to go along with the permanent s.g.r. fix the bill includes a meaningful down payment on medicare reform without any accompanying tax hikes. these reforms include a limitation on so-called medigap first dollar coverage, more robust means testing for medicare parts b and d and program integrity provisions that will strengthen medicare's ability to fight fraud. i'm aware that these are not transformative reforms and that much more work will be necessary to put medicare, not to mention our other entitlement programs, on a more sustainable trajectory. however, any senators, who like me, have been clamoring for entitlement reforms should welcome these changes. after all for years the idea of bipartisan medicare reforms seemed at least far-fetched. president obama and his allies here in congress have stated repeatedly that before they'd consider changes to our safety net programs, republicans would have to agree to massive tax hikes, but here we are just one senate vote away from enacting meaningful and bipartisan medicare refor

the s.g.r. -- that's the physicians' payment -- says -- this is what it says -- quote -- "the s.g.r. change without a full i yield the offset is projected to add an average of around $14 billion a year to the deficit." the "fiscal times," headline -- "medicare doc fix may be no fix at all." paul winfrey economic policy expert at the heritage foundation said this -- quote -- "rather than a permanent replacement of the sustainable growth rate" -- we've been promised that this would be a permanent replacement replacement -- quote -- "it is much more likely that the house doc fix will be a shorter-term patch requiring another series of patchwork legislation just nine years from now." they also conclude in this article, the permanent fix -- quote -- "would add $141 billion to the deficit over the first 10 years and would go as high as $500 billion over two decades as previously reported here." but i did want to emphasize it's really not $141 billion over 10 years. it's $174 billion because when you add up $141 billion in debt in additional debt, over 10 years you pay interest on that becau

so each year since 2003, the s.g.r. formula has called for cuts to physician payments, and each year -- often several times each year -- copping has congress has passed legislation to temporarily prevent the reimbursement reductions from kicking in. while these so-called doc-fix bills have yielded some modest savings with cuts elsewhere in the budget, they have not restrained the quickening pace of medicare spending. and while they've successfully avoided cuts to doctors' pay they've put the medicare system in a near constant state of uncertainty and instability leaving medicare doctors and their patients hanging in the balance. america's physicians and america's seniors deserve better than this, mr. president. but they also deserve better than the bill before us today h.r. 2 the medicare access and chip reauthorization act of 2015. congress has long wanted to repeal the s.g.r., and with good reason but this is not the way to do it. not only does the house bill double down on medicare's broken price control model but it

the second fund is a medical fund and it's really based on the same principle that we used with the s.g.r. fund that we just voted on. that bill passed 92-8. the fund would receive a minimum of $5 million and would be matched up to $30 million as funding that the cornyn fund goes up, and so it really is a parallel fund, but serving the exact same purpose. and this is a way that we were able to eliminate extraneous provisions but still keep the spirit of this really important bill and allow us to move on to my bill, the stop exploitation trafficking act which really is about not prosecuting kids under 18. huge bipartisan support over in the house. passed unanimously through the judiciary committee and will be one of the amendments to this bill. i want to again thank senator murray for her leadership. we've been a team on this, and we've been able to work with senator cornyn and our friends across the aisle to get this done and it is also time, i will end by saying, to confirm the next attorney general of the united states, loretta lynch. thank you. i yield the floor. mr. thune: mr. preside

speaker, after the passage of a clean homeland security bill and the s.g.r. fix, i had hoped that bipartisan cooperation in legislating would be contagious. i was wrong. today, the republicans are back to their old ways of bringing up my way or the highway bills that will be brought to the floor under a closed rule and vetoed by the president. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from texas. mr. sessions: the gentleman is going to have his opportunity today because i'm sure we are going to vote on this, i would like to advise the gentleman, we have no speakers. we spent a couple of hours yesterday in the rules committee fully debating this and understanding this bipartisan bill, so i want to advise the bill, that i will allow him to use the time evidently -- i would like to ask if he has any speakers. mr. mcgovern: i do. mr. sessions: i reserve. the speaker pro tempore: the gentleman reserves the balance of his time. mr. mcgovern: in honor of equal pay day, if we defeat t

events of the tax bills today, your criticism of those and your democrats almost demand -- supported the s.g.r. fix, which adds $10 billion. what's the difference between the two and is that a prove efficiency. ms. pelosi: that's an extent that we have. it's not going to have. and the longer we prolong it, the more expensive it is and it is an investment in people and in that people, not only you call it the doc fix but a remedy for our seniors and as i mentioned earlier today, one of the first bills that was sent to president obama's desk. we couldn't get it signed until we had a democratic president and president obama signed it in this legislation. we extend that and investing the health of our children is a very positive investment. some of it is paid for. we have the initiative to help very -- poor seniors. and that is paid for by increasing to mr. hughes: i am the president of the national press club. we are committed to our profession's future through programming just like this and we fight for a free press worldwide. for more information visit our website, press.org. to donate to progr

bill, but certainly on the s.g.r. bill. and then this week we had two bills pass in bipartisan, both sides, majority voting for them. hopefully we will be able to do that on the appropriations bill. i ask my friend on the milcon, military construction bill-v.a. funding bill, and on the energy and water bill, does the gentleman expect to follow what the gentleman and his party have indicated would be the process for hopings bills under an open rule? -- for appropriation bills under an open rule? i yield. mr. mccarthy: the answer to your question is yes. the gentleman does know being a part how many years on the appropriations process that this is actually the earliest in the history of congress we have ever started appropriation, and it's our goal, i know it's your goal as well, to get all bills done through the house in regular order. it is something that we strive towards. i thank the gentleman for his help. mr. hoyer: i congratulate the gentleman on -- and his party bringing these bills to the floor early. he also says we

unless you decide to fund it and curb more debt like they did with the s.g.r. bill a couple weeks ago, the health care reimbursement bill, unless they do that there will be a short-term band-aid fix at best. but i do think over time -- so it's been about six years since the ryan budget was first put forward. i think over time there's been some willingness on the part of some democrats to listen to it. as has there been some listening to closing the loopholes on tax issues. it's frustrating and you got to be patient and i'm not patient so yes, i understand -- i understand why the frustration. shira: up there, please. >> good evening, mr. cantor. i'm scott. thanks again, for coming together and spending time with us at the forum. i'm a former military officer and part of the business school. mr. cantor: thank you for your leadership. >> my question is in the private and public sector and specifically any differences that you see kind of key to being an effective leader and two, to more get at my question what advice would you get base on your experience in washing

comments that have been made by senator sessions and others that we've got to find a way to offset the s.g.r. vote. it was a good vote, but we need to offset it. and i hope that we can continue to successfully address those issues that senator wyden raised in how we deal with our wildfire management and how we deal with our secure rural schools and pilt funding and we move forward. again, mr. chairman, thank you. i commend you both for the hard work and the hard decisions you have made in bringing us to this point. senator enzi: thank you. congressman black. congresswoman black: thank you, senator enzi. let me begin by saying what an honor it is to serve on this conference committee as we begin important work of adopting a unified budget agreement. that will confront our spending problem and return us to a point of fiscal solvency here in washington. we know that the stakes are high and the challenges are big, but we can also be encouraged by the knowledge that our house and senate passed budgets already reflect many of the same core principles. and that's important because as we have all he

senator mcconnell said the american people expect us to do work, and he used the s.g.r. example as a way that we did work in a constructive bipartisan fashion, making compromises on both sides of the aisle with speaker boehner and leader pelosi representing the two parties, came together and worked and my staff and i think your staff participated as well and we came to an agreement. . i hope we can do that. obviously the budget doesn't that way. we don't like the sequester and we think it undermines the national security and undermines the investments that america needs to make in its infrastructure and its education, health care and environment and other areas that are of critical importance. so i would hope on these issues, while i understand the gentleman's thing that there will be notice of it, i would hope we could have some discussions about it so we could try to come to as we did with s.g.r. an agreement and that passed with 392 votes. you worked hard on it, i worked hard on it. 392 votes in this house. that was one of the best days we have had this year. it may ha

this is what happened, for instance work the recent s.g.r. repeal legislation which had components under the jurisdiction of no less than sex different committees in this body but was presented before us as a single bill. in this case however, because there seems to be some kind of turf war between the intelligence committee and the homeland security committee, we're actually voting on two overlapping bills that in several respects contradict one another. for instance the bills have drastically different determinations of what kind of information may be sheared, what purposes the government may use the information for and what hacking countermeasures companies are allowed to take to protect their networks. but instead of having a meaningful debate on the merits of each bill's report this body would forgo that and simply debate and vote on each bill separately and if they both passed, the rule directs the clerk to mesh them together through something called conforming amendments. not only would this leave businesses to wade their way through tw

after the press went to bed, i think but very important thing and that's a thing called the doc fix passed, s.g.r. passed this body last night in a very bipartisan way. after a series of amendments and an open floor amendment. that's what's supposed to has been around here. one of the reasons that i mention that is that i've always said that if you can't see a doctor you don't have insurance at all. and with the way that we've been setting up medicare payments for doctors, we've been driving them out of the profession. we've been eliminating doctors. we've been having doctors tell their kids don't become a doctor because of what congress is doing and holding them hostage every six months. that got taken care of last night. i don't know; we've been doing that for i think about 18 years just a step at a time. and so it's nice that we are finally able to make that permanent and have the doctors see somewhere to go. now i mentioned that that was medicare. this is the first budget that the republicans have gotten to participate in in many years. but the democrats got to work on the health care bill, a

s.g.r. this is $9 million not that hard to pay for $9 million. we probably spend that just having this debate right here keeping the lights on and the c-span flowing and the chamber going. $9 million, it's easy. if you allow this to come up under an open rule, plenty of amendments could have offered $9 million pay-fors. take it out of any account. it is a relatively small amount of money. take it from any government agency and i'm sure you could find $9 million to agree on to fund this rather than gut a back-door attempt to fund the consumer financial protection agency. nothing precludes tax reform. we are moving further and further away from tax reform by making permanent special interest tax cuts that we agree are part of the discussion for tax reform to eliminate in order to bring down taxes. so it's moving further and further away. doesn't preclude it. makes it harder. mr. speaker, yesterday was equal pay day. if we defeat the previous question, we'll offer an amendment to the rule to allow the house to consider h.r. 1619, introduced by representative delauro, which i'm proud to co-sponsor, to discuss our proposal. i yield 3 1/2 minutes to the

s.g.r. this is $9 million not that hard to pay for $9 million. we probably spend that just having this debate right here keeping the lights on and the c-span flowing and the chamber going. $9 million, it's easy. if you allow this to come up under an open rule, plenty of amendments could have offered $9 million pay-fors. take it out of any account. it is a relatively small amount of money. take it from any government agency and i'm sure you could find $9 million to agree on to fund this rather than gut a back-door attempt to fund the consumer financial protection agency. nothing precludes tax reform. we are moving further and further away from tax reform by making permanent special interest tax cuts that we agree are part of the discussion for tax reform to eliminate in order to bring down taxes. so it's moving further and further away. doesn't preclude it. makes it harder. mr. speaker, yesterday was equal pay day. if we defeat the previous question, we'll offer an amendment to the rule to allow the house to consider h.r. 1619, introduced by representative delauro, which i'm proud to co-sponsor, to discuss our proposal. i yield 3 1/2 minutes to the

it is known as the s.g.r. medicare fix a payment system that affects physicians under the medicare system. it's badly broken. on 17 previous occasions we've extended the current policy in order to make sure that physicians don't get an automatic cut that would deny many medicare beneficiaries access to their physicians, that these are pretty extreme measures. we all understand that it's time to permanently fix this, not just to eliminate the problem but to substitute a payment system that encourages physicians to provide high-quality care and to deal with incentives that reduce the volume of care. and that is what the legislation that passed the house of representatives does. it does it -- it fixes the problem on a permanent basis and i'm certainly hopeful that we can get that enacted shortly because we've already passed the deadline in regards to when the current patch expired. the bill also provides for an extension of the children's health insurance program. i do hope that we can provide a longer extension t

the house s.g.r. bill includes language that is one more example of using women's health as a political football. it is redundant and unnecessary. i am offering an amendment tonight, mr. president -- the presiding officer: the senate will be in order. the senate will be in order. mrs. murray: mr. president i'm offering an amendment tonight that shows that we are making sure that women have a comprehensive access to health care. it focuses on moving women's health care forward by providing a clean extension of community health care funding for four years, not two to provide certainty. it would invest $2 billion in safety net providers for women and their families through title 10 clinics. and finally it will invest in strengthening the women's health care workforce. the presiding officer: the senator's time has expired. mrs. murray: i hope my colleagues will support this amendment and i ask for the yeas and nays. the presiding officer: is there a sufficient second? mr. hatch: mr. president? mr. presiden

colleague from new hampshire knows what i'm talking about in the technical lingo of health care is the s.g.r., the sustainable growth rate. it is a horrendously flawed formula for paying doctors and providers who treat our medicare patients. and yet despite this very sour pedigree, it has dominated much of the discussion about medicare since 1997. now, i wish we had put this flawed reimbursement system in the dust bin of history last year as some of my colleagues know i had sought to do that along with the support of others. but i think now we have reached the point on a bipartisan basis where we have a chance for seniors and their providers to cross the victory line and be better off and have a better system for all americans. and i thought i'd take just a minute or two before discussing some of the other health care efforts that i hope will go forward today to describe how this happened. a little over a year ago there wasn't much reason to think that we wouldn't just keep patching this leaky boat. that's essentially what the senate had been doing for years and years with this flawed progra

extraordinary work of two very talented individuals in our office who have really been the leaders in my view, on this s.g.r. reform cause. one of them is our health chief liz durink. she deserves notice for her leadership creativity and focus and second joycelyn moore who we have the good fortune who came to us from senator rockefeller. she brings great expertise and years of experience to the field. and certainly what i have learned from them after a career of trying to specialize in these issues has done so much to assist the committee assist me. and i want to express my gratitude to them. the work of the bipartisan finance committee staff through all its fits and starts is what got us here today. i want to thank all of them. and i think it's very appropriate that my colleague from washington state senator cantwell who has done so much good work on these issues, is going to close us today. ms. cantwell: mr. president? the presiding officer: the senator from washington. ms. cantwell: mr. president, i want to thank the senator from oregon for his leadership on this legislation and on health care in general