subsection and subsection (y)" and inserting "without regard to this subsection, subsection (y), subsection (z), and section 10202 of the patient protection and affordable care act" each place it appears; (6) by adding after subsection (bb), the following: "(cc) requirement for certain states.-notwithstanding subsections (y), (z), and (aa), in the case of a state that requires political subdivisions within the state to contribute toward the non-federal share of expenditures required under the state plan under section 1902(a)(2), the state shall not be eligible for an increase in its federal medical assistance percentage under such subsections if it requires that political subdivisions pay a greater percentage of the non-federal share of such expenditures, or a greater percentage of the non-federal share of payments under section 1923, than the respective percentages that would have been required by the state under the state plan under this title, state law, or both, as in effect on december 31, 2009, and without regard to any such increase. voluntary contributions by a political subdivision

(k) to carry out this subsection. "(h) medpac and macpac reports. "(1) medpac. the medicare payment advisory commission shall conduct an independent review of the alternatives to current tort litigation that are implemented under grants under subsection (a) to determine the impact of such alternatives on the medicare program under title xviii of the social security act, and its beneficiaries. "(2) macpac. the medicaid and chip payment and access commission shall conduct an independent review of the alternatives to current tort litigation that are implemented under grants under subsection (a) to determine the impact of such alternatives on the medicaid or chip programs under titles xix and xxi of the social security act, and their beneficiaries. "(3) reports. not later than december 31, 2016, the medicare payment advisory commission and the medicaid and chip payment and access commission shall each submit to congress a report that includes the findings and recommendations of each respective commission based on independ

"; and (3) by striking subsection (g) and inserting the following new subsection: "(g) application of pilot program to continuing care hospitals.- "(1) in general.-in conducting the pilot program, the secretary shall apply the provisions of the program so as to separately pilot test the continuing care hospital model. "(2) special rules.-in pilot testing the continuing care hospital model under paragraph (1), the following rules shall apply: "(a) such model shall be tested without the limitation to the conditions selected under subsection (a)(2)(b). "(b) notwithstanding subsection (a)(2)(d), an episode of care shall be defined as the full period that a patient stays in the continuing care hospital plus the first 30 days following discharge from such hospital. "(3) continuing care hospital defined.-in this subsection, the term 'continuing care hospital' means an entity that has demonstrated the ability to meet patient care and patient safety standards and that provides under common management the medical and rehabilitation services provided in inpatient rehabilitation hospitals and uni

the secretary shall determine eligibility for pilot programs under subsection (b). "(d) emergency declaration defined. for purposes of this section, the term 'emergency declaration' means a declaration of a public health emergency under section 104(a) of the comprehensive environmental response, compensation, and liability act of 1980. "(e) environmental exposure affected individual defined. "(1) in general. for purposes of this section, the term 'environmental exposure affected individual' means- "(a) an individual described in paragraph (2); and "(b) an individual described in paragraph (3). "(2) individual described. "(a) in general. an individual described in this paragraph is any individual who- "(i) is diagnosed with 1 or more conditions described in subparagraph (b); "(ii) as demonstrated in such manner as the secretary determines appropriate, has been present for an aggregate total of 6 months in the geographic area subject to an emergency declaration specified in subsection (b)(2)(a), during a period ending- "(i) not less than 10 years prior to such diagnos

section 312 of the public health service act (42 u.s.c. 244) is amended- (1) in subsection (c)(6), after "clearinghouse" insert ", that shall be administered by an organization that has substantial expertise in pediatric education, pediatric medicine, and electrophysiology and sudden death,"; and (2) in the first sentence of subsection (e), by striking "fiscal year 2003" and all that follows through "2006" and inserting "for each of fiscal years 2003 through 2014". sec. 10413. young women's breast health awareness and support of young women diagnosed with breast cancer. (a) short title. this section may be cited as the "young women's breast health education and awareness requires learning young act of 2009" or the "early act". (b) amendment. title iii of the public health service act (42 u.s.c. 241 et seq.), as amended by this act, is further amended by adding at the end the following: "part v-programs relating to breast health and cancer "sec. 399nn. young women's breast health awareness and support of young women diagnosed with breast cancer. "(a) public education campaign. "(1) in gen

nothing in this subsection shall be construed to permit a center established under subsection c- c-1-c to compel health insurance issuers to provide data to the center. two, in clause 1-1, by inserting any agency or instrument of any of the foregoing before and closed. b, section 1103-a of this act is amended in paragraph 1 by inserting or small business in and after any residents of, and two, by striking paragraph two and inserting the following. two, sexting to affordable coverage. an internet website established under paragraph 1 shall to the extent practicable provide ways for residents of and small businesses in any state to receive information on at least the following coverage comeses. a, health insurance coverage offered by health insurance insurers other than coverage that provides reimbursement only for the treatment or mitigation of a single disease or condition or an unreasonably limited set of diseases or conditions as determined by the secretary. b, medicaid coverage under excite 19 of the social security act. coverage under title 1 of the social security act. a state he

nothing in this subsection and the amendments made by this subsection may be construed as establishing regulatory authority or modifying any existing regulatory authority. (3) limitation on termination. notwithstanding any other provision of law, a federal office of minority health or federal appointive position with primary responsibility over minority health issues that is in existence in an office of agency of the department of health and human services on the date of enactment of this section shall not be terminated, reorganized, or have any of its power or duties transferred unless such termination, reorganization, or transfer is approved by an act of congress. (c) redesignation of national center on minority health and health disparities. (1) redesignation. title iv of the public health service act (42 u.s.c. 281 et seq.) is amended- (a) by redesignating subpart 6 of part e as subpart 20; (b) by transferring subpart 20, as so redesignated, to part c of such title iv; (c) by inserting subpart 20, as so redesignated, after subpart 19 of such part c; and (d) in subpart 20, as so red

(c) as subsection (d) and inserting after subsection (b) the following new subsection: "(c) health care-in addition to other taxes, there is hereby imposed on every employer an excise tax, with respect to having individuals in his employ, equal to 8.7 percent of the wages (as defined in section 3121(a)) paid by him with respect to employment (as defined in section 3121(b)).". (b) self-employment income.-section 1401 (relating to rate of tax on self-employment income) is amended by redesignating subsection (c) as subsection (d) and inserting after subsection (b) the following new subsection: "(c) health care.-in addition to other taxes, there shall be imposed for each taxable year, on the self-employment income of every individual, a tax equal to 8.7 percent of the amount of the self-employment income for such taxable year.". (c) comparable taxes for railroad services.- (1) tax on employers.-section 3221 is amended by redesignating subsection (c) as subsections (d) and inserting after subsection (b) the following new subsection: "(c) health care.-in addition to other taxes, there is here

i found particularly troubling and it's under section c, titled "limitations on changes to this subsection." and i quote -- "it shall not be in order in the senate or the house of representatives to consider any bill, resolution, amendment, or conference report that would repeal or otherwise change this subsection." this is not legislation. it's not law. this is a rule change. it's a pretty big deal. we will be passing a new law and at the same time creating a senate rule that makes it out of order to amend or even repeal the law. i'm not even sure that it's constitutional, but if it is, it most certainly is a senate rule. i don't see why the majority party wouldn't put this in every bill. if you like your law, you most certainly would want it to have force for future senates. i mean, we want to bind future congresses. this goes to the fundamental purpose of senate rules: to prevent a tyrannical majority from trampling the rights of the minority or of future congress congresses. mr. president, therefore, i would like to propound a parliamentary inquiry to the chair. does section 3403 of th

b, when the house adjourns on the motion pursuant to this subsection or a declaration pursuant to subsection a on the legislative day of, one, wednesday, december 16, 2009, it shall stand adjourned until 6:00 p.m. on saturday, december 19, 2009. two, saturday, december 19, 2009, it shall stand adjourned until noon on wednesday, december 23, 2009. three, wednesday, december 23, 2009, it shall stand adjourned until 10:00 a.m. on saturday, december 26, 2009. four, saturday, december 26, 2009, it shall stand adjourned until noon, december 30, 2009. five, wednesday, december 30, it shall stand adjourned until 10:00 a.m. on saturday, january 2, 2010. c, if during any adjournment addressed by subsection b the house has received, one, confirmation that the president has approved h.r. 3326. two, a message from the senate transmitting its passage without amendment of h.r. 4314. and, three, a message from the senate transmitting its concurrence and an applicable concurrent resolution of adjournment, the house shall stand adjourn until such concurrent resolution of adjournment. d, the speaker may appoin

"nothing in this subsection shall restrict any nonfederal health insurance issuer offering a qualifiedplan from offering separate supplemental coverage for abortions for which funding is prohibited under this subsection or a plan that includes such abortions so long as (a) premiums for such separate supplemental coverage or plan are paid for entirely with funds not authorized or appropriated by this act; nb) administrative costs and all services offered through such supplemental coverage or plan are paid for using only premiums collected for such coverage or plan; and (c) any such nonfederal health insurance issuer that includes coverage for abortions for which fund something prohibited under this subsection also offers a qualified health plan through the exchange that is identical in every respect except that it does not cover abortions for which funding is prohibited under this subsection." our amendment has the support of the united states conference of catholic bishops, the national right to life committee, the family research council, the ethics and religious liberty commission of

let me quote further from the first subsection. it says that the secretary of secretary and the health of human services are prohibited from implementing the provisions of an amendment made by sections 1401, 1402, 2001, and 2101, end quote. what are those sections? what are those sections would stop taking effect? section 1401 is refundable tax credit providing premium assistance for coverage. those are the tax credit, the tax reduction that help people to buy health insurance. the gregg amendment says you can't help people buy health insurance. you cannot have those tax credits. a second section of the gregg amendment which is the section 1402, what's that? 1402 is the reduced cost for individuals. that's the part that would make co-pays out-of-pocket expenses affordable. the gregg amendment says can't have them reduced cost sharing for individuals. got to keep those co-pays and effect. got to keep those out-of-pocket expenses high. the gregg amendment prevents and expenditures that would help people with those co-pays out-of-pock

let me quote further from the first subsection. quote, the secretary of treasury and secretary of health and human services are prohibited from implementing provisions of an amendment made by sections 1401, 1402, 2001, and 2101. and of quote putting it what are those sections? one of those sections the gregg amendment would take effect. section 1401 is refundable tax credit provided premium assistance for coverage. those are the tax credits the tax reductions that help people buy health insurance, the amendment says it can't help people buy health insurance. you cannot have those tax credits. the second section of the amendment, section 1402, what's that? 1402 is the reduced cost sharing for individuals. that's the part that would make the co-pays out of pocket expenses affordable. the gregg amendment says can't have reduced cost sharing for individuals, got to keep those co-payments in effect and out of pocket expenses too high. speed amendment prevents expenditures that would help people with those co-payments and out of pocket e

but if you look at page 91, section 202, protecting the choice to keep current coverage, subsection a, right under that, all capital letters, grandfathered health insurance coverage defined. this is where it defines if you get to keep it or not. it says the term grandfathered health insurance means individual health insurance coverage offered in force and effect before the first date of this, condition one, issuer offering such coverage does not enroll any individual in such coverage. i had a person back in east texas that i represent, when i was talking about health care say, you know what, i know a lot of people are really concerned about it, i don't want to seem ka louse, but i'm not worried about it, i said, i retired, one of the bigger companies in the country, we have a great union that negotiated us a great health insurance and i've got great insurance, president said if i like it, i can keep it, i'm not worried about everybody else. i'm in good shape. i said, is there any chance anybody else will ever retire from your big company? and be added to the insurance -- the health in

is there really that much to be made in that subsection of the market? >> i think it is important to note that that is one example. it is similar to other services. pricing it high is a way to hurt consumers and the monthly plan that may result in more minutes in the consumer will use our need. they may buy a 200 plan and their back to paying 20 cents. for us, we are not alluding to this. we are saying to people do not need to sit in a rooming, but a plan for consumers to see the same in the marketplace. consumers are being charged the maximum amount that they are willing to pay. rather than the lowest cost. >> what to be the respective companies profit margin? >> i do not have the exact number for that. you could assume that because 99% of text messages are on the rate plans, and a substantial portion of our profits and revenues come from the same percentage of usage. i cannot break this down like this. our networks are not constructed to provide a particular service. i simply cannot break it down the way. i do not have that for you. >> the only statist

garrett: it says on page 291 after line 4, insert the following subsection, conversion to bankruptcy, conversion, the corporation may at any time with the approval of the secretary, when meeting the treasure secretary, and after meeting with the council, consult the proceeding under chapter 7 or chapter 11 of title 11 united states code by filing a petition against the covered financial company under section 303-n of such title. it goes on page 4. the corporation will -- the corporation may serve as a trustee. basically what you have established here is a political decision by the treasury secretary to take an institution that they decide that they are going to put into receivership which you said before would be the end game and allow them to convert back into a 7 or 11 bankruptcy. your statement before and this goes back to my opening comment which you respondsed to, why are we concerned with such a large bill? the reason we're concerned with such a large bill is because obviously the chair and members of your side of the aisle have not read the entire bill. the reason we presented

under section 915 of the public health service act and the community preventive services and as subsection task forces were in existence the day before the enactment of this act shall be transferred to the task force and clinical preventive services and the task force on community preventative and then it goes on to say whatever your recommendations were prior to that enactment are in effect. are you aware of that, sir or maam? >> certainly-- >> yes or no. i am sorry. >> yes. we were aware of that. >> were you aware that during our deliberations? >> no. >> would that change deliberation at all? >> i cannot speculate on what might happen. >> interesting. so what you are saying is according to the love which this committee wants to enact you have now taken ages 40 to 49 and made them a category c which means they will not be paid for under this committee. you say you did not consider cost. is every appendix attached to your task force recommendation, is that something that would then review by the individuals who would make the determination? is that something of value and that is why do you

. >> conducted under this subsection to the extent determined appropriate by the secretary if, one, thermines that such expansion is expected to reduce spending under title 18 without reducing the quality of care or b improve the quality of care and reduce spending. two, the chief act ware of the centers for medicare and medicaid services certifies -- >> again, live coverage of the u.s. senate this afternoon as they are working on health care. the senate reading clerk reading through the manager's amendment. 3:00 the expected time that that will wrap up and then further debate on health care expected after the reading of the manager's amendment. we are still standing by and waiting for remarks from vermont independent senator bernie sanders. he is expected to talk about health care this afternoon. we will have his comments. he is actually standing right there in the doorway. and as soon as he makes his way to the podium we'll have his comments live here on c-span. and a quick reminder that the president will be speaking also. he will talk about health care. that is set for about 1:30 ea

garrett: it says on page 291 after line 4, insert the following subsection, conversion to bankruptcy, conversion, the corporation may at any time with the approval of the secretary, when meeting the treasure secretary, and after meeting with the council, consult the proceeding under chapter 7 or chapter 11 of title 11 united states code by filing a petition against the covered financial company under section 303-n of such title. it goes on page 4. the corporation will -- the corporation may serve as a trustee. basically what you have established here is a political decision by the treasury secretary to take an institution that they decide that they are going to put into receivership which you said before would be the end game and allow them to convert back into a 7 or 11 bankruptcy. your statement before and this goes back to my opening comment which you respondsed to, why are we concerned with such a large bill? the reason we're concerned with such a large bill is because obviously the chair and members of your side of the aisle have not read the entire bill. the reason we presented

presumption in the law that methodologies adequately meeting a determination standard in section 3, subsection f, 2-a. more narrow exemptions and providing for personal information holders notice, quote, serious providers, end quote, in addition to information handling protection data but only for the limited purpose it's of preventing fraud -- purposes of preventing fraud. the f.c.c. may determine to be in compliance if a person is required under any federal law to maintain standards and safeguards for information security and protection of personal information that provides protection he. mr. speaker, with that i yield back the balance of my time. the speaker pro tempore: the gentleman reserves the balance of his time. is that correct? reserves? mr. rush: i reserve. the speaker pro tempore: ok. the gentleman from florida. mr. stearns: mr. speaker, i yield myself such time as i may consume. the speaker pro tempore: the gentleman is recognized. mr. stearns: mr. speaker, i rise in support of h.r. 2221, the data accountability and trust act, and i am very pleased and gratified that we're conside

unanimous consent to modify the amendment by adding the following before the period at the end of subsection (b) "and furthermore not withstanding any other provision of this act or amendment made by this act, net medicare savings specified in the most recent estimate available from the director of the congressional budget office before enactment are appropriated to the secretary and shall be used for such purposes to maintain medicare policies for home health services, skilled nursing facilities, hospice care, hospital services, and benefits provided under medicare advantage program. as under the provisions of such title as specified on the day before the date of the enactment of this act." end of my amendment. i ask unanimous consent. mr. baucus: mr. president, reserving the right to object, under current law if less is spent for medicare providers, the benefits inure to the medicare trust fund beneficiaries. although i have the greatest respect for the senator from iowa, this is a stunt, and i object. the presiding officer: the objection is heard. mr. grassley: then if i could -- the pres