[Congressional Record (Bound Edition), Volume 160 (2014), Part 3]
[House]
[Pages 4357-4367]
[From the U.S. Government Publishing Office, www.gpo.gov]




PROVIDING FOR CONSIDERATION OF H.R. 3189, WATER RIGHTS PROTECTION ACT; 
   PROVIDING FOR CONSIDERATION OF H.R. 4015, SGR REPEAL AND MEDICARE 
     PROVIDER PAYMENT MODERNIZATION ACT Of 2014; AND PROVIDING FOR 
 PROCEEDINGS DURING THE PERIOD FROM MARCH 17, 2014, THROUGH MARCH 21, 
                                  2014

  Mr. BURGESS. Mr. Speaker, by direction of the Committee on Rules, I 
call up House Resolution 515 and ask for its immediate consideration.

[[Page 4358]]

  The Clerk read the resolution, as follows:

                              H. Res. 515

         Resolved, That at any time after adoption of this 
     resolution the Speaker may, pursuant to clause 2(b) of rule 
     XVIII, declare the House resolved into the Committee of the 
     Whole House on the state of the Union for consideration of 
     the bill (H.R. 3189) to prohibit the conditioning of any 
     permit, lease, or other use agreement on the transfer, 
     relinquishment, or other impairment of any water right to the 
     United States by the Secretaries of the Interior and 
     Agriculture. The first reading of the bill shall be dispensed 
     with. All points of order against consideration of the bill 
     are waived. General debate shall be confined to the bill and 
     shall not exceed one hour equally divided and controlled by 
     the chair and ranking minority member of the Committee on 
     Natural Resources. After general debate the bill shall be 
     considered for amendment under the five-minute rule. It shall 
     be in order to consider as an original bill for the purpose 
     of amendment under the five-minute rule the amendment in the 
     nature of a substitute recommended by the Committee on 
     Natural Resources now printed in the bill. The committee 
     amendment in the nature of a substitute shall be considered 
     as read. All points of order against the committee amendment 
     in the nature of a substitute are waived. No amendment to the 
     committee amendment in the nature of a substitute shall be in 
     order except those printed in part A of the report of the 
     Committee on Rules accompanying this resolution. Each such 
     amendment may be offered only in the order printed in the 
     report, may be offered only by a Member designated in the 
     report, shall be considered as read, shall be debatable for 
     the time specified in the report equally divided and 
     controlled by the proponent and an opponent, shall not be 
     subject to amendment, and shall not be subject to a demand 
     for division of the question in the House or in the Committee 
     of the Whole. All points of order against such amendments are 
     waived. At the conclusion of consideration of the bill for 
     amendment the Committee shall rise and report the bill to the 
     House with such amendments as may have been adopted. Any 
     Member may demand a separate vote in the House on any 
     amendment adopted in the Committee of the Whole to the bill 
     or to the committee amendment in the nature of a substitute. 
     The previous question shall be considered as ordered on the 
     bill and amendments thereto to final passage without 
     intervening motion except one motion to recommit with or 
     without instructions.
         Sec. 2.  Upon adoption of this resolution it shall be in 
     order to consider in the House the bill (H.R. 4015) to amend 
     title XVIII of the Social Security Act to repeal the Medicare 
     sustainable growth rate and improve Medicare payments for 
     physicians and other professionals, and for other purposes. 
     All points of order against consideration of the bill are 
     waived. The amendment printed in part B of the report of the 
     Committee on Rules accompanying this resolution shall be 
     considered as adopted. The bill, as amended, shall be 
     considered as read. All points of order against provisions in 
     the bill, as amended, are waived. The previous question shall 
     be considered as ordered on the bill, as amended, and on any 
     amendment thereto to final passage without intervening motion 
     except: (1) one hour of debate equally divided among and 
     controlled by the chair and ranking minority member of the 
     Committee on Energy and Commerce and the chair and ranking 
     minority member of the Committee on Ways and Means; and (2) 
     one motion to recommit with or without instructions.
         Sec. 3.  On any legislative day during the period from 
     March 17, 2014, through March 21, 2014--
          (a) the Journal of the proceedings of the previous day 
     shall be considered as approved; and
         (b) the Chair may at any time declare the House adjourned 
     to meet at a date and time, within the limits of clause 4, 
     section 5, article I of the Constitution, to be announced by 
     the Chair in declaring the adjournment.
         Sec. 4.  The Speaker may appoint Members to perform the 
     duties of the Chair for the duration of the period addressed 
     by section 3 of this resolution as though under clause 8(a) 
     of rule I.

  The SPEAKER pro tempore. The gentleman from Texas is recognized for 1 
hour.
  Mr. BURGESS. Mr. Speaker, for the purpose of debate only, I yield the 
customary 30 minutes to the gentleman from Colorado (Mr. Polis), 
pending which I yield myself such time as I may consume. During 
consideration of this resolution, all time yielded is for the purpose 
of debate only.


                             General Leave

  Mr. BURGESS. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days to revise and extend their remarks.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. BURGESS. Mr. Speaker, House Resolution 515 provides for 
consideration of H.R. 3189, the Water Rights Protection Act, under a 
structured amendment process, making in order three amendments and 
providing for extra time for debate for the substitute amendment, which 
will be offered by Mr. Polis.
  The rule also provides for the consideration of H.R. 4015, the SGR 
Repeal and Medicare Provider Payment Modernization Act of 2014 with one 
amendment, offered by Chairman Camp from the Ways and Means Committee, 
being self-executed in order to ensure that the legislation has a valid 
pay-for.
  This is necessary so that the bill before us does not run afoul with 
the majority's rule on CutGo. As is customary, the rule allows the 
minority to offer a motion to recommit on each bill. Finally, the rule 
provides for the customary district work period authority.
  H.R. 3189, the Water Rights Protection Act, addresses a concern of a 
number of our Western State colleagues who have experienced the Federal 
Government threatening to take over the private water rights of 
businesses and private citizens held on public lands.
  The bill, sponsored by Representative Scott Tipton from Colorado, is 
a bipartisan effort to protect water supplies and property rights 
designated for recreation, agriculture, local conservation, and 
municipal use from Federal Government overreach.
  The bill protects water users and upholds State water laws by 
prohibiting Federal agencies from extorting water rights through their 
use of permits, leases, and other land management arrangements.
  If the floor debate on this bill is anything like the debate which 
members of the Rules Committee observed last night, this discussion 
will be spirited, as this issue deeply affects Western States, where so 
much of their land is controlled by the Federal Government.
  The second bill, H.R. 4015, the SGR repeal legislation, is an issue 
that I have worked on my entire congressional career. It reflects years 
of bipartisan, multicommittee, bicameral discussions and negotiations, 
bringing together Members of all ideological stripes, as well as those 
from the outside, to coalesce around a policy to help patients and to 
help their care providers get out from under the constant threat of 
payment cuts under the current sustainable growth rate structure for 
Medicare payments.
  Everyone agrees, Mr. Speaker, that the Medicare sustainable growth 
rate has got to go; but today, we are considering an actual framework 
to realistically accomplish that goal.
  This formula--the sustainable growth rate formula--was enacted as 
part of the Balanced Budget Act of 1997 in an ultimately misguided 
means by which to restrain Federal spending in Medicare Part B.
  The formula consists of expenditure targets, which are established by 
applying a growth rate, which is designed to bring spending in line 
with the expenditure targets over time.
  Since 2002, this formula has called for a reduction to physician 
reimbursement rates. However, every Congress has consistently passed 
legislation to override this formula. This has led this body to find 
over $150 billion with no solution out of this annual mess.
  If Congress were to let the SGR go into effect, physicians would face 
a 24 percent reduction in reimbursement rates in just a few weeks' 
time. This unrealistic assumption of spending and efficiency have 
plagued the health care profession and our Nation's seniors.
  The bill before us repeals the SGR--let me repeat that because it is 
so important--this bill repeals the sustainable growth rate formula, 
avoiding potentially devastating across-the-board cuts slated for 2014 
and does so at a cost far lower than what Congress has already spent or 
would likely spend over the next 10 years' time.
  The bill provides for 5 years of payment transition, essential to 
allow us to ensure continued beneficiary access, to allow medicine to 
concentrate on moving to a broad adoption of quality reporting, and 
allow Congress to move past the distraction of this formula to

[[Page 4359]]

identify Medicare reforms that can further benefit beneficiaries.
  This bill will also allow providers the time to develop and the time 
to test quality measures and clinical practice improvement activities, 
which will be used for performance assessment during other phases of 
this bill. During the 5-year stability period, physicians will receive 
annual increases of \1/2\ of 1 percent.
  I know, I can hear it already. That is not very much. Correct, it is 
not; but it is more in aggregate than what has been provided over the 
last several years. More importantly, it provides that stability so 
physician offices can plan and plan ahead on how to take care of their 
patients.

                              {time}  1245

  The quality measures implemented in what is called the Merit-Based 
Incentive Payment System will be evidence-based and developed through a 
transparent process that will seek input from provider groups, from 
patient groups, and from other stakeholders.
  Quality reporting will involve a provider's being judged against its 
practice rather than a one-size-fits-all, generic standard of care that 
does not take into account the unique practices of various specialty 
providers.
  Providers will also self-determine their measures. We consolidate 
three reporting programs into the Merit-Based Incentive Payment System, 
easing the administrative burden on doctors while retaining the 
congressionally established goals of quality, resource use, and 
meaningful use.
  The new reimbursement structure ensures continued access to high-
quality care while providing physicians with certainty and security in 
their reimbursements. Physicians will be aware of the benchmarks they 
are competing against, and unlike current law, all penalties assessed 
from those not meeting the benchmarks will go to those who are. This 
keeps the dollars in the Medicare system, and that, ultimately, drives 
the quality, which benefits Medicare patients.
  Standards against which providers will be measured will be developed 
by professional organizations in conjunction with existing programs and 
will incorporate ongoing feedback to doctors, thus further ensuring 
that optimal care is ultimately provided to the patient.
  Realtime feedback will be gained through registries and performance 
data, and doctors are encouraged to participate in the process through 
data reporting. For eligible professionals who choose to opt out of the 
fee-for-service program, alternative payment models will be available. 
These alternative models may include patient-centered medical homes, 
whether they are primary or specialty models, and bundles or episodes 
of care. By encouraging alternative payment models, care coordination, 
and disease management, our proposed solution will inspire innovation. 
Qualifying practices that move a significant number of their patients 
into one of these alternative payment methods will see a 5 percent 
quality bonus. The bill will also take affirmative steps to improve the 
accuracy of relative values and misvalued services.
  But even though we are taking these important steps toward ensuring 
quality care, the bill specifically states that these quality measures 
are not creating a Federal right of action or a legal standard of care 
or a duty of care owed by the health care provider to the patient.
  Mr. Speaker, we have had a lot of discussion. I know my friends on 
the other side of the dais may disagree with having to pay for new 
spending, but this is an important reform that Republicans put in place 
when they reclaimed the majority after the 2010 elections. If you want 
to increase mandatory spending, you should reduce mandatory spending 
elsewhere. This is a simple concept, and I know that my constituents 
and many Americans agree with this.
  The Democrats' substitute highlights the difference between the 
parties on this issue. Democrats have embraced a budget gimmick to 
offset their bill, a gimmick that even the nonpartisan Congressional 
Budget Office has said is not scorable. There is no way that it will 
pay for anything, because the score is zero.
  Republicans want to reform Medicare and the payment system in a 
responsible way and do so in a way that is paid for. If my colleagues 
on the other side can find a legitimate offset, I am happy to review 
it. In fact, this is exactly what we are asking of the United States 
Senate. You don't like our offset. Offer one of your own, and let's 
work together to pass these much-needed reforms.
  This bill is consistent in its themes throughout. We provide payment 
stability, reduce and streamline the administrative burden, increase 
predictability in doctors' interactions with the Centers for Medicare 
and Medicaid Services, build transparency into systems, encourage 
innovation and the delivery of services, and keep providers in the 
driver's seat.
  I encourage my colleagues to vote ``yes'' on the rule and ``yes'' on 
the underlying bills.
  I reserve the balance of my time.
  Mr. POLIS. I thank the gentleman for yielding me the customary 30 
minutes, and I yield myself such time as I may consume.
  Mr. Speaker, we have two bills before us under this rule, which I 
will briefly discuss before getting into the more important topic of 
what bills are not being considered on the floor of the House this 
week.
  Notably, despite comprehensive immigration reform's having passed the 
Senate with more than two-thirds support, despite the fact that there 
are more than 10 million people here in this country illegally, despite 
the fact that our borders are porous and that people are sneaking 
across, as well as illicit goods, despite the fact that we have no 
meaningful workplace enforcement, despite the fact that farmers and the 
faith-based community are crying out for reform--the business 
community, the tech community, labor--there is no immigration bill on 
the floor of the House today. Instead, we are discussing two bills.
  We are discussing one SGR fix. Now, that sounds obscure to people, 
``SGR fix.'' What is that? This is the reimbursement rate for doctors 
under Medicare, and there is a budgetary fiction that long predates me 
in this place. I assume that, at the time, Republicans and Democrats 
created this elaborate budgetary fiction together as this degree of 
budgetary fiction requires both parties' most creative thoughts to 
possibly put it together. So we pretend every year that there are going 
to be large cuts to Medicare. I think Republicans and Democrats know 
that that is not likely to happen. Those cuts would completely gut 
Medicare. Doctors would drop Medicare patients if those cuts were to 
occur.
  So each year and sometimes shorter than a year--sometimes 6 months, 
sometimes 3 months, sometimes 2 years--Democrats and Republicans have 
to come together to figure out how to avoid those automatic cuts that 
otherwise occur. That discussion is about how to pay for avoiding those 
cuts each time.
  Democrats have suggestions to pay for it--let's eliminate oil and gas 
loopholes; let's use the overseas contingency fund. Republicans have 
ideas about how they want to pay for it--in this case, the 52nd repeal 
of ObamaCare. By the way, they want to keep all of the taxes from 
ObamaCare; they just want to get rid of some of the benefits. So they 
are going to keep all of the taxes from ObamaCare--those Republicans 
love those taxes--but they are getting rid of some of the benefits. 
That is the secret of what they are using to pay for it, just so you 
know.
  The real discussion is how to do it, but in this case, the 
Republicans are presumably so embarrassed about their pay-for--the fact 
that they are using the ObamaCare taxes to pay for Medicare--that they 
are slipping it into the rule in what is called the ``deem and pass'' 
language, or what is characterized by some as the ``demon pass'' 
language.
  This rule says:

       The amendment printed in part B of the report of the 
     Committee on Rules accompanying this resolution shall be 
     considered as adopted.


[[Page 4360]]


  That means there is not even going to be a vote on the actual way to 
pay for avoiding the Medicare cuts. It is in the rule, itself. This is 
the most costly rule I have ever seen. This rule costs $138 billion of 
ObamaCare taxes that the Republicans want to use. This is an expensive 
rule, Mr. Speaker. If there is a real desire to talk with Democrats 
about ways to pay for the Medicare SGR fix, also called the ``doc 
fix,'' we are happy to do it. We were hoping that you would allow a 
Democratic pay-for sponsored by Mr. Tierney, who will talk about the 
previous question. Our idea is to use the Overseas Contingency Fund to 
avoid any cut to Medicare beneficiaries, but this rule does not allow 
us to do that. This rule doesn't even allow the House to vote on using 
ObamaCare taxes to pay for SGR. It includes the ``deem and pass'' 
language in the rule, itself--a rule, itself, that includes self-
executing language that costs $138 billion. That is one expensive rule, 
Mr. Speaker, and I certainly hope my colleagues vote ``no.''
  This rule also includes H.R. 3189, the Water Rights Protection Act. 
As my colleague said, those of us in the West feel that whiskey is for 
drinking and water is for fighting about. I think the debate on the 
Rules Committee last night and the upcoming debate here on the floor 
will probably reflect that old adage. The genesis of this particular 
bill is something that Mr. Tipton and I and, I think, many Members of 
this body agree on. We wanted to address a narrow dispute between the 
U.S. Forest Service and ski permit holders that directly impacts my 
district and impacts Mr. Tipton's district.
  I support Mr. Tipton's efforts in that regard, and I was hoping we 
could have gotten the bill to a point where it would have passed near 
unanimously or unanimously. Instead, this bill has become a job-killing 
Republican water grab that even the counties that it was designed to 
help oppose. The counties in my district that have ski resorts--Eagle, 
Rand, Summit County, famous resorts like Winter Park, Vail, Arapahoe 
Basin, Breckenridge, among others--now oppose this bill because it will 
destroy jobs in their counties by destroying recreational opportunities 
like white-water rafting, fishing, year-round tourism opportunities, 
which are critical to the economic success of my district.
  These changes to this job-killing Republican water grab have caused 
this bill to snowball into an effort that will hurt our rivers' health, 
destroy recreational opportunities, and the underlying bill jeopardizes 
the agreements that leave waters in streams and rivers, which allow our 
tourism industry to be so vibrant. Even some of the counties, as we 
mentioned in the Rules Committee yesterday--certainly not all of those 
counties--like Pitkin County and the home of Aspen and Mr. Tipton's 
district, also oppose this bill. Again, there was an overreaching 
decision by the U.S. Forest Service that required ski area permittees 
to transfer the ownership of water rights to the Federal Government. In 
2012, that water directive was overturned by a U.S. District Court 
judge.
  It is important to note that I believe in the purpose of this bill, 
and I hope that we can address it through the amendment that I have 
offered, which allows for 20 minutes of floor debate under this bill. 
This bill can still be saved by this body's endorsing the amendment 
that I have offered as part of this bill, which is also supported by 
ski area representatives from across the Mountain West, along with my 
colleagues from Colorado Ms. DeGette and Mr. Perlmutter.
  Unfortunately, this job-killing Republican water grab bill uses the 
ski area directive as a pretense for making wholesale job-killing 
changes. Look, ski areas have been a punching bag for U.S. Forest 
Service's misguided policies for the last decade. I think we can find 
common cause around a narrow solution. In that time, the Forest Service 
has changed the ski area water policies four times. It has 
inconsistently enforced others' water clauses. It has left ski areas 
subject to the agency's whim. They are very capital-intense ski areas. 
They are the major economic driver of the mountain areas of my 
district, but they have been at the whim of sometimes arbitrary Federal 
actions. Ski areas collectively hold water rights worth hundreds of 
millions of dollars that are critical for their businesses.
  Now, my colleagues might wonder what kind of improvements a ski area 
might want to make. In 2011, this body unanimously voted to support the 
Ski Area Recreational Opportunity Enhancement Act, which allowed ski 
areas to expand summertime activities, like zip lines and mountain 
biking. Amongst some of those other summertime activities that ski 
resorts benefit from are white-water rafting, fishing--the very kinds 
of recreational opportunities that will be impacted by this job-killing 
Republican water grab.
  I entered several pieces of testimony into the record in the Rules 
Committee yesterday--statements from water districts and from 
counties--with regard to how this bill will impact recreational 
opportunities in Colorado. Along with Ms. DeGette, Mr. Perlmutter, Ms. 
DelBene, Ms. Kuster, Mr. Cartwright, and Mr. Huffman, I was proud to 
offer an amendment that would fix and address the issues in H.R. 3189 
and return the bill to its original purpose.
  The amendment ensures that any U.S. Forest Service directive will not 
condition ski area permits on the transfer title of any water right or 
require any ski area permittee to acquire a water right in the name of 
the United States. The amendment ensures the long-term viability of ski 
areas, and it makes sure that this bill is not the job-killing 
Republican water grab that it has become.
  It is important to note that the narrow dispute that was the genesis 
of this bill could have been solved with a suspension measure. We have 
offered language repeatedly to Mr. Tipton and his staff, to the 
committee and its staff, but we were not taken up on that offer, sadly. 
Instead, we have before us a job-killing Republican water grab bill 
that would devastate my district.

                              {time}  1300

  Instead, the manager's amendment was offered, as well as additional 
language in committee.
  This bill is riddled with problems that are not addressed. The bypass 
flows issue is not solved in the manager's amendment, which does 
address the Endangered Species Act component but does nothing to 
address the issues around the Forest Service, BLM, Interior, and 
Agriculture agencies that also have relevant authority under a number 
of statutes, including the Federal Land Policy and Management Act, 
Forest Service and Park Service Organic Act, and Wild and Scenic Rivers 
Act, to impose bypass flows.
  Simply put, the manager's amendment doesn't make the necessary 
improvements to make this a bipartisan measure--they are simply window 
dressing for a job-killing Republican water grab.
  Let's talk about some of the issues in the underlying legislation.
  In the West, water rights are State-based, and any challenge to a 
right or to the system itself is a very delicate proposition to years 
of precedence and claims, subordinate and senior, with regard to water.
  As a result, this legislation only serves to cast doubt on the 
complicated laws and authorities that make up our Nation's and State 
water laws, and that companies, individuals, and counties have made 
decisions on and already have economic investments in.
  In addition, this bill, absent my amendment, muddles the message of 
disapproval over the 2011 decision.
  What exactly are we saying with regard to this bill? A bill that was 
meant to address the needs of ski areas because of the 2011 directive 
instead has become an all-encompassing, job-killing Republican water 
grab, which is not even a clear signal of our unhappiness with the 
original directive.
  I think not only would there be a much cleaner path to actually 
become the law of the land if we were to consider a targeted approach 
encompassed by the amendment that I have offered, but it also, even 
absent becoming law, would send a clear and unambiguous message to the 
U.S. Forest Service of

[[Page 4361]]

congressional disapproval of the directive.
  Instead, I think they will just shrug their shoulders and say, That 
is that crazy House of Representatives.
  This bill is not going to become law. This bill will not have any 
impact--and the message is lost with regard to the 2011 directive.
  If they think this is the House's reaction--muddled, job-killing, 
water-grabbing--to this sort of thing, what is to stop them from doing 
this again? What is to stop them from targeting ranchers? What is to 
stop them from targeting recreation areas?
  When this kind of thing occurs, we need a targeted reaction that can 
become law or a clear and unambiguous message that the House will not 
stand for it.
  In summary, this rule contains $183 billion in ObamaCare taxes that 
are spent for another purpose and allows two bills to come to the 
floor, both of which could be negotiated in good faith with the 
Democrats, and both of which have not.
  I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield myself 1 minute to respond to some 
of this, just to put things in context on a timeline.
  H.R. 4015 was introduced on February 6, 2014. The bill has been 
available to all Members and the public for more than a month. The bill 
is cosponsored by the bipartisan chairs and ranking members of the 
Committees on Energy and Commerce, Ways and Means, and the Senate 
Finance Committee.
  We are recommending no changes to the underlying substance of H.R. 
4015, which has been negotiated on a bipartisan basis.
  I do believe that providing offsets for new spending is an 
appropriate course of action. Therefore, the Camp amendment saves 
almost $170 billion over the next 10 years, and this rule ensures that 
we aren't making future generations foot the bill.
  I yield 4 minutes to the gentleman from Colorado (Mr. Tipton).
  Mr. TIPTON. I thank the gentleman for yielding.
  Mr. Speaker, it is with some dismay that I have to address some of 
the comments that have been made by my good friend and colleague from 
Colorado.
  Unfortunately, through their own words, they are willing to throw 
farmers and ranchers--hardworking Americans--under the bus, for an 
ideological cause, something that we simply cannot accept in the West. 
In the Western United States, water is the lifeblood of our 
communities. H.R. 3189 codifies that existing right.
  The water grab that is taking place is not by this legislation but by 
the very Federal Government that our opponents seem to want to be able 
to protect and put in a position of authority over State rights and the 
Fifth Amendment of the Constitution.
  As a sponsor of this bipartisan legislation, I support the rule on 
H.R. 3189, and I encourage an open debate because I believe the merits 
of this bill will truly speak for themselves.
  Federal attempts to be able to manipulate Federal permit, lease, and 
land management processes to circumvent long-established State water 
law and hijack privately held water rights have sounded the alarm bell 
for all non-Federal water users that rely on these water rights for 
their livelihood.
  The most recent case of the Federal Government's overreach and 
infringement on private property rights involves a U.S. Forest Service 
attempt to require the transfer of privately held water rights to the 
Federal Government as a permit condition on National Forest System 
lands. There is no just compensation for the transfer of these 
privately held rights, despite the facts that many stakeholders have 
invested millions of their own capital in developing them and, in many 
cases, rely on them for their livelihoods.
  This Forest Service permit condition has hurt a number of 
stakeholders in my home State of Colorado, including the Powderhorn ski 
area near Grand Junction. The Aspen ski area in my district, which he 
cited, supports this legislation.
  Despite having been excellent stewards of the environment and their 
water rights, the Forest Service has demanded the relinquishment of 
State-granted water rights from these ski areas in order to continue 
their operations.
  The same tactics have been used in Utah, Nevada, and other Western 
States where agencies have required the surrender of possession of 
water rights in exchange for approving the conditional use of grazing 
allotments.
  This water grab has broad implications that have begun to extend 
beyond the recreation and farming and ranching community, and are now 
threatening municipalities and other businesses.
  As a result of efforts that began in 2011 and encompass testimony 
from several hearings by the Natural Resources Committee, conversations 
with numerous stakeholders across Colorado and the West, and close 
collaboration with my friends on the committee, I introduced this 
bipartisan Water Rights Protection Act.
  This legislation provides critical protection for water rights 
holders from Federal takings by ensuring that Federal agencies cannot 
extort private property rights through uneven-handed negotiations. The 
Water Rights Protection Act offers a sensible approach that preserves 
water rights and the ability to develop water requisite to living in 
the arid West without interfering with water allocations for non-
Federal parties or allocations that protect the environment that is 
cherished by all Westerners.
  To this end, the bill prohibits Federal agencies from pilfering water 
rights through the use of permits, lease, and other land management 
arrangements for which it would otherwise have to pay just compensation 
under the Fifth Amendment of the Constitution. The bill also prohibits 
Federal land management agencies from forcing water users to apply for 
or acquire water rights from the United States rather than for the 
water users themselves.
  Finally, this commonsense legislation provides certainty by upholding 
longstanding Federal deference to State water law in which countless 
water users rely.
  As the American Farm Bureau states in their letter of support:

       H.R. 3189 grants no new rights to any party, nor does it in 
     any way infringe on existing rights of individuals, States, 
     or the Federal Government. This legislation simply reaffirms 
     what has been existing law for generations in the West.

  I am proud that this important piece of legislation that is supported 
by a broad coalition of stakeholders is now present. Water is our most 
precious resource in the West, and long-held private property rights to 
it must be protected from uncompensated Federal takings.
  I urge adoption of the rule.
  Mr. POLIS. Mr. Speaker, I yield 3 minutes to the gentlewoman from 
Texas (Ms. Jackson Lee), to further discuss the rule that allows for 
the debate of the job-killing Republican water grab and the bill to 
keep ObamaCare taxes and remove the benefits.
  Ms. JACKSON LEE. I thank the gentleman very much.
  Might I make a March plea in this March madness?
  Can't we all get along and work together on important items such as 
water rights and the SGR?
  I rise, first of all, to make it very clear that I am a strong 
supporter of providing adequate compensation to our physicians who 
serve Medicare patients. It is important for our seniors to know that 
Medicare will be there when they need it. But it is equally important 
that there are physicians who are willing to attend to them without 
going broke.
  Let it be very clear that I believe my record has been extremely 
strong on the idea of making sure the benefits for seniors are not cut.
  The misrepresentation that the Affordable Care Act cuts Medicare 
benefits is not true. Now we have the sustainable growth rate, which we 
had bipartisan support for, and all of a sudden we have a poison pill 
of a self-executing rule, which was challenged in the Rules Committee, 
to take money from the Affordable Care Act to allegedly help the 
doctors.

[[Page 4362]]

  Every doctor I speak to wants a permanent fix for the SGR. There are 
a number of suggestions made in the other body, somewhat unpleasant, 
but we were willing to look at those particular suggestions.
  As with any business, medical clinics and physician offices have 
payrolls to meet, bills to pay, and expenses to meet as they become 
due. Why are we playing with them when, in essence, we know that this 
is not going anywhere? Why are we not taking care of these physicians 
who spend 8 years and hundreds of thousands of dollars to work to gain 
a degree because they are healers, they believe in it, they want to 
serve the public. Now, rather than have a bipartisan bill--in the 
spirit of St. Patrick's Day--and be able to come together and work 
together, no, we have a bill that poses a serious problem.
  I oppose the rule because it corrupts what would otherwise be a 
strongly supported bipartisan bill to sustain physician reimbursement 
rates, and it is another attempt, again by our friends on the other 
side, to disregard and mislead the public about the Affordable Care 
Act.
  Let me clearly say that 11 groups representing the Nation's seniors--
doctors and advocates--sent a letter to congressional leaders urging 
the House to reject the Republicans' toxic doc fix, the GOP's 51st vote 
to repeal.
  From the letter:

       The undersigned organizations representing Medicare 
     beneficiaries and providers appreciate the bipartisan, 
     bicameral work done to repeal the Sustainable Growth Rate, 
     SGR, and reform the Medicare reimbursement system. The 
     current effort to link, however, SGR reform with changes to 
     the Affordable Care Act injects partisan politics in 
     bipartisan legislation.

  Access to health care for more than 50 million Americans with 
Medicare is a serious matter. We should not schedule a vote that does 
not take seriously the idea of making sure our doctors get sufficient 
compensation.
  The other wrongheaded approach to this is there are no amendments 
being allowed. No amendments, Mr. Speaker. A closed rule. I just saw 
some documentation of how many closed rules we have had in this House.
  The SPEAKER pro tempore (Mr. Womack). The time of the gentlewoman has 
expired.
  Mr. POLIS. I yield the gentlewoman an additional 30 seconds.
  Ms. JACKSON LEE. I thank the gentleman.
  The Jackson Lee amendment that was not allowed would have ensured 
that, notwithstanding any provision of this act, no delay in the 
application of any provision of the Affordable Care Act would have 
occurred. It would have called for some studies about Medicare 
providers. It would have given us real information.
  Jackson Lee amendment No. 2 would have required the Secretary to 
submit a report on cost savings.
  The real point is, between skewing the water rights of people and the 
SGR, this rule should be opposed. We should get back to the drawing 
board.
  Can't we all get along and work together on the right kind of 
legislation for water rights? More importantly, Mr. Speaker, our 
doctors deserve better, and I will say to them, you will get better 
from us.
  Mr. Speaker, I rise to speak in strong opposition to the Rule for 
H.R. 4015, the SGR Repeal and Medicare Provider Payment Modernization 
Act of 2014.
  Let me say first that I am a strong supporter of providing adequate 
compensation to our physicians who serve Medicare patients. It is 
important for our seniors to know that Medicare will be there when they 
need it. But it is equally important that there are physicians who are 
willing to attend to them without going broke.
  That is why we have a Sustainable Growth Rate or ``SGR.'' Medicare 
reimbursement enables rural physicians and hospitals to remain open for 
business.
  As with any business, medical clinics and physician offices have 
payrolls to meet, bills to pay, and expenses to meet as they become 
due. If revenues are not sufficient to cover costs, the business will 
not long survive.
  Thus, it is critical that we not disrupt timely and adequate payment 
to Medicare providers.
  The problem with H.R. 4015 is what happened in the Rules Committee.
  The Rules Committee, on a party line vote, added language to the Rule 
for H.R. 4015 that would delay the Affordable Care Act's implementation 
of the individual mandate.
  I oppose the Rule for two reasons:
  It corrupts what would otherwise be a strongly supported bipartisan 
bill to sustain physician reimbursement rates for medical services 
approved under Medicare, and
  It is another attempt by the Republicans to mislead the public 
regarding the Affordable Care Act.
  The Jackson Lee Amendments offered to the Rules Committee for H.R. 
4015 would have improved the bill by removing the uncertainty that 
physicians would not keep the reimbursement rates they now have for 
treating patients under Medicare.
  Jackson Lee Amendment #1 would have ensured that notwithstanding any 
provision of this Act, no delay in the application of any provisions of 
the Affordable Care Act's individual mandate can take effect before 
January 21, 2017.
  Jackson Lee Amendment #2 would have required the Secretary of Health 
and Human Services to submit a report to Congress on the impact of the 
Medicare provider payments on the diversity and availability of 
physicians and hospitals to underserved rural and urban communities.
  Jackson Lee Amendment #3 would have required the Secretary of Health 
and Human Services to submit a report to Congress on the cost savings 
associated with people no longer using emergency rooms or acute care 
facilities as their primary means of obtaining health care.
  Jackson Lee Amendment #4 would ensure that the bill cannot be 
construed or interpreted to permit or require a delay in the 
application of the Affordable Care Act's individual mandate.
  I know that many predicted that the Affordable Care Act would cause 
havoc on the nation's health care system. But it is not the ACA that is 
causing havoc--it is the 50 desperate but futile attempts by the Tea 
Party to scuttle a law that has been passed by Congress, signed by the 
President, upheld by the Supreme Court.
  The most threatening actions to our nation's healthcare system by Tea 
Party Republicans are their attacks on Medicare.
  In 2014, according to the Kaiser Foundation 16% of the nation's 
people have medical insurance under Medicare:
  Texas has 12% of its residents insured under Medicare;
  Arkansas, Florida and Vermont have 19% of their residents insured 
under Medicare; and
  West Virginia and Maine have 21% of their residents insured under 
Medicare.
  Kentucky; Mississippi, Missouri, Ohio, Oklahoma, Oregon, South 
Dakota, Tennessee, Wisconsin, Ohio, Oklahoma, and Oregon have 18% of 
their residents insured under Medicare.
  Every state has more than 10% of their residents insured by Medicare.
  The uncertainly created by the majority regarding Medicare 
reimbursement over the last several years has forced physicians to 
reevaluate continuing their medical practice and frustrated hospitals 
working to make budget projections over several years into the future--
this is critical to business decision making.
  Because of uncertainty created by Medicare physician reimbursement--
physicians and hospitals have been forced to close their offices, 
reduce services, or merge.
  When patients find they cannot keep their physician or that their 
options for health care are being affected--it is not because of the 
Affordable Care Act.
  Our nation has taken a momentous step in creating a mindset that good 
health is a personal responsibility with the enactment of the 
Affordable Care Act. The health care law did not automatically enroll 
all citizens into the program; it was specifically designed to be an 
opt-in process.
  There are tens of thousands of visitors each day to the website and 
despite problems with the initial rollout of the online health 
insurance registration process, millions have enrolled and experience 
the peace of mind that comes from having affordable, high quality 
health insurance that is there when you need it.
  I have held many events in my District to inform and connect people 
with Navigators and Community Health Centers and send a strong message 
to my constituents encouraging them that now is the time for them to 
obtain affordable, accessible, and high quality health insurance for 
themselves and their families.
  So it is puzzling that with less than 70 legislative days remaining 
in the Second Session of the 113th Congress, we are still seeing 
attempts to end the Affordable Care Act.
  The fact that a bill that is critical to the provision of payments to 
physicians that treat Medicare patients is not safe from the politics 
of the moment is troubling.
  I ask my colleagues to support Medicare patients and their physicians 
by rejecting this Rule.

[[Page 4363]]


  Mr. BURGESS. Mr. Speaker, may I inquire as to the amount of time that 
remains.
  The SPEAKER pro tempore. The gentleman from Texas has 15\1/2\ minutes 
remaining. The gentleman from Colorado has 12 minutes remaining.
  Mr. BURGESS. Thank you, Mr. Speaker.
  I yield myself 2 minutes.
  I wanted to just list some of the exemptions from the individual 
mandate--those passed in a bipartisan manner by the House of 
Representatives and those instituted by executive action by the 
President:
  July 17, we delayed the individual mandate until 2015. Twenty-two 
Democrats voted in favor of that.
  March 10, 2014, delayed the individual penalty for individuals who 
fail to have health care coverage. Twenty-seven Democrats voted in 
favor.
  March 11, H.R. 1814, exempted individuals with certain religious 
beliefs. Passed by a voice vote. Not a single dissenting vote.
  March 11, we exempted volunteer firefighters and emergency responders 
from the individual mandate. The vote was 410-0. 186 Democrats voted in 
favor.
  March 11, we exempted individuals who receive health coverage under 
TRICARE, VA, from being counted towards the employer mandate under the 
ACA. 183 Democrats voted in favor of that exemption.
  This is not something that is exclusive to the House of 
Representatives.

                              {time}  1315

  Just last week, the administration quietly excused millions of people 
from the requirement to purchase health insurance or else pay the tax. 
Now all you need to do is fill out a form attesting that your plan was 
canceled and you believe that the plan options available in the 
marketplace in your area are more expensive than your canceled 
insurance policy. You believe that to be true. You don't have to prove 
it. You believe it to be true. It is self-attestation. So the President 
has already delayed the individual mandate for another 2 years' time.
  This is a reasonable proposal, what is out there today. Yes, doctors 
do need relief, but we need to pay for that. I believe the proposal 
before the Congress today will do just that.
  Mr. Speaker, I reserve the balance of my time.
  Mr. POLIS. Mr. Speaker, I yield myself such time as I may consume.
  The Republicans are getting worse and worse on these ObamaCare votes. 
You would think that you would get better with practice, after 52 times 
they would be better at repealing ObamaCare. That is because this body, 
the House of Representatives, has voted to repeal ObamaCare, in whole 
or in part, 52 times.
  Those votes started out where it was very simple. The votes were to 
repeal everything that was in the Affordable Care Act. That is how 
those votes started. Now they have gotten to the point where the 
Republicans want to keep the taxes from ObamaCare and get rid of the 
benefits. I don't think anybody wants that.
  I mean, if you are talking about repealing the Affordable Care Act, 
you still have people that are split on that. You might have a few more 
people that agree with you or a few more that agree with us, but the 
American people have different opinions about that. But if you offered 
any of them keep all the taxes and get rid of the benefits, I can't 
imagine anybody wants that.
  I would hope that, after so much practice, the Republicans would be 
quite good at this. It seems to be the core competency they are 
developing. Almost every week, in fact, this body repeals ObamaCare, 
but now they are repealing it in a way that keeps all the taxes and 
gets rid of the benefits; so I am quite surprised that the old adage of 
``practice makes perfect'' is far from true with regard to the 
Republican approach to this bill.
  Mr. Speaker, I yield 3 minutes to the gentleman from Wisconsin (Mr. 
Kind).
  Mr. KIND. Mr. Speaker, I thank my good friend from Colorado for 
yielding me this time.
  Mr. Speaker, we have an opportunity in this session of Congress of 
getting rid of an onerous policy that has affected the delivery of 
health care throughout our country since 1997, the so-called 
sustainable growth rate. That is the reimbursement that our doctors, 
our physicians receive in Medicare.
  We have been working hard at this for a number of years. I commend my 
good friend and colleague from Texas for the leadership that he has 
shown on this issue.
  The policy behind the SGR repeal that is going to be before this 
Congress tomorrow has been bipartisan in support. It moves the health 
care system in the direction where it needs to go, with an emphasis on 
quality and value, as opposed to the volume of services and moving away 
from the so-called fee-for-service reimbursement schedule that we have 
right now.
  I believe that if we continue to drive the health care system in that 
direction, we can get much better quality of care for all Americans, 
but at a much better price. There are a lot of tools under the 
Affordable Care Act that are moving us in that direction now to a more 
integrated, coordinated, patient-centered health care delivery system, 
but also a reimbursement system that finally is based on the value or 
the quality of care that is given and no longer the volume of services 
that are rendered.
  In fact, just recently, the Institute of Medicine at the National 
Academy of Sciences came out with their analysis of the health care 
system, and found that we are spending close to $750 billion every year 
on things that don't work. They don't improve patient care. It is the 
overutilization that is costing us so much and, most of the time, 
leading to worse outcomes rather than better outcomes; yet the bill 
with the SGR before us would correct a lot of this with different 
payment models, with the emphasis on quality and value, with value 
incentives built into it.
  The problem that we have before us tomorrow is how they are going to 
pay for it. It is this itch that they have to scratch over and over 
again called the Affordable Care Act, or so-called ObamaCare. They 
can't help themselves but to keep going back to that well in order to 
find offsets and pay-fors for other measures where there is bipartisan 
support and agreement on.
  So we will go through this ruse yet again tomorrow. We will have this 
debate. The vote will probably be along partisan-lines, knowing that it 
is not going to advance anywhere in the Senate, nor would the President 
embrace this type of pay-for eliminating the individual responsibility 
component of the Affordable Care Act. And then we will be right back to 
where we are today, and that is having to sit down, talk to one 
another, find some reasonable offsets in order to finally repeal the 
SGR.
  Repeal of SGR is on sale right now. The Congressional Budget Office 
has been very kind in their score on what repeal would look like--
roughly $138 billion. Still a lot of money. In fact, where current per 
capita health care spending is going right now, it keeps getting better 
month after month. We are at the lowest per capita health care spending 
in the last 50 years, certainly lower than anything that we have ever 
seen under Medicare and Medicaid.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. POLIS. Mr. Speaker, I yield the gentleman an additional 45 
seconds.
  Mr. KIND. So there are some powerful trends that are leading to a 
reduction in overall health care spending, things that we should study 
and explore and try to sustain.
  But moving forward with an SGR repeal based on pay-fors that are 
being offered is just a dead-end road, it is not going to advance, and 
this is too important of a topic, too serious of an issue throughout 
our health care system to play these partisan, political games all over 
again.
  So let's scratch this itch once again, and then, next week, let's 
come back together and see if we can, in a bipartisan fashion, find 
some commonsense, reasonable offsets that both parties can agree to, 
that the Senate can work on, that the President will sign, so we can 
finally get rid of this SGR onus that has been hanging over us.
  Mr. BURGESS. Mr. Speaker, I yield myself 2 minutes.

[[Page 4364]]

  Mr. Speaker, again I remind the body that this language, this 
compromise, this bipartisan, bicameral compromise has been available 
for all to see since February 6. During that time, what response have 
we gotten from the United States Senate as the responsible way to pay 
for this legislation? Crickets. Zero. Nothing.
  We are offering this bill today with the pay-for that has been 
embraced by both sides in a bipartisan fashion, as I have demonstrated 
to you already. This would not be necessary if the Senate had provided 
us feedback on what their approach to a method of paying for this 
legislation would be, but they did not.
  We know the chairman of the Senate Finance Committee, the Finance 
Committee in the other body, the chairwoman has now gone to a different 
occupation, so there is a new chairperson in the other body on the 
Finance Committee, but that shouldn't have been an obstacle. There was 
a way forward to provide the discussion, a preconference conference, if 
you will, because we had all agreed on the policy. This was not a 
mystery. This was not something that one body had done in secret. This 
had all been done out in the open for the past 2 years. So that pathway 
was available.
  But for whatever reason, the other body said no deal. We don't want 
to deal with the House. We want to jam the House at the last minute and 
get them to accept something. Or better yet, let's just do another 
patch and get us past our Election Day. That is a very cynical 
approach.
  Mr. Speaker, today before us on the floor we are taking a responsible 
approach. And guess what. Because we have taken this approach, the 
Senate is now talking once again about their way forward, which, 
ultimately, I think is a good thing.
  Mr. Speaker, I reserve the balance of my time.
  Mr. POLIS. Mr. Speaker, I would like to inquire of the gentleman if 
he has any remaining speakers.
  Mr. BURGESS. As the gentleman from Colorado knows, I am capable of 
filling whatever volume of time remains on my own, but, no, I don't see 
other speakers seeking recognition.
  I would inquire of the gentleman from Colorado his status of 
additional speakers.
  Mr. POLIS. I am prepared to close. I have 6 minutes, and I wanted to 
yield to the gentleman if he has remaining speakers who wanted to speak 
before I close.
  Mr. BURGESS. I am prepared to close.
  Mr. POLIS. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, sadly, with these two bills, while the Republican job-
killing water grab bill and the ObamaCare tax bill are both not going 
to become law, they both have a genesis in a real issue, one that calls 
for bipartisan cooperation, one that affects the water rights of ski 
areas that we have offered language in an amendment that would address, 
the other, my colleague, Mr. Kind, addressed.
  This body has a long tradition of coming together around figuring how 
to pay for SGR. Now, the gentleman mentioned February 6 the language 
was available. The language regarding the SGR fix is not what is in 
dispute. The way of paying for the SGR fix is what is the topic of 
debate between Democrats and Republicans. That language was not seen 
February 6. That language is not even going to be voted upon under this 
rule. It is contained in the rule itself.
  Sadly, while we take up our time on these bills that are not going to 
become law, we continue to avoid action on the pressing issue of 
reforming our immigration system. In August, a number of us sent a 
letter to Speaker Boehner saying that he should introduce comprehensive 
immigration reform legislation. If he failed to do so, we would work 
with a diverse group of our colleagues to introduce a bill for 
comprehensive immigration reform in the House. There were crickets, and 
so my colleagues and I, in October, introduced H.R. 15, comprehensive 
immigration reform, a bill that has bipartisan cosponsors, over 200 
sponsors from both sides of the aisle.
  Immigration reform is supported by an unprecedented coalition, 
including business and tech companies, faith leaders from across the 
country, police, security specialists, but most importantly, the 
American people, who are sick and tired of having over 10 million 
people in our country illegally.
  We need to restore the rule of law. We need to allow American 
families to succeed in our country and to live their dreams. We need to 
have control of our border. We need to implement mandatory workplace 
authentication to ensure that people who are here illegally cannot 
work. Every day that passes is a failure of this body to address these 
issues, and the solution to all of these issues, workplace 
authentication, securing our border, uniting families, those are all in 
H.R. 15.
  Look, we are ready to talk. If you don't want to bring H.R. 15 to a 
vote, Mr. Speaker, what are your immigration bills? What is the package 
of bills that will address these? Because we know it will take a 
multifaceted approach. A wall alone on the southern border doesn't 
solve this issue. The day after that wall is erected, there are still 
10 million people here illegally, and the fact that half the people who 
are here illegally don't sneak across that border, they come here 
legally and then they outstay their welcome and work illegally. So this 
requires a solution that I think this Congress is capable of. I think 
we can work together.
  Rather than consider divisive, job-killing water grab bills, rather 
than consider divisive ObamaCare tax bills that the Republicans want to 
use ObamaCare taxes, rather than repeal them, let's come together 
around immigration reform. House Republicans need to reject offensive 
and unproductive rhetoric and show real leadership that the business 
community in our country is calling out for.
  A few weeks ago, a Wall Street Journal op-ed criticized Republicans' 
failure to act on commonsense reform. The Wall Street Journal said: 
``Republicans have killed immigration reform for now, but the Farm 
Bureau study shows that in the real economy it's still needed.''
  We could increase GDP by 3.3 percent. We can raise American wages by 
$470 billion with immigration reform. We can create 121,000 jobs for 
Americans each year by bringing comprehensive immigration reform to the 
floor.
  Over 70 percent of the American people support immigration reform. It 
is time to act.
  Mr. Speaker, if we defeat the previous question, I will offer an 
amendment to the rule to bring up the reasonable solution that would 
permanently fix the SGR and is offset by capping spending on the 
Overseas Contingency Fund.
  Mr. Speaker, I ask unanimous consent to insert the text of the 
amendment in the Record along with extraneous material immediately 
prior to the vote on the previous question.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Colorado?
  There was no objection.
  Mr. POLIS. Mr. Speaker, unfortunately, but I regret to say 
unsurprisingly, the Republicans continue to play politics with 
Medicare, politics with water that is the lifeblood of the American 
West and the economic lifeblood of the counties that I represent in 
Eagle and Summit County. And all we have here to vote on today is, once 
again, an attempt to undermine the Affordable Care Act, to keep the 
taxes and remove the benefits, and an attempt to grab the water from 
those who would use it for fishing and recreation in the Mountain West.

                              {time}  1330

  I hope that we can do better.
  If we can reject this $183 billion rule, I think it will send a 
message to the Speaker that we are ready for immigration reform.
  We are ready to reach out our hand on the SGR, on the doc fix, and 
figure out the best way to pay for it, taking the best ideas that 
Republicans and Democrats have to offer, working with the gentleman 
from Wisconsin (Mr. Kind) and others to bend the cost curve, so that we 
can deliver a better quality of services to American seniors and 
contain costs more effectively.

[[Page 4365]]

  I urge my colleagues to vote ``no'' and defeat the previous question 
and vote ``no'' on the underlying bills.
  I yield back the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield myself the balance of the time.
  Mr. Speaker, I do want to direct Members' attention to yesterday's 
Wall Street Journal, the article entitled ``ObamaCare's Secret Mandate 
Exemption,'' which goes into some detail about the self-attestation for 
the so-called hardship exemption, which the administration included as 
part of an unrelated rule last week.
  As a consequence, there is an exemption from the individual mandate 
for the next 2 years for anyone who simply wants to go and say: I am 
sorry; this is too tough for me to do.
  Mr. Speaker, today's rule provides for the consideration of two 
important bills, one dealing with critical water rights and the other 
addressing the serious problem in the Medicare Sustainable Growth Rate.
  I certainly want to thank the gentleman from Colorado (Mr. Tipton) on 
H.R. 3189, as well as thank the chairmen and the ranking members of the 
House Committees on Energy and Commerce and Ways and Means, as well as 
the Senate Finance Committee, for coming together for our Nation's 
doctors and seniors.
  As I close, I would like to note that each committee's work is 
represented in H.R. 4015. H.R. 4015's base policy has the backing of 
the House and Senate negotiators and all three committees of 
jurisdiction. The original cosponsors of the bill include the chairmen 
and the ranking members of the full committees of jurisdiction, as well 
as their health subcommittees.
  The bill has gained support from the GOP Doctors Caucus, as well as 
many physicians on the other side of the aisle. We have over 100 
bipartisan cosponsors. The bill's policy has been embraced by organized 
medicine, with well over 700 State and national groups in support of 
the bill.
  From primary care to specialists to surgeons to organized nursing and 
everyone in-between, we have support for this policy. We will not be 
able to accomplish this goal without substantive and immediate 
bipartisan dialogue seeking agreement on reforms to offset the costs 
associated with the policies in H.R. 4015.
  While the delay of the mandate has received bipartisan support, I 
understand the problems that arise and the opposition that arises.
  These reforms must receive the necessary majority support, not only 
of the House and Senate, but also be agreed to by the White House. 
However, no one Chamber can negotiate on such an important task in a 
vacuum.
  This action by the House is a means of clearly demonstrating that the 
legislative policies contained within H.R. 4015 and S. 2000 not only 
have the support of the committees of jurisdiction and organized 
medicine, but can gain the necessary support to pass the House.
  Mr. Speaker, this is clearly not the end of this conversation. It is 
another step--another step of many that have been taken in 
demonstrating to both sides of the Capitol that the committees of 
jurisdiction have produced significant policy that can serve as the 
solution to the sustainable growth rate formula that most of us have 
sought throughout our congressional careers.
  Mr. Speaker, I do want to take a moment to thank some of the staff 
members who have done so much work. I really wanted to start with Dr. 
John O'Shea, who no longer is on the staff, but now works at the 
Brookings Institute.
  Dr. O'Shea, a physician from New York, was hired by committee staff 
for the express purpose of helping develop the policy for repealing the 
sustainable growth rate. In addition, James Decker on my staff assists 
me with rules issues.
  J.P. Paluskiewicz, known affectionately by his friends as J.P., has 
put in extraordinary hours on this project, as have Sarah Johnson and 
Adrianna Simonelli on my personal staff.
  On the committee staff, Clay Alspach and Robert Horne have 
additionally put in hours well above and beyond what ordinarily would 
be required of committee staff in order to see this project come to 
fruition.
  I certainly want to thank Chairman Upton for making this a priority 
during his chairmanship of the Committee on Energy and Commerce; and I 
thank all of the staff--staff on Ways and Means and staff on Senate 
Finance--who have worked on this issue and will continue to work on 
this issue until it is solved.
  Every success we have had at every point in this process was further 
than we have ever come before, and that involved a lot of working 
weekends; but ultimately, if we use this action to springboard to full 
bicameral engagement on the package that can go to the White House and 
get signed by the President, indeed, I think all involved would agree 
that it would be worth it.
  I look forward to passage. I look forward to continuing the process 
with this Chamber and the other Chamber to embrace the underlying 
policy and ultimately identify the offsets that can get this badly 
needed policy into law. I urge my colleagues to support the rule and 
both underlying bills.

                    [From the Hill, March 13, 2014]

                  ObamaCare's Secret Mandate Exemption

       ObamaCare's implementers continue to roam the battlefield 
     and shoot their own wounded, and the latest casualty is the 
     core of the Affordable Care Act--the individual mandate. To 
     wit, last week the Administration quietly excused millions of 
     people from the requirement to purchase health insurance or 
     else pay a tax penalty.
       This latest political reconstruction has received zero 
     media notice, and the Health and Human Services Department 
     didn't think the details were worth discussing in a 
     conference call, press materials or fact sheet. Instead, the 
     mandate suspension was buried in an unrelated rule that was 
     meant to preserve some health plans that don't comply with 
     ObamaCare benefit and redistribution mandates. Our sources 
     only noticed the change this week.
       That seven-page technical bulletin includes a paragraph and 
     footnote that casually mention that a rule in a separate 
     December 2013 bulletin would be extended for two more years, 
     until 2016. Lo and behold, it turns out this second rule, 
     which was supposed to last for only a year, allows Americans 
     whose coverage was cancelled to opt out of the mandate 
     altogether.
       In 2013, HHS decided that ObamaCare's wave of policy 
     terminations qualified as a ``hardship'' that entitled people 
     to a special type of coverage designed for people under age 
     30 or a mandate exemption. HHS originally defined and 
     reserved hardship exemptions for the truly down and out such 
     as battered women, the evicted and bankrupts.
       But amid the post-rollout political backlash, last week the 
     agency created a new category: Now all you need to do is fill 
     out a form attesting that your plan was cancelled and that 
     you ``believe that the plan options available in the 
     [ObamaCare] Marketplace in your area are more expensive than 
     your cancelled health insurance policy'' or ``you consider 
     other available policies unaffordable.''
       This lax standard--no formula or hard test beyond a 
     person's belief--at least ostensibly requires proof such as 
     an insurer termination notice. But people can also qualify 
     for hardships for the unspecified nonreason that ``you 
     experienced another hardship in obtaining health insurance,'' 
     which only requires ``documentation if possible.'' And yet 
     another waiver is available to those who say they are merely 
     unable to afford coverage, regardless of their prior 
     insurance. In a word, these shifting legal benchmarks offer 
     an exemption to everyone who conceivably wants one.
       Keep in mind that the White House argued at the Supreme 
     Court that the individual mandate to buy insurance was 
     indispensable to the law's success, and President Obama 
     continues to say he'd veto the bipartisan bills that would 
     delay or repeal it. So why are ObamaCare liberals silently 
     gutting their own creation now?
       The answers are the implementation fiasco and politics. HHS 
     revealed Tuesday that only 940,000 people signed up for an 
     ObamaCare plan in February, bringing the total to about 4.2 
     million, well below the original 5.7 million projection. The 
     predicted ``surge'' of young beneficiaries isn't 
     materializing even as the end-of-March deadline approaches, 
     and enrollment decelerated in February.
       Meanwhile, a McKinsey & Company survey reports that a mere 
     27% of people joining the exchanges were previously uninsured 
     through February. The survey also found that about half of 
     people who shopped for a plan but did not enroll said 
     premiums were too expensive, even though 80% of this group 
     qualify for subsidies. Some substantial share of the people 
     ObamaCare is supposed to help say it is a bad financial 
     value. You might even call it a hardship.
       HHS is also trying to pre-empt the inevitable political 
     blowback from the nasty 2015

[[Page 4366]]

     tax surprise of fining the uninsured for being uninsured, 
     which could help reopen ObamaCare if voters elect a 
     Republican Senate this November. Keeping its mandate waiver 
     secret for now is an attempt get past November and in the 
     meantime sign up as many people as possible for government-
     subsidized health care. Our sources in the insurance industry 
     are worried the regulatory loophole sets a mandate non-
     enforcement precedent, and they're probably right. The longer 
     it is not enforced, the less likely any President will 
     enforce it.
       The larger point is that there have been so many unilateral 
     executive waivers and delays that ObamaCare must be 
     unrecognizable to its drafters, to the extent they ever knew 
     what the law contained.
                                  ____



                                    Texas Medical Association,

                                       Austin, TX, March 13, 2014.
     Hon. Michael C. Burgess, MD,
     U.S. House of Representatives,
     Washington, DC.
       Dear Representative Burgess: On behalf of the 47,000-plus 
     physician and medical student members of the Texas Medical 
     Association, I am writing to reiterate our strong support for 
     the work you have done to effectuate the repeal of Medicare's 
     Sustainable Growth Rate (SGR) formula. In conjunction with 
     your Texas colleague, Kevin Brady, you have gotten closer to 
     solving this challenging issue than ever before. And you have 
     done so with the support of every member of the Texas 
     delegation, both Democratic and Republican, on the Energy & 
     Commerce and Ways & Means Committees.
       Perhaps more than anyone in Congress, you understand the 
     frustration and anxiety that the ongoing SGR uncertainty 
     creates for practicing physicians. You have worked tirelessly 
     to craft a piece of legislation that not only repeals the SGR 
     immediately, but also guarantees positive updates for 
     physicians for five years, removes potential causes of 
     liability against physicians, and eliminates some unnecessary 
     bureaucratic red tape that prevents physicians from 
     concentrating on patient care.
       We especially appreciate your ongoing consultation and 
     dialogue with TMA and Texas physicians throughout this 
     process.
       As you know well, the SGR Repeal and Medicare Provider 
     Payment Modernization Act of 2014 has made it this far 
     because of a bipartisan, bicameral agreement on the need to 
     replace the SGR. We are committed to helping you finish the 
     task.
           Sincerely,
                                        Stephen L. Brotherton, MD,
                                                        President.

  The material previously referred to by Mr. Polis is as follows:

      An amendment to H. Res. 515 offered by Mr. Polis of Colorado

       Strike section 2 and replace with:
       Sec. 2. Immediately upon adoption of this resolution the 
     Speaker shall, pursuant to clause 2(b) of rule XVIII, declare 
     the House resolved into the Committee of the Whole House on 
     the state of the Union for consideration of the bill (H.R. 
     4209) to amend title XVIII of the Social Security Act to 
     repeal the Medicare sustainable growth rate and improve 
     Medicare payments for physicians and other professionals, and 
     for other purposes. The first reading of the bill shall be 
     dispensed with. All points of order against consideration of 
     the bill are waived. General debate shall be confined to the 
     bill and shall not exceed one hour equally divided among and 
     controlled by the chair and ranking minority member of the 
     Committee on Energy and Commerce, the chair and ranking 
     minority member of the Committee on Ways and Means, and the 
     chair and ranking minority member of the Committee on the 
     Judiciary. After general debate the bill shall be considered 
     for amendment under the five-minute rule. The bill shall be 
     considered as read. All points of order against provisions in 
     the bill are waived. At the conclusion of consideration of 
     the bill for amendment the Committee shall rise and report 
     the bill to the House with such amendments as may have been 
     adopted. The previous question shall be considered as ordered 
     on the bill and amendments thereto to final passage without 
     intervening motion except one motion to recommit with or 
     without instructions. If the Committee of the Whole rises and 
     reports that it has come to no resolution on the bill, then 
     on the next legislative day the House shall, immediately 
     after the third daily order of business under clause 1 of 
     rule XIV, resolve into the Committee of the Whole for further 
     consideration of the bill.
       At the end of the resolution, add the following new 
     section:
       Sec. 5. Clause 1(c) of rule XIX shall not apply to the 
     consideration of H.R. 4209.
                                  ____


        The Vote on the Previous Question: What It Really Means

       This vote, the vote on whether to order the previous 
     question on a special rule, is not merely a procedural vote. 
     A vote against ordering the previous question is a vote 
     against the Republican majority agenda and a vote to allow 
     the Democratic minority to offer an alternative plan. It is a 
     vote about what the House should be debating.
       Mr. Clarence Cannon's Precedents of the House of 
     Representatives (VI, 308-311), describes the vote on the 
     previous question on the rule as ``a motion to direct or 
     control the consideration of the subject before the House 
     being made by the Member in charge.'' To defeat the previous 
     question is to give the opposition a chance to decide the 
     subject before the House. Cannon cites the Speaker's ruling 
     of January 13, 1920, to the effect that ``the refusal of the 
     House to sustain the demand for the previous question passes 
     the control of the resolution to the opposition'' in order to 
     offer an amendment. On March 15, 1909, a member of the 
     majority party offered a rule resolution. The House defeated 
     the previous question and a member of the opposition rose to 
     a parliamentary inquiry, asking who was entitled to 
     recognition. Speaker Joseph G. Cannon (R-Illinois) said: 
     ``The previous question having been refused, the gentleman 
     from New York, Mr. Fitzgerald, who had asked the gentleman to 
     yield to him for an amendment, is entitled to the first 
     recognition.''
       The Republican majority may say ``the vote on the previous 
     question is simply a vote on whether to proceed to an 
     immediate vote on adopting the resolution . . . [and] has no 
     substantive legislative or policy implications whatsoever.'' 
     But that is not what they have always said. Listen to the 
     Republican Leadership Manual on the Legislative Process in 
     the United States House of Representatives, (6th edition, 
     page 135). Here's how the Republicans describe the previous 
     question vote in their own manual: ``Although it is generally 
     not possible to amend the rule because the majority Member 
     controlling the time will not yield for the purpose of 
     offering an amendment, the same result may be achieved by 
     voting down the previous question on the rule. . . When the 
     motion for the previous question is defeated, control of the 
     time passes to the Member who led the opposition to ordering 
     the previous question. That Member, because he then controls 
     the time, may offer an amendment to the rule, or yield for 
     the purpose of amendment.''
       In Deschler's Procedure in the U.S. House of 
     Representatives, the subchapter titled ``Amending Special 
     Rules'' states: ``a refusal to order the previous question on 
     such a rule [a special rule reported from the Committee on 
     Rules] opens the resolution to amendment and further 
     debate.'' (Chapter 21, section 21.2) Section 21.3 continues: 
     ``Upon rejection of the motion for the previous question on a 
     resolution reported from the Committee on Rules, control 
     shifts to the Member leading the opposition to the previous 
     question, who may offer a proper amendment or motion and who 
     controls the time for debate thereon.''
       Clearly, the vote on the previous question on a rule does 
     have substantive policy implications. It is one of the only 
     available tools for those who oppose the Republican 
     majority's agenda and allows those with alternative views the 
     opportunity to offer an alternative plan.

  Mr. BURGESS. With that, I yield back the balance of my time, and I 
move the previous question on the resolution.
  The SPEAKER pro tempore. The question is on ordering the previous 
question.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. POLIS. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 9 of rule XX, the Chair 
will reduce to 5 minutes the minimum time for any electronic vote on 
the question of adoption of the resolution.
  The vote was taken by electronic device, and there were--yeas 227, 
nays 193, not voting 10, as follows:

                             [Roll No. 125]

                               YEAS--227

     Aderholt
     Amash
     Bachus
     Barletta
     Barr
     Barton
     Benishek
     Bentivolio
     Bilirakis
     Bishop (UT)
     Black
     Blackburn
     Boustany
     Brady (TX)
     Bridenstine
     Brooks (AL)
     Brooks (IN)
     Broun (GA)
     Buchanan
     Bucshon
     Burgess
     Byrne
     Calvert
     Camp
     Campbell
     Cantor
     Capito
     Carter
     Cassidy
     Chabot
     Chaffetz
     Coble
     Coffman
     Cole
     Collins (GA)
     Collins (NY)
     Conaway
     Cook
     Cotton
     Cramer
     Crawford
     Crenshaw
     Culberson
     Daines
     Davis, Rodney
     Denham
     Dent
     DeSantis
     DesJarlais
     Diaz-Balart
     Duffy
     Duncan (SC)
     Duncan (TN)
     Ellmers
     Farenthold
     Fincher
     Fitzpatrick
     Fleischmann
     Fleming
     Flores
     Forbes
     Fortenberry
     Foxx
     Franks (AZ)
     Frelinghuysen
     Gardner
     Garrett
     Gerlach
     Gibbs
     Gibson
     Gingrey (GA)
     Gohmert
     Goodlatte
     Gowdy
     Granger
     Graves (GA)
     Graves (MO)
     Griffin (AR)
     Griffith (VA)
     Grimm
     Guthrie
     Hall
     Hanna
     Harper
     Harris
     Hartzler
     Hastings (WA)
     Heck (NV)
     Hensarling
     Herrera Beutler
     Holding
     Hudson
     Huelskamp
     Huizenga (MI)
     Hultgren
     Hunter
     Hurt
     Issa
     Jenkins

[[Page 4367]]


     Johnson (OH)
     Johnson, Sam
     Jones
     Jordan
     Joyce
     Kelly (PA)
     King (IA)
     King (NY)
     Kingston
     Kinzinger (IL)
     Kline
     Labrador
     LaMalfa
     Lamborn
     Lance
     Lankford
     Latham
     Latta
     LoBiondo
     Long
     Lucas
     Luetkemeyer
     Lummis
     Marchant
     Marino
     Massie
     McAllister
     McCarthy (CA)
     McCaul
     McClintock
     McHenry
     McKeon
     McKinley
     McMorris Rodgers
     Meadows
     Meehan
     Messer
     Mica
     Miller (FL)
     Miller (MI)
     Miller, Gary
     Mullin
     Mulvaney
     Murphy (PA)
     Neugebauer
     Noem
     Nugent
     Nunes
     Nunnelee
     Olson
     Palazzo
     Paulsen
     Pearce
     Perry
     Petri
     Pittenger
     Pitts
     Poe (TX)
     Pompeo
     Posey
     Price (GA)
     Reed
     Reichert
     Renacci
     Ribble
     Rice (SC)
     Rigell
     Roby
     Roe (TN)
     Rogers (AL)
     Rogers (KY)
     Rogers (MI)
     Rohrabacher
     Rokita
     Rooney
     Ros-Lehtinen
     Roskam
     Ross
     Rothfus
     Royce
     Runyan
     Ryan (WI)
     Salmon
     Sanford
     Scalise
     Schock
     Schweikert
     Scott, Austin
     Sensenbrenner
     Sessions
     Shimkus
     Shuster
     Simpson
     Smith (MO)
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Southerland
     Stewart
     Stivers
     Stockman
     Stutzman
     Terry
     Thompson (PA)
     Thornberry
     Tiberi
     Tipton
     Turner
     Upton
     Valadao
     Walberg
     Walden
     Walorski
     Weber (TX)
     Webster (FL)
     Wenstrup
     Westmoreland
     Whitfield
     Williams
     Wilson (SC)
     Wittman
     Wolf
     Womack
     Woodall
     Yoder
     Yoho
     Young (AK)
     Young (IN)

                               NAYS--193

     Barber
     Barrow (GA)
     Beatty
     Becerra
     Bera (CA)
     Bishop (GA)
     Bishop (NY)
     Blumenauer
     Bonamici
     Brady (PA)
     Braley (IA)
     Brown (FL)
     Brownley (CA)
     Bustos
     Butterfield
     Capps
     Capuano
     Cardenas
     Carney
     Carson (IN)
     Cartwright
     Castor (FL)
     Castro (TX)
     Chu
     Cicilline
     Clark (MA)
     Clarke (NY)
     Clay
     Cleaver
     Clyburn
     Cohen
     Connolly
     Conyers
     Cooper
     Costa
     Crowley
     Cuellar
     Cummings
     Davis (CA)
     Davis, Danny
     DeFazio
     DeGette
     Delaney
     DeLauro
     DelBene
     Deutch
     Doggett
     Doyle
     Duckworth
     Edwards
     Ellison
     Engel
     Enyart
     Eshoo
     Esty
     Farr
     Fattah
     Foster
     Frankel (FL)
     Fudge
     Gabbard
     Gallego
     Garamendi
     Garcia
     Grayson
     Green, Al
     Green, Gene
     Grijalva
     Gutierrez
     Hahn
     Hanabusa
     Hastings (FL)
     Heck (WA)
     Higgins
     Himes
     Hinojosa
     Holt
     Honda
     Horsford
     Hoyer
     Huffman
     Israel
     Jackson Lee
     Jeffries
     Johnson (GA)
     Johnson, E. B.
     Kaptur
     Keating
     Kelly (IL)
     Kennedy
     Kildee
     Kilmer
     Kind
     Kirkpatrick
     Kuster
     Langevin
     Larsen (WA)
     Larson (CT)
     Lee (CA)
     Levin
     Lewis
     Lipinski
     Loebsack
     Lofgren
     Lowenthal
     Lowey
     Lujan Grisham (NM)
     Lujan, Ben Ray (NM)
     Lynch
     Maffei
     Maloney, Carolyn
     Maloney, Sean
     Matheson
     Matsui
     McCarthy (NY)
     McCollum
     McDermott
     McGovern
     McIntyre
     McNerney
     Meeks
     Meng
     Michaud
     Miller, George
     Moore
     Moran
     Murphy (FL)
     Nadler
     Napolitano
     Neal
     Negrete McLeod
     Nolan
     O'Rourke
     Owens
     Pallone
     Pascrell
     Pastor (AZ)
     Pelosi
     Perlmutter
     Peters (CA)
     Peters (MI)
     Peterson
     Pingree (ME)
     Pocan
     Polis
     Price (NC)
     Quigley
     Rahall
     Richmond
     Roybal-Allard
     Ruiz
     Ruppersberger
     Ryan (OH)
     Sanchez, Linda T.
     Sanchez, Loretta
     Sarbanes
     Schakowsky
     Schiff
     Schneider
     Schrader
     Schwartz
     Scott (VA)
     Scott, David
     Serrano
     Sewell (AL)
     Shea-Porter
     Sherman
     Sinema
     Sires
     Slaughter
     Smith (WA)
     Speier
     Swalwell (CA)
     Takano
     Thompson (CA)
     Thompson (MS)
     Tierney
     Titus
     Tonko
     Tsongas
     Van Hollen
     Vargas
     Veasey
     Vela
     Velazquez
     Visclosky
     Walz
     Wasserman Schultz
     Waters
     Waxman
     Welch
     Wilson (FL)
     Yarmuth

                             NOT VOTING--10

     Amodei
     Bachmann
     Bass
     Courtney
     Dingell
     Gosar
     Payne
     Rangel
     Rush
     Wagner

                              {time}  1404

  Mr. GALLEGO changed his vote from ``yea'' to ``nay.''
  Messrs. BRADY of Texas, MEEHAN, and CALVERT changed their vote from 
``nay'' to ``yea.''
  So the previous question was ordered.
  The result of the vote was announced as above recorded.

                          ____________________