[Congressional Record (Bound Edition), Volume 159 (2013), Part 9]
[House]
[Pages 12250-12256]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           GOP DOCTORS CAUCUS

  The SPEAKER pro tempore (Mr. Cook). Under the Speaker's announced 
policy of January 3, 2013, the gentleman from Georgia (Mr. Gingrey) is 
recognized for 60 minutes as the designee of the majority leader.
  Mr. GINGREY of Georgia. Mr. Speaker, I am joined this evening with my 
colleagues in the House GOP Doctors Caucus, and other Republican 
Members, to talk about this most, most important subject, and that is 
this recent delay of the employer mandate.
  The Obama administration's announcement that it will delay 
implementation of the employer mandate due to the enormous regulatory 
burden on businesses, Mr. Speaker, is proof positive that the 
Affordable Care Act is a job killer.
  The administration's excuse for the delay was to simplify reporting 
requirements for small businesses. But employers haven't been against 
the mandate solely due to its burdensome reporting requirements.

                              {time}  1945

  While it's estimated that ObamaCare will require American job 
creators, families, and health care providers to spend more than 127 
million hours a year on complying with the law, a far greater concern 
to business owners is the impact the mandate will have on job creation. 
The cost of the health insurance and of ObamaCare's fines will drive up 
the costs of labor and will continue to be a drag on this economy. This 
is further evidence that the administration does not get how the law 
will impact the economy.
  The U.S. Chamber reported that 72 percent of small business 
executives would have a harder time hiring because of ObamaCare. The 
employer mandate has been cited by business owners repeatedly as a 
major obstacle to expansion. They simply cannot afford it. At a recent 
small business roundtable, one Georgia business owner said to me, I 
want to provide health care insurance for my employees. ObamaCare has 
forced me to choose between that and hiring new people.
  For instance, one common deterrent to growth that is often cited by 
small businesses is the 50 employee threshold, at which point a 
business must provide insurance to its employees once the 50th full-
time employee is hired. This misguided provision has repeatedly forced 
different hiring practices by these companies.
  I heard that Heatco, a company which specializes in the design and 
manufacture of world-class heating solutions, which is located in my 
district in Bartow County, Georgia, had looked into expanding. The 
thing is that it currently has--you guessed it, Mr. Speaker--49 
employees, and due to the added ObamaCare cost, to expand by adding an 
additional employee, it will cost more than automating some of their 
processes.
  The administration cannot say with a straight face that businesses 
are more concerned with reporting requirements rather than with the 
overbearing costs that ObamaCare will add to their bottom lines.
  President Obama's announcement doesn't reduce the harmful effects 
that the mandate will have on employers as we move forward. It could, 
however, provide cover. Let me repeat that: it could, however, provide 
cover for Democrats during an election year. This political calculation 
protects them from voter backlash and from the reality that ObamaCare--
their law--is to blame for an economy that is literally hemorrhaging 
jobs.
  This is yet another example of the Obama administration's replacing 
the rule of law with partisan, raw politics. This unilateral decision 
is an abuse of executive power; and in my opinion, it is a clear 
demonstration that President Obama will disregard for political gain 
the laws he has signed.
  In 2010, Democrats in Congress determined that the enforcement of the 
egregious employer mandate would begin on January 1, 2014. As bad as 
the law may be, the administration does not have the power to rewrite 
the law. That responsibility belongs--where?--right here in Congress. 
Just look at your Constitution, which I keep in my pocket. It's 
somewhere deep inside my pocket, but I guarantee you that it's in here, 
because I put it in here every single day.
  Legalities aside, postponing the mandate for 1 year is not enough. It 
simply delays the inevitable. When it's eventually enacted, Mr. 
Speaker, hours will still be cut, and pay will still be reduced. 
Businesses hovering just under the 50 employee threshold will still 
have to weigh the costs of expansion; and because of the requirement, 
many will be unable to grow. It is just further proof that the 
administration does not understand how business works.
  The lack of response from this administration is also increasingly 
frustrating. House Republicans have held numerous hearings, asking for 
more information as to how this decision was reached. We have sent 
letters to the Secretary of the Treasury, and we have sent letters to 
the Secretary of Health and Human Services. We have asked witnesses in 
order for us to gain a better insight into this ruling, but have 
continuously been rebuffed, in other words, no response to our 
requests. It's offensive to the American people that the administration 
cannot offer clear guidance on a central piece of its ObamaCare fiasco.
  This delay will also affect the verification of individuals in this 
insurance exchange. It's amazing that the administration is suggesting 
that we will rely on the honor system to determine

[[Page 12251]]

Federal payments. This is truly outrageous. According to the law, you 
aren't eligible for ObamaCare subsidies if your employer has offered 
you what the government considers to be affordable coverage. This is 
spelled out clearly in the law. With the delay of the employer mandate, 
however, the government won't be able to verify whether the individual 
has been offered coverage, and this will open the door--wide open--for 
enormous fraud and abuse, and the costs will skyrocket.
  We've seen the same thing in other entitlement programs that rely on 
this so-called honor system. It's clear that what we are seeing is a 
tactic of ``subsidize first, ask questions later.''
  Remember the old phrase ``pay and chase'' on Medicare claims? It is 
the administration's goal to enroll as many people in the ObamaCare 
exchanges as they can and as soon as they can, i.e., in this year of 
delay, so that we will never be able to repeal this bill. The Federal 
takeover of one-sixth of the economy raises taxes on small business 
owners and on middle class families. It guts Medicare, seniors--it guts 
Medicare--and it will irreparably harm the doctor-patient relationship.
  Instead, we need State-based reforms that will lower costs, give 
patients more control of their own health insurance policies, increase 
access, and ensure a higher standard of care.
  With that, Mr. Speaker, I yield to my colleague, the gentleman from 
Maryland, Dr. Harris, who was an anesthesiologist by profession before 
coming to Congress.
  Mr. HARRIS. I thank the gentleman from Georgia for yielding.
  Mr. Speaker, the doctor is absolutely right. That employer mandate 
will increase the costs for employers, which means we're going to get 
less job creation and less job growth in an economy that can't do with 
any less job creation. In fact, as the doctor probably knows, since 
January, virtually all of the jobs created in this country because of 
this mandate have been part-time jobs. We are rapidly converting to a 
part-time economy. That's not what Americans expect--that's not what 
Americans deserve--and that problem won't be solved until that mandate 
goes away, not just delayed but goes away.
  The doctor talked about the costs per employee when the employee 
pays. What the doctor hadn't mentioned is the cost if you go on the 
individual market, because that's the other market created under the 
President's Affordable Care Act, or ObamaCare. You've also heard much 
in the past week because the President has gone around, pointing to New 
York and saying, Do you see, premiums are going to go down 50 percent--
the wonders of ObamaCare.
  Mr. Speaker, the truth is that the President can only talk about New 
York because, in virtually every other State, there will be huge 
increases. So we have to examine why the decrease in New York is 50 
percent. It's because they start with such a high premium that, even at 
half the cost, they're still multiples of the premiums of those in the 
other States.
  For instance, let's take a look at what the average premium in New 
York right now is for a healthy 30-year-old nonsmoker who is buying a 
policy, because the President and the Secretary of HHS and everyone who 
has screened this plan has said, unless you get healthy young people to 
buy insurance, the whole plan falls apart. So let's look at what it 
will cost for that 30-year-old nonsmoking male--the people who are 
among the highest of the uninsured, the highest in number. This is the 
average plan. The median-priced plan in New York is $5,750 a year, or 
about $500 a month right now.
  Now, that median-priced plan in the President's home State of 
Illinois is $1,450, or about $1,300 a month--about one-fourth the price 
of the New York policies, because New York has ObamaCare-type 
regulations in place. That's why their costs are so high right now. In 
fact, ObamaCare is not quite as regulated as is the New York market, so 
the prices can come down a little bit, but do you know, if it comes 
down from $500 to $250, it's still twice the cost of that policy in 
Illinois right now.
  Maybe we should look at the Vice President's State of Delaware where 
the average 30-year-old male's policy price is about $1,380, or let's 
round to $1,200 a month. That's about one-fourth the price of the 
current policy in New York, and even with those tremendous ObamaCare 
savings, it will be half the price of the policy in New York, the 
ObamaCare policy.
  Let's look at what has happened in some other States other than New 
York. I'll talk about my home State of Maryland, which is the largest 
nonprofit insurer. Yes, Mr. Speaker. I said the ``nonprofit'' insurer, 
because you can't blame profit as the reason for a high cost. The 
largest nonprofit insurer said that the average price increase is 25 
percent; and for a young healthy person, exactly the ones who have to 
be signed up for the ObamaCare scheme to work, it's as high as a 150 
percent increase.
  Mr. Speaker, if we can't get healthy young people to buy insurance 
now, how in the world are we going to convince them to buy insurance in 
Maryland when it costs almost twice as much?
  We can run all the taxpayer-financed ads, because that's what it's 
going to be. All of the people watching who have televisions will see 
what happens this fall as we spend millions and millions of taxpayer 
dollars to try to convince healthy young people to buy a plan that's 
way too overpriced.
  Let's look at California. Maybe the big States are different. New 
York is expensive. Maybe California is different. In California, the 
average cost of that plan for a healthy young person is $2,200, or 
about $200 a month. Why, it's less than half of the cost in New York. 
Sure enough, in figures released last month in California, the costs of 
the ObamaCare individual plan will increase by 64 to 146 percent. So 
that $200-a-month premium is now going to be $400 a month.
  Mr. Speaker, young people who are entering the job market are 
entering at relatively low levels of pay. Where in the world are they 
going to find $400 to pay for an overpriced plan that they've seen 
advertised on their local NBA game--and, of course, with the ads paid 
for with taxpayer dollars?
  This is why this house of cards will collapse. We are in for a rough 
time this fall. People in America who depend on their health care 
insurance are in for a really rough time. The costs are going to go up, 
and the confusion will be immense. Mr. Speaker, Americans deserve 
better, so that's why we have called on the President. Forget the 1-
year delay of the mandate on employers only. We need a permanent delay 
on the entire plan, and the time for it is now. The President today 
made a big deal on his pivot to jobs.
  Mr. President, I would suggest stopping the $100 million trips to 
Africa and go talk to some of our small business employers and ask them 
what are their concerns. How will they create jobs? This is what they 
would tell the President, Mr. Speaker. They would tell the President to 
get rid of that ObamaCare. That's a weight hanging over my business's 
head that I can't afford, that I can't predict, and that is stopping me 
from hiring people; and for the people I have now, it's making me shift 
them to part-time jobs.

                              {time}  2000

  So we've come full circle, Mr. Speaker. If what we want is a part-
time economy, let's barrel ahead with ObamaCare. America deserves much 
better than part-time jobs. We deserve to create full-time, good paying 
jobs by the small businesses and large businesses in this country that 
are just waiting to show economic growth. We have got to remove this 
lead weight from around their neck.
  I thank the doctor from Georgia for yielding the time.
  Mr. GINGREY of Georgia. I thank the gentleman.
  Before I yield time to the gentleman from Kentucky, colleagues, I 
want you to look at this first poster because a lot of what the 
gentleman from Maryland, Mr. Speaker, was talking about in regard to 
costs shows it pretty simply here. The change in the cost per employee, 
because of the health care law, if you have 49 employees, as we've

[[Page 12252]]

talked about, there is no increase in the cost of health care because 
you don't have to provide the government-mandated expensive coverage. 
So there is no increase. That's why, of course, they keep the employee 
rate at 49 and don't hire those extra employees.
  If you're at 50, though, and you are under the mandate, the increase 
is $800 per employee; if you are at 75 employees, the increase is 
$1,200 per employee; 100 employees, a $1,400 increase; and 150, a 
$1,600 per year increase per employee. That's why so many of these 
small businesses are right there, my colleagues, at 49, with no 
increase because no job growth or employees that are hired at 29 hours 
a week. Try to support yourself, much less a family, on 29 hours a 
week.
  I now yield to the gentleman from Kentucky (Mr. Guthrie).
  Mr. GUTHRIE. I thank my friend from Georgia for yielding. I 
appreciate him letting me be a part of the Doctors Caucus for tonight.
  I don't want to pretend that I am a doctor. I certainly am not, but I 
appreciate the opportunity to be here, Mr. Speaker, to talk about the 
health care bill. It's nice that this has been organized so we can be 
here tonight to talk about a topic that is critical to the American 
people, and that's the crushing mandates in ObamaCare.
  As we know, last week, Mr. Speaker, the House considered two bills to 
relieve the American people of these mandates: the Authority for 
Mandate Delay Act would give large employers a reprieve from compliance 
with ObamaCare's employer mandate until 2015, and the Fairness for 
American Families Act would grant individuals until 2015 to comply with 
the law's individual mandate.
  This one-size-fits-all health care law is a train wreck. It's been 
quoted as a train wreck by members of the other party who voted for it 
in the other body. The administration has clearly realized its employer 
mandate will hinder businesses in their ability to grow and, just a few 
weeks ago, announced their decision to delay the implementation of this 
bill.
  I appreciate being here tonight because I come from a small business 
manufacturing background that provides health care at a low cost to our 
employees. I believe I understand the complexities that an employer 
faces in providing health insurance for their workers. This law 
encourages employers to cut workers' hours, pare back their numbers of 
workers, and move workers from existing health insurance plans onto the 
exchange.
  Well, I'm glad to see the administration is finally paying attention 
to the disastrous consequences of this law. It is disappointing that 
they expect families and small business owners to comply with the 
crushing mandates while they give big businesses a break. Improving 
access to health care and making it more affordable should be the goal 
and the outcome. I will continue to fight for full repeal of this law, 
but in the interim, I'm glad the House moved last week to delay the 
implementation of the crushing mandates.
  Mr. Speaker, I thank the gentleman from Georgia for yielding.
  Mr. GINGREY of Georgia. Mr. Speaker, I thank the gentleman from 
Kentucky. Although he is not a member of the House GOP Doctors Caucus, 
I think that we might take a vote here on the House floor. The cochair 
of the House GOP Doctors Caucus is here with me, and I'm going to 
recognize him in just a second. So he and I are cochairs; so, Mr. 
Guthrie, we may indeed make you an honorary member. Thank you very 
much. We appreciate your input.
  Clearly, Mr. Speaker, the issue is not just about the doctor-patient 
relationship. The reason we're giving this presentation tonight and the 
leadership has asked us to talk about this issue, the members of the 
House GOP Doctors Caucus--and it includes medical doctors, I think 
about 16 of us. It includes dentists. It includes a clinical 
psychologist. It includes a hospital administrator--formerly, before 
becoming a Members of Congress--advanced practice nurses, bachelor of 
science nurses, people in the health care space that know of what they 
speak. And in that regard, I can't think of anybody, Mr. Speaker, who 
knows this issue better than my cochairman of the House GOP Doctors 
Caucus and fellow OB/GYN physician, Dr. Phil Roe from Tennessee.
  Mr. ROE of Tennessee. Mr. Speaker, I thank the gentleman for 
yielding, as I want to talk about what Dr. Harris just spoke about a 
minute ago. I want to do that before I actually explain how we got 
where we are to our viewers.
  What Dr. Harris didn't say is that in the small group market in New 
York in 1992, there were 1.2 million people who got their insurance 
through the small group market. At that point in time, Governor Cuomo 
initiated no preexisting conditions in the small group market community 
rating. And ``community rating,'' for those who don't know what that 
means, it means that your sickest patient or your sickest customer 
can't be charged more than three times what a well person is. So 
they're not actually paying the cost of their care; someone else is 
paying that cost. So that's community rating. And ``guaranteed issue'' 
means you can't be turned down, exactly what we're doing here.
  What happened to that market? Within 10 years, that market all but 
evaporated in New York. There were 120,000. It dropped by 90 percent. 
Today, in a State with almost 20 million people, there are 31,000 
people--that's .0016 or so percent of the people--who are in that State 
that get their insurance through that market.
  What is it? Not only did they basically ruin that market, it's now 
one of the most expensive in the United States, and the only way it's 
going to come down is for those premiums to be subsidized by young, 
healthy people. As Dr. Harris said, young people like my three 
children, who just got out of college and are starting their families, 
cannot afford something that basically they're not paying for. I wanted 
to point that out. I thought it was very important to understand how we 
got there and to why we think this won't happen again.
  Let's go back, Dr. Gingrey and Mr. Speaker, to how we got here. 
Basically, the health care debate started because health care needed 
reform in this country. The reason it needed reform is we had costs 
going up more than inflation--no question that was occurring--and we 
had a group of our people in this country who work every day who were 
uninsured. We needed to do that. We had people with preexisting 
conditions that couldn't get health insurance. You and I saw them. It 
was maybe a woman who had developed breast cancer, dropped out of the 
job market, and on the way back in couldn't find it. So there's no 
argument from us that we needed to have health care reform.
  So what did we have? We had a Doctors Caucus at that time that had 
nine physicians, and not one of us was asked one thing about this 
health care bill. I brought 31 years of experience to the House floor 
and experience with health care reform in Tennessee where we tried to 
reform our Medicaid program, called TennCare.
  How is this supposed to work? The idea was we're going to expand 
coverage and make it more affordable.
  What was the President's promise, Mr. Speaker? The promise was, if 
you like your doctor, you can keep your doctor. If you like your health 
insurance coverage, you can keep your health insurance coverage, and 
we're going to make the costs go down.
  What is the reality? People are losing their doctors for a variety of 
reasons, the cost has gone up dramatically, as Dr. Harris pointed out. 
Let me also point out about what sectors are involved and who in health 
insurance. It is complicated.
  In ERISA-approved plans, if you work for a company that provides 
health insurance coverage, that covers about 60 percent of the people 
in this country. About 160 million people work under that. Let's say in 
my practice we have 400-plus employees in my medical practice that get 
their health insurance through their job. That covers about 60 percent 
of the people in this country. Sadly, in the last 4 or 5 years, because 
of the change in the percent of people who are employed in the 
workforce, that number has actually gone

[[Page 12253]]

down 2 percent to 58 percent, instead of going up as it usually does in 
most recoveries. Number two, Medicare, and number three, Medicaid.
  So all of this entire debate about--remember, preexisting conditions 
are not an issue in that group of people, and we're looking at over 80 
percent. So this 2,700-page bill really had to do with less than 20 
percent of the population. I think we could have done something much 
simpler, much less expensive, and certainly much easier to explain.
  We're going to spend an hour here tonight, Mr. Speaker, in trying to 
break this down to where the average person can understand it, 
understand how it affects me and my family. I'm going to hopefully 
share some of those things with you.
  I chair the Subcommittee on Health, Employment, Labor, and Pensions 
in the Education and the Workforce Committee. I've held three hearings 
around the country. I held one in Evansville, Indiana, one in Butler, 
Pennsylvania, and recently in Concord, North Carolina. What happened is 
we had businesses come in. Remember, the market that wasn't functioning 
was a small group market and the individual market. And let me explain 
how the individual market works.
  When I left my practice 5 years ago to run for Congress, after 31 
years of practice, I left the practice, I had group insurance covered 
under ERISA, that 160 million people in my family. I left that, and I 
then am on the individual market. Because I'm treated differently tax-
wise, the day before, I had a tax-deductible health plan. The next day, 
I could buy that plan, but guess what? It was much more expensive 
because it was not tax deductible. That's how individuals find 
themselves. So those are the people we were trying to help.
  What's happened to them? Well, I'll give you an example. In our State 
of Tennessee--Dr. Harris spoke about several States. I spoke to our 
State insurance commissioner just recently, and in the individual 
market, someone out there who is a young person going out to get 
insurance, they've just finished college or whatever--we'll talk about 
the under 26-year-olds in a little bit, about what the bill actually 
did. Those rates are going up between 45 percent and 75 percent in my 
State; in the small group market--that's where small businesses go out 
and select their insurance--50 percent to 55 percent. Does that sound 
like rates are going down? And this story is all over the country. 
State after State after State you see this in.
  I wanted this plan to work because, as I said, we did need health 
care reform, but we needed patient-centered, market-driven health care 
reform that would help hold those costs down and put the decision 
making not in bureaucrats' hands, not in insurance companies' hands, 
but in doctors' and patients' and families' hands. That's who it needs 
to be in.
  I think the ObamaCare plan started this way: How do we fund this 
plan? Well, they knew it was going to be expensive because of all the 
tax subsidies that were going to go out.
  Where did the money come from? The money came from about a $700 
billion grab from Medicare, a plan that's already underfunded, Mr. 
Speaker. Mr. Speaker, we have a plan now in Medicare where for every 
dollar placed in that plan--and I'm on Medicare, as Dr. Gingrey is. 
Every dollar we spend, the recipient gets $3 out. We know that's not 
sustainable. We have as many as 10,000 people a day entering Medicare 
age, which means that every year we're going to have 3 million people 
who turn 65 years of age as the baby boomers hit. We have an already 
underfunded Medicare plan adding in the next 10 years 30 to 36 million 
people onto a plan that we're taking $700 billion out of.
  How do we control that cost, Mr. Speaker? We pass a part of that bill 
called the Independent Payment Advisory Board. Wow.
  What is that? Well, I think that's one of the most egregious parts of 
this entire health care plan, and it's an interesting little thing.
  You have 15 unelected bureaucrats proposed by the President, approved 
by the Senate, paid $164,000 or $165,000 a year to a 6-year term 
accountable to no one. The courts can't do anything about it. We have 
to have 60 votes in the Senate to overturn what they do or agree with 
what they do, and you couldn't get 60 people in the Senate to agree 
that the sun was coming up in the east tomorrow. So don't worry about 
them worrying about your health care.
  What can they do? Basically what they can do, they start out--and 
this board is now supposed to be appointed this year, and they have a 
budget, which we've tried to cut the funding for because, as I said, I 
think it's the most egregious part of this plan.

                              {time}  2015

  What can they do? Well, they can withhold and cut providers. And when 
you cut providers enough, and that's doctors and hospitals and medical 
providers, they will refuse to see those patients. I've had it pointed 
out a thousand times. Oh, it says in the bill, you cannot ration care.
  Well, there is a very good article--and I still read my medical 
journals--in the New England Journal of the Medicine, one of the most 
prestigious journals in this country, that reviewed the Independent 
Payment Advisory Board and looked back over the past 25 years.
  Mr. Speaker, 21--and this analysis of the Independent Payment 
Advisory Board wasn't for it or against it; it was just analyzing the 
effects of it. And in looking back over the past 25 years, in 21 of 
those 25 years, cuts would have occurred. We all know, Dr. Gingrey and 
I know, and we know that our colleagues out there have been prevented 
from cuts by the action of this body right here and the sustainable 
growth rate in Medicare.
  Mr. GINGREY of Georgia. Reclaiming my time just for a second, Mr. 
Speaker, the gentleman is bringing up a subject that is so important 
that our colleagues understand on both sides of the aisle, this IPAB, 
the Independent Payment Advisory Board that Dr. Roe is talking about, 
it's 15 bureaucrats. Well, none of them have been appointed yet. Not 
one. Nada. And the law says that if the Secretary doesn't appoint, or 
these 15 are not appointed--and, yes, they are going to make about 
$175,000 a year--then she, and it's a ``she'' right now, the Secretary 
of Health and Human Services, or whomever in the future, they don't 
have to have that board; one individual bureaucrat can make these cuts, 
these, really, rationing cuts is what it is.
  I yield back to my colleague.
  Mr. ROE of Tennessee. I thank the gentleman for pointing that out. It 
will put the power in one person and take the power away from this body 
right here, which is why we have a bipartisan bill to overturn this and 
reclaim the power which the people gave us. We are accountable to the 
people, and right now when you make those cuts, we would have almost no 
way to fix it.
  I think that is a great point, and I appreciate, Mr. Speaker, Dr. 
Gingrey pointing that out.
  So we have that board, the money grabbed from Medicare.
  Number two, 21 new taxes to pay for this bill. One of them is a 
medical device tax. Let me assure, you as a physician, I have been the 
recipient, as many of my patients have been, from all of the incredible 
improvements in laparoscopic surgery. I watched it start from its 
infancy, learned my first laparoscopic procedure when I was a captain 
at Fort Eustis, Virginia, in 1974 in the military after having returned 
from Korea. I learned how to use a laparoscope, and I watched all of 
this wonderful new equipment occur to where we are doing absolutely 
marvelous things, minimally invasive to patients, and it has improved 
patient care dramatically.
  There will be taxes on that new innovation. What I'm fearful of, in 
my State, the single biggest export we have is medical devices, that 
this will be pushed offshore, and the thing we have been the shining 
star in the world is medical innovation. There's no question about it, 
and we do not want to lose that.
  So we have 21 new taxes. And there are taxes on health care plans; 
the

[[Page 12254]]

mandates are taxes. So we have the taxes.
  ObamaCare works because of a three-legged stool, Mr. Speaker. This is 
how it works:
  It works because of Medicaid expansion. That is over half of the new 
people there, a plan that already is under siege in most States in the 
Union;
  Number two, the individual mandate--that's what I'm getting around 
to--the mandates that occur because we have to have young, healthy 
people subsidizing others to make the individual market work; and
  Number three, the mandate on business.
  And last week in a blog from the Treasury, not in an announcement 
from the White House, just a blog came out and said, hey, we are not 
going to have the business mandate for a year. And I applaud the 
President for that. It is not something that I disagree with. The 
disagreement is it's the law of the land. I don't see how you can 
unilaterally decide I'm going to enforce this part of the law because I 
can't make it work right now, or the individual mandate, and we voted 
last week, as the Speaker knows and I believe the Speaker supported, 
both of the bills that Mr. Guthrie talked about.
  Mr. GINGREY of Georgia. Reclaiming my time just for a second, Sunday 
it was, on the Sunday morning ``Meet the Press,'' and that's what this 
next poster shows, yesterday, on NBC's ``Meet the Press,'' Senate 
Majority Leader Harry Reid, the Democrat majority leader from Nevada, 
proclaimed that:

       ObamaCare has been wonderful for America.

  Well, let's just take a look at some of the headlines from this past 
week on just how wonderful it has been.
  Investors Business Daily says:

       ObamaCare mandate delay, employers keep job cuts. For many 
     workers, the 1-year delay in ObamaCare's employer mandate was 
     too little too late.

  Reuters says analysis:

       ObamaCare struggles to meet make-or-break deadline. With 
     time running out, United States officials are struggling to 
     cope with the task of launching the new online health 
     insurance exchanges at the heart of President Barack Obama's 
     signature health reforms by an October 1 deadline.

  Time magazine:

       ObamaCare increases cost and complications. The Obama 
     administration's recent announcement that the Affordable Care 
     Act's employer mandate will kick in a year late could ripple 
     beyond the brief extension, increasing costs and complicating 
     implementation of other vital parts of the law.

  Think the exchanges as an example.
  And then CNN Money says this:

       Delay in the ObamaCare employer mandate has simply put off 
     rules businesses had already started to adjust to.

  That's the reality here, Mr. Speaker. My colleague from Tennessee 
knows it. I think my colleagues on the Democratic side of the aisle 
know it, and that's why, in my opening remarks, Mr. Speaker, I 
mentioned that, hey, is it really the employers, the small business men 
and women that were knocking on the White House door saying, We can't 
meet these reporting requirements, please help us do something; or was 
it some of my Democratic friends, whether in this Chamber or the other 
body, saying, 2014 is going to be kind of a tough year for us having to 
defend this train wreck? I think that's what the Senator from Montana 
said. Of course, he's going to retire rather than face the music. I 
can't say that I blame him.
  That's what's going on here. People are not dumb. I think they can 
read between the lines. I hope my colleague can stay awhile longer. I'd 
like to yield to him at this point.
  Mr. ROE of Tennessee. I thank the gentleman for yielding.
  You always hear, Mr. Speaker, that Republicans have no ideas for 
health care. Well, we had plenty of ideas; they just weren't heard. We 
had 80 amendments to this bill. None--and I want the people who hear 
this, to show you how frustrating this process has been, now that we're 
looking at this almost incomprehensible bill, is that we had 80 
amendments to the Affordable Care Act taken to the Rules Committee. I 
think I had 10. Not one--not one--amendment was ruled in order. Not 
one.
  Dr. Harris was here a moment ago and talked about the price of an 
individual insurance policy in the State of New York, and then he 
talked about the price of an insurance policy in Delaware and Illinois. 
Think about if a person in New York, an employer, a person in a small 
business, an individual there, hey, I'd like to buy my plan in 
Illinois. If I could buy it across State lines, I could save myself a 
lot of money, and I can guarantee you the price in New York State would 
come down or people would buy those plans somewhere else. That's why 
empowering the free market system will help and work in health care.
  Let me go to the real world, Mr. Speaker. Let me go to Concord, North 
Carolina, and I held a field hearing there. I want to introduce you to 
a business owner there, Mr. Horne, who has a textile manufacturing 
business. He has 350 employees. If you are in the textile business, 
you're a pretty good businessman if you're in business today, as 
difficult as that is. He provided 80 percent of all the health care 
costs for his employees. They covered 20. He covers all preventive 
services, everything. If you need a colonoscopy, if you need a 
mammogram, he covers all of that. In addition to that, he has a health 
nurse at his business to help if you have issues there. So he has a 
prevention and wellness program. He's done everything right.
  So what exactly does he get for this? What he gets for this, when the 
fiscal cliff bill was passed, because of the way his company was set 
up, he got an increase in his personal tax rate. He got that. Number 
two, he got a $62 per person, not per policy but per person, which will 
cost him tens of thousands of dollars. And guess what that money goes 
to do? It goes to indemnify insurance companies so that they'll be 
induced to provide this insurance on the exchange and they won't lose 
money. Mr. Horne gets absolutely nothing.
  So what will he have to do? He'll either have to cut his salaries, 
he'll have to cut the benefits, or he won't hire someone or he won't be 
able to make needed investments.
  Let's go to my hometown of Johnson City, Tennessee, where I was mayor 
before I came here. My political job there was being mayor of our local 
community. I just talked to our city manager not long ago, and we're 
going to get a bill in our community of 60,000 for $177,000, of which 
we get absolutely nothing because it is on the self-insured market. And 
anybody who is self-insured, and a lot of major businesses, and I 
talked to one who's going to get a $25 million--and I won't mention who 
it is. It's a major company. Everyone in this room will know who it is. 
They write a $25 million check. That could be to hire new employees. It 
could be for new plant and equipment. It could be to grow their 
business. It's a globally competitive company that has to compete 
around the world.
  Let me introduce another person here, Sonny's Real Pit Bar-B-Q. 
That's a famous restaurant in the Charlotte area. We had the field 
hearing over there, and we sampled Sonny's barbecue the night before we 
had the field hearing. It was great. What that company is doing is that 
they found out that 70 percent--since the recession, 70 percent of 
people changed their eating-out habits by reducing or even eliminating 
dining out. And increasing menu prices, which is what they'll tell you 
to do, people quit coming to your restaurant and you go out of 
business. What they are finding out is they have had to cut, as Dr. 
Gingrey clearly pointed out, they're looking at cutting their 
employees' hours to 29 or under so that many full-time employees will 
now be part-time employees so they'll go under that threshold of 49.
  The community college where we held the hearing made a very eloquent 
statement that they were going to have to not allow adjunct faculty. 
What most community colleges do, about 65 percent of their faculty are 
full-time, but the others are people in the community, Mr. Speaker, 
maybe like Dr. Gingrey, who would teach a health class or a class on 
whatever issue would be in his specialty.
  Well, now, because of what the IRS has said, you can only teach three

[[Page 12255]]

classes or you hit the 29-hour threshold. How does that happen? Well, 
for every hour you're in the classroom, they count 2 hours outside the 
classroom. I think it's called the Cambridge hour. So you can only 
teach three classes. It will mean in their community college that they 
won't be able to offer certain classes on time. It'll delay students 
getting out. The State of Virginia has 7,000 part-time workers, and 
they're going to be sure they stay under those 29 hours. And they make 
it a little more individual.
  Someone that I know in my district works for a chain restaurant, Mr. 
Speaker, divorced woman who works full-time. She relies on tips and 
relies on her 40 hours a week. She has a health insurance policy. She's 
going to lose her health insurance policy, and they are going to cut 
her hours to 29, which means that for every month, she loses an entire 
week of wages.

                              {time}  2030

  So she now has got to go find a second job to pay her bills, Mr. 
Speaker. And I can go on and on with examples like this that I've heard 
in testimony.
  Just yesterday, we had testimony on the mandate. Certain of the 
businesses appreciate the year of reprieve. We voted here on the House 
floor in a bipartisan manner, Mr. Speaker, I might add, to also take 
individuals. My goodness, here's a person out here that just graduated 
from college, got their first job, and we're taxing them if they don't 
buy this insurance. And let me point out how quickly the young people 
will figure this out.
  I did something rather unique, as Dr. Gingrey did. I heard here on 
the House floor we should pass the bill and then read it and find out 
what's in it. Well, guess what? I did just the opposite. I read the 
bill and found out some things. I went back and checked to be sure I 
was correct on this.
  But here's what happens if you don't pay the penalty. Let's say 
you're a young individual out there and you say, I just can't afford 
$400 or $300 a month out of my paycheck. I've got student loans and 
other things to pay for. I'm trying to get into my first apartment. The 
penalty is this: it's $95 for the first year.
  So what can the IRS do to collect that money? They can't garnish your 
wages. They can't do that. There's no civil or criminal penalty so 
there's nothing they have to come after you. The only thing they can do 
is if you have overpaid your taxes or if you have a refundable credit 
coming in like an earned income tax credit or child tax credit, they 
can withhold your refund. That's the only recourse they have.
  Young people will figure it out. And why will they figure it out and 
not buy it? Why is this going to collapse? It's going to collapse 
because these young people are going to pay the $95, not the $300 a 
month or $200 a month that they're going to pay. They'll pay the one-
time penalty, if the IRS can ever figure out how to collect it. That's 
what they're going to do. And if you don't have all these young, 
healthy people paying in, it doesn't work.
  Mr. GINGREY of Georgia. I've got one last poster that I wanted to 
point out, Mr. Speaker, to my colleagues. It's a little complicated. 
I'll try to make it as simple as I can.
  Basically, let's start right here with the employer. Under that, in 
this diagram, fewer than 50 full-time employees, including full-time 
equivalents, then no employer penalty for offering a health insurance 
benefit. But in the most egregious situation, the employer has 50 or 
more full-time employees, including full-time equivalents, and the 
employer decides not to offer coverage. If a tax credit is obtained by 
at least one of those full-time employees in an exchange, then the 
annual penalty to that employer is $2,000 for the year--not just for 
that one, but for every single employee that he or she employs. It 
could be hundreds; it could be thousands.
  Mr. ROE of Tennessee. Above 30.
  Mr. GINGREY of Georgia. They get a break for 30, yes.
  Again, we just have maybe a little bit of time left, and I wanted to 
point out some things to our colleagues.
  I want to call this ``ObamaCare Shot and Chaser.'' Bear with me a 
little bit because I think this is interesting and cute at the same 
time.
  ObamaCare has been a train wreck since its inception. March 23, 2010, 
almost 3\1/2\ years ago, the Democrats passed it to see what's in it. 
And now families, taxpayers, and job creators are paying one steep 
price. Between its skyrocketing cost, unsustainable and wasteful 
programs, and job-strangling policies, a majority of Americans 
disapprove of this law--and they disapprove of it today.
  On top of that, implementation of ObamaCare has become a full-fledged 
disaster, as we've pointed out this evening. Some of its biggest 
supporters agree with us--and not news media publications that are 
considered particularly conservative.
  As for the President, he just can't seem to make up his mind on the 
employer mandate. He was against it in 2009 before he was for it in 
2010. After signing the mandate into law, the administration announced 
earlier this month it would delay the employer requirement for 1 year. 
When the House of Representatives acted last week to really make it 
constitutional--because he didn't have the right to do that--but when 
we voted to allow him to do that, the same White House issued a veto 
threat on the bill. The thing that he had done and that we made it 
legal for him to do, he's going to veto that.
  So the shot:

       We have heard concerns about the complexity of the employer 
     mandate requirement and the need for more time to implement 
     them effectively. We have listened to your feedback and we 
     are taking action. The administration is announcing that it 
     will provide an additional year before the Affordable Care 
     Act mandatory employer mandate and insurer reporting 
     requirements begin.

  The chaser. That was the bill that we passed, H.R. 2667. Employer 
mandate delay is unnecessary. These are the words of the 
administration:

       Enacting this legislation would undermine key elements of 
     the health law.

  That was stated July 17 by the White House veto threat. President 
Obama's repeated flip-flops on the individual mandate are well-
documented. He pledged support for it in 2007 on the campaign trail to 
a group of union workers. When his health care plan was released months 
later, the individual mandate was noticeably absent. He went on to 
attack his Presidential primary opponents--think HC--for supporting the 
requirement, only to change his mind once again shortly thereafter.
  I could go on and on. I think we've made our point here tonight, and 
maybe we can yield back a little time. I will yield to my colleague, 
and he can yield back to me for closing.
  Mr. Speaker, colleagues on both sides of the aisle, we're here to get 
it right. I've always said this--and I truly believe it--the politics 
will take care of itself. The people will decide. We don't need term 
limits. They term-limit us. Let's quit worrying about the politics, and 
let's do the policy. Let's get the policy right.
  A 2,700-page bill crammed down the throats of the American people 
will never work. It never has worked. It never will work. And that's 
why we're here tonight, taking pains to explain and make sure that 
anybody within earshot understands that we're sincere about this. It's 
not partisan. We need to get rid of this law, and we need to replace it 
with something that truly will effect those changes that Dr. Roe was 
talking about in regard to the cost of health care and the 
accessibility. We didn't even talk about accessibility and about 
whether or not there will be any doctors there to see these patients.
  So I yield to my friend from Tennessee.
  Mr. ROE of Tennessee. People ask me if there are things in the bill I 
like. Absolutely. You can't write a 2,700-page bill and not put some 
things in there that are positive. There are positive things in the 
bill. We should have worked together in a bipartisan way to look at 
those positive things we agreed to and then things we didn't agree to.
  I think the approval rating now for the Affordable Care Act is at 35 
percent. Is this objection just Republicans? Are just Republicans out 
there?
  Well, let me read to you just a little bit here. This came up in 
testimony

[[Page 12256]]

yesterday in my subcommittee hearing. The letter was from James P. 
Hoffa, general president of the International Brotherhood of Teamsters; 
Joseph Hansen, international president of the United Food and 
Commercial Workers Union; and Donald D. Taylor, president of UNITE-
HERE, a union representing hotel, airport, food service, gaming and 
textile workers. This is to then-Speaker Pelosi, now minority leader:

       When you and the President sought our support for the 
     Affordable Care Act, you pledged that if we liked the health 
     plans, we could keep them. Sadly, that promise is under 
     threat. Perverse incentives are causing nightmare scenarios. 
     First, the law creates an incentive for employers to keep 
     employees' work hours below 30 hours a week. Numerous 
     employers have begun to cut workers' hours to avoid this 
     obligation, and many of them are doing so openly. The impact 
     is two-fold: fewer hours means less pay while also losing our 
     current health benefits.

  These are the presidents of three major unions.
  So it's not just Republicans, Mr. Speaker. It's the public beginning 
to focus on this now, because this bill is becoming the law of the land 
January 1. I wish it had worked as smooth as it could. It has not. And 
it has not because it's not doing what it promised, which was the 
single most important thing, which is cut the cost of care so more of 
us out there could afford to have it.
  Mr. GINGREY of Georgia. Mr. Speaker, in closing, I want to thank all 
of the members of the House GOP Doctors Caucus who participated 
tonight. If I tried to add up the number of years of clinical 
experience in our group of about 21 members on the Republican side of 
the aisle in this caucus, it would probably be 600-plus years. So we 
really do know of what we speak. We don't have every answer, but we 
know of what we speak; and we want to get it right. That's what this is 
all about.
  With that, Mr. Speaker, I yield back the balance of my time.

                          ____________________