tv Ways and Means Committee Markup of Affordable Care Act Replacement Bill... CSPAN March 11, 2017 10:04am-12:29pm EST
>> good morning. thank you all for being here. today, our committee is considering legislation to repeal and replacement the affordable care act. while it has helped some, it has inflicted tremendous harm on more families, more workers, and more job creators nationwide. as president trump said in his address to congress last week, obamacare is collapsing. decisive action must be taken to protect all americans. this morning, we will answer president trump's call to action, and we will send a clear message to all who are hurting because of this law. that message is "relief is on the way." working in conjunction with our colleagues on the energy and commerce committee, we will not only take action to repeal obamacare, we will also lay a strong and stable foundation for the patient-centered healthcare system that americans truly deserve. the legislation before us today represents one half of the
american healthcare act, which is the full reconciliation bill we will deliver with our colleagues at energy and commerce. this bill as health and human services secretary tom price wrote to us yesterday, aligns with the president's goal of rescuing americans from the failures of the affordable care act. secretary price praised the bill's proposals as a necessary and important first step toward fulfilling our promises to the american people. and we are fulfilling these promises in a very transparent and thoughtful manner. unlike obamacare, where members of this committee were presented a 794-page bill at midnight for voting mere hours later, this 57-page bill before us today was posted two days ago for all of america to read. it follows nearly 200 hearings held in the house since obamacare's enactment, over 35
in our committee alone, as well as numerous ways and means bills considered and approved by the u.s. house, not to mention it builds upon a better health care proposal we released months ago. the ways and means portion of the american healthcare act takes action on two primary objectives. first, it repeals and dismantles many of obamacare's most crushing burdens for patients, job creators, and healthcare providers. the legislation will provide relief from obamacare taxes and eliminate the tax penalties associated with the individual and employer mandates. without these penalties, washington will no longer be able to strong-arm workers, families, and job creators into obamacare plans they do not want and cannot afford. the second objective of this legislation is to empower individuals and families by providing them, not washington, with control over their
healthcare dollars and decisions. our committee's proposals will help accomplish this in a number of keys ways. one is by enhancing and expanding health savings accounts, or hsas. the bill nearly doubles the amount that americans can contribute to an hsa. it also broadens them so they can be used to cover more expenses, including over the counter medications. ultimately this will allow americans to save more healthcare dollars for the future and spend them based on what they want and need instead of what washington prescribes. but the legislation does not stop there. it will preserve and protect health insurance for the more than 150 million americans who receive coverage through their employer, and the bill also creates a monthly tax credit immediately usable to help low and middle income americans purchase coverage if they do not get it through work or a federal
program. these credits, which are based on age and family size, will give millions of people greater flexibility and freedom to buy insurance that is tailored to their needs, not washington's. with americans in charge of how they use these credits, there will be enhanced competition, lower costs, and better options for patients, workers, and job creators to choose from. finally, i want to make clear the full reconciliation bill will preserve a number of vital patient protections. young americans will be able to remain on their parents' health plans until they are 26 years old. insurance companies will be prohibited from denying people with pre-existing conditions or charging them more. these two protection are under energy and commerce jurisdiction, so they will not be considered in our committee markup this morning. i want to reassure all americans that house republicans are committed to keeping these vital
provisions in place. i also want to reinforce to all americans that we are committed to making the american healthcare act fiscally responsible. we are currently waiting for a cost estimate from the congressional budget office. as everyone on this committee understands this is not out of the ordinary for a markup, and we will wait for a deliberate , comprehensive score from cbo as the process moves forward. the most important thing for all americans to know is that we will ensure our fiscally responsible legislation meets all the reconciliation instructions before it reaches the house floor. we're dedicated to getting these crucial details right for the american people so that we can provide them with the relief they need without any more delays. in closing, i want to thank all the members who helped craft the solutions in the legislation before us today. this bill represents years of
hard work and a number of bipartisan ways and means bills. thank you all for your leadership. today's markup is a critical step in providing all americans with affordable patient-centered healthcare that's tailored to their needs. this is a top priority for all members of our committee. i hope we can all work together to deliver the solutions that our constituents want and deserve. with that, i'll now yield to ranking member neil for his opening remarks. >> thank you, mr. chairman. i am disappointed we are here today to consider legislation that reflects not only bad policy but bad process. and a number of important groups agree. aarp, the american medical association, and the american hospital association all oppose this bill. this bill suffers from an identity crises. -- crisis. is this healthcare or is this a tax cut bill? does it lower costs? no.
does it bend the cost curve? no. does it cover more americans? no. does it cut the deficit? no. even president trump wants more information. earlier this year -- and this week, he called it an unbelievably complex subject. nobody knew healthcare could be so complicated. this republican bill, which they cleverly broke into separate parts to try to distract the american public, fails to protect 152 million americans with pre-existing conditions and would allow insurers to charge older people five times as much as younger people, essentially implementing an age tax. it forces millions to pay more to get less healthcare. i guarantee you, having come from local government in the early stages of my career, that by turning this over to governors, they will use healthcare money for the purpose of paving streets, patching budget deficits, fixing
highways, and not using it for the prescribed purpose of providing healthcare. transparency is clearly lacking in this process. as recently as last week, i called upon house republicans to provide an open and transparent process when they consider any healthcare legislation aimed at repealing or replacing the affordable care act. the goal -- to ensure all americans had the opportunity to fully understand and consider how many and how much this republican healthcare plan will cost and how it will impact them. instead, republicans hid a draft bill somewhere in the basement of the capitol with armed police officers. that is a far cry from the notion of transparency. the american people deserve better. also, to consider a bill of this magnitude without a cbo score is not only puzzling and concerning, it's also irresponsible.
when we created the affordable care act, it was a thoroughly transparent and open process. let me give you the numbers -- fact, not opinion. there were 79 bipartisan health insurance reform hearings and markups over two years. there were 100 hours of hearings. 181 witnesses from both sides of the aisle. 239 republican and democrat amendments, of which 121 were accepted. there was a 30-day online review of the house bill before the markup. 3,000 healthcare town hall meetings and public events were held. in the senate, 53 health insurance reform hearings occurred in the senate finance committee. 8 days of markups with 135 amendments considered in the senate finance committee. 47 bipartisan hearings and other open dialogues, with 300 amendments during a 13-day markup in the senate committee.
25 consecutive days they were in session to discuss healthcare reform in the senate. 160 hours in total the senate spent considering reform legislation. and there were 147 republican amendments in the final senate bill. this bill sabotages the market places where close to 10 million americans today get coverage and starts a death spiral from which it will be very difficult to recover. healthy people won't bother with coverage or instead will buy bare bones policy. sick people who need coverage would buy policies if they're available, but that will undoubtedly become more expensive, more unaffordable, and harder to get. the most egregious part of the republican plan slashes medicaid funding to pay for tax cuts that benefit the rich. medicaid helps pay the cost for more than 60% of all nursing
home care residents nationwide and helps families afford quality nursing home care for their elderly parents and family members with disabilities. the republican medicaid proposal makes it harder and more costly for families to find long-term care for elderly parents or children with severe disabilities. in addition, it would end the medicaid expansion, a move that would have devastating consequences in my state of massachusetts, where it's been a critical tool for thousands of individuals and families with loved ones in long-term care facilities who have dementia. it also provides rehabilitation options for individuals and families in the grips of the opiate addiction. that will be curtailed. the reality is that medicaid is now a middle class benefit. the measure would also cut the span of medicare by two years at a time when millions of baby boomers are joining and will rely upon this critical
initiative. it's a $170 billion tax giveaway to the wealthy while starving the medicare trust fund. hospitals would face crippling debt based on increases in uncompensated care and lower reimbursement rates. in turn, this would lead to job losses in many hospitals and have a negative ripple effect in communities where hospitals are the largest employers. in western massachusetts, bay state health center provides 12,000 jobs and has a $4 billion state-wide economic impact. let's call this bill what it is -- a plan to create chaos in insurance markets that directly impacts patients and providers. it will hurt hospitals and the communities they serve and their regional economies. before concluding, i would like to note that today's markup is really the republicans' first step at tax reform. this legislation is a tax bill. almost every provision amends
the internal revenue code. so we need to view this bill through the lens of tax reform as well. through this lens, we can see clearly that the bill fails the test set out by secretary of the treasury mnuchin for tax reform when he said, quote, "there will be no absolute tax cut for the upper class." >> thank you, mr. neil. the gentleman's time has expired. and we tried to add as much time as possible. at this point, i would like to take a moment and welcome the members of the audience and remind them they are here as our guests. house rules give the chairman responsibility for maintaining order during committee proceedings, and disruptions will not be tolerated. audience members who cause a disruption will be asked to leave. with that, the committee will now proceed with consideration of the budget reconciliation legislative recommendations. we'll take up each of the five subtitles separately. our first order of business is the committee print of budget
recommendations relating to rumination -- relating to a remuneration -- >> mr. chairman -- >> without objection -- >> mr. chairman, i do object. >> it's read and open for amendment at any point. >> mr. chairman, i do object and i would -- >> the gentleman objects, and the clerk will report. >> as indicated to you previously, i have a privileged motion under clause 4a of house rule 16 that i'll offer in writing to you at this point and ask to be heard on my motion. >> mr. chairman. amendment.able the >> questions on -- >> i'd like to hear the motion read at least. if the idea is to shut down debate on it. >> no, absolutely not. so, the clerk will report the motion. >> will you pass the motion down to me?
>> do you want me to just read it? >> the motion is to postpone consideration of the subtitle related to reconciliation, legislative recommendations relating to renumeration for certain insurers to thursday, next march 23rd, 2017, pursuant to clause 4a of house rule 16 , offered by representative lloyd doggett. >> thank you. before we moved to table the motion would the gentleman like , to be heard? >> thank you very much for your courtesy, mr. chairman. this motion simply requests that we reconvene this markup next week. the objective is insight, not
delay. i ask unanimous consent to place in the record, at this time, a request sent to you last weekend side by every democratic member regarding this matter. >> without objection. >> incredibly, for a legislation of this magnitude, this plan, the particular plan we are considering today, even its principles, has never had a single public hearing anywhere. unlike the affordable care act, for which the house heard 181 witnesses in 79 public hearings, republicans reportedly planned to jam this bill through committees today, pass it through the house this month, bring the house bill directly to the senate floor without any senate public hearing. the entire legislative process unlike anything you may have seen in the civics books, all without a single public hearing. this motion simply asks for a
single public forum. indeed, you have kept your lamp under a under a bushel for seven years, so secret that last week , this bill was literally under armed guard in the capitol. kept as secret as donald trump's tax returns. with the seven years you have for the momentous occasion that we join today to replace obamacare, it is surprising that you are so determined to hide your panacea. read the bill. how many times have we heard that with the original affordable care act? well, that rallying cry was met this week with the response that there was no bill to read until the night before last. this motion asks for one week during which expert witnesses can be summoned here to evaluate these far reaching provisions and to determine how many families will suffer because of the hidden fine print.
importantly, we also have been seeking to have a representative president trump to come forward and be questioned about how this bill satisfies his promise of insurance for everybody that offers more and costs less. health care is too important. it impacts too many lives to have a bill jammed through in the same manner as president trump's bungled immigration order, rushed into effect before any meaningful review and creating chaos at the airports. what this bill needs is some extreme vetting. frankly, any vetting at all would be an improvement, because it has not been vetted in any public forum. when any american buys something new, whether it is a new pair of pants, a new car, new appliance, usually helps to ask two questions -- how much does it cost? what is its size?
on this new insurance plan, we are asked to vote without knowing how much it costs and without knowing how much -- without knowing what size it is. how much it covers and how many millions of americans are once again being left out. if you have nothing to hide, a week will not impair your effort. it will afford an opportunity to carefully scrutinize this legislative surprise package that deserves a great deal of scrutiny. great"e -- "it will be isn't a plan. we cannot trust this plan with no administrative witness who has the courage to come to sit at that table and defend and explain it. we don't know the cost. we don't know what it covers. and we don't know who it leaves out. further, this tactic of shutting out the public entirely, of refusing public hearings, of secreting legislation, appears
to be a new tactic of what speaker ryan has called "unified republican government." as ranking member neal has just explained, what we are considering today in this committee is a $600 billion tax cut. the same tactic is the approach that is apparently planned for the next tax cut. and i guess for any -- not only the trump tax break bill that we expect and have been told will be here before a august, but anything else in which you have weak, really loser legislation that requires a heavy hand, because the legislation is so weak you are unwilling to have vetted in the public light up until the very last moment. it is sad. it is really sad. today, at the outset of this process of shutting out public from the democratic process, it is important that we put a stop
to this crumbling of democracy . askinghis motion simply postponement to next thursday to allow the type of consideration , at least in a small way, that this legislation deserves. and i move its adoption. thank you, mr. chairman. >> thank you. mr. teaberry, you are recognized. >> i moved to table the motion. table.tion to motion the those in favor, aye. >> and opposed? >> no. >> and the ayes have it. >> and on that, mr. chairman, i ask for a roll vote. >> okay. the clerk is requested to call the roll. >> mr. johnson. mr. johnson, aye. mr. nunes, aye. mr. teaberry, aye. mr. reichert, aye.
mr. roskum, aye. mr. buchanan? mr. buchanan, aye. mr. smith of nebraska? ms. jenkins? mr. paulsen, aye. mr. marchant, aye. ms. black? ms. black, aye. mr. reade? mr. reade, aye. mr. kelly, aye. mr. rennaise, aye. mr. meehan, aye. ms. nome, aye. mr. holding? mr. holding, aye. mr. smith of missouri, aye. mr. rice, aye. mr. stryker? mr. swikert, aye. ms. malarski, aye.
mr. carvalho's -- mr. carbellow, aye. mr. bishop? aye. mr. neil, no. mr. levin, no. mr. lewis, no. mr. doggett, no. mr. thompson, no. mr. larson, no. mr. blumenauer, no. -- mr. blumenauer? mr. kind, no. mr. pascrell, no. mr. crowley, no. mr. davis, no. ms. sanchez, no. mr. higgins, no. in ms. sewell, no. ms. dellvany, no. ms. chu, no.
subtitle remuneration for certain insurers, section one, renumeration for certain insurers, paragraph 16 of sec the internal revenue code is amended by adding at the following graph -- one, termination. this shall not apply to taxable years beginning after december the 31st, 2017. -- december 31, 2017. ,hairman brady: at this time the measure will be considered read and open for the point. it was distributed along with the green sheet explaining it -- >> mr. chairman, i object. chairman brady: the gentleman
one, termination. this paragraph shall not apply insurers for tax years beginning after december 31, 2017. chairman brady: i will now turn to the chief of staff for the joint committee on taxation to provide a full explanation of the nature of the amendment to read i asked that members hold nature of the amendment. i ask that members pull their comments until he has finished until hold their comments you finish his explanation. >> thank you. in brief, under present law, any lawyer can generally deduct compensation for employees. under present law the deduction for levers services performed by -- is limited to a
deduction of no more than $5,000. the proposal as amended by the substitute would repeal this provision, effective for taxable years beginning after december 31, 2017. in other words, effective 2018. -- thatposal will lose concludes my brief description. i am happy to answer any questions that the members might have. chairman brady: thank you. are there any questions for mr. barthold. mr. neil, your recognized. mr. bneil: current law limits the compensation to employees
and service providers during a tax year to $500,000. publicly traded corporations are subject to a similar rule with respect to executive compensation. the republican plan is a broken promise. it promises lower costs and better coverage for everyone. yet this plan causes masses coverage lost, increased cost to consumers, reductions in needed limits their ability to purchase insurance while giving handouts, again, to those at the very top. but instead of ensuring those in the middle class will love quality, affordable health care, a republican friends would like to start -- will have quality, affordable health care, our public and friends would like to start today by making sure that there is a tax break. mr. barthold, will you repeat the cost of this profession? barthold: the joint
committee staff has estimated this will lose approximately $400 billion. you -- : thank >> a question? >> yes, mr. 11. levin. levin: thank you, mr. chairman. we are starting with a tax provision that will benefit certain people. can you tell me since this is part of an overall set of tax provisions, how much of the tax provisions will go to people with incomes over $200,000 a year in total tax provisions? levin, thed: mr. joint committee staff is working jointly with the congressional budget office on this. in terms of all of the
provisions you have scheduled before you today, some of it involves the new credits for health insurance that depends on coverage and take-up rate in that analysis is not complete at this time, so i cannot answer your question with respect to all of the proposals under consideration today. levin: how about the specific tax provisions that are before us the? -- specific tax provisions that are before us though? mr. barthold: we have not undertaken an analysis of the specific these. remember, it is related to the deduction for denial of compensation, so it affects the tax liability at the business level. level ofso affect the net compensation received by the affected individuals, but as i
say, we have not undertaken an analysis of how this would affect the tax liability of the owners of the insurance business. levin: ok, but i was asking, the provisions involving the investment income tax. what is the lost there, and who does it go to? realizehold: i did not you were asking about one of the bills that is before the committee later. if you will give me a moment, i will pull out that piece of paper. if i. barthold, understand, will be focusing on that section on investment tax later. i would like to focus on the section before. mr. levin: i would like to look
at the tax impact. as we take this one, it's pretty clear who it will benefit. i would like to ask you how it fits into the overall picture in terms of tax cuts. could you please answer that? levin,thold: well, mr. as i explained, i don't have distributional analysis for the overall package. i also do not have distributional analysis for each of the individual components. i have prepared distributional analysis on some individual provisions, in particular on the investment -- net income tax. but mr. brady said that could be a subject of discussion later. mr. levin: can you tell us what it is now? [raps gavel] the estimated budgetary effect of the net
investment income tax the joint committee staff has estimated at $157.6 billion over fiscal years 2017 through 2026. mr. levin: what is the distribution of that? if i recall, you mr. asking for the overall -- barthold: if i recall, you're asking for the overall distribution -- mr. levin: i understand. chairman brady: for these specifics on this, i think that would be best delayed until we tackle this section indefinitely moments. as we look at one, we should look at all of them to see the overall picture because there's going to be $600 billion in lost revenue. as we start on this, i think him
a dangerous path, i think we need to know the overall picture -- as we start on this, think, dangerous cap, i think we need to know the overall picture. chairman brady: the focus is on the picture in front of us. mr. levin: do you have that information? havearthold: my colleagues repaired distributional analysis nethe repeal on the tax on investment income. it is a five-page analysis. i will ask my colleagues to prepare copies for all the members of the committee and i will make it available a little bit later. mr. levin: thank you. chairman brady: the time is expired. does anyone else wish to inquire about the amendment? >> thank you. do i understand you are the only human being who will come before us today to discuss any of these fine provisions? mr. barthold: i have been asked
to describe the provisions before you -- you are the sole person who will be here? mr. barthold: i will draw on the assistance of my colleagues, but -- elseoggett: but no one will be here? you are the only one we can ask questions to? good to know we have one human being here to respond. , if i understand, this one-page bill which is the only thing before us in your testimony is part of the 53-age bill, is it not? -- 53-page bill, is it not? the 53 pages are entirely separate. you have to talk about the for the for the plans
entire reconciliation plan. it will result, i'm sure -- from a technical standpoint, is there not any -- is there any reason the five separate bills before us could not have been joined as one? mr. barthold: in terms of legislative -- mr. doggett: it does have advantages in narrowing the discussion when looking at the larger picture -- mr. barthold: i'm not familiar enough with -- mr. doggett: i'm sure that's the area of your expertise. focusing entirely on this provision and the other five provisions, i just wanted to ask you if there are provisions in the bill that, despite all of the rhetoric criticizing obama care, that really salute -- re, thating obamaca really salute the spirit of
such as where practical, the methods of the formal care act are to be retained as regards these tax -- a be a fertile care act are to be retained as regard these tax credits? chairman brady: mr. doggett, while i precinct question, the scope of this question relates to compensation in the insurance area and i have asked you to combine your questions -- mr. doggett: and so it is. my question to this witness -- is this provision -- i will ask him the same question on those titles -- whether it includes any of the same salute to the spirit and preserving of , like that obamacare on page 37 that says to the greatest extent practicable, use the affordable care act as your lead star? you, mr.brady: thank
doggett. again, that question is beyond the technical scope -- mr. doggett: it is asking if this title includes anything similar to the spirit of obamacare, someone who has been alleged to have been a within the past we can, but as former president barack obama, is there anything tothis title that similar page 37 tries to follow the spirit of obamacare? chairman brady: thank you for repeating the question. mr. barthold is here to answer technical questions about the section -- mr. doggett: i'm only asking him about this section. chairman brady: no, you're asking him about saluting the spirit of obamacare. to doggett: let me try rephrase to comply with the narrow scope you are confining it to.
is there anything in this title that contains a reference to the affordable care act or the desire to follow that act to the greatest extent applicable, similar to what we find on page 37 of the chairman's bill? thisarthold: mr. doggett, provision a men's section 102 of the internal revenue code -- amends section 102 of the internal revenue code. containett: it does not a reference to "the greatest extent applicable" to the affordable care act? and we'll all of the benefits of this bill flow to the insurance industry? mr. barthold: i'm sorry. i didn't hear you. mr. doggett: will all of the benefits of this tax cut flow to the insurance energy? mr. barthold: as i was explaining, the distributional
effects depend on the individuals who may be subject to the bill. it goes to a determination of the net income of the business and will affect the net returns of the owners of that business, so -- chairman brady: thank you, mr. barthold. time is expired. , forank you, mr. barthold being your. a number of people have mentioned the left of the cbo report on this legislation. -- thank you, mr. barthold, for being here. is incredibly important. it provides not only new members of this committee, but the public we represent some sense of whether the provisions of are expected to cause americans to lose health insurance, how much their premiums will increase, or how much out-of-pocket expenses they would experience.
do you have a copy of the estimate from cbo you can share with us? mr. thompson, if the congressional budget office had prepared an estimate, they would have given it to members of the committee probably before they would have -- mr. thompson: so you'll have one either -- so you don't have one either? the cbo put out a statement last night saying that they are in the process of preparing an estimate. my colleagues are actively working right now with counterparts in the congressional budget office on the relationship between the tax provisions you're looking at today and how that affects in terms of the employer market, in terms of the individual market, who would qualify, who would choose to purchase insurance, who may choose not to purchase insurance. -- we will release
the estimate as soon as that is to be and we expect that early next week. it will include the impact on the federal budget as well as the effects on health insurance coverage in premiums. but i have no -- as well as the effects on health insurance coverage and premium spirit but i have no documents right now. mr. thompson: do you know if there is a cbo report on previous draft the republicans have shared and refuse to share with us? when we come a when the congressional budget office, when we work with members in developing legislation, we never tell anyone else about any preliminary work -- have you seen any previous draft of a cbo -- mr. barthold: i should not comment on anything i have seen or not seem to show the same respect we offer your office, sir. question was this asked, but with regard to insurers, is it true that the
ineal of this prohibition this particular bill on windfalls for insurance companies for executives will cost text bears $400 million in --t revenue over the taxpayers $400 million in lost revenue over the next 10 years? mr. barthold: yes, sir. mr. thompson: is it fair to say if this bill were passed it would drive up the cost for the middle class to pay for massive massive -- pay for to pay for massive tax cuts for the wealthy? mr. barthold: i should not make any judgmental statement. a $400 millions tax-cut considered a massive tax-cut? mr. barthold: could you repeat the question question mark i'm sorry. a 400 millionis dollars tax-cut insurance companies would receive if this bill passes, would that be considered a massive tax-cut?
mr. barthold: in my experience before the committee, for good million dollars is one of the smaller numbers the committee often deals with -- so 400 million dollars here and for good million dollars their increasing $597.3lking about billion over 10 years? that's pretty massive. and if unpaid for. is that correct? mr. barthold: you have the estimates before you. again, it's not complete because the overall analysis will include changes to the existing premium assistance -- have ampson: so we don't cbo report that would tell us exactly how much -- a cbo report that would tell us how many people will lose their coverage. we don't have a cbo report that tells us your numbers of $600 americans what the
people would be charged for this bill that we only got last night . thank you. chairman brady: mr. higgins, your recognized. -- you are recognized. higgins: thank you, mr. chairman. this bill would allow insurance companies to claim exorbitant executive compensation as a business expense for the duction from taxes. i think this is fundamental to the whole health care debate that we are engaged in. are you familiar with united health care? mr. barthold: in my familiar with -- higgins: united health care? mr. barthold: somewhat, sir. ceohiggins: that same earned $102 million with stock options.
the cigna ceo earned millions of dollars. the aetna ceo earned $70.3 million. and thumb, the ceo earned $13.6 million. i would say the real response -- earned 13 point $6 million. i think the real response would be in admonishment for insurance companies to bring your salaries in line with reality. eo --nited health care c it was also disclosed last month united health care, the nation from largest provider of medicare services was being sued by the department of justice for fraud. reported $46 care billion in revenues in the third quarter. fraud alleges that united health in properlyn
charging the medicare program by hundreds of millions of dollars. and we're sitting here talking about giving big insurance companies a tax break on the exorbitant compensation that they pay their executives? you can be on one side of this debate. you are either with people in who work hard every single day, follow the rules to pay health insurance premiums that are too high and expect one thing -- and that is at the end of the day, when they or their insurance,s help they will not get screwed by private insurance companies or you are with private insurance companies, who want to embrace tovisions in this bill
protect consumers, particularly the elderly. we talk about executive compensation tax-deductible of four exorbitant executive compensation, it says it all. so, i don't think this provision is justifiable. i think it is morally reprehensible. i yelled back. -- i yield back. so, in order of hands being raised, i will recognize mr. kind. mr. khan: thank you, mr. chairman. just so we are clear on what the :ubtitle entails, -- mr. kind thank you, mr. chairman. just so we're clear on what the subtitle entails, they are allowed to deduct up to half a
million dollars of executive compensation. is that correct? is more than it executives that are covered, but yes, that's correct. it includes officers, directors, other workers, service providers -- basically anyone working in the insurance company. mr. barthold: basically, sir. mr. kind: right down to the janitor. what this subtitle would do is the that current cap, make sky the limit, they can do. all employees -- conforms haveit treatment of health insurance providers to that of all other businesses. remember there is still, for all a billion dollar limitation of code section 16 2. mr. kind: so there would still
be a $1 million cap? health insurance would be subject to the general rules that apply economy wide, yes, sir. mr. kind: removing the cap and moving it back to -- one million -- it is a narrow workgroup. it's only be fought -- it is a r group. e fivenly b th officers. so it would only apply to the ceo and the next three highest paid employees? mr. barthold: that is a general rule that applies to all businesses across the united states. yes, sir. mr. kind: do you know how many dismisses would be affected by this? what the number is? of barthold: i do not know
the top of my head. i will ask my colleagues to check. know how manye individuals of this lifting of the cap would affect? sure ithold: i'm not would know the number of individuals either, sir. i will check. mr. kind: we do know it will bring me 10-year cost to $400 million. mr. barthold: that is correct. policyd: do you know the behind that? why there is a cap on insurance compensation? mr. barthold: you would have to research the debate at the time of the affordable care act. mr. kind: would it seem plausible that if insurance companies or to benefit in any way as far as the prophets, they would not pass that on in the -- as far as the profits, they would not pass that on? mr. barthold: perhaps, but in the general rule, the million
dollar we were reviewing a beene moments ago, has part of the law since 1993. so it well predated this -- mr. kind: just with your general knowledge of insurance companies and employee compensation, are there are number of people who work for insurance companies that exceed a $1 million annual compensation package? mr. barthold: mr. higgins already noted some. mr. kind: i'm talking overall. large corporations in the united states, it's not uncommon to see high-ranking officers' compensation in excess of $1 million. when you see the analogy, the fixed operating costs of medicare, versus what private insurers and the private marketplace operating --to 70%
17% operating costs, part of that is compensation. is that correct mr. barthold: yes, sir. --is that correct? mr. barthold: yes, sir. mr. kind: so, under this legislation they would be able to the duct even more for tax purposes. is that correct -- they would be able to deduct even more for tax purposes. is that correct? mr. barthold: they would leave in place the current law cap on the narrower universe of employees. chairman brady: mr. crowley, you are recognized. mr. kralev: thank you, mr. chairman. mr. barthold, thank you for coming before the committee again.
if this were to become law, and would thatig if, change the baseline? mr. barthold: if there is any committeee joint would update baselines. mr. crowley: so it would have an impact? mr. barthold: yes. mr. crowley: so the deductions for corporations, wealthy individuals? mr. barthold: remember the net budget point, mr. crowley. we don't have the full estimate -- mr. crowley: we are dealing with a lot of bills. we are dealing with a lot of information absent, quite
frankly. but we have an over $600 billion hit, correct? mr. barthold: approximately. mr. crowley: the american people want to know what they have done when theerall deficit time comes about. nearly tax giveaway of $600 billion. i do appreciate you clarifying that locally. can you tell me how much of that tax benefit accrues to individuals with less than hundred thousand dollars in income? mr. crowley, i do not have a complete distributional analysis, in part because we do not have complete analysis of the effects of the entire legislation. we do have distribution analysis on individual parts, one of
which i will provide to the committee later -- i cannot provide that information. mr. crowley: can you tell me when you will have that information? it will be part of the work that we do jointly with the congressional budget office. mr. crowley: so assuming monday of next week we may have that before goes to the budget committee? mr. barthold: i don't think they said monday. i think they said next week. mr. crowley: so if the committee marks of early next week, they, too, may not have an information? mr. barthold: i don't want to speak for my colleagues. mr. crowley: it's possible it will not be before the budget committee. mr. barthold: it's possible. mr. crowley: possible? mr. barthold: they will want to do a good job. mr. crowley: i only wish the members would allow us to slow that down and allow you to complete your work before we
consider legislation like we are today. what about over $100 million? can you tell me what the impact will be for them? mr. barthold: again, i cannot give a complete answer. i do have some pieces, one of aich will be made available little bit later, as i promised mr. levin. mr. crowley: and for the same people making over -- mr. barthold: we do are just of usual analysis relative to our individual tax simulation model, mr. crowley, and we do not think that we can make good statistical inferences for the relatively smaller samples of individuals above $500 million area so, we report to the committee at levels above $1 million, but not at tranches above $500 million. i will not be reporting anything -- mr. crowley: i appreciate your candor and your honesty with the committee. but it is clear you don't have the information to give to us,
and yet we are taking action on without incredibly pertinent information that our constituents with superior about, the american people deserve to know, who benefits and how well they benefit from these tax cuts. imputing to you, but i would suggest to the overall committee that we should heed the words of mr. doggett. we should slow down, get that information before we move forward and do incredible damage to the system at hand. as much as you may not like it, what you are attempting to do would have incredibly serious health and life risks, mr. chairman. [raps gavel] chairman brady: thank you. time is expired. >> thank you, mr. chairman. thank you, mr. barthold. .t has already been explained
this dealing with health care in america is a very complex and, complicated issue to grasp. i appreciate the time that you and your staff to put into this. i was wondering if he might be able to, and i know you've talked about this when you were mr. levin. providingou would be a distributional analysis. for a lot of people viewing this , senior's fearful of what is happening to this, they hear these numbers thrown around. they say ok, you will talk about js7, and they have no idea what that means.
use of the distributional analysis. can you explain what that is? , mr.arthold: certainly larson. the distributional analysis we provide to the members tries to look at the effective tax benefit or tax increase across -- across population the taxing population. so, a person listening at home making toy $5,000 the year or $30,000 the year, they would know from your they will receive in what individuals earning over $1 million would receive. -- a person listening now making $25,000 a year or $30,000 a year. what with those bands be distributional --
distributionally? mr. barthold: we have income categories of less than $10,000, $10,000 to $20,000 -- those,son: but all of they would have a clear understanding. but you can't give that to us today because you don't have the information? mr. barthold: i will be giving some information today. mr. larson: but you can only give us part of that because you, in fact, don't have what we don't have and what our constituents don't have, which is the information, which begs the question, why are we rushing to this? we have had seven years to come -- you what should be would gather from the acrimony -- would be side pretty symbol and straightforward. would be--
prettysimple and straightforward. pretty simple and straightforward. but they can't get one scintilla of information to know what is going to happen to their health care. and even in the very narrow area , i'me discussing here wondering if the insurance executives know -- is this something that they asked for? is this something they were looking for in the bill? is this something they suggested would be part of driving costs down and making health care more affordable and ensuring all americans have health care? i know a lot of them in my district. i don't think that's the case. in yet, -- and yet, we see this
incredible windfall that is before us. and that is why i think the distributional analysis is so important. because people are going to see what they are going to get versus what people at the top receive.oing to so, i think your committee. unfortunately, you're not able to give us -- maybe a small portion, but not a complete portion. that is not your fault. that is this rush to go to a public vote on this today, a markup on this today, when we definitely need to know more , especially the distributional analysis that would be extraordinarily helpful and insightful to the american public. thank you. chairman brady: thank you. dr. davis, your recognized.
>> thank you, mr. chairman. thank you, mr. barthold. community centers have become wealthy of the most effective ways of delivering health care to low and moderate income people. repeal inage of this of way impact those centers excellence? and if so, how? mr. barthold: mr. davis, the provision before us relates to health insurance providers. as a general matter, community health centers are not affected by this provision and would not be affected by provision that limits compensation.
there might be some circumstances -- and not aware of it -- where an insurance company based sponsor of certain -based health centers -- there could be situations where there is some related effects, but the provision before us right now is about the touctibility of compensation employees of health insurance companies, health insurance providers. askdavis: well, let me about hospitals. i think all of us are concerned impactospitals and what passage might have on those disproportionate share hospitals, those hospitals that care for large numbers of low, moderate income patients as part of their base. onld there be impact provisions for the continued services of those institutions?
mr. barthold: from this provision, no, sir. -- affects is about health insurance providers. it's not about people who manage care facilities, hospitals, clinics, or the like. it's about people who offer insurance in the individual market. those businesses that offer insurance. mr. davis: and let me ask -- some states have decided during of the affordable care act, to expand medicaid. what impact would this have on the medicaid in the states? i'm afraid i'm not knowledgeable enough about medicaid and what other proposed -- may don made the
in terms of funding choices. i can't answer your question. mr. davis: so, we don't see any great disruption of health care delivery? mr. barthold: i can't speak to your question about medicaid. this particular provision is relative to your questions. you are asking questions about clinics and hospitals, so the service providers. this provision is about the taxable income, the allowable, deductible expenses of those businesses that are in the business of offering individuals or group health insurance coverage. mr. davis: are we then in any way executing a robin hood in reverse plan? services fornish the middle and lower income and provide breaks for the wealthy?
mr. barthold: um -- chairman brady: mr. davis, mr. barthold is here to answer technical questions about the bill. that is beyond the scope of this section. mr. davis: thank you, mr. chairman. i yield back. chairman brady: thank you. --resentative dunn banning y --esentative dellvann dellvany, you are recognized. have a heartbreaking letter from one of my constituents. we all know one of the achievements of health care reform is bringing young
americans into the help your system. diane wrote to me and said, we did not know her headaches were the symptom of a life-threatening condition. was assigned an mri, but she did not have health care. she thought it was migraines. we deal with guilt and anger that we live in this wealthy country where young people are afraid to get what could be a life-saving test. i don't think there is any parent in this room that would not be moved by the story. it is awful. highlights the important distinction is -- distinct and between access and covers. it's not enough to have access. you must have coverage for dr. redmond did care that they need because it can literally be the
difference between life and death. subtitleoking at this that you have said you would estimate is a loss of $400 billion over 10 years. is that correct? mr. barthold: that is correct. ms. delbene: what impact would that be given that it is taking away revenue that could be used for health care? what impact does it have on coverage for family like -- families like diane's? questions go the to the broader scope of the u.s. health care system. this provision is really just about deductible expenses for health insurance providers. what happens in terms of the federal budget in how the members choose to spend those funds is up to this committee and others in congress. thiselbene: but given that
is less revenue and we're supposed to only be looking at this particular subtitle by itself because were not talking about the entire bill -- is there anything the subtitle would do to improve coverage for a family like diane's? mr. barthold: i -- i really shouldn't comment on the overall coverage effects. that is part of the analysis that is still forthcoming. we have a piece of legislation we are talking creates a tax break for insurance companies, reduces revenues by $400 million -- on your number -- and does nothing to help families across our country? does nothing to help provide coverage. if anything undermines that. that's very disappointing that
we are only talking about a tax break not talking about families and coverage at all. unless we have some -- and we don't have the information you discussed, the cbo score and the distributions, so until we have that, there's no other information that will help us , what's again,ll how legislation like this helps families in providing quality families across the country. mr. barthold: my colleagues working with the cbo, and the cbo has said they will release her estimate as soon as it is ready. they hope early next week. they will include effects on the federal budget, affects on insurance coverage. ms. delbene: but we are supposed to be voting on this today. i guess we will be voting on any in the absence of
information. thank you for your time. i yelled back. you are brady: recognized. i want to make sure i textstand the underlying emergencyeatment of care and abortion services. unbelievably, this bill takes away the requirement that health plans offer maternity care and the objective result is it would incentivize women to have abortions? chairman brady: m.s chu, -- ms. chu, if i make a later opportunity to look at that. -- mr. barthold's expertise i will ask you to focus on this
section of the bill. ms. chu: getting to the tax credits issue, mr. barthold, i read this as saying there are no tax credits for plans that cover abortions. is that correct? i may, again,: if we will have plenty of opportunity to explore those questions. in this section of the markup, mr. barthold is available to answer technical questions dealing with this section. ms. chu: how about the tax credits to providing maternity care? i willn brady: appreciate the repeated question. mr. barthold is here to answer technical questions about this section of the bill related to communication and insurance companies. i would torment that republicans are taking away women's access to maternity services -- i would come if the republicans are taking away women's access -- i wouldy services
comment republicans are taking away women's access to maternity services. i would like to yield to mr. doggett. thedoggett: i thank gentleman. it's a regretful you cannot get answers to questions with such far-reaching effect. , want to be sure, mr. barthold on this particular bill i understand as effect. currently, an insurance company can do. the first $500,000 of compensation to its chief executive. mr. barthold: chief executive and any other employee. mr. doggett: right. -- barthold: mr. barthold: notit will be able to did -- i think in etna -- aetna's be able to do.ll million if it is
performance pay -- $17.3 million if it is performance pay instead of $500,000. mr. barthold: there are some requirement such as being approved by shareholders -- mr. doggett: i understand the requirements of that provision -- the answer is yes. basically taxpayers are now subsidizing the first $500,000 of insurance compensation. once this bill passes, the american taxpayer will be asked to subsidize -- if it needs the other provisions of the statute for aetna andon so on.
millions of dollars that american taxpayers will have to subsidize instead of limiting it to happen million dollars. it's not that those insurance companies cannot pay out those in norma sums for their chief executives, and i guess you are vice president, you just get a few million dollars, but their shareholders are responsible for covering those costs, and now we will inject the american subsidizend let them those salaries by permitting that 100% deduction. isn't that how it works, mr. barthold:? -- isn't that how it works, mr. barthold? it would permit a deduction as an ordinary business expense. no limit at all? mr. barthold: no limit, but their prohibitions against unreasonable compensation --
how are those enforced? is not $17 million unreasonable. what is the limit? how do you determine what is unreasonable? isirman brady: the time expired. ms. sanchez, you are recognized. mr. chairman, i will yield back. i will save my questions for another section of the bill. oh, excuse me. i yield to mr. kind by time. mr. kind: i appreciate ms. sanchez yielding her time. i'm confused. there is a provision that limits to $1p three executives million, but if is structured in performance pay, the sky is the limit? to barthold: i did not mean mislead you. $1ce 1993, congress enacted
million of compensation, the deductibility limit of $1 million of compensation, provided that compensation in excess of $1 million may be deductible if it is --formance-based came out perform his-based and if it is between vote of the shareholders. if itformance-based and is put to a vote of the shareholders. mr. kind: so what mr. doggett was representing was accurate? mr. barthold: yes, yes. mr. kind: they can to ducted as a business expense? mr. barthold: that is correct. i apologize if i misled you before. mr. kind: i appreciate you clarify not. i also appreciate that you are still working with the congressional budget office that is supposed to be acting as a nonpartisan referee, scoring these bills. it is my understanding from a plain reading of this legislation that this huge tax giveaway now to insurance ceo's
with the deductibility of this provision is going to be paid for in part by reducing tax credits to middle-class, working families and being paid for in part by a serious reduction in medicaid funding that for our states. is that correct? mr. barthold: i should not characterize what pays for anything else in the bill. there are many moving parts. mr. kind: i appreciate that. we will get into that a little bit later. to yield to mr. thompson? yes, if mr. thompson wants my time. mr. thompson: i thank you. i think the windfall of compensation takes away -- rips away health coverage for every day, working americans.
and there's another part here that i don't think has been mentioned. job loss. it is my understanding that this bill, this combination of bills we are going to pass today are going to cost the american jobs. some 3 million lost in california, it's about to,000 jobs we're going lose. not only do people lose their , but insurance executives get millions and millions and millions of dollars , but americans are going to lose their jobs to feather the these million dollars -- millionaires in this backdoor way. i think it's important that members of the committee understand what it is we are voting on. had cbo done the report and we
had that before us, i'm assuming we would not have had to find out by good luck that this was the case. we would have had this information. i think there's probably more in this bill that we are going to find out that hurts the american people that we were sent here to represent. i can't understand why it is we are insistent on having this hearing today without the information but for us. -- having this hearing today without the information for us. chairman brady: thank you. ms.thompson: it is sanchez's time. ms. sanchez: i yield whatever time remains to mr. pascal -- mr. pascrell. an historic time, mr.
chairman. i go back to the president's great speech last week when he said "the time for small thinking is over." we are thinking big. when i go back to the campaign -- bended -- hasked expended, you are down to your own time. >> thank you. the speech connects with how we will connect with the working people of this country. how we will be sympathetic to their needs. -- thiswhat we find out is a historic moment. because theoggling, big thinking is now for the big boys.
so much of the money we are saving when we cut all of these is forand everybody cutting taxes but do not look at the consequences many times, and the president cabinet, it is estimated to have a net worth of $30 million. good for them. anyone in his cabinet benefit from this tax provision? president'sf the cabinet are not employees of health insurance companies, so no. in the provision before us right now. >> would anyone in his cabinet benefit from the other tax cuts?
which are nearly 600 billion in cuts that we are talking about today? mr. pascrell. >> i'm not finished. >> a reminder, questioning is related to this section of the bill. >> it is directly connected to what we are talking about, i believe. >> a general reminder. questions to your our guest who has expertise on this part of the bill. >> mr. chairman, a point of inquiry. at least 15 to 20 seconds transpired in your gentle to the gentleman from new jersey. can you restore that time to the clock? >> we will restore them both. >> thank you. >> we are talking about nearly
600 billion in tax cuts, are we not? is that not to remain in the first part of the bill we are talking about today? i am asking the chair. >> will you repeat the question? >> we are talking about $600 , but i, in that range think that relates to what we are talking about. the bill we are marking of today. -- marking up today. i want to know if anyone in the cabinet will benefit from these tax cuts of the $600 billion. even members of the cabinet would benefit from that. >> i appreciate the question, and mr. barr told has expertise related to this portion of the
bill. tore will be hours for us answer those questions as we move through the bill. >> is in it strange mr. chairman that we come here to mark up the alternative we have been talking about for six or seven years. doesn't it strike you as peculiar that the first thing we are doing is not only cutting all the revenue out of the bill? with that revenue, the first thing we do is take care of insurance executives and other people of a certain income level. moment, aftern a the questions are complete, we will begin asking for those who begin to strike the last word. that will give you an opportunity to explore that area. >> i yield back. >> mr. chairman, thank you. thank you, gentlemen.
bartold it is a $600 billion tax cut, correct? >> if i may remind members, his expertise is related to this portion of the bill. your questions should not go beyond the scope of this section. >> how much of a tax cut are we talking about? >> this particular provision will reduce federal receipts i $400 million over a ten-year budget. the expansionough -- medicaid expansion cuts that the state of new york will see a reduction of $5.7 million in medicaid expansion funds. new york where local governments contribute to , it is quite possible that localities will be facing
property tax increases because of those cuts. i just want the constituencies in new york to understand that pharmaceutical executives will benefit tremendously to the tune of anywhere between 400 million to $600 million. meanwhile, local governments in new york state will have to consider increasing property taxes to make up for these tax cuts. i want to state that for the record. i appreciate your time and the time in the -- and the time of the gentleman from new jersey. --i give the rest of my time yield the rest of my time. >> is it safe to assume that if the insurance companies are able to enhance their compensation, one of the beneficiaries could be any individual who holds private stock in those companies? whether it is a member of
congress or the administration? >> at its simplest level, the provision affects the computation of the net taxable income of business. >> i would assume that if a sharon's -- if an insurance company was able to reduce their tax responsibility, it could enhance the value of their stock. the shareholders would benefit. >> thank you. the time has ended -- the time has now benefited on mr. pascre ll's time. >> thank you, mr. chair. i want to make sure i can find myself to the renumeration for insurance executives. this title will give a net executivesinsurance and have less money coming into the federal government to the tune of $400 million. is that right?
>> tax receipts largely from these businesses will be -- them, it is a windfall for and not for the taxpayers. my question is, do we know how many insurance executives actually benefit from this provision currently? >> i believe that is the same question mr. thompson asked earlier, and i do not have that information. i am checking with my colleagues to make sure we know the number of companies who may be limited under present law. >> do we know what the average deduction is with respect to this provision? what is the average compensation of the executive? what is the average deduction? >> i am checking with my colleagues. if i get supplemental provision i have asked about, i will make it available to all members of the committee. --can you also add to that
are there any regional or geographic distances between compensation and the production related to insurance executives? i assume you do not know that either. can you add that to the list of things to explore? x regional is -- well -- we do, not usually measured things on it regional basis, because the committee is making analysis on a national basis. too not have information as if this particular limitation would be -- >> i guess you can imagine it doesn't matter to me, especially since the district i represent has .6% of the people that make over $200,000. you can imagine the constituency i represent looks in all of the fact that we are giving a $400 million windfall to insurance
executives when they can barely .fford food on the table the average income for my district is $34,000. it seems a little out of balance. i understand you may not focus on geographical distances, but folks iramount to the represent, because this bill will represent in 357,000 alabamians being ticked off health care. -- kicked off health care. that is something along with the job loss -- that would be 20,000 jobs alone in my district. you can imagine that stirs up a lot of real concern by the american people over having a title, the first title out of the gate be a windfall for insurance executives. my last question, mr. chairman -- with respect to the insurance
, prior to the implementation of the affordable muchact, do you know how the average deductible was for insurance executives? know what expenses or claimed in the 10 or were affected -- in 2010 or were affected. >> i just want to say for the record that it is woefully inadequate for us to be able to vote on a proposal such as this went even our expert cannot give us concrete, very relevant information at how many people -- how many insurance executives will benefit. the average deductible. these are basic questions we need to be able to answer in order to vote on a bill such as this. i want to state for the record that this is unacceptable and woefully inadequate. i think it is airy irresponsible of us to pick up a bill like this without having information it is woefully--
irresponsible of us to pick up a bill like this without having information as to how much these things will cost. >> i think my friend from hisgia for yielding to me time. just to clarify what it would mean for the insurance companies -- by repealing the cap on deductibility and allowing it to rise to unlimited heights based on performance pay, this directly works to the benefit of the insurance company's bottom line, because they reduce their tax liability with this provision? >> yes, yes sir. >> that could be used as an excuse to enhance executive pay with the insurance company. we know -- three have any data how thisd show provision could lead to enhanced
executive compensation packages? economic effect of present law is that if you were to give a covered individual additional compensation beyond costs the00 limit, it because itners more, is not a deductible expense. cheaper would make it to provide additional compensation. evidenceaware of any employmentitivity of or business compensation offers to such a change. >> i understand. i would suspect that those of us on this side would have less to complain about with this provision if there was any evidence for data to show that if insurance companies can increase their bottom line by
being able to expense this to a greater extent -- that could be used for the reduction of premiums or deductibles for the customers of those insurance plans. that would not necessarily be a bad thing. is there any evidence that supports that kind of cause and effect? >> i am not aware of any insuranceetween company profitability and short-term effect on market prices. >> on it premiums and deductibility that customers would have to pay. if youto presume that are able to reduce joint tax liabilities, the market would favorably, because you can show a healthy profit statement. share prices would go up as well. is that a logical consequence or what we are doing here today? >> the economic incentives as you have laid out increases the
net income of the business. it would be seen as more valuable. it would then be a question of .ow much magnitude >> i think it is safe to assume that if profitability increases for an insurance company, then sure -- share prices go up. any shareholders would benefit off that. >> that is a possibility. it would be a question of thistude -- how important is to the overall market valuation of the enterprise. >> so, a member of the administration could be in line to profit from this type of provision before us today. >> any shareholder, sir. any am wondering if implications -- stock act
invocations may apply to this provision. fromohibits self-dealing numbers of congress in legislation pending before us. this is one where if you are a private shareholder, it could certainly work to the benefit of the individual shareholders what is being done today. i throw that out there for yours and ours consideration as we move forward. i feel back to georgia. >> the gentleman from georgia goes back. before we moved to strike the last word, are there any other members that wish to question our guest? does anyone wish to strike the last word? mr. leventhal, you are recognized. >> i want to quickly summarize why there is such deep feelings on our side and maybe silence on the other side. markupstarting off this
with a giveaway to insurance executives. $600 part and parcel of billion in lost revenue. i just want to mention, because it will come later, that everyone should understand why our focus. the two largest provisions -- the .9% medicare tax and the net investment income tax, those provisions come to about $275 billion. about half of the $600 billion in lost revenue. those two provisions, according to the capuchin tables that we have -- the distribution tables that we have, over one half of each of those goes to someone making over $1 million a year.
another -- another corridor will go to those making over $500 million. -- $500,000. so, what we have here to kick markups discussion and is the beginning of a huge giveaway to the very wealthy. a huge giveaway. side,lence from the other i would think, would indicate deep embarrassment if possible. -- in what isg called by the speaker "what they had been dreaming of," $600 billion in lost revenue with the
vast majority going to very wealthy families. that describes so vividly the , and itwith this bill will emphasize those who are going to lose their insurance and if it's and coverage -- insurance benefits and coverage. millions and millions while billions go to the very few. that is what this is all about. i yield back. -- mr.er chairman chairman? >> does it when also to strike the last word? >> thank you. five piecesas carved out to minimize the opportunity to show the interconnection between this measure and the overall republican bill. that is why the free that the frequent interruptions to narrow discussion and cut off questions
is a deliberate part of the presentation of this bill in this fashion. it did not need to be done this way. it is done that way so as to constrict not only our ability to have reviewed the bill and what it cost and covers, but to try to limit with in that what amendment we can offer and what we can discuss and what questions we can raise. despite those limitations that have been imposed unfairly upon us, there is striking evidence of what is occurring here and what has not occurred here. this first measure, done under the guise of repealing obamacare, is to give a $400 million windfall to the insurance industry. now, which member of the insurance industry had the courage to come and sit at that desk and tell us they needed the $400 million? none.
like the rest of this story bill, they did not have the courage to have a single public hearing on it. we never had any discussion. in all the seven years of white is that taxpayers ought to have to -- ought to have to subsidize an annual salary for some insurance executive. amazing this morning is that in this discussion, that silence has continued. you would think we were asking someone to comment on whether or not president obama was a criminal who wiretapped president trump at trump tower, because they have been silent on that. you would think we were asking taxpresident trump's returns, because they have been silent on that. indeed, every outrageous statement and crazy tweet, they are silent on that.
again, in this hearing, they are silent again. we have not heard one member of who is attee republican speak up to explain why insurance companies deserve a $400 million windfall as part of a 600 million dollar giveaway in this tax measure. they are quiet, they are silent. just as they are silent in aqueous and the wrongdoing -- and acquiesce in the wrongdoing of this administration. it is not only important to point out the wrong been committed here, a wrong on american families, a wrong that will lead to property tax increase, a wrong that will lead in texas to people who have their first family physician to no longer have that. do not know how many millions will be affected when this vote is cast.
we do know that $600 million is being drained out of the treasury and being drained out of the treasury with this first step of 400 million for a totally unjustified windfall for the health insurance industry, and that no one ever felt it was necessary to explain or justify in public hearing or public comment a single word about it. i yield back. you, mr. doggett. does anyone else wish to strike the last word? dr. davis? you are recognized. dr. davis: thank you, mr. chairman. billbill is the first tax from the president -- from the republican congress and president trump. rather than have the hard working americans feel comfortable, the tax provision onwers millions of dollars
millionaires and billionaires. on owners of wealthy pharmaceutical companies. these republican bills pay for costsndfall by increasing for tens of millions of working families and retirees. the two tax benefits in this -- 156.7ost 150 sex billion dollars. -- about 400 million would get $700 apiece every year. this is a billionaire's bonus. will 400 wealthy families receive a benefit for about 800,000 people in 20 states. these cuts will almost certainly trumpectly to president
and a high percentage of his cabinet. the wonder mr. trump is so enthusiastic in his support of this bill. my colleagues must think the president and his cabinet are doing a good job to reward themselves so generously so quickly. given the small number of people affected, this provision looks very much like a congressionally mark -- earmark. the american people hope they have elected republican leaders who would create jobs and give them a handout instead of using billion dollar credit. this bill harms in that majority of americans to get 157.6 billion dollars to the most
secure an advantage among us. i urge my colleagues to close giveearmark that would millions of dollars in raises to president trump and much of his cabinet. i yield back. >> thank you. this anyone else wish to strike the last word? other any amendments in the nature of a substitute? joan and from organ is -- the gentleman from oregon is recognized for the purpose of offering his amendment. >> i would like to reserve a point of order, please. >> point of order has been reserved. [inaudible]
discovered the health care was complicated when it meeting with the governor's. in fact, he said, famously, who knew? well, every member of this committee knew that health care is complicated. we have some great little buttons that say "we knew, " and i think our republican friends knew. we have is a claim by the president that we are going to have health insurance for everyone. "people can expect to have great health care. it will be in a much simplified form, less expensive, much better." the airone on repeatedly along with the vice president to repeat this pledge to the american people.
in somewhat of a consultative position here. we have not scratched -- of a complicated position here. we have not scratched the as we had with the affordable care act where we had hundreds of witnesses, cbo score, hundreds of committee hearings. we are forced to rely on articles published hastily in the last 48 hours. we have organizations that are coming forward, the american medical association and hospital organization, aarp, they are pointing out the flaws in this puzzle. i have a very simple amendment -- in this proposal. i have a very simple amendment that says nothing of -- nothing in this bill will take lace unless the congressional budget office certifies that everyone gets health insurance as part of this bill. that it keeps president trump's
promise. chairman, that this is kind of the least we can do. we are rushing into this blindly. we do not have a score. we have never had at the witness table -- i feel mr.'s -- i feel sorry for mr. bartold. he is on the receiving end. the questions being asked should have been asked to experts in health care, economics come a insurance companies, the medical profession, hospitals, people who care for the disabled, people who manage programs on the state level. there ought to be a full and complete hearing of the implications. the fact that we are going to have 50 to 64-year-olds with a 60% increase in the premium rates -- that ought to be a
concern to everybody on this committee. to thet to be available american public to decide if the increase in financial burden on citizens who are approaching medicare, but not quite there yet -- that should have been part of the debate. it should have been part of the effort here, listening to the experts, about the impact of taking $170 billion out of the trust funds for medicare. the president has aimlessly promised that it would not be cut -- famously promised it would not betide. this proposal ends the guarantee that we rely on with medicaid and its expansion. enacted, would begin a retreat of medicaid. it would cap, lower, shift burdens to the states.
it would put the people who deal with the elderly and disabled in chaos. a state will lose almost billion dollars in 2019 as we are struggling with two-year budget. so, because we have not followed regular order, because we do not have a cbo score, because we have not heard from experts who can give dimension to these challenges, i think the least we should do is approve my amendment to make sure it does not go into affect unless we can sertify the president's claim about a health-care program that will be great, less expensive, and cover more people. i respectfully suggest that we all ought to approve this amendment to give the american people the trump guarantee.
>> does the gentleman from ohio wish to insist on his point of order? order, i make a point of to the note that it is not germane to the amendment. it violates house rule 16 clause seven as the contingency amendment was brought up. i go back. gentleman who offered the amendment wish to speak on the point of order. >> i respectfully disagree. i think what we are talking about here with the legislation -- we are still trying to figure out what you have in here and what the impacts are. that is what it would be great to have a cbo score. be great toit would have a hearing to be able to bring in people to flesh this out. i think, being able to make sure that we can give the american rances that they are
going to be double to get what the president and republicans have pledged is entirely germane. i think it is something that you should give the benefit of the doubt to give peace of mind to the american public. part of what is going on here now is the failure to be able to follow regular order. , weo not have the cbo score have had no hearings, it was jammed through in a day or two when you are trying to undo something that we all worked on for weeks and weeks and months. you had six solid years not to chip away at but to reform, reflash, to deal with -- refresh, to deal with. i think it is an embarrassment to the great tradition of this committee. mr. chairman, frankly, i do not think this is how you want to do
business. i think you are a serious legislator. that making good on the president's pledge that it is going to provide that are care for more people at lest , let usat less cost roll up our sleeves and do that. we should not have a guarantee up front. i do not think it is inappropriate for us to consider the amendment at this time. >> i would note that regular order has been followed. it was posted two days in advance. the public has been able to read the bill, and the committee has held 45 hearings on the affordable care act. regularwe are following order, we are following germane role. i'm ready to rule that it is not germane to the nature of the substitute him up because it violates house rule 16 clause seven. the contingency treated by the amendment requires a
determination about health coverage that is broader than a narrow subject of the commitment -- of the amendment. point of order is sustained. the amendment is not in order. >> i would challenge the ruling of the chair. chairman-- >> the motion on the table -- the ayes have it. the motion to table is the same. is requested.vote the clerk will call the role. -- the roll. johnson? mr. nunez? >> aye.
>> the clerk will report the vote. >> 23 aye. 16 nay. >> the motion to table is approved. >> point of order, mr. chairman. in the less than 40 hours, less , the bill text was released, the president, vice president, the secretary of human services has said that the language we consider today is still open to consideration to the work in progress. surely, this -- >> if i may -- >> mr. chairman, i am getting to my question. is this a discussion draft before us which these comments seem to indicate? or is this a markup of the final
bill without any hearing? recommendations to the reconciliation bill. >> mr. chairman, point of order. is it -- are we deliberating right now the final bill before the ways and means committee as you know it? >> we are deliberating on the recommendations to reconciliation to be forwarded to the committee on regular order. thatesident trump stated the bill is now out for negotiation. has said itsident is a framework for reform and at the white house is open to improvements. secretary price has said it is a work in progress. i asked again, is this the final version of the draft proposal? x thank you. that question has been asked and answered. amendments toher
allowed to speak on the amended. >> the committee voted along party lines to block my request and to cover up president trump's tax returns. this is an effort to give the committee another opportunity to consider the intervening events since that vote was taken and to incorporate a request regarding president trump's tax returns into this legislation. since we considered the matter last month, our colleague, who i know will want to speak separately on this amendment, has sent a second letter to you urging the committee to use its authority under current law to obtain a copy of the tax returns and view it in a closed executive session. 165request was signed by million -- 165 members of this house.
two republicans have stepped forward to join mr. sanford and mr. jones. since intervening period we have considered this matter, the need for mr. trump's tax returns have become more urgent. they could reveal russian entanglements. every meeting with russian contacts heightens the need to see the returns. i admit that we democrats have perhaps approach this in the wrong direction. that we got it backwards. the question we should have been asking from the outset to make it easy is, will any trump campaign surrogate who did not meet with the russians please raise your hand? because this keeps coming out week after week, revelation after revelation. it is not sufficient to say there is nothing to see here. first it was paul manafort, and
then the national security adviser michael flynn, and now the attorney general jeff with thewho met russian ambassador at the republican national convention. jared kushner who met with him during the meeting. we need to see the tax return. president trump said at a press conference last month that he has no deals with russia. that may or may not be true. right now, he may never have been able to close a real estate deal in russia, we can take him meetingwn word in his on the david letterman show in 2013 when he said quote, "i have done a lot of business with the russians. they are smart, and they are tough." of hiscan take the word son, donald trump junior, who said in 2008, "russians make up a pretty disproportionate cross-section of our assets."
of course, we do not have a tax return or 2008 are many other -- four 2008 are many other used to evaluate the extent that this conflict exists. -- how iss not it this not a bipartisan issue? we have a statute that goes back decades and authorizes this committee to take a professional review of all of mr. trump's tax returns. it will take professional expertise. this is a president who brags about how he has been the tax code to his whim. he bragged about not paying a penny in taxes. he came off better than how these insurance companies will
off of the provisions in this bill. how has he managed to do that? how will his tax returns look if he is now overlooking the internal revenue service? will he make a great deal for himself and his family not available to the american people? there was a recent analysis i a series of -- by reporters who said under what they think is in this bill, they do not have a score all the data, that president trump personally stands to rake in million from two giant tax breaks in this bill. as we get to the tanning salon section, we can explore whether those in mar-a-lago or his other resorts -- he will benefit even from the tanning provisions here. two giant tax breaks
$7 million. i think it is important to adopt this amendment. hell has his own comments on it. i will let him speak. >> will the gentleman insist on his point of order? point of order to the commitment that it is not germane to the substitute. it violates house rules 16 clause seven. the tax code regarding confidentiality of the tax code is outside the topic of enumeration here today. >> that judgment offering the eminent wish to speak on the point of order? >> i would. but i will yield part of my time to speak on the point of order ll who authored
the letters sent to you. >> thank you for giving. thank you, mr. speaker. mr. speaker, you had stated that in section 6103 of the tax code that it was designed to protect privacy. but you failed to address the 6103.egislative intent of it was put into the tax code specifically so our committee, the ways and means committee, would have oversight of conflicts in the executive branch of government. the congress recognized it needed this authority after that scandal i talked about in 1923. change, this tax could happened. -- tax code change happened. what could be more in line with the spirit of the law then examining a sitting president's
conflict of interest? the argument for protecting privacy and narrowly interpreting the purpose of 6103 ring hollow when you just voted to disclose the confidential tax inormation of 51 taxpayers 2014. a disclosure that was in no way essential to present in your case to the department of justice against lois lerner. very short memories and selective memories, mr. chairman. where were your privacy concerns -- privacy concerns then? -- these werean ordinary figures apply for nonprofit status. not public figures. -- also argued that the
there is no such limitation written in 6103 granting authority to this committee, the ways and means committee, to return -- review tax returns enclosed session. as i mentioned, the authority put in place to examine conflicts of interest. mr. trump's conflicts of , they go through many, many issues. is the china trade marks, well, there are a whole bunch of them here. it is good stuff, mr. chairman. you ought to read about. mar-a-lago, whatever they call that place down there in hidden valley. the trump hotel in d.c.. argentina, and the relationship the president has with the president of argentina. very interesting.
you should read about it sometime. the defense department rentals. the apprentice tv show. the dakota access pipeline. the dubai golf course. the dominican republic. the canadian hotel we just heard about last week. let me just bring it back home on january 11. trump,sident, president the president of the united states of america announced he would place control of his assets into the hands of his two adult sons and a longtime associate. the plan would terminate the foreign it deals -- four and deals, undermined -- terminate deals, recently
a promise to build new golf courses. the director of the office of government ethics, certainly no lackey, recommended divestiture from his business holdings, and effortst trump's were meaningless. i do not think divestiture is a two high of a high of a price to pay to be the president of the united states." i'm sure you agree with that, mr. chairman, but i will not ask you. this is the case, the possibility that outside actors will attempt to influence his policies i supporting or denying his is ms. interest will be a
interestss business will be a very relevant issue. >> iq, all-time has expired. -- thank you, all-time has expired. i know you are sincere in your position in your reference letters that you and others have sent to me. introduce a to response to basically point out that what you request would be an abuse of authority by the tax-writing committee. with that, i am repaired to rule that this amendment is not germane. >> i wish you would yield in the future, mr. chairman. >> i am prepared to rule that the amendment is not germane. it violates house rules 16 clause seven by creating an unrelated contingency that is beyond the narrow subject matter of the subtitle. >> esther chairman--
>> point of order is sustained. the amendment is not in order. >> mr. chairman? ofi would request an appeal the record of the chair. a record vote. >> a record -- a table motion has been made. >> all those in favor signal by saying i. all those opposed say no. table has been sustained. through thetinue process, a rollcall is requested. the clerk will call the roll. >> mr. johnson. >> aye. >> mr. nunez? >> aye.