tv Budget Committee Votes 19-17 to Report GOP Health Care Bill to House CSPAN March 16, 2017 3:59pm-7:17pm EDT
>> the house budget committee wrapping up 5 56 hours of consideration of the republican health care bill, the replacement plan for the 2010 health care law, the affordable care act. if you want to see this hearing again we will show you a portion in just a moment. you can also see last weeks ways and means committee meeting and the markup in energy and commerce. go to our website sees ben.org and type in health care legislation. today's hearing got underway at about 10 o'clock eastern this morning and again we will show you a portion of hearing beginning now. >> the committee will now come to order. ask the numbers to take their
seats. today we meet to report the recommendation submitted to the budget committee pursuant to reconciliation instructions set forth in title two of s. con. res. three, the concurrent resolution on the budget for the fiscal year 2017. under the congressional budget act of 1974 the budget committee has the role of coining the reconciliation submissions of the committees on ways and means and energy and commerce, and reporting the bill to the house without any substantive revision. after reporting the measure that committee will conclude with any final motions. under the agreement i have reached with the ranking member, mr. yarmuth from kentucky, today's market will be conducted as follows. the ranking member and i will each make an opening statement. as per our usual practice ask members insert written statements in the record.
i will hold the record open until the end of the day for that purpose. we will then proceed with a motion to report to the house the recommendations submitted to us pursuant to the reconciliation instruction. after voting to report the american health care act of 20172017 we will then entertain any wrap up motions on these motions there will be a total of 20 minutes of debate evenly divided. the proponent and opponent when you recognize for ten minutes each with one minute for each proponent to close. [inaudible] >> i now recognize the gentleman from indiana, mr. rokita. >> since we're scheduled to a floor votes later today i ask unanimous consent that consistent with house rule 16,
the chairman be authorized to declare a recess at any time. >> without objection, so order ordered. we will now move to the opening statements and without objection i would ask to submit exaneo materials for the record. >> good morning and welcome to this market at the house budget committee. we are here today to act on the american health care act. this bill seeks to address one of the most fundamental policy challenges that we face. how to reduce the cost of health care and give all americans access to quality care. this is something that house republicans have talked about for years, and the opportunity is finally here to fulfill the promise that we've made to the american people. under the leadership of speaker ryan, this body began to formalize an approach for patient centered health care under our better way playing. the better way plan outlined our
philosophy for health care reform. we need to take control of health care decisions away from the government and give it back to the patients and the doctors. we need to reduce costs and ensure that everyone has access to quality care and we need to reform and allow states to modernize government programs like medicaid to strengthen them and ensure they provide for people that they were intended to help. that's what our bill does. the american healt health care t provides portable monthly tax credits, not tied to a job or a washington mandated program. this provides more flexibility to americans who don't currently have insurance through their emoyer. and with lower cost by increasing competition and choice. this bill also provides for more insurance options by allowing individuals and families to buy the insurance plan that they need and want at a price that they can afford.
it's not the job of the government to tell all americans exactly what type of insurance coverage they should purchase. our plan allows for people to choose the plan that best meets their needs and increases the amount of money that can be placed in their health care savings account to ensure that individuals and families can spend and save their health care dollars the way they want. the american health care act is also a once in a generation entitlement reform. medicaid spending is growing out of control and this bill reforms and modernizes the medicaid for the 21st century. reforming the program and giving states greater flexibility to make the program fits the needs of their citizens will protect the program and make sure that it is available for the populations it is intended to serve. after all, the issues that face california are very different from the issues that face my state of tennessee. most importantly, this bill
protects our most vulnerable citizens. in total this bill reduces the deficit by 337 billion over ten years and lowers taxes by 883 billion over the same time. for individuals and small business owners. at the same time premiums will decrease by 10% by 2026. this legislation is a conservative vision of free market, patient centered health care. it dismantles the obamacare mandates on taxes, puts health care decisions back in the hands of patients and doctors where they belong and as a nurse i know how important this is. this is a conservative health care vision that we've been talking about 14 years, for years. and it is our response to the outcry from her own constituents to rescue them from obamacare. to my republican colleagues who have doubts today i encourage you, don't cut off the
discussion. stay in this effort and help us with this proposal and designate to the committees and pushing further for conservative reforms. members who desire to see this bill in peru have every right to make their voices heard and we are united in our goal, to repeal obamacare and replace it with a patient centered health care. right now obamacare is imploding. we were promised premiums that would decrease by $2500 and instead average family premiums in the employer market soared by $4300 we were promised that health care costs would go down pick instead deductibles have skyrocketed we were promised we could keep our doctors and health insurance plans. and instead millions of americans have lost their insurance and the doctors about it like. in short, the affordable care act was neither affordable nor did it provide the quality of care that american people deserve. but we also have to remember
marketplace while other places in my state, people have an insurance card but they can't get care. jenny, a resident of my district reached out to say her family's insurance premiums rose from 340 month to $860 a month and i quote her saying to us, health insurance shouldn't cost the same as a mortgage payment. george from west moreland in my district reached out to my office to say that this will be the first year since he was very young that he would not be able to afford health insurance. before obamacare, he was paying $458 a month for health insurance. this year, is premium is a whopping $1160 a mon. he said and i quote, please do something. anything to work and help the situation. during a recent tele-town hall where i had over 8000 constituents on my phone at
the same time, more than 70 percent surveyed said obamacare had a negative impact or no positive impact ontheir life . these are real stories and real people who have been impacted by obamacare. these stories are the reason i am drawn to public service in the first place, we have a chance to fix the problems that are ailing our healthcare system and i cannot sit idly by and let this opportunity pass . we made a promise to the american people to repeal this law and replace it with something that is patient centered, healthcare reforms where americans can have the insurance they want at a price they can afford . and this bill is a good first step. but it's not all that we are doing. my good friend and former chairman of this committee, doctor tom price, now the secretary of hhs has begun the process of rolling back some of the burdensome
regulations and requirements that were entered by obamacare. that process will continue as secretary price worked to dismantle the regulatory regime that's putting governments to patients and their doctors and driving up the cost of coverage and at the same time, i look forward to future legislation which addresses issues that cannot be included in this reconciliation bill. these pieces of legislation will provide a more robust and competitive marketplace to bring down health care costs for all americans. already my colleagues on the judiciary committee and the education and workforce committee are working on separate pieces of legislation that will foster rater competition among healthcare insurers that will implement significant medical malpractice reforms and that will allow small businesses to band together with all plans and negotiate from lower costs for their employees.
this is our three-pronged approach. delivering patient centered healthcare reform. the american healthcare act is a strong first step in this process. it secures key conservative victories to lower costs and put patients back in charge of their health care decisions, while ushering in the most significant reforms to entitlement programs in decades. in accordance with 1974 congressional budget act, the committee plays a role in combining the litigation from the energy and commerce and ways and means committee into a single bill in the fiscal year 2017 budget resolution. i want to thank the committees who helped draft this legislation for their efforts and i look forward to today's markup. i strongly support this bill and i urge all our colleagues on both sides of the aisle to work with us to pass this important piece of lettuce and bring relief to the american people. with that, i yield the ranking member ms. yarmouth
>> i have to admit i was at a loss on how to begin this opening statement. i don'know what else needs to be said one 24 million people will lose their health coverage if we pass this bill. i know the republicans stand about cbo estimates being unreliable. my colleagues can claim whatever they want. the fact remains the still cost hundreds of billions of dollars from medicaid, that's indisputable. cut still larger every year, 20 percent of medicaid programs in 2026 and they get deeper and deeper every year after that. you can't cut medicaid, without dramatically cutting coverage and care. let's be clear about who would lose that coverage and care. it's parents struggling to get by on poverty level wages, seniors in nursing homes, children and people who are too disabled to work. let's be honest, this is not a health care bill. it is an ideological document, a fantasy about freedom and choice in a market that doesn't exist.
but what is real about this bill is painfully real. it gives $600 billion in tax cuts to corporations and the wealthy, paid for in the worst possible way, by jeopardizing the health and well-being of american families. it takes life saving healthcare from those in need to give tax cuts to the rich with devastating consequences for families across the country. this is robin hood in reverse, but far worse . >> speaker ryan loves to talk about giving people the freedom and choice to decide whether to have health insurance or not. insurance companies the freedom of choice to cherry pick young, healthy enrollees ansell them cheap, stripped-down healthcare plans. that would work if young people had the freedom to choose whether to get cancer or not or get in a serious accident or not which they obviously don't area that doesn't stop speaker ryan from pretending this bill will create magical healthcare free markets that exist nowhere in the world.
it's a fantasy land where young people don't get sick and apparently they don't grow old leader so they don't have to worry about being priced out of the market as this bill does. that's nonsense and that's why cbo doesn't predict more people will be insured under this bill. cbo says the opposite, the number of people without insurance will nearly double. i think that's all you need to know if you're wondering why this bill is being rushed through the floor. remember, it was introduced last monday, marked up in the energy and commerce committee's two days later. now before our committee, it will be on the house floor as soon as republican leadership can get there. there have been no congressional hearings on this legislation, not a single hearing on legislation that impacts the healthcare of every american family. if i were them, i wouldn't want to talk about this bill either. i certainly wouldn't want to defend but the american people deserve to know what's in it so let's run through the facts.
14 million americans will lose coverage next year. that number rises to 24 million people by 2026. in fact, it rises to 21 million in 2020. consider that. in just three years, the entire gains under the affordable care act will be wiped out. these people will live in fear that theyre o serious illness or car accident away from bankruptcy. the nonpartisan congressional budget office estimates premiums in the individual market will jump by 15 to 20 percent in 2018 and 2019. yes, by the end of the decade, premiums will be 10 percent less in current law but the main reason for that drop is largely because older people will be priced out of the market which i hope no one would want to brag about. for example, a 64-year-old making less than $27,000 a year currently pays $1700 a year for coverage under the
affordable care act. under this bill, that same person's premiums skyrocket to more than $14,000 a year. he or she would have to spend more than half of their income coverage. that's not progress, that's a crisis. it gets worse. pretty much everyone in the individual market has other costs including deductibles will be higher. for lower income individuals, healthcare costs will be significantly higher. this bill increases financial risk for consumers and eliminates the requirement that insurers provide to certain actuarial values which means these companies can sell plans that offermuch less financial protection . plus, it takes 170 billion dollars from the medicaid trust fund, shortening the life of that program by three years. it does all that, cutting
coverage for millions of americans, increasing costs and reducing care for millions more to give millionaires $50,000 tax cut every year, and $144 billion tax cut to insurance companies, and a $25 billion tax cut to the pharmaceutical industry. and a special tax cut to subsidized the colonization of health insurance executives who often make $10 million or more a year. it's a pretty remarkable document, particularly when you think about what was promised to the american people. president trump repeatedly said that the replacement bill would preserve existing coverage. that everybody would have insurance, and it would be less expensive and much better. it's going to be great. he also pledged that medicare and medicaid would not be cut. none of that is in this bill. in fact, the exact opposite of every one of those promises from made to the
american people is what's in this bill. the secretary of health and human services, price stated more people would be covered that are covered right now and nobody will be worse off financially, not true. speaker ryan promised no one would be left out in the cold and no one would be worse off . wrong. republican chairwoman kathy morris rogers pledged no one who has coverage because of obamacare today will lose that coverage. wrong again. you won't find any of those promises kept in this bill. promises made by the president of the united states, secretary of health and human services, the speaker of the house and other members of house congressional leadership. let's remember, this bill is the first step. republican strategy, a strategy they have publicly stated was to take away the affordable care act that services like maternity care, substance abuse services and others will be covered.
ultimately, this bill, future legislation and expected efforts to end consumer protections through regulation will put insurance companies back in charge, allowing them to once again decide who lives and who dies. i strongly oppose this bill and i am not alone in that opposition. it is opposed by america's hospitals, doctors, nurses, the aarp, the american cancer society, the american diabetes association, national disability rights network, governors from both sides of the aisle and more and more of our republican colleagues in the house .
this bill is not what the american people want. they have made that clear by showing up by the thousands at town halls across the country. we can improve the affordable care act and we should. but i urge my republican colleagues to vote no on this bill and work with us to ensure every family has access to quality, affordable health care. the american people deserve no less. thank you and i yelled back. >> thank you mister yarmouth. following a practice i ask unanimous consent that members have until the end of the day to make a statement for the record. without objection, so ordered. >> we will now proceed with reading, proceed with reporting the american health care act of 2017 to the house, and i want to remind the members mth tn will come at the conclusion of the vote on this procedure. i ask unanimous consent that the first reading be dispensed with, the clerk will report the title of the measure to be reported. >> the bill to provide for reconciliation pursuant to title iii of the resolution on the budget for fiscal year 2017. section 310 of the congressional budget act of 1974 requires the budget committee to report the reconciliation bill to the house without any substantive revisions, motions to amend
the bill will not be entertained. i now recognize the gentleman, mister akita for a motion to order the reconciliation bill. >> thank you madam chair. i move the committee order reported the american health care act of 2070 with the recommendation that the bill be passed. >> the question is on ordering the american health care bill 2017 to be reported favorably to the house. holders in favor signify by saying i. those opposed, no. in the opinion of the chair, the aye's habit. a reported vote is requested, the clerk will call the roll . >>. [roll call]
>> other members who havenot voted wish to change their vote ? >> i don't think i've been recorded you have not been recorded. >> i vote aye. >> mister cole, aye. >> are there any other members who have no voted want to ch their vote? i would like the gentleman to be rorted, >> mister sanford, no. >> any other members would like to change their vote? if not, the court shall report. >> the aye's are 19and the nose are 17. >> the aye's habit and the motion is freed to the american health care act of 2017 ordered reported to the house of representatives with a favorable recommendation. i know that a quorum is present . >> madam chairman, i have the requisite number of days to file. >> so ordered, i recognize the gentleman from indiana, strategic.
>> i ask unanimous consent that on the measure just reported, staff the authorized to make any necessary technical and conforming corrections prior to the bill such as inserting the short title of the bill and that the motion to reconsider be laid on the table and that the chair be authorized offer motions to go to congress pursuant to clause one of house bill 22 on the bill just reported for any companion measure from the senate . >> without objection, so ordered. with the bill having been favorably reported, i ask unanimous consent at the committee follow its long-standing custom of this committee and the entertainment motions in the order specified in the agreed-upon list made available to the members. debate on these motions will be limited to 20 minutes each, equally divided with one minute reserved for the proponent to close. the designated proponent and opponent of the motion will each be allowed to fulfill their time. without objection, so ordered
. i would like to also remind members that these motions do not amend the proposed bill and are not binding on the rules committee. that leaves the consideration of the health care act of 2017. ... okay, thank you. mister boyle. [inaudible conversation] i now recognize mister boyle for the motion. >> thank you, madam chairman i have amotion on the desk . >> the clerk will read the motion.
>> the motion offered by representative boyle and jeffries, mister boyle and jeffries move that the committee on the budget direct the chairman to request on behalf of the committee that the rules for consideration of the american health care act in order and amendments that would prohibit any provision of the bill from taking effect until the secretary of health and human services certifies that relative to current law, its provisions and amendments result in one, no increase in the amount of individuals without health insurance, too, more affordable healthcare as measured by the amount paid out-of-pocket toward healthcare and three, better health insurance as noted by improved health insurance benefits. >> thank you madam chair. this motion support an amendment to the bill that would prevent any provision of the american health care act from being implemented until the secretary of hhs certifies that it fulfill the
promises made by president trump to the american people. the president has promised that there would be no increase in the number of individuals without health insurance. that healthcare would become more affordable, that lower out-of-pocket costs and that the quality of health insurance would be better. just this januar the president said quote, we're going to have insurance for everybody. that quote, people can expect to have great healthcare and he is against the notion that quote, you can't pay for it, you don't get it. we are hard-pressed to see how any of this bill's provisions fulfill any of the presidents promises and the american people deserve to know specifically how our healthcare system is improved by taking insurance away from 24 million americans. stripping $880 billion out of medicaid over 10 years and
shoveling 600 billion in tax cuts to the wealthiest americans. which is nearly twice as much as the paltry $361 billion this bill provides in premiums and cost sharing assistance to those americans who need it. the president has assured us that quote, we are going to have insurance for everybody. much less expensive and much better. this motion simply request a clear explanation as to why under this bill, a typical 64-year-old with an income of $26,500 would be forced to pay 14,600 and premiums by 2026, almost 13,000 more than what he or she pays now under obamacare. how is that quote, less expensive and much better? i yield to mister jeffries. >>
workout. first trumpcare will directly lead to millions of americans losing their insurance. according to cbo within the next year, 14 milliondditional americans will be without health care coverage. within the next ten years, 24 million hard-working americans will lose health insurance altogether. the president assured americans that affordably will not be the reason they lose their coverage. yet trumpcare takes dead aim at the poor, the sick and the elderly. cbo estimates 14 million will
lose access to medicaid within the next ten years. that same estimate projects people age 50-64 with incomes below 49,000, for a family of four would be more than twice as likely to be uninsured under this bill. trumpcare guaranteed to decreased in out-of-pocket costs. yet again, trumpcare falls short. the gop plan will force that was into purchasing plans with even higher deductibles and higher cost-sharing, and they will bear more of the cost of premiums, a 64-year-old with an income of 26,500 will pay almost $13,000 more for the premiums in the individual market within the next ten years. rising cost will hit older americans, low income families and people living in rural areas
especially hard. third, trumpcare will dramatically reduce the quality of health insurance. almost $900 billion cut in medicaid will force states to reduce benefits and limit care for loincome families. it will be especially harmful for seniors in nursing homes and children with disabilities who rely on medicaid. this bill will also allow insurers to offer plans that will provide significantly less protection, exposing enrollees to greater financial risk. and we know that the cbo expects that insurers will take advantage of this to design principles and appeal to people who do not expect to need much medical care. scripture in matthew 25, versus 3535 says for i was hungry you gave me something to eat. i was thirsty, you gave me
something to drink. i was a stranger and you took me in. i was naked and you clothed me. i was sick and you look after me. trumpcare fails on all scores. i yield back. >> thank you. i now yield one minute to the recognition of our committee, the gentleman mr. yarmuth. >> thank you. thank you for yielding here just to elaborate a little bit on what's already been said to one of the key elements of this proposal, one of the most damaging one is the guarantees of the coverage that we provided in the affordable care act. and as i stated in my opening statement, this bill would allow insurance companies to sell coverage without mental health coverage in spite of the fact we have an enormous opiate and drug addiction problem in this
country. it would allow insurance companies to reduce the actual values so a very, very small portion of the actual out-of-pocket costs of care would be the responsibility of the insured and not the insurance company. and in many other ways, increasing the exposure of the people covered under this, these policies. and to get another broken promise that the president made including i might mention before yielding back that he did make the promise also that he would not touch medicare, and this legislation cuts $170 billion out of the medicare trust fund and reduces the financial viability of the program by three years. i yield back. >> i yield to the gentleman from the common law of massachusetts, mr. moulton. >> i want to take my call it from pennsylvania for yielding me time.
on sunday health and human services secretary price said the house republican plan will leave no one worse off financially. no one worse off. tell that to the 14 million americans who won't have access to health care next year because of this bill. tell that to the 16 million seniors and individuals with disabilities who will pay drastically more for health care next year because of this bill tell tt to the 3 million veterans who will lose their health care coverage because of this bill. thank you for your service, but you will be a lot worse off. don't take it from me. let's read the cbo report. the cbo report says that cost-sharing payments including deductibles with ten to be
higher than us and to spend under the current law. once again the american people are being told alternative facts by trump and his administration. thank you and i yield back. >> thank you. i yield one minute to mr. khan khanna. >> thank you mr. boyle, and thank you for your leadership. as you pointed out the president promised three things here more coverage, better benefits and lower costs. so how was he going to do it? in 200 2000 he wrote and i quota canadian style single-payer system in which all payments are made from medical care are made to a single agency helped canadians live longer and healthier than americans. the president thought that a single payer system was the only way to live up to his promises. what he ought to do is work with senator sanders from medicare for all if you serious about living up to any of the commitments he has made. i yield back my time. >> thank you.
i now yield one minute to ms. jackson lee. >> i want to thank both he and mr. jeffries for this very important amendment. let me take note of the speakers comment to ensure that we know that we are not speaking about health care ll. for the reasons that this amendment is so important. speaker ryan indicated that it's welfare reform. we're talking about trillions in this program. talk with hundreds of billions a year throughout the country. this is so much bigger by orders of magnitude and welfare reform. speaking about what you all are doing to medicaid is. this is a bus to medicaid bill. it is not a health care bill. it ignores completely the response that has been given to the american people by the president, that everyone will have insurance. people covered under the law can
expect to have great health care. that is not the case and so i ask opposition to the bill and support of the amendment. i yield back. >> thank you. i yield back. >> the gentleman yields back. i'd like to recognize mr. mcclintock for the opponent for ten minutes. >> thank you, madam chair. mr. boyle and mr. jeffries raise a good point regarding the structure of the tax credit in particular and i'm going to address that in my amendment number 11. but the absurdity of the motion is clearly illustrated in the cbo is own report. they may have missed it. they devoted an entire section of that report entitled uncertainty surrounding the estimates and what statement they can't predict how federal agencies and states that insurers and employers come individual doctors and hospitals would react to the law and they can't predict how the law would actually be implemented.
i distinctly remember president obama certifying to the nation that we would see an average $2500 drop in the cost of her health care premiums. instead we've seen a $4300 increase in those premiums. obamacare averaged premiums are up 25 25% last year, still biggr increases expected. i distinctly remember president obama certifying to the nation that if you like your plan you couldeep ur plaintiff in fact, millions of americans lost their plans and were fceonto the obamacare exchanges. one-third of our counties have no choice at all. there's only one provider and another third there are only two providers. i distinctly remember the cbo certifying the 21 million individuals would enroll in obamacare exchanges by 2016. 2016. in fact, only 11 million did. i don't believe that president obama deliberately lied about this. as yogi berra famously sicken
particular difficult, especially when when they involve the future. the fact is complex chemical interventions in the marketplace create a wide variety of unintended and often perverse consequences. we are not dealing with the wreckage from such an intervention. we know for a fact that hasn't worked well for a majority of americans who gets sent their premiums skyrocketing pickets denied the and the choices thata free market offers. it sent providers link from the market at it a sent taxpayer costs spiraling. nobody contends the bill before us is a perfect plan. it's not even a complete plenty of which we're sending this than a comprehensive reform that completely repeals obamacare and completely replaces it with a healthy, vibrant, competitive and consumer driven market. this bill consists of only those measures that are permitted under the reconciliation process and relies on administrative rules and follow up legislation to complete the work. that's another of the limitations of the cbo's claim
to clairvoyance that only looks at one piece of the reform. the bill now before us without even attempting to assess the other measures that make it fullyorkable. i believe with all of the measures are implemented consumers will have the widest range of choices to select a plan that best meets their needs in a competitive environment where a large number of health plans across the country are tripping over each other to offer consumers the best service at the lowest price and with a tax system that supports and assist families in keeping his plans within the financial reach. is that a certainty? of course not. it's more likely go to control costs and expand choices and ensure accessibility and promote innovation and excellence than the current system. that i believe is a reasonable expectation. i would now like the one in f ministry mission dose of minnesota. >> thank you mr. mcclintock. there's a lot of talk today about broken promises but the poster child of broken promises has been the affordable care act.
after mcclintock talks up premieres nationwide that i can tell you about. the governor of minnesota democratic governor said the affordable care act is no longer affordable. the commerce commission called it an emergency situation with premiums rising 50-67% in the last two years. when blue cross blue shield got out of the minnesota market 100,000 were left without a plan even though the president promised you could keep your doctor can keep your plan. this is a debacle and everybody in minnesota knows it's a debacle. the exchanges are shocked. the state of minnesota to pass a $310 million emergency legislation just to keep the exchange and the people buying on it marginally afloat. that's the crisis we are in. not to address this to the best of our ability but be a derelict of not only our promises but our duty as a body. i yield back to mr. mcclintoc mcclintock. >> i now yield a minute and ha
half. >> i think my colleague and i appreciate the motion that is made by my colleagues on the other side. unfortunately, this motion is really just an aspirational proposal. it doesn't offer any specifics. it just says what they would like and what they would wish to get his typical washington. that's the problem. people around the country are sick and tired of what washington does, which is often nothing. we have a situation around us where yes many people across the country are happy with the aca, but just as many if not more are seeing extraordinary increases in premiums, extraordinary increases in deductibles. they can no longer afford it. they may have insurance in some instances but they don't have something that's affordable, that they can buy and that they can use for themselves and their families. and unfortunately motion our colleagues are offering on the
other side is just washington speak ticket doesn't even make a suggestion as to what the chair is supposed to do if she went to the rules committee, if you wanted to exchange the tax credits of advance refundable tax credits. one of the great things about the proposal in front of us is that we are finally starting to treat people who don't have employer-provided health insurance, equalizing e tax treatment for those. there are 160, 179 people across the country that have simply provide health insurance. it's not taxable to them but if you are the $45,000 household husband and wife with two kids, you get no tax preference at all if your employer doesn't provide insurance. this legislation addresses that. my colleagues on the other side don't think i it's sufficient enough, don't think it's substantial. why aren't you suggesting to the chair that she address that with the rules committee? but no, you offer a press
release as a motion. this is typical washington speak that doesn't advance the process, that doesn't change anything. it's just looking to score political points. it's not looking to fix anything. and frankly my friends, we've got to fix the mess that the aca has cratered and the health insurance markets around this country, and that is what we're trying to do. as mr. mcclintock said this is not a full plan. this is not a full plan but it is a first step on making a full plan to replace it. i yield back. >> i would elect to yield a minute and half to mr. grothman of wisconsin. >> yeah, thank you. this thing is important when you try to push this motion, where we stand today. okay, we're at a point where 30% of the countess there's only one player left. if we waited another year i'm not sure how many counties are out there wouldn't have any plan at all. there are pasted still one plan. when you have so little
competition, it's not surprising that the premiums are going up by 25% this year. i suppose it might be some people, some commentators who want to say we ought to wait a year before taking this vote. if we waited a year we would see what type of treatment increase should have when you have no competition at all. nevertheless, we're going forward this bill today. the goal of this builder do is bring a little more free market competition into the health care market which will result in what we need more than anything else, and that is have over all health care costs dropped. there are individual businesses out there in the market, employers who are doing a great job of containing or health care costs and they're doing it because they are not stuck in obamacare monopoly type situation. there is no reason why health care costs in this country shouldn't fall. you can look at health care procedures that are not covered by insurance, just everything else driven by technology and
things like basic -- lay sick, cosmetic surgery are following. i think the private sector through a variety of means are causing or directing their employees to have health care costs go well below these big increases we're seeing in obamacare. so again i think people have to remember what a train wreck obamacare is at this time, and even more what is a train wreck it would be of some irresponsible people had their way. we waited a year to see exactly what happens when the government tried to take over this big segment of the economy. >> madam chairman, i would conclude by pointing out that the reason the cbo notes and initial dro drop-off in enrollmt and increase in premiums is that they believe the only reason many people purchase these plans is because they are forced to buy them.
i think that speaks volumes of obamacare's failures. markets work on the voluntary choices that are made by consumers, and republican patient has always been one of a vibrant and competitive market where consumers have the widest possible range of choices and the support of tax code tosure c coverage within the financial reach. yield back. >> mr. boyle, the public of the motion is recognized for one minute to close. >> thank you, madam chairman. i had to give the designers of trumpcare credit as of this bill is somehow more damaging to working americans that a straightforward repeal of the aca would have been. according to the nonpartisan congressional budget office, premiums will grow 24-29% in just two years, 52 million americans will be uninsured within ten years, $170 billion will be drained from the medicare trust fund, actually
moving up the insolvency date by two years, at the number of americans covered in the employer-provided insurance market, not the exchanges, will fall by 7 million. all of the evidence suggests that this bill will worsen every aspect of her health care system. and return us to a time before the aca when coverage was neither accessible nor affordable. the burden is on the trump administration to prove otherwise and to finally make good on its promises. thank you, madam chair spinner the question is on agreeing to the motion offered by mr. bugger all those in favor? those opposed? in the opinion of the chair the no's have it. a roll call vote has been requested. the clerk will call the roll. [roll call]
if not, the clerk shall report. >> on that vote the ayes are 20 and the no's are 14. >> the no's have it and the motion is not agreed to. i now recognize mr. higgins for the purpose of a motion. i want to remind you that are nine minutes on the clock and then you get one minute to close. >> madam chair, i have a motion at the desk. >> the clerk will read the motion. >> a motion offered by representatives higgins and mr. kahane. they moved the committee on the budget direct its chairman to request on behalf of the committee that the rule for consideration of american health care act make an order an amendment that would one, strike all provisions in the bill to reduce number of americans with health insurance coverage can increase cost of reduced benefits, reduce the number of
americans with health insurance cover can increase cost for poor and middle has come -- for the wealthy health insurance companies and their executives and pharmaceutical companies. spirit mr. higgins is recognized for a total of ten minutes with one minute reserve to close. >> thank you, madam chair. yesterday, president trump said that we are involved in a big fat, beautiful negotiation that we are negotiating with everybody regarding the health care. no, you're not, mr. president. this mess belongs to you. house republicans and the insurance industry exclusively. this plan is a scam being perpetrated on and against the american people. if you are 50-64 years old you get clobbered. in fact, according to the republican led congressional budget office, if you are 64,
you make $26,000 a year, your health insurance bill will increase under your plan by more than $12,000. from $1700 a year to $14,000. by the way, i would remind my colleagues you should know that the white house scored this bill as well and there's a reason wy you don't know about that. well, let me get to the big and fat of the presidents characterization. united health care is one of the largest health care providers in america, private insurance company. their ceo in 2004 was compensated with $66 million. he actually took a pay cut because he made $102 million in 2010. there is a provision in this bill that says explicitly this
bill will allow insurance companies to claim exorbitant executive compensation as a business expense for deduction from taxes, okay? three weeks ago the department of justice opened up an investigation on united health care for overbilling medicare program not by tens of millions of dollars, not by hundreds of millions of dollars but by billions of dollars. so you're going to vote this massive tax cut united health care, their executives and their cronies in the midst of all of this. this is morally reprehensible. i now yield three minutes to mr. o'connor. >> -- mr. o'connor. >> thank youthank you, mr. higg. the cbo report shows that the numbers here just don't add up. you can't say that you're going
to save $1 trillion in the deficit and give folks must subsidy than they're getting under the affordable care act and still claim that people are not going to lose their insurance. so my concern and the reason i brought this motion with mr. higgins is let's just be honest about what's going on. if you want to get people less funding to buy subsidies because you think that that's going to lower some part of the deficit, then just say you don't care about people who are lower middle class income families having insurance. it's going to meet less people are getting medicaid. it's more important to give tax breaks or tax cuts to grow the economy. this is going to help the deficit, but what's wrong about this is let's not pretend. let's have a philosophical debate about the issues. do we care about expanding coverage which is going to cost more, and is it worth that cost
as a society, or do we care more about reducing costs and taking money away? we can debate that but let's have a debate about the facts and that is what is so disconcerting is where not debating the facts. i yield back the balance of my time. >> i now yield one minute to ms. >> thank you very much. i want to thank yourself and congressman condit for this motion. i am a strong supporter of the. it would strike the massive tax breaks in this bill and ensure that no american lose access to health insurance. it's completely unconscionable that this so-called health bill continues republicans assault on the poor, low income indiduals, families just struggling to make end meet. does it buy into medicaid expansion and with a health care away 4 million americans. but we know this really isn't even a health care plan at all. let's call it what it really is.
it's a massive tax cut for the wealthy disguised as a health care plan. this bill is a $600 billion tax giveaway which is the largest transfer of wealth from working families to the rich in our nation's history, period. what's more, tens of americans will suffer just of my republican colleagues can hand the 40 400 wealthiest families n america a $2.48 million tax break each year. by paying for it this is how they do it. using medicaid and insurance exchanges as a piggy bank to pay for these enormous tax breaks. it's really a disgrace. >> i yield one minute to mr. moulton. >> a couple days ago i received a call from a marine i start with. who is suffering from addiction and needed help. that's wh what he called. he needed help. i like to tell some of my republican colleagues to take
that call the xml explain why that help is not going to be there next year for him. we are discussing here is not just about caps and budgets. it's about our values. it's about what's right and wrong with health care in america today. and under the republican proposal, it is right for the rich to get better health care. for the poor to continue being sick. it is right for the sons and daughters of the richest americans to be well cared for while the sons and daughters of our veterans who put their lives on the line for our country are less sick. this is about our values. and i think we collectively are failing to meet that test. i yield back. ..
finally we're looking for something different. were sick and tired of being ignored by washington dc. you've had a popular uprising throughout the western world after 30 years of stagnant incomes. what to our friends in the majority do? they offer us a bill that actually gives a record tax cut to those making over $10 million a year. i think i didn't quite believe it or read the language. if you are a ceo of a health insurance company, who on
average makes about $13 million a year, you will get egg aggregate 400 million-dollar tax break, some populism. i yield back. >> you have one minute. >> thank you mr. higgins for your leadership to prevent this unprecedented shift of wealth from working people to millionaires to billionaires and corporations. let us beclear that this pay more for less spell is not a health care bill. it is a tax bill that give $600 billion of dollars of tax cuts to the wealthiest and payor on the backs of poor and middle-class household. in fact, the one basic principle that seems to be consistent in the spell is that the richer you are the bigger your tax cut. for instance, the top 4% of income earners that earn more than $300 million a year will get a total a total tax rate of 275 million or about $200,000
year and each. working families see their benefits cut in their premiums rise. madame turman, this is america we don't want to begrudge people good fortune but this bill is pure greed. the rich get richer while 24 million people are stripped of healthcare. i yield back. >> thank you madam chair. >> i now recognize the opponent of the motion, mr. smith from missouri for ten minutes. >> i clearly oppose this motion because it is our responsibility to limit the size and scope of the federal government and that's what this bill does. we must advance this conservative solution to get control of spending and save our country from economic despair. when the folks on the other side of the aisle talk about taking from away from the poor, you're talking about taking away from the people i represent. i know the working poor. i note the lower middle class
looks like because i represent the 14th economic distressed congressional district in the country. that is out of 436 districts. in my district the median household income, not of an individual, the household income is right at $40000 a year. about 20% of the people live below the poverty line. according to peyser estimates, less than 3.4% of the people in my congressional district and rolled in obama care. through healthcare .gov. that last than 26000 people in southeast, south central missouri. those people, the 3.4% were forced to participate in obama
care and in 26 of the 30 counties that we have in our congressional district, how many choices do they have a smart one. one choice. i'll tell you what obama care gave us. obama care gave us in missouri very few options. it took away our doctors. president obama promised me to keep our doctor. we lost our doctors. he promised that we could keep our healthcare plans. 4.7 million people lost their health care plans under obama care. we lost our freedoms. but you know what obama care gave us? obama care gave us tax increases on the poor in the middle class. obama care taxed wheelchairs, so don't stand there on that side
of the aisle and say that poor people don't use wheelchairs. obama care taxed the poor and the middle class. actually, the majority was on the middle class. it was over $1 trillion dollars of taxes. twenty-one different tax increases. you can say your talking points but if you're telling me the poor don't use medical equipment, you're wrong. you're wrong and you text that. you tax drugs. you tax numerous items. what this bill does is repeal over $800 billion worth of taxes that you all pushed. that's on the backs of the poor and the middle class. in trump care, we are not taking away their healthcare. were not raising their taxes. were actually giving them more options by stabilizing the market. our bill doesn't hurt the middle class like obama care.
it cuts 800 billion in taxes that they currently face because of obama care. our bill doesn't pull the rug out from underneath the middle-class. cbo said that after we restore the freedom for people to buy health insurance, if they wanted, 14 million people will choose not to buy it. it will be there twice once again. no longer a mandate from washington dc. madam chair i would like to yield two minutes to mr. grossman. >> thank you. the problem i have with this motion is that, i think, it's fundamentally dishonest about who is paying for this plan, who is getting the benefit of the plan. it falls back on the rhetoric that somehow we are benefiting the rich and unfairly picking on the poor. under our plan we continue a
very generous medicaid program and we have tax cuts. they are refundable tax credits and we don't like to use the word tax because it's misleading. it a gift to the government tords her health insurance. where does the money come from the tax credits and where does it come from medicaid? okay. we know in this country i'm not some big mr. apology for the rich -- we'll talk later about tax return in the original plan but we have to be honest here the top 3% of the tax returns pay for about 50% of our government right now which is to state the top 3% are going to pay for these tax credits and the top 3% are going going to
pay for our generous medicaid program. meanwhile on the other end of things, you can be a married couple, have a couple a couple of kids and make $40000 a year and pay no tax at all. meanwhile our tax credits are phasing out when you begin to make $75000 a year. that's wildly mildly wealthy. i was everyone to make 75,000 a year and there's a lot of middle-class making 75 grand a year. their benefit is going to be themselves. when they get up around 90 or 100 or hundred hundred 20000 a year they'll get no benefit at all. what's happening on of this plan is that you are poorly having the wealthy pay for the benefits and i don't want to call them poor but people without much money are the ones who are going to be getting something without taking anything in. that's just was going on and to say something otherwise is fundamentally dishonest is what is going on here.
this is like many plans, something which you have to look at all hypothetically, to get these tax credits. that's not the wealthy. on the other hand, if you are making a single person making hundred 2030 grand a year, you're paid, you're paid for these benefits and not getting benefit back. that's fine. but to say that we are having the wealthy somehow gets a big benefit out of our medical system and were taking advantage of the so-called poor, it's the exact opposite of what's going on. thank you mr. grossman high-yield to mr. bergman. >> i want to thank the gentlemen for yielding time for me to speak on this motion. it's fitting that were here today discussing concerns with healthcare policy that would reduce the number of americans
with health insurance the policy that would raise costs for americans, the policy that could potentially reduce the benefits in any way. because that congress discussed his concerns back when obama care was being considered and passed maybe we wouldn't be here today. the reality is that obama care, the very legislation that most of my colleagues on the other side here today supported has increased cost, reduced access for millions of americans and left the american taxpayer on the hook for this unsustainable health care law. under oba re we've seen soaring premiums, higher deductibles, narrow insurance markets, and most recently, most recently, dates with only one insurer in their marketplace. means of americans have found healthcare options under obama care so up unappealing and unaffordable that instead of purchasing coverage they have
chosen to pay the individual mandate according to the irs in 2016, roughly 6.5 million americans paid 3.000000000 the penalty and more than 12.7 million claimed an exemption from the penalty. that's roughly 20 million people who decided that obama care was not worth the trouble and not worth the price. that is not increased coverage or better access to care. that is less choice, less freedom for americans across the country and for the people in my home state of michigan who work hard and want freedom to choose what is best for themselves and their families. individual freedom are the very foundation of our country. i encourage my colleagues to vote against this motion.
>> thank you mr. bergman i yield a moment. >> thank you, representative smith. 25% increase in premiums and $4300 an increase deductibles across the country and the tax on the middle class, i don't know what is. i come from rural america. the rural districts like mine are predominantly middle-class and working-class folks, small businesses, family farmers main street americans and obama care regulations are crushing our rural hospitals, 600 on the brink of going out of business. how are farmers and ranchers going to feed and clothe the american people in that scenario i see i'm out of town. i yield back-to-back mr. higgins, the proponent of the motion is recognized to close. >> thank you, madam chair. the republican-led congressional budget office is estimated loss of those with health insurance be 14 million. the white house score that they won't share with you is about 17 million. in this debate, when you reduce it to its irreducible essence,
you're either either with insurance companies that are making record profit and will make even more under your belt or your with the american people. to they want to pay premiums throughout their lives? but when they need healthcare they want to ensure that if there without deductibles, without surcharges, without all these added costs. we have an opportunity to work together to develop a plan that works for the american people i yield back. >> the question to the motion offered by mr. ho it all those in favor signal i in the opinion of the chair the no's have it. a recorded vote is rude requested. [roll call] [roll call]
>> the no's are 22. the no's have it in the most is not agree to. i now recognize for a motion. >> the clerk will read the motion. >> a motion offered by representative in jackson lee. they moved that the committee direct its chairman to request on the committee that the rule for consideration of the american healthcare act make an order an amendment that would warrant striking the bill that dens medicaid to a. capita funding system and three, strike newtek new tax breaks for the wealthy and corporations in the bill. >> she is recognized for one minute with one minute close. >> unfortunately, we are here
for the most tragic of reasons to fulfill a plan that is a betrayal of the american people. how is this plan up a trail ? when you cynically strip 24 million people of healthcare and double the number of uninsured in the company's from 52 million. when you undermine the healthcare safety net for re than 70 million americans like seniors, children and and their parents struggling to get by on poverty level wages, and people to disable to work. that is a betrayal. last night on cnn i listen to secretary tom price tried to contour angry rural doctors and retired teachers and cancer survivors to know that this bill is a betrayal and when asked by danna bass if he could promise that no 50 to 64-year-old would see their costs increase, secretary price could not answer. this motion to instruct would turn back the misguided attempts to strip $880 billion from medicaid from for medicaid from 14 million americans in 31 states across the country.
the reality is that even republican governor from states like michigan, ohio, and nevada agree that medicaid expansion has been a huge benefit to real people in their states. in my home state of washington, medicaid expansion expansion has helped over 600,000 people and cut the number of uninsured in half to just 5.8%. stripping medicaid also affects over a million people who suffer from substance abuse, disorders like opioids and getting treated one of the most cynical actions under this bill are the wholesale transfer of billions of dollars of medicaid costs to the state. this is the opposite of states rights. it's like telling states that your left holding the bag and in this case body bags for the millions of people who suffer life-and-death consequences. i now yield three minutes to this jackson lee let me think
the gentle lady that i'm authored thiamendment with. this saves lives. the mess that i colleagues talk about are the lines of americans who are elderly, who are blind, poor children. many of them veterans and hard-working persons, their families and that is who been devastated by the loss of $800 billion from medicaid. it is the lady in arkansas - backed by the way, i know there is no one here who is from kentucky but there is a lady from arkansas who asked senator this mac i was looking to my colleagues on the other side, mr. chairman. you're on the right side of the issue. i've heard too eloquently. this lady posed the question to senator cotton, my husband who worked, who struggle is
suffering from congestive heart failure, open-heart surgery, dementia, alzheimer's, and they had insurance, $29 a month under obama care, $39 for this hard-working woman. she invited the senator her home this is important because this bill is pay more for less, this is nothing but a devolution and an ending of medicare. the speaker of the house said this is why i'm so excited about it. this is why i think people need to see the forest through the trees. we are decentralizing an entitlement, granting it back to the states and capping a growth, that's never been done before. they are blowing up medicaid. you are throwing people to the street. as the scriptures have been quoted, where is the good samaritan?
this bill will impact negatively 31 states who have expanded medicaid that have been able to help people. it will give a huge tax credit to pharmaceuticals $25 million, it is the greatest transfer of wealth to the 1% of this nation riches and it ends the opportunity for the operant nursing home of my constituents who because she did not have healthcare, did not take her medicine and when she did not take her medicine she is now in a nursing home with a stroke where she is without her faculties and heart disease. the medicaid of obama care pays for her. my conclusion is 73 million people in america get their insurance and their healthcare insurance from medicaid. you are killing it and denying it. you are taking away the lifeline.
you are not hearing the stories. i asked my colleague to support the john paul jackson amendment. >> i now yield one minute from new mexico. >> thank you, very much for my colleagues in washington. i too am joining in that $880 billion out of medicaid, not only destroys families but it destroys economies. our republican governor expanded medicaid and we had the highest uninsured rate in the country. now we are seeing uninsured rates hovering right about ten to 11% in this this economy. we've lost 70% mining jobs, 1700 utility sector jobs and a third of our oil rigs have left. that means that affordable care act bought 6100 jobs, hundred jobs, we have the worst unemployment rate in the
country. this $880 billion represents 900,000 people in new mexico mexico getting healthcare. that's clinics, doctors, it's half our population. it devastates rural in front your states and make them less important and less equal in this debate. with that, you'll back. >> thank you. i now yield one minute to mr. jeffries from new york. >> this bill is a direct attack on the poor, the sick and the elderly. once again, house republicans are cutting taxes for the wealthy and the well-off and jamming up working families by devastating medicaid. trump care is not a health care bill is a giveaway to the rich and the same list this bill provides 275 billion-dollar tax cuts to millionaires and billionaires. health insurance ceos and executives get a
400 million-dollar tax cut. the top 400 countries earners in this country will get an annual tax cut of $700 million. year. yes, the great yankee catcher yogi berra should be quoted saying, it's like déjà vu all over again. >> thank you, i i yield one minute to mr. egan. >> thank you madam chair. i think that when you look at healthcare with the medicare program to the medicaid program with the va, you've got about 155 million people. the federal government needs to view itself as a major purchaser of healthcare and use the leverage those numbers to drive down the cost of health care generally in prescription drugs in particular. you see that the age group
between 50 to 64 takes a major hit in the spell. allow them to buy into medicare and they will reduce those costs by about $7600 a year dollars a year. i yelled back. >> i yield to the remainder. >> thank you. this bill would decimate the medicaid program ripping away healthcare from 600,000 people. in my district alone medicaid expansion has meant 36000 more people are covered. that's 36000 people who won't go bankrupt just because they got sick. access to affordable coverage is not healthcare is a false promise. make no mistake that 36000 people in my district will sll need healthcare like katie, mike and stick to it who had coverage from maternity care things to medicaid expansion while her daughter was born healthy and
happy and she told me quote, i can't can't imagine what i would have done without medicaid. let's not go backwards. support this motion and i yield back. >> thank you, i yield back madam chair i now recognize the opponent of this motion, for ten minutes. >> thank you, madam chair. madam chairman the motion put forward by my democratic colleagues is don't destroy medicaid and take away healthcare from the most vulnerable. really? i had to read that motion several times and still can't believe it's actually being offered. take away medicaid or care from the most vulnerable ? madam chairman thanks the affordable care act the destruction a medicaid for those who need it most is already occurring. a study by the urban institute put forward data that 82% that would be nearly eligible for medicaid under obama care would
not have a child in the household, not only that but all that 82% 69% would be men and women ages 19 to 44. what many many would concede is the best working years of a of a person's life. under obama care through enhanced math rates, medicaid expansion states have seen federal medicaid dollars increase for working aides, able-bodied, able-bodied adults anywhere from 133% to 200% more than the funding for those who qualified for medicaid prior to obama care, including seniors and individuals with disabilities. the discrepancy in the amount of funding between medicaid expansion and traditional medicaid is a gross injustice for the people that medicaid was originally designed to protect, the elderly, the blinds and the disabled. madam chairman chairman in my home state of arkansas, the
foundation reports that there are 2955 disabled 955 disabled people on a waiting list for medicaid for a medicaid home community-based services waiver. the story is the same across the country. in my neighboring state of texas, 116,000, florida 21,000, illinois 16,000 and on and on nationwide. hundreds of thousands of people with disabilities and the elderly are being penalized and punished through no fault of their own because on march 201, 2010 this house led by many of those on the isle today made a conscious decision to increase enrollment for young able-bodied adults into a program that was intended to help the truly needy. the gentle lady talks about my home state of arkansas, my state took the medicaid expansion and one of the many families affected by the neglect in the traditional medicaid program in
my state is a family of skyler oberman. skyler was born with a rare neurologicalondition any 2060 ns report lindsay oberman, her mother said she feared her daughter won't live long enough to receive the assistance she has been waiting on nearly her whole life. skyler's condition condition caused her to have multiple seizures a day and her mother is her full-time caretaker. the oberman family and many families like them, can't just call him a babysitter if they need to step away for a couple of hours but a medicaid waiver would help pay for that. under obama care we have seen medicaid rolls in increased by millions of people, spending increased by billions of dollars but unfortunately it has caused the needs of the disabled people such as skyler oberman to be put on the back burner, all in the name of insurance coverage, not healthcare. madam chairman i find it
appalling that the needs of the truly needle in this nation are being ignored to protect the political legacy. it is well past time that we as leaders stand together and say no more. it is time that we return the medicaid program back to the purpose for which it was created and that is to help the elderly and disabled. i asked my colleagues in joining me in untying the hands of our nation's governor so that they have the ability to take the federally provided money for medicaid dollars and assist citizens the best way they know how. iron to my colleagues on both side the aisle to stand for those who truly need our help and oppose this amendment. i would now like to recognize for three to quarter minutes >> i think the gentleman for yielding. as a federal government has imposed more and more red tape and regulations, the states have cut payments to healthcare providers. low income patients many of whom live in less and less access to quality care.
medicaid recipients frequently have a hard time finding a doctor and often encounter long wait times to see the doctors that will even accept medicaid in its current form. something has to be done. medicaid recipients also frequently see receive inferior treatment, less less skilled surgeons, receive poor postoperative instructions and the worst outcomes than people on private insurance. a2007 study by the washington said the and were charged more for hospital visits then either uninsured patients or those in private insurance. uninsured patients have shorter hospital stays and those who are forced to take this broken medicaid system and promise. the american healthcare act put medicaid on a budget, it doesn't cut medicaid. funding will continue and will continue to grow to match the needs of the states to cover their populations that are most in need.
but it no longer under this plan would reward states who don't care providers well or otherwise want to gain the system. with almost $20 trillion in debt this is the responsible thing to do. let's care for our most vulnerable, to provide the proper safety net without a hammock and also begin making sure that the next generation is in the first generation in ameran history that will be worse off than the current one. it's never been done before desperate people on this committee should allow this to happen. this is the right way forward please deny this motion to instruct. i yield to the gentleman. >> thank you. i yield to three to quarter minutes. >> as members of the house budget committee, i think most of us would agree that our priority is to establish and enforce control of our budget.
today as members of this committee we are given an opportunity to do just that in the realm of healthcare. though i am not debating the services that medicaid provides to us we can't ignore the direction that the medicaid program is going. my friends on other side the aisle claimed that by phasing out medicaid expansion we are stripping away coverage from the most vulnerable. i also heard the word betrayal. i believe the contrary is true. by continuing on this path of unsustainability we are betraying the american people. we are slowly stripping away any possibility of prospects for our children and grandchildren, we are on an unsustainable path that we can't keep spending money we do not have. if we sit and do nothing and its
current rate, medicaid spending will reach 957,000,000,000 x 2025. again, unsustainable 2025. again, unsustainable. that's the betrayal. this reconciliation there were viewing today's takes this first step in modernizing our 1955 design a medicaid that has made it impossible for states to manage their bondage. we are strengthening our medicaid program for the future. to the american healthcare act will have greater flexibility to reduce costs by tailoring program specific to the individual population. in addition, the asean power states and the states abilities to further assist states to cover low income populations. by making these commonsense reforms we will finally be able to bend the cost that is crippled our budget for too long. but, if you haven't artie gotten it, my.is we are an unsustainable path. we are the budget committee. in less than ten years we will
be looking at a $1 trillion $1 trillion spending and counting in federal medicaid dollars and this unsustainable path jeopardizes the federal and state government to provide that assistance to our most vulnerable patients who rely on this program. the ahc eight empowers us to be better stewards of our taxpayer dollars. it is the same thing american families have to do every day, spend within their means. it's the same thing small businesses do every day, spend within their means. we need to take care of our most vulnerable ? yes we do. today, tomorrow and in the future by spending within our means. the answer is been a better steward of taxpayer dollars and just not close our eyes to the fact that the current program is unsustainable. i yield back thank you gentlemen. to provide the best care to the most vulnerable we not only need
to deny this motion we need to fully repeal the affordable care act in this bill and in future actions and we need to enhance the spell to give states the flexibility to provide for their own and with that i yield back to the gentleman yields back. the proponent of the motion is recognized for one minute to post. >> let me just summarize by saying the cutng maid $880 billion in medicaid spending is irresponsible. you don't have to listen to me. how about listing to republican governors across our country let me just quote two. governor from nevada expanding medicaid made health care accessible many nevadans who had never had options before. governor snyder from michigan, we have over 600,000 michiganders and we have a lot of positive data both in terms of healthcare behaviors and
better outcomes helping people. madame chairman the madam chairman facts are clear. medicaid expansion helps provide insurance to those who otherwise cannot afford it and would remain uninsured. it makes coverage affordable or 16 million seniors and people with disabilities across the nation. medicaid is the primary care for long-term care and many of millions of seniors, the only real long-term care option. i urge my colleagues on both sides of the i'll. >> i yield back. >> all those in favor signify by saying i, those opposed, no in the opinion of the chair the no's have it. a recorded vote is requested the clerk will call the roll. >> [roll call] >> [roll call]
>> i now recognize mr. moulton from massachusetts for the purpose of a motion. >> madam chairman i have a motion to present the mac the most office on offered by moulton and yarmouth. mr. moulton and mr. yarmouth direct its chairman to request on behalf of the committee that the rule for consideration of the american healthcare act make it order an amendment that would one, strike all provisions from the bill that alone or in combination will increase total out-of-pocket costs for health care paid by individuals who are not millionaires or will increase the number of individuals without health insurance and two, strike new tax breaks for the wealthy and corporations in the bill. >> is recogned for ten minutes withne to close. >> thank you. we've heard at term care increases choice and freedom. let's talk about where that's true. here's how to care increases choice: you'll have the choice
between paying your rent, paying your heating bill, paying for treating breast cancer. the choice between paying for cancer medicines for your kids and having to declare bankruptcy to do so. here's how to care increases freedom. freedom underthe spell will be free from healthcare. countless americans will be free from living healthy and longer lives. all those americans will be free from the overwhelming benefits of preventative care. including the benefits of keeping healthcare costs reasonable for all of us who do have health insurance because it keeps those without care out of the emergency room where they get the most costly healthcare in the world. i got a letter recently from larry, 69.
his brother lives in a nursing home and within a year his brother will exhaust savings and will have to apply for a medicaid. larry will face the same prospect sometime after 2020. here's what he wrote to me, i will not mince words, this plan will result in avoidable suffering and many premature preventable and agonizing early death in the state and across the nation. all this to give $197,000 tax cut to each of the top .1%. it's a false choice between making improvements to obama care and passing this bill unless you're one of the republicans who only voted to repeal it, 6565 times before they came up with a replacement. or you're a publican who calls it a reasonable debate when we were even able to offer an amendment before we voted on the bill. some of my republican colleagues say this bill cut taxes for the middle class. in some ways it does, while dramatically increasing their healthcare costs.
my colleague from missions is that obama care reduced access to care for some people. really? it increased access to care for far more. these republican talking points are missing the. it's like telling mrs. lincoln the show at ford field was fantastic aside from that disruption halfway through. we also heard that people back in our district want this change. really? the new national poll finds that 24% of voters support this republican bill. even among republican voters, only 37% are in favor of the proposal. care about bipartisanship? independence support 22%. a lot of democrats who are ready and willing to have a fact-based, truth fact-based, truth based discussion about how to improve obama care. in fact, i know many republicans are as well. voting for the spell only make the situation worse or everyone.
with that i'd like to yield to mr. yaouth. >> thank you, mr. moulton. i'm proud to join you in joining you. let's take a minute and think about why were here today. republicans don't like the affordable care act. we get that. republicans have campaigned now for six years against the affordable care act promising to repeal it. we get that. but now it's put up or shut up time. republicans have been forced to actually come up with an alternative. were saying in this debate today and through these motions to instruct, if you're going to come up with an alternative, make it something that's going to improve the situation. don't talk to us about the
problems with the affordable care act, we understand that there are problems, tell, tell us how this plan makes it better. tell us how this plan provides quality care and affordable price in a way that's better than the affordable care act. that's what we haven't seen. we've even seen claims that don't make sense. i listen to mr. smith from missouri talking about wheelchair taxes. wheelchairs are exempt from the tax as are most consumer medical products. what were saying in this amendment is do not pass anything that answer the cost of medical america, middle american incomes paid for by enormous tax cuts for the wealthiest americans from major pharmaceutical companies and major corporations. i yield back. >> i want to thank for making remer and i yield one minute. >> thank you. i want to thank my colleagues
from massachusetts. i agree with many of my republican colleagues, that we want to do something about healthcare costs. for many it is too high in the entire system is continuing to be too expensive for most americans. in fact the affordable care act to exactly address that wasn't invested in prevention. in the treatment of the most chronic diseases. if we do that successfully and continually, which this bill diminishes and completely destroys, the us could increase costs by 218 and reduce the economic impact of the chronic diseases by one point to trillion annually. this is in a bill about trying to make healthcare affordable and it certainly most not a bill about making it accessible to middle-class americans. this is about giving insurance
pharmaceutical companies a giant bonus. i yield back. >> thank you. i yield one minute ms. wasserman schultz. i have in my hands what is known as a wish sandwich. a wish you much is two pieces of bread in which you wish there was something in between but there's nothing there. republicans could wish all the promises that they made were there, interim care, but cruelly they are not. our nation's uninsured rates are below 9%. those are the facts. the republican bill aims to roll back the progress by snatching healthcare away from millions of americans. now that we have a cbo, actual facts we know that 24 million people will be thrown off their health insurance by 2026. low income americans will be hit the hardest. cbo estimates 14 million people will lose medicaid coverage over the next ten years.
we are talking about children, pregnant women, disabled people, seniors and patients making ends meet. not unlike a wish sandwich. they are forcing hard-working families to foot the bill for a 600 tax breaks for millionaires and billionaires. a wish sandwich is not what the american people were promised and it is unchangeable. >> i yield one minute. >> thank you, mr. moulton for yielding and thank you for offering this motion. republicans claim that the repeal plan would make insurance more affordable for the american people. it will in fact just do the opposite. this bill especially raises costs were older and americans by allowing an insurance companies to charge seniors higher premiums than under the current law. the aarp estimates that people age 60 to 64 will be charged over $3000 more every year for their insurance. many seniors living on fixed
income and are alreadystrugglinf their health insurance. under this bill,lder oer americans will struggle even more to purchase insurance and there will be in the worst position without health care than a young individual. this will lead to worse outcomes. it baffles me that republicans are willing to charge seniors for their health insurance while giving insurance ceos, millions of tax breaks. americans shouldn't have to pay more for less and older americans shouldn't be subjected to an age tax. definitely not alternate affects. i asked my colleagues to support this motion to instruct. i yield back. >> i now recognize the opponent of the motion, mr. johnson of ohio for ten minutes. >> thank you, madam madam chair. i rise in opposition to this motion and i want to thank my colleague, ms. wasserman schultz for showing the wish sandwich.
i grew up eating wish sandwiches. i know what they taste like. the unfortunate thing is that the american people have been eating wish sandwiches on healthcare for the last seven years.under obama care. the one thing we both agree on is that we we want all americans to have affordable healthcare. we agree on that. unfortunately, obama care doesn't give us that. it's harming millions of americans. healthcare costs are skyrocketing, patient's choices are dwindling and millions are forced to pay a penalty or by health insurance that they don't want. americans may have health insurance on paper but they don't have access. there's a big difference between health insurance coverage and access to affordable care.
in cambridge ohio i talked to a couple that own a business, 18000-dollar a year premium, 9000-dollar a year deductible that's $27000 out of their pockets before the insurance pays a time. another couple out of richmond ohio, $20,000 premium, $9000 deductible, 29,000 out of their deductible, 29000 out of their pockets before the insurance pays a dime. folks, that's not access to affordable healthcare. instead of expanding the number of individuals by making coverage more affordable we know that obama care penalizes americans who do not by a health care plan often because they can't afford to. that meets the standards of washington bureaucrats but that doesn't mean the standards of hard-working middle-class american people. millions of americans have found
healthcare under obama care to be so unappealing and unaffordable that instead of purchasing coverage, they've chosen to pay the individual mandate penalty according to the irs in 2016, roughly 6.5 million americans paid 3 billion for the penalty and more than 12.7 million claimed an exemption from the penalty. that's almost 21 trillion people who have decided that obama care is simply not worth the trouble for the price. in fact, humana recently announced that the companies leaving the obama care's exchange that the end of the year. as reported that humana's membership has declined by 69% since last year and the company is seen further signs of an unbalanced risk pool. the company's withdrawal will have a big impact in states like tennessee as humana is the only exchange insurer in several of the counties.
unlike obama care, our plan doesn't impose a top-down government mandate to force individuals into any health care plan instead it empowers patients to make the right healthcare decision for themselves and their families. given the freedom afforded to individuals to choose the plans that fits their needs under our plan, it shouldn't be a surprise that cbo protects individuals will exercise that freedom. cbo confirms that most dropping in coverage is attributed to the repeal of the individual mandate because people are no longer forced to purchase government mandated coverage. in 2018 for example, while we transition from obama care to patient centered reforms, 6 million people will stop using medicaid and choose to purchase a plan that works for them and
that they can afford. presumably, people are making decisions based on their best interest. why is that a bad thing ? additionally, our plan strengthens medicaid, a critical lifeline for millions of americans. you know something, it's a good thing to focus medicaid on those who need it most, women, children, elderly, seniors and those with disabilities. let those who choose to transition off of medicaid moved to a plan of their own choosing. madam chair at this time i'd like to yield so time toy colleague from texas, . harrington. >> thank you, mr. johnson. a lot of folks in west texas wish obama care would just go away. i'm proud and excited and delighted to have the opportunity to make their wish come true. i'm looking at the motion, do not make middle-class americans
pay more, more than what ? more than 25% increase on their premiums? more than $4300 increase in their deductibles? folks, that's a huge tax on the middle class. obama care has forced millions of a middle class pay the penalty rather than sign up for insurance. insurance, not not care that they don't need and that they can afford as a result over 20 million people paid the fine or got an exemption rather than sign up for obama care. twice the number of people who enrolled in obama care. all the while, 12 million other, other, mostly middle-class individuals and families, suffered with increasing deductibles, increasing premiums, trapped force, it would unaffordable care and as i said before rural districts like mine are made up of small businesses and family farms and main street americans.
obama care and the crushing $58 billion in regulations has decimated rural community hospitals. cbo protected that because of government mandates we would lose millions of small business jobs. that's west texas. that's rural america. that's a tax on the middle class. i yield back to my colleague. >> i think the gentleman for yielding. i yield two minutes to mr. ferguson from georgia. >> thank you, mr. johnson. i'm going to read this. strike all provisions of the bill that alone or in combination will increase the out-of-pocket care for healthcare pay by individuals who are not millionaires or really increase those who don't have access to care. madachairman, mr. johnson, i wonder why the world my colleaes on the other side of the aisle didn't have the courage or wisdom to ask this
question or offer this resolution when obama care was on the table as well. i have a constituent that came into my office, my district office this past week, and he laid on my table's insurance premiums from two years ago were $900. that he laid on the next year and it had risen to $1700. this year it's going to be over $2400 a month. twice as much as he pays for his house. with a 7000-dollar deductible. he and his wife and their six children simply can't afford to go to the doctor. it's devastating done. i guess, mr. asad and millions of other million class families and small business owners and those with limited incomes, i guess they want to know the answer why this question wasn't
asked when the democrats had the chance many years ago. i yield back to thank the gentleman for yielding back. madam chair we've heard it mentioned several times that the american healthcare act is going to cut medicaid. i don't think that's what cbo actually said. i think what cbo actually said is that by 2026 we would be spending a lot less on medicaid. i come from a business background. there is a big difference between putting something and making something more efficient and more cost-effective. that's what the american people have asked us to do and that's what we do under the american healthcare act. we focus medicaid spending on the people that need it.
we put competition and innovation into the system so that it costs less, quality goes up and those that are on medicaid today can begin to transition their lives to choose the health care plan that they want. to claim that the american healthcare act is throwing millions of americans off the medicaid boss, is dishonest, it's untrue and we ought to tell the truth. madam chairman, i yield back back. >> the gentleman yields back. >> mr. moulton is recognized for one minute to close. >> i'd like to yield to mr. caskey. >> i think the gentleman for yielding to me. i want to say to my republican colleagues that you better proceed carefully. if you believe the myth of lower class you do it at your own risk.
your bill imposes a huge age tax on the near seniors, 50 to 6464 years old in your district. that's the reason the aarp, 35 million members strong opposes the repeal bill. the cbo told us and it bears repeating that the cost of for a 64 -year-old earning $26000 a year would go from 11700 under obama care to $14600 under the republican plan. these exorbitant premiums will leave millions of older americans unable to board their insurance and by 2026 the uninsured rate from 60 to 64 earning less than $30000 will more than double to 30% according to the cbo. here's the headline in the new
[roll call] >> are there any members who have not voted or wish to change their vote? if not, the clerk shall report. >> madam chairman, on that vote the ayes are 13 and the nos are 21. >> the nos have it, the motion is now agreed to. i now recognize ms. lee from california for the purpose of a motion. >> thank you very much, madam chair. i have a motion at the desk. >> the clerk will read the motion. >> the motion offered by representatives lee and schakowsky, ms. lee and ms. schakowsky move the
committee direct its chairman to request on the behalf of the committee that the rules for consideration of the american health care act make an amendment that prohibits mandatory funding for planned parenthood clinics for one year. >> i now recognize to opponent -- proponent of the bill, ms. lee, for ten minutes with one minute reserved the close. >> thank you, madam chair. my motion to instruct is really very simple. it would strike language from the republican bill that prohibits mandatory funding for planned parenthood for one year. here we are again with the bill that attacks womenndom's access to comprehensive health care. by defunding planned parenthood for one year, this disastrous bill leaves millions of women out in the cold. shamefully, this bill would prevent millions of women from accessing critical health care services such as cancer and sti screenings and contraceptive care.
even worse, more than 390,000 women would lose access, and up to 650,000 women could taste reduced access to -- face reduced access to preventive health care. defunding planned parenthood is not just dangerous to the health of millions of individuals, but it would also hurt our neigh's economic -- nation's economic security. according to the congressional budget office, defunding planned parenthood would increase the federal deficit by $106 million over the next ten years. and what's worse, cbo found that defunding planned parenthood would lead to more unp intended pregnancies -- unintended pregnancies, not less. we know that planned parenthood is one of the nation's leading providers of high quality, affordable health care for women and their families. in 204 alone, planned parenthood provided critical health care services to 2.5 million patients, more than 360,000 breast cancer exams and 270,000 pap tests.
in my home state alone, california, planned parenthood serves 776 women in 2014. 89% of which were women on medicaid. denying access to health providers such as planned parenthood will hurt women who these these services the most, low come women and womenf color. now, i don't know if these areed consequences. regardless, this is what you are doing in this bill. now i would like to yield three minutes to ms. shah i kousky who is -- schakowsky who is cosponsor of this motion. thank you. >> thank you so much. i'm really crowd to offer this motion with my colleague, congresswoman lee. here we go again. and last week we spent quite some time at two in the morning in the energy and commerce committee discussing whether the provision in the republican repeal bill actually targets just planned parenthood. but cbo cleared this up for us when it stated that in no
uncertain terms, quote: only planned parenthood federation of america and its affiliates and clinics would be affected. the witch hunt goes on. this is in direct contradiction, by the way, with what the majority told us at our markup in the energy and commerce committee. it bell begs the question, why are republicans trying to pretend that this is thinking other than defunding planned parenthood? republicans claim that community health centers can just make up the difference despite study after study and the community health centers themselves saying otherwise. over half of planned parenthood health centers are this health professional shortaging areas, rural or medically underserved areas. these are places that desperately need more care providers, and yet republicans are trying to make it harder for women in these areas to access care. and we're talking about a lot of women.
one in five women use planned parenthood for their primary health care, for cancer screenings, for hiv and std testings and, yes, men also use planned parenthood clinics. the cbo projects that about 15% of people living in those areas would lose coverage, would lose access to care, and there is no evidence that community health centers could take on all the planned parenthood patients or en provide the same level of reproductive health services. teen pregnancy and abortion rates are at historic lows. defunding planned parenthood and other reproductive health providers would take away the very services that have lowered those rates. i find it ironic that republicans claim that they want to increase choice for people and allow them to make their own health decisions and choose their own providers? apparently, that doesn't apply to women.
so let me be clear, the republican plot to defund planned parenthood is nothing more than a direct attack on women, and that's why i strongly urge support for this motion so we can finally remove this harmful provision from the republican repeal bill. american women are watching, and trust me, they are not just democratic women, but women of all stripes and political parties, and i yield back. >> thank you. now i'd like to yield one minute to mr. jeff jeffreys. >> thank you. just when we thought the war on women was over, this outrageous bill comes to the rescue. i really don't think and don't understand the clinical obsession that many of my colleagues have with planned parenthood. it's unhealthy, and it's unconscionable. planned parenthood does a tremendous amount of good for the women of america, and don't just take my word more -- for it.
when discussing planned parenthood on several occasions, donald trump stated: they also, however, servicewomen. we have to help women. a lot of women are helped. so we have to look at the positives for planned parenthood. on another occasion he sated: millions and millions of women cervical cancer, breast cancer are helped by planned parenthood. well said, mr. president. i yield back. >> thank you. now i yield one minute to ms. dell vainny. >> thank you. i support this motion to stop yet another irresponsible attack on women's health. the last congress i sat through an unbelievable 15-month charade of a select committee whose sole purpose was to spread false information about planned parenthood. now the majority is continuing their reckless campaign by denying life-saving care to americans. simply because they oppose a woman with's
constitutionally-protected right to choose. sometimes it seems like all chamber does is attack women's health, but as long as that happens, i'll keep reminding everyone that 2.5 million americans receive essential care through planned parenthood. 78% of their patients are low income. planned parenthood annually provides more than 34,000 cancer screenings in washington state. and nationwide planned parenthood helps prevent more than 500,000 unintended pregnancies. politicians do not have the right to make health care decisions for women. it's that simple. i support this motion, and i yield back. >> thank you. now i'd like to yield one minute to ms. wasserman-schultz. >> thank you. in yet another attack on women's health, the republican bill would defund one of our nation's most critical health care providers, planned parenthood. approximately one in five women have relied on a planned parenthood center for care in her lifetime.
the republicans will tell you that simply redirecting funds to community health centers will avert the substantial gap in services americans are going to experience as a result of this devastating cut. so we know that is false. 54% of planned parenthood health centers are in rural or medically-underserved areas. they provide care to women and men who otherwise have nowhere to turn. gutting this funding wl translate to millions of americans going without a high quality, hh care provider. that is simply irresponsible. thank the gentlewoman for yielding, and i urge my colleagues to support the motion. >> thank you. now i'd like to yield one minute to ms.-- [inaudible] >> thank you, congresswoman lee, for your leadership. i'm horrified at the maniacal crusade the majority has been pursuing the to destroy women's access to health care with little regard to who actually gets hurt. according to polling by kaiser family foundation, 75% of americans agree that defunding planned parenthood is a bad
idea, and that includes 57% of republican women and 55% of republican men. defunding planned parenthood hurts rural women as well as poor and working women. three-quarters of planned parenthood patients have incomes that are 150% of poverty or less, and at least 60% receive services through medicaid or title x. and more than half of planned parenthood centers are located in medically-underserved areas like rural communities. the cbo projection is that 15% of those people would lose access to care. >> the gentle lady's time has expired. >> i urge my colleagues to support this motion, and i yield back. >> i now recognize myself as to opponent of this motion for ten minutes. let me begin by saying that i've been a nurse for over 45 years, and so this is a subject matter which i know about personally from caring for women and being a woman myself. we want to make sure that women have access to health care
services and preventive care that they need while also insuring that our federal tax dollars are not going to an ganization that performs elective abortions like planned parenthood. the republican proposal does not take money away. let me just say that again. it does not take money away. instead, it redirects these funds to community health centers. these are nonprofit, community-based clinics that provide comprehensive, yes, comprehensive care. i'm talking about centers that are able to diagnose and treat conditions. and they are in underserved areas with high levels of poverty and infant mortality. there are more than 9,000 community health centers, facilities across this country. in 2015 community health centers provided health care services to more than 20 million americans, nearly 60% of which were female. in comparison, planned parenthood served fewer than
three million in 2015. let me go back and say that again. the community health centers served 20 million while planned parenthood served three million. though planned parenthood advocates regularly claim that women receive mammograms at its facilities, none of these organizations -- can 650 of these facilities -- actually offer mammograms. in contrast, community health centers are major providers of mammograms, particularly to women who are hispanic, african-american, medicaid recipients and uninsured. these centers have the ability to provide comprehensive women's health care services. not ju diagnosis, but also treatment. i also want to bring up a report, and this is not a report that comes from republicans, this report actually comes from planned parenthood themselves. to just let's take a look at
their own report, this is their own language. come pre-- and this comes from their 2016 report. we haven't received their 2017 yet. comprehensive services have dropped by nearly 8 -- 18% in just one year and are down by 20% since 2010. so the claim that women get their contraceptives from there, services have dropped by 18%. cancer screening and prevention services have dropped by 27% in just one year. and by 57% since 2010. overall total services dropped by 11% in just one year and are down 14% since 2010. yet the record number of abortions are 323,999, basically unchanged from the prior year. soif we talk about those preventative services that women need, we can see that those services are down while their
abortion services are maintained at the same level. on an issue of highly charged as abortion where the american people are deeply divided, we should make every effort to insure that their taxpayer dollars do not go to the nation's largest single provider of abortions. this bill includes those protections. additionally, it irtantos impo note that this provision only applies for one year which will give congress the necessary time to determine whether to continue this policy forward in future legislation. and their report are will give us an indication once we see the 2017 report, we'll see the these services that my colleagues on the other side of the aisle hold up as being services that are needed by women and that this is a war on women -- and by the way, let me just say when i hear this phrase "a war on women," it makes me shudder.
how many of those 322,999 babies that are aborted are female? you want to talk about a war on women? how many of those little girls will never be able to grow up and know about being their fullest potential? that's the true war on women, let's be honest. in addition to providing an additional 4332 million to -- 422 million to community health care centers that they're not currently getting but they will get, and if we were to listen to my colleagues on the other side of the aisle which used a report which, by the way, is taken from the gentleman's name that was the original founder of planned parenthood. so i do have a question about the report, and we see differences in other reports. but in addition to providing this $422 million to community health care center that is provide more comprehensive care,
that currently if we're going to overload them, we should absolutely give them more money that serves the needs of the income women, the american health care act insures that women on medicaid will have access. this is an additional to breast and cervical cancer screening and treatment. so additional dollars for these services will be given to these community health care centers, to be sure, that when they take up these additional services, they will have money to treat women for these particular services. i would now like to yield three minutes to my colleague, mr. woodall, from georgia. >> thank you, madam chair. i'll be hard rested to improve upon -- pressed to improve upon what you've had to say. truth is, when i saw the motions to construct that were out, i was thinking directly about community health care centers and the work that they do. i was in cosmo center in my district just two weeks ago, and exactly as mr. westerman has said, as you've seen medicaid
dollars get diverted to working-aged, able-bodied men, you've seen a squeeze on the intended recipients of the program, women and children. the cosmo center in my district has started a dental clinic and a pediatric clinic because it's so hard to find the women and get them into the clinic. folks are taking care of their children instead of taking care of themselves. they're using the dent alkalinic and the pediatric clinic to expand their services. they're doing amazing work in that space. yes, this bill would add 10% to the community health center budget, and i promise you those dollars are going to be used to serve. i went back and i read section 103 which is the section that folks are talking about striking. i doesn't say -- it doesn't say a word about planned parenthood. it doesay 're not gog to fund ccs tt provide abortions. i don't doubt my colleagues for a moment when they tell me that this isn't about abortions, that
this is about providing services to women. i don't doubt 'em for a moment. i've never been to a planned parenthood clinic,king but i don't doubt them. but what my chairwoman has told me is this is a one-year provision. and what i would say to my friends is if this, if the abortion provisions that planned parenthood provide is really such a minor, inconsequential portion of their portfolio and what they are really committed to is mammograms and cervical cancer and birth control and that whole panoply of women's health issues that we talk about, you can count me as your advocate. the day planned parenthood decides that ending life is not part of their mission, preserving life is, and that's all this bill asks for right here. my friend, mr. jeffreys, says he wants to know when the war on women is going to be over. i would tell my friend there was never a war on women, through bees -- but there is a tight for life. if my friend hope that is the fight for life will end, it never will. because i promise you there is not one person on the other side
of this issue who cares more than any member on this side of the table. not one. we're talking about abortion. we're talking about life. we're not talking about women's health care services. the moment my friends concede that abortion does not need to be a part of their portfolio, they can count me in support. but today, madam speaker -- madam chair, i oppose this moon to struct. and i yield back. >> i now yield the balance of the time to mr. arrington. >> madam chairman, i'm not here to relitigate roe v. wade as much as i'd like to, i just don't want my tax dollars to go to places and people that provide abortion. and the vast majority of americans agree and to oppose using federal funds for abortion. this sentiment is reflected in the bipartisan hyde amendment that we pass every year barring federal dollars from being used for abortions. the american health care act is merely enforcing the spirit and
intent of the hyde amendment. to say that only 3% of planned parenthood services go to abortion is to diminish the fact that they're the largest abortion provider in the country. to try to make the argument that planned parenthood doesn't receive direct funding for abortions is to question the intelligence of the american people who understand the fungibility of money. and the fact that indirect support for this practice is supporting it the nonetheless. to suggest this bill harms women is a hollow argument. and as the cofounder of the laura w. bush institute for women's health, i'm offended by some of these hyperbolic accusations from my colleagues on the other side of the aisle. the ahca does the right thing by enforcing the current law and the public sentiment regarding funding for abortions. i yield back. >> all time has expired. i now recognize the proponent of the motion, ms. lee, to close for one minute. >> thank you, madam chair.
let me say once again i'm extremely disappointed that this fast-track reconciliation ll would defund planned parenthood and underhe the health and well-being of women d families. it's a sham, and it's really a shame. republicans are making this about abortion when it's not and shouldn't be about members of congress interfering in women's private health care decisions. i would always, also like to note that while my colleagues on the other side of the aisle try to tell us that planned parenthood doesn't appear in the bill, that simply isn't true. cbo is clear that only planned parenthood, its affiliates and clinics would be affected by this disastrous and this heartless provision. we know that for many women in america planned parenthood is the only place they can access high quality, affordable health care. we should be expanding access to planned parenthood so that more women can receive care that they need and the care that they deserve rather than taking away health care for the most vulnerable women.
i urge my colleagues to support this motion. thank you and i yield back. >> the question on agreeing to the motion offered by ms. lee, all those in favor signify by saying aye. >> aye. >> those to opposed, no. >> no. >> in the opinion of the chair, the ayes have it. >>ing madam chair, i ask for a recorded vote. >> a recorded vote is requested. the clerk will call the roll. [roll call]
[roll call] >> treny members who he not voted or wish to change their vote? if not, the clerk shall report. >> madam chairman, on that vote the ayes are 1 and the nos -- 13, and the nos are 21 -- the ayes are 14, excuse me, the nos are 21. >> the nos have it, the motion is not agreed to. i now recognize ms. delbene for the purposes of a motion. >> madam chair, i have a motion at the desk. >> the clerk will read the motion. >> a motion offered by
representatives delbene and wasserman-schultz, the committee on the budget direct its chairman to request on behalf of the committee that the rule for consideration of the american health care act of 2017 make an order and and amendment that would strike the language that shrinks the insolvency by three years by repealing the additional medicare tax on high income workers. >> ms. dell benny is recognized for a total of ten minutes with one minute reserved to close. >> thank you, madam chair. one of the most unconscionable parts of this incredibly dangerous bill is that it directly attacks seniors and the medicare program. medicare is a lifeline for more than 58 million americans including 90,000 in my district alone. my motion would protect seniors and medicare by eliminating ther irresponsible provision that robs the medicare trust fund of $170 billion. finish -- the bill we're considering today unnecessarily
weakens the trust fund's solvency by three years, and it does this by providing the top .1% of the wealthiest americans a tax cut of more than $200,000 a year. this is a tax cut they didn't ask for and don't need, and it comes at the expense of our nation's seniors. it's truly shameful. every day 10,000 americans turn 65. they expect medicare to be there for them just as it was for generations before. in ten years 75 million americans will rely on medicare for affordable, quality health care. we should be strengthening medicare, not setting our country on a path towards another unnecessary manufactured crisis. medicare reduces poverty and insures seniors and people with disabilities always have access to the care that they need. i recently sat down with three seniors in my district at one's kitchen table, doris and lance
in kirkland, and grace from redmond. they told me how important the medicare program is to each of them by providing the kind of coverage they need at a price they can afford. if this bill goes forward with this provision intact, robbing the medicare trust fund and damaging the program's future, it's doris, lance, grace and so many others like them that will be harmed. we should not be passing a bill that does nothing to improve anyone's life and especially not a bill that ultimately forces seniors to pay more for their care. it's hard to believe we're even here having this debate. i now yield three minutes to ms. wasserman schultz. >> i thank the gentlewoman for yielding, because this is simple. we should be strengthening medicare for our seniors and disabled workers, not weakening it. with that common sense imi, our motion aims to strip away the trumpcare provision that would take $billioout of the medicare trust fund and shorten its life by three years.
that is in stark contrast to the affordable care act which extended the life of the medicare trust fund by 11 years. today, 58 million seniors and americans with disabilities depend on medicare for their health care including more than four million in my home state of florida. and that number is not getting smaller. as our nation's population gets older, that number will increase to more than 75 million people. that means we soon will have greater or need for the program and fewer resources to support it. with this bill, republicans plan to give the top .1% of americans a tax break of more than $200,000 a year, all on the backs of our seniors. for instance, a 64-year-old with an item of $26,500 in the individual market will pay $12,900 more in their premiums every year. and to be clear, this bill starts to prey on the elderly even before they become seniors when they are in their 50s n. the words of the aarp executive vice president nancy lemond, quote: before people even reach
retirement age, big insurance companieses could be allowed to charge them an age tax that adds up to thousands of dollars more per year. not only is that cruel, but it is also unsustainable. under trumpcare, older americans would be charged five times more than younger people, increasing costs for those already on a fixed income who can least afford it. and though we now have a nonpartisan analysis confirming trumpcare will deliver less care and more pain to millions of americans, the majority remains as committed as ever to ramming this bill down our throats. accoing to the nonpartisan congressional budget office, the the trumpcare bill would yank insurance coverage from 14 million people next year, the longer-term projections are even grimmer or with as many as 24 million people projected to lose cover an by 2026. now our republican colleagues are already trying to discredit this nonpartisan analysis, but let's face it, no matter how you slice it, the numbers will be appalling in terms of their toll on human health. and i also note the iron think that the nonpartisan congressional budget office is
led by a director who was appointed by speaker paul ryan and former congressman tom price who is now the secretary of health and human services. it certainly seems you can ask anyone except the republicans obsessed we repealing the affordable care act, and they'll tell you this bill hurts our seniors, and the very people president trump promised he would protect. we cannot allow trump care's prescription to make america sick again. thank you. i yield back the balance of my time. >> i yield one minute to the gentleman from california. >> thank you. i just want to echo ms. wasserman-schultz's comments about what is, what these cuts are doing. if you -- i highly recommend dr. him el steven's paper in the annals of internal medicine. they point out that medicare is the most efficient program that exists. it's a 2.2% overhead. what we ought to be doing is ec tending medicare, not weakening
it, and this provision, this bill would weaken medicare and potentially bankrupt medicare by 2028. so i am strongly supportive of this motion. i yield back my time. >> thank you. and now i yield one minute to car baa hall. >> thank you for offering this important motion. approximately 127,000 seniors and personses with disabilities -- persons with disabilities in california's 24th congressional district count on medicare to provide affordable, quality health care. that number will only increase as our nation's population gets older. we should be strengthening medicare, not weakening it. this bill takes a staggering $170 billion out of the medicare
trust fund and shortens its life pan by three years. span by three years. this will result in more seniors living in poverty. it does this while giving the top .1% of americans, those with an annual income of $3.9 million or more let me repeat that, $3.9 million or more, tax cut of more than $200,000 per year. this provision threatens our nation's most vulnerable citizens, and for that reason i ask my colleagues to support this motion to instruct. thank you, i yield back. finish. >> thank you, and now i yield toll ms. saw kousky. >> i thank the gentlewoman for yielding. candidate trump bragged, actually more than once, during the campaign and after he's been elected, this is what he said during the campaign that, quote: he's the first and only potential gop candidate to state there will be no cuts to social
security, medicare and medicaid. unquote. he's done that to great applause of his audience. but the truth is that the promise will be broken if this bill ever becomes law. it would reduce the solvency by three years of medicare, snatching $170 billion from the medicare trust fund to give the richest americans a tax break. this bill allows insurers to charge older americans thousands more for insurance, increased costs to medicare, reduce funding for the medicare trust fund, and it's clear how house republicans intend to treat senior citizens. and it actually opens the door for more republican proposals, reopening the doughnut hole, taking away free preventive care, turning medicare into a voucher program which is something that the speaker of the house has promoted along with, actually, the hhs
secretary, now-secretary. ask seniors across the country are paying close attention and have every reason to worry. again, these are reliable voters. they pay attention to their costs for health care, and i would urge all of my colleagues to support this motion. i yield back. >> thank you. again, it is critically important that we support medicare. i urge my colleagues to support this motion, and i yield back. >> i now recognize to opponent of the motion be, mr.ly key that om indiana, for ten minutes. >> i thank madam chairman for recognizing me. every time i meet with constituents in indiana, i hear about the crushing burden that taxes that are included in obamacare have on buzzes and families. -- businesses and families. so if we're going to repeal this insidious law -- thankfully, we are -- doesn't it make sense to repeal the terrible taxes that went with it?
obamacare has imposed upon us americans 21 new taxes costing more than $1 trillion, many of which have impacted lower middle class americans. in addition to hitting these families with increased taxes, obamacare also hit the same lower middle class families by cutting medicare providers and services, using those savings for yet new and more government programs under obamacare. it just continues to fascinate me that anytime the left getses getses -- gets an idea to help people, quote-unquote, they go to a new government program, and they pay for it by taxing us even more with absolutely no regard for the jobs that will be lost. the if a company is getting taxed more, private or public, they have less money to hire someone with. and if they keep the person in the job, they may go out of business altogether.
because of these taxes. or if they don't do one of two or in combination of one of the two, the consumer ends up paying a higher price for the good or service provided by these companies. ironically, the same consumers that the left proposes to try to help. one e green juice tax in particular has targeted seniors. it's driving up the cost of prescription drugs by increasing taxes on drug companies. who better to pay for your leftist plan than a profit-making company like a drug company, right? that's what the left thinks. since 2011 nearly $17 billion has been collected from branded prescription drug manufacturers leading to higher and higher prices on those who have no choice to pay the cost like our seniors. and according to the congressional budge office, this tax is expected to raise $27 billion over the ten-year period. however, as all americans know, those taxes were not borne by
the drug companies, but in any common sense scenario were passed on to the consumers in the form of higher prices. for example, gilead sciences reported in 2015 that their $337 million tax lowered the company's earnings from $2.05 a share to $1.84 a share. it is highly likely that in order to recover that revenue, to stay this business, to keep people hired that they passed these costs along to consumers in the form of higher drug costs. this tax, along with most other taxes in obamacare, need to be repealed. this will put more money in the pockets of americans who need it m older or americans who need it. paying for obamacare's failed policies on the backs of seniors was not a solution when this law was passed, and it's only gotten worse. i fully support repealing these taxes and preserving medicare for future generations. w, thankfully, because of the leadership of this committee
over the last six years, we have put solutions in place, solutions that strengthen medicare to make sure it's around for the next generation and not continuing to add to our $20 trillion debt. did we get a better idea from the left when we put these ideas forward for the last six years? no. we got tv commercials with a lanky gentleman in short hair acting as if he was going to push an elder orally person in a -- elderly person in a wheelchair off a cliff. that committee needs to stick to its guns, we need to repeal this insidious law and its taxes, and we need to bring real medicare reform to this country so that it's around for our children and grandchildren without giving them the bill. with that, i'd like to yield three minutes to the gentleman from georgia, mr. ferguson. >> thank you. you know, it's amazing to me, i sort of feel a little bit like
mr. be rikita does, madam chairman, every time we turn around and look at the left, they believe that they can tax their way out of a problem. and what we have seen after 21 new taxes and almost a billion dollars -- excuse me, almost a trillion dollars of cost is that we have seen an implosion of a health care system and a health care plan. and what's happening is that the taxes, the $716 billion that was stripped out of medicare with the aca was used to not pay for health care, but used to grow government bureaucracy that is providers to deliver quality health care to our patients. i've been, i've been treating patients in my dental practice for 25 years. we understand that the ongoing cost of regulation and burdens don't, doesn't result in higher quality care for the patients. in fact, it diminishes the
quality of care for patients whether they are young or whether they are old. it is something that i experienced firsthand year in and year out. the further this plan went along, the lesser my ability to spend quality time with patients and provide them the care that they needed. and i don't come from an area that is extremely wealthy. i come there an area where a majority of our population lives below the median standard of living. i come from an area made up of hard working men and women that are fighting every single day. and one of the things that they want after a long career of working and fighting and scrapping to raise their familieses and to provide an income is they want exactly what somebody on the ore side just -- the other side just said. they expect and they want medicare to be there in the end. well, what's happening now is that we are being quite
disingenuous when we say that repealing the aca will save medicare. it won't. massive reforms and an honest conversation with ourselves expect amecapeople are needed -- and the american people are needed to keep the solvency of a program that is so needed across this nation. if we don't reform this program and make it effective and make it, and make it sustainable, not only will we be unable to keep our promise on medicare, but because of the damage that the mandatory spending curve is having on our federal budge, we will not be able to keep a single promise that we've made no matter which party is in control. being willing to have the tough conversations about this program are important because it's an important program. my mom and dad use this program. they worked hard all of their lives, and they received this
benefit that they should. but i will tell you that if we continue to go down this road and we continue to kick the can down the road and we are disingenuous by saying that repealing the affordable care act will, in fact, save medicare, we're fooling ourselves. and shame on us for that. we've got to do a better job. we can no longer look each other in the face and say by stripping $716 billion out of medicare to save obamacare -- to make obamacare work in the beginning -- >> i thank the gentleman, reclaiming my time. i'd like to recognize the gentleman from minnesota for the remainder of time, mr. lewis. >> thank you so much. it is the height of irony to have the other side offer a motion on weakening medicare. because the cruelest political con i saw in mlitime was the idea that obamacare robbed $716 billion out of medicare, and
they say that increases the solvency of medicare but then turn around and spend it on the aca. that was the infamous double counting that everybody acknowledged. the total dishonest accounting. we're going to take $716 billion out of provider payments that will increase the solvency of the program, oh, but then we're gone going to spend it on the aca. ever wonder why we've got a $20 trillion national debt? we can't count. but the dishonesty of the accounting is one thing. how they so-called increased the solvency is another by reducing provider payments. now, it's not to insurance executives, it's to hospitals, to doctors, to nurses. and you know what that amounts to? fewer benefits, less access and, in fact, this week in the local paper in minneapolis-st. paul, i will read you verbatim, mayo clinic's chief executive made a startling announcement, the rochester-based health system will give preference to patients with private insurance over those with lower-paying medicaid
or medicare coverage the they seek care at the same time and have comparable conditions. that is de facto rationing. what they're saying is when you get reimbursed at 50 to 60 to 70% of market rates, guess what? we're not interested in your business. that's what the other side did to medicare beneficiaries, and now they're talking about weaking medicare, are you kidding me? -- weakening medicare. are you kidding me? we can reform the system. because this 2024 when the program goes to a trillion dollars, it's insolvent. we all know that. so we can reform it by offering a new plan, a plan that the 1999 thomas commission maybe recommended, some form of premium subsidies. or we can continue the other side by cutting provider payments -- >> [inaudible] >> opt out of care for medicare men fish belies -- >> the gentleman's time has expired. ms. delbene, the proponent of
the motion, is recogzed for one minute to close. >> thank you. the way to insure our health care system is working is to build off of the reforms we've already made and make improvements like allowing medicare to negotiate drug price. this bill does the exact opposite. older americans want to see medicare strengthened and preserved for generations, not attacked. and it's just another broken promise from this president who repeatedly committed not to cut medicare. this motion would restore that promise, scrapping a provision that directly attacks seniors and people with disabilities for no other reason than to give a tax cut to the wealthiest americans. whether you're a democrat or a republican, it makes no difference right now. this bill makes no sense, and we all know it. certainly not for seniors and not for those with disabilities, so for lance, for doris, for grace and millions around the country just like them, i urge my colleagues to support this
notion, and i yield back. >> the question is on the grant of the motion offered by ms. delbene. all those this faye signify by saying aye. >> aye. >> those opposed, no. >> in the opinion of chair, the nos have it. >> [inaudible] >> a recorded vote is requested. the clerk will call the roll. [roll call] [roll call]
[roll call] >> there any members who have not voted or wish to change their vote? if not, the clerk shall report. >> madam chairman, the ayes are 13 and the nos are 21. >> the nos have it and the motion is not agreed to. i now recognize ms. lujan gosh sham from new mexico for purpose of a motion. >> thank you, madam chair. last year donald trump promised
to end the opioid epidemic -- >> ms. yearn sham, if you will -- >> you went right to the nine minutes, so i just jumped right ahead. madam chairman, i have a motion at the desk. >> thank you very much. the clerk will read the motion. >> a motion offered by representatives hue hand grisham and carb hall, they move that the committee on the budget direct its chairman to request on behalf of the committee that the rule for consideration of the american health care act make and order an amendment that would prohibit any provision of the bill from taking effect until e secretary of health and human rvices certifies that relevant -- relative to current law its provisions and amendments would not, one, decrease coverage for mental health and substance abuse disorder treatment; two, increase out of pocket costs for mental health and substance abuse disorder treatment or, three, undermine parity in coverage between mental health and substance abuse disorder benefits or other benefits.
>> you are recognized if for a total of ten minutes with one minute reserved to close. >> thank you, madam chair. last year donald trump promised to end the open owed end -- opioid epidemic. republican congressmen from districts with some of the highest overdose deaths in the country have promised resources. from 2014 to 2015, tennessee, 13.8%. pennsylvania, 20.1%. kentucky, 21.1%. ohio, 21.5. florida, 22 .7. now, after last year i really believed that addressing this was a bipartisan issue. but here we are with a bill that would repeal the requirement that medicaid cover basic behavioral health and addiction services. in my home state of new mexico, i can unequivocally tell you what that looks like when you combine an opioid epidemic with a lack of services in behavioral
health. opioid addiction has been a crisis this new mexico for two decades -- in new mexico for two decades, long before the rest of the country. the stories of the lost lives are tragic, and they deserve to be heard. and, in fact, in january president trump or said prescription drug companies are literally getting away with murder. and so i ask unanimous consent, madam chair, to enter into the record a collection of bitch wares -- of obituaries i have from a small town in new mexico describing the victims of opioid -- >> without objection. >> thank you, madam chair. and this is from a small town, this collection. more than one death a week which we've also submitted to the last white house and this one. manyf them died because they don't have access to the treatment that they need. this happens when you cut behavioral health and substance abuse services. people die. cutting funds from are the
medicaid program and removing benefit requirements mean that even fewer people will have access and even more people will die. kicking them off the medicaid rolls mean that fewer people have coverage to access any treatment services that might remain. nearly 1.3 million people receive treatment for mental health and substance abuse disorders under medicaid expansion. i urge my colleagues to support this motion. i now yield to the gentleman from california for three minutes. >> thank you, congresswoman lujan grisham. i am honored to co-lead this effort with you. this motion supports continued access to mental health and substance abuse disorder treatment. i want to share with you a little bit from my own personal experience. as a county supervisor working as a local elected official, i saw firsthand the challenges of individuals or families with individuals who were going
through hardship by not, for not having access to mental health services. i saw their angst, i i i saw the crisis that we were enduring. on a personal note, when i was a young boy, my sister committed suicide. i can't think but to think if it would have been a different outcome if she had access to mental health services. this are republican replacement an will ma it harder for people suffering from mental heth and substance abuse disorders to access the health coverage they need. it makes dramatic changes to the nongroup market, provides insufficient subsidies to purchase coverage and guts $880 billion from medicaid. low and moderate income people will be hit the hardest. an estimated 44 million americans experience a mental illness each year including ten,
over ten million whose illness is serious enough that it interferes with their daily life activities. i urge my colleagues to support this motion and to support continued access to mental health care. thank you, i yield back. >> [inaudible] >> thank you. i want to thank the gentle lady for yielding and for this motion. i'm in full support of it, and let me just say once again this bill shamefully repeals the medicaid expansion, ending coverage for our mental health and substance abuse disorder services for millions of americans. let me be clear, this bill would worsen the opioid epidemic and severely reduce access to mental health services. it would kick 1.2 million people with a serious mental health
disorder and 3 million people with a substance abuse disorder off their care. this is outrageous. we though that under aca medicaid expansion dramatically exnded access to high quality affordable mental health and substance abuse care. by ripping away access to these critical serviceses, once again we hurt those who these help the most, low income individuals and people of color. i hope that you care about these americans also, but i tell you, the consequences of what you are doing today really make me wonder. there are some winners and some lose ors, excuse me -- losers, excuse me, and most vulnerable people, unfortunately, are the losers. madam chair, as a psychiatric social worker by profession, i know firsthand that all americans, all americans deserve access to quality mental health care. it's important for their care, for their community and for our economy. thank you, and i yield. >> thank you.
i now yield one minute to ranking member yarmouth. >> i thank my colleagues for yielding. just last month in my louisville, kentucky, district emergency services received 52 overdose calls over the course of 32 hours. i have here articles from "the washington post," new york times, fox news, cnn and "usa today" that detail how the opioid crisis is negatively affecting my constituents, and i ask unanimous consent that they be included in the record. >> without objection. >> thank you. as my colleague mentioned last year on a bipartisan basis we made a huge step forward in addressing the substance abuse and mental health problems plaguing our nation. as she mentioned, kentucky was one of those states disproportionately affected but certainly not the only one. by removing the guarantee of mental health and substance abuse coveran medicaidnd forcing 24 milon people off of their health care as well as eliminating the guarantee that
private insurance, commercial insurance includes this coverage, we are wiping out many of the gains that we just made to insure access to vital mental health services, so i urge your support for the motion and yield back. thank you. >> thank you. i now yield one minute to ms. jackson lee. obamacare had mental health coverage for the many who are suffering from a drug addiction.
as my colleague from keith that, in a a usa today article, sherry reynolds talk about her son who's been drug free for 16 months but she also talked about her step son who suffered from mental illness and killed himself about untreated in 2010 who couldn't get medical treatment. the question is where is our compassion ? for my fellow texans, 1,874,000 individuals got health care coverage which included mental health coverage under the affordable care act. coverage under the affordable care act. 1,009,250,000 individuals purchased high quality health insurance. by this bill mental health persons will suffer and they will die. i support this amendment because i don't want americans to die. i yelled back to thank you, madam chair. i yield yield back to mr. chair thank you to the lady. i recognize the opponent for the motion, mr. cole for the for ten
minutes. >> i want to begin by acknowledging what my good friend from kentucky said last year, we did do something in a bipartisan we spent $500 million around we passed into mental major health overhaul and this year, $500 million additionally. this is a problem that we all recognize exists and were all willing to do something about. when i listen to the debate of a, and it's been one that both sides have made sincere and detailed points on this matter i look at it differently from some of our newer members because i was here the last time we went to this debate. as a member of congress when obamacare was enacted and we were told at that time that if we passed it, cost would go lower. they haven't. we were told that we would have more choices, we don't. we were told that if you liked
her doctor when you like your plan you could keep them. the reality, for many people, that, that wasn't the truth. in my home state we are in a crisis situation and the obama situation. the rates are going up 69%, next year for those who pay the full rates and were down to a single provider for an entire state that doesn't sound like a successful system to me. i look at the american health care act i see several things: first, the three essential pillars are damaged. first employer-based healthcare, where most americans get it. it pushes back this owner cadillac tax for eight years something i think we need to get rid of all together. we should never be taxing people for their health care plan. second, it keeps the basic medicaid function intact and it keeps medicare for older seniors , although many comments
today both the systems are very much in need of reform. the bill also provides a transition period for people that are actually currently, getting healthcare in medicaid expansion or some other form of obamacare. the act does a number of things which we ought to talk a little bit more about. first of all, it is not required, if you don't want to participate you shouldn't have to. that's a big change from obamacare. second, it provides direct health to individuals in the form of tax credits, refundable tax credits so you can pick what you think is best for you. that to me is the hallmark of any good healthcare system. finally, over time it lowers the cost of premium and again, over time it lowers the deficit of the country. this is not a bad thing. i think we ought to leave a failing system and move to a 40 system that promises to be
behan were doingoday. i would also suggest this product isn't finalized. it will change during the course of the legislative process. it will change in the house and certainly, in the senate. but saying where were at is exactly the wrong thing to do. that i want to yield to my friend from new york three minutes. >> thank you, mr. cole. i appreciate the opportunity. i think all of us recognize the need to ensure adequate and sufficient and good mental health services are available. i think as mr. cole stated all of us on both sides of the aisle come to that.of view. the bottom line is that this legislation is going to give state flexibility in how they design programs and some states will emphasize one aspect of the system over others. i'm confident that in our state of new york mental health and substance abuse will be something that will be significant for the designers of
our plan but unlike the current system we're new york state, for instance, has 100 plan amendments, the state will be able to design programs and policies that will be efficient and effective for them and i think they'll be better oversight. we are also on the budget committee. it's impossible to forget -- make this a month ago the cbo told us that the national debt will go from 19 trillion to 29 trillion in just ten years. it will be ill or responsible for us not to seek ways in which we can lower the debt curve because otherwise we'll leave our children and grand children within impossible financial condition and situation to deal with. another aspect that has been raised by my friends on the other side, they complain about the age band proposal. right now, they call it age distribution. it's three to one in the aca.
you can part a six-year-old becomes more than you could cart a 20 -year-old. this legislation would give the experts testified six weeks ago, it gives states the option to move to five to one. the problem will be in states like new york where the law says it has to be one-to-one. that's how new york destroyed its own insurance market. the key here is to create more flexibility, more more ability for states to design their programs, and also to have more ability in terms of the insurance law. the insurance law and fairness, in the age banding situation, by not lowering cost efficiently for young healthy people we did not have enough of those people in the pool to support the insurance market and that's why so many insurers around the country have pulled out of the system. we have to have an actuarial sound insurance market for it to function properly and that's why the option to move to a 5218
banding makes sense, states can do it and frankly, we need to do it because that's how will lower premiums for the vast majority of the american people right now our pain extraordinary increases in their deductible and premiums and unaffordable health insurance. what good is insurance if you can afford it? thk you, mr. chairman chairman. i yield back to the circle. >> mr. chairman i would like to yield the balance of my time to my good friend from georgia, mr. would also be back i think my friend for yielding. i'd say to mr. carbajal we haven't had a chance to get to each other. i appreciate your amendment. she is a warrior for her folks back home but she's a happy warrior and someone you can work with on absolutely anything she just wants to make things better for both at home and that the intent of this a minute here. i'm grateful to you for that. i don't know if my colleagues had a chance to read this bill
this morning, not a silly. [laughter] but i do want to recommend the editorials because one of our colleagues, doctor tim murphy who has been here a number of terms, tim murphy is a tireless fighter for mental health coverage in the body and it was entirely a collective weight, 42222 that we passed bill across the finish line and present bible signed it into law last year. i would like you to read what mr. timothy said today. the aca did little to provide real medical models of treatment for those suffering with metal illness. numbers are skyrocketing with deaths. at all-time highs. after a long fought battle in congress with president bush he signed the equity act in 2008
but it wasn't until 2013 that the obama administration finally implemented parity, leaving millions of americans with behavioral conditions fighting with insurance companies for years. this bill is going to offer about $1 billion in new flexibility for the great state of georgia where we grapple with those with suicide and addiction. we will have opportunities to serve in ways we never had to do it before. i oppose my friends amendment because i don't want a mandate that everybody has to do with the same way i do it. regions with high opiate addiction will do it differently than other places like alaska who have a high suicide villages but it gives us the opportunity to do it in ways that georgia that we have never had the opportunity to serve our constituency before. i encourage you to read doctor murphy's entire editorial and you'll find two things: it
doesn't matter what law we passed if we lack the collective will to have impactful back home and you'll find that it is belief and our experience that we do share that collective will and we can make a difference for folks. i respectfully opposed the motion to and look forward to making a difference. i yield back to back ms. longer's and from mexico is recognized for one minute close. >> thank you, mr. chair. i would appreciate the words of mr. woodall and the balanced markofow we want to deal with the opiate remarks. we all want to deal with behavioral issues. one of my good friends, was one of the originators that was making sure that there was a mental health parity law that
had never been realized. keep in mind there are two constants here, pharmaceutical companies and insurance companies who have no motivation to make it cost-effective or better. were really continuing to invest in their greed. we gave them patent accent we gave them not negotiate prices, we we let them sell our drug that we pay for four tensions on the dollar and we don't allow any reimportation back in. everything they have asked for, this congress has given them including the insurance companies that are only regulated by state and it is frankly, a negative negative aspect of ability. why would we give them the money that we need to have had access and has i had six seconds, new mexico already did it. >> your overtime. >> as i yield back. [inaudible] all those opposed, no.
>> are there any members who have not voted or wish to change their vote? the gentleman from alabama. >> i'm record. >> mr. palmer, no. are there any other numbers that have not voted or wish to change their vote for smart. >> on that vote the eyes are 14 and then days are 22. >> the motion does not pass. there are both expected to be
called on the floor of the house soon so i this time the committee will stand to recess and we will resume directly after the votes on the floor of the house. [inaudible conversations] >> were any significant voted or changes that you made to gop healthcare bill? >> the budget committee does not have the they cannot change the text of the legislation. they passed for motion that instructed the rule committee to consider the amendment on a variety of different topics including the possibly inclusion of work requirements for able-bodied adults on the medicaid program, as well as going back on obama's medicare expansion to an earlier date. a lot of these motions were written in a v