most egregious component of obamacare that compels americans to buy a policy produced or approved by the federal government, vote no on the bill. thank you, mr. speaker. the speaker pro tempore: the gentleman's time has expired. the gentleman from michigan. mr. conyers: i'm pleased to yield to the gentleman from georgia, hank johnson, for 1 1/2 minutes, to defend the obamacare legislation. the speaker pro tempore: the gentleman is recognized for a minute and a half. mr. johnson: thank you, mr. speaker. and thank you, mr. ranking member. i rise in opposition to the repeal of health reform. repeal of health care reform would strip 32 million americans of health insurance including 139,000 residents of my district. repeal will allow insurers to discriminate against people with pre-existing conditions and re-open the doughnut hole which would devastate joseph williams, a former corrections officer in my district, who relies on

medicare for his prescription drugs. i'll be voting against repeal and i urge my colleagues to do the same. and i yield back the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from texas. mr. smith: i yield two minutes to the gentleman from north carolina, mr. coble, who is also the chairman of the courts and commercial and administrative law subcommittee of the judiciary committee. the speaker pro tempore: the gentleman is recognized for two minutes. mr. coble: i appreciate the gentleman from texas. mr. speaker when we debated health care reform during the 111th congress, i made the statement that we need to fine tune the edge and not overhaul it. i reiterate that theory today. president obama in my opinion elevated health care to the number one issue facing america, mistakingly so in my opinion. i think the number one issue facing america then and now involves jobs or more precisely lack of jobs and reckless

spending. there is agreement from both sides of the aisle that we need to improve our health care system. these improvements must enhance the quality and accessibility of care in a fiscally responsible manner. the law implemented last year failed to meet this criteria, particularly the onerous 1099 tax incede on small businesses, that is just one glaring example. by repealing obamacare, we will have the opportunity to take more prudent approach of fine tuning our health care law to ensure that it encompasses sound principles. mr. speaker, this will likely be an obvious partisan vote. but it also serves a purpose. it sends message to the american people that we are serious about fixing our broken health care system. physicians do this daily. they make a diagnosis and fix the problem. i support the passage of h.r. 4 because congress should take the

same approach. fix the problem. much energy and attention was directed to this matter when it probably should have been directed to jobs and reckless spending. too late for that now. but we need to address it and i look forward to the vote i guess will be tomorrow and i yield back the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from michigan. mr. conyers: mr. speaker, i recognize dr. judy chu of california, a very valuable member of the judiciary committee, for one minute. the speaker pro tempore: the gentlelady from california voiced for one minute. ms. chu: thank you, mr. chair. the health care repeal act will hurt many people but especially seniors. it raises costs for prescriptions and preventative care, it weakens medicare and it takes away your freedom to make your own decisions, returning your health back to the hands of insurance companies. at the start of this year, seniors began receiving free preventative services such as

mammograms and an annual example. if repeal succeeds, goodbye free checkups and free life-saving tests. today seniors in the medicare doughnut hole are getting half off many brand name drugs. but if repeal passes, your prescription drugs are going to double and those who get a $250 check to help cover high drug costs might even have to pay it back. the original health reform bill extended medicare's life until 2029, but if we repeal it, the medicare trust funds become insolvent in six short years. the patients right to repeal act hurts seniors. it's dangerous for america's health. the speaker pro tempore: the gentlelady yields back. the gentleman from texas. mr. smith: i yield two minutes to the gentleman from texas, mr. poe, who is actually a member of three subcommittees of the judiciary committee. the speaker pro tempore: the gentleman is recognized for two minutes. mr. poe: mr. speaker, never before in the history of our great country has the tax been

levied on individual americans by the federal government with the purpose of forcing citizens to do something the government wants them to do. and never before has the government self-righteously ordered americans to buy a product or pay a punitive fine. in my opinion the constitution does not give the federal government, even well-intentioned government, the authority to make citizens buy any product, whether it's a car, whether it's health insurance or even whether it's a box of chocolates. the individual mandate provision of the health care bill is unconstitutional. the author of the constitution, james madison, said, the powers delegated by the constitution to the federal government are few and defined. those that remain to state governments are numerous and indefinite. the health care bill is a theft of the individual freedom to control one's health, to have it now controlled by government. big government doesn't mean better shutions -- solutions. in fact, as someone has said, it

you think the problem's government -- if you think the problems government creates are bad, just wait until you see government solutions. government is partially to blame for the health care yy sis and the nationalized health care -- crisis and the nationalize health care government solution is unconstitutional. if you like the efficiency of the post office, the competence of fema and the compassion of the i.r.s., we will love the nationalized health care bill. certainly what we do here in congress should be constitutional and we should repeal the health care bill and come up with constitutional solutions for health problems. and that's just the way it is. i yield back. the speaker pro tempore: the gentleman yields back. the gentleman from michigan. mr. conyers: mr. speaker, i want to take this opportunity to congratulate lamar smith on becoming the chairman of the house judiciary committee during the 112th session of congress. and i turn now to the former chairman of the constitutional subcommittee, jerry nadler of

new york, and i recognize him for two minutes. the speaker pro tempore: the gentleman is recognized for two minutes. mr. nadler: i thank the gentleman for yielding. mr. speaker, i rise in opposition to the republican effort to deny 32 million americans health care, to deny millions of middle class americans the ability to get health care insurance if they have can pre-existing conditions and to drive up our national debt by an additional $1.4 trillion over the next 20 years. the affordable care wast act with a stave off the 55% of bankruptcy caused by health care emergencies. by banning rescissions, banning pre-existing conditions, banning lifetime coverage caps and capping annual out-of-pocket expenses this law ensures nobody will go broke if they get sick. this will save lives of the approximately 45,000 americans who die every year because they lack health insurance. for american seniors, the affordable care act strengthens the medicare program. seniors no longer pay out of pocket for preventative services and the dough null hole will be

closed. the notice to small businesses will get billions of dollars in tax credits to help them provide health coverage to their employees, unless of course the republicans are successful in enacting a massive tax increase on small businesses by repealing the law. we did all this and more while reducing the deficit by what c.b.o. now estimates will be $230 billion in the first 10 years and $1.2 trillion in the next 10 years. the republicans say the bill is an unprecedented or unconstitutional expansion of congressional power. they are wrong. there's nothing radical, dangerous or unconstitutional about the act. we have the power to enact this comprehensive plan including its minimum coverage requirement under the commerce, necessary and proper general welfare clause of article 1, section 8 of the constitution. similar attacks were levied against the social security act of 1935 saying it was unconstitutional for the same reasons. those arguments were unsounded a rejected then and will fair no better today. indeed, leading republican

lawmakers championed individual mandates as part of their health equity and access reform today act of 1983. the requirement of individual participation was valid then and it is valid now. for all of these reasons i strongly encourage my colleagues to vote no on this misguided repeal bill. i thank you and yield back. the speaker pro tempore: the gentleman's time has expired. the gentleman from texas. mr. smith: mr. speaker, i yield two minutes to the gentleman from california, mr. lungren swhorks a chairman of the house administration committee. the speaker pro tempore: the gentleman from california is recognized for two minutes. mr. lungren: thank you very much, mr. speaker. mr. speaker, in the scope of the american constitutional system of governing, the congress is a body whose power is defined within the context of imnumerated powers and this is more than a matter of structural mechanics because it goes to the heart of the issue of governmental power. or of if one prefers the slip side of the coin, personal freedom and responsibility. if government has the power to require that you buy item a, it

means that you are less able to buy item b, c, d or anything else. now economists would call this the opportunity costs or foregone goods or services. but the fundamental question is the question of freedom to choose how we as individuals will spend the fruits of our labor. certainly the commerce clause lax the elassitiesity that would accommodate a requirement that every american buy health insurance which conforms to the dictates of the federal government and the federal government would change it on a yearly basis. such an interpretation would render the nation articulated by james madison and federalist 45 that is one of limited government anality. i know we have smart people here. i know we have those in the administration who believe that this is totally constitutional.

but frankly, mr. speaker, my bet goes with james madison. he did say that the powers delegated by the proposed constitution of the federal government are few and defined. he did say that the federal government will be exercising their responsibilities principally on external objects as war, peace negotiations and foreign commerce and the states would do much else. then we have the 10th amendment, later adopted. which said again that this is a government of limited, imnumerated powers. now either the 10th amendment means something or it means nothing and either james madison knows what he was talking about or he does not. the speaker pro tempore: the gentleman's time has expired. the gentleman from michigan. mr. conyers: mr. speaker, i'm pleased to recognize and congratulate the gentleman from maryland, the ranking member of government reform, elijah cummings, for one minute.

the speaker pro tempore: the gentleman is recognized for one minute. mr. cummings: thank you very much, mr. speaker. i rise before you in opposition to the bill we are considering today. i've heard from many of my constituents and small business owners who are grateful for the benefits of this law. children with pre-existing conditions are no longer being denied access to private health insurance. mafrlede small businesses offering health insurance to their employees are eligible for a 35% tax credit. further raverpbinging member of committee on government -- further, as ranking member of committee on government and oversight reform, i know that this would eliminate the private health plan providing coverage for many uninsured americans with pre-existing conditions. i find it repugnant that republicans want to strip americans of this law's protections that will save the lives of our fellow citizens. i urge a no vote on this bill and i yield back. the speaker pro tempore: the gentleman yields back. the gentleman from texas. mr. smith: mr. speaker, i yield two minutes to the gentleman from texas, mr. gohmert. the speaker pro tempore: the

gentleman from texas is recognized for two minutes. mr. gohmert: thank you, mr. speaker. less we forget, this is the disaster that we're told would be repugnant it started out as an act to amend the internal revenue code of 1986, first time home buyers' credit of the u.s. armed forces. we took a bill that was designed to help veterans and the senate stripped it all out and stuck in this disaster of a health care bill, just as we heard in the late 1990's that you can't pass welfare reform, you'll leave women without anything, you heartless, mean people. it was because people here had hearts and wanted to see women with children doing better that welfare reform had to be done. it was sent to the president and wouldn't sign it and finally he

signed it. and for the first time since the great society legislation came about, after 30 years of flatlining when adjusted for inflation, single women with children, after welfare reform began to have increases in income. we heard all the naysayers then and we are hearing them now. it's because we want people to have the best health care. it's because we don't want what the president said when he told the democratic caucus before it passed, gee, you go to the doctor now and have five tests, after this bill, you'll go and get one test. my mother had to have six days to find her tumor. i want health care to be legislated the way the president promised it would be and once we get this disaster out of the way, no matter how many times we have to send it, it will be time

to pass a bill that gets real health care reform. i yield back. the speaker pro tempore: the gentleman from michigan. mr. conyers: i recognize representative sewell from alabama for one minute. the speaker pro tempore: the gentlewoman is recognized for one minute. ms. sewell: i rise in opposition to repeal this legislation that has helped so many constituents of mine. nearly two weeks ago, i was honored by being sworn in as a representative of the 7th congressional district of alabama. on day one, i received numerous calls from my constituents urging me to oppose this repeal and i heard from countless voices that the health care that has been enacted has helped them. let me tell you a story. both are on medicare. mr. cheetham have suffered

several heart attacks. during several of the provisions in the affordable health care act has helped them to get their prescriptions. now they don't have to choose between putting food on the table, gas in their cars or paying for their medication. the affordable care act is the first step towards strengthening our health care system and is saving the lives of many many in my district. i urge my colleagues to vote know on this resolution. the speaker pro tempore: the gentleman from texas. mr. smith: i yield two minutes to the the gentleman from virginia, mr. goodlatte. the speaker pro tempore: the gentleman from virginia is recognized for two minutes. mr. goodlatte: i thank the chame for yielding. i rise in strong support of this legislation, which repeals the sweeping health care reform law rammed through congress last year. this new law amounts to a big government takeover of our

health care system, one that will lead to fewer choices, higher prices and rationed care and creates more than 150 new government agencies and programs at a cost of well over $1.2 trillion. it includes over $560 billion indefinite stating new tax increases and cuts medicare by over $500 billion. americans are frustrated by rising health care costs. we must repeal the new health care law that kills jobs, raises taxes and causes seniors to lose the coverage they have and increases the costs of health care coverage. we must replace it with commonsense reforms that lower health care costs and empower patients. for those who argue that somehow this is going to save the taxpayers' money, think of the mandates that are not covered by the federal government. think of the fact that it is not

credible at a time when senior citizens and baby boomers are going to retire in unprecedented numbers to takes $500 billion out of the medicare program and think of the jobs being lost because the taxes on this are already being put into place. yet the benefits don't occur for four years. that legislation was smoking mirrors. this legislation repeals it. we should sort it and then start anew on commonsense reforms and i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from michigan. mr. conyers: i recognize the gentleman from iowa, mr. braley, for one minute. the speaker pro tempore: the gentleman is recognized for one minute. mr. braley: i thank the gentleman for yielding. i want to show the face of the repeal of health care. this is tucker wright from iowa, he is four years old and two years ago before the affordable care act was passed, he was

diagnosed with liver cancer and had 2/3 of his liver removed and he faces a long and uncertain medical future. but on january 2 of this year, because we passed the affordable health care act, tucker's father brett was able to change jobs because he no longer had to worry about the stigma of pre-existing conditions. now, when you talk about repealing this bill, i tell you why it's not a good deal for tucker wright, because even though our friends talk about wanting to fix some of the problems that they now think are important, the first thing that's going to happen to tucker wright and his family as soon as this bill is repealed is his family will get a recision letter from the insurance company because they will no longer be able to provide insurance to this young boy because he has pre-existing conditions. that's why this bill is a bad idea and i urge you to vote no and think about tucker wright.

i yield back. mr. smith: madam speaker, how much time remains. the speaker pro tempore: the gentleman from texas has 5 1/2 minutes. the gentleman from michigan has 8 1/2 minutes. mr. smith: i reserve our time. the speaker pro tempore: the gentleman from michigan. mr. conyers: mr. walz of minnesota is recognized for one minute. the speaker pro tempore: the gentleman from minnesota is recognized for one minute. mr. walz: thank you, madam speaker. i rise today to state my strong opposition to the repealing of the affordable care act. it will eliminate consumer protections, raise taxes on small businesses, explode deficits and put insurance c.e.o.'s between americans and their doctor. i represent mayo clinic. they are a symbol when we deliver the world's highest

quality care at the most efficient and effective costs. when we passed this law last year, they said it was a good first step and i agree. now is not the time to step backwards. folks in my district are seeing the benefits of this law. seniors have help for getting prescription drugs and saving money and just a few weeks ago, i received a letter from a dad in my district named paul. his son is 21, works part-time and has diabetes. joe couldn't get the insurance he needed to pay for the expensive equipment he needs to stay healthy and alive. paul said thank you for passing the affordable care act. because of the law, joe got back on his parents' insurance. a vote to repeal this legislation pulls that card away. the speaker pro tempore: the gentleman from texas. mr. smith: i yield one minute to the the gentleman from new york, mr. reed, new member of the judiciary committee. the speaker pro tempore: the gentleman is recognized for one minute.

mr. reed: i rise today in support of the repeal of the job-killing obamacare legislation. this bill is a whopping 2,500 pages of of new spending and government bureaucracy. rushed to approval after only 48 hours of arm twisting and deal making. unfortunately, just as republicans predicted, this legislation did absolutely nothing to address the real problem in the health care, its costs. republicans have advocated for tort reform to be included in any legislation, for just as long those who have wrote this legislation have ignored the need for tort reform. the congressional budget office estimates tort reform initiatives could save $54 billion. i will say that the other side attempted to reform tort reform by providing $50 million for states to consider the concept of tofert reform. here we go again, another

example of what's wrong with washington, spending $50 million how to figure out how to save money. republicans have a better plan, which one which reduces health care costs. the speaker pro tempore: the gentleman's time has expired. mr. smith: i yield to the jar 30 seconds. reed reed american -- mr. reed: gets lawyers and bureaucrats out of our lawyers. let's repeal the bill and focus on bipartisan initiatives like fixing the doughnut hole and without spending an additional $50 million. until we do so, jobs will continue to be lost. i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from michigan. mr. conyers: we recognize for one minute the gentleman from missouri, rust carnahan. the speaker pro tempore: the gentleman is recognized for one minute.

mr. carnahan: i rise in strong opposition to this bill that would hurt small businesses in missouri who are finally imagining access to affordable coverage for their employees. the health care coverage for small firms has increased at more than 12%. those small business owners will lose tax credits that are providing up to 50% of their health care costs and will have to drop the very health insurance they have now been able to provide employees and their families. these are real people. people like michelle barron, who owns a book store. she used to provide health care, but over the years, couldn't keep up. she had to drop employees and finally drop her own coverage because of pre-existing conditions. last year when the health care bill was signed into law, new options opened up for issue ell and other business owners like her. if we repeal health care, it will turn back the clock for

small business owners. insurers will go back to denying coverage for pre-existing conditions and small business owners would lose tax credits to make health care coverage affordable. we can't go back to insurance company control. this is not the time to step backwards. i yield back. the speaker pro tempore: the gentleman from texas. mr. smith: i yield one minute to the the gentleman from arizona, mr. quayle. the speaker pro tempore: the gentleman is recognized for one minute. mr. quayle: i rise in support of house resolution 2. last year, behind closed doors and against the will of the american people, the democratic majority of the 111th congress passed a bill that fundamentally changes the doctor-patient relationship and passed the bill that will increase the cost of health care and explode our national debt. they passed the bill that expands the scope of government well beyond the parameters set forth in the constitution. the genius of our constitution, that this will document didn't set forth what the government must do for us but rather the

government can't do to us. to require every individual to enter within a commercial contract falls within that category. the people of my district understands this, just as they understand our health care system needs reforms that will reduce costs and increase access. unfortunately, the health care bill that was passed will increase costs and increase our national debt. those who drafted the bill will try to conceal the true costs from the american people, but if you look beyond, that bill increases our debt by $701 billion. it is time to get our country back on the right track and h.r. 2 is the necessary step to fulfilling that mission. the speaker pro tempore: the gentleman's time has expired. the gentleman from michigan. mr. conyers: i recognize the distinguished gentlelady from florida, debbie wasserman schultz for two minutes. ms. wasserman schultz: thank you

maspspspspsp it's important to address the notion of job killing versus job creating. we have heard a lot of talk about the title of this bill and the jobs that it supposedly kills. let's look at the facts here though, of the 1.1 million private sector jobs documented that were created last year, 200,000 of those were in the health care sector or 1/5. we had an average of 20,000 jobs per month created in the health care sector alone over the course of the last two years. there have been no job losses in the health care sector, none. and i challenge our colleagues on the other side of the aisle, on the republican side of the aisle who are advocating the repeal of health care reform on the premise that it is a job killer, to name one area of health care, one, where there had been job losses. i would suspect that we would hear crickets chirping because

there are none. there isn't a single area, not before and not since. and also, i think it is important to address the comments from the the gentleman from texas, mr. gohmert, who stated president obama told the democratic caucus that health care reform would allow us to shrink five tests performed on a patient to one. that is not true. that never happened. he never said that and at the end of the day, we need to make sure we are entitled to our opinions, but not to our own facts. i suspect that our colleagues on the other side of the aisle are making up their own facts, because their arguments don't stand on the strength of their ideas and aren't strong enough to stand on their own. i thought it was important to clear that up, mr. speaker. and i yield back. . mr. smith: mr. speaker, i yield

one minute to mr. griffin, maybe of the judiciary committee. the speaker pro tempore: the gentleman from arkansas is recognized for one minute. mr. griffith: mr. speaker, i thank -- mr. griffin: i believe we need health care reform badly. but the law we got isn't what we need. this is why i rise today in support of h.r. 2, to repeal the current health care law. the health care law provides for an increased government role and will ultimately lead to decisions made by the government instead of doctors and patients. it ignores the issue of cost. it was loaded with gimmicks to make it seem deficit-neutral. but once those are accounted for, we find that it adds over $700 billion to the deficit in the next 10 years. the health care law and especially the unconstitutional mandate handicaps our ability to grow jobs. small businesses will be hit hardest because they operate on the tightest margins and will have the toughest time complying

with the onerous regulations. many of the regulations are still not written, creating uncertainty for employers. we must repeal the law and replace it with one that lowers costs, preserves the doctor-patient relationship -- the speaker pro tempore: the gentleman's time has expired. mr. smith: i yield the gentleman an additional 30 seconds. mr. griffin: thank you, mr. chairman. lets americans keep the coverage they have, allows the private sector to create jobs and follows the constitution. thank you, i yield back the balance of my time. the speaker pro tempore: the gentleman yields back. the gentleman from michigan. mr. conyers: madam speaker, i yield rob andrews of new jersey one minute. the speaker pro tempore: the gentleman from new jersey is recognized for one minute. mr. andrews: i ask unanimous consent to revise and extend my remarks. the speaker pro tempore: without objection. mr. andrews: thank you, madam speaker. madam speaker, as we meet this afternoon there are 15 million unemployed americans. and no matter where you go in this country, you hear that the number one concern of our

constituents is creating an environment where businesses and entrepreneurs can put people back to work. so what is the house doing this week? relitigating, regurge dating, rearguing a political debate about health care again. i believe the people of this country want us to work together to get jobs back in the american economy. the republicans offer us a slogan, a job-killing health care bill. what kills jobs is paral sis in congress -- paralysis in congress. what kills jobs is ignoring the economic problems of this country. no it's not simply the right vote on the merits, it's the right vote because this is the wrong bill at the wrong time. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back. the gentleman from texas. mr. smith: madam speaker, we only have one more speaker on this side and we're prepared to close. the speaker pro tempore: the gentleman from michigan. mr. conyers: how much time have

we remaining? the speaker pro tempore: the gentleman from michigan has 3 1/2 minutes remaining. the gentleman from texas has 1 3/4. the gentleman from michigan. mr. conyers: i yield myself a minute. the speaker pro tempore: the gentleman is recognized for one minute. mr. conyers: i'd like -- because this is the judiciary committee and so little has been said about the constitutionality, i am pleased to quote from the dean of the law school of the university of california who said that opposing health care reform and relying on an argument that it is unconstitutional is an inadequate way to proceed.

somebody here must remember that there is medicare, medicaid, social security. please, this is not new that the government would be intervening in this way. maybe we need to revise and revisit the questions of constitutionality. the speaker pro tempore: the gentleman from texas. mr. smith: madam speaker, we continue to be ready to close. the speaker pro tempore: the gentleman from michigan. mr. conyers: i yield to sheila jackson lee of texas, a senior member of the committee, for the remaining time. which is about one minute. the speaker pro tempore: the gentlewoman from texas is recognized for 2 1/2 minutes. ms. jackson lee: mr. chairman,

you're absolutely right. this is a constitutional question that has been raised. as i came to the floor earlier, i mentioned my predecessor, congresswoman jordan, who believed in this constitution without question. i mentioned the 14th amendment. i now mention the fifth amendment. first of all, the commerce clause covers this bill but the fifth amendment speaks specifically to denying someone their life and liberty without due process. that is what h.r. 2 does. and i rise in opposition to it. and i rise in opposition because it is important that we preserve lives and we recognize that 40 million-plus are uninsured. in my own county, harris county, this bill will allow some 800,000 uninsured members of harris county, citizens of harris county, to be insured in texas. in addition, the texas department of insurance, as many other states, have already begun implementing this bill, the patient protection bill, gladly so and saying it will help save lives and provide for the

families of their states. can you tell me what is more unconstitutional than taking away from the people of america their fifth amendment rights, their 14th amendment rights and the right to equal protection under the law? i know that mr. lamb, who suffers from schizophrenia, with his family, mrs. betty, when had to go to the e.r. room in texas because no insurance, mr. smith who was on dialysis, or mr. fields whose mother couldn't get dental care, i know they would question why we're taking away their rights. today we stand before this body, we beg of them to ask themselves whether this is all about politics or about the american people. i'm prepared to stand, extend a hand of friendship. standing on the constitution to enable us to provide for all of the citizens of this country. this bill has been vetted, this bill is constitutional and it protects the constitutional rights of those who ask the question, must i die, must my china child die because i am now

-- child die because i am now disallowed from getting insurance? this is about your primary care doctor. this is about closing the doughnut hole that will allow you to be able to get discounts on your prescription drugs that some of you have avoided because you have to pay your rent and you have to buy your food. texas, a big state, has already said through a governmental agency, we need this bill. and we hope that those who come from our state and many other states will not vote against the protection of patients, vote against h.r. 2 and provide yourself with the protection of the constitution. i yield back. the speaker pro tempore: the gentleman from texas. mr. smith: madam speaker, i yield myself the balance of my time. the speaker pro tempore: the gentleman is recognized. mr. smith: madam speaker, the democrats' health care bill squanders health care resources and taxpayer money by encouraging wasteful, defensive medicine. it explicitly prevents stage from making any -- states from

making legal reforms under its provisions and expands opportunities for lawyers to sue doctors who did absolutely nothing wrong. and it limits the supply of doctors when patients need them most. in fact, one particularly costly part of our health care system is the practice of so-called defensive medicine which occur when is doctors are forced by the threat of lawsuits to conduct tests and prescribe drugs that are not medically required. a survey released last year found defensive medicine is practiced by virtually all physicians. lawsuit abuse does more than make medical care much more expensive, it drives doctors out of business. doctors who especiallyize in inherently high-risk fields are leaving their practices and hospitals are shutting down because their high exposure to liability makes law suit -- lawsuit shine insurance unaffordable and it can have deadly consequences. hundreds and thousands of patients may die annually for lack of doctors.

madam speaker, the democrats' health care law will produce more litigation and less effective health care. that is why it should be repealed. i'll yield back. the speaker pro tempore: the gentleman yields back. the speaker pro tempore: the gentleman from missouri, mr. graves, and the gentlelady from new york, mr. velazquez, will each control 20 minutes. the chair recognizes the gentleman from missouri. mr. graves: thank you, madam speaker. madam speaker, i yield myself such time as i may consume. the speaker pro tempore: the gentleman is recognized. grave grave thank you, madam speaker. madam speaker, i rise today in support of h.r. 2, legislation to repeal the job-destroying

health care law that was rushed through congress last year. the american people have repeatedly voiced their frustration over the way the health care law put the american -- or put the government between patients and their doctors. they have protested this law, they have demanded that reform of our nation's health care system focus not on bigger government, not on more bureaucrat, but on targeting commonsense changes that encourage competition and better choices. instead of listening to the people, washington gave them a law that piles more than $500 billion in tax increases on families and small businesses. this will force as much as 80% of all small businesses to give up their current coverage and could cost our economy $1.6 million -- 1.6 million jobs, one million of which could come from small businesses. all of these new regulations and restrictions included in the law will make it more difficult for small businesses to hire new workers, expand their operations and offer competitive wages. with unemployment still hovering above 9%, families and businesses cannot afford more regulations and red tape from

washington. it's going to make jobs more scarce and further slow our economic recovery. my republican colleagues and i repeatedly tried to reach across the aisle to craft a better bill when this was pushed through. and was disappointed that rather than listened to their counterparts and the american people, those in charge when this was pushed through chose to put a completely partisan, wildly unpopular bill through the people's house. we now have an opportunity to give the people what they want by repealing this law and replacing it with meaningful reforms that will cut costs and increase access without creating big problems for businesses or piling more unsustainable debt on future generations. i urge friends and members to vote in support of this and repeal this legislation and join me in implementing better solutions for improving our nation's health care stim -- system. i'll reserve the balance of my time. the speaker pro tempore: the gentleman reserves the balance of his time. the gentlewoman from new york. ms. velazquez: madam speaker, i ask unanimous consent to revise and extend my remarks. the speaker pro tempore: without objection. ms. velazquez: madam speaker, i yield myself as much time as i

may consume. i rise in opposition to the bill before us today. as we begin the 112th congress, it is unfortunate that one of the first bills before this body is more about politics than poim. this bill will not help a single small business secure a loan, open a new market for its products or invest back nits operations. -- back in its operations. the other side acknowledges this legislation is going nowhere. it is ironic this grandstanding occurs when health insurance continues to be a top challenge facing small businesses. over the last decade, small employers have seen their premiums rise by over 114% with no sign of relief. it is hard to imagine how repeal will help small businesses. in fact, it could do significant

harm. the bill before us today imposes a $40 billion tax increase by eliminatinging critical small business tax credits. these have already helped secure costs and reduced and increased coverage rates by nearly 12% in the past year. repeal will also eliminate choices for entrepreneurs. currently in the majority of states the two largest insurers have a combined market share of 70% or more. by doing away with reforms that establish new health insurance markets, it will limit small businesses' ability to secure coverage. small businesses already pay 20% more than their corporate counterparts and the laws of new

safeguards will compound this problem. because of health reform, insurers are no longer able to raise rates arbitrarily without explaining why. they cannot deny coverage based on a pre-existing condition or because an employee gets sick. passage of this bill will also strip new protections that provide small businesses we have heard how important reforms were excluded from the original legislation. they say for this reason, the house will start from scratch and enact a new health care law. however, when republicans were in control of both chambers and held the other office, they talk about their solutions for nearly a decade and yet, nothing happened. in the meantime, small businesses saw their employees'

premiums rise by an average of $700 every single year. small businesses pay nearly $14,000 for a policy that cost $6,500 in 2000. why should small businesses believe they can deliver on a promise this time? while our economy has added nearly 400,000 jobs over the past three months, more must be done. we must continue to confront the problem of health coverage for small businesses, but voting for today's bill will not do that. i urge members to oppose the bill and i urge the new leadership to find meaningful ways to address this nation's economic challenges. i reserve the balance of my time. the speaker pro tempore: the gentlman reserves the balance of his time. the gentleman from missouri.

>> i would yield one minute to the the gentleman from south carolina. mr. mulvaney: i rise in favor of h.r. 2 and it's hard to know where to begin when you are talking about how bad the current health care legislation is for small business. the current health care bill that this congress passed last year has an inp senttive for businesses to go from 50 to 49. incentive to go from 25 employees to fewer and disincentive for small businesses to go. a financial incentive to pay your employees less because the tax credits that we talked about last year goes away as you pay your folks more. it's almost as if the folks who wrote this piece of legislation last year have no idea how small business works or don't care. either way the current health care legislation is a complete disaster for small business and number one priority for small

business this year should be repealing the existing health care and passing of h.r. 2. and i yield back. the speaker pro tempore: the gentlewoman from new york. ms. velazquez: i yield as much time as necessary. in the state of south carolina, as a result of this repeal legislation, small businesses in the state of south carolina will see a tax increase of $540 million. with that, i yield two minutes to the the gentleman from, mr. cicilline. mr. cicilline: i thank the gentleman for yielding. i rise in strong opposition to h.r. 2. if we repeal, the following things will happen, children with pre-existing diseases will be denied coverage and people under the age of 26 will be denied. seniors will pay more and small businesses will pay 20% more than their corporate

counterparts for providing the same health care coverage. small businesses would lose the incentive for providing coverage to their employees and up to 50% tax credit which has increased coverage of small firms by more than 10% and would use that tax credit to hire additional employees. this law establishes consumer protections, incentivizes wellness programs and establishes cost controls and cost-cutting exchanges. for small businesses, that means driving down the cost of providing health insurance and providing assistance for small businesses that are struggling to skyrocketing premiums. small businesses pay 18% more than than large businesses for the same coverage and health insurance premiums have gone up three times faster than wages in the past 10 years. i would just -- i ask for 15 seconds. small business tax credits are critical to providing small

businesses the opportunity to provide insurance to their employees. we made a promise to those small businesses to make it yees easier to thrive and this is the first good step and i urge to vote against this repeal. >> i yield one minute to the the gentleman from tennessee for one minute. mr. fleischmann: i rise in support of the repeal of obamacare. this is my first speech on the floor as a member of congress and i thought it only appropriate that it be on this topic, a topic i campaigned hard on and a topic i believe strongly in. we must repeal this health care legislation. as a small business owner for the past 24 years, i know firsthand the kind of damage this legislation would do to american small business if it is allowed to be put in place. the national federation of independent business research foundation conducted a study that showed the employer mandate

found in obamacare could lead to a loss of 1.6 million jobs throughout the country and 66% of those lost jobs would come from the small business work force. that same study showed that small businesses would lose roughly $113 billion in output. as a member of the small business committee, i promise to use my personal experience to fight every day for small business owners everywhere. the speaker pro tempore: the gentleman's time has expired. mr. fleischmann: starting tonight, we must repeal obamacare and i yield back. ms. velazquez: i yield two minutes to the the gentleman from north carolina. the speaker pro tempore: the gentleman is recognized for two minutes. >> i rise today to speak against this bill, even before the recession, my state, north carolina, was losing one wave of jobs after another in our

traditional industries and we have needed the energy and job creation that comes from small business, from people leaving jobs whether jumped or pushed and starting their own business. half of our economy is generated by small business and even more important, small businesses create 75% of new jobs. by providing access to state high risk pools, the health care reform bill passed last year will make it possible for small businesses to start their own business without worrying they are going to lose health care for themselves and their families and i know what it's like to buy health insurance for employees. one of the greatest frustrations, trying to find something affordable and trying to figure out what you bought and you won't know until one of your employees gets sick or hurt. the bill passed last year, the legislation will make it affordable. it will provide tax credits to

35% for small businesses to provide health insurance and will go up to 50%. that will increase health care coverage among small business owners and even more important and they will know what they got, insurance that really covers what it ought to cover and not filled with small print exceptions of one kind of care after another, one condition after another. employees are going to get the care they need. reform has freed people to want to start a business, do it without worrying about what kind of shape that's going to leave them in and their family members in and i urge my colleagues to vote against this bill, to put those small businesses back in the uncertain land. thank you. i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from missouri. >> i yield one minute to another member of the small business committee, gentlelady from

washington. mr. butterfield: i rise in support of this -- ms. herrera beutler: and i rise in support of this bill. this year, we have the chance to correct mistakes made by both parties. the obamacare bill passed by the other party last year was the wrong approach and does nothing to decrease the inflationary curve of health care. it was the wrong approach. and no party is perfect last time the party had the majority, many on our side of the aisle worked diligently to reform health care, the job was left undone. getting this right is one of the reasons my constituents sent me to congress. solutions exist that can fix our health care system and bring costs down for middle-income families. today, we hit reset on health care reform and i invite my colleagues to join me in advancing solutions, solutions

like small business health plans, ending junk lawsuits that drive up the costs of everyone's cost and health savings accounts and buying insurance across state lines. the speaker pro tempore: the gentlewoman from from new york. ms. velazquez: i would like to inquire how much time is remaining. the speaker pro tempore: 12 1/4 minutes remaining and the gentleman from missouri has 15 minutes remaining. ms. velazquez: at this time, i reserve. the speaker pro tempore: the gentleman from missouri. >> madam speaker, i would yield one minute to the the gentleman from colorado, mr. tip ton. the speaker pro tempore: the gentleman is recognized for one minute. mr. tipton: thank you, madam speaker. the question is, will we accept what is or are we willing to commit for what to be. america has always been the land of self-determination.

our constitutionally-guaranteed rights as individuals, as a people, as a nation, has made us flourish. creativity are hallmarks. i rise in support of house resolution 2. it does not indict inat the present time but it does address outcome. the deeper we dig into the health care act, the more we discover that it is stopping job creation, building more government and placing tax burdens on american families who are already struggling. we can and must do better. let us commit ourselves to hold these concerns, affordability and ack set built and empower our people to make their own choices and empower private sector solutions that will lower costs and increase the quality of care and eliminate government and not build bigger government. i yield the balance of my time. the speaker pro tempore: the gentlewoman from new york.

ms. velazquez: i yield 2 1/2 minutes to the the gentlewoman from california. the speaker pro tempore: the gentlewoman is recognized for 2 1/2 minutes. ms. roybal-allard: many americans have more freedom to choose. in my congressional district, 40% of my constituents were uninsured, thousands more were underinsured and living on the brink of financial disaster when facing an illness or accident. with health reform positive change is taking place for them and for individuals, families and small businesses throughout the country. young adults can remain on their parents' insurance until 26. seniors not living in fear are thankful for discounts on brand-named drugs. families of pre-existing conditions are comforted by the new high risk insurance pool and those facing serious illnesses are relieved their insurers can no longer drop them.

small businesses which abound in my district and mainstay in the minority communities can take advantage of tax credits to offer health insurance to their employees. a 2009 study by an economist found that without reform, over the next decade, employers will pay trillions of dollars in employee health costs, potentially cut 170,000 small business jobs and lose $51.2 billion in profits. that is why the founder and c.e.o. of the small business majority supports health care reform. madam speaker, h.r. 2 will hurt small business and will repeal the freedoms and protections americans now have and it will return control of their health care to the insurance companies. i yield back the balance of my time. the speaker pro tempore: the gentlewoman yields back.

the gentleman from missouri. >> i yield one minute to the the gentleman from louisiana, mr. landry. the speaker pro tempore: the gentleman is recognized for one mind. mr. landry: >> i -- mr. landry: it is with great enthusiasm that i rise to encourage my colleagues to stand with the american people. the hard-working families and small business owners across our country and vote for repealing the job-killing health care law. in march, they passed a massive government-run health care law that will kill jobs and increase the size of our federal government. the bill calls for tax increases on american families, wasteful spending of taxpayer dollars and new mandates on small businesses. this is wrong. voters made it clear in november that business as usual must end. i submitted the necessary paperwork to decline the health care plan offered to members of congress. i rejected its benefits because

washington must work just like the american people must work. we are not above them. i hope my actions i will energize the efforts to repeal the government-run health care law and i encourage my colleagues to vote yes on this bill and promote commonsense solutions of promoting health insurance across state lines, pooling small businesses to leverage purchasing power. thank you, madam chairman. . the speaker pro tempore: the gentleman from missouri. mr. graves: at this time, i yield one minute to the gentleman from illinois, mr. walsh. the speaker pro tempore: the gentleman is recognized for one minute. mr. walsh: i rise in support of h.r. 2, repealing the job-killing health care act. i commend the leadership for simplifying this process by drafting a two-page bill for repeal.

it will be very clear where we stand on repeal. during this past campaign, i, like a lot of candidates, spoke to small businesses every single day. there's a reason why 90% of small business men and women in this country support repeal. from the billions in taxes to the needless paperwork to the burdensome regulations to the $1.6 million estimated job loss, small business men and women are adamant that we need to repeal. finally, madam speaker, our opposition last year said if you like your plan, you can keep it. to date, there are 222 organizations, including some of obamacare's biggest supporters who have received waivers. why? why, if the law was so worthy, would there be a need for waivers? thank you, madam speaker. the speaker pro tempore: the gentlewoman from new york. ms. velazquez: i yield myself as much time as necessary.

the speaker pro tempore: the gentlewoman is recognized. ms. velazquez: as a result of this repeal legislation, small businesses in the state of illinois will see a tax increase of $1.7 billion. with that, i yield two minutes to the gentleman from connecticut, mr. murphy. the speaker pro tempore: the gentleman is recognized for two minutes. mr. murphy: thank you very much. madam speaker, when i testified against this repeal before the rules committee, i told the story of a family in my district, the husband lost his job and therefore his insurance because of a debilitating snir. his -- injury. the family faced a choice, either dip into their savings account, their high school son's college fund, or sell their house. they first chose to spend down their savings. when i told the story a republican said, whey they had money they had asset, i don't get it, why should someone else pay their bills?

she didn't get it. no one should be forced on the street because one of their family members get sick. there is a moral imtertive to be our brother's keeper but there's a fiscal imperative. when that family's savings is done, they're out on the street, we all pick up the cost. small businesses pick up the cost. that's why small businesses are paying 18% more than big businesses. that's why about $1,100 of every premium goes to cover the uninsure. there are thousands of small businesses in connecticut organized under the us a pises of a group called small businesses for health care reform calling -- crying out for this repeal to be defeated. they see the $260 billion price tag that's going to land on their head as well as the continuation of discriminatory practices that ask small businesses to pay for the uninsured like that family that i talked about. this bill isn't anything more than that political statement. families in my district, small businesses in my district, need

more than politics. they need answers. i yield back my time. the speaker pro tempore: the gentleman from missouri. mr. graves: madam speaker, at this time, i yield one minute to the gentleman from iowa, mr. king. the speaker pro tempore: the gentleman is recognized for one minute. mr. king: i thank the chairman for yielding time. i listened to this delivery ahead of me, i spent 28 1/2 years in business, i met payroll over 1,400 consecutive weeks. i never saw a regulation that made my job easier or allowed me to make more money. this is thousands of pages of regulation, it's oppress toiv small business, it should be called the entrepreneurial extinction act, not the health care plan. this is obamacare, it must be pulled out completely by the roots. the 34er7b people know this. that's why there are 87 freshman republicans on this side, nine freshmen democrats on this side. the american people have spoken resoundingly, it is our obligation to go down this path. it's not symbolic. it's very important.

without this vote on this floor, we can't move forward with the rest of the scenario to eliminate obamacare. the language in the bill is simple. it concludes with this language. act is repealed and the provisions of law amended or repealed by such law are restored as if such act had never been enacted, close quote. thank you, mr. speaker, i yield back the balance of my time. the speaker pro tempore: the gentlewoman from new york. ms. velez kezz: how much time is remaining on each side? the speaker pro tempore: the gentlewoman from new york has eight minutes remain, the gentleman from missouri has 11 minutes remaining. ms. velez kezz: i yield two minutes to the gentleman from -- ms. velazquez: i yield two minutes to the gentleman from new mexico. the speaker pro tempore: the gentleman is recognized. >> during these tough economic times it's critical we make job creation a top priority. that's why i'm concerned about the impact h.r. 2 will have on small businesses. it will repeal a tax credit for

small businesses that offered health insurance to their employees. it would allow an insurer to deny business coverage if their employees have pre-existing conditions. mr. lujan: as a result of reform, new mexicans no longer face this. if this is repealed, having cancer, diabetes or being a victim of domestic violence will be cause for losing health care. people like yvonne from santa fe would have to worry about losing their health care. yvonne lost her job when the company she worked for was shipped overseas. she was diabetic and because of the high cost of cobra, she was fored to ration her medicine. as a result, she became gravely ill and had to visit the emergency room. her doctors noticed another problem that required further examination yet because yvonne could not afford cobra and because private insurance companies would not insure her because she had diabetes, the

hospital released her. the only option yvonne had was to wait two months to be seen at the university of new mexico hospital. she was diagnosed with a form of lung cancer that would have been caught earlier had she not been kicked out. she passed away from complications resulting from the cancer having suffered through a system that discriminated against her we cannot return to the days when people like yvonne are forced to suffer because of insurance companies' bad practice. let's not turn a blind eye on people lie e-- like yvonne. the speaker pro tempore: the gentleman from missouri. mr. graves: thank you, madam speaker. at this time, i yield one minute to the gentlelady from north carolina a nurse and the new chairwoman of the subcommittee on health care and technology, mrs. ellmers. the speaker pro tempore: the gentleman from north carolina is recognized for one minute. mrs. ellmers: i ask unanimous consent that my remarks be revise and extend -- that i be able to revise and extend my remarks. the speaker pro tempore: without

objection. mrs. ellmers: when i ran for congress, i vowed to end obamacare. and with my first vote in the 112th congress, i will do so. as a nurse for 20 year, co-owner of a wounds care clinic and in practice with my husband in his general surgery practice, we know the problems that exist for americans in health care. instead of being a remedy to these problems, omaw -- obamacare has already done more harm than good to both the quality of health care in our country as well as our economy. as a nurse, i look for pathways to solutions, this is a problematic pathway, undoubtedly. in the face of rising unemployment, unsustainable federal deficits and overwhelming public opposition, it took more than a year to cobble together an unpopular government takeover of health care. so riddled with provisions that violate right-to-life principles and support government rationing of care that it cannot simply be

patched. obamacare is bad for workers, it's bad for employers and bad for america. repealing it allows us to start -- thank you very much. i yield back the balance of my time. mr. graves: i yield the gentlelady 30 more seconds. the speaker pro tempore: the gentlelady is recognized. mrs. ellmers: thank you. repealing it allows us to start with a clean slate and look at market-based reforms that will actually lower health care costs. it will increase accessibility, let americans keep their plans if they have them and they like them and it will forestall impending drastic changes that have create uncertainty in the lives of so many americans. to this congress, i will work with my colleagues on both sides of the aisle to repeal and replace the job-killing regulations and state bankrupting mandates. the bill to repeal the so-call aid fordable health plan --

the speaker pro tempore: the gentlelady's time has expired. mrs. ellmers: thank you so much. the speaker pro tempore: the gentlelady from new york. ms. velazquez: i reserve. the speaker pro tempore: the gentleman from missouri. mr. graves: i recognize the gentlelady from new york. the speaker pro tempore: the gentlelady is recognized. >> i rise in strong support of this bill to repeal the affordable care act. i can tell you that athe affordable care act will take care away from patients. it transfers power from consumers to the government. ms. hayworth: to make crucial decisions that belong in the hands of patients and their doctors. it neglects to deal effectively with reforms and medical liability that are desperately needed to reduce the

unconscionable cost of medicine. our vote to repeal is not merely symbolic, it represents the true will of the american public and will pave the way to reform our health care in a way that will allow our citizens to have the good, cost-effective health care and affordable, portable health insurance they need while maintaining the quality, choice, and innovation that represents the best of american medicine. thank you, madam speaker and i yield back the balance of my time. the speaker pro tempore: the gentlewoman from new york. ms. velazquez: i continue to reserve. the speaker pro tempore: the gentleman from missouri. mr. graves: thank you, madam speaker. at this time, i yield one minute to the gentleman from arizona, mr. bossier. the speaker pro tempore: the gentleman from arizona is recognized for one minute. mr. gosar: the health care law passed last year did not fix any problems, it only made things worse.

small businesses can barely make ends meet. now the federal government is imposing more mandates, more taxes and more red tape. enough is enough. as a health care provider, small business owner and father, i know that the way to provide more health care to individuals and create more jobs is not through government bureaucracies, deficit spending and higher taxes. rather we need to empower businesses, big and small, to band together to purchase health insurance. we need to implement real health care reform that will lower the cost of care and open up access. tort reform, red tape reform, pre-existing conditions reform. these are reforms that will work. reform the current law failed to adequately address or ignored altogether. if we are serious about putting our nation back to work, we can start by repealing this onerous health care law and work hand in hand with the american people to implement true health care reform. i yield back the balance of my time. the speaker pro tempore: the

gentlewoman from new york. ms. velazquez: i continue to reserve. the speaker pro tempore: the gentleman from missouri. mr. graves: thank you, madam speaker. at this time i yield one minute to the gentleman from pennsylvania, mr. fitzpatrick. the speaker pro tempore: the gentleman is recognized for one minute. mr. fitzpatrick: i rise in support of the repeal of the so-call aid fordable care act because the affordable care act is unaffordable for small businesses and individuals. since the passage of the act, my constituents have seen double digit premium increases. the act is unaffordable for states already billions in the red and unable to shoulder billions more in medicaid costs. it is unaffordable for seniors who will see reductions in medicare spending. and it's unaffordable for the american tabblings payer who will see a $700 billion increase in the deficit. we must enact real health care reform, tort reform for doctors,

permitting individuals real competition to purchase across state lines and enacting and enhancing health savings accounts. these are the cornerstones of real health care reform and affordability to make health care affordable and accessible for seniors, states and generations of taxpayers to come. i yield back. the speaker pro tempore: the gentlewoman from new york. ms. velazquez: how much time does each side have remaining? the speaker pro tempore: the gentlelady has six minutes remain, the gentleman from missouri has six and a half minutes remaining. ms. velazquez: i yield two minutes to the gentlelady from california. the speaker pro tempore: the gentlelady is recognized for two minutes. ms. richardson: i urge my colleagues to keep true to the -- to the call for civility. this isn't obamacare, it's called the affordable care act. at a time when americans have a

chance to see a regular doctor, to prevent sitting in hospital rooms in emergency waiting for desperate care, we have a chance. what does this mean to small businesses in california and my own home taun, 15,100 small businesses have seen a 50% tax credit to provide health care for the first time for their employees. over 16,000 additional small businesses will now be eligible for health care exchanges that will make insurance affordable. now are talking about considering something that would prevent medicare for 63,000 beneficiaries, extending coverage to 88,000 residents in my district. that's what we're talking about and when you are talking about guaranteeing 17,000 residents who had pre-existing conditions. i will vote no on h.r. 2 and i urge my colleagues to consider not reversing, it's not time to

go back, it's time to step forward. i yield back. the speaker pro tempore: the gentlewoman yields back. the gentleman from missouri. mr. graves: i yield one minute to the the gentleman from ohio. the speaker pro tempore: the gentleman is recognized for one minute. mr. stivers: thank you, madam speaker. i thank the gentleman for yielding time. i rise in support because doing otherwise would be supporting the job-killing status quo and that is unacceptable. whether we start over or work to fix the current law, we must act. i'm committed to work in a bipartisan to support reforms that we agree on, such as helping people with pre-existing conditions get access and allowing young adults to stay on their parents' plan but i want to eliminate the mandates and 1099 requirement in the legislation. small business owner from my

district called the other day and wanted to talk to me about the burdens of the 1099 provision and called it a nightmare and will increase her burden by 12 times. we need to lower health care costs for families and allow a more patient-centered approach and not placing burdens on the backs of small business owners. i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from missouri. mr. graves: i yield one minute to the the gentleman from arkansas, mr. womack. the speaker pro tempore: the gentleman is recognized for one minute. mr. womack: thank you for the time. throughout this debate, there has been talk about jobs and there should be. there is little doubt that this law impacts american workers. take for example, an electric company in my district. it has 6,000 employees across america and the impact is $2.9

million. how does a company like valdor absorb that cost by automating its processes and through attrition, allowing 50 jobs to disappear. eliminating 50 jobs in the first year of this law for a company like valdor not to mention thousands of companies across america similarly situated is not my idea of restoring economic prosperity for america. i urge my colleagues to support h.r. 2 and begin the process of crafting a meaningful, affordable and workable solution. that's the way forward. i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. the gentlewoman from new york. ms. velazquez: i yield 1 1/2 minutes to the the gentleman from new york, mr. wiener. the speaker pro tempore: the gentleman is recognized. mr. weiner: any of the members who have spoken about the impact on small business, are any of them in favor of the tax incentive that is provided on small businesses to provide health care? of course they are. now, they might not know it's in the bill because to listen to

the rhetoric, they just came off the campaign trail, they said government takeover, job killing, but i would urge you to read the bill. small businesses get 30% to 50% tax incentive to provide health care. and you know what requirements they have to go along with that? none. no gaudy regulation, no government takeover and just a word, i know you are caught up in the rhetoric of the campaign, this is tax breaks that are going to go to citizens to buy private insurance policies. where is the government takeover in that? some of us believe that medicare which you referred to as a government takeover in health care, which i'm sure you are opposed, some of us believe that the insurance companies aren't providing value added here, but they are the beneficiaries. small businesses today, if the republicans are successful, will lose that tax incentive. you think that will create a lot

of jobs, guys? and you think small businesses benefit when they don't provide health insurance? who do you think pays that bill, the bill fairy? your taxpayers. what's your solution? they don't have a solution. we know what they are against and against tort reform and don't know what they are for. welcome to the republican majority. the speaker pro tempore: members are reminded to address their comments to the chair. the gentleman from missouri. mr. graves: madam speaker, i would yield two minutes to the the gentleman from new york, mr. gibson. mr. gibson: permission to revise and extend my remarks. i thank the gentleman for yielding. i express the sentiments of my district. with health care costs continuing to rise several times the rate of inflation year after year, clearly we need reform.

health care costs were 4.7% in 1960, they are over 17% today. the bill passed last year is not the answer. we will end up with higher costs, higher premiums, higher taxes and burdensome regulation and more big government at a time we should be consolidating. we need to start over again and i believe we can find solutions that drive down costs and expands access without hurting small businesses and stepping on our freedoms. this bill passed last year expands the government's expansion in health care, which is significantly increasing in my district. at a time when both sides of the aisle believe we should be focusing on job creation, this is not the way forward. the new taxes and regulations will hurt our small businesses, including the medical device industry where our region leads

the nation. the new law, if not repealed, will hurt families across my district and across america. the changes to the medicaid program will put burdens on states already facing difficult challenges. i plan to vote for repeal. and later this week, i plan to vote for house resolution 9 to instruct committees to report a replacement bill for wider options and choices and medical liability reform. we should engage in a civil, bipartisan discussion with our colleagues across the aisle. our replacement bill should include coverage for pre-existing conditions and ensure that coverage can't be dropped when you are sick. the fate of this repeal effort will hinge on the kept and quality of the replacement bill. if we bring forward in this house a new plan that drives down costs and increases access and protecting choices, i believe the people evaluating the two plans will pressure the senate and president to repeal

and replace because we need reform but the bill is not the answer. we need to start over. the speaker pro tempore: the gentleman's time has expired. the gentlewoman from new york. ms. velazquez: i would like to inquire as to how much time is remaining. the speaker pro tempore: the the gentlewoman from new york has three minutes remaining. the gentleman from missouri has 2 1/2 minutes remaining. ms. velazquez: i would like to inquire through the chair how many speakers the gentleman has remaining. the speaker pro tempore: the gentleman from missouri. mr. graves: i don't have any more speakers and i'm prepared to close. ms. velazquez: i yield two minutes to the the gentleman from california, mr. garamendi. the gentleman is recognized for two minutes. mr. garamendi: madam speaker, this is the most remarkable of all chambers where discussions take place because if you say something that is not true, somebody will believe that it's actually true. what i have heard today on the

floor, i'm going, well, that's a marvelous thing, when, in fact, our colleagues on the republican side want to enact reforms that are already in place. already in place is the patients' bill of rights. no recisions. no pre-existing conditions. children being able to stay or young adults being able to stay on their parents' policies until the age of 26. they say they want it, it's the law of america. would you. what are we going to repeal? you going to repeal that? you small businesses to be taken care of? so do we. if you employ less than 50 people as a small business, you don't have any requirements at all. if you want to provide health insurance to your employees, wow, the government is going to give you a subsidy, 35% now and building to 50% in the years ahead. what's wrong with that?

where's the harm to small business? what in the world are you guys talking about here? i don't get it. it's in the law already. everything i have heard in the last half hour is the law of america. so, why are you repealing it, so the insurance companies can get another shot at taking over the care of patients, which is exactly what they do and exactly what i know, because i was the insurance commissioner eight years in california and i know what the insurance companies do. they are the ones that make the decisions. we don't want that to happen. that's why the patients' bill of rights is the law in america today. the patients' bill of rights would be repealed by h.r. 2. not good for americans. not good. some 30 million people would lose their opportunity for insurance. i yield back my time, madam speaker. the speaker pro tempore: the gentlewoman from new york.

ms. velazquez: madam speaker, will will small businesses lose if health care reform is repealed? the small business tax credits of up to 50% will be lost. insurers will be able to continue price gouging. insurers will be able to deny small business coverage without any justification. new health insurance upshoots for small businesses will be eliminated. small businesses will be unable to pool resources to purchase coverage. insurers will be able to delay small businesses access to health insurance. new health options for the self-employed will be abottle issued. i urge a no vote and i hope that we stand the remainder of this congress measures that truly get small businesses hiring and

creating jobs. what we need is to get this economy back on track. by repealing health care reform, we will not achieve that. i yield back the balance of my time. the speaker pro tempore: the speaker pro tempore: the gentleman from missouri. mr. graves: some of my colleagues on the other side of the aisle continue to argue or continue to claim that the health care law is going to benefit small businesses despite the mount of facts that are out there, specifically what was argued earlier is the health care tax credit is going to make it easier for employers to offset the costs to provide health insurance. unfortunately, this is far from the truth, any potential assistance from this tax credit is outweighed by the paperwork burdens that this law is going to pile on small businesses. madam sperger, the american -- speaker, the american people spoke loudly and move away that imposes burdens on

entrepreneurs. madam speaker, i urge my colleagues to vote for h.r. 2 and let's get back on track. i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. pursuant to clause 1-c of >> the house of representatives completed two hours of hearings today. the additional five hours of debate and a final vote on the proposed repeal are scheduled for tomorrow. the house is back in session wednesday morning at 10:00 a.m. eastern. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2010] >> in a few moments, they center for policy analysis briefing. in a little more than an hour, the house democratic steering committee hosts a panel of citizens talking about their

medical situations and why they support the new health care law. >> chinese president hu jintao was on a four-day visit to the united states, his first since 2006. learn more about him and watch c-span coverage about his visits from over the years. it is washington your way. >> as the house began debate on repealing health care law, the national center for policy analysis released its recommendations for proposed changes to the law. it began with the president, john goodman. this is a little more than an hour.

>> good morning. we are joined by representatives of the heritage foundation, the american enterprise institute, the cato institute, the american action network, and other think tanks that are also with us in spirit that could not be here physically today. both on the right and on the left. our interest is in the health reform bill that was passed last spring. if -- and there are some major defects in that bill that we think are so serious and severe that congress will have to reopen the health care law and make major changes to it, even if there are no critics around. i want to briefly go over 10 of those major problems in the bill and then each of our speakers will address certain parts of it. number one is an impossible

mandate. all this will be required to have a health insurance plan that will -- a cost of which will be growing at twice the rate of our income. you don't have to be a mathematician or an economist and know that, if you are forced to buy something, the cost of which is growing at twice the rate of your growth of income, eventually, it will crowd out everything else that you are buying. barack obama did not create this problem. this problem has been going on for four decades. for the last 40 years, a health care costs have been growing at twice the rate of growth of our income. the united states is not the worst case in the world. in fact, we are just under the european average. so this is a problem for the entire developed world. but even though barack obama did not create the problem, the bill that we passed makes it worse because what it will do is lock us into that very a sustainable

path. if we continue on the path indefinitely into the future, by about mid century, today's young folks will reach retirement age and health care will have crowded out everything else that they consume. i suppose that that is not the goal that we want to reach. the problem with the bill is that it takes away from the private-sector many of the tools that are now there that allow you to control the health insurance cost, and letting the package of benefits, more cost sharing, all of that goes away and walks into a path that is unsustainable and undesirable. then we have is our system of subsidies. the hotel down the street has a lot of workers that are making only $15 per hour. they are the maids, busboys, the custodial folks, the garden

folks. according to the congressional budget office, if these people make it over to the health insurance exchange that will be set up under the new health law, there will be able to acquire a health-insurance plan for a family that costs $15,000 and the government will pay almost all the premiums. then if they have a lot of out- of-pocket costs, the government will reimburse them for those and the cbo projects that the total benefit they will get is about $19,000. on the other hand, if these employees stay with the hotel and get their health insurance from that hotel, the only subsidy they get is the subsidy that is currently in the tax law, which means the ability of the hotel to pay premiums with untaxed dollars. but since people at this way is little to not pay income taxes, we are only avoiding the payroll tax. the ability to do that is only a little more than $2,000.

they could have something for free worth $19,000. where do you think people will end up? economy tells me that they will find their way into the exchange. if the marriott employees do not do it, but the others do, marriott will find it very hard to compete in the marketplace with labor costs that it% higher than all its competitors. i do not know what firms will do, but i can conceive of a world in which firms completely reorganized to take advantage of these new subsidies. the strange thing is that, if marriott has an employee that makes 9000 that -- $90,000 or $100,000, that employee gets no subsidy if he goes into the exchange. if he gets his and assurance from the marriott, however, marriott gets the subsidy with the current tax law, the ability to pay prelims with pre-tax dollars, avoiding the payroll

tax. but for the higher income, also state and local income taxes. those subsidies are about equal to half the cost of the insurance. so a higher-income employees once his intered -- once his insurance from -- once his insurance from the hotel. what will employers do? end entirely independent contractors and such? there will be decisions that will not be good for the job market, not the kind of labor market situation that gives employers conference and lets them know what will happen. we have health insurance exchange that creates perverse incentives for the insurers. you charge everybody the same premium, regardless of health care costs, everybody's

incentives are distorted. the person that has health problems and will look at the premiums and say that health insurance looks cheap to me and they will tend to over insure. the person who is healthy will look at the premiums and think that it is way too high and some will decide to under- insured. incentives for the plans are to avoid the sick and attract the healthy. here in washington, at open season time in the late fall, what kinds of ads do you see in newspapers? you see as a young healthy people with children and the implicit message is that temecula put the people in these ads, we want you in our plan. -- the implicit message is that, if you look like the people in these ads, we want you in our plan. if you have aids or some other difficult-to-treat condition,

consider us. remember the phrase "you are in good hands with all state?" they have a catastrophic seen and they say, we know that you do not care about health insurance until you have an accident. but when the really bad thing happens, they say, we will take care of you. in health care, however, it is the other way around. we give health insurance companies an incentive to attract the healthy and tell the sick or potentially set that we hope you do not get sick at all and we wanted to go someplace else. you do not want to erect a health care sense of -- a health care system that avoids people who has problems. one that is better is the medicare advantage programs where they tried to recruit senior citizens with high health care costs because they know they will get a premium that is much higher than

the premium paid by everyone else. we have in this loppers incentives foridua iiv. we have a fine for being uninsured, which is, quite frankly, not great enough if you want to make the premium completely independent of people's expected health care costs. in massachusetts today, people are going barehen they are healthy. they are signing up for health inrance after they get sick. the number of people who do that is increasing each year. it is a small problem for massachusetts right now, but it will be a huge problem for dallas were coming in dallas, they find that medicaid patients end up in the emergency room. it does not matter so much to medicaid because it is taxed pair -- it is taxpayer-funded anyway. bluecross will not survive very long in the health-insurance marketplace. we have made promises that we

cannot possibly keep. according to the congressional budget office estimates, we will ensure about 32 million people who would otherwise be uninsured. if the economic estimates are correct, those people go out and try to double the amount of health care that they have been consuming. we have millions of people, 90 million in the last estimate, that will have access to preventive care with no deductible and no copayment, benefits that they did not previously have. let me give you some idea how bad that is. economists at duke university estimated if everybody in america went out and got the preventive care that is prevented -- that is recommended by the preventive care task force that will set the standard for the new health plans. the estimate was that the average primary care physician in the united states would have to work more than seven hours every working day to ride these services, essentially providing services to help the people,

leaving little time left over to take care of the sick. what i'm describing is a huge increase in the demand for care. in this legislation, we did little or nothing about the supply. early on, there were versions of the bill that had line-item expenditures to produce more doctors and nurses and so forth. but all of that was zero out on the final passage, probably to keep the cost of the legislation down. the cbo that probably figured, if we do not have many more doctors, they cannot deliver more care, and we cannot spend more money. but what we will have is a large increase in demand, no change in supply, and a huge rationing problem. in this country and other countries, we do not primarily care -- we do not primarily pay for care with money. we pay it with time.

please stand by

patientscases, medicare phag have trouble finding people who will serve them. the elderly may be there as well. if medicare payments to drop below medicaid, the elderly may behind the low-income families in getting their care. there are large burdens here for these dates, where it will be --

for the state, where it will be difficult for them to meet them. this legislation does nothing to solve the problem of portability, which is the biggest problem that most people have. there is no legislation that produces affordable health insurance. it regulates both the patients and doctors. if we really want to solve health care problems, we want to get rid of waste in the system and higher-quality care. many patients and doctors who will do it. but there will lead to a gifted and had incentives to do so. -- but there will be no incentives to do so. every patient, every doctor, every nurse, and every hospital the administrator will have to do just that, lower costs and raise quality.

i want to turn the program over to my colleagues. this program is co-sponsored by the heritage foundation. robert moffitt who is here today was very kind to put this program together. >> thank you for the chance to be here during the since -- during this event. obviously, this is a central piece of legislation and one that ought to be examined very closely. i want to echo the remarks that the john made about the impacts of the law from the perspective of health policy. but i was taught that, when one looks at legislation, it must look at it in the context of the nation's problems. the top two problems in the nation today is an economy that is badly underperforming and the need to generate jobs for americans and a federal budget outlook which is coming in and

of itself, so threatening as to really cast in doubt the future prosperity and freedom of americans. this legislation is quite damaging from the perspectives. first of all, the health care sector is now moving to one- fifth of the economy. everything john set about improving incentives in that sector would constitute improve economic policy, and getting higher quality in care and less cost and improvements in efficiency. those are things that we ought to support as a matter of economic policy in the united states. on top of that, there is sspill over to the rest of the economy. you can save $500 billion in taxes over the next 10 years. i do nothing that anybody in the room would say, if you want to create jobs, should we raise $500 billion in taxes over the next 10 years?

some of those taxes will show up in the form of reduced incentives. there is a so-called medicare tax, a surtax on investment incomes for high-income americans. that is a pure trackincrease inx on marginal tax rate. it will have the same kinds of entities that were the subject of so much discussion and recent debate over extending the 2001- 2003 tax laws. small businesses and entrepreneurs in america will create new firms and generate job growth. indebted in this bill is damaging incentives for those individuals. there are all sorts of inputs into health services that will lead to higher costs to those services when held some -- to those services. when health services are more mix and sift -- more expensive,

there will be higher premiums. you will see the bottom line show up in every small business in america. every businessman will have to do the calculation that says i have to pay my workers less to cover the cost of the premium increases i am seeing. there will be some workers, those in particular with minimum wages, where you cannot lower their cash to offset the premiums. we will see those jobs go away. again, it will be the low-income workers were primarily damaged by this bill and the economics at -- economic incentives that are in it. this is a recipe for less less jobs in america. it is a recipe for slower economic growth. that is just putting the $500 billion in taxes in. there is nothing about sending out checks for $1 trillion worth of seven cities that will generate job growth in the united states. nothing about that has ever been

a successful path to economic performance. i believe that the nature of the subsidies -- i want to echo what john said -- in addition to the real efficiency costs and the growth impacts of this bill, there is some deep and fairness associated with how these subsidies are distributed. the example he gave was a rare one. there are two people who are otherwise identical. you have one woman making $70,000 and gets her entrance from air her employer and gets the tax benefit from the employer-sponsored insurance. another woman making $70,000 goes to the exchanges and get $7,000 in federal subsidies. that is an industry that is so profound that it will not be allowed to persist. one that i am deeply nervous about is that a future congress will fix that in every by giving everybody $7,000 and making the bottom line cost so much more expensive than it already is. i want to turn to the budgetary

implications. they're very closely related to the economic incentives. there are many ways to look at the budgetary implications. the first one i would ask you to begin with is the last one. set up two new open-ended income of programs that will grow at 8% per year as far as the eye can see. that is faster than the economy will grow. it is faster than any notion of revenues will grow. we will set two new programs that will grow faster than the economy for as far as the eye can see and we're supposed to believe that it reduces the deficit. it is impossible to make that claim with a straight face. we have cbo estimates of budgetary impact which showed a deficit reduction from the bill. but i do not think it is widely understood that this particular estimates and the nature and that thoserules -- thu particular estimates are forced

by the nature under which the cbo has to follow the rules. if you take away those rules and look at this in any realistic fashion, our estimate is that the bill would reduce the estimates by $500 billion the first 10 years and $1.50 trillion in the next 10 years. that is an important thing from the future the economy to the fairness perspective. the rules are so offensive and it has to do every young person in the audience. this bill is the biggest generational money grab in history. it forces every young american to buy insurance, thereby pay for the cost of those who are older and sicker than them, and then, having done that, when

they get to the end of their working careers, they will inherit the trillions of dollars in debt that this bill will produce and will be saddled with paying that off as well. from any perspective of fairness, that is simply wrong. it comes at a time when it is also dangerous. everyone has heard a lot about the budget outlook. regardless of which one of the particular forecasts you look at, the united states is in the fiscal situation that is unprecedented in its history. over the next 10 years, we are likely to run deficits that averaged nearly $1 trillion by the end and zero of -- an average over $600 billion each year. at the end of six years, we will have over a dollar trillion in deficit. we will be borrowing just to pay for the interest. that is a recipe for financial disaster. all along that path, we will meet the technical criteria for downgrade. that is the fiscal outlook before they passed this

legislation. this legislation will make it worse. i stipulate that introducing a damaging bill to a stiffest -- to a dangers fiscal situation will not generate jobs. thank you. [applause] >> thomas miller is a former senior health economist and is now with the enterprise institute. if you're interested in health policy and you look at the journals, it is hard not to find tom miller everywhere you look. let's give him a warm hand. [applause] >> thank you very much, john. there is a lot of repeal-and- replace work to be done. you can also find them at our

website. coming soon also, with my co- author and others, "y obamacare is wrong for america." look for it. today, john asked me to focus on something else -- how to improve the health care delivery system and health care quality through u.s., political, and other ways and means. we have to give chase the way we think about the issue. there should be health outcomes and value. helter quality is too often viewed in process terms, -- health care quality is too often viewed in process terms. there is no single setting. it does not mean there are not

institutional process no- brainers. that is just not the big story on how to get better value. we also need to reach beyond the conventional health care delivery system. a wide range of actors shape it. two different individuals should have exactly the same health insurance and differences in health, both initially and after getting the same diagnosis and it can be vastly different depending on where and how they go to for treatment, how to make decisions as patients, and a host of other factors earlier in their life that brought them to that particular point. " we always forget to look for the health outcome keys that are lost from the health care

funding lampposts. let's be more humble about providing simple guarantee answers. the patient protection and care act is promising what is unbelievable and what is all too predictable. in the flyover land of the law, the unicorns and health care delivery reform miracles, or science fair projects that never got out of the exhibition hall, we have various 3 iterations of repackaged centralized command and control edicts from the usual sources who issued the previous ones that failed outright or aggravated the systems pre-existing chronic conditions. the latest cliche is that every idea for dealing with health care is --

they managed to leave out a few important ideas, like choice, competition, personal responsibility, truth in labeling, market pricing, respect for personal preferences, incentives for better performance and decision making, double entry bookkeeping, and even arithmetic. most of the quality of experts who tried to sell the message bore over that most americans do not hear or believe, yes we believe the health care costs are too much, even though you only see a fraction of the full expense directly or there are too many barriers of getting more of what we want when we wanted, but a vast majority actually think that the health care they receive is excellent or good. that is partly why you will hear politicians talk a lot more in public about high health care costs or spending on the uninjured and the patient

protection affordable care act provisions. the reality is that our health care system, although excellent in many important ways, is not perfect. different approaches could increase its value. with some more on his choices, it could push forward in a more competitive and transportranspat marketplace. the meter is running on my time. first, throttle back a good bit of the overbearing regulation. two, guarantee a socially acceptable floor of health care services for the less fortunate, but stopped attending to subsidize some much of everyone else's bill when it mostly becomes more wasteful rounds of dollar trading. 3, stop pretending that all care must be high quality and can be

high quality and available to everyone all the time. instead, let's encourage more competition in seeking and delivering care whose value continues to improve from whatever it is in the moment. you cannot just imagine the merkel of a totally unfettered free market -- the miracle of a totally unfettered free market. policy changes can help private parties compete in measuring and reporting better have different parties in the health care system performs so they can be rewarded. i have written about this in greater length elsewhere. the new law is not totally barack -- not totally moronic. but it is on a consensus standards that, by the time they are derived, they're too weak, too unrealistic, or to outdated, and perhaps all three of the same time.

while other provisions drive to a more concentrated health care marketplace, it is less competitive and more politically dependent. we cannot expected to be perfect. we cannot measure everything or even most things. but we should use what is best available within limits of current data and measures while acknowledging those limitations. we should also shut up about quality when we do not know one way or the other. decide what you really want to waste your money on. we need information much more about provider performance and about insurers and the insurance they offer. and about physicians, not always that the group level, the information needs to be a combination of measurable health

outcomes or intermediate markers for them. it is the value combination that matters, not just quality, cost, or price alone. this whole area is complicated, contentious, a evolutionary, and full of caution and caveat. but we ignore it at our peril without beginning to engage. basic sweeney are to do aggregate data and -- there are basics we need to do to aggregate data and assess it. thank you. [applause] >> thank you, tom. michael cannon is at the cato institute. some months back, he recruited a university of chicago professor to show us how we really ought to be handling the problem of pre-existing conditions.

we had a lively discussion of it at my blog. i have asked him to tell you about it today. please welcome michael cannon. [applause] >> thank you, john. thank you all for coming. i may have to leave before the question and answer period. if you have any further questions about my remarks, i encourage you to visit the cato institute web site. you may have heard today that the department of health and human services released a study that says that about half of non-elderly americans have a pre-existing condition and repealing the health care law known as obamacare would mean that those folks who have trouble getting coverage. but, in obamacare, it guarantees that those folks would get coverage and the care that they need. there is problem with that. a government survey conducted just a few years ago found that only 1% of americans had ever been turned down for health

insurance. that is consistent with other research. research by the rand corporation looked at lightly regulated individual insurance markets, such as california's, and found that lots of people with pre- existing conditions get injured even when the insurance company has the ability to deny them coverage or to charge them higher premiums. it is a tricky thing, really, to get people to keep the promises that they make too sick people. this is true whether you are talking about pollock health let's look at the record. there was a long- term promise to sick people. employer-sponsored health insurance. if you know that history come you know that this market is a creation of government. in the 1940's, the government through a series of accidents

decided that employer-sponsored health insurance would be exempt from payroll taxes and income taxes, which created a huge tax break. have a corresponding penalty -- purchasing on your own -- if you want to purchase it on your own, it can cause people twice as much for the same or less coverage compared to getting that through an employer. this is the horse the government decided to back. but if you think about it, your insurance plan for your employer does not provide you a long-term promise to take care of you when you're sick. they only provide medical care so long as you are still connected to that employer. if you get sick and cannot work, you lose that health insurance and you run your own. the individual market, researchers have found, even with various regulations, fines

or secure health insurance than employer-sponsored health insurance. for people with high costs illnesses, they are likely to keep their insurance than that they had it through an employer. that is the situation the government created when it decided it would increase access to health insurance. nine out of 10 people with health insurance or in this employer-sponsored health market where you do not get a guarantee that you'll be taken care of over the course of a long-term illness. how about another khmer -- government solution and? we heard about the medicare program 20 years later. we're going to provide secure health insurance for people in old days so they created the medicare program for people over age 65. yes, medicare provides secure access to health insurance for

the time being. they do it in part by being completely fiscally unsustainable. we cannot continue to provide access to the medicare that seniors had been accessing in medicare for the past decade. in addition to that, one of the ways that medicare is so financially unsustainable is that 33% of medicare spending does not provide any value, does not make patients healthier or happier. that is where research shows as. and it causes most of

in any event, if we actually were to go down this road, you certainly want have access for senior citizens to private- sector options than many of them do not have today. it does not make sense because medicare advantage by $136 billion and reduce their access to those private plans or to maintain the existing limitations on senior citizens' ability to go outside the medicare program in contract privately for medical services that they need. if they have to go in a very different direction. ladies and gentlemen, we are entering today and tomorrow a

second phase of this great national debate. the one thing we want to keep in mind is that congress has direct responsibility as the board of directors for one of the largest programs, the medicare program, and they have to figure out a way to get this financial house in order. by now medicare has unfunded liabilities of over $30 trillion. please tell me, and is there any member of congress that knows right now how we're going to handle this financial challenge? does anybody know? the truth of the matter is, nobody knows. but we are faced with debt, and many of you are young people and you will in fact pay the price for inaction in this area. there is a way out. we have to think about restructuring medicare. if changing it from the existing, open-ended entitlement that exists today to a program which in fact is paid, on real competitive insurance. -- adjustsiums

premiums, and subsidies to -- ending subsidies. to get away from what we have today. we should provide the beneficiaries with a wide range of choice in health care plans and options and at the same time make sure that in future medicare systems that we will expand access to physicians and reduce the number who say they refuse to take medicare patients or accept new medicare patients. there are ways to do this. my own view is that many of you are enrolled in a program which is actually quite good in terms of organizing health insurance benefits, the federal employees health benefits program. it is driven by a true free market principles, direct competition. eat your dissatisfied with your health insurance package, you can fire your health insurance plan. that is not a bad option.

it is not an option for the future of our senior citizens as well. if they will have to depend upon making good decisions to give them access to the quality health care that they deserve. think you very much. >> thank you, bob. that was very informative and very good. i want to open up the floor for questions. if you will tell us you -- who you were directing your question to. let's have a handout. -- a hand up. well let me just begin by asking this question. to the panelists believe that senior citizens realize what has happened to them under this legislation, and what do you think will happen what the

medicare provision? will we go forward? we carry out the way law was written or will it have to be changed? who wants to take this? >> i bet it was very interesting that both the actuary at cms and the director of the congressional budget office both publicly stated and formal, official correspondence to the congressional leadership that they did not think that the medicare payment deductions were sustainable over time. but the cbo and the cms actuary. we have never quite gone here before at this level of payment reductions. i think that whether the survivor not, it is highly unlikely that these kinds of reductions will survive. >> let me address this question

to doug holtz-eakin. what happens when you have a bill with a huge expense and the way you thought you were going to pay for it does not pan out? >> nothing good. [laughter] this is been the history of entitlement programs in the united states. they are launched with fanfare, that includes their budgetary soundness over time, enrollments expand, benefits are added to what was originally envisioned, the incentives are such that no one is ever going to impose things on programs that cause the beneficiaries to scrap or say. so we get this enormously bloated title -- entitlement program. that is in the history and medicare, medicaid, and likely to be the future of this law unless we change course. we end up where we are today, with enormous structural deficits that are so large and

so troubling that they literally threatened to cut acid -- the capacity of the u.s. economy to provide a high roll standard of living than we have now and that is something we simply cannot do. >> we value currency with economic balances. we can also the value health care -- devalue health care, either explicitly or directed. >> you mentioned the department report that suggest that about 30% of the spending in medicare is wasteful and goes to -- is spent on care that provides no particular good for people, so my first question is -- doesn't that suggest that there is in fact allow that to be pulled out of medicare? and if so, how do we do that? steady path -- published last month looking at mcallen texas, and looking at variations

in medicare spending and they found that the variations and private spending. this does not seem to exist in private spending, at least in these two locations. my understanding it that the administration, a lot of plans for obamacare were based on the idea that this same sort of problems existed in private and public health insurance. what does this say about the reform and how will play out? >> the fat is measured crudely as an aggregate. 15 years ago, people are rediscovering that there is much variation in private-sector health care then there is and medicare. there was another program or managed care plans or there was a variation on a regional basis. the tendency of research is that there is a bias in the field. you go where the data is.

we had medicare data and you could show this type of crude variants and band you prop up a lot of theories around it. it could be true that the nature of the medicare program lends itself to more of that waste and variation without -- there are two principles in dealing with this. we're not ready to go there. putting money in the hands of the patients and the consumers? we have that that much. we do need some type of -- even though they are imperfect -- markers as to what is better or worse, not perfect, something in that regard. we're building a lot of matters which may not tell us that, but that is the general direction to go. you can always find it right here on the map in this particular area and pinpointing get that passed politically? probably not for you would probably have to decentralize that. >> let me add one thing to that.

tom's answer was very good. there probably is 30% waste in medicare. maybe there is more, but when he get the bill, you do not get an item that says these items are waste. then it would be easy to get rid of the ways. you do not know where the waste is. what we mean when they say say there is ways, there is inefficient hospital and minister are an efficient group of doctors that could have done this for 70% of the cost of was suspended. unless they have an incentive to do that, they are not going to do it. we have to get -- we cannot get rid of the waste unless it is in someone self-interest to do it. >> should congress even attempt to fix this legislation? is it possible that thinks this law or you think that tweaks as a whole cannot make it difference? the whole thing has to go? >> take your shot at it. >> the issue here is what is your vision for the future of

health care in america. what i think the law represents is a very specific vision of health care policy. we know our colleagues very well who disagree with us. frankly this is their vision of what health care system should look like. they believe, many of them very strongly, that health insurance plans should the public utilities and should be heavily regulated by the federal government, and the federal government should make the key decisions allocating resources in the health care system,-and making decisions about what will be covered and how will be financed. that is not my view and i think my colleagues here share my view. . but the bill does represent that point of view. having said that, i would say that in answer to your question that you actually cannot build a system based on free-market principles of consumer choice, and competition on a foundation

which is fundamentally incompatible with that vision. a foundation which is built primarily on central planning and bureaucratic regulations. again, that is not the personal opinion. that is what the law does. i understand that our friends on the other side, they have the very different vision on this. let me make one observation before i stop. in the early 2000's, the idea of the health insurance exchange became very popular among health policy analyst. the idea behind that was competition among private health-care plans. there had been riding on this issue. but at the university of california, a number of analysts got together and said, look, this is a great idea. if we should do is have a health insurance exchange with a taxpayer-financed public option. what was the purpose of it? it was very open and very

publicly celebrated. it was a way to get to a single payer health care system by basically undercutting private health insurance. that is the image, that is the vision. we have a different one. >> this was a package deal. it was not all you can eat, it was all you could stomach before regurgitating. you can also talk about a few appetizers. we have seen patients that probably need the entire meal. pulling one part that means the rest has to go, it's like saying i'll have one of column may, one of column b, and do not worry about the rest in that regard. we're pulling apart the most obnoxious features and playing for time. if the designers of this legislation want to institutionalize and make inevitable the early parts. this is something that can be

pulled up quickly and need to get on to what we need in its place. it does not mean that nothing remains. we have to be in front of things that make sense. >> after the repeal vote in the house, voting on a resolution, are you confident that with a goals to come up with replacement regulation will make the serious structural changes you're talking about on how health care is paid for? >> i think there is good reason to be optimistic on that front. what people not forget, given the events of the past few years, that is that if you dial back to the beginning of the roof health care reform debate in the united states, there was a tremendous amount of bipartisan consensus about the need for reform. if there was a tremendous amount of a consensus about what reform should look like, how much should provide incentives to root out low-valued care, to

centralize, and equalized across states, the cost differences we have seen, provide better insurance options. none of that was in dispute. so there is no reason to be at all skeptical about the notion that you could go out and find a common objective. it is also the case that there was a tremendous amount of bipartisan agreement on a whole lot of the delivery system reforms that would improve the quality of care in the united states. where there was great disagreement was in the nature of the insurance reforms and how doing -- how to cover more people. this legislation is by and large about ladder at the expense of the former. so we could go back and do better on a bipartisan basis by concentrating on the real problem, which is the u.s. delivery system, and not on massive expansion of check writing will power at the federal level. >> there is going to be a political gridlock in terms of

repealed for over the next two years. there will be a lot of forward movement at the state level with the exchanges as they look forward to 2014. does it make sense for one state or multiple states to try experimenting with some of the models who have outlined here? resistance, one model, not just private insurers but also medicare to participate? >> a lot does not allow enough of that experimentation. the states will have to be more aggressive than what are going to be the rule sent down from hhs. there is some leeway but you get into this plea-bargain game where you think, give me more slight, can i have a few more? it does not actually turn it around. i will be speaking tomorrow at the national congress on health insurance reform. there is a different way to do exchanges. to some extent, states have to put something on the ground

which is not going to get that within the parameters of what they're told in washington to do. they need to get examples the work in the next two years and see what we actually prefer. dobie things that make sense to the people that live there or an entirely different regulatory scheme which is not where we need to go. >> the only thing i would add to that is that the administration seems very desperate to me to get something to work. i think that is why they gave waivers to 1 million workers, including 30,000 mcdonnell's workers. they do not want to be embarrassed by bad things happening. they want to see some good things happening. that makes me think that they might be willing to be flexible. yes? >> what doctors, the physician payment cut, they are not going to get paid anything, who would want to be a doctor anymore, and how are we supposed to fix that?

>> anybody want to take that one? >> let me take a shot at it. no, i honestly think that one of the most serious problems facing the country is the demoralization of the medical profession. physicians are dispirited. many of us have an opportunity and it is a great privilege for me to have an opportunity to address and talk at professional medical meetings were members of the medical profession are gathered, and the talk among themselves a lot about the profession and how they can function in this environment. the environment for independent medical professionals is becoming increasingly hostile. you are expected now to go to work for a hospital. you are expected to join a large practice. at the same time, you are expected to absorb a massive

number of people who are going to be getting care under medicaid. medicaid, really, if you want to talk about the big change in this bill in terms of insurance coverage, if what we have with all the people getting health insurance will get it through medicaid. talk to decisions about what that means. it means that every single time, the patient walks into the room, the patient is going to incur a financial loss. it also means that more and more people, are going to end up in hospital emergency rooms. this is been completely overlooked in the past health care debate. the degree to which medicaid is a driver of hospital room overcrowding, i think the situation is very serious. the only way to change that, it seems to me, is to change the fundamental underlying financial structure of our health insurance system. where we basically have an opportunity for people to buy

the health insurance which is best for them, and enter into the kind of relationship with the doctor that used to be the norm. what i am saying and it is pretty radical here, what we ought to do is make one of the goals of health care reform the restoration of the traditional doctor-patient relationship for those who wanted. not all people wanted. but many of us do. that is why the president has spent so much time saying, in form after form, if you like your relationship with your doctor, you will be able to keep it. the problem that you and i are struck with it that you may want to keep your relationship with your doctor but your doctor may not be able to keep his relationship with you. >> i think that goal of one-to- one relationships, you can just be around doctor now. >> dr. burgess is with us here.

doug holtz-eakin tells me that there are 20 doctors in the house of representatives with a margin 80 new members and the house, 20 or doctors. ted and i hope we will hear from all of you in the debate that starts later today. >> it tells you how hostile the medical profession has become that we seek refuge in congress. [laughter] >> we are glad to see you there. >> there no requirements for reserves, class is that only have to pay $5 increments while others have to pay to under $40. can you talk of the sustainability of a program like that chris mark >> the class act is a new long-term care insurance program whose basic structure on paper is, pay premiums in what you were, it

looks like a payroll tax, and once you're in for five years, you're eligible for benefits. we've seen the structure before for social security, medicare, and they are in deep trouble, given the way that they are structured. just to quote someone who would know a lot about this, kent conrad called upon the scheme. i think that as an optimistic. because the way the program is set up, it looks like an enormous amount of adverse selection so that the people who want to claim benefits will have well above average costs. the premiums will become the were close to paying -- no where close to paying the full cost. they could get into a death spiral, but it would just be shoveling much more general revenue into it. on the quality of the policy,

one the worst parts of the bill, and not any way i see to redeem. the fix this or repealed? you that just got to repeal the class act. it is underlay unworkable and dangerous. >> and we have this commission set up telling us what to do about on funded entitlement programs, and then we pass a bill that creates another one. >> the president's on commission and its final report recommended repealing the class act. that is a very telling recommendation coming quickly after the bill became law. >> one of the debates that congress has had is about earmarked for it lobbyists come up and get special treatment and now we have hundreds of waivers being sought for the department of health and human services. is this another prescription for political favoritism in the granting of waivers, much like we've seen in the corrupt

practices of earmarked. >> it is incredibly troubling. the waivers we have seen already up and that they see evidence of the and workability of the law. -- are prima facie prima evidence of the un workability of the law. there appears to be no particular transparent process by large kurds -- by which large groups could get a waiver to keep the competition fair. it is a really troubling aspect of the implementation of blog. >> i would like to so that. if we have time for one last question. anyone want to ask it? >> the delivery reform aspects of the bill. they're a been a lot of fun coordinated care and i was curious what you think that focuses good, and if so, that

consumer-directed approach, can deal with these issues? >> coordinated care, managed care, evidence-based medicine, pilot programs, do you think that the workers are more >> randomly, yes. in an organized, political fashion, and a. if you throw enough money at something, a few things will seep out. but it is organized in a way that seems to stop innovation could you do not have that up -- the feedback that determines what works and what does not. you're trying to manage from on high and thinking that you are calling it innovation. you get no incremental gains. we will also have markets with incentives with people spending their own money, the fastest route to innovation. >> the fundamental problem with our government health programs is that we send a message to consumers that they can have all the highest quality -- quality care that the one at no cost.

and then we tell the providers, cut it out. stop charging so much. we do not pay them and that is why they are discouraged. you can put everything you want in the mill that. until you address the mismatch between the promise and the capability, it will not work. and we have been doing pilot programs and experimental programs trying to find out what works of that everyone can copy it. for 25 years, it has not worked in education. it probably will not work in health care. thank you all for coming. [applause]

>> also on capitol hill today, democrats assembled a group of citizens opposed to the repeal of the healthcare law. this part of the event is an hour. >> shortly after treatment, i began my work as an advocate for the national press cancer coalition and for health care reform. since 1995, i have been without a reoccurrence of the disease. that sounds like a great story, doesn't it? a story with the best outcome you could hear when learning a family member or a friend is

faced with breast cancer. well, as most aspects of life, it was not that simple. in 2000, my husband, and lost his job and in turn health insurance coverage for our family. he decided to open his own consulting business and elected to continue health coverage through cobra. we remain covered for 18 months. the maximum time allowed for this interest. calvin and i began shopping around for new insurance plans. once we found one, it seemed to be a good fit and we apply. california been in my only son of the three still at home in time or approved. -- calvin and my only son of three still at home at that time was approved immediately. i supplied information but did not hear back for two months. i tried to find out what the holdup was. i did not get a street dancer.

a total of four months went by until i found out definitively i was denied insurance. when i asked the insurance representative point-blank that if i was denied coverage due to my breast cancer diagnosis years ago, i was met with heavy silence. the best they can offer me was a recommendation to find and ensure who would offer me health insurance. i lived without insurance for three years. during that time, i broke my foot twice, had to visit the emergency room each time, any time i had a cold or needed treatment for a common ailment, i visited the walk-in clinic. all of these this its had to be paid out of pocket. at point -- at one time, i had a mammogram. a technician found a suspicious mass and recommended a biopsy.

thankfully, the mass turns out to be scar tissue but i still had to pay full price, out of pocket, for this costly screening in surgery. it turned out to be a false alarm. i wish i could explain to you what it is like every day with the knowledge that your press cancer could come back, and to couple that fear with reality at being uninsured is devastating. after three years without coverage, my family and i moved from california to virginia. we wanted to start over. we wanted to look for new opportunities near where my husband and i both grew up and had family support. calvin and i were able to find work and health coverage through his employer. but for three years, i never knew if there would be a recurrence and i would not be able to afford the care that i needed. i lived in fear that a cancer returned, i would not have insurance to pay for the treatment to enable me to beat

the disease again and continue living as a healthy breast cancer survivor that i had been for the last 16 years. for years, i have been a field corner, team leader advocate for the national breast cancer coalition. i have fought for health care reform last year, and proudly celebrated the passage of the patient protection and affordable care act. for me, this law represents protection from the uncertainty and fear that came with being denied health insurance coverage because of my past disease. it represented freedom for my husband and me to make important choices about our lives and careers without the specter of pre-existing condition hanging over our heads. and it means that no other breast cancer survivor would be forced to walk in my shoe. but removing these protections would bring a halt to the

progress and mean a huge step backwards for all of us. >> thank you very much, for taking the time to share your story with a sprig of like to recognize another. welcome to the committee. thank you for your time and for your willingness to share your history with us. >> i want to think chairman miller, chairwoman delauro, leader pelosi, democratic leadership, and others for this opportunity testified. my 22 year-old son is a full- time college student, works part time, and is also a hemophiliac patient. his condition requires periodic testing and leaves them vulnerable to the more serious complications and conditions.

prior to consumer protection, he could not stay on our family's insurance. we were quite concerned about the options that we had at that time, which for him to go uninsured hoping for the best, or to pay huge premiums if we were able to find coverage for him at all. we now have the right to keep him on our insurance until age 26, giving him time to finish college and get a full-time job. this also ensures that when that time comes, he will have the insurance options available to him even with a preexisting condition. repealing important and consumer rights means not only that my son will not be allowed to stay on our insurance policies until 826 but that he will not set a date when pre-existing conditions do not dictate the ability to get health insurance and insurers cannot charge astronomical prices for conditions you cannot have any control over.

many students are in this exact position. well educated youth -- this legislation is very helpful to support building our country's intellectual capital math as azeri to move us forward in the global economy. allowing us to keep them on our insurance until age 26 came at the perfect time. by age 26, we hope that he will graduate and have a job. we have the option to keep him on our insurance at a time when family so often to keep their kids covered all are left worried about how to cover kid. >> all like to recognize ed burke. thank you for joining us. >> [unintelligible]

>> they are not picking up your sound. bring it closer to you. thanks, ed. >> how was that? usually i am told to be quiet. i wanted that bank chairman willard, and my fellow floridians, ms. wasserman schultz, as well as the families usa and others. my name is ed burke and i'm a 52-year-old severe hemophiliacs. it is a bleeding sore that can be inherited or come from a spontaneous gene mutation. i opposed the repeal legislation being considered in the house of representatives this week, simply put, because they will lose the freedom to lose my job if efforts to repeal my protections are successful. i grew up in the serbs of

philadelphia, pennsylvania, with an older sister and brother and younger brother. in the 1960's, the only treatment for an internal bleeding disorder was an infusion accompanied by a few nights in the hospital. when the medical bills arrived, their offering noting that we had a pre-existing commission and the insurer did not cover any medical costs. this seemed audacious same -- since my parents worked full- time jobs to make sure they had adequate benefits for other children. even though they paid their monthly premiums for a family of six, the insurance kept their money without providing any assistance with the mounting medical bills. to me and to millions of americans with a chronic

disease, this was a blatant discrimination. but our new protection into this practice, protecting individuals with preexisting conditions and providing families with the security they deserved. as you said earlier, $125 million and we are up to four more already. those individuals in the united states to have a chronic disease, a disability, or a functional limitations. these americans account for three-quarters of the nation's health spending. nearly all medicare and morally -- more than 80% of medicaid spending, it is attributable to chronic disease. i bring those statistics to your decision -- attention for the following reason. in the mid-1970s, a medical break through for hemophiliacs was discovered. we did receive an infusion of the protein our bodies to not make and we control our bleeding

episodes. unfortunately, this new madison was and still is very expensive. for me at 6 feet 4 inches and 200 pounds. [laughter] >> looking good. >> i and use 15 jens a week, at $100 a unit. it cost me a million dollars annually. this has been highly problematic due to the health insurance industry's creation of a lifetime caps. most americans to their employer had a two-man dollar cap on insurance claims and help the american with no chronic disease will have been able to have gotten by with a long time without reaching the cap. but for someone like me, this can be devastating. actually something wrong?

once you had reached your lifetime cap, he paid for your health care out of pocket or you change jobs and sometimes even careers in order to have health benefits in the new cap. in the end, lifetime caps forced you to make tough life altering decisions for you and your family. often forcing the individual like myself onto it federal or state insurance program that other taxpayers like yourself will pick up the bill for. however, for new patients rights prohibits insurance companies from adding such caps. they even removed annual limits so that any american can receive all the care that they need without fear. it leaves them to focus instead on living as healthy and will live as possible. when elected officials are voting to repeal patients' rights legislation, they are in reality forcing americans like

myself, all working, taxpaying citizen, back for world where health insurance is constantly an issue and lifesaving care is often out of reach. that, my fellow americans, is about to occur in the halls of congress. i stand here today or sit here today in front of my representatives and asked them not to play politics with our lives. i recalled last wednesday when president obama, regarding the tucson tragedy, he was happy to share with us that representative gabby giffords had opened her eyes. i hope that the rest of congress will do the same. thank you very much.

>> i am a cancer survivor, ovarian cancer. my colleague, debbie wasserman schultz, his breast cancer survivor. the fact of the matter is, the specter of those recurring illnesses is always there if you are rich in the notion you could not get care, getting it paid for it is pretty intimidating. dr. cohen, we would like to hear from you. >> good afternoon. i stated before, my name is a debt cut in -- odette cohen. i am on member of a small practice in new jersey. i think chairman miller, chairwoman delauro, leader policy, and the members of this

committee for inviting me here to testify. small businesses are the backbone of our economy. in new jersey, we account for 98.5% of the state's employers. and another 590,000 new jersey residents are self-employed. on behalf of the new jersey small businesses, i think you for the work you have done to enact legislation to make health care were better for us. as a small business owner, i opposed efforts to roll back protections and benefits of the healthcare law. both my business and my patients stand to lose important benefits if the law is repealed or if it is voted down. -- water down. as a small-business owner, when i started my medical practice 20 years ago, i was not able to afford medical coverage for my employees. i was therefore not able to compete successfully for the

most qualified applicants. i lost many of them to larger companies that offer better benefits. now that i do offer health insurance coverage, in 2009 my premiums when up to 30%. last year, my premium went up 50%. hickey%. i was forced to change my plan for a less quality plan with higher co-payments. it felt like being in a sinking ship. but all that has changed because of the new health care law. it has come in handy as it throws a lifeline to small businesses like mine by protecting us from on reasonable rate hikes.

my business is one of an estimated 144,000 businesses in new jersey that could benefit from the new health care tax credits. the monies that i will get from these tax credits gives me the option to be able to absorb the increased rates that my employees would be responsible for, or pay benefits for an additional employee. as these credits and other incentives expand over the next four years, i am hoping that i will be able to hire one more provider and some support staff. repealing these credits would prevent me from expanding my taxes and creating jobs in my community. i am also looking forward to 2014. this is when the state insurance exchange is expected to be up and running. through the exchange, my business will be able to pull together with thousands of other

small businesses across the state to be able to access quality insurance plans for lower costs. a vote to scrap these exchanges is of vovovovovosind the discrimination and the lack of bargaining power small businesses face today in the insurance market. as a physician, i am keenly aware it that patients are not getting fair value for their premium dollars. insurance companies use premium money to pay for things that have nothing to do with health care. things like executive bonuses, lobbying activities, and expensive political advertising. but now, thanks to the health care law, small businesses and other consumers can count on having a basic level of value for our premium dollars. and insurance companies -- if

insurance companies do not meet minimum standards, we would give rebates starting next year. i say it is about time. small business owners and our employees should have the same rights of protections as everybody else. but that is not how things worked before the new law was passed. i know this from personal experience. in 2008, two of my first cousins were diagnosed with cancer about the same time. my girl cousin, her name is rhonda, 25 years old, she worked for all large corporation and have health insurance coverage through her job. as soon as she found the something was wrong, she sought help. despite the fact that she was diagnosed with the most aggressive breast cancer for a young lady, she is well and alive today because she was able to see care early.

this is the sow for my other cousin, roger. -- this is not so for my other cousin, roger, who was 35 years old. he worked for small business that could not afford health care insurance. uninsured, he did not seek care early on. when his pain became unbearable, he went to the emergency room. he had gone a couple of times but this time the pain was quite unbearable. within a couple of days, he was diagnosed with end-stage metastatic cancer. roger died a couple of days later. because he worked with a small business because of large company, it should not be out choice between life and death in the united states. but what was the choice for my cousin? the new health care law changes that, giving small businesses and our employees the basic

security and protections we deserve. these lifelines -- tax credits, stronger rate review, new consumer protections, and the insurance exchanges -- these all help give small businesses a fighting chance to gain access to quality affordable health care. as a small business owner and a decision, i believe we must continue to advance policies aimed at providing quality care for everyone. we must also a defense policies that puts health care decisions back into the hands of patients and doctors, and also for rewarding quality care. we must also not step back into the broken health care system of the past. i urge you to stand with us, main street small businesses, rightsose patients'

repeal legislation. thank you so much. >> bank you, dr. cohen. thank you for your power for march. will hear from alexander look tight, our student. >> they keep. democratic leadership and committee members, thank you for having me here today. my name is alexander left side -- lataille. this past year graduated from congress -- from college. i was looking for a job and as you can imagine the economy has made it harder for companies to hire new people. however by graduation day, had believed they had secured a great prospect working with a private company contract with the federal aviation administration. nevertheless, due to budget issues, timing and o