child dying for freedom in afghanistan and iraq, and ask god to bless the house and senate that we will do what is right in the eyes of god for his people here in america. i ask god to give wisdom, strength, and courage to the president of the united states that he will do what is right in the eyes of god for his people. and i close three times, god please, god please, god please continue to bless america. i yield back the balance of my time. . the speaker pro tempore: members are reminded to make their remarks to the chair. we have somebody in front of you. sorry. the chair recognizes the gentlelady from california, ms. woolsey, for five minutes. ms. woolsey: thank you, mr. speaker. actually, i would have yielded to the gentleman from colorado, but i have a markup right now.

mr. speaker, tonight the president of the united states has an opportunity to show the bold leadership that the american people are crying out for regarding afghanistan. tonight, he will announce how many troops will be redeployed out of afghanistan. this must not be, as early reports are indicating, a token withdrawal, bringing only as few as 5,000 troops home now and 5,000 troops home by the end of the year. because that number falls tragically and painfully short of what the national security and moral decency demands. there are many interpretations, mr. speaker, of sizeable swift or significant as the requests for him in his drawdown, but

none of those interpretations go so low as 5,000 now and 5,000 by the end of the year. sizeable, swift or significant is not what 5,000 troops would accomplish. 10,000 troops doesn't even bring us to where we were before the surge. that's not a new way forward in afghanistan. we were promised a new way forward in afghanistan. and it's going to take 18 months just to get even that much done. how many times are we going to move the goal post? anything less than a major shift in afghanistan policy will be a huge disappointment to the americans who are paying for it in blood and treasure. clear, strong jorts of our

country -- majorities of our country believe it's time we finally end this awful foreign policy blunder. this is not a partisan stance. you just heard congressman walter jones from north carolina. this is common sense. several republicans in this body oppose this war. even some of the republicans running for president have expressed concern about continuing the military occupation much longer. it's simply not acceptable to ask for more patience and more time for this strategy to work. you mean 10 years isn't enough? how many families were missing a seat at the table on father's day this past weekend because we kept giving this dreadful policy one more chance? afghanistan casualties are on

the rise, mr. speaker. with 2011 on pace to be the deadliest year yet and 43% of fatalities having occurred since the surge began a year and a half ago. how many more people have to die, mr. speaker? both u.s. service members and afghan citizens before we say enough? how many more lives have to be destroyed, how many more young americans have to leave limbs behind in afghanistan, how many more have to come home ravaged by posttraumatic stress, and how many more billions in taxpayer money do we have to waste for the principle of having our people killed and our global credibility destroyed? for pennies on the dollar we could fight terrorism the right way, with a sievian surge that

emphasizes humanitarian and political aid and reconciliation. mr. speaker, it continues to pain me that we have to scratch and claw for every single dollar of federal investment in the american people. one child nutrition program last week was held out there as an example of what we don't need. but we do. but also we're scratching to support health care, education. even support for veterans. but we still continue to waste $10 billion a month in afghanistan. in the time i take to give this speech, roughly $1 million will fly out of the treasury to pay for this war. mr. speaker, i implore the president to listen to the american people.

tonight is a moment where he could make history. end the war, bring our troops home. i yield back. the speaker pro tempore: the chair recognizes the gentleman from texas, mr. carter, for five minutes. mr. carter: i ask unanimous consent to address the house. the speaker pro tempore: without objection. mr. carter: mr. speaker, i rise today to urge the democrat leadership in the senate to merely take up the fiscal year 2012 department of homeland security appropriation bill which was passed by this house on june 2. with the 10th anniversary of the tragic attacks of september 11 rapidly approaching, the proliferation of violence along the southern border and natural disasters, it is irresponsible for senate democrats to hold up this bill any longer. the house passed bill included $1 billion in supplemental funding in fema disaster relief program that is available immediately upon passage. these funds are desperately

needed to respond to natural disaster that have swept the country, including the wildfires which have devastated my home state of texas. the house-passed bill uses taxpayer dollars wisely, cutting $1.1 billion from tweer 2011 levels while -- from fiscal year 2011 levels while making sure that the border security and others are fully funded. it putting the security of american citizens at risk and disaster relief on hold. any further delay is unacceptable. i urge my senate colleagues to make passage of f.y. 2012 d.h.s. appropriation bill a top priority, and i yield back the balance of my time.

the speaker pro tempore: the gentleman from colorado. mr. polis: i ask unanimous consent to address the house for five minute. the speaker pro tempore: without objection. mr. polis: 40 years ago this month, president nixon launched the year on drugs. four decades later, i ask americans to share with me their thoughts on what i believe would be a major public policy failure. just listen this story from neal from baltimore. late in the evening on october 30, 2000, neal was telephoned. late night calls weren't unusual. he was told that one of his officers was shot and taken to the hospital. the officer was a corporal and undercover narcotics agents for the maryland state police. he was assigned to the dreg enforcement task force and was buying drugs from washington, d.c. when the dealer decided he wanted both the drugs and the money for himself. he returned to the car the officer was driving, paused for

a moment and shot the police officer at point blank range on the side of his head. arriving at the hospital, neal was guided to the room where the officer laid with his headbandaged and bloodied. neal finished this story writing, when the people are gone and the quiet come, the question becomes why? he rehashed the evept. how could this happen, what went wrong, what was the protocol? the questions i was asking dealt with the symptoms of the much larger problem, the war on drugs. every comprehensive objective study has recommended that adults should not be criminalized for using marijuana. medical science tells us by any reasonable health standard marijuana is comparable to alcohol. it's less addictive, less toxic and unlike alcohol, marijuana does not make users aggressive and violent. and we also know the

criminalization comes at a very high cost. each year more arrests are made for marijuana possession than for all violent crimes combined. again, each year more arrests are made for marijuana possession than for all violent crimes combined. marijuana arrests in the u.s. average 850,000 a year. that's one every 37 seconds, and 89% of those are for possession, not manufacture, not sale. now, marijuana prohibition is having a negative impact. we have mexican drug cartels growing millions of plants on federal land. we've been down this prohibition path with alcohol and it failed. it increased crime and violence. crime bosses got rich. murder rates skyrocketed and the prison filled. we're seeing the same results today from marijuana prohibition. prohibition does not stop people from using marijuana. in fact, marijuana is the largest cash crop in the country. it just gives criminals and violent gangs an exclusive

franchise on marijuana sales. it drains resources from laumpt that would better be -- law enforcement that would better be spent fighting crime. it makes it harder for keeping it away from children. what have we learned from the four decades of the drug war? the biggest part of the harm involving marijuana involves with the criminalization of marijuana and it's time to end. brian from due page. when brian's son was in eighth grade, an incident in school led to a discovery of a small amount of auverage marijuana. the real tragedy followed. as a result of the incident, brian's son was expelled and barred from re-entering any school in the district. he was forced into a school of delinquents where he was grouped with kids who committed violent crimes. he was basically treated like a criminal. here's what brian, the father, had to say about his son's experience. to do this to teach my son a lesson, it didn't help him.

it harmed him. the school district solution to finding a small bag of marijuana was to expel four students, no education, no counseling, no help. just kicked them out and washed their hands of the whole thing. now, using marijuana is harmful. smoking is harmful. drinking is harmful. in fact, i applaud the f.d.a.'s new highlighting of the dangers of smoking and encourage similar efforts to discourage marijuana which are impossible under the colonel criminalization regime. it wastes billions of dollars of taxpayer money, fosters drug-related violence and does nothing who is confronting serious addiction, a serious health issue. after 40 years, it's time to put an end to the drug failures. i yield back the balance of my time. the speaker pro tempore: the chair recognizes the gentleman from california, mr. hunter, for five -- honda, for five minutes. mr. honda: thank you, mr. speaker. good morning.

i rise today to urge the president and this congress to listen to the american people when negotiating a budget agreement. as much as the politicians argue, they don't seem to hear the good sense of the american people. the many closed door meetings in washington to decide on america's future are filled instead with us owe tarik and formulas purported to close the deficit. one group wants budget caps. another wants trigger clauses. another wants simplistic rules. none of these will work. this is not governing. governing is about setting priorities and following through. governing is about ensuring that the interest and values of the american people are at the negotiating table. if not any new deal will benefit only the rich and powerful or simply postpone any real decisions until after 2012. either way america will lose. a budget deal needs to be publicly debated and needs to reflect the true values and views of the american people.

one group in congress gets this. the congressional progressive caucus has heard the message of the american people who want to cut the deficit without cutting into america's future and without destroying america's sense of fairness. ask the public what they want and they will tell you. let us defend our health programs for the elderly and the poor, medicare and medicaid. let us hold to our intergenerational promise of social security. let us invest in education, research and development and fix our crumbling infrastructure. let us bring our men and women home from iraq and afghanistan and save at least $150 billion a year, not to mention the lives saved as well. let us rebuild america. any budget agreement does not hurt the economy. america's economic progress but many families are still struggling and we must do more to create jobs. any budget agreement must raise revenue.

americans know it. it will be irresponsible, unfair or unwise to reduce the deficit and debt while leaving tax breaks for big corporations and millionaires in place. a fair budget will not emerge from behind closed doors. we need an open budget process, one that keeps the interest and the american people front and center. the congressional progressive caucus wants to bring the people's budget to a forefront of publicly held negotiations as well as a budget plan that will truly put the american dream back within the reach of the majority of the americans. i yield back. . the speaker pro tempore: the chair recognizes the gentleman from minnesota, mr. paulson, for five minutes. mr. paulsen: thank you, mr. speaker. one year ago last week the white house proclaimed that the summer of 2010 would officially be known as the summer of recovery. now 52 weeks later unemployment remains painfully high at 9.1%. the housing crisis has not improved.

nearly 14 million americans are out of work. as i travel my district in minnesota from bloomington, to coin rapids, i hear from minnesotans and small business owners understandably concerned. my constituents were told that $1 trillion stimulus package would keep unemployment below 8%. they were clearly sold a bill of goods as unemployment has now been above 8% for more than two years straight. house republicans have a plan to jump-start our economy and create jobs. our plan takes commonsense steps to reducing legislative burdens, regulatory burdens that will help small businesses, that will help entrepreneurs. actually takes common sense to fix an out-of-date tax code so our employers are more competitive around the world. we also take steps to pass three pending free trade agreements with colombia, panama, and south korea that would create up to

250,000 new jobs through new sales to new customers. and also we will maximize domestic energy production by reducing our dependence on foreign oil and also lowering gas prices. finally, mr. speaker, and most importantly, by paying down our unsustainable debt burden and starting to live within our means, we will make the steps necessary to enact commonsense, pro-growth strategies that will create serpt in the business environment, that will actually grow our economy and create jobs and put america back to work. i yield back. the speaker pro tempore: the chair recognizes the gentlelady from is -- wisconsin, you are recognized for five minutes. ms. moore: thank you, mr. chairman. i ask unanimous consent to revise and extend my remarks. the speaker pro tempore: without objection. ms. moore: thank you so much, mr. chair. i can tell you that one of the most heartbreaking experiences that i have had as a member of congress is to watch this congress attempt to balance the

deficit and the budget on the backs of infants, on the backs of children who need their educational opportunity, and on the backs of seniors. we have seen gargantuan efforts to cut medicare, the main program to prevent poverty for our seniors, medicaid, women, infants, and children's program, nutrition programs for children, effort to decimate educational opportunity for young people while we refuse to end tax breaks for big oil. the oig five companies made nearly $1 trillion -- the big five oil companies made nearly $1 trillion in profits in the last decade, yet we continue to insist on providing tax breaks for these profitable companies. every year, every year we

provide subsidies to oil companies that they pocket. in addition to that, mr. chairman, we are cutting food from babies. i saw numerous, numerous amendments to cut moneys for lactating moms, pregnant women, newborn babies while we refuse to end the tax breaks for millionaires. we cannot afford another $800 billion in tax cuts for the top 2% in our country. this is backwards. this un-american -- this is un-american. with that i yield back the balance of my time. the speaker pro tempore: pursuant to clause 12-a of rule 1, the chair declares the house in recess until the hour of

>> the ways and means committee is talking with medicare trustees about the financial state of the program. the latest trustees report projects costs rising faster than previously predicted. and a shorter period of insolvency for the medicare hospital trust fund. it got under way about a half-hour ago and this is live coverage on c-span. >> as mr. starks mentioned earlier, congress has always addressed this issue by making changes. as a matter of fact, of the 40 years on this chart, 18 of those years the solvency date is less than it is today in 2011. as you recognize is a problem

because of the downturn in the economy. so i'd like to have someone give you this and get your analysis of it. and nen -- then also the affordable care act that was mentioned was an attempt to put in place provisions that would in fact improve the quality and reduce the costs of health care. everything from bundling around a hospital admission to reducing hospital readmissions, to expanding fraud fighting efforts. your trustees report recognized that. can you tell us what your assessment of the delivery system reforms in the a.c.a.? >> i'm once again going to have to take off my trustees hat for this. >> did you take these policies into consideration when you did this? >> yes.

these follow the estimates by the actuary of the impact of those reforms on cost. now, there are many which both the c.m.s. actuary and the congressional budget office didn't provide savings for or provided quite modest savings that if all the planets come into alinement and things work out well and some of the initiatives that i discussed in my prepared statement come to pass, we could see significantly more in the way of savings. on the other hand, some of them may prove to be ones that congress reconsiders or ones that don't work out as well as the c.b.o. and c.m.s. have estimated. we are in a period of huge uncertainty, i think, right now.

but those base numbers are in our projections. i think the -- >> i think the language on page 2 of the report says major program of research and development for alternate provider -- alternative provider payment mechanisms and other commanges intended to improve the quality of health care and reduce the cost of medicare. this improves the cost and the quality of health care outside of medicare as well. i think that's important to note. c.m.s. did a press release on your report. in it they say without the reforms in the affordable care act the medicare trust fund would expire in just five years, in 2016. the report issued today shows these reforms added eight years of solvency. and i'd like to ask unanimous consent to submit this to the record. >> without objection. >> thank you.

>> the gentleman from california, mr. nunnest -- nunes, is recognized for five minutes. mr. -- >> thank you, mr. chairman. i'd like to ask the witness these questions of insolvency. i'm not sure how long you have been trustees, but when we look back throughout time, if you go back five years, 10 years, 15, 20 years ago we always knew we had an insolvency issue. so that's -- i don't think anyone disagree was that and there's always been a need to save medicare and save social security. when we -- but when you analyze the problem today, and you know here in this body we are locked into this budget debt limit increase fight and budget fight where it doesn't appear like there's any fix in sight, and basically one of the major holdups is are we going to deal with these entitlement programs

to solve this insolvency problem. i don't believe we ever defaulted on or debt. we are getting very close to that if we don't have an agreement soon. so my question to you is, is the situation more serious, more urgent today than what it was when you look back to 10 years ago and 20 years ago? >> i think the answer to that is yes. both because the medicare problem is embedded in a larger fiscal problem. and because as opposed to five, 10, 20 years ago the baby boomers are retiring. they are beginning to apply for medicare benefits. and so the acceleration of the burden that we talked about as a future problem 10 years, 15 years ago is now upon us.

and this makes some solutions more difficult because the numbers of individuals who are receiving benefits is rising rapidly. >> i have a two-part answer for you. one, we have a much more serious overall situation, unified deficits are much larger than previously were. but secondly, we have an urgency that arises from demographics. each year that has more baby boomers going on the benefit rolls and there was a great reluctance, bipartisan reluctance to draw benefits from people who depend upon them. the cost grows enormously with every passing year. >> i would like to add a third issue to differentiate myself from my colleague here. and that is that we have enacted major changes already in the

medicare program. so in some sense the cupboard's barely bear, we can't go and open it up and cut provider payments even more. can we sustain the ones we already adopted? >> there's no question every day in my office people are coming in, health care providers, are coming in one way or another, either to my district office or here in washington, and complaining about the status of the health care system. as it relates to the affordable care act, medicare, medicaid, there is a problem throughout all of these programs. would it be good policy if somehow this congress could move legislation that would take anyone that's 55 years of age and older and keep them on traditional medicare? would that be a good goal for this congress to paragraph particular in?

-- partake in? >> are we saying anyone who is over 55 keeping traditional medicare and sort of hold them harmless from any future changes at all? >> if we could accomplish that. >> i think it's good policy to try to hold people who are near retirement or in retirement held harmless as much as possible from any future changes. having said that, with every passing year it gets harder and harder to hold harmless even people who are older than 55. five, 10 years from now you would ask me the same question, i might look at you and say, i don't think you will be able to do that. >> right. i guess a believer even old dogs can learn new tricks. when we make a statement as you made and congressman ryan also made about we'll let people 55 and over stay in the system that

they are in now, it implies that you want to keep that system unchanged. and quite frankly i don't think that's appropriate policy. i think medicare should evolve. in a gradual way. we have the affordable care act and innovation center. we have some changes in payment mechanisms and things like that. that would gradually change medicare. and i think pushing those forward as fast -- >> i think we agree that there should be gradual change. and that's why in mr. ryan's plan he proposed 55 and over because that gives people time for retirement planning and such they can deal with the changes. however i think where we disagree is where this problem just seems to be bigger than what, as you both said earlier, this problem appears to be bigger than what it was 10, 20

years ago. i think we have to act quickly in order to save medicare for everyone. >> the gentleman's time has expired. the gentleman from oregon, mr. blumenauer, is recognized for five minutes. >> thank you very much, mr. chairman. i would just pose questions to our panelists not to answer now because i have some others i want to get to. if you would reflect, because aappreciate mr. blhous, that we'll take over 79 million americans and freeze them in medicare as it is now, although my friend from wisconsin takes the reviled savings from the affordable care act and counts them, assumes them in trying to make his plan pencil, but we will be having a situation where there is a huge population that will grow smaller over time, but still millions of people, 30

years from now, an ever sicker, smaller population that my friend when he asked it to be scored just assumed the general fund would pick up the gap. i really appreciate it if you two experts might reflect and maybe share with the committee what that impact is going to be over time. >> just briefly? >> i don't have much -- if i have time at the end i might do it. but i just really like to be able to lock in what that means. we haven't been able to get a good figure. it wasn't scored in terms of what that extra costs would be for an older, sicker population although declining would still be millions of people. and i would take modest exception to my friend's characterization that i have had -- takes the control out of congress and puts us inevitably towards rationing and price

control. as i think he knows, that the recommendations are just that and they will come to congress and we have to vote it up or down. i think that's really good that we have a mechanism because we have seen political failure on both sides of the aisle on things like base closing and repeated failure with medicare. we are already seeing some people trying to walk back ipad's ability. i have heard my republican friends decry the fact that providers right now aren't getting enough money and yet we can't afford what we are giving them. and they don't want a control mechanism. i'm wondering is there any reason why with the help of ipad to maybe stiven the spine of congress that we couldn't mimic the best practices that are going on right now with medicare

in my community, my colleague, mr. kind, mr. ryan's state of wisconsin where costs are dramatically lower than other parts of the country, and performance is better. is there any inherent reason that we can't mimic that behavior? >> it's certainly a goal that we should strive to achieve. but it's very difficult to figure out how to get from here to there. how to get from miami to wisconsin. >> but some people have figured it out, haven't they? some people have figured it out. we are not all miami. we are not texas. >> and we don't really know how to convince miami to mimic the behaviors of wisconsin, minnesota some of the other practice pattern states.

>> that are more effective. >> in many cases that are more effective. >> i have to -- i'm troubled a little bit with this because i think we do know what works. i think there is bipartisan agreement, at least there has been, until recent years, of some of the experiments in the affordable care act, the a.c.o.'s of dealing with unnecessary hospital readmissions, being able to have more attention to primary care. dealing with freight, with waste, fraud, and abuse. there is a litany of bipartisan actions that can be taken to squeeze far more out of the existing medicare system. but people haven't been innocented to do it and congress in both parties has wobbled at least until we are starting to move back with the affordable care act. i think we are setting our

sights too low. i think we ought to be accelerating the reforms talked about and, yes, there is a little discipline. there are some price signals. i don't think that's control. but we are not just going to open the spicked -- spick the and pay people for -- spigot and pay people for procedure after procedure after procedure which is why doctors are getting more money even though the reimbursement rates are low. i think there is a bipartisan consensus about how it could be done once we get out of this whirl we are in right now. thank you. >> the gentleman's time has expired. the gentleman from washington, mr. reichert, is recognized for five minutes. mr. reichert: thank you, mr. chairman. thank you, gentlemen, for appearing this morning. i agree with mr. blumenauer. we must find a bipartisan solution to this. and i think we need to be more optimistic. there is one. i think many of the members have expressed that this morning. however there have been some

comments that have been made that sort of puzzle me a little bit like the question was asked earlier, why are we even paying attention to this issue? i think it's obvious from your testimony there are some major things that you are expressing this morning to all of us, to all americans, as some may be watching c-span and don't have a life, medicare is going bankrupt. you both agree with that and it's accelerating, true? yes? >> yes. >> medicare's dire financial status is actually drastically understated. would you agree with that? >> yes. >> it's very likely to be significantly understated. >> sir? >> i'm unsure of that. i think if we don't take full advantage of the d.n.a. issues

in the afford -- of the issues in the affordable care act, if we don't encourage all of the innovation going on in the private sector and nonprofit sector -- >> wasn't it understated a year ago? in a report. here we are today. we are accelerating the -- >> i think the -- >> is that a yes? >> no. i'm not sure what your question is. were you referring to the 2010 report? >> yes. >> and this report also has warnings which say excel -- >> accelerated, is that not true? >> yes, it has. changes largely in the economic -- >> you would not expect that to continue? >> i hope the economy is going to rebound. >> are you not sure, ok. massive tax increases. you see that on the horizon or benefit cuts if we don't do

something now? isn't that the scenario? if he -- we don't act now, we must do something now. would you both agree with that? >> i would say that the on the h.i. side, the implication trust fund exhaustion would be a benefit reduction in the absence of legislation. on the s.m.i. side the implication would be greater revenue retirements which would -- requirements which would lead to higher tax burdens. >> the thing that's confusing to a lot of americans they see this health care bill out there that's been passed and implemented by some degree or another and still more laws do take effect. there is a $600 billion tax pay in this bill. $600 billion worth of taxes applied to small businesses and people to pay for this. how can we get the economy going if we continue to tax small businesses, $523 billion in cuts to medicare. so no wonder people are

expecting higher premiums and fewer benefits in medicare. i wanted to ask a specific question regarding the alternative scenario. it states that eefer july medicare spending is expect -- it sits that overall medicare spend something expected to increase 6% g.d.p., an increase over the trustee's report. growth of this magnitude would substantially increase the strain on the nation's workers, economy, and federal budget. could you elaborate on what this may look like related to these important areas and another national priorities like education and medical research? >> i would just say, first of all i agree with the doctor that the main projected trustees report is probably a best case scenario and this is would be the pessimistic scenario. the reality is probably somewhere in the middle. we take that worse case

scenario, that is an unprecedented level of fiscal strain for the federal government. if you consider over 10% of g.d.p. from one federal program alone, that's roughly twice as much as any federal program to this point has ever absorbed. it would be over half relative to g.d.p., over half the size of the entire federal government, relative to the economy, as recently as 2008. so to have over half of our historic norms in terms of the federal size of government to one program would be an unprecedented strain. >> my comment on this is long before those numbers would be realized, this nation is going to have to address its deficit and debt problem. in my view medicare will be one contributor to a solution and so those numbers are horrific. long before we face them, we are

going to have to make some much more fundamental changes in our revenues and exmendy tures -- expenditures across the board. >> the gentleman's time has expired. the gentleman from new jersey, mr. pascrell, is recognized. >> thank you, mr. chairman. how are you today? what is a logical, we learn in logic 101, may not be true. it's our premises that determine those things. i don't know, i want to enter into the record, mr. chairman, the s&p indices concerning health care, health care costs, and bring to your attention, mr. chairman, that in 2010 medicare

claim costs associated with hospital and professional services for patients covered under medicare increased at a more modest 3.2% rate, much lower than the private sector. much lower than the private sector. and i would like to ask to begin with and very briefly in response, i appreciate that, what do you think attributed to the slowdown, to the more moderate pace of entries in medicare? as well as the private sector going down, too, but not to the degree of medicare. why do you think that happened? both of you. either of you. >> my response to that would be one factor is certainly the turndown in the economy which has left some seniors and others

with less income to pay their co-insurance, co-payments and so on. conceivable that some even had to drop their medigap policies. the more importance here is the attention that c.m.s. and the providers have begun to pay to overuse of services. and many practitioners are looking anew at their practice pattern. >> which is a major target of the health care act, right? >> yes, and it's a major change in attitude and behavior. i think that's going on throughout the society and it's a good development. >> thank you. >> i generally agree with that. i think certainly the overall state of the economy played a role and the factors just spoke

off also played a role. i would be candid, i don't know the answer. short-term fluctuations in these cost levels are very difficult not only to predict but explain after the fact. my level of uncertainty as to what to attribute that to is high. >> i would contend that even before it is -- it's only 20% in effect that the health care act has had an effect on the very costs that we are trying to reduce because we are never going to have a medicare program that is able to keep up with inflation in a rising costs of health care until we control in some way, shape, or form una capitalistic system the rise of -- under a capitalisic system the rise of health care costs. we need to do something about that. and we are trying to do something about that. 1/3 of the entire health care act dealt with medicare and

medicaid. and how we could save money in the process much of it was not scored in the final analysis. now, we had a major change. in the report of 1997 the report of the trustees in 19 the 7, -- 1997, brought about some very interesting things. the beginning of medicare advantage. the beginning of the process to start to privatize 8 the system. -- to privatize the system. now, we pay 12% more to these private plans, and seniors are going to pay much more if we move, obviously, to privatize the whole process. under the guise of trying to straighten out medicare. look, all of these reports in

1970 as the gentleman from california pointed out before, to now, talk about the dire position in which medicare is in. every one of those reports. that the world is coming to an end as far as medicare is concerned. that did not happen. as for my friend from wisconsin talks about double accounting, this is what a bank account was all about. you take the money out of the account as you need it. you don't take it all out. i believe very analagous to those funds in a bank account. when money is deposited, the dollars are used for other purposes until they are withdrawn. what's so different about what we do in terms of how we are calculating savings in the future? so we need to take a look, mr. chairman, at not only the logic of what we say, but if there's any resemblance to the truth. this is not reality tv. thank you. the speaker pro tempore: the

gentleman's time has expired. the gentleman from georgia, dr. price, is recognized for five minutes. >> i thank the chair and i thank our witnesses for coming to help us understand what are the financial operations of medicare. we are talking about the financial, the role of the trustees, right? not the clinical side of health care. as a physician we are talking about money today we are not talking about quality of health care, those kinds of things, that are so important to patients across this country. our friends on the other side of the aisle have a penchant for mischaracterizing our solution, i think. i want to touch on a couple of things that mr. stark mentioned. he said that our proposal, our positive solution was a voucher plan for medicare. well, it is a voucher plan, you know that, both you know that, correct? you understand our program is not a voucher program, it's a premium support program. >> the difference between premium support and vouchers has

been explained by some as the payment not relating to the cost of the underlying enterprise. that is a distinction that i am not -- >> you supported preesm yum support program in the -- premium support program in the mid 1990's. >> yes. >> you wouldn't have called it a voucher program, would you? in fact you didn't at that time, did you? >> no. >> you called it a premium support program. that's important to know. mr. stark also said that our positive solution ends guaranteed benefits for seniors. well, that's not true. you know that. in fact we save medicare for future generations. in fact, in our proposal it actually stipulates that the program must be guaranteed, isn't that true, when you read oiler program? >> to the extent that i know the details of the program -- >> it's a guaranteed program, that's correct. mr. stark also mentioned the issue of private contracting and

said that if private contracts were allowed in the medicare program, which many of you -- us believe is the pressure valve that needs to be put in place to relieve the pressure that currently exists in medicare, in response to his question wouldn't that cause access problems, you said f. not regulated, is your quote, if not regulated it might cause access problems. are you aware of any pros posal that would put in place private contracting without regulation? >> i think this is a matter of degree as well as existence. >> are you aware of any? >> no. >> isn't it mob that an appropriately regulated and structured private contracting program would in fact increase access for medicare and seniors in this country, isn't that possible? >> it's possible but not probable i would say. >> i would beg to differ with you on that. there's certainly individuals who understand the huge challenges with access right now that seniors have and that one

of the ways to solve it as you have identified in your list of solutions is something that allows for increasing access. i want to touch on the medicare trigger. this is now the sixth year in a row that the trustees have said that the board of trustees are required to issue a determination projected excess general revenue from medicare funding. this is the sixth consecutive such finding. when that trigger occurs it's the obligation of the president to then propose to congress a solution to fix that problem, is that correct? >> yes. >> and have you received any solution that this administration has offered for having had this trigger be punched through for the past three years under his watch? >> no. >> have you seen that? >> no. i think the congress has waived the requirement. >> under the democrat control in

the past, yes. they said, don't worry about that, right? isn't that what they did? don't worry about the money. >> yes. >> i want to touch on this whole issue of medicare changing. in fact you said that there are significant changes to medicare through the ppaca which is the reform bill they put through. which has already been adopted ends medicare as we know it. would you agree with that statement? >> it transforms the program as all legislation in the past -- >> medicare as we know it right now in this colloquial term used out there, it doesn't exist under the democrats' plan already, is that correct? >> well, the question is what are we referring to as medicare. if we are saying -- >> medicare as we know it. >> fee for service managed care program, it exists after the

affordable care act as it did before the affordable care act. >> medicare as we know it, the program that exists right now has been changed significantly under ppaca, would you agree with that statement? >> there have been significant changes. >> medicare as we know it is already gone and done so by the reform bill put in place. mr. chairman, my time has expired but i look forward to submitting further questions for the panel. >> i thank the chairman. the gentleman from new york, mr. rangel, is recognized for five minutes. mr. rangel: thank you, mr. chairman, for calling this meeting. i think it's helpful just to clear the air to have experts that are objective, that will have their reputations to protect long after the election is over. i think you have to agree that whatever decisions we make that's going to cause any dissatisfaction with our constituents, it's much easier

when the parties are talking together. they may not be happy with democrats or republicans, but at least they would not be nearly as angry if the parties themselves have taken different positions. the fact that so many republicans got elected, attacking so-called obamacare, forced democrats to get re-elected in attacking the ryan care. and now the facts are not nearly as important, it appears to me, as the parties getting re-elected. so, unlike mr. blumenauer, i just can't believe that a nation that owes so much to our asian population can spend trillions of dollars rebuilding the economy of afghanistan and iraq unable to say we can't provide decent care.

that means that we got to have to have reform. and it means it's going to be painful to a lot. but it also means that as long as we fight each other, then the parties don't want to make decisions. let me ask this. as relates to medicare insolvency, do you believe that the affordable care act goes in the direction of dealing with the question of solvency? >> certainly the affordable care act extended the period, duration of medicare h.i. solvency. >> does it constantly request that we review what changes have to be made from the congress and the administration in order to protect that solvency? i mean do you believe that we are not dealing with the problem

at all and that we need a dramatically different approach? i don't have a problem changing the approach if it's bipartisan and we agree this is best. i believe that an old dog can use new tricks. i believe that if the republicans come in and they say obamacare is moving in the right direction, not fast enough. and we think these changes have to be made, that's not going to happen, if it happens at all, until after the election. so my question to you as being objective professionals are you satisfied that the affordable act bill allows itself to deal with solvency if certain changes are made? do you believe that we are just hanging it out there and ignoring the problem? we know that this great country has the ability working together

to deal with that problem. >> i would say this. three things that come to mind. one is, the primary engine under the affordable care act for extending the solvency is the annual adjustments in the reimbursement rates for growth and economywide multifactor productivity. in the last trustees report that engine was powerful enough to account for basically the overall contours of the cost projections over the long term. this year's trustee report relies a little bit more on the payment advisory board. basically in order to hit the savings targets in the affordable care act, the productivity adjustments themselves won't be completely -- >> i really -- i'm going to get the answer but my time is so

restricted. really what i want to do is understand the premium support position more clearly. whether you call it a voucher or premium support, does anyone contradict that the health insurance company major obligation is to make a profit? >> no. >> that's their job. two, if you are trying to make a profit, does anyone challenge the fact that the selection of people to be insured are based on the risk involved? answer, no. if indeed a person is more vulnerable when their older, are they less inclined to get a fair strike, less inclined to get benefits without higher costs? answer, no. so the premium support idea guarantees that you get something but you can only get what you are able to afford to get, is that true?

that's true. and so i don't care what you call it, the fact is that we are making major adjustments and putting the entire ability of people to get health care in the hands of those people that really don't want you as a client. i got a not a voucher, i got support. but you are not guaranteeing i have enough support to get the health care that i have for my kids that i get, right? >> the gentleman's time has expired. our witness can respond in written letter to the committee on the question. the gentleman from florida, our new member to the subcommittee, mr. buchanan, is recognized for five minutes. mr. buchanan: thank you, mr. chairman, for holding such an important hearing. also look forward to working with you as chairman and the rest of the members on the subcommittee. also like to thank our witnesses for being here today.

again-u i want to go over a -- i want to go over a couple points. medicare trustee which you projected, we touched on thisier, would become insol van hollen 2024 instead of -- insolvent 2024 instead of 2010. we are in florida so obviously it's a big issue all over the country but percentagewise much bigger in florida. where we are looking at projecting the 2024, one thing i don't believe was taken into account is the reduction or the doc fix or s.g.r. was taken into effect in terms of looking at insolsen have i. when we project this out and look down the road talking with doctors in our community, i'm very, very concerned a lot of them will have to go out of businesses. a lot of the big practices, we got another 30% cut we are looking at, but doesn't take

into -- any impact in terms of the viability of medicare long term. so i guess wouldn't you agree that these cuts if they go into place would drive the insolvency date? because we aring loot a $300 bling problem quicker and i would like both gentlemen to respond. >> the solvency issue relates to the h.i. or hospital insurance fund and the doc fix. . part of s.m.i. and that is not facted by solvency issues because the way the part b trust fund is constructed, it can never go -- it can never be exhausted. general revenues are automatically given to the

trust fund to make up the difference between projected costs and premium payments. the date of exhaustion of the h.i. trust fund. >> i've been here a little over five years and we had a doc fix once or twice a year. i don't know how anyone runs a business, especially allowing these medical practices, and have them look for a 15% to 30% cut every year. i don't see how this is part of the overall medicare viability of the medical community. the other gentleman. >> i think that the principal effect of the doc fix override would be in the overall cost to part b. where we see these huge cuts happen we see it a little over 2.25 of g.d.p.

the s.m.i. side if you assume the doc fix reductions are overridden. >> mr. blahous, let me ask you another question. a harvard study says that a malpractice cost at about -- we could save as much as $55 billion a year. do you think we should have medical malpractice reform, especially as we' looking to drive -- we're looking to drive down costs? >> well, certainly speaking as a trustee, everything we can do to hold down the growth of cost would make our overall financial projection better for medicare. yes, if we can produce that level of savings for medicare through malpractice reform that would -- >> is that something you personally have looked at as a trustee, med mal costs in terms of medicare because i can tell you doctors about defensive medicine, running a lot more tests than they feel they need to just to make sure they're covered in case one in 1,000 or

10,000 cases where someone has a tumor doesn't end up being something more substantial? is this something you've looked at in terms of tort legal reform? >> not so much because of the trustees' process is scoring current law. it's different from the congressional budget office where they produce these menus of policy alternatives. generally the trustees' process we don't tend to evaluate alternative policies to current law. but obviously, you know, we would draw heavily from the input of everyone from c.b.o. to the medicare panels to others in scoring such provisions if it were enacted into law. >> mr. reischaue, do you know the impact either as a trustee or your own personal opinion in terms of driving down costs because this is obviously something -- again, i meet with a lot of doctors. i have a neurosurgeon that says his medical malpractice is

$200,000 a year. has to see $1,000 worth of revenue to pay the $200,000 in insurance. they're practicing a lot of defensive medicine. i think it's a big area where we can make a big change in. what's your thoughts? >> my thought is that there are a number of studies trying to estimate the impact of malpractice reform on overall health care costs by and large they come out saying this is a huge contributor to the rapid growth of costs, of health care costs. but certainly reform would be a contributor to lowering the growth of -- by producing the level, really a one-time level shift. i would align myself with dr.

blahous' comments that subchange would be a good change. >> the gentleman's time has expired. >> i yield back. >> the gentleman from wisconsin, mr. kind, is recognized for five minutes. >> thank you, mr. chairman. i want to thank our witnesses for your update today. mr. reischauer, maybe i can start with you. i see this chart showing the trustee report dating back to 1970 regarding the year of solvency. this tracks economic performance, whether we're in a growth state or declining state and how that influences the ultimate solvency of this trust fund. is that something that's consistent with what the trustees are finding, too, what the sfreng of our economy and the payroll revenue -- strength of our economy and the payroll revenue? >> certainly that's a very important contributor as is legislation and various times in this list the congress has enacted significant legislative changes that have prolonged the life of the h.i. trust fund.

>> i'm looking particularly at the late 1990's, 2000 or so, we had a period of robust economic growth and the trustee showed 25, 28 years of solvency unlike the great recession that we're coming through right now and we've had a dropoff of the number of years of solvency. so i think one of the best things we can do as a nation, increase the solvency of the trust fund is to get this economy back on track, creating good-paying jobs. would you agree with that? >> i would agree. >> and regarding med mal reform and the impact that's going to have. i think the president's there as well. if we're going to be asking doctors through the affordable care act, there should be greater safe havens for that type of practice system. this is where -- you lose me on that. 37 states have already enacted med mal reform, including the state of wisconsin. unless those 13 states that

haven't taken action yet on med mal reform is driving all this additional cost in the health care system, i don't see it. in fact, studies though -- show that the utilization of doctors in the state that have med mal in it is very little than the states that don't have med mal reform, is that what you found in your analysis? >> i haven't done any independent analysis but i am aware of studies that have come to that conclusion. >> well, this is what i think will also help and this has been baked in the affordable care act is we need to move forward on delivery system reform. expecting better outcomes at beater price. there are models that do work and work very well. they're hiley integrated, patient focused that are producing the better results for the better bang of the buck. what's incentive in the affordable care act is driving that system to a better efficient and better

outcome-based system but at beater price. the fact is that studies have shown over and over again that a large part of the health care dollars is going to tests and procedures that aren't working, it isn't improving patient care. some range as high and $800 billion in a $it 2.4 trillion -- $2.4 trillion system that is not getting the good bang for the buck. the ultimate verdict in how successful we are in driving costs down is changing the way we pay for health care, to reward outcome and value as opposed to the volume-based payments that occur in medicare. would you agree with that analysis? >> i would. >> and there are things on track right now that will lead us to that, hopefully the promised land of payment reform. maybe one that was brought up for criticism today or the work that the institute of medicine is doing right now in changing the fee for service system for a fee for value system.

and it will help the health insurance market and how they reimburse with health care expenses. so the concern i have, and with the ryan plan, the rch plan that was just passed is they would do away with all these reforms. and instead create a voucher plan that virtually ends medicare without addressing the systemic problem we have in the health care system which is the rising costs and what we need to do to bend that cost curve. and moving with reforms in the affordable care act. we're rewarding good quality outcomes is the thing we need to to shore up the trust fund and ultimately the long-term of the sustainability of the medicare problem. would you agree with that? >> you know, i'm not sure what my trustee had on. i should be opining on these issues. but, you know, i think the affordable care act -- >> even in the trustees' report they do acknowledge some of the

reforms that are contained in the affordable care act that -- >> move in the direction of providing better care at a reduced cost, yes. >> as a former c.e.o. yourself it's tough to get a score from c.b.o. on health care savings. you all seem to come from missouri, the show me state. you have to see it before it gets scored. there are things we need to move forward on. we don't know the savings on the cost curve, is that right? >> i was criticized in this very room for that. >> i know you were as others have been and probably will be. thank you for your testimony. >> the gentleman's time has expired. the gentleman from illinois, mr. roskam, is recognized for five minutes. >> thank you, mr. chairman. your report shows that medicare will now be bankrupt in 2024. the americans would then be forced to either endure a massive tax hike or immediate

17% reduction in expenditures. in other words, an immediate 17% medicare cut. can you explain what you mean by immediate? >> the way the trust fund works, both on the medicare and medicaid side, the expenditures programs out there is limited by what's in the trust fund. now, the s.m.i. side is not an issue. we get whatever is required to keep pace with cost. but once that trust fund runs out the program lacks the authority to make benefit payments. now, there have been a lot of legal analysis done of what happens when the trust fund runs out and they don't all agree. but a fairly common one is that payments would simply have to be suspended or delayed until the requisite financing would come in the trust fund which would reduce payments simply by virtue of delay. >> and that is the common

understanding of immediate meaning this present moment in time, in other words, when insolvency happens you are immediately prohibited based on the law and based on your understanding from the trustee from paying anything further out and your estimation is that it would be a 17% cut in a benefit, is that correct? >> well, it's 17% on average over 75 years. now, it varies according to year. in 2024 specifically it's about 10%. it increases and then it becomes about 25% by the mid 2040's. >> so in average -- go ahead. >> what i think my colleague was describing is when the trust fund became insolvent, money would still be flowing in from tax receipts and medicare would delay paying bills. and so hospital would send its bill in and rather than it being paid in 24 days, it might have to wait five months.

and the intermediaries and other payers would be writing out the checks, transferring the resources to the hospital, to the hospice, whatever, on a much-delayed basis. >> so that cut, just so i'm clear, is not a hypothetical cut. it's not a hypothetical delafmente it's an actual delay in payment to the point of reaching the 17% number based on your own projection, is that right? >> that's right. the social security act, which deals with these trust fund issues, is very explicit that payments can only be made from the trust funds. >> so there's no other flexibility? if the revenues aren't will, if an insolvency is declared, you have no other remedy but to move forward and make those cuts, is that right? >> right. the programs don't have the authority to borrow in excess of the resources provided by the trust funds.

>> and absent some change mountain program, your prediction -- in the program, your prediction is that's what the program would be in 2024? >> that's right. >> with respect to the hospital system. >> i understand. so when the gentleman from wisconsin said there's a proposal out there by the majority on this committee that ends medicare in fact medicare as we know it will end in 2024 absent some change in policy or some change in moving forward, that's right, isn't it? >> yes. >> i yield back. >> the gentleman yields back. the gentleman from washington is recognized, mr. mcdermott, for five minutes. >> thank you, mr. chairman. i appreciate you allowing me to ask questions. i have a report from a c.m.s. actuary who says that we're

talking just now about a 17% reduction in expenditures if nothing is done. they suggest that if the affordable care act were repealed, as the majority is trying to do, it would require 53% reduction in benefits or 134% increase in the payroll tax to cover the deficit. so what we've seen here proposed by mr. ryan seems to me is something that would make things much worse, at least according to the -- if you believe the actuary. now, i want to ask you a question that i sat here thinking about this whole time listening to. i came in to medicine in 1963. i graduated from medical school just before medicare started. so i've seen the whole district. i heard it was going to be socialism and the end of medicine was going to exist in

this country. and i've watched it and it is clear to me that the decision to give doctors the right to set their own fees was a crucial error made in 1964 when they wrote that they could have their usually and customary fees, they really set in motion an awful lot of what we're looking at today. and you know about the ruck, the update committee. most people don't know what that is but you know about it, and they set the rates. now, why is there no discussion in your report about reform of the ruck committee or the rate setting that is done? we don't have a -- we don't have a fee schedule set by the government. we have the ruck committee recommending to us what we should pay and that's what we pay. now, how can we have control of costs if we don't have the medical profession in some kind

of direct negotiation with the government about what's going to be paid? the s.g.r. was a simplistic idea that was never worked because it only controlled one thing and it left all the ability to raise rates -- raise amounts of money by doing more of the same procedure. i see in "the washington post" of this week, many hospitals overuse double c.t. scans. there are thousands of examples of overuse of procedures in the medical care, but the ruck says you get this amount a month for doing that and, boy, they do them and do them and do them and the s.g.r. has had no control whatsoever on that. how do we get there if we don't get the doctors at the table someplace to negotiate about their part in this game? it's not just between the government and the medicare

beneficiaries. there was a third party here that we're ignoring and that's the physicians and the health care system. >> are you looking at me? >> yes, sir. many times. >> i believe the ruck is an advisory committee that gives its recommendations to c.m.s. and c.m.s. is the ultimate decider -- >> the ruck sets 85% to 90%. >> what the ruck does is look terrell tif values and decides which procedures, interventions -- to relative values and decides which procedures, interventions is to be paid. and there are a few volunteers for being overpaid and many claimants for being underpaid.

when they balance out what would happen if these changes were made if there is -- if on the whole it saves resources, then those resources are thrown back into the overall pool and the whole pool is raised. so it's designed to be in a sense budget neutral which i don't think, you know, personally, is an appropriate thing. and i believe the administration has made a suggestion that the overpayment amounts for procedures that we believe are overpaid should be used to reduce overall costs. and, you know, i think we need a more robust review procedure like the ruck, one that reviews these amounts more frequently than is now the case.

and aggressively looks at what's happening in the balance of the market, private sector with respect to fees from these various procedures and we could improve the accuracy of payments much more and probably save some money. >> the gentleman's time has expired. >> thank you. i hope you put that in the report next year. >> the backup payment advisory commission which i served for nine years has made recommendations and analyzed this issue quite frequently in its reports. >> the gentleman's time has expired. the gentleman from louisiana, dr. boustany, is recognized for five minutes. >> thank you, mr. chairman. as a heart surgeon, i had the tremendous privilege of operating on thousands of medicare beneficiaries, and i can tell you patient by patient perhaps better than anybody in this room understand the value

of the medicare program and the importance it plays in the lives of seniors, especially seniors back home in louisiana, many of whom have very limited means and depend on this truly for their life. i could go on and on about the quality and what we need to do to establish and maintain and strengthen a good patient-doctor relationship based on high-quality medicine while managing costs. but that's not the purpose of the hearing. we're here to talk about the financial solvency of this program and some of the things we need to do. you know, the medicare actuary has been quoted of saying that the improved hospital trust fund financing cannot be simultaneously used to finance other federal outlays such as coverage expansions and to the extent the trust fund, despite the appearance of this result from the accounting conventions meaning we can't double count. this is a real problem. i tell you as a physician who worked with many, many medicare patients, this is a huge disservice to medicare

beneficiaries across this country. we have an obligation to fix this program and to get it right. and when i see this double counting and the fact that we're playing games with the s.g.r. and the reimbursement structure, this is lirlely legislative malpractice -- literally legislative malpractice. you go on with the ipad, this is another example of where you're going to try to keep the lid on a boiling pot of liquid. it's not really going to be in the best interest of maintaining high-quality patient care between a doctor and a patient. my question is this -- we know with current law we're headed toward 2024 with the insolvency of the hospital trust fund which means medicare as we know it, at least that part, the hospital care, ends. is that correct? >> it certainly -- it does not have the resources.

>> so if we don't correct this problem, then there will not be a payment mechanism for hospital care for our seniors. >> there will still be a payment mechanism but it would not be able to pay and on a delayed basis. >> and before we get to that point, there clearly is not a simple situation where we get to the point and it stops. would you suggest that there will probably be other forms of rationing for our seniors before we get to that point under current law with regard to hospital care? >> in fact, it is a situation where you get to that point and fall off the cliff. you know, participants will be even after the date of insolvency entitled to the benefits that are laid out in the program. providers may choose not to

provide as much care because they will have to wait a long time or a longer time to get paid for it. but it is a situation that up to that point everything seems fine. >> that gives us the access problem because that's the other side of this equation whereby the further we go it seems year after year we're seeing more and more problems with access for our seniors. so in effect if you don't have access or limited access, delayed access, is that rationing? >> well, i would say -- there's two elements of this issue. one is the sudden withdrawal of benefits that would occur in 2024. then there is the other question, as we constrain our reimbursement rates under current law and even prior to 2024, does that have the effect

of causing providers to withdraw from medicare or go out of business? and this is obviously something we are wrestling with as trustees and the actuaries are wrestling with analytically. >> i guess my answer is yes based on dealing with many, many physicians across this country. we're seeing worsening access problems. i saw it back in the 1990's in my own practice where as a heart surgeon treating a patient who came in the emergency room needing emergency open heart surgery, as a cardiologist and i we were unable to see primary care providers to help them. we have an obligation to deal with this. the problem i have on the other side of the aisle we see these characterizations that republicans want to end medicare and -- the point is medicare is ending under current law which they put in place. and we need to take our heads out of the sand. i ask our colleagues on the

other side of the aisle to take their heads out of the sand as well as the president who has deliberately ignored this trigger. we have to be honest with the american people. and we have to be honest with seniors who depend on this very valuable medicare program and get this right. it's critically important. i see my time has expired, mr. chairman. thank you. >> i thank the gentleman. the gentlelady from tennessee, mrs. black, is recognized for five minutes. >> thank you, mr. chairman. first i'd like to begin by thanking me for allowing me to sit on this committee although i am not an assigned member. though i appreciate that. mr. blahous, i'd like to discuss the graph you have on page 5 of your written testimony and up on the screen showing medicare costs and noninterest income by source as a percentage of g.d.p. medicare is expected to make up a rapidly increasingly percentage of g.d.p. as you did talk about in your testimony

over of the -- in the upcoming decade. the trustees' report says it will rise 9.9% of g.d.p. in 2010 to 3.4% in 2035. the trustee report projects that 20 -- $21.3 trillion will be needed to pay medicare in the next 75 years. account country afford to fund the s.m.i. trust fund at this level? >> well, i would say two things. one is that would be under current law it would be an enormous expansion of physical pressure on the federal budget. and far beyond any burdens we have carried in the past to finance medicare s.m.i., the vast majority is funded by the general government revenues. but this understates the case. the best case scenario in which infants be -- physician payment

rates are suddenly reduced by 29% next year. so in practice we're likely to be significantly higher than this. >> and given that information and your -- you're referencing that money would have to come from the general fund because obviously it's not coming in, we don't get enough money on the beneficiary side, would you agree this is also going to impact some of the other national priorities, maybe such as education or roads or some of those areas? >> absolutely. i would say the growth of our medicare spending and the growth of our health care spending generally is probably the single greatest threat of discretionary spending throughout the federal budget. >> and given that, even if the medicare s.m.i. trust fund is not technically going bankrupt but the hospital insurance fund, is it fair to say it is bankrupting our federal budget?

could it bankrupt our federal budget? >> the way i would put it is there's no single cause of our overall fiscal problems but under an untenable current law scenario that c.b.o. and everyone else projects over the long term, this is about as big a contributor to it as anything. >> obviously when it starts taking up that great percentage of our g.d.p., then we're going to have to in some way make some decisions about what it is we're going to fund or not fund. let me also ask you this, do you think that congress-enacted policies that reduced medicare spending by $15 billion over the next 10 years will be sufficient to address medicare's financial crisis? >> no. >> no. ok. so i agree with you, and unfortunately there's a growing chorus from our congressional democrats to simply do nothing and wait for the so-called delivery reforms from their health care overhaul to take effect but c.b.o. estimates those policies -- >> and you can see all of this program later in our video

library at c-span.org. the u.s. house is about to gavel in for legislative work. members will debate today a bill to change u.s. patent and trademark law. one of the provisions gives patent priority to the first to file rather than the first to invent which is currently used. later today, the house will begin debate on changes to the offshore drilling permit process which tightens the e.p.a.'s deadline for deciding whether permits abide by the clean air act. it changes the air quality standards for offshore oil drilling. now live house coverage here on c-span. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2011] house will be in order. the prayer will be offered by the guest chaplain, the reverend dr. joe pool, from the first united methodist church of rockwell, texas. the chaplain: let us pray. loving god, creator of all things and author of all life and giver of all grace, you have

brought us to this time through the blessings of your hand and we remember that we do not work alone. serve without your spirit or act without your guidance. open your heart to us as we depend on you for wisdom beyond ourselves, discernment that fulfills the cry of need, and the strength for the challenges we face. may we be about your work of justice and mercy, security and peace, comfort and provision. forgive us our shortcomings, create in us your will and way, write these upon our hearts so that we might serve you as we serve your people. we invoke the recognition of your sustaining and guiding presence at today's session and beyond. accomplish in us the work of your hands, may we be worthy of all that is entrusted to us this day. in your most holy name we pray,

amen. the speaker pro tempore: the chair has examined the journal of the last day's proceedings and announces to the house his approval thereof. pursuant to clause 1 of rule 1, the journal stands approved. the pledge of allegiance will be led by the gentleman from north carolina, mr. coble. mr. coble: i ask our friends in the gallery to join us in the pledge. i pledge allegiance to the flag of the united states of america and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. the speaker pro tempore: without objection, the gentleman from texas, mr. hall, is recognized for one minute. mr. hall: mr. speaker, i'm honored today to again recognize our guest chaplain, the reverend dr. joe c. pool, pastor of my

home church, hometown, first united methodist church of rockwell, texas. he spansd more than 0 years in texas and served in pastor in urban and gainesville prior to serving in my hometown. reverend pool earned a bachelor of arts degree from the southwestern university in georgetown. earned both a master of theology degree and doctor of ministry degree from perkin school of theology at southern met disuniversity. he's been a long time member of the executive board. over the past quarter century reverend pool has led mission trips to the appalachian region, mks, and been involved in hurricane recovery and rebuilding efforts throughout texas, louisiana, through hurricanes andrew, katrina, and rita. active in community service he was selected as an outstanding young man of america three times and also selected for inclusion in who's who in america. reverend pool is blessed by his wife, their three children, candice, corey, and amanda, and

rockwell is in turn blessed by this minister and his family. reverend pool is known as a wonderful preacher, great teach, and close friend of mine and friend of many and may god continue to bless his life and ministry for many years to come. i would be remiss if i didn't also tell you or perhaps warn you he and pete sessions were roommates at the university. i yield back my time. the speaker pro tempore: the chair will entertain up to 15 further one-minute speeches on each side of the aisle. without objection, the gentleman from north carolina, mr. coble, is recognized for one minute. mr. coble: i thank the speaker. mr. speaker, jack mckeon resides in elon, north carolina, and in 2003 he became the oldest manager to win a world series championship. having defeated the new york yankees. yack was recently recalled by the florida marlins and find

himself in the marl lynn house again, this time as the second oldest manager to manage a major league team. jack responded when people questioned his age he said, experience should not be penalized. and jack further said, i'll probably be managing when i'm 95. from one ok at that againairian to another on behalf of the citizens of the sixth district of north carolina, we extend hardy good wishes to jack mckeon for the remainder of this season and until he's 95 years of age. i yield back, mr. speaker. the speaker pro tempore: the gentleman yields back the balance of his time. for what purpose does the gentleman from rhode island rise? mr. cicilline: i ask unanimous consent to address the house for one minute. the speaker pro tempore: without objection, the gentleman is recognized for one minute. mr. cicilline: thank you, mr. speaker. i rise today to recognize and honor emily gordon and dillon burke, young advocates in the fight to cure type one diabetes. they are making a significant impact on the research for diabetes and their work will benefit future generations.

that's because they are both delegates representing rhode island in the juvenile diabetes research foundation children's congress gathered here in washington this week and they are with us on the floor today. emily and dillon are working to raise public awareness of the critical need for diabetes research to eliminate this disease. diagnosed at 17 months old, emily has known diabetes for most of her life and doesn't view herself as different from other children. and dillon has seen firsthand some of the complications since his father has the disease. the work they are performing during the children's congress is critical to nearly 26 million americans who have diabetes. i commend and congratulate them for overcoming great obstacles to work towards a cure that will improve and stabilize generations to come. welcome. i yield back the balance of my time. . the speaker pro tempore: the chair will remind members not to address members that are in the audience. for what purpose does the gentleman from pennsylvania rise? >> i ask unanimous consent to

address the house for one minute and to revise and extend. the speaker pro tempore: the gentleman from pennsylvania, mr. pitts, is recognized for one minute. mr. pitts: some recognize why the nearly $1 trillion in government stimulus spending failed to hold down unemployment or reinvigorate our economy. philip greenspan, owner and operator of a helicopter company in boston, understands why government doesn't efficiently spend the public's money. in a june 16 blog post he relates his maddening experience with federal bureaucracy. as the manager of his company he must administrator a random drug test to employees. as the only employee he must surprise himself with the drug test. as the manager he must take a course on giving drug tests. as the only worker. mr. greenspun notes all these requirements and steps don't just cost him money but cost the federal government since f.a.a. employees must ensure all these requirements are met. this is a small i illustration of how government makes the

simple, complex and hurt both businesses and taxpayers. another reason why we need a smaller, less expensive federal government so that our private sector can grow again. i yield back. the speaker pro tempore: the gentleman's time has expired. for what purpose does the gentleman from tennessee rise? mr. cohen: to address the house for one minute. the speaker pro tempore: the gentleman from tennessee is recognized for one minute. mr. cohen: thank you, mr. speaker. up to today i was concerned that my friends on the republican side were only trying to defeat great democratic programs of the 20th century. medicare, which will be celebrating its 46th birth da i next month, is the -- birthday next month, is the great laws that have been passed in this house and is in danger. social security passed in the 1930's, one of the great social advances of the 20th century under president franklin roosevelt, also in danger. all democratic presidents and democratic congresses. there is a bipartisan effort to destroy the work of the 20th century. a bill coming to the floor is going to try to end the clean

water act. so it's bipartisan. richard nixon passed the clean water act. i'm a history buff and i think richard nixon should be known, not just for watergate but for clean water. i hope they don't repeal richard nixon's signature achievement, the clean water act. mr. speaker, i yield back the remainder of my time. the speaker pro tempore: the gentleman yields back the balance of his time. for what purpose does the gentleman from florida rise? >> perm mission to address the house for one minute. the speaker pro tempore: without objection, the gentleman from florida is recognized for one minute. >> mr. speaker, international competitiveness is critical to revitalizing america's economy. that's why it's so imperative that we move forward the free trade agreements with colombia, panama and south korea. passage of these f.t.a.'s will not only improve our relationships with these countries but it will also create new trade jobs for america. make no mistake, creating jobs and growing the economy are the most important issue today facing america.

mr. buchanan: the u.s. international trade commission reported the passage of these free trade agreements could create as many as 250,000 american jobs. in florida we have 14 deep-water sea ports that generates over $65 billion in economic value to the state. these trade agreements will only enhance that figure. it's time that we get serious and start competing with the global marketplace. that time is right now. and i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. for what purpose does the gentleman from missouri rise? >> to address the house for one minute. the speaker pro tempore: without objection, the gentleman from missouri is recognized for one minute. mr. carnahan: thank you, mr. speaker. our seniors need medicare. as we prepare to celebrate the 46th anniversary next month, history shows medicare has been one of the most successful health care programs in our nation. seniors rely on it, but my republican colleagues' family want to end medicare as we know

it. missouri's own harry truman conceived a medicare and was the recipient of the first medicare card in 1965 and was signed into law by l.b.j. at the time 40% of america's seniors over 65 lived at or below the poverty level. now more than 40 million seniors are enrolled in medicare including one million missourians and the poverty rate for seniors has dropped to only 10%. the republican plan is to reopen the doughnut hole, double seniors' medical expenses and give insurance companies the power to ration care. we cannot let this happen. everyone agrees we must make serious cuts to lower our debt, but we have to take a balanced approach that doesn't threaten our fragile recovery or scapegoat american seniors. i ask my colleagues to set our differences aside and have a serious conversation about our debt that respects what seniors need and deserve. i yield back. the speaker pro tempore: the gentleman's time has expired. for what purpose does the

gentleman from new jersey rise? >> request to address the house for one minute. the speaker pro tempore: without objection, the gentleman is recognized for one minute. >> mr. speaker, i rise today to raise awareness about muscular dystrophy. there is no cure and affects boys disproportionately. mr. runyan: the disease affects approximately one and 3,500 male births. conditions of the disease include deterioration of the muscular tissue, abnormal bone development and paralysis and eventually death. earlier this year my office was contacted by several families from my district whose young sons are living with this disease. it takes lives too quickly but due in large part to the research development there are three signs of hope. over the last five years congress has appropriated $175 million to n.i.h. for these efforts.

in 2010 the n.i.h. awarded three grants, particularly to new jersey institutions, totaling $874,000. two of the grants were awarded to the university of medicine and dentistly in new jersey to explore treatments for congenital disease and the third were -- i hope that these and other -- the speaker pro tempore: the gentleman's time has expired. mr. runyan: i yield back, mr. chairman. the speaker pro tempore: the gentleman's time has expired. for what purpose does the gentleman from michigan rise? >> to address the house for one minute and to revise and extend. the speaker pro tempore: without objection, the gentleman from michigan is recognized for one minute. mr. clarke: thank you, mr. speaker. it's time for us in this congress to begin withdrawing both our troops and our tax dollars from afghanistan. now, for now it's important to still train the afghan national army, but we don't have to

spend $100 billion a year and keep over 100,000 troops in afghanistan to help keep stability in that country. we need to cut back our borrowing and our spending in afghanistan in order to cut our debt and our deficit right here. but equally important, let's take that money that was slated to afghanistan and it's our tax dollars in the first place and let's redirect it to the united states to protect americans here at home with stronger homeland security. and all the money we spent in afghanistan repairing bridges and roads and building schools and businesses, let's redirect both the economic aid to the united states because we need jobs here. redirect our tax dollars from afghanistan to help americans back to work. the speaker pro tempore: the gentleman's time has expired. for what purpose does the gentlelady from illinois rise? mrs. biggert: i ask unanimous consent to address the house

for one minute and to revise and extend. the speaker pro tempore: without objection, the gentlelady is recognized for one minute. mrs. biggert: mr. speaker, it is with heavy heart that i rise today to honor the life of an american soldier from illinois who made the ultimate sacrifice in the service of his country. private first class michael c. olivieri was a dedicated soldier serving his first tour of duty in baghdad where he was helping to train and support the iraqi police. on june 6 his base came under attack resulting in the death of five soldiers, including michael. last week would have marked michael's first wedding anniversary which he had hoped to celebrate during his scheduled visit home. during that same visit he was to attend his sister's wedding. mr. speaker, michael was a caring husband, a loving son and grandson, a beloved sibling and a dear friend to countless in his -- people in his

community. he went on to enlist in the army where his talents were in full display. often playing the guitar to his soldiers, he lifted the hearts of his fellow soldiers and will be lost to those who knew and loved him. today i'd like to offer my heart felt condolences to his wife, his parents, his sisters, his brother and his grandparents and dorothy regal. private michael c. oliveri was a great man, distinguished soldier and true american hero. i yield back. the speaker pro tempore: the gentlelady yields back her time. for what purpose does the gentleman from oregon rise? >> to address the house for one minute. the speaker pro tempore: without objection, the gentleman is recognized for one minute. mr. defazio: last december with one vote congress voted to add $1 billion by extending all the bush tax cuts and adding a new social security tax holiday. the premise was it would put america back to work. get what, it hasn't worked.

this country is anemic at best. now the republicans and the president want to double down. they want to expand and continue the social security tax holiday at a cost of $225 billion borrowed. how about instead of more tax cuts, instead of reducing investments and infrastructure, how about $220 billion of reinvestment to our crumbling infrastructure? in engineering, in small businesses and manufacturing, add $1.5 trillion to our economy. the choice is clear. more failed policies of the past or investment in the future. . the speaker pro tempore: the gentleman's time has expired. for what purpose does the gentleman from alabama rise? >> address the house for one minute. revise and extend. the speaker pro tempore: without objection, the gentleman from alabama is recognized for one minute. mr. aderholt: mr. speaker, i rise today to ask one simple question to the other chamber across the capitol, where is

their appropriation bill for the department of homeland security for f.y. 2012? on june 3, some 19 days ago, the house passed its version of f.y. 2012 appropriation bill for the department of homeland security. a bill that not only invokes fiscal discipline and needed oversight, but one that ensures our frontline security and personnel and homeland security programs are adequately funded for the coming fiscal year. in addition, the house passed bill includes $1 billion in supplemental funding for fema's disaster relief efforts that is available immediately upon enactment. unfortunately as of today we have seen absolutely no action from the other body. there is no plan, no leadership, and no commitment to fiscal discipline, security, or disaster relief. the democrat leadership on the other body was not elected to wait. that is not what the american people elected them to do.

waiting only puts our security and disaster relief on hold. the speaker pro tempore: the gentleman's time has expired. mr. aderholt: i yield back the balance of my time. the speaker pro tempore: the gentleman's time has expired. for what purpose does the gentleman from kentucky rise? mr. yarmuth: permission to address the house for one minute. the speaker pro tempore: without objection. the gentleman is recognized. mr. yarmuth: thank you. mr. speaker, we are now less than six weeks away from a magical date, august 2. that's the day when the secretary of treasury said we will essentially have to foreclose on the united states of america. we will begin paying china before we pay our troops. that's right. that's the day we run out of tricks to avoid raising the debt ceiling in this country. this sunday, the minority leader of the senate, said on cbs news that he was actually threatening basically to derail whatever deal comes on raising the debt ceiling if we don't do a deal on entitlements. it's an interesting threat. i would like to point out what was written in the "washington

post." what specifically is the threat here? that republicans will endanger the economy and run a campaign demanding deep medicare cuts necessitated by an unrelenting hostility to tax increases on the richest americans in an election year? that's not a credible threat. at some point democrats need to begin saying no to this stuff and now is a good time as any. i say no. i yield back. the speaker pro tempore: the gentleman's time has expired. for what purpose does the gentleman from pennsylvania rise? >> address the house for one minute. revise and extend my remarks. the speaker pro tempore: without objection, the gentleman is recognized for one minute. >> thank you, mr. speaker. i, too, rise today to urge the senate to take up the fiscal year -- this year's homeland security appropriations bills. mr. dent: the senate has a bad habit of waiting to do just about anything. it's bad enough the senate has refused to even take up a budget. it's been hundreds of days before they considered to do one. now they are derelict in their duties by failing to deal with the homeland security appropriation bill. we need to fund i.c.e., the coast guard, and many other critical functions of this

department. of course fema has great needs right now with the floods in missouri and elsewhere. and all the tragedies we have seen with the tornadoes across the country. it's important now that we get this funding that was appropriated out of the house. get it through the senate. mr. speaker, the 10th anniversary of 9/11, those horrific attacks just weeks away, and disasters occurring all over the country. i certainly today urge that the senate move forward. there can be no further delay. the motto of the senate simply can't be do nothing. do nothing, do nothing. start slow and wind down from there. that's what we seem to be getting. not on this bill. move the house appropriations bill on homeland security immediately. thank you. i yield back. the speaker pro tempore: the gentleman's time has expired. for what purpose does the gentleman from michigan rise? without objection, the gentleman is recognized for one minute. >> mr. speaker, i rise today to express my growing concern regarding the events unfolding in syria. president assad has repeatedly

refused to usher in democratic reforms for his people and instead has chosen to continue his indiscriminate killings of innocent men, women, and children. his ruthless campaign of brew tality has shifted to northern syria where syrian security forces led by president assad's brother have instilled fear in the residentsment many of those innocently protesting for reform and freedom have been gunned down and many more have fled their homes, leaving all belongings and possessions behind. mr. peters: with a complete ban on the entry of foreign journalists into the country, it is nearly impossible to determine just how dire the circumstances are. however with the thousands of syrians fleeing the violence into nearby turkey, it is clear that conditions both in syria and on the turkish-syrian border are deteriorating. i therefore urge president assad to allow humanitarian aid groups access into syria. by refusing entry, assad has forced his own people to not only live undeplorable conditions but he has forced them to live in a constant state

of fear. aid groups must be allowed in to provide the vital care. if the syrian regime has any compassion, it will do so. i yield back. the speaker pro tempore: the gentleman's time has expired. for what purpose does the gentleman from cap as rise? without objection. the gentleman from kansas virginia tech. >> thank you, mr. speaker. today i rise for a very special trib boot to a strong, wonderful, sweet woman who has played a remarkable role in my life. ed in a yoder, my grand -- edna yoder, my grandmother, will be celebrating her birthday next week. she reflects the heart and soul of our american heritage and the spirit that is the bedrock of our nation's values. mr. yoder: born in 1911 and raised on a kansas farm, she and my grandfather carved a way of life out of the kansas prairie through hard work, determination, and strong heartland values. each time i step on the floor of the ubs house, i strive to honor these principle that is my grandmother and her generation

have taught us. mr. speaker, join me in wishing my grandmother a happy 100th birthday. i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. for what purpose does the gentleman from colorado rise? mr. polis: permission to address the house for one minute. the speaker pro tempore: without objection, the gentleman from colorado is recognized. mr. polis: thank you, mr. speaker. there has been a lot of discussion in the house how to characterize the republican plan to eliminate medicare. i want to start with the definition. oxford english dictionary definition of medicare, a federal system of health insurance for people over 65 years of age and for certain younger people with disabilities. so again a federal system of health insurance. if you replace a federal system of health insurance with a federal system of assistance or voucher or helping to pay part of the costs, you don't have anything that meets the definition of what we know as medicare. maybe they want to call it medi assist, medivoucher, maybe it coverses -- covers the cost of

care for some people. according to nonpartisan estimates the average senior will have to pay $6,000 more for health care by the time the republican budget is fully implemented. whatever it is, it ain't medicare. medicare is very simple. the american people truly understand what medicare is. we all have family that rely on medicare. lord knows we need to improve medicare to help make sure it's sustainable for the next generation. ending medicare is not an agreement. the speaker pro tempore: the gentleman's time has expired. for what purpose does the gentleman from wisconsin rise? >> mr. speaker, i ask unanimous consent to address the house for one minute. revise and extend my remarks. the speaker pro tempore: without objection, the gentleman from wisconsin is recognized for one minute. >> mr. speaker, shortly the house will begin its consideration of the so-called patent reform bill. mr. sensenbrenner: at last night's meeting of the rules committee, when the debate on the rule within the committee wrapped up, the chairman chastised the judiciary committee for voting out a bill in violation of house rules.

and specifically the house cut-go rules. however the rules committee also voted a waiver that allows the cut-go rules to be ignored. that waiver is described by its supporters as a technical correction. this technical correction involves $700 million. hardly something that is technical. seems to me that the best thing that should have been done was the rules committee ordered the bill rereferred to the judiciary committee so the judiciary committee could do it right in conformity with the house rules. like the gentleman from michigan, mr. conyers did, when he was the chair and which i did when i was the chair. we ought to know this when we are debating it. i yield back. the speaker pro tempore: the gentleman's time has expired. for what purpose does the gentleman from south carolina rise? mr. wilson: permission to address the house for one minute. revise and extend. the speaker pro tempore: without

objection, the gentleman from south carolina is recognized. mr. wilson: mr. speaker, the unemployment rate for the month of may was 9.1%. this marks the 28th consecutive month that unemployment has been at 8% or above. the president said unemployment would never reach 8% with his economic policies. which have sadly failed. tragically almost 14 million americans are unemployed and looking for a job. the average job seeker in america is running unemployed for almost 40 years. almost 10 months. this administration and its job-killing policies continue to spend and borrow money at a reckless rate without understanding a basic and fundamental principle. when the federal government borrows money wildly, it takes it away from the private sector's ability to create jobs. the house republicans have solutions to promote jobs with the cut in congressional plan. first you cut spending and then small businesses add jobs. this is the best way for families to get back on the path

to prosperity. in conclusion, god bless our troops and we will never forget september 11 and the global war on terrorism. the speaker pro tempore: the gentleman yields back the balance of his time. for what purpose does the gentleman from florida rise? >> mr. speaker, by direction of the committee on rules i call up house resolution 316 and ask for its immediate consideration. the speaker pro tempore: the clerk will report the resolution. the clerk: house calendar number 46, house resolution 316. resolved, that at any time after the adoption of this resolution the speaker may, pursuant to clause 2-b of rule 18, declare the house resolved into the committee of the whole house on the state of the union for consideration of the bill, h.r. 2021, to amend the clean air act regarding the air pollution from

outer continental shelf activities. the first reading of the bill shall be dispensed with. all points of order against consideration of the bill are waived. general debate shall be confined to the bill and shall not exceed one hour equally divided and controlled by the chair and ranking minority member of the committee on energy and commerce. after general debate, the bill shall be considered for amendment under the five-minute rule. the bill shall be considered as read. all points of order against provisions in the bill are waived. no amendment to the bill shall be in order except those printed in part a of the report of the committee on rules accompanying this resolution. each such amendment may be offered only in the order printed in the report, may be offered only by a member designated in the report, shall be considered as read, shall be debatable for the time specified in the report equally divided and controlled by the proponent and an opponent, shall not be subject to amendment, and shall

not be subject to demand for division of the question in the house or in the committee of the whole. all points of order against such amendments are waived. at the conclusion of consideration of the bill for amendment, the committee shall rise and report the bill to the house with such amendments as may have been adopted. the previous question shall be considered as ordered on the bill and amendments thereto to final passage without intervening motion except one motion to recommit with or without instructions. section 2, at any time after the adoption of this resolution, the speaker may, pursuant to clause 2-b of rule 18, declare the house resolved into the committee of the whole house on the state of the union for consideration of the bill, h.r. 1249, to amend title 35 united states code to provide for patent reform. . the first reading of the bill shall be dispensed with. all points of order against

consideration of the bill are waived. an initial period of general debate shall be confined to the question of the constitutionality of the bill and shall not exceed 20 minutes equally divided and controlled by representative smith of texas and representative kaptur of ohio or their respective designees. a subsequent period of general debate shall be confined to the bill and shall not exceed one hour equally divided and controlled by the chair and ranking minority member of the committee on the judiciary. after general debate the bill shall be considered for amendment under the five-minute rule. it shall be in order to consider as an original bill for the purpose of amendment under the five-minute rule the amendment in the nature of a substitute recommended by the committee on the judiciary now printed in the bill. the committee amendment in the nature of a substitute shall be considered as read. all points of order against the committee amendment in the nature of a substitute are waived. no amendment to the committee amendment in the nature of a substitute shall be in order

except those printed in part b of the report of the committee on rules accompanying this resolution. each such amendment may be offered only in the order printed in the report, may be offered only by a member designated in the report, shall be considered as read, shall be debatable for the time specified in the report equally divided and controlled by the proponent and an opponent, shall not be subject to amendment, and shall not be subject to a demand for division of the question in the house or in the committee of the whole. all points of order against such amendments are waived. at the conclusion of consideration of the bill for amendment the committee shall rise and report the bill to the house with such amendments as may have been adopted. any member may demand a separate vote in the house on any amendment adopted in the committee of the whole to the bill or to the committee amendment in the nature of a substitute. the previous question shall be considered as ordered on the bill and amendments thereto to

final passage without intervening motion except one motion to recommit with or without instructions. section 3. upon receipt of a message from the senate transmitting h.r. 1249 with a senate amendment or amendments thereto, it shall be in order to consider in the house without intervention of any point of order a single motion offered by the chair of the committee on the judiciary or his designee that the house disagree to the senate amendment or amendments and request or agree to a conference with the senate thereon. the motion shall be debatable for one hour equally divided and controlled by the chair and ranking minority member of the committee on the judiciary. the previous question shall be considered as ordered on the motion to its adoption without intervening motion or demand for division of the question. the speaker pro tempore: for

what purpose does the gentleman from california rise? mr. garamendi: mr. speaker, i rise a point of order because it violates section 426-a of the congressional budget act. it contains a waiver of all points of order against consideration of the bill which includes a waiver of section 425 of the congressional budget act which causes a violation of section 426-a. the speaker pro tempore: the gentleman from california makes a point of order that the resolution violates section 426-a of the congressional budget act of 1974. the gentleman has met the threshold burden under the rule and the gentleman from california and a member opposed will each control 10 minutes of debate on the question of consideration. following debate, the chair will put the question of consideration as the statutory means of disposing of the point of order. the chair recognizes the gentleman from california. mr. garamendi: thank you, mr. speaker. i rise to this point of order

not necessarily out of concern for the unfunded mandates, although there are many in this resolution, 2021, the jobs and permitting act of 2011. i rise to the point of order because it's one of the very few vehicles we have, given the house rule, that we can actually talk about what's in this bill and there are plenty of things in this bill. i also note that the resolution includes h.r. 1249 which talks about patents because that also violates the house's cut-go rule. let me speak to h.r. 2021, the jobs and permitting act of 2011, which is actually better noted as the bad lung and emphysema, cancer act of 2011. it gives offshore oil a pass to poe lute -- pollute to vessels

which counts up to 80% of the pollution. i guess if you are in the gulf of mexico and the wind is blowing to the shore you would care about this. in california the wind almost always blows on to the shore and the offshore drilling and the additional pollution that would be allowed because of this is a serious problem for california. it poses a health risk, smoke, fumes, dust, ash, black carbon, all of these things blow on the shore in california where we have quite enough air pollution without this additional amount. our local communities do have the right and should even though this bill would tend to limit it to go to the e.p.a. it cuts the review time in half, thereby denying local communities the full opportunity to express their concerns about the additional pollution. it eliminates third-party

expert decisionmaking from the environmental appeals board. and then 20 years of environmental appeals board created under the george w. bush e.p.a. and it eliminates that. many, many problems here, and i would like to raise them all but by including the permitting -- the patents in this, i would like now to yield three minutes to my colleague from california so that she might express her concerns about the -- the speaker pro tempore: the gentlewoman from california is recognized for three minutes. ms. lofgren: thank you, mr. speaker. it has a discretionary cost of over $346 billion over the next five years, $1.1 billion over the next 10 years. the manager's amendment violates the new cut-go rules by endoing the n.i.c. diversion language which eliminates a procedure that would have decreased the budget deficit by $717 million over five years.

this is not offset. this violates the cut-go rules that the majority put in place. i would note also that the rule has -- and the manager's amendment has many other problems. i'm very disappointed that having worked on the patent reform measures since 1997 that we are yanking defeat from the jaws of victory here today. the rule does not permit consideration of mr. connier's amendment that was focused on the fee matter that violates the -- corrects the violation of the rule. it also does not permit consideration of the grace period, preservation and prior clarification that is essential to small ventures. if we are to go to the first to file system, we need to make sure that we protect prior user

rights and we protect the grace period that has been with our system for so long or else we are going to disempower small innovators. that is simply wrong. this is a bill that had in the past gain nearly unanimous support when mr. sensenbrenner was chair, when mr. conyers was chair. i am distressed to report today that i cannot support this measure after working on it since 1997. not only does it violate the rules, it costs the treasury and it will disempower small innovative inventors. so this is wrong, and the amendments that could have been put in order to correct them were not permitted. i think this is really quite a shame and i would urge that the measure not be brought up.

as mr. sensenbrenner suggested, it should be sent back to the judiciary committee for further work. i would yield back to mr. garamendi so he may yield to the former chairman. the speaker pro tempore: the gentleman from california controls the time. the gentleman from california is recognized. garegare may i inquire as to how much time i have remaining? the speaker pro tempore: the gentleman from california has five minutes. garegare very good. i think i would like to now yield two minutes to mr. sensenbrenner. the speaker pro tempore: the gentleman from wisconsin is recognized. mr. sensenbrenner: thank you very much, mr. speaker. i rise in the support of the move of the gentleman from california, mr. garamendi, to delay consideration of the rule. and i want to talk about the patent bill specifically. the rules committee granted a waiver of cut-go rules to this bill so that it would not be subject to a point of order. i believe in the cut-go rules, and i am told by the supporters of this bill that this waiver is just technical because the

committee violated the rules of turning discretionary spending into mandatory spending. as we have just heard, this technical waiver involves $717 million. it is hardly technical, and in fact at the end of the rules committee consideration of this rule last night the chairman of the rules committee admonished the chairman the judiciary committee committee, mr. smith of texas, that he should not be reporting out legislation that violates house rules. now, rather than giving the judiciary committee a get-out-of-jail-free card with the $717 million technical waiver, we should send this bill back to the judiciary committee so that they can fix up their own mess rather than having the house or the rules committee to do it. now, making a motion to send the bill back to the judiciary committee is not in order because i looked into that. the only way we can get this

legislation fixed up without a $717 million technical waiver of cut-go rules is to support the motion that the gentleman from california, mr. garamendi, is making and i go across the aisle by agreeing that he is on the right track on this, and i hope that he is supported. i yield back. the speaker pro tempore: the gentleman from california is recognized. mr. garamendi: i thank the gentleman. i reserve the balance of my time. the speaker pro tempore: the gentleman from california reserves the balance of his time. for what purpose does the gentleman from florida rise? mr. nugent: i rise to claim time in opposition to a point of order and in favor of consideration of the resolution, and i reserve the balance of my time. the speaker pro tempore: the gentleman reserves the balance of his time. the gentleman from california. mr. garamendi: well, i think he tossed it back to me, mr. speaker, and so let me go ahead and finish this up. mr. sensenbrenner accurately talked about the way in which this particular resolution and the underlying bill on the

patent bill violates the house rule that was written not more than 5 1/2 months ago. why would we want to violate the rules that we put in place to prevent excessive federal spending? doesn't make sense to me, so i agree with mr. sensenbrenner. send this thing back. it's a violation of the rule, and i would ask for a ruling on that from the chair. the other point that i'd like to make is a similar point with regard to the offshore oil drilling bill which really does present a very serious problem for california. all of the offshore drilling in california, and it's very extensive. it's the second largest area for offshore drilling in the united states, is immediately off the california coast where we have serious air pollution problems, some of the serious in the nation. all of those offshore drilling platforms pollute. air pollution of many different kinds causing potential harm to the citizens of southern

california. those onshore winds bring those pollutants onto the shore and cause additional air pollution problems which then require under this bill that the local communities take additional action to reduce the pollutants that are generated onshore, creating a very serious economic problem. in addition, the bill requires that the issues raised -- any legal issue raised has to be taken up in the district court here in washington, d.c. by my calculation, that's nearly 3,000 miles away from where the problem exists, that is southern california, placing an incredible burden on them and an unfunded mandate that they have to then come out of their own budgets to come to washington, d.c., to take up any legal issue that is raised. an unfunded mandate clearly in violations of the rules of the

house and, therefore, a point of order is in order, and i would hope that the chair -- or the speaker -- would so rule. many other problems beyond the air pollution and the like, i'll let those go. i'll reserve the balance of my time. the speaker pro tempore: the gentleman reserves the balance of his time. the gentleman from florida is recognized. mr. nugent: mr. speaker, the question before the house is, should the house now consider h.r. 316? while the resolution waives all points of order against consideration of the bill, the committee is not aware of any points of order. the waiver is prove latic in nature. the -- it would oppose both intergovernmental and private sector mandates. as defined by the unified mandates reform act on certain patent application. other entities would also be preempted from the courts to hear certain patent cases. however, the patten and

trademark office, the congressional budget office estimates that the cost of complying with both mandates to state, local and tribal governments would fall far below the annual threshold established by the unfunded mandates reform act because the cost of complying with the mandates fall below the annual threshold. it is prophylactic in nature. i ask members to vote yes on the question of consideration and i reserve the balance of my time. the speaker pro tempore: the gentleman from florida verve the balance of his time. the gentleman from california has 30 seconds and is recognized. mr. garamendi: i would like it dwreeled to mr. sensenbrenner. the speaker pro tempore: the gentleman from wisconsin is recognized. mr. sensenbrenner: $717 million cut-go waiver is not prophylactic in nature. it's whether we are going to

abide by our cut-go rules or whether we won't. and the way we enforce the cut-go rules is by delaying consideration of this legislation, sending the passed bill back to committee and letting the committee spend some time complying with the rules of the house of representatives. this is a terrible precedent to set. don't set it now. the speaker pro tempore: the gentleman's time has expired. the gentleman from california's time has expired and the gentleman from florida is recognized. mr. nugent: yeah, mr. speaker, what's amazing about this is we're going to stop debate on the house floor about very important legislation that needs to move forward. both of those pieces of legislation. and so we need to have open debate on the house floor with opposing viewpoints. with the ability to have amendments added on the floor, which we have allowed in this rule. so, with that, mr. speaker, i'd like to yield my time now to mr.

dreier of from california, the chairman of the rules -- mr. dreier from california, the chairman of the rules committee. mr. dreier: mr. speaker, let me say that we obviously are dealing with an irregular development that took place in the judiciary committee, that being the notion of believing somehow that they could appropriate dollars. we know full well that the judiciary committee cannot engage in the appropriations process itself. and so all that this provision that we are pursuing does is allows us to take from mandatory back to discretionary spending without any cost whatsoever, the power will fall with this institution, with the first branch of government which is exactly where it should be and everyone, everyone, mr. speaker, talks about the concerns that we have over mandatory spending, both democrats and republicans

alike have made it clear that if we don't deal with the issue of mandatory spending we're not going to successfully address the economic and budget challenges that we face. and so all this provision does is it allows us to deal with what was an irregular development that took place in the judiciary committee and it is for that reason think a support my friend from florida's effort. i'm happy to yield to my friend. >> excuse me, i doned hold the time -- i don't hold the time. >> can the gentleman from california please explain to the house how we're going to cut spending by violating our cut-go rules with a $717 million waiver when the gentleman from california's already chastised the judiciary committee for violating the rules? mr. dreier: would the gentleman yield? mr. nugent: i will. mr. dreier: let me just say that this has absolutely no effect whatsoever on the actual

spending level, the budget committee and by the way the congressional budget office is not able to take in the mix the details of this extraordinary development that took place in the judiciary committee. and so there is not going to be any cost, this is a provision which clearly, clearly will allow us, as my friend from florida has said, to proceed with a very important debate and to rectify a mistake that was made there. and i thank my friend for yielding. the speaker pro tempore: the gentleman from florida controls the time and is recognized. mr. nugent: with that i yield back the balance of my time. the speaker pro tempore: the gentleman from florida yields back his time. all time having expired, the question is, will the house now consider the resolution. those in favor say aye. those opposed, no. in the opinion of the chair, the ayes have it. >> mr. speaker. i ask for the yeas and nays. the speaker pro tempore: the yeas and nays are requested. all those in favor of taking

this vote by the yeas and nays will rise and remain standing until counted. inc., in cooperation with the united states house of representatives. any use of the closed-captioned coverage of the house proceedings for political or commercial purposes is expressly prohibited by the u.s. house of representatives.]

the speaker pro tempore: on this vote the yeas are 214, the nays --

the speaker pro tempore: on this vote the yeas are 215, the nays are 189, with one member voting present. the question of consideration is decided in the affirmative. without objection, the motion to reconsider is laid on the table. would members kindly clear the well. would members kindly clear the well. members engaged in conversation in the well, please take your conversations from the floor.

the speaker pro tempore: the house is not in order. would all members please take their side bar conversations off the floor. the gentleman from florida is recognized for one hour. mr. nugent: mr. speaker, for the purposes of debate only, i yield the customary 30 minutes from the gentleman from of colorado, mr. polis, pending which i yield myself such time as i may consume. during consideration of this resolution, all time -- >> the house is not in order. the speaker pro tempore: the gentleman is correct, the house is not in order. would all members please take their conversations from the floor.

the gentleman may proceed. mr. nugent: during consideration of this resolution, all time is yielded for the purposes of debate only. mr. speaker, i ask unanimous consent that all members have five legislative days to revise and extend their remarks. the speaker pro tempore: without objection, so ordered. mr. nugent: house resolution 316 provides for the structured rule for consideration of both h.r. 1249 and h.r. 2021. the rule provides for ample debate on both of these bills and gives members of both minority and a majority the opportunity to participate in the debate. mr. speaker, i rise today in support of h.res. 316, as i said before, this rule provides for consideration of two different bills. h.r. 1249, the american invents act, and h.r. 2021, the jobs and

energy permitting act of 2011. although these bills share one rule, the house will have opportunity to consider these pieceses of legislation separately and the rule ensures that we'll have full transparent debate on both of these bills. article 1, section 8 of the constitution delegates congress the exclusive authority over the u.s. patent law. however, congress has not enacted a comprehensive patent reform for nearly 60 years, since the patent act of 1952. the american invent act makes significant substantive procedural and technical changes to current u.s. patent law and is designed to put american inventors on a level playingfield with their global competitors. i've heard from my colleagues on both sides of the aisle about concerns they have with the american invents act. in fact, i have some of those

same concerns myself. as colleagues on the other side of the aisle and some on this side of the aisle are going to point out this rule waives cut-go. quite frankly, mr. speaker, i hate that we have to waive cut-go to bring this legislation to the house floor. however, i need to stress to members on both sides of the aisle that even though this rule may waive cut-go, it does not increase the budget or its deficit. the judiciary committee wrote a bill that violated the house rule by appropriating when it moved patent fees from discretionary spending to mandatory spending. the manager's amendment fixes the judiciary committee's violation of those house rules, the manager amendment does this at the instistence of the rules committee and the leadership. this is the right thing to do. the constitution makes it clear that the power of the purse must

stay in congress and i believe abdicating agency funding to p.t.o. would clearly violate the constitution. however, by moving money back to the discretionary spending, chairman smith's manager amendment does, through a technicality, violate cut-go. again, let me remind my colleagues that while a manager's amendment does require a technical waiver of cut-go, this does not increase the deficit. let me say it again, this does not increase the deficit. in fact, budget committee chairman ryan supports this solution because, one, the manager's amendment ensures that the funding for p.t.o. stays on the discretionary side where it is subject to appropriation, but enforcement and oversight. two, this is the only technical waiver of cut-go rule because the provisions of the manager amendment was not included in the reported bill.

as i said before, i don't like it that we need to waiver cut-go. however, it is the right thing to do so we can ensure institutionally that the power of the purse continues to lie with congress, where our founding fathers intended it to be. additionally, i'm proud to say this is the first time ever, the first time ever this rule actually specifically designates 20 minutes for debate devoted exclusively to the constitutionality concerning h.r. 1249. we opened the 112th congress with reading the united states constitution. i believe we can't let the conversation end there. therefore i'm proud of this rule which continues to reflect congress' commitment to our nation's foundation, the constitution. but this rule isn't just for h.r. 1249, but it's also for

h.r. 2021, the jobs and energy permitting act. mr. speaker, i strongly support this legislation. the u.s. geological survey estimates that alaska's seas contain 27.9 billion, that's with a b, barrels of oil and -- and 122 trillion feet of natural gas. these resources, if developed, could produce up to one million barrels of oil per day for domestic energy consumption. however, while companies may have drilling leases to these lands, they continue to be mired in red tape. this bill helps cut through these delays. h.r. 2021 eliminates the permitting back and forth that occurs between the environmental protection agency and its

environmental appeals board. rather than having exploration air permits repeatedly approved and then rescinded by the e.p.a. and its review board, under h.r. 2021 the e.p.a. will be required to take final action, either granting or denying the permit, within six months. mr. speaker, the american people are tired of the e.p.a. keeping us from taking advantage of our own natural resources. we're the only country in the world that does that. and, mr. speaker, the obama administration has put their green agenda and e.p.a. bureaucracy over american jobs and the ability for our energy security. h.r. 2021 helps bring the end to those irresponsible policies. i encourage my colleagues to vote yes on the rule and i will reserve the balance of my time. the speaker pro tempore: the gentleman reserves the balance of his time. the gentleman from colorado is recognized. mr. polis: thank you, mr. speaker.

i thank my friend from florida for yielding me the customary 30 minutes and i yield myself such time as i may consume. the speaker pro tempore: the gentleman is recognized. mr. polis: mr. speaker, patents are one of the most critical components that drive american innovation and drive our economy, drive invention and innovation. regrettably for a variety of reasons the bill that this rule makes in order fails to ensure that the patent office has the resources it needs to process patent applications in a timely manner. now, i am grateful that this rule allows discussion of a number of important amendments including my amendment, but there are a number of underlying flaws in the manager's amendment to this bill. inventors, innovators and job creation should not be on hold due to delays in patent aplolve -- approval. i'm an inventor of several patents. and i can tell you that the quickest one that i received took over five years until it was granted. by the time it was granted i had sold the company and was no longer involved in the sector. the internet and information economy move in a speed, in a

different time frame than our patent review process operates under. yet this legislation in its current form with the manager's amendment might actually serve to ensure that those delays continue. because of a quabble between factions on the majority side. rather than resolve these differences to the benefit of american inventors, instead the baby has been split. a decision that would cause king solomon great receipt sense. the bad news for any american innovator pursuing a patent, as well as employees that new businesses might support is we fail to resolve some of the most pressing issues within the patent and trademark administration through this law. the issue is that h.r. 1249 change what had i would consider one of the most important aspects of patent reform and while there are very legitimate and important policy discussions on the aspect of patent reform, in equally if not more important in equally if not more important issue is adequate funding for