>> white house coverage goes to davenport, iowa. he will be at the scott county democratic party dinner. our live coverage starting around 9:00 p.m. eastern. an op-ed today in the "wall street journal" today. and more news about potential presidential candidates, "politico" with a story. quoting him from an event in columbia a dressing a luncheon saying we need quote a leader who looks the market people in the eye and says we will do whatever it takes to make sure radical islamic terrorism does not wash up on american soil. the governors in houston, south carolina today. you can read more at politico.c om. >> here are some of our future programs this weekend on the c-span networks. on "booktv," eric foner -- and

the formation of the underground railroad. and said in an antenna clock abba debbie faced journalist -- on the rise and leadership of isis in the middle east. and saturday morning, studying at not a clock eastern, and throughout the day on c-span3, "american history tv" joint historians and authors at the abraham lincoln symposium. live important theater. and said he is thing at 6:00 on "american artifacts," a visit to the national museum of health and medicine, to view items from the civil war -- their civil war collection. find a complete television schedule at c-span.org. and let us know what you think about the poor gets you are watching. call us at (202) 626-3400. email us at comments@c-span.org. or send us a tweet @cspan #comments. join the c-span conversation. like us on facebook, follow us on twitter.

>> the house and senate are out today. next week, they will both take up their versions of the 2016 budget plans. live coverage of the house here on c-span on c-span two. earlier this week, the house budget committee prepared its budget in a daylong session. here are some of the committees -- committee's markup. [indistinct chatter]

>> amendment number four relates to medicare. mr. chairman: miss grisham is recognized for six minutes. >> thank you, mr. chairman. the population of the united states continues to be on the verge of two magic demographic shift. since 2002, the number of americans aged 65 and older has increased by putting 1%. and the aging of the baby boom generation will only accelerate this growth. in only 15 years, older americans will account for about 20% of the u.s. population, up from 13% today. by 2050, the population of older americans is expected to double by over 80 million people. by 2050, the -- population of

americans 85 and older is estimated to more than triple from five and a half million in 2010, 219 million in 2050. at about 71% of these adult have a disability or will need assistance with at least one activity of daily living. so they can't feed themselves just themselves, or bathe themselves. as a former secretary to the mexico department of aging and long-term services, i understand the difficulties older americans face. they often face a unique set of risks and challenges, including a football housing, access to social services, and transportation. but chronic health issues may be the biggest threats to the economic security of older americans. and poverty aggravates everything because, of course, the porter you are, the sicker -- poorer you are, the sicker you are. medicare has helped countless americans be independent and

financially secure, including an estimated 55 million americans who are receiving benefits today. in fact, as medicare was signed into law, poverty among older americans has dropped from 35% the year i was born, 1959, 29% today. however, medicare is not perfect. although it covers nearly all adults aged 65 and older premiums, deductibles, and co-pays have left many americans with higher expenses. it is estimated that between 2010 and 2040, annual out-of-pocket house cost for americans aged 65 and older will more than double in inflation adjusted dollars. but medicare reform under the affordable care act has helped control costs, increased benefits, and extend medicare solvency. since the aca was enacted, premiums for part b and d have largely unchanged. seniors have saved more than $15

billion on their prescription drugs. the aca helped close the prescription drug donut hole and the life of the medicare trust fund has been extended by 13 years. our path for to build upon the success of. and we should strengthen medicare. improve essential benefits, and contain costs. but this republican budget moves us backwards. it turns -- it puts insurance companies ahead of seniors. it shifts more costs to beneficiaries. and it forces seniors to either pay more or scale out unnecessary medical care. based on what we know from nonpartisan congressional budget office analyses, there is no evidence that a voucher plan will significantly reduce medicare spending without significantly increasing cost for beneficiaries. my an amendment would prefer's -- preserve the medicare guarantee, and a pro-dex -- protects benefits for over --

million americans. the hard thing to do is to strengthen medicare, to improve its essential benefits, and help older americans live with the economic security and dignity that they deserve. this is what we should be doing. mr. chairman, i yield back the balance of my time. mr. chairman: the gentle lady yields back. i now recognize for seven minutes the gentle lady from tennessee. >> thank you, mr. chairman. i want to just set something straight here to make sure we have the actual facts on the table. so, first of all, let's take a look at what's the cdo has told us about the medicare program. they tell us in a report that it will be bankrupt by 2030 unless there are significant reforms that are made to the program. second, let's also take a look at failing trust funds, and look

at what the affordable care act and the president rating of medicare to 700 billion plus dollars -- that is only -- has only worsened the problem of a fund that is not sustainable. in addition to that, as a proponent of this amendment is already alluded to, there are about 10,000 baby boomers that are retiring every day that are going to be coming into this program. so we see that a fund that has already failed is going to have a significant number of new folks coming into it. so, let's take a look at what the republicans propose. first of all, i don't understand why my colleagues on the other side of the aisle continued to call this a voucher program. a voucher program is right you give someone money, they then take the money and go out and purchase whatever the product is. this is not a voucher program. this is a premium support program, much like what we have in the workforce for those

employers who provide insurance. so, with our plan, it would allow the recipients's choice -- recipients choice, which is a really good thing that would allow them to choose a program that best suits their needs. it is a guaranteed program. it would then take that subsidy that payment and actually give it to the plan. it is very much like medicare part d, which is working. we know that there is a program out there that is already similar to what we are proposing, and it has worked. and that tells us this program would also work. i also want to correct something to say we are to lose medicare as we know it. our plan action provides for traditional fee for service, and it remains an option for ever. i don't know about you, but seniors that i have talked to don't want us to tell them what is best for them. you want to be able to choose. so they will have that choice

between a premium support program or they can stay in traditional fee for service. they make that decision. we know that this plan has been scored, and it does show the latest report from cbo shows that premium support connection produce savings to seniors and also to the federal government. so, if we're talking about a plan that does to 2030 and we are looking at real reform, we know, by the congressional budget office screening this that this is a program that action can work. -- actually can work. it transitions to the new medicare program for future generations. those that are currently in it and those that come to the future have that choice. we also, on our program, make sure that those who need the most help get that help. so those at the lower incomes will get more support with there's a premium -- there

premium assistance. and those at a significantly higher income may get nothing at all to help them because they can afford that themselves. again, it gives our seniors more freedom, it allows competition to come into the market, and we know that anytime there is competition, it drives down the cost. that is something that occurs in other programs, and it will work in this program, as well. the real threat, the real threat the medicare is the guaranteed -- we know that by all of the reports that are done. by not doing anything, that is really the largest threat. and doing nothing or worse trying to ration the care, represents the greatest that to our seniors's health security. so i would urge my colleagues to look at the true facts of this, and urge them to vote no on this amendment. mr. chairman, i yield back. mr. chairman: the gentle kitty

-- the gentle lady yields back. the gentleman from arkansas wishes to speak. the gentleman is recognized. >> thank you, mr. chairman. i would like to complement the gentle lady from tennessee for such an excellent job she did explaining what is actually in our budget proposal for medicare, and how we are very much concerned about the future of medicare. my parents are on medicare. we all know people who use medicare. and we want to preserve it. as you just stated, it is due to go bankrupt in 2030. we have to implement changes now, or this will get worse as we move down the road. and i will also reiterate, it is not a voucher program. and if people choose to stay on the fee for service program, by all means they can stay there. so why are we afraid to give them the choice and the options to choose something different? something that has proven to

work. something that is proven to save money. something that will provide more options for seniors, which means more market competition, which means lower prices and better quality. this is a great opportunity that we have to implement the ideas that are in this budget proposal , and i do hope that everyone will give this a lot of consideration, a lot of positive consideration that we will adopt this. thank you, mr. chairman. i yield back my time. mr. chairman: the gentleman yield track is time. recognized for one minute to close. >> thank you, mr. chairman. i want to clarify a couple of things. one, as we talk about what cbo scoring is and isn't, we have -- i think we have a tendency to mix apples and oranges. cbo is also quite clearly scored that in the voucher program, which is defined as a premium assistance as a voucher -- if you look at that definition, you

will see that clearly defined -- that those premiums for those seniors will rise by 100% in 2020. you can stay in the fee for service program, but you pay more. what this is now is not a guarantee of the medicare program, it is a guarantee for insurance companies will continue to ration to your -- and what happens to this population, if they don't have access to the healthcare services, not only does it affect their economic security and their poverty rates will go up, but in fact, it will cause health care costs in emergency rooms and hospitals to go up. so this is in savings at all. the reality is that the $700 billion that we refer to in the a football care act moves administrative costs away and give it back to beneficiaries. those are what we should be talking about. mr. chairman: your time has occurred. all those in favor will say, aye.

all those opposed will say, no. the no's have it. the clerk will call the roll. >> mr. garrett? no. mr. cole? mr. cole, no. mr. mcclintock? mr. mcclintock, no. -- ms. -- ? ms. -- no. mr. woodall? mr. woodall? ms. -- ? no. ms. hartford? ms. hartford, no. mr. -- ? mr. sanford? mr. sanford, no. mr. womack's? mr. lomax, no. --

mr. buchanan to echo mr. buchanan, no. mr. van hollen, aye. mr. yaar miss, aye. mr. ryan? mr. ryan aye. ms. moore? ms. moore, aye. mr. mcdermott? mr. mcdermott? ms. lee? ms. lee, aye. ms. lujan grisham? ms. lujan grisham aye. mr. lou? mr. lou, aye. mr. -- ?

mr. garrick? mr. garrick, no. mr. woodall? mr. woodall? no. mr. -- ? mr. moody? mr. moody? mr. -- ? mr. mcdermott? mr. moulton? mr. chairman? mr. chairman, no. -- mr. chairman: have all members voted? all members voted. any members wish to change their vote? if not, the tally. >> on that note, the aye's are 20 and the nose -- no's are 11. mr. chairman: the next amendment is amendment number 5.

the staff will distribute the copies of the amendment. >> amendment number five relating to medicaid. mr. chairman: the young lady is recognized for six minutes. >> thank you, mr. chairman. i am offering a simple amendment that would reject the 913 billion in cuts to medicaid over 10 years that is contained in the budget resolution we are considering today. my an amendment will ensure that seniors, people disabilities, and working, is to not lose access to critical health care and long-term care services by reversing the cuts to the base medicaid program contained in this resolution. medicaid is the workhorse of our health care system. it is a critical part of the safety net that provides essential health care and long-term care services to 69 million americans. it is not the most glamorous program, but it is very

successful in supporting the most vulnerable among us. medicaid beneficiaries include poor children, and their families. someone with serval palsy or multiple sclerosis or autism. or a senior who needs help getting dressed in the morning and feeding themselves. further, the medicaid program provides health insurance for one in three children in america. these are exactly the people that would be damaged by these drastic cuts to the medicaid program. turning medicaid into a black granite, as this budget proposes, is not the answer. it does nothing to reduce health costs, but would inevitably shift burdens to the state and would lead to a dramatic cut in health care support. for the 69 million americans who depend on medicaid. and impose a sears financial hardship on them and their families. in fact, the cbo analyzed a similar proposal from then

chairman's budget and they concluded that states would likely have to make significant cuts to their programs if the system was adopted. and, i quote, cutbacks might involved reduced eligibility for medicaid and lower payments to providers, or increased cost sharing by beneficiaries. all of which would reduce access to care. is this really what the american people are asking for? cbo has also estimated that turning medicaid into a black grant would result in states dropping between 14 and 20 million people from medicaid budget by the 10th year. this is right when we have seen the uninsured -- is this right when we have seen the uninsured rate dropped by over seven and a half percent? we cannot afford to take a step backwards. we are beginning to make so much

progress. we also cannot forget the impact that these medicaid cuts will have on seniors. seniors and persons with disabilities make up almost one quarter of the medicaid population, and account for two thirds of the spending. medicaid is the largest payer for long-term care services and support in the united states, which most americans will need at some point in their lives. medicaid pays for nearly half of all long-term care in this country. when this program was absolutely not designed for that purpose and that is a different issue we need to talk about. but here, let's protect those it is protecting right now. we need a real long-term care system in this country and you will hear more from me on that later. but in the meantime, we should not be cutting medicaid which provide such essential services to so many who need it. and i yield back the balance of my time. mr. chairman: the gentle lady yields back. i am pleased to have the gentle

lady from tennessee be recognized for seven minutes. >> -- mr. chairman: i'm sorry, i apologize. i recognize the gentleman from indiana. in opposition. seven minutes in opposition. >> thank you. i have hope -- i hope i am not out of the vice chairman's job, as well. i appreciate the chairman recognizing me, and i appreciate again this issue being brought to the floor. i want to address some of the things that have been said so far. and make sure everyone understands that what our budget does, with the flexibility in it does for medicaid, is strengthen and preserve it for the future. to make sure that those who really and truly need the care

can get it. because right now, that is not the case. as the gentlewoman alluded to. the current system, the current program is broken. and that is an understatement. i want to be clear that this budget we are proposing intends to spend $3.33 trillion over the next decade on medicaid and other health programs. medicaid spending increases over the ten-year window that this budget assumes. according to cbo, current medicaid, the program the gentle lady is calling about, is growing at an annual rate of 5% to 6% of the economy only grows at 2.6%. this budget proposes simply to slow the growth and spending and give states the flexibility so that regardless of the slow growth and spending, they can still meet the needs of those --

citizens, those constituents, who truly need the care. spending growth at the rate i just described is in play not to say able -- not sustainable. and if not sustainable it will ultimately not be available to anyone. but the problem with medicaid is not just that it spends too much. it is not just -- it was mentioned repeatedly of access people need. time and again, we hear reports of medicaid patients unable to even find a doctor who will see them. patients on medicaid often have worse health outcomes than those who have no insurance at all. and the doctors, nurses, and hospitals who want to treat these patients in the cannot afford medicaid's reimbursement rates, which can be as low as 70% of what private insurance would pay. four states and taxpayers, the current medicaid system means massive spending and ever larger deficits. hear this. states are now spending more on this program than they are on

education. something has to be done. when something is this broke the wrong answer is to throw -- is to throw more money at it expecting a different result. that is analogous insanity. medicaid has one of the highest estimated improper payment rates of any federal program. in fiscal year 2016, total spending on medicaid, the combined federal and state shares, is expected to total $578 billion. and over the next 10 years, cbo expects total spending on medicaid to be $4.6 trillion. the answer, instead, is to put states i can charge of their own medicaid programs and give them the power to design reforms that fit the unique needs of their populations. across the nation, states have used existing, albeit limited

flexibility found in the current medicaid programs that have allowed them to achieve these results without increasing their budgets or their outlays for the program. look at rhode island. hardly a conservative state. our plan gives the flexibility needed for states so that they can do, frankly, with this federal government has failed to do. chiefly among them, three things. let the government closest to the people determine who actually needs the help that medicaid provides. let's let the states determine what that kenneth help looks like. and finally how that help is dispersed and received. i trust estates. i trust our local officials and a local community leaders to come up with the system that they know is best for their community. and with that, i am pleased to yield to -- two minutes to the gentleman from michigan.

>> thank you very much. and i also want to speak to the issue of flexibility because as a former state legislator, one of the things we observed in our state was the opportunity to innovate. when the medicaid expansion went into effect in michigan, there was a tremendous opportunity to improve the life -- lifestyles choices, and incentivize healthy behaviors. now, the state had to go to the federal government for a waiver on that. what we are doing here is we are saying, let's get states the ultimate flexibility, and to innovate according to their unique characteristics. in michigan, in the year 2000, we had between one and eight and one and nine michigan resident on medicaid. now if the expansion, we have one in four michigan resident on medicaid. as we have noticed across the country, over 30% of physicians

are not even excepting new medicaid patients. this is at the same time when federal reimbursement rates for medicaid are being cut across the country. so, it is not a sustainable program. i think what this does is put us in a far better path to innovate and to encourage healthy behaviors, and get on a more sustainable path for the future. i yield back. mr. chairman: i think the gentleman. i would like to yield the remainder of the time to the gentleman who has been recognized. mr. westerman. >> thank you. and i will be brief and just weird rate some of the things that have already been said, and tell you about the expansion my state. not only we have a fourth of the population getting medicaid services but a third of the population getting medicaid services. and 20% of them are able-bodied working adults.

in my state, medicaid not only is more than k-12 education, it is more than k-12 education higher education, and corrections combined. it is the single largest expenditure in our state by far. i was told that when i got to washington dc, a 3% or 4% growth is considered a cut. i really as the way things are perceived up. . this budget actually makes medicaid sustainable over the future. i yield back. mr. chairman: time has expired. recognized for one minute to close. >> i think you mr. chairman -- you, mr. chairman. i have great respect for all that the gentleman, especially the gentleman from michigan. we have worked together on many things, but i would say that the flexibility that needs to be talked about is exactly what does exist in this program. and you are all talking about the great amount of money being spent, it is because there is so much need out there. we have a real crisis in this

country. the fact of the matter is that every state in the nation has at least one medicaid waiver. and there are over 350 waivers nationwide. states can already decide who they cover, what benefits they provide, and how they deliver health care services. if states want to experiment with different models, they have the ability to do that. you all say that people can get access to doctors, but numerous studies have shown medicaid has improved access to primary care and preventative services. specifically, the landmark medicaid study in or gone found that people with medicaid -- oregon were -- mr. chairman: the lady's time has expired. all those in favor will say aye. all those opposed, no. the no's habit. a local vote. >> mr. okie that? mr. okada, no.

mr. garrett? mr. garrett? -- mr. -- ? mr. cole? mr. cole, no. mr. mcclintock? mr. mcclintock, no. ms. -- ? ms. -- , no. mr. woodall? mr. woodall? ms. blackburn? ms. blackburn, no. ms. hartzler? ms. hartzler, no. -- mr.? -- mr. -- , no. mr. -- ? mr. -- ? mr. sanford? mr. sandford, no. mr. -- ? mr. brock? mr. brock, no. mr. blunt? mr. blood, no. mr. mooney? mr. mooney? esther goffman?

mr. goffman, no. mr. palmer? is to palmer's, no. -- mr. palmer, no. mr. westerman? mr. westerman, no. mr. -- ? mr. van hollen, aye. mr. llama? mr. yamane aye. mr. ryan? mr. ryan, aye. ms. moore? ms. moore aye. ms. -- ? ms. -- aye. mr. mcdermott? is to mcdermott? ms. lee? is lee aye. mr. gauguin? is to go can, -- mr. gauguin aye. ms. single? ms. single aye. mr. lou? mr. lou aye. mr. moulton?

mr. moulton? mr. garrett? mr. garrett, no. mr. -- ? -- mr., no. mr. woodall? esther woodall, no. -- mr. woodall, no. mr. buchanan? mr. buchanan, no. mr. chairman? mr. chairman, no. mr. chairman: have all numbers voted? and a member with change their vote? if not, the clerk will report the tally. >> mr. chairman, on that vote, the aye's are 12 ending no's are 20. the chair will make an announcement -- mr. chairman: it is the chairs can -- intention to continue through the remainder of the markup without stopping. we will have a bipartisan meal. it will be supper.

in the room. and we ask members to partake during the time when they are not participating in debate, but to be present for all votes. and i apologize for the break that we had before, but i think we can finish and good season if we keep rolling through this. at this point, have amendment number six. the clerk will designate the amendment. the staff of the stupid the copies. >> amendment number six relating to health care coverage. mr. chairman: recognize for six minutes. -- recognized for six minutes. >> -- i want to thank the gentleman from new jersey for offering this important amendment to protect health coverage, keeping it affordable for families. the photo care act is working. it is working for americans, and

now republicans want to throw another wrench into the mix, and eliminate tax credits for families that have been able to buy health coverage in the exchanges. this caught my eye especially because florida families will be the most impacted if the tax credits go away. despite the political opposition at home in the state of florida we have 1.6 million floridians sign up in the exchange. they took the personal responsibility and signed up. and many come with the help of the tax credits, are finding it very affordable. the annual premium is $82 per month to him. meaning life and death, means better quality of life for the families. and now i really oppose with the republicans are doing in their budget, and that is to attempt to pull the rug out from under them again by saying they are going to repeal the affordable care act. and in doing so, eliminate the tax credits. well, let me say. let me say something about the cole peterson, a single mother

in my district got divorced in the past year. you are going to hurt her and her family. she was able to get a plan for herself and her three daughters. her monthly premium was $468. she received a credit of $150. what you said is it is phenomenal for my family. it enables me not only to be able to afford the policy, it helps me to stay healthy, it helps me not have the fear of any, gets sick do i go to the doctors are doing good to the groceries this week? mr. chairman: thank you. -- >> thank you. on the other side of the aisle they have done everything in the power to repeal it. this is like what happens when we passed plan b. we lost, you guys won that vote. we went back to our districts and made it work. and then we made a commitment. if we ever become the majority, we would fill in the doughnut hole.

that is, you don't pay premiums you don't get benefits between $2300 and $3200. we were very different, mr. chairman, the viewer. yes. the house has already voted 56 times to repeal the aca. we shouldn't be surprised that your budget, once again, assumes the aca is appeal. however, today's market gives us another opportunity to put into real terms exactly what the repeal means. mr. chairman, my amendment would restore the aca's premium tax credits, which helps millard of of -- millions of americans offset the cost. -- for the 1% and for those corporations in this country. i want it to be arguing on behalf of the american people. this year, 8 million people received premium tax credits. next to her, 15 million. according to the congressional budget office.

my home state of new jersey, 200 and 43,000 -- 243,000 esteems an annual tax credit. the budget is a tax hike on every single one of them. repealing the aca takes away these tax credits for millions of americans and will only resource -- reverse the product -- progress. i want you to stand in front of those people in your state and tell them you know longer have that tax credit heard if you have it i'm taking it away, and we are going to raise your taxes. i hope you vote for me. the united states's uninsured rate has continued to decline reaching a low of 12.9%. the uninsured rate for working age adults has stopped from 20.3% to 13.2% since october 2013. i think that is progress. maybe you don't consider that progress. i consider that progress. when the aca marketplace is

opened, a 30 -- 35% drop in the uninsured rate. without the aca, there would be 17 million more uninsured people this year, and 23 more uninsured people next year. what is your plan to help those people? tell me. america is ready to hear this. we are waiting. i said this afternoon -- this curtain doesn't even go up, for crying out loud. you have no plan. before the aca, many people were paying for plants that can provide them with the coverage they need it. they purchased plant at high out-of-pocket costs. americans were denied coverage for pre-existing conditions. and insurance companies arbitrarily increase the premiums to the point where they can afford insurance. people were charged more because insurance companies decided they were too old, too sick, or even the wrong gender. wow -- you just discover that?

yet, what was my republican friends's answer? repeal, repeal, repeal. joe, joe, drill. you, repeal, repeal. they should have been able to come up with an alternative for this law. they can't find anything. but again, the budget provides no alternative. we will get to that. mr. chairman: the gentleman's time is expired. > i respectfully leal> -- yield back to you. mr. chairman: i appreciate that. i think i am correct that the gentle 80 from tennessee is recognized for seven minutes. >> mr. chairman, i appreciate that. and i, too -- my friend across the way there, i hope that mr. pascoe will come to me to

tennessee because i would love to have them out. to hear some of the real-life stories of how this is adversely impacted people, individuals. there is a lady down in my district, an accountant. she was in a plan that was the unacceptable by obamacare. do you know what her insurance cost went up for month? 700%. now, she has been adversely impacted. you could also go with me to wayne county, and you could talk to employers who will tell you that the impacts of obamacare are very very real. they see them every single day. and they want this off the books. you ask what is our plan? levitate something good after we had 162 different bills. we had 162 different -- no, sir,

i will not yield to you. no, sir, i will not. we had a hundred 62 -- 162 different bills there. -- guess what happened? cbo says the 2 million people would be in there. because costs are lower. now, when it comes to this issue of subsidies i -- and i will say this, i have to say i'm glad you are looking at what will happen after -- versus burwell because you know that day is coming and you know that you are going to see the ruling that will probably not be in your favor. so i give you credit for coming to the table with something because we have 36 states that didn't set up their own state-run exchanges.

and, you know, you have got to look at what is going to happen. when you talk about the subsidies, let me tell you. this is the letter i got from secretary burwell. i think this is why insurance is too expensive to afford and why we do need to get this off the books. what we are confident in our position, a decision against the administration and the king case would cause massive damage to millions of people, losing their health insurance subsidies, and therefore, would no longer be able to afford health insurance. we have got a product too expensive to afford. this is why we need to work together to get the cost of not only health insurance, but the delivery of health care -- get the cost down and improve access. that should be a goal we share. second, without tax subsidies healthy individuals would be far less likely to purchase health insurance, leaving a disproportionate number of sick

individuals in the individual insurance market place. now, this is from the secretary talking about the plan. and you have to have the subsidies because the product is too expensive to afford. so, therefore, i think it behooves us to realize that what we have got here is the president's law made health insurance more costly by requiring plans to include washington dc determined benefits and levels of coverage that health exchange subsidies are going to cost taxpayers $1.1 trillion over the next 10 years. it is going to adversely impact the taxpayer because they are paying more. and the subsidies cost a lot more than that however, because americans lose their freedom of choice and the health coverage

that they want to purchase. at this time, i want to yield to miss black from tennessee for her comments. >> i think my colleague for yielding. i want to talk about what i'm hearing back in my district. this past saturday, i was at it with the party for my granddaughter. one of the grandmothers was there and she came up to me and said, you know, this really hasn't helped me at all because even though my premiums are partially paid for me -- and she is one of those lower income single ladies that is working hard in a factory, where they don't provide insurance, but she says, this is what is happening for me. the premiums are high. but i do get some assistance with that. but here is the real problem. my co-pays are so high that i can afford to pay my co-pays in order to be able to get the services that i need. she has high blood pressure and she has diabetes. she cannot afford her

medications because the co-pays are so high and getting her medication. also, what i'm hearing throughout my district consistently is the fact that i can't use the same doctor are used to use, the hospitals that are used to go to does not accept this form of insurance even though blue cross blue shield, i thought i was getting into a really good program. and then there are other providers, such as may be there fiscal -- physical therapist -- their physical therapist. i would like to be able to say that this is the answer, but it is not the answer. the answer is asked to having a more patient centered program where it is not washington down program, but a program that comes from the communities and up. where there is affordability and accessibility and quality and choice. right now, there is not choice. there is a limited number of programs in each one of the states that people can even choose from. their doctors are not honor

their hospitals are not on there. what good is it to have insurance where you are paying out-of-pocket? the insurance is not providing you what you need. you can get your medicines, you can't use the hospitals that you are accustomed to. despite all of this, the reports are saying that even though we do have maybe 8 million people -- another report, 60 million people, that is also adding in some folks like the students who are in school that are on their parents's so the number are -- is a little foggy, but despite that the reports are still saying we are going to have 30 million people who are undershirt -- uninsured. we can -- being one where we put the patients and their families and their doctors in charge. esther chairman, i yield back. mr. chairman: the gentle lady yield back. one minute to close. >> i am waiting anxiously to

hear this great plan in the sky. i'm waiting for what the alternative is. my colleagues, for the remarks and their recognition, the vast importance of the foot book care act and the premium tax credits that the law provides. the reality, mr. chairman, that the republican budget would take away affordable health care insurance for millions and jessica increase the number of people without health insurance. and there is no plan to fix this. you cite sir, several cases. i am talking about the millions and millions who have insurance who didn't have it before. this is not the perfect thing. we never said aca was a perfect plan. what you said, plan b was a perfect plan. of course, now, it is also imperfect because we changed it. until last are, republican efforts to repeal the aca were in many respects impactful only in the abstract. today, the major coverage expansion provision has gone

into effect, meaning that 16.4 million americans -- can i finish the sentence? mr. chairman: how many pauses? >> only 20 more words. thank you, mr. chairman. you have been most gracious. now have health insurance because of this law. and many of them have premium tax credits that help them afford their insurance. i hope you will vote for this amendment. it makes sense. it doesn't take you off your path. mr. chairman: and i hope that my charity is not a bad omen for the future for activities. the gentleman's time has expired. the question is on agreeing to the amendment could all those in favor will say, aye. those opposed will say, no. the no's have it. the clerk will call the roll. >> -- mr.? -- mr. garrett? esther garret?

mr. garrett, no. mr. chairman: [indiscernible] >> mr. garrett? mr. garrett, no. mr. -- , no. mr. kohl's? mr. kohl's, no. mr. mcclintock? mr. mcclintock, no. miss black? miss black, no. ms. -- ? ms. blackburn? ms. blackburn, no. ms. hartzler? ms. hartzler, no. mr. -- ? mr. rice, no. mr. -- ? mr. -- ? mr. sanford? mr. sanford, no. mr. womack? mr. womack, no. mr. brett? mr. brett, no.

mr. bluhm? mr. bluhm, no. mr. mooney? mr. woody, no. mr. grow some -- mr. palmer? mr. palmer, no. mr. -- ? -- -- mr. -- , no. mr. westermann? esther westermann, no. mr. buchanan teco mr. buchanan -- mr. van holland? mr. van hollen,aye. mr. pascoe? is to pascoe -- mr. pascoe aye. ms. moore? ms. moore, aye. mr. mcdermott? mr. mcdermott? ms. lee? ms. lee, aye. mr. -- ? mr. -- i -- aye.

mr. dingell? ms. dingell, aye. mr. norcross? mr. norcross, aye. mr. moulton? esther moulton aye -- mr. moulton, aye. mr. akita, no. mr. -- ? mr. -- , no. mr. chairman? mr. chairman, no. mr. chairman: have all members voted? any member wish to change their vote? the clerk will report the tally. >> mr. chairman, on that vote the aye's are 13 and the no's are 22. mr. chairman: the amendment is not agreed to. the next amendment is amended to seven. >> amendment number seven offered by ms. more related to

the nutrition program. mr. chairman: the young lady from wisconsin is recognized for six minutes. >> thank you, mr. chairman -- mr. chairman: i apologize, six minutes and then you will have one minute to close. >> thank you. i will yield two minutes each to representative lee representative ryan, and representative -- respectively in that order. if i made -- mr. chairman: if i may note that the gentle lady controls all the time. the chair will not stop people after their two minutes. you have to do that, gentle lady. >> can you wind the clock back to six minutes? mr. chairman: we will do that. >> in that order, representative lee, ryan, -- . and i will stop you. [laughter] >> let me thank you, congresswoman, for once again offering this amendment to

protect nutrition assistance. you know from personal experience, i know from personal experience. many know that the majority of people don't want to be on food stamps. they want a job, they want to be able to take care of their families and live the american gene. -- dream. including 2.1 million children. in fact, more than 70% of snap participants are families with children. people in every state and every congressional district experience food hardships, yet this republican budget continues the trend of decimating food assistance in the long-term, and tinkering with block grants, are schemes that could endanger food assistance delivery. what is worse, and let me just mention the cbo report, our democratic -- requested a cbo report on snap cuts on low income households. and this report found that cuts

which are the poorest families deeper into poverty. in this report, the cbo analyzed three different proposals to reduce aggregate snap spending by 50%. cbo found that with each proposal family -- families earning the least amount of income found vastly disproportionately negative impacts. under at least one proposal, a family of three on snap with an income below $15,000 per year would see a $600 cuts. this report also discusses how to -- excuse me, how proposals to turn snap into a block grant program, which republicans have put forward in previous budget address, could allow for federal snap funding to be diverted to other programs and creates the potential for even worse economic conditions for low income families. we know this would only increase hunger in our community. we cannot allow this vital

nutrition lifelike, which is what it is, for our most vulnerable to happen. >> thank you, ms. lee. i yield to him. >> i think the gentle lady. i want to make a quick point that we ask other transportation funding is going to come for the highway trust fund. we will figure that out later. about the house care -- health care is, we'll figure that out later. how about the tax rates? this budget is anything but certain. and to speak of uncertainty, we saw the statistics. the top 1% get 17% of the tax expenditures. the average ceo is making $296 for every one dollar that the worker makes. and here we are offering an amendment to make sure that the least among us can have some

food. and we're going to get resistance. these deep cuts to the snap program aren't compassionate. they are irresponsible and quite frankly, they are bad economics. they are bad economics. if we want to start growing the economy, we have to start making sure that the average person has the money in their pocket. i want to make one last point before i get cut off. the issue of nutrition. this -- earlier amendments were talking about medicaid did we wait until -- medicaid. we wait until kids get really, really sick, and then we take them into the medicaid program. half the country will either have diabetes or prediabetes in the next years. the issue is healthy food and getting healthy food to our citizens. this is one piece of it, and we need to do a better job with the snap program. to just cut these benefits and just wait till they drive up costs because they are eating bad food is not the right approach.

i yield back. >> thank you. >> thank you. i think my colleague from wisconsin. my home state, you often hear me talk about this, is one of the hungriest states in the united states. and this budget only makes it worse. it will jeopardize the ability of veterans, seniors, the disabled, and children to get the nutrition that they need to be healthy. it is estimated that approximately 900,000 veterans nationwide live in households that rely on snap. in my district, they have a current line for stamp benefits. nearly 90% of beneficiaries live in a household with a child, a senior, or a disabled person. half of the beneficiaries our children. for millions of hard-working countries across the family, it provides a vital lifeline that helps make ends meet.

-- achieved by having healthier children and families, on behalf of 442 -- 442,000 recipients, i support mike -- encourage my colleagues to support this amendment. i yield back. >> we yield back. mr. chairman: the gentle lady yields back. i am pleased to recognize the government for michigan for seven minutes. >> thank you, mr. chairman. i would like to make a brief statement, and then also ask mr. mcclintock to speak to this amendment. you know, i would urge a no vote on this. one of the things that i think is important about our budget is that it balances within 10 years. another thing that is important about a budget is it promotes economic growth. i think we can all agree that the best thing we could do for low income families in this country is to have jobs and

promote economic growth. one of the most innovative things i have seen this states, talking about over the years laboratories of democracy, people able to innovate with different programs at the state level. and that is something that this proposal also does. go i think we all can agree that we want to have fun available for those who truly need it. one of the things that i learned as a state legislator one day was that someone who had one a million-dollar lottery award was continuing to use snap benefits and was being encouraged to do so by our state department of human services. i found that shocking. it was because the people who truly need it would not be able to get it if those kinds of things continued. what i found is that there is no test, there was no means testing

other than an income test that did not consider lottery winnings to the income -- to be income. what was interesting when we went further into that and close that loophole in our state, and i understand in the 2014 bill that there is an effort to close that bill as well, however, the secretary of agriculture has not distributed to states the guidelines on how to do that and what is considered a substantial amount of winnings. i say this because i think it is important that we empower states because they know their people best and they know what works best in their state. rather than having the federal government do a top-down approach, i think it is important that we allow flexibility for the states. the goal is that everyone who needs it would be able to receive it. right now, the states have no

incentive because 100% of the benefits are paid for by the federal government and the states simply administer the program. with that, i would like to invite mr. rokeach us to speak. rep. rokita: i would simply like to add to the discussion that if you include description may -- this question a spending -- discretionary spending that the government spends almost 800 million dollars a year on 92 different programs and by any objective observation can only be called a poorly coordinated effort to fight poverty. the figure that i just mentioned does not include state and local spending. unfortunately, our approach over the last several decades has been built on the premise that somehow -- and this is totally erroneous -- that somehow

compassion is best measured by how much we spent, not by how many we can lift out of poverty. and that is exactly what our budget turns on its head. let us find ways to help people who really truly need it and get them out of the situation that they are and, not letting them remain dependent on a federal program. this week's cbo report about state facility allotment say "given such authority, the states might be able to define edwardsville the -- eligibility and moreover allow states more flexibility and experimentation for approaches that were successful in some states could adopt others." i know we are on the right track here with our budget. i would just urge my colleagues and all them to join as an effort. with that, i yield back to mr. molinari.

rep. moolenaar: i like to call on mr. mcclintock from california. the>> it is roughly doubling every six years. the snap caseload has increased from 2002. the 28 million from 2008, the 46 million in 2014, roughly doubling every eight years. this exponential increases incurring -- occurring while the unemployment rate is slowly inching down. roughly half the population is going to be on food stamps and 16 years which is about the same time that we are being warned that social security and medicare are being bankrupt. our democratic colleagues would have us continue down this road

that anybody with a list of common sense can see is completely unsustainable. this budget makes critical course corrections now while there is still time to do so. with regard to snap, the budget follows the successful model of the 1996 welfare reform act. it strengthens work requirements. it restores to the states the interim reform. -- the innovative reforms in their be a lot more credibility if we had not arty heard in 96 -- 1996 and been thoroughly discredited by expanded the democratic criticism reminds a the economist who said, "that might work in practice, but i cannot see how that could possibly work in theory." i yield back. chairman: gentlemen yields back. the gentleman from wisconsin has one minute to close.

rep. moore: the atwater would be proud of you all today. he would block grants and cut it by $125 billion over 10 years. let us keep the single real, y'all. you talk about uncertainty uncertainty, uncertainty. me tell you that in my district a quarter of the children are uncertain on when the next meal is going to come from. let us really be clear. this program -- two thirds of the recipients are not able to work. they are babies, they are elders, and they are disabled people. this program has work requirements and 80% of the people work who are on this program. we talk about cutting the 92 programs. there is not one conversation about cutting any of the tax expenditures $1 trillion a year. lets us keep it real.

it is cruel to take foods out of the mouth of babes. chairman: all those in favor will say i those opposed say no. the nose have it. clerk: mr. rokita? no. mr. garrett? no. mr. cole? no. mr. mcclintock? mr. mcclintock, no. miss black? miss black, no. mr. woodall? mr. woodall, no. miss blackburn? miss blackburn, no. miss hartzler? miss hartzler, no. mr. rice? mr. rice, no. mr. sussman? mr. sussman, no.

mr. sanford? mr. sanford, no. mr. womack? mr. womack, no. mr. rat? no. mr. bluhm? mr. bluhm, no. mr. mooney? mr. mooney, no. mr. groshong? no. mr. palmer? mr. palmer, no. mr. moll are? no. mr. westermann? mr. westermann, no. mr. mcammond? mr. buchanan, no. mr. van hollen? mr. van hollen aye. as if escrow? mr. pascoe, aye. miss more? miss moore aye.

ms. castor? ms. castor, aye. ms. lee? ms. lee aye. ms. lujan grisham? ms. lujan grisham ateye. mr. lou? mr. lou aye. mr. moulton? mr. moulton aye. mr. chairman? mr. chairman, no. chairman: have all members voted ? do any members was to change their votes? they will record the tally. clerk:ayes had 13 endocyte

22. -- and the noes at 20. rep. moore: it is hard to believe that many of our republican colleagues went to hearings on these policies last year. we see a budget that seems to ignore the fact that there are still more than 45 million americans living in poverty. this budget helps tear down poverty. here we are with that conversation right from the table. nowhere in this budget is that provision found. my amendment lays out the

anti-problems from social security to medicaid and the supplemental nutrition assistance program and the earned income tax credit. we know that these programs work , even with 45 million people living in poverty, the poverty rate has gone down more than one third since 1967 when 12 initiatives under the war on poverty were passed. rep. lee: we have seen the poverty rates go down. once again my republican colleagues once a cut or turn programs and to block grants which evidence clearly shows are less effective. in fact, this week, and i want to reference the cbo report that shows the effect of snap cuts on those living in part movie. mr. chairman, i would like this to be added to the record. chairman: without confession. rep. lee: this moves money

around to other programs than food assistance. i just want to respond to the gentleman who mention the fact that snap benefits continue go up and more people continue go on since 28. best since 2008. i want to say that thank god people did have snapped to rely on because many people would've gone hungry if we had not had snap in place. that to me is totally outrageous to want to block something that gives people a lifeline just to eat in this country. also with regard to economic activities, as it relates to snap each dollar things back $1.79 in economic activity. it is a good economic policy to have. make no mistake. no one is saying these programs are perfect. that is why my mm it establishes a common sense and copperheads of approach to proven programs the corrugated and national strategy to cut poverty in half in 10 years. that is 22 million americans

lifted out of poverty in the next decade. this comprehensive approach means ensuring a living wage and streamlining states, local, and federal programs. let me take a moment and yield 15 seconds to my colleague from wisconsin. congressman more. rep. moore: last year, we as americans spent $61 billion on food for cats and dogs. rep. lee: let me now yield a minute to my congresswoman lujan grisham. collects topoverty by half in a decade. it is not even bipartisan. it is a nonpartisan issue did it

ought to be a nonpartisan issue today. rep. grisham: according to the most recent census data, 14 and a half percent -- 14.5% of u.s. population lived in poverty in 2014. it doesn't affect everyone equally. african-americans, hispanics and native americans all have poverty above 20%. it does not affect the community equally. new mexico, texas kentucky, and alabama -- states represented by many levers of this committee on both sides of the aisle struggled with consistently high poverty levels. in my home state 31% of new mexico children. highest rate in the country. we need a national strategy to eradicate poverty in the country and extend opportunity to everyone. i do encourage my colleagues to vote yes on the support an amendment. thank you. i yield back. chairman: mr. mcclintock is

recognized for seven minutes. rep. mcclintock: thank you mr. chairman. this is a debate that has been going on in this country and in this country -- congress and this committee from within 50 years. in other forms, it has gone on for thousand years. 300,000 roman citizens were on some form of public relief food in 1766, benjamin franklin wrote, "i am for doing good to the poor, but i differ in opinion to the means." i think the best way to get them out of it is by dripping out of it. and my youth i traveled much, i observed a different countries that public prisoners is made for the poor the less they provide for themselves and they became poor. in 1996, we put that proposition to the test. under president clinton, in his words, ended welfare as we know it.

we set time limits on welfare. we require welfare recipients to look or train for work as a condition of receiving welfare. the left wing of his own party would drive million it's a part of the -- into poverty. children and female-headed households fell to 39.3% by 2001. it was the single largest sustained reduction in child poverty in this group since the onset of the great society. the only places where this did not occur were states like california, that essentially opted out of the federal welfare reform and the result was one of the highest poverty unemployment rates in the country. by the way, during the clinton years, federal spending was cut by a miraculous 4% of gdp. the result was a profound period of economic growth and prosperity. john f. kennedy was right. a rising tide list all boats.

kennedy dramatically cut marginal tax rates and the economy blossomed. the good news is that we know what works. we know how to reduce poverty and grow the economy. it is precisely the policies called for in this budget. it provides stronger work incentives for programs like food stamps. it reduces government borrowing and crafts the capital that would otherwise be available to small businesses who provide more and better jobs. it removes the obamacare 30 our triggers that trap americans and part-time work and it reduces federal spending. we know how to grow the economy and we know how to lift people out of poverty because we have so many times before. the problem is this administration and strengthening band of supporters in congress continued to pursue policies that just have not worked. in fact, it is estimated that the obama recovery simply mirrored the reagan economy that

millions more americans would be working today and the income would be thousands of dollars higher than they are today. this debate has a going on for centuries and continue to go on for many more until we heed the lessons of history and choose the policies that actually work. this budget does that. i know some of my colleagues invested trillions of dollars in the policies that have not worked. and human nature being what it is -- the more we invest in our mistakes, the less willing we are to admit them. that is why we are debating this amendment once again today. with that, i yield to minutes to mr.. >> i think a lot of the problem here is that we are doing so much to fight poverty that we are encouraging people to behave in ways that are probably not the best for themselves or their children.

looked at the earned income tax credit which you mentioned. the amount of money that we are shoveling out the door on your income tax credit is doubled the last 50 years for you look at the snap program. between 2000, over four times as much money and snap. the couple of years ago the congressional research service did a study, nasa showing the amount of money that families are getting, but the total amount which assumes a goes to government employees fit i cannot vouch for, but it feels like they are pretty sharp people and they are telling us that we are spending $60,000 a year per family that we are helping out here. $60,000 a year. if that study is right. the problem is not that we are trying not enough, we are trying

so much, but despite all of our effort, we are getting a situation in which people are -- too many of them hitting in such a fashion in which they are not going to get out of poverty. if you want to have a good stable family, if we want to have people working as hard as they can, we have to change the approach and not just flood more money at the problem. right now, if you look at the numbers, we just flood and money in the past. other things that they talk about here -- this is spent more money on education. look at the amount of money that we are spending per child and how much it has gone up in the last 40 years. it is through the roof and spending more money on education were to solve a problem that would solve the problem. the huge increase in number of kids going to problems -- college -- does that solve the problem? i'm going to vote no on this amendment. i think we need a new approach designed more to encourage people to work their way out of poverty and a new approach which

encouraged more people to raise children to provide a good example and a more stable environment. i will yield my last-minute to a freshman. i have a really good friend, but a new friend. mr. bluhm, i yield the last minute to him. mr.rep. blum: we have 50 incubators of problems from and the area are called states. then i did work for -- in maryland, they cut welfare rolls by 80% while decreasing poverty. what is exciting is that this allows states to experiment in innovative ways to lift americans out of poverty and turn them into taxing citizens. ideal my time.

chairman: the gentleman yield back. mislead has one minute to close. rep. lee: i'm not going to them and say how i feel to some the mark us remarks that were made. you're talking about a budget that won't raise the minimum wage and people making a little over seven dollars and our who are working and taking care of the family who deserve a fair shot at the american dream. the working poor -- you're talking about people who care about their children and want to have a living wage in this budget will even raise the minimum wage, let alone the living wage. secondly, let me just say that this economy -- to my friend from california, blossomed for some, but it did not blossomed for all. we are talking about one in five children living in poverty. in the african-american community, you're talking about one in three living in poverty. when you look at the fact that

-- and you have it in your budget now, workforce training funds cut. you're cutting all of those pathways out of poverty. gentlelady chairman: it's time has expired. all those in favor say saye. the noes have it. clerk: mr. akita? no. mr. garrett? mr. garrett, no. mr. diaz? mr. ds no. mr. cole? mr. cole, no. mr. mcclintock? mr. mcclintock, no. miss black? missed black, no. mr. woodall? mr. woodall, no. miss blackburn? missed blackburn, no.

mr. hartzler? missed hartzler, no. mr. rice? mr. rice, no. mr. sussman? mr. sussman, no. mr. sanford? mr. sanford, no. mr. womack? mr. womack, no. mr. bratt? mr. bratt, no. mr. bluhm? mr. bluhm, no. mr. mooney, no. mr. grossman? mr. grossman know -- mr. grossman, no. mr. palmer? mr. palmer, no. mr. molinari? mr. molinari, no. mr. westermann? mr. westermann, no. esther became an? mr. buchanan, no. mr. van hollen? mr. van hollen, aye. mr. yarmouth?

aye. mr. ryan? mr. ryan aye. miss more? miss more, aye. ms. castor? ms. castor, aye. mr. mcdermott? miss lee? misleass lee ate. ms. lujan grisham? miss lujan grisham aye. mr. northcross, mr. northcross, atye. mr. chairman? mr. chairman, no. chairman: have all members voted? is any member was to change their vote? the clerk will report. clerk: on that vote, the ayes

are 12 and the noes are 22. thechairman: the next amendment is number nine. clerk: offered by ms. castor. chairman: ms. castor is recognized for six minutes. rep. castor: it is through an expanded and sustained investment that i propose to hardwire into our nation's budget. it takes nih funding out of the annual budget battle and moves it from discretionary to mandatory, thereby providing certain see -- certa to medical professionalsint andy hope to families across the country. is it discretionary? no, it is not and it shouldn't be. my amendment recommence

america's leadership to scientific euros and treatments. the sequester and segment funding for nih have taken a serious toll over the last decade and the nih's budget has not kept pace with inflation. this is led to a good decline and purchasing power. we have all heard dr. francis collins say this and it has been especially acute in the fast the years, despite the democrats giving nih a great shot in the arm under the recovery act. on january, the journal published a report and recommendations. they said, the u.s. funding declined to 50% in 2012 as the global total. after that, and u.s. companies. it did percent to 41%. meanwhile, asia, particularly china, they tripled investment. u.s. share of life science patents declined from 57% in

1981 to 51% in 2011, especially the most valuable patents. what they said to us and policymakers is that a new investment is required in order to be realizing scientific discoveries and improve care. given international trends, the united states will relinquish its historical international lead in the next decade unless such measures are undertaken. so, colleagues, let us work together to get nih funding back on track, be on the lip service saying that we all support nih. let us take action. let us really tackle alzheimer's and finally care for cancer, a less the treatment that improve people's lives. biomedical research is across the country are counting on us and families are counting on us. i yield a minute to the gentleman from kentucky, john yarmouth. rep. yarmuth: i would like to highlight comments about the increase in nih funding in the

stand up to cancer event. that was kevin yoder of candace who said "why are we spending $60 billion in nih research yucca we are spending over 30 billion." honestly, i'm not a big fan of deficit spending, but i think i can go to my 16 month old daughter and say that i borrowed money in your name to cure cancer and she would thank me. representative matt salmon of arizona said, "i've been recognized by numerous groups is one of the tightfisted people in the entire congress. that having been said, i believe with all my heart and soul that of the federal government does not lead the way on conquering cancer than it will not get done. i want to fight this fight. i've lost one too many friends to this dreadful disease and i do not what to see another person succumbed to this." i can now say that i agree wholeheartedly with both a member of the republican study committee budget and spending task force and a member who not only signed a contract with

america, that advocated for carving ronald reagan's face into mount rushmore. let us embrace this moment of bipartisanship and pass this amendment and properly fund this important research. rep. norcroft: polio was an epidemic that was not possible to cure. earlier this week, i stood in front of the building where dr. found the cure -- the vaccine for polio. how much has this changed our world? here we are faced with countless issues standing before us about cancer. you have heard about all the others. many of these can be a just through the proper motives in our pharmaceutical -- companies but they won't.

the prophet won't drive it. that is where we need to be. we need to be there to save those people from these the ability to and diseases for which there is no court -- the futile as hitting diseases for which there is no cure. the cure that they find may save your life also. >> i yield my remaining time to congresswoman lee from california. rep. lee: i would like to thank the research. some of the resurgence of the national institute of health for federal funding programs are really vital to the health and wellness of our nation. we know that research funding creates the job of the future and ensures their nation remains of the cutting edge of the global economy. but if our republican colleagues continue to dramatically cut science funding research, that our current skill gap will grow even larger. ultimately, our young people

will be discouraged from joining science and technology fields, field lower in the low -- fields that are already low with women and women of color. we should be making it easier for argued to join critical fields and help shape and inform our nature, not making it harder. our investment in biomedical research is extremely important. on a personal note, my sister has multiple sclerosis. my mother just passed with copd. we all have family members who benefit from nih and biomedical research. i urge and vote for this amendment. chairman: mr. mooney is recognized for seven minutes. rep. mooney: i like to put my colleagues on the other side of the aisle on east in this budget assumes robust funding for nih. it is rather discretionary and therefore, the final amount provided to nih will be

ultimately decided by the committee on appropriations. the language states the important contribution of nih led to an increase in the nih budget from 1997 to 2005. with this budget doubling bandar -- both under democrat and repulsive president, it does not state that in addition to that, the nih spending nearly tripled from 2007 to 2010. we are robustly funding nih. as we say and our policy statement, america is the greatest, most innovative nation on earth. our people are innovators, entrepreneurs, visionaries, and the latest -- relentless builders of the future. americans are responsible for the first telephone, airplane computer, first man on the moon, great in the first vaccine for polio, and legions of other scientific and medical breakthroughs that have improved and prolonged human health and life for countless people in america and around the world.

it is the policy of this resolution to support the important work that medical innovators that the country including private sector innovators, medical centers, and the national institutes of health. our budget calls for strong funding for agencies that engage in valuable research and development, like nih, while also urging washington to get out of the way of researchers discoverers, innovators all of the country. however, in tough budget times, every agency that supports public health research including the department of health and human services collectively must work to ensure that all these resources are spent in the most effective manner to avoid duplication and waste and to coordinate the activity toward collective public health and research goals and objectives. i like to yield as much my time as seeking consume to gentlelady

vicky hartzler. rep. hartzler: i want to thank the latest in florida for offering the amendment. i consider her a friend and look forward to working with her on this. this is a very important subject. we need to make sure that we invest in finding those cures that are so important. i disagree that with the path and i do not think we need to start another mandatory program. we have sony mandatory -- so many mandatory spending programs right now that are a real problem to our budget. but, we do need to address this issue. i know that i've supported and called for making sure that we invested the good thing about our budget is that it does not cut funding to the nih. it is fully funding nih. that is why we did a good week of cut it. we could have found savings here. but we prioritize because we do believe that it is very important. they mention a lot of different

diseases and we all are impacted by people laugh -- who have had cancer. something near and dear to my heart is alzheimer's. i just want to share a little bit about that. i lost my mother two months ago with it. my mother-in-law last year. this is something that i think nih needs to prioritize and spend more money on within their budget because every day, there 10,000 baby boomers who reach 65. of those baby boomers, one in eight will develop alzheimer's, which is just a devastating disease. over 5 million americans are living with alzheimer's, as many as 16 million will have the disease by 2050. that means one in three seniors dies with alzheimer's. right now, it is the costliest disease in america and it is very costly to the taxpayer. i think it is imperative that nih spend more of its budget on that and prioritize it.

the thing that concerns me is some reports coming out of nih on how they are allocating the money that we have are the given them. let me show you some of those examples. news reports and come out that taxpayer dollars have been spent by nih recently on grants examining public health education and campaign in china. they have used our textiles, some of these precious dollars that i think should be going to alzheimer's, cancer, muscular dystrophy, you name it. things impacting our constituents. they funded a grant in california for nearly $7 million to study tobacco and its link to the tea party. the nih has funded grants of one half million dollars a year to the national opinion research center to evaluate the impact of actual government policies in thailand on the local thai family ability to save for future concerts. the nih grant sponsored an

advocacy group for the illegal development of lobbying type material. finally, 1.7 million study is underway with our dollars that should be going to alzheimer's to see it doing traditional dances such as salsa and the cha-cha can spark physical activity. this is ridiculous. i call upon nih to spend the money that we give you on the diseases that are devastating families and are breaking the bank of our budget as well. but we do want to continue to prioritize it and that is why we do fully fund it. i do not support the proposal for mandatory. i look forward to supporting the goals of my colleague and i yield back. chairman: i yield the remaining time to congressman rokita. rep. rokita: i associate with

the comments made by congresswoman hartzler. i want to direct your attention to this pie graph over here. $3.5 trillion on it. as you can see, most of the money, over 60%, is spent on auto pilot programs, mandatory spending. that large piece of the pie is only going to go up, leaving less and less for discretionary spending, including nih. mr. yoder made mention and he said that we would love to be spending more on nih, but we get crowded out by the mandatory spending going on. that is what we need to fix. i yield back. chairman: ms. castor is recognized for one minute rep. castor: do not let america's leadership to suffer.

we can take action on this together tonight. we only find one amendment during the budget process that we can agree on. i urge you to select this one as the bipartisan amendment. alzheimer's, cancer, heart disease, diabetes. think about the toll that these diseases are taking upon families all across her district to think about the young researchers whose grants are coming to an end because congress has not responded to a call to action. indeed, the republican budget would lead to 1300 fewer medical research grants because of health and budget keeps the sequester in place and constrains the ability to put dollars into medical research. that is why i urge you to move it from discretionary the mandatory. america's leadership in the world should not be discretionary. i yield back. chairman: all those in favor say ateye.

all those against say no. but knows have it. clark will call role. clerk: mr. rokita? no. mr. garrett? mr. garrett, no. mr. cole? mr. cole, no. mr. mcclintock? mr. mcclintock, no. ms. black? ms. black, no. mr. woodall? mr. woodall, no. ms. blackburn? ms. blackburn? miss hartzler? miss hartzler, no. mr. rice? mr. rice, no. mr. sussman? mr. sussman, no. mr. sanford? mr. sanford, no. mr. womack? mr. womack, no. mr. rat?

no. mr. many? mr. mooney, no. mr. grossman? mr. grossman, no. mr. westermann? mr. westermann, no. mr. buchanan? mr. buchanan, no. mr. van hollen? mr. van hollen, aye. mr. pascoe? mr. pascoe, aye. miss more? miss more, aye. miss lee? miss lee aye. ms. lujan grisham? miss lujan grisham?

miss angle? miss angle aye. mr. moulton? mr. moulton, aye. miss blackburn? miss blackburn, no. mr. chairman? mr. chairman, no. chairman: have all members voted? any member wish to change their vote? the clerk will report. clerk: on that vote, ayes are 12 in the nose or 22. chairman: agreement -- amendment is not agree to. the next amendment is number 10. clerk: amendment number 10 offered by mr. mcdermott on medicaid and medicare. chairman: mr. mcdermott is

recognized for six minutes. rep. mcdermott: thank you, mr. chairman feet this budget fails to address the growing crisis in this country. rather than building of upon this, republicans have allowed this to fall by the wayside. this makes it harder to access insurance fit the affordable care act have tremendous excess -- success to americans who do not have coverage from 20.3% to 13.2%. unfortunately, the primary care workforce is not keeping pace with the growing number of uninsured americans. according to a new study the country will face a shortage as many as 31,000 primary care doctors by 2025. throughout the country rural and low income urban communities will be hit the hardest and patients who need care will be the ones who suffer the most. we will know why this is

happening. for years, our medical system has increasingly scared new doctors away from the practice of primary care. the main reason for that is money. specials anyone -- earn more than primary care doctors for the median is $230,000. the specialist earns an average of $400,000 for that scares many from primary care, especially in rural and low-income areas. educational debt makes this process even more problematic. the meeting cost of attending a medical school is about $55,000 per year and costs continue to climb. as a result, 80 6% of medical school graduates have educational debt. the average graduates are $170,000 in debt and a quarter have debt over $250,000.

burdened by that kind of debt, the majority of young doctors choose lucrative specialty trade over primary care. there are two ways we should address that crisis. the single most effective way to get that provided that we need is by educating doctors in the way that we educate military officers. we should apply defensible's of reserve officer training course and provide free medical education in exchange for a five-year commitment to serve as primary care doctors in underserved areas. this will allow us to praise primary care doctors where we need them, and most importantly, have them stated i call the program are box. -- our docs. we also have to start the conversation about shrinking reimbursements for help -- federal health programs for my amendment strengthens to initiatives that we have improved compensation for primary care providers.

it continues the policy of medicaid payment parity. it helps primary care providers within medicator -- medicaid on equal footing for those on medicare. second, increased payments to primary care providers through medicare. unfortunately, that was in the affordable care act and my republican colleagues have not shown any interest in continuing these important investments. blaster, they love medicaid payment parity to expire, and so far, they have done nothing to ensure that medicare primary programs continued through 2015. low reimbursement rates for primary care limits the numbers of providers who will be willing to participate and federal health programs. that is why both of these initiatives are both so important. before the afford will care act medicaid only paid physicians 58% of what a medicare rate for

the same services was good a recent study published in the in win one journal of medicine found that the medicaid primary care about which wasn't a ca approved appointment availability substantially without increasing wait times. my amendment would continue these critical initiatives by extending both the medicare and medicaid primary payment bonds. these are smart investments that will likely improve access to care for the american people. those of you who represent rural districts ought to be paying special attention to this because it is you who struggle with keeping doctors in your districts. and i reserve the balance of my time. chairman: that is not accommodated under the rule. the gentleman has another minute 20 seconds. you have one minute to close at the end. rep. mcclintock: if you want me to go on? chairman: i'm happy to have the yield back. rep. mcclintock: i will save my minute. chairman: yields back.

i recognize that gentlelady from tennessee, miss black. rep. black: this amendment would increase our total medicaid spending by $5.4 billion in fiscal year 2016 and $54 billion over the next 10 years. pretty big numbers, but let's take a look at what we are currently spending. so in fiscal year 2016, without this amendment, the total spending on medicaid combined federal and state shares are expected to be 580 $4 billion. over the next 10 years, the cbo expects the total federal spending on medicaid will be $4.7 trillion. that is with the tea -- trillion dollars. if it weren't just money, we would have solve this problem. this problem really is not a problem of spending, even with all the spending medicaid continues to have access problems. with all due respect, this

amendment does not fix the problem. it just simply throws more money . so that will not take care of the problem. worse, this amendment picks winners and losers among the primary care doctors because -- this amendment provides only enough funding to increase payments to primary care doctors who truly treat newly eligible medicaid. and they live in the states that have expanded programs. you can see that it does pick winners and losers. what happens to the rest of those folks? well, they are just out of luck. the problem with medicaid is that it is structural. decades of this one-size-fits-all mandate coming down from washington as we have seen in some the other programs leave the patients with less access and, oftentimes worse health problems. i know that we have all seen this in each one of our states. the answer instead, is to put the states back in charge of their own medicaid programs and

to give them the power to design the reforms that feet -- fit the unique needs of their population. we can look in some states who have done it. i'm going to raise up one that is from right here of our cochairman. indiana, for instance, they implement the reforms in the healthy indiana plant and the patient centered system that provided health coverage to uninsured residents who did not qualify for medicaid. and they have seen significant results in the program. i've heard them brag about this pilot program. this is really where the innovation should be. it should be back at the state level where it is closest to the population, so that it can directly affect those populations in particular. we also know that there's a lot of abuse that is out there. we continue to get reports about abuse. we know that medicaid has the

second-highest improper payment rate of any real federal payment program. about $22 billion in federal funds are wasted every year instead of serving families in need. the closer it is to the state, the better it is controlled in the last of that fraud and waste. those dollars can really go to taking care of patients. this budget does not cut benefits. instead, a give states that flexibility and the resources to design those innovative programs that hopefully when they see results, it will be picked up by other states and copy. they will be more responsive to the citizens needs rather than a federal one-size-fits-all. so i would encourage my colleagues to vote no on this amendment and i yield back, mr. chairman. chairman: the generally a -- the gentlelady yields back. the gentleman from washington is closing.

rep. mcdermott: medicated not come into existence because states are doing such a good job. medicaid existed because the states weren't doing anything. the federal government said that we will put up half the money if you put up half the money and here's our half and you can run the program. you can design it yourself. some states did good things and some states did bad things. the fact is that if you live in a rural area, you have a hard time finding a physician. in the state of washington and idaho, we have a program in the north west called whammy. all of these states have big rural areas. it is hard to get doctors to work out there because of your pay off $250,000 with the debt in you are out in a rural area and you're not getting paid as much as you are getting paid in seattle or boise or one of the big cities, you simply are not going to go out there.

you are not going to spend your life and debt in a rural area taking care of people and have to drag that debt. what we're trying to do is help those doctors who do go out there with an additional amount of money, and they clearly aren't being paid. chairman: the gentleman's time has expired. the question is on agreement to the amendment of dr. mcdermott. all those in favor. all this oppose. the gentleman wishes a recorded vote. clerk: mr. garrett? mr. garrett? mr. diaz? mr. cole? mr. cole? mr. mcclintock? mr. mcclintock, no.

ms. black? miss black, no. mr. woodall? mr. woodall, no. ms. blackburn? ms. blackburn, no. miss hartzler? miss hartzler, no. mr. rice? mr. rice, no. mr. sussman? mr. sussman, no. mr. sanford? mr. sanford, no. mr. womack? mr. womack, no. mr. bratt? mr. bratt, no. mr. bluhm? mr. bluhm, no. mr. mooney? mr. mooney, no. mr. grossman? mr. grossman, no. mr. palmer? mr. palmer, no. mr. molnar?

no. mr. westermann? mr. westermann, no. mr. buchanan? mr. buchanan, no. mr. van hollen? mr. van hollen, aye. mr. yarmouth, aye. mr. pascal, aye. mr. ryan, aye. ms. castor? this castor, aye. mr. mcdermott, aye. miss lee aye. ms. lujan grisham? ms. lujan grisham? mr. lou? mr. lou, aye.

mr. norcross? mr. norcross? mr. moulton? mr. moulton, aye. mr. garrett? mr. garrett, no. mr. cole? mr. cole, no. mr. chairman? mr. chairman, no. chairman: at all members voted? any member wish to change the vote? clerk will report. clerk: the ayes are 12 and the nos are 21. chairman: the next amendment is number 12. clerk: amendment number 12 offered by mr. yarmouth in immigration reform. chairman: mr. yarmouth is recognized for 10 minister -- 10

minutes. rep. yarmuth: there are some issues that we all agree need to be addressed immediately. i think it is safe to say that everything on one of us believes that our current immigration system is broken. what is often missing from the reform debate is the economic impact of enacting conference of immigration reform legislation. according to the cbo comprehensive bipartisan immigration reform legislation passed by the senate in the last congress would've reduced our deficit by $900 billion of the next two decades. also boozing our economy -- boosting our economy by 5.4% and increasing production. who knows? maybe the bill that my good friend have helped to write as the gang of eight would've been more significant. social security actuary estimates that immigration reform would reduce the social security shortfall and extend

the life of the program by use. that is because, under competent of immigration form, millions of relatively young citizens will be working and paying into social security and medicare but not collecting benefits for some of the case. thereby, stabilizing the program while baby boomers receive their benefits. but yet, once again, this year's budget proposal before us today does nothing to adjust the problems with our immigration system. more importantly, it does not take advantage of the positive economic impact of reform. our current system keeps families of illegal immigrants and u.s. is -- u.s. citizen separated for decades. and alas for the exportation of undocumented workers to the detriment of all workers and actively discourage illegal immigration. that is why we see everyone from the u.s. chamber of commerce labor units, the agriculture community, and countless other

organizations and interest groups agree that immigration reform is key to our nations huger. -- nature and future. i mentioned this in this amendment to entered his of immigration reform as part of the budget. we should take this opportunity to secure our borders, expand the size of our work force ensure that every individual working here is paying taxes and contributing fully to our society. all while we boost our economy and reduce the deficit. this amendment is the right thing to do. the dire need to address this issue is real. and it has been delayed for far too long. the majority of american people