until they pay a price that's so great, systematic and comprehensive, that he will understand that we no longer operate by the rule of the jungle in europe or indeed anywhere else in this planet. not with our blessing. not with our apology. so i strongly support the legislation before us and urge my colleagues to join with all of us in telling mr. putin, we will not stand idly by with history doomed to repeat itself. i yield back to the gentleman from new york. thank the speaker. the speaker pro tempore: the gentleman from virginia has yielded back. the gentleman from california is recognized. mr. royce: mr. speaker, i yield three minutes to the gentleman from new jersey, mr. smith, chairman of the foreign affairs subcommittee on africa, global health, global human rights, and international organizations. the speaker pro tempore: the gentleman from new jersey is recognized for three minutes. mr. smith: mr. speaker, i rise in strong support of the ukranian support act. i want to thank my friends and colleagues, chairman royce and ranking member engel for introducing this comprehensive

legislation to support ukraine and its urgent effort to meet its current crisis, including building up its democratic institutions. mr. speaker, russia's land grab in crimea violates the core principles of several bilateral and multilateral agreements and treaties between ukraine and russia. the buddha pest memorandum, the united nations charter, as well as the hell sinka -- helsinki final act. this includes strong sanctions against russians directly responsible for the aggression. h.r. 4278 also authorizes targeted sanctions against ukranians involved in undermining the democratic processes and provides assistance to the ukranian government for identifying and recovering stolen assets. it is after all these criminal officials, including and especiallyiana could he vitch -- yanokovich who have so harmed the ukranian people.

another key provision of the bill provides support for ukraine's democracy and civil society and i want to recognize the importance of supporting as well the faith-based groups and organizations that played such a prominent role, particularly on the humanitarian side, in supporting the movement for democracy and the rule of law. the ukraineian democracy movement is in charge part a religious movement. orthodox and catholic clergy for example were prominent in the protest, and the drama of priests carrying icons, confronting soldiers became as much a symbol of the democratization movement as anything else. again when people were wounded, when people were being dragged away, it was the clergy that tried to step in to mitigate the violence against them. let me also point out that a catholic news service article that just hit the wire points out that members of the ukranian catholic church are fleaing cry me -- fleeing crimea to escape

threats of arrest and property seizures. the situation, quote, remains very serious and we don't know what will happen. the new government here is portraying us as nationalists and extremists. a parish representative-elector in crimea. he said that officials from the russian security service, or f.s.b., had called him in for questioning about his community and asked whether or not he recognized the new order. he pointed out that one priest in particular was actually beaten by russian forces, and again members will recall, i remember during the 1980's when i first came here how so many within the church, including orthodox church, were beaten, sent to the gulag because of their religious faith. this could be the harbinger of a new wave of repression against people of faith. ukranian catholic church by way of reminder was one of those churches that was outlawed during soviet times, and now we see the same kind of reputation

of that kind of repression. this legislation is a clear step in the right direction. no peace of legislation is -- will do it all. we have to appeal to the russians to stop this. but again cease the persecution of people in the crimea. the speaker pro tempore: the time of the gentleman from new jersey has expired. the gentleman from new york is recognized. mr. engel: thank you, mr. speaker. it's now my pleasure to yield three minutes to the democratic whip, the gentleman from maryland, mr. hoyer. the speaker pro tempore: the gentleman from maryland is recognized. mr. hoyer: i thank my friend, the ranking member, mr. engel from new york, and i thank mr. royce, the chairman of the committee, for bringing this bill to the floor. and working in a bipartisan fashion to affect an objective that i strongly support. i thank both of them for their work. the ongoing russian aggression against ukraine is unacceptable. in a gross violation of international law. i agree with president obama that russia's acting from a position of weakness, however.

strong nations do not invade and annex territory from their smaller neighbors by force. and strong nations do not suppress the free expression of ideas and the voices of dissent within their own society. those are the hallmarks not of a great nation but insecure bully. great nations are those that stand together to reaffirm the principles of liberty and international order. great nations are those that commit to peaceful diplomacy while protecting free and open debate among our citizens. the american people continue to stand with the people of ukraine, mr. speaker, because we believe they have a right to join the nations of the world that are free and able to shape their own future. that is why through this bill we pledge our support as the new government in kiev works to stabilize its economy, provide security to its citizens, and ensure that all ukranians are afforded the opportunities that

come with vibrant, democratic institutions and basic freedoms. that is what this bill offers the people of ukraine. what it offers president putin and his associates is an opportunity to end their misguided, unjustified, and illegal incursion in ukraine's internal affairs. because it affords them a choice, mr. speaker, that here the international law and end their aggression or face increasingly punitive sanction that is will further isolate russia from the global community. the one item miss interesting this otherwise strong bill, unfortunately, is ratification of i.m.f. quota reform. i hope the house will take action on that piece soon. however, this is a good bill. we ought to support this bill. we ought to pass this bill and send mr. putin a clear message that the united states congress and the nation we represent will

not stand for russia's actions and that we are ready to help ukraine reach for the future it so richly deserves. i yield back the balance of my time. the speaker pro tempore: the gentleman from maryland yields back. the gentleman from california is recognized. mr. royce: mr. speaker, i yield three minutes to the gentleman from california, mr. rohrabacher , chairman of the foreign affairs subcommittee on europe,ure asia, and meerging threats -- eurasia, and emerging threats. the speaker pro tempore: the gentleman from california, mr. rohrabacher, is recognized for three minutes. mr. rohrabacher: mr. speaker, i rise in opposition to this legislation, and i realize that i am a lone voice, or almost a lone voice in this discussion today. i see this legislation as a bipartisan green light to reigniting the cold war. unfortunately, many of my friends and colleagues, both colleagues today and my friends from the time when i spent in

the reagan white house, seven years, many of these people feel that the cold war is not over. that it never did end. they are more comfortable with that -- with treating russia as if it was still under communist rule. well, putin is not a communist leader. putin is a nationalist who loves his country. and he's looking out for the national interest of his country. for us to try to demonize him and try to suggest that he is doing this like he did in the cold war, and k.g.b.,ets, is not doing the cause of peace any good in ukraine, a democratically elected president, this is what started this whole slide in the wrong direction toward the type of confrontation we are having today, that a democratically elected president was removed

from power. this precipitated, and that was a democratically elected president who is more inclined towards better relations with russia, he was removed from power and then the russian government under mr. putin decided to ensure the people of crimea the right to self-determination, because even secretary of state kerry has verified and testified before our committee that the people of crimea obviously want to be part of russia. this is not a power grab. this is defending their right for self-determination. . certainly the people of crimea have the right to make that determination, judgment as the people of kosovo had their right to leave serbia behind. our military action there to try to protect the right of self-determination of the kosovo people, it cost many, many lives and this russian military move, which is called this power grab, has resulted

in the loss of one life. that is in stark contrast to when we bombed bell grad, we bombed serbia. now, this should not be -- we should not permit ourselves to reignite a cold war, we should make sure shah we realize that the actions that we are taking here, suggesting the united states must rush in and be the arbiter in every one of these type of conflicts, is only stretching our budget, but in this particular bill, we are going to, what, put our name on a loan of $800 million to a country that we're going to have to borrow the money from china to get. the united states can no longer afford to write every -- right every wrong in the world and be the arbiter. the speaker pro tempore: the gentleman's time has expired. mr. rohrabacher: we'd be ash traiting in the wrong -- ash traiting in the wrong direction. the speaker pro tempore: the gentleman from california is recognized. >> i yield myself such time as i may consume. the speaker pro tempore: the gentleman is recognized. >> i thank the gentleman.

mr. royce: part of our problem here is with president putin's definition of what is the russian nation in his speech. when he says the russian nation is divided by borders, he is sending a message that with respect not just to crimea, but other areas throughout europe, that russia may be staking a claim. and here's the difficulty. in crimea, yes, the population today is majority ethnic russian. but there was a time when -- before joe stalin moved a wide segment of the population into beria and before the force collection, there was a time when the majority population is very different than it is today. 56% of those ethnic -- of that ethnic group perished. but this is a problem that we also have in eastern europe and

in eastern and southern ukraine. because you had some eight million ukrainians also perish during stalin's rule and ethnic russians came into that area as a consequence. now, the thing we need to remember is that it is in fact the russian-speaking population in the east, as well as the ukrainian-speaking in the west, that voted for independence for ukraine. that voted strongly to have a separate state. and if the -- this issue is allowed to stand without the world responding, the question is, is that argument then made in latvia and estonia? is that argument made in all of the former russian states? i do not think in any way this is comparable to kosovo. in kosovo nato responded to a brutal campaign of ethnic cleansing by former ugeslaskian forces.

in crimea, russia attempted to justify its actions by fabricating the myth of widespread violence against the ethnic russian population. even going as far as to equate it to the bloodshed occurring in syria. clearly this is not true. we know it's not true. in terms of the election itself, opponents were sigh lenlsed, international -- silenced, international monitors were barred, crimean charters themselves boycotted the very election. voters were not given the option of preserving crimea's current status within ukraine. independence and de facto independence were the only options. and the bogus vote there was also unnecessary because the ukrainian government had made it clear that it was willing to discuss increased autonomy for crimea. now, here is the problem going forward. we know the view taken internationally on this subject. the u.n. security council

condemns russia's unprovoked aggression against ukraine and russia stood alone, stood slupetly alone in this case -- absolutely alone in this case. because even ukrainians themselves have gone to the sites of the russian media reported attacks against ethnic russian minorities to show that is not occurring. hat is in fact propaganda. we can't let this stand. one of the other things we're doing in this bill is improving our broadcasting into ukraine in the region to dispel these myths and spread the truth about the situation there. so, i'm going to reserve the balance of my time at this time. the speaker pro tempore: the gentleman reserves the balance of his time. the gentleman from new york is ecognized. >> thank you, mr. speaker. i now yield two minutes to the gentlewoman from texas, ms. jackson lee. the speaker pro tempore: the gentlelady is recognized for

two minutes. ms. jackson lee: let me thank the managers of this legislation, the chairman of the foreign affairs committee, and the ranking member of the foreign affairs committee for their leadership and for their commitment as i acknowledge the other body as well. this morning a bright announcement came from mr. putin, that he was drawing russians to a program of exercise in the name of labor and defense. someone said reminiscent of s drew tory, when other their nations together in massive public exercises to show the world that they were not going to be part of the world order.

i believe that we should be engaged, that diplomacy is right. i also don't believe in condemnation of a nation purely for its ideological disagreement. but in this instance it is important for the united states to make a public stand. as a member of the interparliamentarian exchange, meeting with europeans over the years, i know that they are proud of the democracy that they've maintained since the horrors of world war ii. today the united states, the pass and of this legislation and ultimately hopefully the signing by the president will tell the world that the united states stands firmly on democratic principles. the people of ukraine, those in kiev and places around, still have the knowledge that america stands by it economically, with

loan guarantees, but it also stands against a despot who has illegally moved into a sovereign nation with no provocation, undermining the military base of ukraine. and so i'd ask my colleagues to join against a despot and for a people and support the underlying legislation. i thank mr. engel for the time. i yield back. the speaker pro tempore: the gentlelady's time has expired. the gentleman from california is recognized. mr. royce: i yield two minutes to the gentleman from texas, mr. poe, chairman of the foreign affairs subcommittee on terrorism, nonproliferation and trade. the speaker pro tempore: the gentleman from texas is recognized for two minutes. mr. poe: i thank the chairman for the time and i also thank the chairman and the ranking member for bringing this legislation to the floor and a very speedy and efficient manner -- in a very speedy and efficient manner. i will also say i have great respect for my friend from california, mr. rohrabacher. he knows a lot about foreign

affairs. but we disagree on what the evidence shows in this particular matter. mr. speaker, mark twain once said that history doesn't repeat itself, but it does rhyme. well, russia's quite the poet these days. in 2008 russia invaded georgia. confiscated 1/3 of that nation's territory. the world watched. complained a little bit. the world moved on. there were no consequences. and the russians, mr. speaker, are still there. again, second verse, same as the first. the napoleon of siberia has invaded ukraine and seized crimea. putin is bent on establishing a soviet-style empire and allegedly uniting russian-speaking people throughout the world. who knows who his next target will be? it could be our friends in maldovea, the rest of ukraine,

or estonia. russia has been able to maintain dominance over the region because of its vast energy sources, especially natural gas. six countries in europe rely 100% on russia for their natural gas. russia uses gas as a political and economic weapon to manipulate these countries. i was in ukraine in winter when russia turned off the gas for political reasons. it was cold. it was dark. this bill helps disarm that hostage tactic. it includes my amendment that commits the u.s. to helping ukraine use american natural gas. there must be consequences for the bully putin, for invading other nations like ukraine. justice requires there be consequences. and, mr. speaker, justice is what we do. and that's just the way it is. the speaker pro tempore: the gentleman's time has expired. the gentleman from new york is recognized. mr. engel: thank you, mr. speaker. may i inquire of how much time each of us has? the speaker pro tempore: the gentleman has eight minutes

remaining. and the gentleman from california has no minutes remaining. mr. engel: has -- none? the speaker pro tempore: the gentleman from california's time has expired. mr. engel: i ask unanimous consent that the gentleman from california be allowed to control three minutes of my remaining time. the speaker pro tempore: without objection. mr. engel: thank you very much, mr. speaker. what we're doing this morning is the congress at its best. what we're doing this morning is standing up to a bully and telling him that his actions will not stand. what we're doing is saying that in the 21st century, it is no longer acceptable for dictators to invade other countries. and what we're saying to the people of ukraine is that we stand behind you, we're with you, we haven't forgotten you

and we're going to do everything possible to make you whole again. we're going to do everything possible to let you know that the west wants to partner with you. we're going to do everything possible to stand up for freedom and democracy with you. i think that's a very noble cause. it's not pie in the sky. no one's advocating a war with boots on the ground against russia. but we are advocating that there has to be some standards in the world. if we let putin get away with this, then it sends a green light to putin that he can continue to do this and to every other despot and dictator around the world that they can do whatever they like and the world is just indifferent or too afraid to act. i think this is a opportunity -- an opportunity and i think this is a time when one day we'll be able to say to our

grandchildren that we acted together. i want to again commend chairman royce for working with me in a bipartisan fashion and we will be going to ukraine together in a few short weeks to show the ukrainian people that america stands with them. i urge my colleagues again to support the bill and i reserve the balance of my time. the speaker pro tempore: the gentleman reserves the balance of his time. the gentleman from california is recognized. mr. royce: thank you, mr. speaker. i yield one minute to the gentleman from indiana, mr. messer, a member of the committee on foreign affairs. mr. messer: thank you. mr. speaker, i rise in support of this important bipartisan bill and commend chairman royce and ranking member engel for bringing this measure forward. today's legislation makes clear that as a nation we speak with one voice regarding russia's aggression. the situation in the ukraine is undoubtedly complex. the history between crimea and russia dates back centuries, close to 60% of the population

identifies as ethnic russians. but several facts are clear. russia has amassed troops and perpetrated a breach of international law with its unwarranted aggression. the elections in crimea took place under an illegal occupation, it did not resemble anything close to a real election. and consequently the results should not and cannot be recognized. lastly, there is little doubt that if the world does not act, russia's territorial aggression will expand and continue. whatever the complexities, this invasion of a sovereign country is not justified. period. today's bill makes clear america will not tolerate russia's territorial aggression in ukraine or elsewhere. i urge my colleagues to support it. the speaker pro tempore: the gentleman's time has expired.

the gentleman from new york is recognized. mr. engel: may i inquire, mr. speaker, how much remaining time i have? the speaker pro tempore: the gentleman has 3 1/2 minutes remaining. mr. engel: ok. then i yield two minutes to the gentleman from michigan, the ranking member of the ways and means committee, mr. levin. the speaker pro tempore: the gentleman from michigan is recognized for two minutes. without objection. mr. levin: i rise in strong support of this bill. as ukraine is fighting for its independence and the people of ukraine are fighting to preserve and to deepen their democracy, we must stand squarely with them. it's been said here, including by the majority leader, that this is a first step. and i'd like to make very clear we really should be taking in this bill another step.

we should be in this bill as was proposed in the senate and by many of us some assistance to make sure that the i.m.f. can perform its fullest role. that was the preference of president obama. e made it clear we should act, the u.s. we should also be able to help the i.m.f. to act as fully and effectively as possible. so i think today instead of anybody here coming and criticizing the president, they should essentially be supporting him in his efforts to have the fullest array of assistance to the ukrainian democracy. so if this is only the first step, let's take some additional steps and stand together on a

bipartisan basis instead of at times i think taking partisan shots verbally at the president of the united states. i yield back. the speaker pro tempore: the gentleman yields back. the gentleman from california is recognized. the gentleman from new york is ecognized. mr. engel: thank you, mr. speaker. may i inquire how much time i have? the speaker pro tempore: the gentleman from new york has 1 1/2 minutes remaining. mr. engel: i yield one minute of that time to the gentlewoman from ohio, ms. kaptur. the speaker pro tempore: the gentlelady from ohio is recognized for one minute. ms. kaptur: i want to thank the esteemed ranking member of new york, eliot engel, a dear friend, for yielding time in support of ukraine support act, h.r. 4278. and for his leadership from the time we traveled to ukraine

together and to congressman royce, the chairman of the committee, to reaffirm america's strong support for liberty and the people of ukraine at this really critical time in world history and the history of central and eastern europe. the assistance that is contemplated here is in the form of a loan guarantee, and will aid ukraine's efforts to recover its own missing assets to pay the money back. ukraine is fully capable of earning its way forward. it's already the third largest grain exporter in the world. this is nothing that can't be repaid. in addition, the bill authorizes $10 million for international broadcasting to ukraine. i can guarantee you i did an interview with voice of america about a week ago. i received emails from people in ukraine. they are waiting to hear the song -- the speaker pro tempore: the gentlelady's time has expired. ms. kaptur: pass this legislation quickly on a

bipartisan basis and stand for freedom. the speaker pro tempore: the gentlelady's time has expired. the gentleman from new york is recognized. mr. engel: thank you, mr. speaker. in closing let me again say what a pleasure it is to work with chairman royce in a bipartisan basis. and you can see, again, strong bipartisan support for this bill. ms. kaptur didn't mention that she was co-chair of the ukrainian caucus. we have members on both sides of the aisle all standing together to say, the united states stands with the people of ukraine. please vote yes. i yield back. the speaker pro tempore: the gentleman yields back. the gentleman from california is recognized. mr. royce: i yield myself such time as i may consume. the speaker pro tempore: the gentleman is recognized for two minutes. mr. royce: thank you, mr. speaker. this is not a new cold war. president reagan ended the cold war. the way he did that, frankly, was by leading, but also with a strategy which drove down the price of oil and gas which was

the stranglehold which not only russia had over eastern europe, but also funded the ability of the former soviet union, militarily, to carry out an expansion program. today you have the circumstance where president putin relies almost solely, 70% of the exports, 52% of the budget as i indicated, comes from a monopoly position on oil and gas. that is why i think it is very important that we understand what the polls and what the hungarians understood when they exported $2 billion cubic yards of gas last year to ukraine in order to try to keep the ability of russia from manipulating the situation into leading to the very chaos that was brought about. we need to understand when the

u.s.-e.u. annual summit just occurred, and the e.u. asked us to be part of a program to ship gas into that market in order to offset this monopoly control and pricing by russia, that we should be part of this. this is part of this bill. but also part of the bill is the important consequence of communicating to the people in that region and offsetting the propaganda that russia right now is sending into the country. we address that issue as well in this legislation. as well as good governance issues and the steps that are needed in order to reform the economy inside ukraine. in order to set up the rule of law, independent courts. the polls are on the groundworking on this issue right now. the united states needs to support that effort. and this sends one last message that if you're in the business of helping to invade a country

it was probably one of the most important days of my entire life. i've never been so proud. to go home to my district over this weekend and have people

laughing at congress, laughing at congressmen, laughing at this institution, brings dishonor on all of us. i will give you couple of examples. i was at a pizza hut this weekend with my son mark and my daughter sarah, my wife leslie. a gentleman from the booth behind me asked me, are you going to pay with this -- pay for this with a check, congressman? we need to expose this, mr. speaker. announce the list of names. chair would like to warn the gentleman that he is not supposed to use exhibits. >> find more highlights from 30 years of house coverage on our facebook page here it -- page. to you by your local cable or satellite provider. ortiz.names are shelley

we attend an art school. throughout the years, we have seen how lack of support for treatment can result in devastating evidence, as well as stress for those individuals and their families. when i look back on the incident that took place in tucson, the tragedy were councilmember difference was shot, theffords was young man who did those shootings had been displaying symptoms of mental illness for at least two years before that time. >> we announced the winners of this year's cspan student videocam competition on what's the most important issue congress should address this year. watch the top 21 winning videos starting tuesday and every weekday throughout the month. see all the winning documentaries online on studentcam.org.

we showed you the debate leading up to final passage on the bill the would provide more aid to ukraine an additional sanctions against russia for their annexation of crimea. that passed in the house by a vote of 399 to 19. stacy caper with "national journal" said the house and senate almost simultaneously bills, saying the bills passed by overwhelming margins, but a clear path .orward remains elusive lawmakers were unsure if they could reconcile the different send one to president obama to sign by the end of the week. the house took up what was ,alled the doc fix bill today dealing with doctors facing a 24% cut in their pay if congress do not act. we will show you the debate on that next and the very quick final passage vote, which

happened at midday today. gentleman from pennsylvania. mr. pitts: mr. speaker, i ask unanimous consent that all members may have five legislative days to revise and and insert remarks extraneous materials in the record on the bill. the speaker pro tempore: without objection. mr. pitts: mr. speaker, i yield myself such time as i may consume. the speaker pro tempore: the gentleman is recognized. mr. pitts: mr. speaker, i wish i was getting ready to vote on a bill that would permanently repeal and reform the sustainable growth rate. in the chamber we passed a bill that would do that and that would fully offset the cost of the repeal by delaying a provision of the affordable care act that the administration just keeps delaying themselves. in fact, it was partially delayed again just yesterday. unfortunately, we have reached another doc fix deadline. i believe that we must act to protect america's seniors and ensure that they can continue

to see the doctors they know and trust and that is why i have introduced legislation that represents a bipartisan, bicameral agreement that would give us additional time to work out our differences and pass permanent repeal. we are closer than ever to reaching that goal. we have an agreement on policy. we need to overcome our differences about the responsible way to pay for those new policies. i hope that we can act before we reach the new deadline of march 31, 2015. in fact, we should try to reach a bicameral agreement before the end of this congress. i'm glad that speaker boehner has offered his continuing support to this effort. with the house having acted, we hope that the senate can also pass an s.g.r. repeal that has real pay-fors. then, we can begin the process of working through our

differences in a conference committee. . i'm sponsoring this bill today because it is my earnest hope that this is the last patch we'll have to pass. i urge all of my colleagues to support this bill and i reserve the balance of my time. the speaker pro tempore: the gentleman reserves. the gentleman from new jersey. mr. pallone: thank you, mr. speaker. i yield myself such time as i may consume. the speaker pro tempore: the gentleman virginia tech. mr. pallone: mr. speaker, i'm sorry but i simply cannot support yet another temporary s.g.r. patch. this bill is bad for seniors and it's bad for doctors. we want to achieve a permanent solution to this ongoing problem. this bill does nothing to achieve that goal. in fact, it sets back months and months of hard work. what we should be considering today is a bipartisan, bicameral agreement that my colleague and i developed. that bill is what doctors' groups and patient groups support. that bill can also be offset without robbing one provider to pay another provider.

what's before us today doesn't fix the problem. it exacerbates t we had a true opportunity to finally accomplish what our constituents have asked us to do for a decade, and that's pass a permanent repeal of the s.g.r., but the republican leadership sletting that opportunity slip away. and i respect my colleague from pennsylvania, but i don't believe that if we pass another patch that we are going to go back and do a permanent fix. my fear is by doing this we will lose the opportunity to do the permanent fix, and it simply slipsway. two weeks ago republicans brought to the floor our agreement, but they added a poison bill offset that they knew the president and the senate would never accept, a delay of critical affordable care act provisions. all that accomplished was wasting time. and has led us to this scenario, spending another nearly $20 billion on a patch. meanwhile, this bill includes health policies that have never seen the light of day. some have been used as offsets. others as sweeteners to get members to vote for it, but i'm not falling for t that is no way

to govern. the senate is actually poised to vote on our bipartisan agreement that is fully offset. it does so without cutting from the health care system. that is the bill we should be considering here today. seniors do not want us to kick the can again for another year. the doctor community spoke loud and clearly yesterday, no more patches. so i ask my colleagues, let's not go down this road again. instead, let's come together and pass a permanent solution. let's get the job done. vote no on this bill. i reserve the balance of my time. the speaker pro tempore: the gentleman reserves. the gentleman from pennsylvania. mr. pitts: mr. speaker, at this time i'm pleased to yield two minutes to the gentleman from florida, an important member of the health subcommittee, mr. bilirakis. the speaker pro tempore: the gentleman from florida is recognized for two minute. mr. bilirakis: thank you, mr. speaker. thank you, mr. chairman. the s.g.r. cuts would reduce doctors compensation for treating compare patients by 24%. seniors and physicians cannot

afford that and congress cannot let it happen in five days. the legislation before us would patch the s.g.r. for a year. i support this legislation. of course reluctantly. two weeks ago the house passed a permanent repeal and replacement of the s.g.r. that was fully paid for. the fix provided doctors who treat medicare patients with certainty. that's what they need. and incentivized and rewarded doctors to keep seniors healthy. the senate needs to negotiate, mr. speaker. if they don't like the house pay for, come up with one. let's come together and get this done. a patch isn't the best solution, we can replace the s.g.r. but the senate has to work with us. again, let's get this done, let's work together and get it done thank you very much, i yield back, mr. chairman. the speaker pro tempore: the gentleman yields back. the gentleman from pennsylvania reserves. the gentleman from new jersey. mr. pallone: mr. chairman, mr. speaker, i now yield to the

gentleman from washington, mr. mcdermott, three minutes. the speaker pro tempore: the gentleman from washington is ecognized for three minutes. r. mcdermott: mr. speaker, winston churchill apparently once said, americans will always do the right thing. but only after they tried everything else. then again, churchill never tried to fix the doc fix in the united states congress. for 10 years we have been trying to fix the sustainable growth rate in medicare. for 10 years we have kicked the can down the road for 17 different short-term passed votes. the protecting access to medicare act of 2014 is a mixed bag of some important , some problematic

provisions, such as the end renal stainl disease polcy, and some provisions that have never been vetted in front of the congress, in front of committees at all. and more importantly this bill represents our 18th failure to rebuild the bedrock of the medicare program. our 18th failure to provide american seniors with the safety and security of a permanent fix to the s.g.r. that's why the a.m.a. is voting no on this bill. that's why most physicians' groups are strongly opposed to this bill. last night my office was flooded with messages from various physician groups. i, for one, still believe in finding a way to do what's right. i, for one, am dedicated to the principle of seizing the moment and accomplishing big things on behalf of the american people. we thought we were going to do

it this time. so when it comes to this mix bag piece of legislation, cooked up in the dead of night, put on the web at two minutes before 12 a couple days ago, revised several times since, not much more than 48 hours ago this stuff started. i vote no. enough with trying everything else. it's time to do what's right. a permanent doc fix. argued, debated, and agreed upon is what our seniors need, it's what our doctors need to help them manage their practices. it's what our nation needs and deserves. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back. the gentleman from new jersey reserves. the gentleman from pennsylvania. before i: mr. speaker, yield to the chairman of the energy and commerce committee, it we have groups in support,

who express support for this bill, the american clinical laboratory association, american college of radiology, easter seals, family research council, juvenile diabetes research foundation, medical imaging and technology alliance, pennsylvania partnership for children, zero to three, national center or infants, toddlers and families, among others. and i would urge members to seriously consider this. at this time i'm pleased to yield whatever time he may consume to the gentleman from michigan, the chairman of the energy and commerce committee, mr. upton. the speaker pro tempore: the gentleman from michigan is recognized for such time as he may consume. mr. upton: thank you, mr. speaker. i thank the distinguished chair of the health subcommittee. i have a statement for the record which i'll ask unanimous consent to submit for the record. mr. speaker, here we are at the very end of -- when the doc fix expires, march 31. that's next week.

we have tried in a very responsible way for many months to try and resolve this issue, and i commend my friend, mr. waxman, and others and we passed our bill out of committee last summer, 51-0. speaker boehner said he didn't think we could honor mother teresa for sainthood with a vote like that. i commend my good friend, mr. camp from michigan, and sandy levin, the gentleman from michigan, on the floor now, as we work together and work with the senate as well to actually lock in place a bill on literally the last day that chairman baucus was in the united states senate to resolve thflt and we knew all along we were going to have to have a pay for. and here in the house a couple weeks ago we passed a bill. some on partisan lines, not 100% on either side, but we passed a

10-year fix with a pay for. great ninth grade civics teacher, no longer with us, he's with the lord. but i tell you as i sit down with my students as i did this week, a lot of them are here in town, and speak to my high schools and colleges, they know there's never such a thing maybe as a perfect bill. one of the first lessons in civics is that you pass a bill in the house, you pass a bill in the senate. they are always different. you go to conference, you work out the differences, it comes back. nobody wants this expiration of the doc fix. nobody. it hurts our physician community. they care about the folks that they treat. literally they are going to have almost a 30% reduction caught in the services that they provide as early as next week.

but let's think about our most vulnerable, too. our seniors. they've got those doctor appointments. they want to be there. and maybe with a 30% cut those physicians will say, gosh, we just can't do this. that appointment is canceled. we are going to just stop serving medicare patients, period. those over 65. we don't want that. we don't want that hurting our most vulnerable. so we passed here in the house a couple weeks ago a 10-year bill. response from the senate is, nothing. yes, we have had some discussions. a former member of our committee, he's diligently trying to get something done, but they've got no bill ready for passage on the senate floor that either matches what we did to go to conference. they've got nothing. there's a lot of talk about

maybe just doing a bill without a pay for. some phony savings. that's not what this house is about. it's a lot of money. and we have some rules in the house we got to -- you got to for it.ay that's the real difficulty in trying to get things done. so, here we are the end of the week, the cuts come in, next tuesday, april 1, so we are sending -- trying to send another offer to the senate. you're not going to take the 10-year fix, let's try a one-year fix. it is paid for. it's about $20 billion. a number of little provisions in there that i think are important. again working with all sides. last night we were somewhat surprised a number of groups came out against it, but the alternative is the door gets shut. we don't have a backup plan, all right. this is the bill. d if we can get 290 votes, everybody's here, 2/3 vote,

that's great. we'll send yet another offer to the senate, and they can choose either one. they can take our 10-year bill, they can take a one-year bill, they could pass something different and we can come to conference. and i must say that this bill, it's a one-year bill, it doesn't stop us from still trying to negotiate something for a permanent fix, because that's what every one of us wants. it doesn't stop us from getting that done. but at least it stops what otherwise will be the denial of services to the most vulnerable. our seniors who may not understand what's happening. it continues the process to move forward. so we've got a couple options that we are teeing up. obviously we have to pass it today here with a 2/3 vote and let the senate key side -- decide which alternative or pass

something else, but pass something so that we can go to conference. the f that happens, then c fix is not fixed and for however long that period is, the cuts come into play. so it would be nice if we could actually pass this by voice. what do you think? it will get us off the dime. and again we'll toss it to the senate to try and get it done. no one wants it to expire, but without one of these two bills, it expires. and we don't want that to happen. i would urge my colleagues on both sides of the aisle, my friend, mr. pallone, my friend, mr. waxman and others, yes, we need to get this thing done. it is the best that we can do right now. and there's not a plan b for next week.

i yield back the balance of my time. the speaker pro tempore: the gentleman yields back. the gentleman from pennsylvania reserves. the gentleman from new jersey. mr. pallone: mr. speaker, i yield three minutes to the gentleman from oregon, mr. blumenauer. the speaker pro tempore: the gentleman from oregon is recognized for three minutes. mr. blumenauer: thank you, mr. speaker. thank you, mr. pallone. i cannot express my disappointment with the proposed additional temporary patch o the sustainable growth rate, the s.g.r., the doc fix. it's morphed no an annual ritual, disrupting the provision of medical -- medicine in this country as the physicians plead with us to not do something crazy. it's simply today an accounting sleight of hand.

it's a power play and a fundraising tool, to be sure, that disrupts the practice of medicine, but we have absolutely no intention of ever having the s.g.r. cut occur. it may bite for a day or two, but we're not going to allow a reduction on that order of magnitude. we will find some sort of adjustment, as we always have, that will not be satisfactory and will continue the uncertainty and the indignity that is inflicted on people in the health care space and more important on the people that they serve. if you want to actually cut health care spending, we could do so, and if we would stop this charade of meaningless gestures of repealing the affordable care act and actually get down to cases, fine tuning and moving forward, we would be there. there are a range of potential savings within the health care space that is acknowledged by virtually everybody in the industry and every expert

that's looked at it. but it can't be done in a cavalier fashion, according to some ritualistic formula, and it can't be done overnight and it's going to require a steady hand, slug politicians acting like grownups. in the meantime, i think it's important to stop this trafficesty. remember, when we had a similar pointless exercise with the alternative minimum tax, realizing that the supposed savings were not real, that the full bite would never take effect, what did we do? we finally reset the budget baseline and moved on. and that's exactly what we should do with the s.g.r. and then deal meaningfully in the adjustments in accelerating health care reform, not a 54th time to repeal the affordable care act. we should be rewarding people who are providing high-value care and finding ways to be

more efficient and adjusting the system to slowly squeeze out our areas of inefficiencyy. it won't be -- inefficiency. it won't be easy but it is definitely in our capacity and it is already starting around the country. maybe congress should consider debating this issue with an open rule, allowing everybody to come to the floor to speak, to offer amendments, to debate it fully and see what we can come up with. it won't be any worse. let's end the charade, give the health care space some certainty and get down to work being a full partner in the reform and enhancement of our health care system. the speaker pro tempore: the gentleman's time has expired. for what purpose does the gentleman from pennsylvania seek recognition? mr. pitts: may i inquire of the time? the speaker pro tempore: the gentleman from pennsylvania has 2 1/2 minutes. the gentleman from new jersey

has 12 1/2 minutes. mr. pitts: could i inquire of the minority how many speakers they have left? mr. pallone: i have at least two left. mr. pitts: ok. i'll reserve. the speaker pro tempore: the gentleman from pennsylvania reserves. the gentleman from new jersey. mr. pallone: i yield now three minutes, mr. speaker, to the ranking member of the energy and commerce committee, mr. waxman. the speaker pro tempore: the gentleman from california is recognized for three minutes. mr. waxman: i thank the gentleman for yielding to me. mr. speaker, today congress will vote on another patch to the medicare physician payment system, but it should not be that way. we need a permanent fix. earlier this year, we seemed on track for a permanent fix. we reached a bipartisan agreement on what a permanent fix should look like. that bill was introduced by both republican and democratic leaders, mr. camp, mr. upton,

dr. burgess, myself, senator baucus and senator hatch. that bill is supported by the ysicians and the patient groups. it would not cut payments and that bill would fix this problem permanently. the bill before us today is not a permanent fix. it's a short-term fix. two weeks ago republicans brought up the bipartisan bill for the permanent fix with a poison pill offset that undermines reform for low-income families. that was two weeks wasted where we could have worked toward a permanent solution. i heard my colleague -- republican colleagues say it's too hard to find offsets or we don't have enough time to come up with the offsets to get a permanent bill done. let's not forget, republicans do not insist on offsets on things they really care about. trillions in tax cuts for the

wealthy, no need to offset that. a medicare prescription drug bill that costs far more than this permanent fix to the s.g.r., no need to offset that. but when we talk about protecting seniors' access to their doctors, their answer is different. . speaker, i would urge that in the end this is a vote members will need to make up their own minds about. we may be forced to support a short-term patch, but i am not ready to concede that so i'm not ready to support this bill that's before us. let's keep working on getting a permanent solution, and i yield back the balance of my time. the speaker pro tempore: the gentleman yields back. the gentleman from pennsylvania is recognized. mr. pitts: i continue to reserve. the speaker pro tempore: the gentleman from pennsylvania continues to reserve. the gentleman from new jersey is recognized. mr. pallone: mr. speaker, i yield three minutes now to the

ranking member of the ways and means committee, mr. levin. the speaker pro tempore: the gentleman from michigan is recognized for three minutes. mr. levin: i ask unanimous consent to revise and extend. the speaker pro tempore: without objection. mr. levin: so let me describe briefly the challenge before us. this bill is very disappointing. the three committees have to ed on a bipartisan basis put together a bill that would address once and for all s.g.r. and would reform the payment system. indeed it would transform this bill that we worked on a bipartisan basis, the physician payment system into one that's acceptable for high-quality care rewards value and provides needed stability for providers and beneficiaries. the bill has a much larger cost than this patch. though patches themselves are

expensive, but i want, in response to the gentleman, the chairman of the energy and commerce, to make a few comments. there's been no serious discussion all of these weeks out how we would pay for the permanent fix. there just has been a dare gation of -- darigation of responsibility. also, what's happened here is a product that hasn't gone through the legislative process , this patch. instead, it's a complex $20 billion bill, no public hearing, no committee hearings, no regular order. the draft of the bill became publicly available at midnight tuesday, and there were flaws so it was refiled and we got this bill just, what, 24 hours

ago? in this present legislation, it contains a completely new unvetted lab payment system. it undermines delivery system reforms for dialysis patients. it includes promising things for patient care but fails to include key protections to minimize discrimination against certain patients. so, look, in a few words, we deserve better and we need to do better. as a result, a large number of physician groups have expressed their opposition to this. so what this bill does today is miss the opportunity to do full-scale repeal and replace the physician payment system. the senate still needs to vote on a permanent fix.

the chairman of energy and commerce said, well, we passed that kind of a bill. yes, the 10-year fix was a partisan bill that had no chance of passage in the senate. zero chance of passage. the senate still plans, as i understand, to vote on a permanent fix. we should let the senate process unfold. we have more time to get this right. we do not -- i ask for an additional minute. i ask for an additional minute from mr. -- mr. pallone, i ask for an additional minute. mr. pallone: i yield an additional minute to mr. levin. the speaker pro tempore: the gentleman is recognized for one minute. mr. levin: so we have more time to get this right. it is not correct that if we don't act today that there will be any impact on seniors. we could let the senate act, to try to do something permanently

and come back next week if we have to and take up this bill. so this is the challenge before us. we're here once again doing something that's very temporary, that's very, very expensive, and we are failing to step up to the plate on permanent reform, on permanent reform and a permanent fix. and doing it with a legislative process with a product that has not gone through committee, has had no public hearings, has had no real hearing. we should not be acting blindly. i yield back the balance of my time. the speaker pro tempore: the time of the gentleman from michigan has expired. the gentleman from pennsylvania is recognized. mr. pitts: mr. speaker, i continue to reserve. the speaker pro tempore: the gentleman from pennsylvania continues to reserve his time.

the gentleman from new jersey is recognized. mr. pallone: mr. speaker, i yield one minute to the democratic leader, ms. pelosi. the speaker pro tempore: the gentlewoman from california is recognized for one minute. ms. pelosi: thank you very much, mr. speaker. i thank the gentleman for yielding. i thank him for his leadership on issues that relate to the health and well-being of the american people. i also commend the leadership of the previous speaker, our ranking member on the ways and means committee, mr. levin, as well as that of mr. waxman. they have been two champions on the subject of health care in america and doing so in a fiscally sound way. and while i appreciate the concerns that they expressed here, and i share them, and i will speak to that, i do think that we have to think carefully about the decision that we make. i know that they have. this is an example -- the leadership bringing this bill

to the floor on the short fuse that the expiration date is march 31 without most people in this room without ever having on what is in the bill what is a missed opportunity. we should be considering right now a bill that would permanently, permanently speak to the s.g.r. for those in the public, i know it's inside baseball talk, s.g.r. that is the rate that docs are compensated for treating medicare patients. so don't think of s.g.r. think of the patients. and that's what we're doing here. think of the certainty that they need in terms of their health care, and that is our seniors. think of the certainty that a permanent fix, paid for or not, but let's say paid for, would

mean to remove the uncertainty from this debate. the american medical association is opposed to this bill that son the floor today -- is on the floor today because it is a pitch. how many times have you heard people talk -- how many times have you heard people talk about a band-aid? we're just putting a band-aid on it. we are not getting to the underlying challenge that we face. this is a band-aid and that's why the docs oppose it. this patch. now, i did hear the distinguished gentleman from florida, bilirakis, say if you don't like these pay-fors, suggest your own. we've suggested our own. overseas d oco, the account. the republicans said it's a gimmick. it wasn't a gimmick that's in the ryan -- when it was in the ryan budget. it works for you when it works for you but you don't want to put it to work for america's seniors.

here's the thing. the senate majority and the house majority came together to produce this patch, this band-aid. it's the wrong way to go. it does not address the underlying problem. we could have done that. we've been trying to do it for 10 years. and it's always, always, always something that the republican majority has backed away from and limited and done in a short -- on a short fuse. there's so many things that are wrong with this bill, but the simple fact is that the clock , ticking, and on march 31 it's bad news for seniors and for the doctors who treat them in the medicare program. our seniors depend on medicare. they depend on medicare, and this is a weakening of it. so it's just the same old, same old, let's see what we can do to

find some pay fors that really undermine the health and well-being of the american people. those same pay fors done properly could be part of a permanent fix. but instead they are part of the band-aid. this is all to say to my colleagues, you are a going -- you're going to have to weigh the decision as you weigh the equity. is it better to just succumb to what we have, no matter how mediocre and how missed an opportunity is? is it better to say let's hold out until our republican colleagues agree to the full g.r. essentially a fix forever, paid for by o.c.o. it's really important to note the following. the shorter the fix, the more expensive it is.

we have been seeing that year in and year out. if we had dealt with this, six, seven years ago, it would have cost much less. year to s to patch one next, sometimes less than a year to the next. so this is not about reducing the deficit. it's not about the good health of the american people. it's just an ideological reality that we have to deal with from the republican side of the aisle. so when the docs, a.m.a., says we are opposed to this, vote it down, that's important to us. i say to them talk to your republican friends. they have the power to do a permanent fix paid for by o.c.o. they refuse to do it. so we have something less good that we can do for the american people. and if this sounds a little confusing, it's because it is.

and members have to make the decision as to whether they will vote for this just because we are forced into it or whether they want to hold out for something much better. this would be a more appropriate debate a month ago. where the clock does not run out over the weekend. but this is a tactic, it's a technique used by the majority to force the hand without the proper weighing of equities in all of it. so my colleagues, i just urge you to try to weigh those equities. i, myself, come down on the side of supporting the legislation because, frankly, i believe that any uncertainty in the minds of our seniors about their ability to see their doctors will certainly be -- republicans will say this is because the affordable care act. and i just don't want to give them another opportunity to

misrepresent what this is about. if the affordable care act never existed, we would still be here debating s.g.r. they are two separate subjects. but as we know any excuse will do to undermine the great legislation that the affordable care act was about life, healthier life, liberty of people to pursue their happiness because they have the freedom to do so. better quality, lower cost, more accessibility. that's how i come to the conclusion of -- let's not give them another false claim. let's just get this done, but let us not give up on the prospect of even before this expires of having a long-term permanent fix to s.g.r. it makes all the sense in the world. it has no partisanship about it. it is sensible.

and it will cost less. to do more for our seniors. a challenge is there, the solution is clear, the republicans have rejected that, so we are at their mercy. my conclusion is to vote yes. members will have to come to their own conclusions on it. i frankly wish that the republicans in their power would have brought the bill to the floor under a rule so we could have a proper debate on it instead of requiring a 290-vote requirement to pass it. but the shortness of receiving this information only this morning members are finding out what it is, it's really hard to predict who will vote pro, who will vote con, who will vote aye, who will vote no. this is a silly decision to bring this to the floor in this form when we know a path that is much better. but i'm not going to give you another reason to go out there and make your claims about the

affordable care act which have no basis in fact. with that i urge my colleagues to pray over it as i will and yield back the balance of my time. the speaker pro tempore: the time of the distinguished minority leader has expired. the gentleman from pennsylvania has 10 1/2 minutes remaining. the gentleman from new jersey has five minutes remaining. the gentleman from pennsylvania is recognized. mr. pitts: may i inquire of the minority how many speakers they have left? we are prepared to close. mr. pallone: at this time i have one more speaker. mr. pitts: i continue to reserve. the speaker pro tempore: the gentleman from pennsylvania continues to reserve. the gentleman from new jersey is recognized. mr. pallone: mr. speaker, i yield two minutes to the gentleman from connecticut, mr. courtney, a member of the armed services committee. the speaker pro tempore: the gentleman from connecticut is recognized for two minutes. mr. courtney: thank you, mr. speaker. mr. speaker, i just wanted to follow up on a point that leader pelosi just made regarding the o.c.o. account, the overseas contingency operations account. which in armed services we are dealing with right now. the president came over with his o.c.o. request for this year of $80 billion.

this funds the troops over in afghanistan, the 34,000 that are still fighting courageously to defend our country. at the end of this year, the projection is is that troop level will be brought down to, at the highest level, of 10,000, possibly even lower, combat missions for all intents and purposes will come to an end. as the congressional budget office has democrat straight over and over again, they will score savings with the o.c.o. drawdown that's going to happen at the end of this year. the ryan budget has used those o.c.o. savings to help balance its own priorities. so this is not funny money. this is not hypothetical. anyone who has been on a could he dell -- codel over to afghanistan knows we are spending money over there, and next year we'll spend less money because of our change in deployments in afghanistan. the cost of a permanent fix to s.g.r. is $135 billion over the next 10 years. you can only -- you only need a portion of the o.c.o. account to

permanently fix s.g.r. everybody who has even come close to discussing this issue knows that in this building. and hopefully the senate when they take this up next week are going to move forward with a permanent fix using totally valid, verified savings by the congressional budget office in the o.c.o. account. it is a peace dividend in terms of drawing down from afghanistan that we can finally stabilize the medicare system by making sure that these are not going -- fees are not going to be subjected to this annual cliff, that denies access in far too many cases in doctors' offices across the country. again i just want to emphasize the point. it is not like we are powerless here to come up with an s.g.r. fix for which there is bipartisan support using verifiable, valid savings by the congressional budget office in the o.c.o. account. our brave soldiers are going to be drawing down closer to the end this year to zero. we can use those savings to fix

america's health care system. i yield back the balance of my time. the speaker pro tempore: the gentleman from connecticut has expired. the gentleman from pennsylvania is recognized. mr. pitts: mr. speaker, i'm prepared to close. i continue to reserve. mr. pallone: i still have three minutes, mr. speaker? the speaker pro tempore: yes. the gentleman from new jersey has three minutes. mr. pallone: i'll go first. i yield myself such time as i may consume. the speaker pro tempore: the gentleman is recognized. mr. pallone: first of all, mr. speaker, i'd like to point out and i'd like to ask -- enter into the record a letter from the american medical association and many, many other physicians' groups as well as state medical societies in opposition to the legislation. let me just read the first paragraph. it's addressed to the speaker and democratic leader. it says on behalf of the undersigned physician organizations we are writing to express our strong opposition to

h.r. 4302, and we urge you to vote against the bill when it is considered on the floor. again that's from the a.m.a. many specialty doctor groups, and a number of state medical societies. i would also point out that it's my strong belief, and i know that my chairman of the subcommittee disagrees on this, but it is my strong belief that if this bill passes that we will not have an opportunity to bring up the larger permanent fix. we will not negotiate that. i doubt very much that that would be the case. i would now reserve the balance of my time. nd yield one minute to our democratic whip. mr. hoyer: i thank the gentleman for yielding. perhaps we ought to have a criteria of everybody who has read this bill can vote on it. my bet is it would be very few members who would be able to vote on this bill. this is an eight-page summary of this bill. with probably 50 paragraphs in

it about changes that have been affected in the medicare system. none of us know what the substance of this bill is. we have a lot of rhetoric in 010 about reading the bills. i challenge any member to come up here and say i have read this bill. i am for a permanent fix in the sustainable growth rate for doctors. i have pledged that for the last four or five years. we have a bipartisan agreement to affect that exact end. but as so often is the case, we do not have the courage to rationally fund that agreement. that is why america is in trouble fiscally. this is a game. unworthy of this institution and the american people.

mr. pallone: mr. speaker, i yield the balance of our time to the democratic whip. the speaker pro tempore: the gentleman from new jersey has 45 seconds remaining. that time will be yielded to the gentleman from maryland. mr. hoyer: i thank the speaker. it is unfortunate that we have been put in this position with less than 48 hours notice of what's in this bill. to do something all of us know needs to be done. the doctors of america, at least the organized doctors of america, have said vote no on this bill. because they know, we know, the "wall street journal" knows, we have to fix this permanently. not patch it every year. it's a fraud. and both sides have committed that fraud. and we ought to stop it. we ought to fix this. americans ought to expect us to

fix it. the doctors expect us to fix it. seniors expect us to fix it. what a lamentable fact we cannot sum mon -- summon the courage and wisdom to do just that. the speaker pro tempore: the time of the gentleman from maryland has expired. mr. hoyer: i yield back the balance of my time. that i do not have. the speaker pro tempore: the gentleman from pennsylvania is recognized. he has 10 1/2 minutes remaining. mr. pitts: mr. speaker, i want to read out the title of a blast that i just received from the heritage foundation, some of our members might be interested in this. quote, a temporary s.g.r. patch is better than permanent deficits. in support of the bill. my colleagues, this morning seniors are watching. this is not a game.

we are thinking of seniors and certainty for them. a vote no today is a vote against seniors. we are not voting for the a.m.a. today. we are voting for or against seniors today. we will continue to work with all of our might for a permanent repeal of s.g.r. we have worked on this for three years. we must get there as soon as possible. but we are at a deadline. and this is the last vote we will have. if you vote no on this bill, you're voting for more uncertainty. you're voting for a cut to doctor reimbursements. you are voting against seniors. let us vote for seniors this morning. vote for h.r. 4302. i yield back the balance of my time. the speaker pro tempore: the

gentleman from pennsylvania has yielded back. all time having now expired on this bill, the question is, will the house suspend the rules and pass the bill h.r. 432 -- 4302. so many as are in favor say aye. those opposed, no. in the opinion of the chair, 2/3 of those voting having responded in the affirmative, the rules are suspended, the bill is passed, and without objection the motion to reconsider is laid upon the table. mr. hoyer: mr. speaker. mr. speaker. the speaker pro tempore: the gentleman from pennsylvania is recognized. mr. pitts: i object to the vote on the grounds that a quorum is not present and make a point of order a quorum is not present. the speaker pro tempore: pu >> you see a congressman from requesting the vote. shortly afterward, the house gavels in out for recess. republicans met in the speaker's office and elsewhere. the house republican doctors caucus met with republican leadership.

and with recorders camped outside the speaker's office in the house chamber, time to find out whether the house had the votes to move forward. keep in mind, this came up as a suspension bill, meaning it needed 2/3 of those present and voting to pass. earlier today, a reporter treated the house is either about to pass the patch or pull it. any democrats opposed, but policy said she would support it many democrats opposed, but pelosi said she would support it. this is what happened. >> the house will be in order. pursuant to clause 8 of rule 20, the unpinnished business is the question on suspending the ules and passing 3302 -- 4302. the clerk: h.r. 4302, a bill to amend the social security act, to extend medicare payments to physicians and other provisions

of the medicare and medicaid programs and for other purposes. the speaker pro tempore: the question is, will the house suspend the rules and pass the bill. those in favor say aye. those opposed, no. in the opinion of the chair, 2/3 of those voting having responded in the affirmative, the rules are suspended, the bill is passed and, without >> steve womack gaveling out. the fact that the house passes by voice vote the short term, one year doc fix. doctors are facing a 24% cut on their medicare payments by monday if the house and senate do not act. later, as the house finished and went into special order speeches, as he often does, texas republican lewis gomer came to the floor. "the hill" reports that he blessed the decision to voice vote, and said he and other numbers would monitor the floor to ensure it cannot happen again.

he had tome of what say on the house floor earlier. gohmert: thank you, mr. speaker. a surprising twist today. who says there's nothing surprising in washington. we were told there was a potential for a bill to come to the floor today over -- to deal s.g.r., issue of the sustainable growth rate, or the doc fix as it's sometimes called. and there had been some disagreement in our party what would be the best way to handle it. we had a bill, one-year extension, one-year that included some other things that some of the people that are providing the care that haven't been properly treated in reimbursement areas were not happy about. so it appeared we didn't have -- our leaders may not have had the votes.

by the surprise that it was voice voted and no one asked for a recorded vote because normally, see, we trust our leaders that if there's an mportant bill that our leadership understands someone here, on a bill, will request a recorded vote and we'll get a recorded vote and we'll all be able to either vote for, vote against. otherwise we have to keep people here all the time. and it did bring back to mind the time that was not so fond sometimes -2008, 2009 and 2010 when on the first day back in washington, whether it was a monday or tuesday, the first day, there's suspension bills. those are bills that are expected to pass and have 2/3 of

the body vote for them, naming courthouses, naming federal buildings, recognizing some important person or deed, those type of things. and they are generally agreed to. despite all the negativity in washington, those are things that we agree to constantly. both sides of the aisle work together on getting accomplished. but we saw very quickly after republicans lost the majority in november of 2006, sometimes republican leadership would agree to allow some suspensions to go when it was extremely important, it should never have been brought to the floor on suspension, which means it doesn't go through subcommittee, doesn't go through committee, just comes to the floor without having gone through rules committee, and that's why it takes 2/3 of a vote because it's

bypassed the normal procedure. so there were a handful of us that decided back in 2007, since republican leadership at that time were agreeing to things that we knew our other friends in the republican side, some friends on the democratic side, would never vote for, if it was a recorded vote, where everyone had the chance to vote, i started flying back early, i know tom price did at times, lynn westmoreland did at times, but i got to where i was flying back even if i thought somebody else was covering the floor. but the reason was to make sure that since we couldn't trust that our leadership would not agree to some bill that we thought was hurtful to the country, was hurtful to the constitution, or to our constituents, we had to be here to ask for a recorded vote. went unnoticed except by leadership, staff on both sides,

and it got to where when i came to the floor and would sit here for three or four hours, i would have staff come up, usually democratic staff since they were in the majority, and say, well, obviously you're concerned about some issue. sometimes i would just -- i was just here to object to make sure nothing was brought to the floor without any notice. sometimes there was a particular suspension that i felt should have a recorded vote. so i would show up and i would, after the voice vote, request a recorded vote. and that's why staff started coming up and saying, look, which one are you going to demand a recorded vote on? are you going to object to? sometimes i would get up and speak against the bill. but it got to where if i had an objection, they knew, because i had done it, between the time of the call for a recorded vote, would go back to my office, i

would type up a notice on why a bill was not a good bill, and i would be standing at the door getting a few other people to stand at other doors to hand out little flyers to members of congress as they came to the floor explaining why it wasn't a good bill. sometimes i won. sometimes i lost. but all you had to get was one more than 1/3 of the votes to bring down a suspension. so we were able to deal with that issue and make sure that people knew you're going to try to pull that stuff, we are going to have people sit here so that you can't just pass something on a voice vote. without it being called for a recorded vote. so i was very surprised today that with us in the majority, our own leadership in charge, something as important as the doctor fix would be brought to the floor on a voice vote.

i would have come over earlier except there was a recess, back in session, recess, back in session. i didn't know how long the recesses were going to be. now i know that i need to get with some other members and meak sure we have people on the floor -- make sure we have people on the floor since we won't be sure what our own leadership is going to do. that's very unf >> the house earlier today passing the bill that would extend medicare payments to doctors in the next year. that past on a voice vote. also passing today, a bill that provides additional aid to ukraine and codifies additional sanctions against russia for their annexation of crimea. the house returns tomorrow for pro forma session. back for legislative week next tuesday noon.

likely to tidy up some of the work on the ukraine bill in particular. follow live house coverage here on c-span. eastern,at 8:00 p.m. president obama meets with pope francis at the vatican. the epan two, administrator testifies on the 2015 budget request. and on c-span 3, the senate education committee olds a hearing on the federal student loan program. earlier today, a briefing was held at the pentagon on the release of the investigation into allegations that air force officers in the nuclear core cheated on nuclear weapons for efficiency tests. those tests assess the knowledge of operating nuclear warheads. this briefing is 45 minutes. >> good afternoon. thank you for being here. kathleen cook, director of air force public affairs.

we will discuss findings and enhancements that will take place across the nuclear enterprise. we will begin with statements by secretary james and general wilson. following those remarks, we will take your questions. one question and one follow-on. with time, we will take additional questions. if you are identified, please state your name and affiliation. if we do not have time to answer your questions, happy to assist. ado, i willfurther introduce the honorable deborah lee james, secretary of the air wilson,nd stephen strike command. >> good afternoon. thank you for joining us today. general wilson and i promised you periodic updates about our

very important nuclear mission. the cheating incident and our efforts to address these matters. we are grateful that use vent time with us this afternoon. as you may recall during our last briefing in january, general wilson and i showed you there were 92 crew members under investigation for some level of involvement and a test compromise at the air force base. either they participated in cheating or knew something about it without reporting it all stop back in january, general wilson launched a commander-directed investigation, and forced improvement program, to get to the bottom of this situation and to recommend needed improvements. further, the secretary of defense order that we provide him a plan within 60 days, containing a way forward.

finally, when we provided our last update, i offered you seven -- what i call my observations from my recent visits to the missile bases. i would like to run through these reflate, and some of the top level updates for you. generalwill yield to wilson, who will provide more details. january, and has been confirmed through subsequent investigations, we do have some systemic issues in our missile community. indeed, there are cultural issues here. up on spottyicked morality and micromanagement and soat all the bases, did those who participated in our follow-on reviews. then,s what led me, back to call for a holistic plan going forward to address this community and some of these issues. not simply a plan to address the cheating alone.

indeed, the commander-directed investigation and forced improvement program does have a number of recommendations to address the overall climate within the community and issues of -- just in recognition of how important the nuclear mission is to our national security. january, i certainly felt that the testing and training environment was unhealthy. drive for 100% on exams, when 90% was the standard, and the use of these boards in some cases for the sole differentiator on who got promoted and who did not seemed inappropriate to me. we will be changing rather dramatically how we conduct testing and training, going forward, while at all times keeping the standards and evaluation criteria appropriately high for those who are involved with nuclear matters. i told you there would be accountability both for the missile ears -- the missileiers

involved, and leaders. nine officers in leadership positions were recommended for removal. one officer submitted his resignation and will retire. this is a total of 10 leaders at all. -- in all. --e of these leaders regard were directly involved in the test compromise. failed toike they provide adequate oversight of their crew force. the investigation ultimately grew to 100 officers that were implicated in being investigated as part of the compromise. of the 100, nine actually were not substantiated and will be returned to duty as soon as practicable. to givewilson is going you more details on one of this shortly. given that this was a major failure in integrity, the fourth

thing i talked about in january was how i thought we needed to reinvigorate our core values across the air force. called on each of us in the services to double down in this effort. officialppointed a new to coordinate with all of us on this important matter. our core values, which are integrity first, service before self, and excellent -- excellence in all we do -- these have to guide us on and off duty, in-home, in the office, and on the battlefield. living a life of personal integrity, but it also means taking action when you see something in your environment that it -- that is not right. if it is between your peers, subordinates, or superiors, your duty is to act. general welch, chief cody, and i washed and air force-wide

initiative two weeks ago to reinvigorate our core values across the force. the key components will include such things as a standdown wingman day, to focus every airman on our core values. using our formal education to ensure our airman received core values throughout their career, not just the beginning, and launching a resource center on the air force portal, to provide commanders and senior nco's the tools they need to reinforce values at the unit level. a fifth, sixth, and seventh observation back in january. these had to do with incentives. do we or do we not need incentives. professional developments, and what i called other investments. was that weon this say this is an important mission. do we put enough of our money where our mouth is when it comes

to resource decisions? are their career paths and adequate leadership trading which are commensurate with the importance of this mission? these are the questions that were on my mind. is, we will need time to fully flesh out these areas. have $19 year 2014, we million funded for some of the areas within the force improvement program, including launch control center refurbishment and infrastructure repairs. the 20th air force has identified an additional $3 million for quality of life requirements. budget,iscal year 2015 we have requested $455 million to sustain our minuteman squadrons, icbm helicopter support, and critical communications areas. millionidentified $154

in other requirements associated with our force improvement program, including readiness training and improvements to launch control facilities. as we execute our funding in 2014, we are going to seek to rearrange as much as possible to fund these important programs. we are not going to wait. we are going to move forward. wilson has established several quick look action teams that will be developing specific recommendations on these other areas i mentioned, like and accolades. and what do we do about professional development? these teams will report at the end of april. secretary hagel earlier in the week said he is confident we are on the right track to improve support to our nuclear forces, and ensure trust and confidence in this vital mission. reinforce that our

nuclear deterrence mission is critical to national security. it is very strong. the reviews we just conducted confirm this. i continue to have great confidence in this mission, as does the secretary of defense and the way this mission is being performed. i also have great confidence in the team. our nuclear professionals have safely stood watch over america. as in the past, today's nuclear airmen continue that legacy, taking great pride in their work and performing superbly under difficult conditions. the issues we have our top. while we have not made progress in certain areas in recent years, there is more work to be done. while i am sure we will get there, because we will provide

the persistent focus and leadership this deserves, and getting this right for people, as far as i am concerned, is the number one goal, and it is critical for our efforts going forward. and we are committed to getting it right for the people. with that, we will turn it over to general wilson. >> i would like to take a few moments to update you on the investigation i ordered. the actions we are taking to hold our people accountable. we are using this opportunity to improve this underpriced. the special investigation whileered this compromise investigating several air force officers for alleged drug activity. the investigation-to include from the airers force base and montana. found test material on them. this sparked a new investigation that implicated officers for

sending, receiving, requesting, or having knowledge of compromise testing material. investigators found that four officers were at the center of a ring where test material was shared. when we briefed this issue in , the test taking place in august and september -- forensic analysis of crewmember cell phones showed a potential chain as far back as november 2011, and as recently as november of 2013. analysis found that one of the texts included a photograph of a classified test answer. i cannot give additional information for security reasons. i can assure you that at no time did this compromise of test safety orver put the

security of the nuclear deterrent force at risk. january, we conducted a commander investigation. colonel holmes and his team looked at the missile wings, as well as the air force base. they reviewed the testing, training, and evaluation for combat crew members. his commander directed the investigation of results, provided far-reaching recommendations in the following areas. cultureg organizational , empowering crew commanders, improving the quality and purpose of training, and reforming testing and evaluations. we can say that across the 20th air force, the leadership focus on perfection led commanders to micromanage their people.

and was met by personally monitoring and directing daily operations, imposing unrelenting testing and inspections, with the goal of eliminating all human error. this approach is unrealistic, given the icbm mission is built around redundancy through weapon design, standardized seizures, and teamwork. leaders placed too much emphasis on monthly test scores, although they require passing score is 90%. crewmembers help richard to score 100% on each and every test. forgot execution in the field is more important than what happens in the classroom. none of these needed the information to pass the test. they felt compelled to cheat to get a perfect score. global strike command tries for a culture of excellence and compliance. the icbm environment, there has been an unhealthy

overemphasis on perfection, and a marked fear of failure, which from identifying their weaknesses and working to correct them. advancementerail and potentially end their career. the constant oversight, inspection, and testing regimen alienated supporters. a lack of mid-level officers contributed to a gap between squadron leaders and missile crews. development is critical to ensuring accountability. they are striking a better balance between mission and people. befessional development must present and alive in all squadrons at all levels. crew important to veteran commanders to provide leadership activities and make them responsible for developing skills and knowledge of the cruise. training and testing procedures identified a separation between training and

evaluation that facilitates a healthy productive training environment. we are going to place greater emphasis on how we train and that bettertions assess crew performance in the operational environment. this will allow us to deemphasize the significance of scoring 100%, while ensuring our crew remains ready to perform their mission. secretary james and i have said that all mennning and women would be held accountable for their actions and in actions that allowed this to happen. 92 airmen were involved in this compromise. this number has changed with the details of who was involved and at what level. allow me to walk through the evolution of those numbers and where they stand today. general holmes and his team reviewed 88 of 98 cases that were transferred from the osi. it showed various levels of

involvement from officers who sent, received, and solicited test material, or those who had knowledge but failed to report allegations against nine officers were found to be unsubstantiated. you will find these numbers in the report you will have access to today. concluded the cdi report, investigative were continued. cases continue to transition between osi and command authority, based on who was involved at what level. of individuals involved stands at 100. osi still maintains jurisdiction over 10 cases. are underhe nine investigation for illegal drug activity. at the conclusion of this briefing, we are going to provide you a test which will provide you the categories of

all involved. we are responsible for ensuring you are trained, ready, and able to do the mission. commanders are also responsible when our people fall short. has takenbert stanley responsibility for this failure. this morning, major general jack weinstein accepted colonel stanley's resignation. theal stanley has served nation and the air force with armor and distinction for the past 25 years. he relinquished command this morning and will retire. nine leaders from the group and squadron level. commanderions group removed.ship ability he also removed the deputy commander. the commanders of the 10th,

12th, and 490th missile squadron and the support squadron. weinstein also removed the directors of operations of the operational support squadron and the 10th missile squadron. people weree the test compromise. however, the failed adequate leadership, supervision, and oversight of the crew force. he was a career nuclear security force later. he joins from the global strike command staff, where he previously led our security forces division. tom previously served as the interim crew commander from august to november of this year. he is the right leader to move the team forward. disciplinary actions will also be taken about -- against the substantiatedave

the investigation. details are being served today. after completion of these actions, a determination will be made on the officers as to whether they returned to alert duty. they will be retrained, recertified, and returned to duty. wing has continued to perform its mission uninterrupted. we are continuing to monitor the crew force, as well as the our --y of , we are are watching using this as an opportunity to make significant and important improvements across the whole enterprise. we launched the force improvement program in february.

this is monitored after the navy program. the force improvement team included a diverse 69 person working group and presto of airmen from operations, maintenance, the security force, .nd helicopter it included navy submarines and crewmembers. the purpose was to create an aggressive, action-oriented, field-influence program, with a goal of making substantial changes. the grassroots level, working to identify challenges and propose actions directly. the team collected nearly 2000 surveys to the field, and interviewed 835 people on how we could make things better in the field. with theed these investigation to develop a list of nearly 400 action items i can

act on. i am ready to implement as many of those as i can. those that i cannot, i am bringing forward to be able to fix. there are over 2000 people in air force strike command. doe the 9.5% of our airmen this mission with excellence every day. adversaries and assure our friends. they live our core values. we believe the changes we will institute will insure all of our people live up to our high standards. let me close by saying the execution of the icbm mission has gone largely unchanged since in first missiliers started 1959. we are not just putting a fresh coat of paint on these problems. we are taking bold action through extensive changes to the ways we teach, train, and leave our crew force. the changes we are making will

be a turning point for the icbm community that will improve the mission as well as the airmen, most lengthening our core values. the nation demands the highest standards of accountability from the force entrusted with the most powerful weapons on the planet. we are committed to living up to those standards. thank you very much. mentioned the lieutenant general having reviewed the training and testing at all the icbm bases. did he specifically asked individuals whether they had cheated on any of the testing in the past? if you did not, how can you be sure? >> general holmes went out to each of the bases. he talked to the leadership at every base -- wing commanders, squad commanders, chiefs, supervisors, specific focus groups. missile crew commanders as well as the deputies. to listave information

potentially disqualifying information of any crew member. he went where the investigation took him. he pulled on the strength of evidence, and it did not lead outside that air force base. did you specifically ask people whether they cheated at the other bases? >> he asked specific questions to focus groups. i asked every crew member. we looked at the information once. >> have you looked at potentially disqualifying -- what do you mean when you say that? asked them specifically, were they aware of any test

?ompromise we asked each crew member in the icbm community that. >> and none said they had? >> none of that. >> you said again today you remain confident in the ability, given the wing, to carry out its mission. but you have just fired nine leaders. how can you be confident you you the leadership which obviously did not have confidence in, because you fired them? >> i did not fire them. they were removed by 20th air force. the vast majority of people are doing a good job and performing superbly across the missile community. place, andeaders in leadership that global strike

selected. i have confidence in them. what proportion of the officers in leadership positions does that represent? >> i cannot give you a specific number, but i will say the group as well as each of the force squadrons, the three tactical squadrons -- that leadership was removed, along with many of the operations officers. across the wing, 200 missiliers. we removed nine of them. it is a significant proportion of the leadership at the base to be short. it is, david. , the folks tell you people wene out, the have put in place, bring in a great skill set.

coreing as well as elements from the mission area. one of the group commanders came in from the defense strike reduction agency. mission expert on the as well as evaluations. we brought in an expert and trainer as well as having an icbm background. every one of the leaders was hand-picked. >> a point of clarification. these were kernels? >> lieutenant colonel. one was a major. >> and 79 officers implicated in some way. what would the punishment be? is it a reprimand? >> letters of counseling, admonishment, reprimand, nontraditional -- nonjudicial punishment, up to and including court-martial.

>> to talk about the perfection of the test. you do not have to get 100 anymore. you are going to focus on training and field exercises. do you just say, do not worry, you do not have to get 100 anymore? >> 90% is a passing grade. it is pass or fail, and we are not keeping score other than pass or fail. that is one of the areas we are looking at. >> he will focus more on that than you have in the past? >> six years ago, there were similar announcements going with firing and wholesale changes being promised within the nuclear community. now, another major problem has come up. why does it take major problems to come up within the nuclear world for these changes? does the air force fail to be proactive in identifying these problems before major

problems come up? >> this is an enterprise that all of us take seriously. what we have identified is we thissystemic problems on perfectionist standard culture. what we are trying to get through is we have flawless execution in the field with teamwork, and the perfection is the standard that made people micromanage folks, and that is part of the culture we are going off right now to fix. a portion of the program is getting to part of what you just described, how do i change the culture and how do i change it for the entered to make it where we have commanders in the field that recognize error, and can be in powered to fix it and move forward. >> the perfectionism, sounds like an excuse. cheating is the