tv Politics and Public Policy Today CSPAN January 5, 2016 6:13pm-7:01pm EST
>> i tell you who will be the winners. the winners, no matter what we do, are going to be insurance companies. they have been here and they're going to stay here. and they're going to continue to do the things that they have done. for all the years -- coming up on 51 years that i've been a professional, my insurance has gone up every year. not one did it not go up. and that isn't because of health problems or anything else. coming up on 80 years, i'm lucky to be here. the simple fact of the matter is that insurance companies are driving a part of this train. and some of them have acted responsibly. and the thing that is more disturbing to me than anything in my state -- it's one of the 22 states that didn't expand medicaid. and there are people right now in the state of florida nearly 900,000 of them that are uninsu
uninsured. you know where they go. they go to the emergency room. who pays? the taxpayers wind up paying. every time. i yield back the balance of my time. >> thank you very much. the gentleman from texas, dr. michael burgess. >> thank you, mr. chairman i. want to thank our witnesses for being here. i've been promised time by mr. woodall to speak on the floor on this tomorrow. i won't go through the entire things that i had. i do remember a time up here in march of 2010 when the senate bill was brought to the rules committee for us to vote on on the floor the next day. and i did come to the rules committee with 18 what i thought were very valid suggestions for improvement in the affordable care act. every one was methodically turned down by a 9-4 vote by the rules committee when the democrats were in control of this committee. i also remember a hearing that was held in september of 2008.
it was the same day that lehman brothers filed for bankruptcy. so it was one of those days that gets etched into your memory. the hearing that we were having was the crisis in healthcare. the real crisis was outside the hearing room where the economic system was melting down around us. but there we were in the hearing room focused on the cost of healthcare. we had an enormous panel of witnesses. it took almost forever to get through the entire testimony of all of the witnesses. and a question was asked -- i can't say it was by me. it was by another member of the subcommittee who just asked all of these experts assembled in front of us, what is it going to cost to provide -- if we say we're going to have nobody in this country uninsured, what is the cost going to be? there was one of those eight or nine or ten witnesses who even offered an observation. and his observation was, it depends on what you are going to
do. if it's medicaid, you can probably do that for $60 million a year. if at the time there were presidential candidates who were talking about an fqhc -- i'm sorry, a federal employee health benefit plan type of benefit for everyone in the country and doing the math on that. it was $800 billion a year. $8 trillion over the ten-year budget cycle since we have the budget committee here. and that was an astounding difference, $60 billion a year to $800 billion a year. it was kind of like, can you not hit the broadside of a barn? but the difference was, what benefit are you providing? well, it turns out as all of the story with the affordable care act unfolded, we basically got medica medicaid, because that was the cost that eventually came through the senate health committee and ultimately the senate finance committee, the cost, because if you remember,
after the senate health committee came forward with their figures, they said we will cover an additional 12 million people with $1.4 trillion, everyone went, i think the term is mashugana. the consequence was after that the entire discussion became cost and coverage. it was no longer what are you going to provide. it was cost and coverage. and you had to keep the number under a trillion dollars. that was the game. you remember this. had you to keep the cost under a trillion dollars. you had to cover 30 million people. the process was then massaged until they got by in by the then congressional budget off to say, the senate has a bill that covers 30 million people and it costs just right at a trillion dollars. remember that was one passed on christmas eve? big snowstorm coming to washington. everyone wanted to get out of town. then we got it some three months later. and it limped across the house floor without a single republican vote.
but i do remember that hear iin so well because it was shortly after that there was an editorial published in "the wall street journal" that talked about a governor in indiana, mitch daniels, who had provided healthcare to his state employees in a voluntary program. it was called the healthy indiana program. it was basically a high deductible policy with a health savings account which the governor would provide to the state employee in total -- the total sum of dollars necessary to pay that deductible that year. if none of that was used, it accrued year over year in that health savings account and it would grow and governor daniels found something magic happened when people spend their own money for healthcare. even if it wasn't their own money in the first place. so governor daniels was able to hold his healthcare costs down significantly while every other -- whether it was ppo,
hmo, medicare, medicaid was going up 7%, 8% in 2008 and he was able to hold his costs down significantly in his state. why we didn't subpoena governor daniels to our subcommittee, chain him to the witness table until he spilled the beans on what his program was. and i think that still today forms what would be a very reasonable program for us to approach. i brought some of those ideas here to the rules committee march of 2010. and each one was rejected. i even brought an amendment which would have expanded medicaid. i took a lot of criticism from people on my side because i create aid new mandatory population of the 535 members of the house and the senate and said we will put senators and house members on medicaid. maybe they will be more ingenius about finding a way to make this system work rather than just
expanding it. i want to ask both of the members here -- because they're on the budget committee. i don't really have a head for figures like i should. but we heard a question asked about the cost of medicare and medicare overhead. and i think this is an important point that is often lost in the discussion. dr. price, you and i both ran medical practices. we know how stout overhead expenses can be in running a medical practice, running a hospital. they are probably even steeper. one of the line items in running -- in that overhead cost, one of the line items is the cost of capital. you will hire new doctor. you have to borrow money to do that. your friendly banker who was allowing you the privilege of borrowing the money will figure in a cost of what that loan is going to be. so in medicare, how do you
all -- the budgetary process, how do you account for the cost of capital when medicare needs to go out and borrow money? >> well, it's a great point, because the fact of the matter is, the statistic of medicare's administrative costs being 2% or 3% is tossed around. the fact of the matter,medicare offloads all of their administration on to the providers of care across this country. so the physicians, the hospitals, the clinics, the ambulatory centers, all of them are performing the administrative duties and abs b absorbing those costs that medicare forces them to absorb. so it's not 2% that's administrative fees and costs in medicare. it's comparable and i suspect it's greater than it is in the private sector. but it's virtually impossible to determine that because it's co-mingled with the other administrative costs within a medical practice or hospital. >> and co-mingled with the
administrative costs. he could probably give us insight into the amount of money that they had to appropriate to medicare or to hhs simply for the administrative function of administering this very large program. the cost of capital, the cost of borrowing for medicare, they don't borrow money. they take it from the treasury. pay it back, maybe, maybe not. if you and i borrowed money, we would have to figure the cost of us reand suffice it to say, the are not required to -- for that to be a line item. i have one other set of comments on the planned parenthood issue. texas did in 2011, as many people recall, governor perry at the time said that texas was going to exclude providers from
their women's health program who provided abortion services. that was by the state decision calendar year 2011. texas excluded organizations that performed or promoted elective abortions and women's health programs and at the same time texas increased funding to community based services. funding for 2011 were at historically high levels and that has been maintained. in 2013, the texas department of health and human services in a survey of patient capacity concluded that in most cases, the state had the capacity to serve even more women in 2013 than it had in 2011 when planned parenthood was included as a provider. community based clinics expanded their services to offer more robust family planning to
improve access. from 2011 to 2013, there was a steady and significant decrease in pregnancies in women 15 to 44 in texas. so the consequences of this action were not an increase in unintended pregnancies. it was an overall decrease in the number of pregnancies. comments were made about the democrat graph ins of the population served. i want to point out, planned parenthood centers and federally qualified health centers are be definition serving different populations. health centers serve almost 23 million people in 2014 as compared to 2.7 served by planned parenthood centered. 8% were 65 or over as opposed to a planned parenthood center which is providing services to people in the reproductive years. federally qualified health centers are required -- this is important. people forget this. federally qualified health
centers are required to be located in health professional shortage areas, underserved areas or rural areas. planned parenthood centers are not subject to those requirements. we can say a lot of things about both aspects of this wre reconciliation bill that's coming forward. i'm with the majority of the opinions that have been expressed here. i think this is a reasonable approach. why is it that the affordable care act has never had -- you think you are giving stuff away. why wouldn't it be just astronomically popular? and yet 52, 53, 54% of people are opposed to the affordable care act. to me, the reason is, the individual mandate has changed the fundamental nature of the relationship between the government and the governed. i do still hold on to that romantic notion that we should only have government with the consent of the governed.
now it is being forced upon us. so it is that coercive affect of the affordable care act that in fact provides the core row receive environment that has never allowed the affordth care act to enjoy significant popularity. i welcome a day like you, i look forward to it, i'm optimistic. i think the future is bright in the healthcare arena. i thank you for bringing this bill for us today. i will be lap happy to support . i yield back the balance of my time. >> thank you very much. i do not see mr. polis here. the gentleman from ohio is recognized. >> thank you, mr. chairman. dr. price, thank you for being here. thanks for your care for a lot of patients, thousands of patients over your time practicing medicine. thanks to the gentleman from kentucky for being here. i appreciate you both giving us your time today and your opinions. i was really struck by something you said earlier, dr. price,
about the difference between health coverage and healthcare. we have told millions of americans that they have coverage, but they're not getting care. and they can't afford care. and when they get care, they are being chased -- something i don't remember you saying, being chased by bill collectors the rest of their life because of high deductibles they didn't have. we have confused coverage with care. just because you have a piece of paper or a card that says you have insurance doesn't mean you will get care. it's a real problem that millions of americans are facing and paying the price for for these reforms that aren't working. i appreciate your willingness to take this head on and try to address it. and i think it's really important. the know, the one question nobody is asked today, in traditional insurance covered treatments is, how much does it cost. when nobody asks how much it
costs, there's never any downward pressure on price. price just spirals out of control. dr. price, i wonder -- you may or may not be familiar with the relative costs of these things. but can you talk about the inflation on insurance covered treatments versus the cost of elective treatments in the healthcare marketplace, things like cosmetic surgery that are not covered, where the individual actually shops on things like price as one -- price and quality as their data points for making decisions? are you familiar with the price trends in those two different categories? >> it's a great point. because the areas where there is no control of prices and where the government is not involved, in fact, there is downward pressure. and we have seen huge decrease in the cost of those procedures themselves, whether it's cosmetic surgery or whether it's
lasic surgery. there's evidence all across the spectrum, if you have a market, if you have a situation where individuals are actually able to select the kind of coverage, the kind of care, the individual that's caring for them, then there is much greater cost control. >> so it goes back to allocation of resources and what republicans have said all along is, a free market system encourages innovation, inefficiencies that will ultimately reduce price and increase quality. dr. price, do you think that would work in healthcare? >> have i no doubt about it. one of the things that's lost is the incredible importance of innovation. when you have a system that incentivizes innovation and incentivizes higher quality and greater efficiency and the kinds of decisions that reward those things, you get them. when you have a system that's
controlled by the federal government and which is gla shall in its ability to move on anything, witness that the fact the previous majority party has been loath to even consider responsibility common sense changes to this law, what happens is that you don't get them. consequently, you don't get the highest quality and you don't get innovation. i am reminded from my colleagues all of the time in the area of orange peaices, the other areas of world that they go to see what is cutting edge, because the technology in this country is losing to other countries because of the force of the federal government that it's disincentivizing higher quality. >> you have been a physician for how many years? >> 35. >> in your 30 years as a physician, medicare and medicaid, government programs, how do they compensate
physicians, on what basis? >> it's a great question as well, because it's hard to tell how they compensate. >> fee for service, right? >> it's a cost control. it's a dictated price to the individuals providing the care. >> this is probably controversial to talk about. but inside our government programs, they thought medicare worked great. but shouldn't we change the way we compensate physicians a little bit to pay them for outcomes as procedures? if you pay for more procedures you get more. if we can shift the model to give physicians a bonus payment for outcomes, won't we get better outcomes? >> you may. the jury is still out on that. i would suggest they're not mutually exclusive. >> i agree. we probably have to find -- >> if you allow for the flexibility that exists and the innovation in the payment system
as well and the payment models. what's right for one patient from a payment model may not be what's right for another patient. >> aren't we seeing private insurance companies move to some payments for quality over time? >> absolutely. >> is the federal government following that trend? >> they followed it in a way that is more dictatorial as opposed to expansive and flexible and innovative. consequently, i am certain they will not get to the right position. >> does that kill innovation. >> choices, quality, all the things the american people want are being harmed by the federal government's intervention. >> i can make two points? >> i would like to hear your perspective. >> i want to agree about the question of consumer concern about cost. years ago before i was in politics i was working for a healthcare company. spoke to the downtown rotary club, 600 people there and i asked them, how many of you have asked what a medical procedure costs? three hands went up. i think that is definitely a factor.
the problem with that is, when you are talking about cosmetic surgery or whatever you are talking about, voluntary procedures, you not talking about when you are sick or injured where the demand -- supply and demand equation changes. you are less concerned about costs when you are sick or injured. in medicare, the affordable care act sets a number of things in play in terms of medicare reform to change the compensation system to reward performance, institutions, hospitals and so forth and providers. fortunately, this bill would not change that. i think part of it recognizes that the medicare reforms that were put in place, affordable care act, have been successful because -- the jury is still out, as you said, about exactly what the cause and affect is. but the fact is that medicare prices -- medicare's budget costs were inflating 7% before the affordable care act went into place. it's down to 3% now.
under atted forable care act, the rise in costs of medicare has -- the growth has improved dramatically. now, that's because of affordable care act or partially because of it. the coincidence is there. >> are you familiar with the way that obamacare treats hospital owned physician practices? do you realize they get paid under obamacare a higher reimbursement rate than the physician own eed practice did? >> yes. >> do you realize that is increasing the acceleration with which hospitals are buying physician practices and not only increasing the cost but also changing who controllings the referral process and those doctor -- hospital owned physician practices are strongly encouraged, i will use with air quotes, to refer inside their own hospital in controlling.
so it's not only driving up cost, it's taking away free choice. it is i believe a -- i have good friends in hospital industry. this is not their doing. the government made these choices to reimburse hospital owned physician practices at a higher rate. it's fundamentally change the relationship between the patient and the doctor. it is raising costs. it's another one of the things i am scared about about the future of our healthcare system. because of what happens to referrals. when a hospital owned physician practice, which is encouraged under the payment system to be bought by the hospital, controls the referral, do you ever think they're going to send you to the best quality care or are they going to send you to the care they own? that's the problem with total control in one place. that's one of my concerns and
why i like dr. price's alt alternati alternative. i'm really concerned about that much power in one place. we are -- we, the government, we the people, have allowed that to happen by paying hospitals more when they own a physician practice. it's terrible. >> absolutely. >> i agree with you. >> and i didn't mean to go off on that rant. my friends -- i'm sure i will get calls from my friends in the hospital industry now. i just think it's bad policy. and i know we have to fix that, too. we have a lot of work ahead of us. i hope we can all come together on those -- on some reforms to fix our healthcare system overall. it's too bad that this has to be so contentious. frankly, there's good ideas all around. although, it sounds like everybody on that side of the i' aisle is saying we need to move to single payer system, which causes me great concern, because it's more power in one place.
and in the places that have a single payer system, canada, just to our north, people die waiting in line. they create a cueing system. instead of giving everybody care and innovation, they create a line. if you wait too long in line, you happen to pass away, that just is part of the way the system works. in europe and in canada. and that's why so many people come to the cleveland clinic in ohio, in my home state, and go to all other -- all the other great hospitals in america from all around the world because we have the best healthcare in the world. we need to make sure we get it to our people. i want to go back where i started, which is with dr. price. we should not confuse coverage with care. we need to get people good healthcare and coverage, saying you have a card that says you have health insurance, even though your deductible is $15,000, that you don't have anymore, is a problem.
i just have one more question. you talked about the individual mandate and how great it was and it was saving everybody because now the people can't just get sick and get care. help me through this. i believe somebody could pay the penalty of $900 a year until they get sick and then take the coverage. couldn't they still do that? >> they can still do that. i didn't say the individual mandate was a great thing. i said that the guaranteed issue provision, which again eliminates discrimination because of medical history, does not work unless there is a pre-existing condition -- i mean, an individual mandate. otherwise, people wait until they get sick and buy coverage. >> coverage costs $6,000 a year and a penalty of $900 a year, is there still an incentive to maybe not get coverage until you
get sick? >> well, actually, the penalty is going up depending on what your income level is. i think it's $1600 a year. >> okay. is there still an incentive to wait and get coverage when you get sick? >> there could be. there could be. >> it seems to me that we haven't really solved that problem with the way this system works. what i would rather do is make sure we make healthcare affordable for everyone through innovation and competition and then more people will actually opt in. we have 30 million people who have chosen not to take this syst system. that's too many. thank you. i took too long. thank you both for your time. i appreciate your willingness to answer our questions. and thank you for being here. >> thanks. >> mr. polis?
mr. burn? >> thank you. chairman, i wasn't here when the law was passed. it's my understanding that at the time the aca was passed, 80% of americans either had health insurance, medicare or medicaid. is that right? >> that's in the ballpark, 80 to 85. >> i think i heard the other day that as of the most recent signup, that 5% of the people in america have now gotten insurance or medicaid that didn't have it before as a result of the law. is that about right? >> yes, but it's tough to compare those figures, because, for example, those of us on the federal employee health benefits program are now on obamacare. we were forced to be on obamacare. they use those numbers to inflate the folks that have gotten coverage. >> let's give it 5%. >> that's fair. >> 5%. so we know that we changed the law that affects the healthcare for 85% of the people in america
to help 5% of the people of america. the reason it's not the other complete uninsured people is that we know from a recent "new york times" article that a lot of the people that should be signing up have elected not to sign up and said, we're going to pay the penalty because the penalty costs me less than paying the premiums and my deductible. have you heard that as well? >> absolutely. that's the financial incentive not to be covered. >> so the majority of the people that this should have been aimed at are electing to pay the penalty rather than get the insurance. so we're not going to even reach the majority of the uninsured people because they choose not to be insured. >> and i think that's accurate. and i think that's one of the reasons that we could look toward more positive solutions that would actually provide a financial incentive for folks to gain coverage as opposed to a disincentive.
>> i want to -- i wrote it down because i thought it was so right. she said, i don't understand the great zeal to take healthcare aware from people. and i agree with you. i don't understand that either. i remember the president said when this law was being considered and afterwards, if you like your health insurance plan, you can keep it. and that turned out not to be true. and he said it over and over and over again. i spent my christmas holidays -- i was out shopping a lot. there were a lot of people shopping at the last minute. i heard from those people that lost their healthcare because of this law. i don't understand the zeal for law that took healthcare away from my constituents. i don't understand that. if we have an opportunity to go back and try to fix this, not
just for 85% -- it would be worth it to fix it for them. but for everybody in america, we come up with a common sense healthcare plan that helps everybody, that gets something where we are in control and not some bureaucracy in washington, one of the most difficult bureaucracies i have dealt with in my life. the most difficult people i have had to deal with. why would we empower them instead of empowering our constituents to make their own decisions without us telling them what kind of health insurance you have to have, what kind of coverage you have to have. telling doctors how to provide healthcare to us. you knew a good friend of mine unfortunately died recently. jeff terry from my district. who took medicaid patients as a urologist, even though he lost
money on them, because he knew without him there would be no urology care for people in my district who were medicaid eligible. and yet when he tried to come up here and get some relief from some of these regulations from the bureaucracy up here, he was pushed back. he was told no. somebody is trying to help has been told no by the bureaucracy that's supposed to be there to help us. could you explain that to me? i don't understand how that's helping doctors or patients. sg >> you mentioned jeff terry who had an untimely death last fall who -- i don't know anybody who was -- who has been more passionate about providing care for his patients. and he would volunteer and donate his time to come to washington to try to help cms get it right. and was just rebuffed time after time after time. but a greater champion for
patients i haven't met. >> thank you for that. i got to meet with his family before christmas and give them a little gift from those of us that knew and loved jeff. i want to say one final thing. i heard from mr. mcgovern this bill is going nowhere. this bill is going to the desk of the president of the united states. and never in all the other attempts has a bill gone to the desk of the president of the united states. the president has the opportunity to do the right thing. and he hasn't had that opportunity since the law was passed. he can do the right thing, sign this bill, give us all an opportunity to work together as democrats and republicans and doctors and patients and insurance companies and everybody to come up with something that works for the american people. so i am pleased that you did this. i thank you for doing this. >> could you yield one second?
>> when i'm finished. i'm be happy to yield to you. at this point in time, i want to make sure that we're all aware that this bill is going somewhere. it's going to the desk of the president of the united states. and none of these bills have gone there before. and it's time for the president to do the right thing. i'd be happy to yield time. >> i was going to say that the president will veto the bill. if that satisfies your base, fine. we have been here for two hours talking about a bill that's going to be vetoed. i think there are other people waiting. i'm not saying that you talk too long. i'm saying this has gone on for a long time. this is the 62nd time we've had this debate. if that's going some place and makes everybody happy, then fine, terrific, it's going some place. it's not going to become law. i'm happy about that. i know you are not. >> i reclaim my time. i understand what the gentleman is saying. he said it's going nowhere. it is going somewhere. may not be going far enough.
but it's going somewhere. the american people get to see this. the american people, we know by all the polls, do not like this law. they get to decide, do i want somebody that's going to continue with this failed law that took my healthcare plan away from me where i'm going to go with somebody that's going to go different. i'm glad we're giving them that choice. i'm confident the yoult cooutco be. i yield back. >> the gentleman from washington is recognized. >> thank you, madam chair. one of the advantages in sitting at the end seat here is you can listen to what everybody says. many of the things that have been said today that i agree with, some i don't. you don't have to listen to me, because a lot of the things i was going to say has been said. i do think that this is an important debate to have. i think the people that elected
us are glad we're having this debate. they want us to have this debate. this is one of the biggest issues that i hear about in my district. i'm sure that's true in many of your districts as well. concern of people that in my district especially that certainly i agree that there are some people better off now than they were before this law was passed. but there are a good number of people that are not. their costs have gone up. insurance preem miums have gone. their choices are fewer than what they were before. this is certainly not the solution to the healthcare situation we have in this country. i applaud the efforts i think we're taking here and the important step to move us closer to giving the people in this country what they want in a patient centered kind of healthcare system. this is an important step.
it is going somewhere. it's taking us down the road of coming -- getting to a place where we want to be. as far as the other provision in this legislation that has to do with the planned parenthood provision and funding, a lot has been said about that. and certainly i think that this is a very important issue to people back home as well. i just had one question about that. like i said, i will keep my comments brief. but we're increasing the amount of money going to community health centers to be able to make up the difference for what may be an impact to the clinics that are not going to be funded. so the question that comes to mind is -- out of the -- it has to do with capacity. could you tell me a little bit, either one of you, the ability of the community health centers to take up the slack, so to
speak, or fill whatever gap or void that might be created if we reduce the funding to planned parenthood? >> i appreciate the question. it's an important point. because we mentioned, 235 million, extra $235 million in fiscal year 2016 and '17 for the community health centers. on top of about $3.6 billion to provide for services in the community health centers. again, ballpark figure, but instead of about 500 clinics that planned parenthood has, it's about 13,000 is my recollection and the community health centers and as i think mr. woodall or dr. burgess pointed out, those are by definition, in the areas that
are lower served. and have to be in those area, so the rural areas and the areas where greater needs may exist. and care for women especially and this bill would address that. >> in my district, louisville, kentucky, heavily urbanized area, we have three major public health care centers. they've all said there's no way they could akccommodate 5,000 people a year. the other issue, i think it's been a very region to region and area and place to place. many do not have obgyn specialists on staff or capabilities. if they're looking for those services, they're not necessarily going to get them. >> with the increased funding,
it does help build the infrastructure necessary to do that. sounded like the amount of funding has increased over time. thank you very much for that. and again, appreciate you guys being here. bringing this important topic up and just to start 2016 on a good note. i want to thank everybody for wonderful christmas cards that we received from each of us. look forward to a productive 2016. >> did you have an opportunity to participate? >> thank you very much. i went down to vote. the only other member that seeks time from this panel. i want to thank both of you for taking time. we've called the floor to ask them to please hold on for a couple of minutes.
you'll find you need to hustle. thank you very much. i appreciate your help. this closes the hearing portion on the amendment. hr 3671. i would now like to call up hr 712, sunshine for regulatory decrees and settlement act of 2015. would welcome a panel that would include the panel, the chairman of the government oversight and reform, mr. and mr. conley from virginia as they are here or would be joining us and thank you very much is there any other member that would wish to be heard on this matter? at this time, we will proceed accordingly. we're going to do that.
we've already before you were here, gave our opening statements, we're delighted you're here. statement on this. >> i thank you for this opportunity to speak. the sunshine for regulatory. the past several year, we've witnessed a surge in the number of new regular lace, dramatically impacting the lives of every day americans. the all economic transparent alert act is authored by congressman radcliffe. the committee and oversight forum reported favorably the alert act of may 29th of 2015. it's a simple transparency bill.
requires administration to provide legislation before the regulations go into effect on a monthly basis, as opposed to the way the current structure is. agtdsys will be required to list all the regulations expected to be proposed or finalized within the final year. it seems like an open suggestion that was offered be by mr. radcliffe. makes immense sense to us. if requires that each regulation list the objective of the regulation, legal basis and the current stage in the rule making process. if the agency expects to finalize the regulation within the following year, the agency is required to provide regulation such as cause, completion date and the economic effects and to make sure agencies are making a good faith effort, the act prohibits regulations from going into effect until they've been listed on the monthly reports no less
than six months prior to the notification. in rare cases when the president determines the rule is necessary for national security enforcement of criminal law, protectinging health and safety or compliance with international trade agreements, the six-month requirement can be waive d, buti would hope that would be few and far fween. by the administration's own estimates, the last ten years alone have imposed the cost of more than $100 billion a year annually. for simply trying to offer transparency. i think that's why it saw a favorable support within the committee and we urge its adoption. >> thank you very much. i'd now like to go to your counterpart, mr. conley, who is here representing government, the gentleman, mr. conley, is recognized. >> thank you. and mr. chairman and ranking member, members of the rules committee, happy new year and i appreciate the opportunity to
testify. i think we can all agree that the purported goal of hr 1155, agencies should eliminate duplicate rules, however, they're already required to do so under a series of executive orders issued by the president. 712. want me to do -- to finish this, too, or just go to 712? sfwl this is your time. >> thank you. i'll talk about these two bills. executive order 13563 issued on january 11, 2011, requires agencies to develop plans for reviewing existing rules and requires agencies to engage in periodic review. 13610 issued by the president on may 10th, 2012, requires agencies to institutionalize regular assessment of
significant regulations in retrospect to report twice a year to the office of information for regulatory affairs. on their progress. in addition, congress has been engaged in obsessive oversight of agency rules such as the epa's clean power plan and rules under the affordable care act as the majority exercises congressional authority to conduct oversight of agency regulatory activities. the skir mack would authorize $30 million to establish a nine-member commission. made up of unelected officials. to perform a function, agencies and congress already can and should be providing. this delegation of authority is almost unprecedented. this commission would wield enormous authority. for example, the commission would have virtually unlimit sub
pea na power. most agencies inspectors general do not have the able ility to compel witnesses to f testify, yet this bill would provide the authority to a commission solely focused on rule making. and then impose a regulatory scheme in which agencies would have to purr pose eliminating and existing regulation before promulgating a new one. that forces sergeant is into an orb arbitrary position of preserving safety protections or respondinging to new situations and threats. actually, potentially, jeopardizing the very public health and safety that is their mission. this bill provides no safe harbor, exceptions for rules, no matter how important.
also opens up agency compliance to endless court rall chals by aply pliing judicial review. elijah cummings and myself committed an amendment to strike that title. alts to exempt independent agencies. it would require independent agencies such as the sec to obtain a prooufl on the accuracy of their regulatory cross calculations. these agtssys are not required to submit rules for such reviews as it would threaten their independence. perhaps the real provision itself. i'd also like to briefly address hr 712. specifically title two, which includes the next of the all economic regulations. agencies are required to provide status updates on