
  I would like to just take a deep breath now and turn it over to my 
colleague from the great northeastern part of the United States.
  Peter, would you join us and carry on this discussion.
  Mr. WELCH. Yes, thank you. I appreciate your historical perspective 
on it.
  There are really two things that I want to address. Number one: What 
are the policies that were part of getting us to that $11.5 trillion 
deficit? Number two: What do we need to do now in order to get to 
fiscal balance?
  The two policies were, one, a war of choice where the Pentagon in its 
activities was not subject to the same scrutiny of actually having to 
pay as you go, so the cost of the war in Iraq was $1 trillion. The war 
in Afghanistan, as you mentioned, started out as a mission to dislodge 
Osama bin Laden. It was transformed into nation-building.

                              {time}  1810

  And no matter how necessary or debatable either of those events were, 
those wars were, you do have to pay for it. It's not as though because 
it's in the name of national security it can be exempt from fiscal 
responsibility. In fact, what's unusual is that this is the first time 
in the history of our country where we have been at war where we 
actually haven't asked for shared sacrifice by the taxpayers, but we've 
made the entire burden be borne by our military. So we've got to pay; 
and we didn't do it, as you pointed out.
  The second is the theory that's being advanced by many that if you 
cut taxes, it will create wealth and create jobs. In some places and 
some times and in some circumstances that will work. In fact, many 
standard economists say that in a recession, it's the time to cut 
taxes, not raise them. But the more that is focused on the middle class 
who are struggling--especially in a down economic time--to pay their 
bills, if they get a tax cut, they have discretionary income or they 
have income liberated, that money is going to go right back into the 
economy. But every tax cut does not generate jobs, and many tax cuts 
end up adding significantly to the deficit.
  The President Bush tax cut in 2001 and the President Bush tax cut in 
2003 added $2.3 billion to the deficit. So you have a Pentagon that is 
not subject to pay-as-you-go and you have tax cuts that don't pay for 
themselves. Those are two major contributing factors to that $11.5 
trillion deficit on the heels of a $5.6 trillion surplus. The debate we 
are having now in this House is enormously consequential to the future. 
Republicans won this last election, and a major argument they made is 
that we've got to get spending under control. They're right. I agree 
with that. We have to get to fiscal balance.
  The challenge is if we're going to get there, do we need a plan that 
repeats those two policies of the Bush administration, namely, keeping 
the Pentagon off the table and increasing tax cuts, particularly to the 
high end, but keeping off the table Pentagon savings, keeping off the 
table eliminating tax loopholes and keeping off the table the question 
of revenues?
  Democrats, in my view, have to be willing to come forward and say, 
look, the programs that we have been strong supporters of have to be 
re-examined, we have to reform them, we have to make them more 
efficient; and if they are not working, we have to acknowledge that and 
move on. We have to do our share. The President's proposal that would 
freeze domestic spending for 5 years is pretty dramatic, but many 
Democrats would be willing to support tough medicine as long as the 
plan had on the table other things that are major contributors to the 
fiscal situation we're in. That's, of course, revenues; that's, of 
course, the Pentagon; and that's, of course, tax loopholes in the tax 
system.
  We can get from where we are to where we need to be. We saw that in 
recent years when it happened under President Clinton. Again, as you 
pointed out, in those years, Tax Codes matter; but in the Clinton years 
when we had higher tax rates, we created 20 million jobs. In the Bush 
years when we had lower tax rates, we created 600,000 jobs. And also 
incomes were increasing.
  So this has to be reviewed by this body, in my view, as a practical 
problem for us to solve, not an ideological argument that every tax cut 
is going to be beneficial anymore than every spending program is going 
to be beneficial. You have to apply judgment to the situation at hand. 
The big challenge for us is restoring the fiscal balance.
  Mr. GARAMENDI. Let me thank my colleague from Vermont, Peter Welch, 
for this presentation on the tax policy. I think we probably would want 
to stay with that a few moments. I know my colleague from New York (Mr. 
Tonko) is here, and perhaps you would like to opine and to share with 
us your thoughts on these issues of the budget and how we can deal with 
the deficit.
  Mr. TONKO. Thank you, Representative Garamendi. And I compliment 
Representative Welch for what I believe is a balanced approach to how 
to solve the deficit situation, the debt situation, and certainly how 
do we move forward with a sound budget that can invest in America at a 
time when other nations are investing in a clean-energy, innovation 
economy. We don't have the luxury to just hone in on deficit, or budget 
carving here that solely relies on impacts through domestic program 
cuts on our middle class families, our working families and the poor.
  What we have seen here is trillions' worth of cuts to domestic 
programs, impacting the ability to pay utility bills, impacting the 
ability to perhaps send your adult child off to college, to dream the 
American Dream, to own a home and to have an affordable home budget. 
All of these items are at risk here. We're putting people most 
vulnerable at risk. We have seen almost a flat curve for the growth in 
household income across America, just a slight bump upward, while we've 
seen an exponential rise in corporate executive

[[Page 5909]]

salaries, in millionaire and billionaire wealth. That's where the 
growth has been.
  The recovery here has seen that happening with a downward spiral, a 
downward mobile quality to the comeback of our efforts here in this 
country. So it is important for us to make certain that there is a 
balance here, that we're calling upon all tools in the toolkit to make 
it all happen.
  And this chart absolutely tells a story. Over the last 40 years, 
middle class wages have stagnated while millionaires and billionaires 
have trumped all by 256 percent.
  Now, this tells a story. When people are talking about not wanting to 
visit a fairness in tax policy here, when we have seen the anger in 
America expressed via the many, many households that the great 
multitudes of people in this country are portrayed in the middle class, 
they are the population that have expressed anger, and rightfully so, 
that anger has got to be addressed through fairness in tax policy, 
through an across-the-board impact of solution here that will enable us 
to do what's fair and do what's correct.
  I watch the savings that they talk about here with the Republican 
plan. The Republicans will talk about the huge amounts of savings that 
they produce all through cuts on the domestic programs, again impacting 
working families, the poor and the middle class. Well, those aren't 
savings because in order to be savings, they might be in a locked box 
or assumed to go after relieving the deficit. But instead, they take 
these trillions in like amounts and provide tax cuts for millionaires, 
billionaires and corporations and still continue to hand out mindlessly 
the subsidies to big oil companies. This is what is so most egregious 
about this budget.
  Instead of working towards a balance that looks at revenues, that 
looks at the domestic programs that require investment, no, they are 
going pell-mell into an all-out attack on the middle class. That's 
wrong. And also in the outcome as they slide programs, assistance and 
investments to middle class America, as they slide it over to the 
millionaire, billionaire, corporate and big oil companies crowd, that 
community, what happens in the interim? With this Republican plan for a 
budget, we grow debt by $8 trillion.
  So where have we gained here? This sounds like a repeat of the pre-
recession years where we were not acknowledging fairness in revenues, 
where we were allowing for a falling apart of the system. At the same 
time we took the watchdog out of the equation on the financial sector 
on Wall Street. We allowed for working families' portfolios of 
investments to go to ruination where we lost $2.8 trillion in 
accumulated wealth on 401(k)s and various other investment materials. 
And this is what happened: we destroyed the economy, and now we're 
going to repeat history, history of the worst kind.
  Let's pick up on the history of the best kind. Let's pick up on 
investing in jobs as we did in the FDR years where we came out of tough 
economic times and people knew the dignity of work and we saw projects 
built across America, not the trickle-down theory that didn't work 
during the Reagan administration and the trickle-down theory that 
didn't work during the second Bush Presidency. It just didn't happen.
  And my question is, I can't help but rhetorically ask, why would we 
revisit that kind of scenario again knowing that we're just crawling 
out of the recession and we're growing private sector jobs to the tune 
of $2 million in just over a year? Why would we disrupt that progress? 
I ask, why would we disrupt that?
  Representative Garamendi, I think it is great that we're bringing 
this information to the forefront here and allowing it to be exchanged 
with the people that we serve day in and day out who have expressed, 
rightfully, the anger about the onus, the burden and the unnecessary 
pain that has been placed upon households of modest annual income 
means.
  Mr. GARAMENDI. The chart that you and I shared a moment ago is up 
here next to me; and it clearly shows that we have seen a middle class 
in America that has seen very, very little progress over the last two 
decades and, instead, an enormous shift of wealth and income to the top 
1 or 2 percent of the Nation.

                              {time}  1820

  There has been a 256 percent increase in income to the very wealthy, 
and as I said, it trumps all of the income gains by the rest of the 
economy. Those at the bottom saw maybe a 10 to 11 percent increase. The 
rest, very, very little.
  I look up and I see my colleague, the gentleman from the great State 
of Oregon (Mr. Blumenauer). Thank you for joining us. We talked earlier 
today about the upcoming debt limit. Please join with us and share with 
us your thoughts on what we are doing here, what we shouldn't be doing, 
or should be doing.
  Mr. BLUMENAUER. I appreciate your leadership and your focusing on the 
issues that face us.
  Having spent hours in the Budget Committee so far this Congress, I 
must admit that I was shocked and surprised with the profoundly 
negative approach that is being taken by my good friend, Paul Ryan, the 
chair of the Budget Committee and my Republican friends.
  First of all, there is in essence a refusal to zero in on the three 
areas of greatest increase in the budget. We see repeated charts that 
talk about Medicare going through the roof over the next 50 years. And 
it is true. We need to get Medicare spending under control because the 
past path is not sustainable. But ironically what is ignored is that 
the approach that is being offered by the Republicans in their budget 
actually ignores the major provisions that have been placed in statute 
now that would actually reduce the rate of Medicare spending in the 
future.
  We have taken every significant, independently verified promising 
initiative to bend that cost curve, and they have been stripped away. 
We watched Republicans attack Democrats because there were provisions 
to be able to make a difference with Medicare spending, claiming it 
would somehow slash Medicare for senior citizens by a half-trillion 
dollars. Well, Congressman Garamendi, you and I come from areas of the 
country that actually have been able to reduce health care costs, they 
are below the national average, and in both areas we actually have 
higher performance; better health care, less cost. If the rest of 
America practiced medicine the way it is practiced in our two 
communities, there would not be a Medicare crisis.
  What we have done with the reform act was embed those notions to be 
able to provide incentives to reward value over volume, not just pay 
for procedures. To be able to have accountable care organizations, 
bundling of services, to actually have some financial disincentives for 
unnecessary hospital readmissions. All of these, the experts tell us, 
could save over $1.2 trillion over the next 20 years. And, in fact, if 
we had the courage to actually improve and accelerate and enhance, 
there are greater savings because the doctors, the nurses, the 
hospitals in our two communities have proven that it is possible. But 
our Republican friends have simply decided to turn their back on that. 
They are going to take the Medicare savings and spend it for tax cuts 
for people who need it the least.
  I can't help but turn back to you because you have an interesting 
chart there on the floor that may say it all.
  Mr. GARAMENDI. I thank you, and let's just do a colloquy here back 
and forth. You've talked about ways in which we can bend the cost curve 
for health care for all Americans, not only those on Medicare. It was 
in the Affordable Care Act, the health care reform. Our Republican 
friends like to call it ObamaCare because it actually would reduce the 
cost of medical services for everybody, whether you are in Medicare or 
Kaiser or anywhere else. And you mentioned four very, very important 
ways it does it. One is hospital readmissions, otherwise known as 
hospital infections. Our former colleague a week ago likely died of a 
hospital infection. The Affordable Care Act places a heavy burden on 
hospitals that have a high infection rate, or readmissions. It is a 
very, very expensive, deadly situation. It is just one of several ways 
in

[[Page 5910]]

which the Affordable Care Act reduced over time the cost of medical 
services.
  You were here on the floor. I voted ``no,'' you voted ``no'' on a 
bill that Republicans forced through this House that eliminates 
wellness. What in the world was that all about? Why would you ever 
eliminate wellness: obesity, blood pressure, proper eating, nutrition, 
public health, vaccinations--all of these things to keep people 
healthy. Healthy people don't cost money. They don't run up the price 
of medical services. So they want to repeal that, and I'm going, that 
makes no sense at all. You are actually increasing the deficit by doing 
that. And then they take it to the ultimate step of terminating 
Medicare.
  This has become my favorite. It's the tombstone for Medicare. In the 
Republican budget is a proposal that would terminate Medicare for all 
Americans who are less than 55 years of age today. If you are 65, maybe 
it would continue on. But if you look at the totality of their 
proposal, it is the termination of Medicare and this is what we have. 
``Medicare, 1965 to 2011, created by LBJ, destroyed by the GOP.'' 
Unbelievable. And along with it, a significant reduction in Medicaid, 
which in California we call Medi-Cal.
  Your expertise, Mr. Blumenauer, on the health care issue and the 
experience in Oregon on how we can reduce the cost of medical care 
needs to be heard by every Member of this House. So if you would 
continue on and share with us this issue of medical services and how we 
can reduce the cost, save Medicare, and simultaneously addressing the 
deficit.
  Mr. BLUMENAUER. Your point is well taken in terms of what they would 
do terminating Medicare as we know it for everybody under 55 years of 
age. We are talking about over 230 million Americans. And as a result 
of this, it is clear, you can look at the Congressional Budget Office, 
other independent experts, it is not going to reduce the cost of health 
care. In fact, it is going to increase the cost of health care in 
America. But what it does is it is going to put an ever-increasing 
burden on elderly Americans. It is going to have a gap because 
ultimately they are not going to enable people to have Medicare until 
they are 67. They are going to have a small voucher that is given to 
the insurance company. Bear in mind the reason that LBJ and the 
Democratic Congress in 1965 enacted Medicare was because America's 
elderly could not get good insurance coverage that was comprehensive 
and affordable. Senior citizens, like it or not, are older. They are 
frailer. They are less healthy than younger Americans, and they are not 
working as much. They don't have the income. They need help. Now, our 
Republican friends would lead us to believe that all of a sudden there 
will be a private insurance market, which by the way sounds 
suspiciously like the exchanges that they said were bad in the health 
reform act, and they would force people into them, but they would have 
decreasing premium support.

                              {time}  1830

  I think it is also appropriate to just reflect for a moment about 
what happens to the 78 million geezer baby boomers who are 55 or older 
who will be under Medicare. That's going to continue for years. It's 
going to be increasingly inefficient. It appears as though there are 
some extra costs that are embedded for existing and soon-to-be future 
Medicare recipients that are going to continue to distort, drive up 
costs, and, of course, nationally we're all going to pay more for the 
privilege.
  I would suggest this tombstone is something that people should 
consider carefully, because it's going to mean, I sincerely believe, 
not just the death of Medicare but it is going to provide profound 
shifts and dislocations within our health care system, hurt the 
providers, and provide less effective health care for our elderly 
citizens.
  Mr. GARAMENDI. Let me add to that and carry on a little piece of it.
  The Republican budget, which we will be voting on here on the floor 
of Congress in the next 2 days, has provisions that are equally harmful 
to seniors and to wannabe seniors, people who want to get to be 65 or 
67 years of age, and these are the Medicaid reductions.
  In the proposal that the Republicans will bring to this floor, the 
Road to Ruin proposal, is a block grant to the States for Medicaid 
services. In California, we call it Medi-Cal. This is a program that 
provides benefits to the poor and those who cannot afford medical 
services because they are severely disabled, mentally disabled, or 
seniors that cannot afford services in nursing homes. The block grant 
is less than what is now available to nearly every State, and it is 
scheduled to be reduced in the years ahead, the purpose of which is 
presumably to deal with the deficit, but what it does is it takes that 
whole population of seniors, current seniors, and others who are 
currently served by the Medicaid program and puts them at risk. The 
effect will be to throw seniors out of nursing homes, seniors that are 
on Medicaid or Medi-Cal in California. It is the most onerous and 
hardhearted proposal I have yet seen. These are people that are in 
desperate need of services, services for the mentally ill, services for 
the severely disabled, services for seniors who are in nursing homes 
and who cannot afford the cost of nursing homes. That's another part of 
this provision in the budget.
  What is happening here is a shift, a shift of costs from the overall 
American economy in the Federal budget to the individuals, not to the 
wealthy, not to those who have income, but rather to those who have so 
little. And it's not the only shift that's occurring.
  Mr. BLUMENAUER. If we could just follow up on this for a moment, 
because you are talking about something that ought to concern each and 
every citizen. Medicaid. In your State Medi-Cal. We've had the Oregon 
health plan. There are other States that have variations on that. It 
provides health care, as you say, for our most vulnerable populations: 
the elderly, disabled, extremely poor people.
  Mr. GARAMENDI. And the young.
  Mr. BLUMENAUER. It is very cost effective. There are complaints that 
the benefits under Medicaid are actually very low, and it's hard for 
physicians and hospitals, medical providers, to deal with this. But by 
moving to a block grant that, as you say, it is designed to go down 
over time. And unlike the current system, which is sort of 
countercyclical, where the Federal Government has given more money in 
times of distress, which it's done to your State and my State in the 
last 2 years. If we hadn't got the extra payments from the Federal 
Government to help with Medicaid, I can't imagine what shape people 
would have been in in Sacramento and Salem, Oregon. The legislature 
would have just melted down. What this proposal is, is to continue this 
ratcheting down, no benefits when times are tough, and put States in a 
situation where too often they are either unable, or in the case of 
some States, unwilling to react. It's going to have a cascading effect.
  You mentioned the problem that's very likely to emerge with people 
being literally tossed out of nursing homes. This is something that 
Americans need to step back and look at what is being designed as part 
of this very pessimistic road map that is going to have very serious 
negative consequences.
  Mr. GARAMENDI. I thank you for that.
  I am going to shift to another very, very important part of the 
Republican budget proposal, and that is their total unwillingness to 
deal with the reality of the revenues that the Federal Government needs 
in order to continue to provide all of the multitude of services that 
are part of a modern society: everything from defense to homeland 
security as well as the medical and social services that we have been 
talking about.
  I'm going to put this up, it's a little cute, but I think it pretty 
much illustrates one of the profound problems in the Republican budget.
  ``What Do They All Have in Common?'' We've got the unicorn over 
there, we have Bugs Bunny, and then we have this thing that says the 
corporate tax rate, 35 percent, large corporations like Exxon. It's a 
fallacy.

[[Page 5911]]

Large corporations and small corporations in America don't pay 35 
percent corporate income tax. In fact, if one were to take a look at 
Exxon, in 2008 they had the largest profit of any company in the world. 
In 2009, they had a profit of about $19 billion and their effective tax 
rate, how much they actually paid in taxes, was zero. Not 35 percent. 
Not 30 percent. Not 25, not 20, not 15, not 10, but zero.
  Now it happens that they're not the only corporation. The Republican 
proposal actually would make this situation worse. It would take this 
35 percent and reduce it to 25 percent.
  What are we talking about here? Why would we want to do that? 
Apparently they want to do that because they want to take their 
savings, Medicare, by terminating Medicare, Medicaid, by reducing 
Medicaid and all of the other savings, the savings that they presume 
they're going to get from abolishing the wellness programs, high blood 
pressure screenings and so forth, and on and on and on, and give it to 
the corporations.
  Let's understand that American corporations currently get a tax break 
for sending American jobs overseas. American corporations currently get 
a tax break for oil drilling. The oil industry in the United States is 
the most profitable industry in the world. We just talked about 
ExxonMobil. All of the other oil companies in the last 10 years have 
had a profit of $947 billion, just under $1 trillion. Yet they continue 
to receive tax breaks in the order of $12 billion to $15 billion a 
year, of our tax money, handed over to the oil companies at a time when 
they are now charging us over $4 a gallon for gasoline.
  And what is that all about? Well, it's all about the ability of the 
oil industry to maintain a subsidy, a tax break out of the American 
taxpayer's pocket, handed over to the oil company, and they've had that 
subsidy for nearly a century. I'm saying, enough of that. Bring that 
money back into the Treasury, use it for green energy, solar, wind, 
renewable energy, for research, use it for the things that we need to 
do, including reducing the deficit. But oh, no. Oh, no. They don't want 
to do that. Our Republican colleagues want to continue to give to the 
oil industry the kind of tax breaks that they have.
  If that's not enough, our Republican colleagues want to make sure 
that this fellow, Donald Trump, he wants to be President, probably to 
maintain the extraordinary tax break that he presently has. The 
Republicans want to reduce the taxes for Donald Trump and for other 
billionaires, millionaires, from 35 percent to 25 percent.

                              {time}  1840

  You go, why should we do that at a time when we're taking money away 
from seniors, at a time when we're forcing the middle class to pay 
more, at a time when you're shifting the cost of all of these services 
to the middle class, at a time when you're going after the unions and 
trying to destroy the union movement in America? Why in the world would 
you give Donald Trump, why would you give billionaires, why would you 
give those people at the very tiptop of the American economy, those 
people that now control over 25 percent of all of the wealth in 
America, the top 1 percent of wage earners in America, why would you 
give them, not a 10 percent, it's about a 17 percent reduction in their 
taxes? It makes no sense at all.
  We talk about shared sacrifice. The Republican budget proposal that 
will be on this floor later this week will not be shared sacrifice. It 
is, in fact, giving to the top of the American heap of all taxpayers, 
of all wealth, even more. I suppose it must be the trickle-down theory, 
that if these folks, if Donald Trump and the other billionaires and 
millionaires have more money, somehow jobs will be created. The fact is 
it doesn't work. Don't believe me. Take a look at the American economy 
from 2001 to 2009, the George W. Bush period.
  George W. Bush started the first very year of his Presidency with 
massive tax cuts that created a 2-plus trillion dollar deficit and very 
few jobs. During the Clinton period, we ended with a $5.3 trillion 
surplus and the creation of over 22 million jobs, and the tax rate for 
Mr. Trump and for other millionaires and billionaires was 39 percent. 
It is, in fact, the history of America's economy that proves that 
you're not going to create more jobs by reducing the taxes for Mr. 
Trump and the like.
  So what do these things have in common: a unicorn, Bugs Bunny, and 
the corporate tax rate of 35 percent? They are all fictional, every one 
of them.
  I want to move now to another subject. I'll make this my last, and 
I'll make it kind of quick. If we're going to grow the American 
economy, we have to make the critical investments that are the 
foundation of economic growth in any and every country. Whether you are 
Singapore, whether you are China or any of the European countries, 
France or Britain, the United Kingdom or the United States, there are 
fundamental investments that the society has to make, and many of these 
investments are made through the general public's government. Let me 
just turn to those investments.
  This is part of our Make It in America agenda, the Democratic agenda 
of rebuilding the great American manufacturing base. If America is 
going to make it, we must make it in America. We have to rebuild the 
manufacturing base of America. We can do it, but it's going to take 
critical investments. I want to just point them out here as we go 
through this and then compare these to the Republican proposal, the 
budget proposal that we're going to be voting on.
  The first one is trade. Now, the Republican proposal doesn't deal 
with trade and goods because they're not going to do any more harm to 
it, but this is a fair trade policy. This is a policy of trade where we 
do not give away our manufacturing industry to places like China. I am 
sick and tired of going into Target or any other store in America and 
finding ``Made in China,'' ``Made in Europe,'' made everywhere but in 
America. Enough of that. We need to see ``Made in America'' once again 
on the store shelves in America.
  In California, the California government--not my responsibility, I 
wasn't responsible for it at the time--when they go out and they build 
a new bridge from Oakland to San Francisco, a multibillion-dollar 
bridge, and they buy steel from China because it's 10 percent cheaper, 
I'm going, Stop it. Stop it. And so today, in the Resources Committee, 
I introduced an amendment.
  Now it's ``Drill, baby, drill.'' It's our Republican colleagues who 
want to drill anywhere and everywhere and all the time. I think it's 
the wrong thing to do. We need to move to renewables. But if we're 
going to drill, then why don't we drill with American-made equipment? 
Why don't we require that those drilling rigs, those pipes, those 
technologies, the drill bits, the blowout preventers be made in 
America? I introduced that amendment. The Republicans brushed it aside 
saying they didn't want to go that way. Okay, fine. But we need, on 
trade policy, to make sure that our trade policy does not disadvantage 
American manufacturers.
  Taxes. I just talked about taxes. Why in the world would the 
Republicans vote against a tax policy that actually is now law? We 
passed this last December. Why would they vote against a tax policy 
that would reduce--nearly eliminate--the tax breaks that American 
corporations get when they send jobs offshore? Why would you vote 
against that tax break that American corporations have? I don't 
understand it. It's over, at least partially over, there's more that 
needs to be done, and my Democratic colleagues and I are asking our 
Republican colleagues to work with us to eliminate the rest of those 
tax breaks that American corporations get when they send jobs overseas.
  We talked about some other issues here. For example, last December, 
the Democrats pushed through, Obama signed a bill that allowed American 
corporations and businesses to write off 100 percent year one--this 
year--100 percent of capital investment so that we encourage American 
manufacturers to invest in America so that they can be more productive.
  Energy policy, extremely important. We cannot any longer put our 
economy

[[Page 5912]]

and our national security at risk to foreign oil producers. So I guess 
part of the ``Drill, baby, drill'' is to try to deal with that, but 
that's not going to solve the problem. We need additional and new 
energy sources, and that's where the green energy, the future energy 
comes in.
  Don't take it from me. Talk to our American military. Talk to the 
Navy, the Air Force, the Army. They think way ahead, and they know that 
they cannot depend upon oil. They need to move to other sources of 
energy. They did it years ago. They had wind on their ships. Then they 
went to coal. Then they went to oil. They are now using nuclear power. 
But they also know that many of their pieces of equipment--a jet 
airplane isn't going to have a nuclear reactor. So they want to free 
themselves from the grip of the petro dictators around the world and 
they want to be able to have energy made here in America. This is 
biofuels, advanced biofuels of all kinds.
  We ought to follow the lead of our military here, and we must create 
energy projects that provide us with clean renewable energy, whether 
it's nuclear or the green energy: solar, wind, biofuels and geothermal, 
all the rest. So energy policy becomes extremely important.
  Labor. It turns out, if one were to look at American economic 
history, you would be able to track the rise of labor in the thirties, 
forties, fifties and sixties tracking perfectly with the rise of the 
middle class in America. So as labor became more predominant in 
America, we saw the American middle class grow right along with the 
labor movement.
  Beginning in the 1970s, we saw the decline of the labor movement. If 
you track the decline of the labor movement, you will find the decline 
of the American middle class tracking perfectly with the decline of the 
labor movement. Now we find all across the Midwest--in Wisconsin and 
Ohio--a major movement to take yet another shot at labor, to weaken 
labor or to destroy labor. In the process, you will find the further 
decline of the middle class of America should they succeed at that.
  But this is more than just the labor movement. This is preparing the 
American worker to be competitive in a modern economy. This is 
education. This is job training. These are programs to retrain and to 
bring into the workplace workers who are prepared to deal with the 
modern machinery and the modern equipment that a well-placed and well-
executed economy must have.
  I want to move to the next one, which is, in fact, education. Earlier 
today, I met with the President of California State University, East 
Bay, part of my district in California.

                              {time}  1850

  And the president, Mohamoyad Qayoumi, who happens to be an Afghan, 
was talking about programs that they're putting in place in the East 
Bay of California, San Francisco Bay, to encourage the education of 
children--modern technology, using iPhones, using techniques in 
computer technology--so that the kids who are into these things in a 
big way will be able to learn, not going out and buying expensive 
textbooks every year that are out of date the next year, but rather to 
use online publications and be able to bring to the students all of the 
world.
  I was going home last weekend, and I got a call from my wife. She 
said, Can you find a light bulb for the projector? It's out. We need a 
light bulb for the projector. I said, I just got off the airplane. I 
don't know what I'm going to do.
  I got online, I punched up my Safari, and I looked for light bulbs. 
In a matter of moments, I found, not too far from the airport, a photo 
shop that had the light bulb.
  The whole world is here. The whole world is available for a student 
who's just curious. You cannot help but be curious. All you need to do 
is get online, and you can find out everything about the world around 
us, anything you're into with science, and it turns out that this 
little piece of equipment, according to President Qayoumi, is also a 
tool for the teacher. The test can be taken on this. And in taking that 
test, the teacher immediately knows what the student does not know. And 
so the next day in class that could be dealt with.
  I think I'm running out of time here, and I'm going to finish very, 
very quickly with intellectual property. This is the transition of all 
of the research into the manufacturing sector. Make It in America. We 
have to do this. We can do this if we have the right policies in place.
  With that, I yield back the balance of my time.

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