matter is, as the chairman pointed out, that's what the president's health care bill does. that's the bill that you all adopted. which is removingus from the me and putting in place this unelected board of 15 bureaucrats which wes necessary their plan, in your plan, because you've got to control costs because you don't trust people. when bureaucrats choose, lose. when bureaucrats choose, patients lose. that's the program you all have put in place. medicare andat it's important the chairman has eloquently outlined how we propose to do that. i would draw your attention to page 61 on the budget which goes through the four main points which is those in and near retirement will see no changes whatsoever. that for future generations they are provided a guaranteed health coverage, line five.

guaranteea61, line five. in addition, as the chairman said, those with higher health challenges receive more assistance, and, finally, the fourth program puts medicare on a sustainable path and becomes solvent over the long term which the president's proposal does not and your proposal does not. i urge a rejection of the amendment adoption. >> i will yield the remainder of our time and recognize the gentlelady one minute for the purpose of closing. >> we're going to try and split this one. i yield half a minute. >> can i just put that chart back up? i think it's a very useful chart. a very useful chart. can you put that up, please. is it coming up? let me -- you want the whole thing? >> yeah, yeah, i do. i want all three lines because i think this makes a very useful

point. the first -- thank you, mr. chairman. the first point it makes is despite everything we've heard from our republican colleagues the democrats didn't have a plan to contain medicare costs, what it says is it's essentially the same in terms of medicare costs. the red line in terms of medicare savings. what the red line shows is the risk if things go wrong. and under your proposal the risk for when things go wrong, if this doesn't work, is put on the seniors. the cost is put on the seniors. and the reason that is very different than what we have for ourselves as members of congress and what federal employees have federal employees, you don't r. you will always get about 75% of whatever the increase in costs are picked up by the federal employees health benefit program. whereas under this proposal the senior eats it all, and that's why we do call itt suggests the

support from medicare rises as health care rises. the way you do this is the risk it's put on the senior. i yield. >> and my time is up and i just want to say there's a huge disagreement here. some of the assumnsde were so i, there's a lot more discussiowe' medicare, strengthening it, continuing it. you can see it can be done. >> we have another amendment so we can keep this conversation going on the next one. the question is on agreeing to the amendment offered by the gentle lady from pennsylvania. all of those in favor say aye. those opposed no. in the opinion of the chair, the nos have it. a recorded vote is. >> mr. garrett. mr. simpson. mr. simpson no

mr. campbell? mr. campbell, no. mr. calvert? mr. calvert, no. mr. akin, noole? mr. cole, no. mr. price? mr. cclintock, no. mr.langford? ms. black? ms. black, no. ms. dribble, mr. flores. mr. flores, no. mr. mullvaney no. mr. young? >> no. >> mr. young, no. mr. amash, no. mr. ita, no.

mr. gunta, no. mr. woodall? mr. woodall, no. mr. van hollen? >> yes. >> mr. van hollen, aye. ms. schwarz aye. ms. captor mr. doggett aye. mr. blumenour aye. ms.ccollum. mr. pascrell? mr. honda? mr. honda, aye. mr. ryan of ohio? mr. ryan,aye. ms. ms. moore, aye.ms. castor?

aye. mr. schueler? n. schueler, aye. mr. garrett? mr. garrett, no. >> are there any members, other change their vote? if not, the clerk shall report. >> mr. chairman, on that vot ar. 's miss castor, i think, isn't it? yeah, i do, but i just want to -- yep. go ahead and offer. >> thank you, mr. chairman.

>> so d by ms. cast an amendment at the desk. >> the gentle lady from florida has an amendment at the desk. the clerk will designate. >> anre by ms. castor relating to medicare. >> the gentle lady is recognized for nine minutes. >> thank you, mr addition to the republican plan that breaks the promise of medicare and ends medicare as we know it, the republicans also proposed to raise the cost of prescription drugs and slash theen in place for two years now and are working very well. this is a real double whammy oe america. here is what my amendment does. it proposes to retain the closing of the doughnut hole and the money that's going back into the pockets of our older neighbors, parents and grandparents, proposes to retain those important new screenings,

the mammograms and colonoscopies that are saving lives and to retain that important new wells this visit that has become very popular and actually policy. so, first, doughnut hole. under the affordable care act that has been in place for two years what is currently happening is that cliff that many of our ol fallen off of when it came to paying for their prescription drugs is now are getting 50% discounts on brand name drugs under medicare part "d." that doughnut hole will be completely closed by a20eady h 3.5 million seniors with high drug costs. on average it the average medicare beneficiary over $600. in my florida district alone

over 6,000 have received prescription drug discounts and it is predicted that through 2021 this will save our older neighbors $2,400 and our parents and grandparentll have to struggle with those very expensive prescription drugs. unfortunately in the republican budget the republicans proposed to put these cost s back on our seniors with high drug costs have them make very difficult choices. the affordable care act also nv estimated $32.5 million seniors and disabled individuals with a or colonoscopy.eening such as a because of the affordae distri 70,000 of ld preventative screening without an

co-payment that oftentimes kept them out of the doctor's office unfortunately, will increase the cost. they will now have to go back and pay additional co-payments if they want to go in for those wellness . visit in 2011, 2.3 million seniors in traditional medicare took advantage of this new benefit. through the republican budget and repeal it would take this important tool that patients and their doctors realize is really saving lives. it is smart policy and the repuan medicare and they shouldn't roll back these important reforms that are making a difference in the lives of our older th time to ms.

schwarz. please speak on the amendment. >> well, thank you very mh look, the republicans keep saying that their voucher plan, premium support plan they prefer to call it, would not change anything for current seniors. that is simply not true. it was just said again in response to the previous amendment there will be no change. no shift in cost. only for futureot for current seniors. that is simply not true. repeal of the affordable care act, the fact that we are gradually closing that prescription drug gap, the coverage gap, means morers will be paying more out of pocket right away if the republicans get their way and repeal the affordable care act, that they would not be able to afford their prescriptions, they will get sicker, increase costs for understand. so castor said this is benefiting 3.5 million

seniors now. they would lose this benefit so you can no longer say, unless you vote for this amendment, that, in fact, you are protecting current seniors from a cost shift. so i want to say this is extremely important to seniors in my district. i can't believe it isn't also protect their health, their safety, their economic security and health security into the futu, with the benefits they receive under the affordable care act that the republicans seek to yield back. >> tomember, mr. nk you, ms. castor, and thank you for offering this amendment and just to first emphasize a point that's already been made which this budget immediately, immediately reduce benefits to medicare beneficiaries because therdle c that doughnut hole that provides

that support for seniors in need and this budget reopens the doughnut hole an an immediate change for those seniors. i think it also needs to be pointed out that when we did the affordable care act we used savings. for example, by ending the subsidies to priete insurance carriers that were way hi14eing paid. weor ue purpose of providing these additional benefits. in other words we used those ts prescription drug benefit, and the budget we have for us from the republicans takes those savings. we heard -- you take the savings even though a the lot of ads were run against a lot of people based on those savings, but while you take those savings you don't plow any of them, none of them, back into medicare. you don't plow any into the back of preventive services and you

closing the prescription drug doughnut hole and that's why i think it's so important we adopt this amendment. >> are you okay with -- >> i w like to yield to mr. doggett. >> let's do it, yeah. [ inaudible ] >> check his >> thank you. for many american families the first real affect of the affordable care act will be felt by them in a positive way in 2014. but for seniors, the affordable health care act is already producing and for all of us, all those who expressed concern about the long-term solvency and sustainability of the medicare system, by plowing the savgs ac

cost last year into this plan, we are extending the life and solvency of the medicare trust fund by over a decade. seniors who face tremendous prescription drug costs and there's much more that needs to be done in this way, are already saving millions of dollars across the country on one of the focuses on encouraging cost control is prevention as ms. cass tore has said and there's an emphasis on prevention in this bill that i think will produce more savings. this amendment serves a valuable purpose in protecting our bene they're already getting, and i yield back. >> yeah, and i'll take one minute to close quickly and urge my budget and break the promise of medicare that allows all our eir tirement years in ts and dignity and don't pass a budget that will roll back these very

important consumer protections and improve benefits under medicare, closure of the dou doughnut hole, these new screenings, and the wellness visit. don't juomhe aarp who just sent a letter to the congress. they said budget -- >> you can conclude that in the i'm going to is it stick to a tight clock. >> you'll get a minute at the the vote. >> thank you, mr. chairman. with all due respect to my colleague who is proposing amendment who says that this is breaking the promise to medicare to look in the mirror. lo pthsident's law, the law that was congress does, in fact, break the promise to seniors because it removes $500 billion from medicare and puts in place a 15r not payment to physicians to care f s

occur. look at our budget, our budget pays 61. lines one and two. current medicare benefits are preserved for those in and near retirement without section two on page 61, a guaranteed health coverage for recipients they choose the plan that best suits their nee. who be in charge? is it going to be the federal veard unelected bureaucrats or is it going to be patients? you said the other side has sai our budget is adopted and put into law. you are absolutely right. we'll end the raid on medicare and we will end the 15-member unelected board of bureaucrats decide what kind of cakerosencare seniors. this talks about the doughnut hole and the doughnut hole provision of the new law has had the affect of prices.

the chairman asked the cbo to determine what the cost increase were and i'll quote from the letter available to all of us. quote, the increase in prices would make federal cost ts for medicare drug benefits and the st higher than they would have been in the absence of those provisions. it imposes an annual fee on importers of brand name drugs. the cbo expects the fee will increase the price of drugs purchased through medicare and the prices of newly introduced drugs purchased through medicaid and other federal programslly,u drug plans will increase so the premiums paid will increase, quimpres, and strengthens medicare. the medicare plan the seniors of this country know is already being altered and will be changed significantly and care if we allowtwo to ms. blac.

>> thank you, mr. chairman. i'll be very brief on this. i think that my colleague has made those points very clearly that when we talk about changing medicare as we know it, are that's already been done in the patient affordability act where there was han dollars that was taken out of theund and put in a the exchanges. the breaking of promises has already started by my colleagues on the other side. it has been said very clearly that we are going to give seniors an opportunity to have choice of their own. we're going to put it back to them to allow them to choose th. some may find that a drug program is more important. others may find thatay is the co we think 0 our seniors just because they're seniors can't make those choices? they will make good'll ke choice program that best suits their

needs. so thank you, mr. chairman. >> i urge repeal of the amendment and yiime. the gentle lady from floridaone chairman. i would say to my colleague from georgia if you agree medicare benefits and older americans shouldn't be harmed, then you should support my amendment. if you don't think the republican budget changes ben i problem you would have. my amendment simply says very clearly we will improvements that have been in place for two years closing the doughnut hole, allowing those screenings without additional co-payments, and that all-important annual wellness visit. you've argued time and time again that the affordable care act took half a billion dollars out of medicare. well, medicare. it took it away from the insurance companies that were receiving large overpayments. medpak's recommendation, half a

billion dollars was plowa the d lness visit. so i urge you, again, don't break the promise of medicare and don't just take it from me. >> the time has expired. >> the proposal lacks balance to jeopardize the health and economic security. eired. look, because of this clock is why i'm being tough. the gentle lady, come on. the question is on agreeing to the amendment offered by the gentle lady from florida. all those in favor say aye. all those opposed say no. >> no. >> the nos have it. >> roll call vote. >> the clerk wroll. >> mr. garrett? mr. no. will campbell? mr. campbell, no. mr. calvert? mr. calrtcole mr. cole, no.

mr. price? mr. price, no. mr. mcclintock, no. mr. tz? mr. stutsman, no. mr. langford? mr. langford, no. ms. no. mr. flores? >> no. >> mr. flores, no. mr. mull>>no. >> mr. mulvaney, no. mr. young? mr. mr. amash? no. mr. garrett? >> no. tt, no garre >> mr. van hollen, aye. aye. >> ms. schwarz, aye. ms. captor aye. mr. blumenour, aye.

mr. mccollum, aye. mr. mr. honda? mr. honda, aye. mr. ryan ofryan, aye. ms. wasserman ms. moore? ms. moore, aye. ms. castor? schueler?, mr. schueler, aye. ms. bass. ms. bass, aye. ms. bonei, mr. chairman? >> no. >> mr. chairman, no. >> are there any members looking to vote or to change vote? >> ms. wasserman schultz, aye. >> the clerk will report. >> mr. chairman, on that vote the ayes are 15 and the nos are.

since we have four votes, recess subject to theal the

the committee will come that was our last series of votes for the day, so we should not have any more interruptions of that. i believe mr. um recognized for purpose -- i apologize. your. i was over in an appropriations meeting with the secretary of it vote and i would have been a yes for thatte iope i'm recorded as a yes for the second vote. i was here present for it, thank you. >> the record will reflectprefe. >> thank you, mr. chairman. i have amendment number three which i would offer. designate amendment. >> the amendment offered and related to transportation.

he copies of the amendment and the gentleman from oregon is recognized for nine minutes. >>nk appreciated the exchange w the staff earlier about so us ought to be deeply concerned about and what i made part of the record was the article whic staff that in terms of the level of money we are going to have t e obligations right now that we have made to state and local transportation agencies, road and transit. it is, deficient and there's a whole host of reasons. we can point o that. mr. chairman, i know you have been sympathetic to our having a hearing on infrastructure finance before this commi stuf

out of the way. the interests that you and mr. van hollen have expressed means a lot to me. this should beco together. with a group of stakeholders that range from the women's garden club to the sierra club, the u.s. chamber, organi cyclists and truckers who are convinced we need to do a better job of funding the problem of rebuilding and renewing america. we arethose of you who have tra china, europe, japan, spain, you know, it looks pretty sad. india invests three times their gross domestic product higher than the united states.ishe 150 transcontinental railroad act

which helped tie the country together in the 1800s. the interstate highway act, what we've done with aviation -- these are important things for our nation's economy and the co. we have been -- the only way we've gotten through is by propping it up with general fund $34 billion that will keep us afloat and i would note that the last two big deficit reduction packages president c included gas tax increases to help fund this going forward. it was part of what we heard when we met informally with of their effort. we cannot approve this budget in good conscience and look the folks at home in the eye. i truly think that we ought to move up to be able to help fill part of the gap until we can get

past the election, maybe get to a point where we can work cooperatively on something that used to be bipartisan and still is, frankly, with a lot of the work that i do around the country with local governments and in some states. the amendment is a simple one. mr. chairman, you mentioned speaking to to the health care approach you have.i right. wealthy people can afford to pay more out of pocket. wealthy people pay more out of pocket. the main thing is we would providehe $50 billion that we need to be able to make sure we're not going further into debt, and that we are not shortchangingeoe who rely on us. and whether you talk to the