Marcia Fudge

Ms. FUDGE

Ms. FUDGE. Yes

Ms. FUDGE

Ms. FUDGE. Thank you very, very much. I am so pleased to have you join me this evening, Mr. Ellison. I thank you for your work. You do outstanding work on behalf of people in the most need, and I am happy you could join me. It seems as though now we have been joined by our Chair, the Honorable Barbara Lee, the gentlelady from California. I will now yield to our chairwoman. Thank you so much for being here.

Ms. FUDGE. Thank you so much, Madam Chair. It's always a pleasure to have you join me. Even though we generally do this on Monday nights, this is a special Wednesday night for us, so I appreciate your taking the time to stop by. Thank you very much. Mr. Speaker, as I mentioned, I believe this Congress is willing to take a stand for seniors. I am proud to be a cosponsor of several pieces of legislation and to be a signatory on a number of letters to congressional leadership and Federal agencies which were authored to help seniors who are facing mounting financial and medical concerns. One important bill, the Social Security COLA Fix for 2010 Act, ensures that seniors receive their COLAs for 2010. This legislation will help offset rising costs by providing seniors with a one-time $150 payment in lieu of the Social Security COLA. The offset is fully paid for, and the legislation would not affect other Federal programs. For example, the one-time $150 payment would not count as income, and as a result, it would not push seniors who are too young to qualify for Medicare out of the eligibility for Medicaid. I want to talk just a bit about end-stage renal disease, Mr. Speaker, which is a disease that affects many seniors in my district and around the country. They are those who experience kidney failure. Last year, Congress passed legislation to provide up to six sessions of pre-end- stage renal disease education to Medicare beneficiaries experiencing kidney failure. I joined a number of other Members of Congress and sent a letter to the directors of the Centers for Medicare and Medicaid Services, urging them to reconsider the proposed physician fee schedule, which would reimburse a 60-minute kidney education service, provided by a licensed physician, at the same rate as a 15-minute session provided by a nutritionist. The letter also requests that CMS reconsider the restriction on who can administer pre-end-stage renal disease education. Currently, only physicians can provide this service, although, licensed practitioners, such as nurses and nutritionists, are available and are trained to provide this education as well. Adjusting the reimbursement rate and allowing multiple types of licensed practitioners to educate seniors with kidney failure will ensure that seniors facing end-stage renal disease will get the care and education they need. For many seniors, their major concern about aging is the fear of losing their mental capabilities. That is why I am a cosponsor of the Alzheimer's Breakthrough Act of 2009, which is a bipartisan piece of legislation that includes an authorization of $2 billion for Alzheimer's funding at the National Institutes of Health, for support for caregiver programs and for a national summit on Alzheimer's. Another piece of legislation which is essential to the welfare of America's seniors is the America's Affordable Health Choices Act of 2009. While some seniors have received misinformation and have voiced suspicions that health care reform would cut Medicare benefits, many know the truth about this bill. Medicare will be absolutely strengthened under the proposal. As we all know, the health care reform bill is not yet complete, and many more changes will be made before it becomes law. While I cannot predict how the bill will be structured once it is finalized, I can tell you that I am fighting to ensure health care for seniors will not be diminished in any way. Under the House proposal, seniors should notice a number of improvements in services. To be more specific, the House proposal will protect Medicare by shoring up funding for the program across the board so that all Americans will have this benefit as they grow older. The bill will lower drug costs by eliminating the Medicare part D doughnut hole for prescription-drug coverage. The doughnut hole refers to a costly gap in the Medicare part D prescription drug plan. The plan currently covers up to $2,700 per year in prescription-drug benefits. Then it stops. Coverage does not begin again until a recipient's drug cost exceeds $6,100 annually, thus, leaving the recipient responsible for paying all drug costs between $2,700 and $6,100. Under the proposed legislation, seniors could receive a 50 percent discount on brand name drugs in the doughnut hole immediately after the bill passes. This is a measure that would provide immediate relief for seniors who must choose to either purchase medication or food--a choice no American should be forced to make. The legislation provides free preventative care. Seniors would pay nothing on preventative screenings and services designed to keep them healthier longer. The bill improves primary care by ensuring that seniors are able to spend more time with their primary care doctors. There are provisions to enhance safety by developing national standards that measure medical care quality by investing in patient safety and by rewarding doctors and nurses who administer high-quality care. The legislation increases oversight by cracking down on waste, fraud, abuse and medical overpayments. There are provisions that encourage hospitals with high readmission rates to provide transitional and coordinated care services. Finally, Mr. Speaker, the bill has new initiatives to improve nursing home quality and transparency. Seniors should not be fearful. Change, we know, is difficult, but as Henry Ford said: Don't find fault; find a remedy. Experts who have studied the House health care reform legislation found that the proposed changes actually strengthen Medicare and improve beneficiaries' care and access to physicians. Passing legislation that improves the lives of seniors is the number one priority in this Congress. Seniors should not have to fear or wait any longer. I say to all of the seniors: We are fighting for you. Every day, we are fighting for you, and we will not let you down.

Ms. FUDGE. Thank you. You are absolutely right; we cannot survive with the status quo. And the other thing that this bill does is it allows us to say to those who have for so long not been able to really live a healthy lifestyle--not because they don't want to, but because they don't have the ability to--to now say, look, we are going to put resources in your neighborhood community clinic so that you can go and make sure that your children have the proper exams and the proper things before they go to school. We are going to be in a position where we say to them, we are going to make this health care accessible to you, not just on Monday through Friday from 8 to 4, when working parents have to work; but because of the resources we're providing, we are now opening these clinics on Saturday. We are now saying to them we are going to make this more convenient for you because we want you to be healthy. We want to set the example, set the standard; and it's time we do those kinds of things for the people we serve because that is our job is to take care of the people we serve. I yield back.

Ms. FUDGE. I just wanted to say that, as you talk, it just really gives me some encouragement that we have put in place legislation that is going to allow us to deal with preventive care and wellness. Certainly that is an issue in our neighborhoods and all neighborhoods, especially neighborhoods of poor people and middle class people. It has become a major issue just finding the resources and the time and ability to go to the doctor and say, I have a small problem, let's take care of it before it becomes a big problem. And I think that just what you're talking about is preserving the longevity of grandma and your uncles and your aunts based upon the fact that they are going to be healthier longer is very, very important. And I yield back.

Ms. FUDGE. That's absolutely right. Will the gentleman yield?

Ms. FUDGE. Mr. Speaker, the Congressional Black Caucus, the CBC, is proud to present this hour on issues that concern America's senior citizens. The CBC is chaired by the Honorable Barbara Lee from the Ninth Congressional District of California. I am Representative Marcia L. Fudge from the 11th Congressional District of Ohio, and I am the anchor of the CBC hour. The vision of the founding members of the Congressional Black Caucus, to promote the public welfare through legislation designed to meet the needs of millions of neglected citizens, continues to be a focal point for the legislative work and political activities of the Congressional Black Caucus today. Tonight, the CBC will focus its attention on the issues currently confronting our seniors. In his last speech, Hubert Humphrey said, The moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy, and the handicapped. The fact that some Americans work their entire life, regularly paying into Social Security and are confronted by poverty in their golden years is indeed a problem, Mr. Speaker. The social insecurity facing our Nation's seniors is not a Democratic problem or a Republican problem; it is an American problem, Mr. Speaker. This year's news headlines tell the story: ``Seniors Struggle With High Cost of Housing and Food, Barely Getting By''; ``Seniors Struggle to Survive''; ``Single Seniors Can't Make Ends Meet''; ``Subsidized Lunches in Greater Demand Among Senior Citizens''; ``Forty Percent of Senior Citizens Not Taking Prescribed Medicines Due to Budget''; ``Senior Citizens See Largest Gain in Credit Card Debt As Recession, Medical Costs Take a Toll.'' Mr. Speaker, our country will recover from this recession, but we cannot forget the seniors who struggled before the recession began. Many live on fixed incomes and find it difficult to live under the pressure of high medical bills and the rising cost of essentials like medication, food, and housing. One of the most disheartening news headlines of 2009 had the title, ``U.S. Is Losing Ground on Preventable Deaths.'' In this story, AARP reported that Americans are dying too soon, although the United States spends $2.4 trillion a year on medical care, vastly more per capita than comparable countries. Our Nation ranks last when compared to 19 other industrialized nations on premature deaths caused by illnesses such as diabetes, epilepsy, stroke, influenza, ulcers and pneumonia, all medical issues that disproportionately attack and weaken American seniors. In my district, senior citizens call my office daily. Some call looking for reassurance that Medicare will be strengthened through the health care reform, and others asking questions about the future of Social Security. One senior called just this past week. He is an 85-year-old man living in public housing. He has an artificial leg which he has had since the age of 11. He is worried that his Social Security check will not cover the cost of the medications he uses for complications caused by his artificial limb if the cost of his medications continues to climb. I am confident, Mr. Speaker, this Congress will answer the calls and the concerns of these seniors, and I will not rest until all seniors have their answers. Reports have been looming for years about the long-term financial problems of Social Security. The retirement program is projected to start paying out more than it receives in the year 2016. According to the Social Security trustee, without changes, the retirement fund will be depleted by 2037. Demographic factors are accelerating Social Security problems. Life expectancy is increasing faster than anticipated. In 1940, a 65-year- old man could expect to live maybe another 12 years. Today it's 15 years, and by 2040, it will be 17 years. The fertility rate is falling faster than expected, from 3.6 children for a typical woman of childbearing age in 1960 to just two today, and a projected 1.9 by 2020. The elderly portion of the population will likely rise from 12 percent today to 20 percent by 2050, increasing the number of retirees from 34 million to 80 million. The smaller working age population and larger elderly population means that where there were more than five workers for each retiree in 1960 and 3.3 workers per retiree today, by 2030 there will be just two workers to pay the taxes for the benefits of each retiree. Social Security is a pay-as-you-go system, as you know, with each generation of workers paying the benefits of current retirees. This works fine as long as the working population grows faster than the retired population; but now that the trend has reversed, the system is simply unsustainable. Congress and the Social Security Administration are seeking solutions to this long-term problem; but at the same time, we have to work on the existing problems confronting our seniors on Social Security. Recently, the Congressional Budget Office reported that for the first time in 35 years older Americans will not receive a cost-of-living adjustment, or COLA, increase in their Social Security checks in 2010. This is bad news for many retirees living on a fixed income because although the cost of necessary goods like food will continue to rise, seniors who rely on Social Security checks will not see their budgets increase. To compound this problem, millions of the same seniors whose budgets may be tighter than ever will also face much higher Medicare part B and Medicare part D premiums next year. Medicare part B insurance covers doctors visits, lab work, physical therapy, and other types of outpatient services. Medicare part D is the Medicare prescription drug program. A Federal law, known as the ``hold harmless'' rule, prevents the annual cost of part B premiums from rising higher than that year's Social Security COLA. For example, if your annual Social Security income increases by 5 percent, the yearly part of part B premiums cannot increase by more than 5 percent. The problem is that, while this hold harmless rule covers some Medicare part D patients, it does not cover any of the 28 million seniors insured by Medicare part D prescription drug coverage, and it does not cover about 11 million Medicare part B seniors. Mr. Speaker, I have been joined today by my colleague and friend, the Congressman from Minnesota. I would like to yield as much time as he may consume.

Ms. FUDGE. Mr. Speaker, I ask for unanimous consent that all Members be given 5 days to revise and extend their remarks.

Ms. FUDGE

Ms. FUDGE. Mr. Speaker, I ask unanimous consent that all Members be given 5 legislative days to enter remarks into the Record on this topic.

Ms. FUDGE. Thank you, Madam Chair. Mr. Speaker, I would just very much like to thank our Chair for being here at every Special Order, for the support that she has given to me personally but, more importantly, for the leadership she gives to the CBC. I thank you, Madam Chair, for being here. Mr. Speaker, if I may continue, I wanted to just talk about the economic prosperity on the African continent. Many African countries do still, indeed, struggle to achieve economic sustainability and growth. This pursuit is undermined in part by the large number of citizens who have not received a basic education. Not a single economically viable nation achieved its prosperity without implementing near universal primary education. Additionally, education increases a Nation's gross domestic product. Adults with a primary school education earn twice as much as adults without any schooling. In the areas of health, education and behavior changes are also the most effective way to address preventible diseases, including smallpox, tuberculosis, diarrhea and other water-borne illnesses. According to some estimations, if all children completed primary education, 700,000 new cases of AIDS and HIV could be prevented each year. We also need to improve the political stability and reduce conflict. Education and the free exchange of ideas also encourages democratic styles of government. When citizens are well informed, they are more likely to participate in their democracy. As it relates to violent conflicts, education that teaches tolerance, the value of each individual, and respect for different beliefs is the best method to reduce violence and extremism. Basic education provides girls and women with expanded employment opportunities, which is important for the overall advancement of families. Women's employability is especially crucial if they are the family's sole support. Children of educated women are in better health and are twice as likely to be enrolled in school. Mr. Speaker, 75 million children worldwide are not at school; 55 percent of them are girls. Sub-Saharan Africa accounts for nearly one- half of the world's school-age children who are not enrolled in school. Twelve percent of the developing world's primary school-age population is not in school; more than 80 percent of them are in rural areas, and the vast majority are poor. Globally, 134 countries account for two- thirds of the out-of-school children, and current projections show that those countries will have 29 million out-of-school children by the year 2015. Among African nations, there are various barriers to basic education. The lack of school buildings, shortage of teachers, prohibitive compulsory fees, and unique challenges faced by girls all limit many Africans' abilities to access formal education. However, these challenges are not insurmountable. Nearly 80 million new places of instruction must be created in order for all school-age African children to be accommodated. This will be a large undertaking, to say the least. I applaud African governments for making progress towards the goals advanced in the Dakar Framework for Action in 2000. That framework was a statement signed by 164 countries during the 2000 World Education Forum stating that their commitment to universal education was strong. But without diligent support from the international community, these great goals will remain elusive. In addition to the need for new schools, it is estimated that an additional 3 million teachers are needed in Africa in order for the continent to reach its goal of universal education by the year 2015. In Nigeria, which is the most populous country in Africa, there is a shortage of 1 million teachers. Not only are workforce shortages caused by the difficulty to obtain thorough education, the availability of teachers on the continent is also impacted by the HIV/AIDS epidemic. The disease, itself, has robbed education systems of manpower and knowledge and continues to drive up cost. In a report released by the World Bank in 2002, an estimated 860,000 children in sub-Saharan Africa lost teachers to AIDS in 1999. In some cases where there has been an increase in class enrollment, the loss of one teacher can affect hundreds of students. The cost of replacing these instructors is prohibitive for many countries. If the nation of Swaziland hired and trained enough staff to replace the teachers lost to HIV and AIDS, the estimated cost would be $233 million, more than half of the government's budget for 2001-2002. Again, there are too many primary and secondary schools in the developing world that are forced to rely on student fees to supplement government funding. These fees, while modest by American standards, often prevent children from enrolling. Similarly, some families cannot afford the uniforms commonly required by the schools. In 2003, Kenya eliminated primary school fees in a step towards universal primary education for its entire population. In Kenya alone, 1.5 million students who had not previously attended school then enrolled, increasing the average class size from 40 to 120. Kenya took a step in the right direction, but these actions must be coupled with greater investment by local governments and donors to address the issues of quality that arise when access to education is increased. While this statistic represents an improvement in the rate of primary school enrollment during the early nineties of over 10 percent, we should also be aware that the problems still remain. In countries such as Djibouti, Ethiopia, Niger and Mali, less than half of all school-age children go to school, and there is a disparity in enrollment rates between boys and girls. Forty-two percent of girls as opposed to 38 percent of boys are out of school. As the international community and donors discuss the importance of quality education, we must remember the vast numbers of teachers who will need to be trained and what this means to the international partners who work with African governments and civil society groups. Education is a long-term path to economic viability. Stimulating small businesses through microlending is another method of improving the economies of developing nations, which will ultimately lead to expanded trade and business opportunities for all of the world. I and several Members recently returned from a congressional delegation to Tunisia, Rwanda, Zimbabwe and Senegal. Our goal was to educate Members on the impact that the global financial crisis has had on the continent of Africa. Additionally, we examined the regional impact of multilateral development banks, international financial institutions, and the International Monetary Fund. The codel spent significant time examining the effect of the global economic crisis on local economies. We were especially interested in how the multilateral development banks and the United States supports, particularly the African Development Bank, are helping countries to obtain grants, loans and technical assistance. We also explored the role and impact of the IMF on the region during this period of economic crisis. Africa is of increasing strategic interest to the global economy. The continent is expected to soon provide the United States with more petroleum than the Middle East. Again, I will repeat. The continent of Africa is expected to soon provide the United States with more petroleum than we get from the Middle East. Several reports state that more than half of all Africans are estimated to live on a dollar or less a day. The nations we visited were interested in help up, not a handout. Well-intentioned countries and organizations have poured billions of dollars into improving conditions for Africans, but their efforts have repeatedly failed to stimulate large-scale sustainable growth. This is, in part, because many of these groups do not fully incorporate local traditions, values and attitudes into their assistance programs. Assistance can only be successful if it is culturally sensitive and adapts to the needs of the local community. The direct impact of the global crisis on Africa, however, has been relatively contained. Many African nations have not been severely affected by the crisis since African banks generally are not well integrated into the global financial system. Nonetheless, African countries still are at risk of indirect adverse effects, such as reduced worldwide demand for African exports, a dampening of economic growth, a tightening of credit, and reduced remittance flows. Despite these setbacks, Mr. Speaker, African countries can greatly benefit from programs that both encourage productivity and promote economic independence. Access to formal financial services is a key component of economic development. One method to facilitate development is microfinance. Microfinance is when banking institutions or even individuals grant small loans to other individuals, usually to establish or expand a small or self-sustaining business. When individuals gain access to credit, they can start a business, hire their neighbors, and stimulate local economic growth. For example, a loan made to a woman to buy a sewing machine can yield an income when she offers her sewing and tailoring services. Or if a loan helps a family purchase a cow, the milk produced from the cow can generate both nourishment and income. The average microfinance loan amount ranges from $50 to $5,000, and the repayment cycle can range from 90 days to 18 months. Repayment of microfinance loans is 98 percent compared to regular business loans by traditional lenders. Official microfinance organizations are currently only reaching 5 to 8 percent of the businesses who are in dire need of loans. Access to credit for the poor is in dire need as well. Microfinancing institutions also provide access to savings accounts. Microfinance has proven to be successful because of its ability to reach the poor, especially women with highly sustainable programs that have a positive impact. As the United Nations Office of Special Adviser on Africa reports, women are a better credit risk than men and more responsible managers of meager resources. Furthermore, women are, and I quote, more committed to using their loans for the benefit of their household rather than self-gratifying consumption, as is common among many African men. Empowering women sets families on the path toward economic independence. This case study demonstrates how microfinance can help alleviate poverty. In 2007, Absa Bank Group in South Africa established a dedicated microenterprise finance unit to make funding more readily available to businesses that are formally excluded from getting regular bank loans. It has been estimated that as many as 97 percent of microentrepreneurs in South Africa had no access to loans prior to receiving funding through the AMEF. Today, more than 4.5 million people on low incomes use Absa Bank services for everything from microloans to saving accounts and transactions, leading the way for microenterprise loans in South Africa. In addition to providing loans, microfinance institutions can also support individuals by keeping savings in a secure manner and by helping to accumulate interest on deposits. This allows the poor to lift themselves out of poverty. Self-reliance, Mr. Speaker, is the key. I've seen both the despair and the resiliency of Africans. In Rwanda I met a woman who was given a cow. Shortly after she received the cow, the cow had a calf, which she was then obligated to give to her neighbor. But based upon the cow she had and the milk that she could harvest from that particular cow, she was able to not only feed her family but to sell enough milk to then buy a bicycle. She bought a bicycle, Mr. Speaker, so that she could ride the 3 miles it took to get clean water. So instead of walking, now she could ride and send her children to get clean water. She then made enough money to send her children to school and pay the fees. She then took out a loan and bought another cow, and with that cow she is able now to buy food and clothing. She is able to do much more than she was before. She is really quite an entrepreneur. And, by the way, Mr. Speaker, this woman has AIDS. But she is raising five children on her own because someone gave her a cow and she had the ability to go from there. Mr. Speaker, in the very near future, microloans that support small- scale entrepreneurship will improve the lives of Africans and empower them to work their way out of poverty. Microfinance is already proven in India and Bangladesh to be an effective economic development strategy. According to World Vision, one loan, just one loan, can create 40 jobs in a community of approximately 600 to 700 people. The difficulties faced by African nations should not deter us from providing assistance. Through America's support of expanding basic education and access to financial services, we can assist African leaders and people in creating a more vibrant continent and, in turn, a richer world. My recent experience has confirmed for me that both of these approaches can empower people by providing them with confidence, self-esteem, and the financial means to contribute to their economic advancement. Our leadership and our moral strength is only enhanced when we help others. Truly, Mr. Speaker, we lift as we rise.

Ms. FUDGE. Certainly I appreciate the opportunity to join my colleagues of the Congressional Black Caucus, the CBC, for this Special Order. Currently, the CBC is chaired by the Honorable Barbara Lee from the Ninth Congressional District of California. My name is Congresswoman Marcia L. Fudge, and I represent the 11th Congressional District of the State of Ohio. CBC members are advocates for the human family nationally and internationally and have played a significant role as local and regional activists. We continue to work diligently to be the conscience of the Congress, but understand all politics are local. Therefore, we provide dedicated and focused service to the citizens of the congressional districts we serve. The vision of the founding members of the Congressional Black Caucus, to promote the public welfare through legislation designed to meet the needs of millions of neglected citizens, continues to be a focal point for the legislative work and political activities of the Congressional Black Caucus. As Members of Congress, CBC members also promote legislation to aid neglected citizens throughout the world. We understand that the United States, as a bellwether, has the ability to positively impact our neighbors abroad. The United States is a leader in advocating for the underprivileged at home and abroad. Americans understand that if we uplift others, then we, too, will be advanced. With this in mind, tonight's CBC hour will focus on poverty reduction and the economic, social and political outlook for the continent of Africa. Specifically, I will discuss increasing access to both education and financial services in Africa. As a member of the Education and Labor Committee, I know well the far-reaching effects of education on individuals' quality of life and a nation's economic competitiveness. In the context of improving developing nations such as many African countries, the basic education offers the hope of a more prosperous world. The benefits of basic education are innumerable. For instance, we know that when all citizens receive a good education, their nation's economic prosperity is increased, preventable illness is decreased, democratic ideals are spread, violent conflicts are reduced, and women are able to advance further than if they were discouraged from pursuing their studies. Mr. Speaker, I see we have been joined by our Chair, the Honorable Barbara Lee from California. I would now like to yield to the gentlelady, Mr. Speaker.

Ms. FUDGE

Ms. FUDGE. Mr. Speaker, I just want to again thank Representative Jackson-Lee. She is always well prepared. She understands the issues, and she talks very clearly to the American people. So I thank you again for participating. I now yield to our colleague, the gentlewoman from California, who this, I think, may be her first time joining us in the last couple of months, Representative Diane Watson; and we are looking forward to her remarks.

Ms. FUDGE. I thank the gentlewoman. Mr. Speaker, in closing, I would like to say just two things. One, of course, is we all know health care needs to be reformed. We all know that the time is now to do it. We know that the cost to not do it is going to be significantly higher the longer we wait. I just want to say that, people who think that those who are uninsured shouldn't be given an opportunity--nine million of the uninsured today are children. We need to do something about that. Many uninsured are seniors, and we need to certainly do something about that. So I would hope that all Members of this House would look at the needs of the people we represent and move to do the right thing.

Ms. FUDGE. Mr. Speaker, I ask unanimous consent that all Members be given 5 days to revise and extend their remarks on the subject of this Special Order.

Ms. FUDGE. Mr. Speaker, I would like to just set the record straight. I've listened to my colleagues from across the aisle, and I do want to make clear to the American people that, if you have health insurance now and you want to keep it, you can. You don't need to change. I also want to say to the American people that this plan is, one, about choice. It's not about government-run anything. It's about choice. It's about making sure that we spend more time worrying about the people than we do about the insurance companies. So I just want to make sure that people understand. I'm very curious to understand and to know what my colleague meant when he kept saying ``they,'' ``they,'' ``they.'' I don't know if he was talking about retirees or about the working poor or if he was talking about minorities or if he was talking about people who have been laid off or about people who have lost their jobs because their companies have closed. I don't know who ``they'' is, but certainly, at some point, I'd like to know who that is. Now to my remarks, Mr. Speaker. The Congressional Black Caucus, the CBC, is proud to present this hour on health care. The CBC is chaired by the honorable Barbara Lee from the Ninth Congressional District of California. I am Representative Marcia L. Fudge from the 11th Congressional District of Ohio. I am the anchor of this CBC hour. The vision of the Founding Fathers of the Congressional Black Caucus to promote the public welfare through legislation, designed to meet the needs of millions of neglected citizens continues to be a focal point for the legislative work and for the political activities of the Congressional Black Caucus today. Tonight, the CBC will focus its attention on health care reform. I am proud to serve on one of the three House committees that authored H.R. 3200, the America's Affordable Health Choices Act of 2009. The public health insurance option--also known as the Public Plan--is an essential part of H.R. 3200. The Public Plan is an innovative tool that will move America's health insurance system beyond the status quo and into a system that provides choices and forces private insurance companies to compete. Competition guarantees that all Americans will be able to access quality coverage while preserving what works in today's system and expanding choices and containing costs. Some argue there is no need for a public plan, as did our colleagues on the other side of the aisle. Others say that a public plan will put private insurance companies out of business. I say this: Today's health insurance companies are operating in a manner that is making health coverage increasingly out of reach for the average American. Premiums are soaring higher and higher, and health insurance choices are becoming fewer and fewer. For example, in my home State of Ohio, since 2000, the average family premiums have increased by 92 percent, that's 9-2, 92 percent. When faced with such an increase, you would think that Ohioans would have a number of choices and could decide to move to another insurer that offers a more competitive premium. Well, it's not that easy, Mr. Speaker, because the choice of insurance companies is severely limited in the State of Ohio and across America. In Ohio, the top two insurance providers controlled 61 percent of the health care market in 2008. In fact, 94 percent of the metropolitan areas in the United States are highly concentrated, meaning that one insurance company or a small group of insurance companies dominate the majority of the market. And the problem is even worse for small businesses. In Ohio, the top 5 insurers control 85 percent of the market that provides health insurance to small businesses. This is what we call a consolidated health insurance market. There is no real competition. So the companies that are monopolizing the market are setting the prices and the standards that have led to more than 1 million uninsured Ohioans and 46 million uninsured Americans. A public plan will be one of several options within H.R. 3200, the new health exchange that it will provide that is needed to reform our health insurance market. As I mentioned earlier, H.R. 3200's public plan offers competition. Currently, our health insurance system is inefficient and expensive. Without competition, private insurers have no incentive to improve. By forcing market reforms in the area of administrative costs and through better delivery of services, the public plan will serve as a real competition and set the standard by which other insurers are measured. The public plan will operate as a guaranteed backup that will ensure everyone that everyone has access to affordable health care no matter what happens. A public plan will give millions of hardworking families peace of mind. Both the public plan and competing private plans will offer a standard benefit package that covers essential health services such as inpatient and outpatient hospital care and maternity and mental health services. The package will also offer preventative services like Well Baby and Well Child Care and screenings for diseases like diabetes and hypertension. Preventative care is a benefit that is important to cutting the cost of health care. Providing preventative care will allow us finally to spend less by keeping healthy people healthy, instead of waiting until someone is very ill and then providing more costly treatment. Under the standard benefit package, patients will no longer pay for preventative services, and the annual dollar amount spent on health care by consumers will be limited to $5,000 for an individual and to $10,000 for a family. Therefore, no one should ever again face bankruptcy from health care costs. The private insurance market must be reformed. We cannot afford to do nothing. $100 billion of America's $2.5 trillion in health care spending goes to the cost of administering private insurance. Projections have shown that it is possible to save more than $3 billion in 2009 alone and $40 billion over 10 years simply by reducing administrative spending in health care. The status quo is unacceptable, Mr. Speaker. Things will only get worse if we continue to let private insurance companies set the standards. Every American risks losing their health insurance and/or seeing their costs skyrocket without action. Families will continue to spend a disproportionately large amount of money on health care expenses. The cost of an employer-sponsored family health insurance plan will reach $24,000 in the year 2016, an increase of 84 percent if we do nothing to fix our broken system. American businesses will continue to fall behind. Employers' spending on health care premiums will more than double to $885 billion in the year 2019. And one in five employers will stop offering health benefits altogether because of rising costs in the next 3 to 5 years. Further, our government will not be able to keep up with the rising cost of health insurance. As Americans lose their private insurance, many will be added to the already strained government programs. Combined with the rising cost of care, spending on Medicare and Medicaid will double from $720 billion in 2009 to $1.4 trillion in 2019. It is time to level the playing field with the public plan. The public plan will be required to meet the same benefit requirements and comply with the same insurance reforms as private plans. Individuals and families will qualify for financial assistance in purchasing health insurance and will have the option to choose among the private carriers and the public plan. Today's health insurance companies can either be more efficient and provide the coverage that Americans need or make way for the insurers that will agree to be responsive to the financial and health care needs of millions of Americans. In closing, I would like to highlight two important pieces of health reform legislation. The first, to address the needs of the poor and those with low incomes, I recently introduced the Health Information Technology Public Utility Act of 2009 to facilitate nationwide adoption of electronic health records, particularly among America's free clinics. Although health care IT funding was included in the American Recovery and Reinvestment Act of 2009, America's free clinics are not eligible for funding under the Act. This piece of legislation has also been introduced in the Senate by Senator John Rockefeller, a Democrat from West Virginia. Lastly, recognizing the health care needs of our Nation's underserved populations, the CBC introduced the Health Equity and Accountability Act of 2009 under the leadership of delegate Donna Christensen. Along with other CBC Members, I urge our colleagues to include this legislation in the America's Affordable Health Choices Act of 2009. With that, Mr. Speaker, I would now like to yield to the distinguished Member from the Virgin Islands, my friend and colleague and an expert in health care reform, Representative Christensen.

Ms. FUDGE. Thank you very much. Let me just, again, thank my colleague, Dr. Christensen. I just have to say that there are so many of us in this House who look to you not just because you are a physician, but certainly because you have studied health care for many, many years and have advocated for reform. And we thank you for your work and certainly want to support your efforts in making sure that this gets done the way that it should. We have now been joined by our colleague and friend from the great State of Texas. I would now like to, Mr. Speaker, yield to the Honorable Sheila Jackson-Lee, the gentlelady from Texas.

Ms. FUDGE. Mr. Speaker, I do indeed want to thank my colleague and friend Representative Watson from California. Certainly she presented to us information that I think is important to the American people, well thought out and well said. I thank you so much for being a part of this hour. Mr. Speaker, I yield to Representative Jackson-Lee from Texas.

Ms. FUDGE

Ms. FUDGE. Thank you so much. I found very interesting the charts that you have there. I'm certainly hoping that people at home will see what we are trying to do for them. Certainly, I think it's important that they understand that our job is to represent them. Our job is to make sure that we can provide the best plan that is possible, and I believe that we are moving in the right direction to do that. I certainly do want to talk a little bit more about small businesses. That has been a real issue in this Congress, as to what is going to happen with small employers once we move to a plan such as this. Let me just say that I do sit on the Education and Labor Committee and was able to include an amendment, a very important amendment, that will provide small employers, those who have 100 employees or less, tools that can give them the resources and counseling to help them make better health care plan choices once this plan takes effect. We want to keep our small businesses very strong. We know that small businesses represent 99 percent of all businesses in America and employ more than 53 percent of our Nation's workforce, so we cannot afford to not help our small businesses. I don't know why people continue to say, Oh, we're not going to help small businesses. We indeed are. We all understand how important it is. We're going to help them when they have to make the important decisions about affordable health care and coverage for their employees. I believe that this assistance will greatly reduce the chances of a small business choosing a health care plan that does not serve their interest or that of their employees. I, too, want to thank the Congressional Black Caucus for their work, and Dr. Donna Christensen, who has worked so tirelessly on our bill, which is the Health Equity and Accountability Act of 2009, which was under her leadership. But what they're talking about is making it easier for people who live in underserved communities to be a part of America and a part of what it means to be a healthy and well-rounded person in this country. We're going to talk about improving workforce diversity, strengthening and coordinating data collection, which is so very, very important. We're going to ensure that there is some accountability, and we're going to improve the evaluation and information that comes back to us so that we can say, Yes, we are doing well, or, No, we need to change, or, We can get better at this area. So we're going to work very, very hard to improve all health care services for all Americans. I want to just thank you for spending some time with me. I certainly do believe that if we put together the kind of plan that is on this chart, then we're going to do what the American people want us to do. We know that 72 percent of all Americans today want health care reform. I believe that if we want to do the job that people have sent us here to do--they have given us a direction. They have said we want health care reform, and I believe that it is incumbent upon us to provide that.

Ms. FUDGE. Thank you very much, Madam Chair. Mr. Speaker, we have the honor of being joined this evening by the majority whip. I would at this time yield to the gentleman from South Carolina (Mr. Clyburn).

Ms. FUDGE. Mr. Speaker, I would now like to yield to my friend and colleague, the gentlewoman from Texas (Ms. Eddie Bernice Johnson).

Ms. FUDGE. Let me say this as well as we talk about preventive health care. I do live in a community where we do have some of the best health care in the world. But what I also know is it costs three times as much to go to a hospital emergency room as it does to your doctor's office. What I envision with this preventative care is people who now only see a doctor when they are so sick that they have to go to an emergency room will now go to see a physician on a regular basis, that they will go and have annual physical exams, they will go and have their mammograms, they will go and have their cancer treatments. They will do that because it will be less expensive. They will have the health care to do it. We're going to make sure it is accessible because we're going to put money into these community clinics so that they can get to these clinics and go on a regular basis. I just believe that if we do this, we're going to see a much healthier and happier America. We're going to be able to take care of our seniors, to take care of our children. I think it's going to make a huge difference in where we go as a Nation. So I just want to be as supportive as you have been and as all of us are as we look at where we're going to take this country as it relates to health care. With that, Mr. Speaker, I so much thank you for the opportunity to address you and this body, and I yield back the balance of our time.

Ms. FUDGE. Mr. Speaker, I ask unanimous consent that all Members be given 5 legislative days to revise and extend their remarks on the subject of my Special Order.

Ms. FUDGE. The Congressional Black Caucus, the CBC, is proud to present this hour on health care. The CBC is chaired by the Honorable Barbara Lee from the Ninth Congressional District of California. I am Representative Marcia L. Fudge from the 11th District of Ohio, and I am the anchor for this hour. Mr. Speaker, I would now like to yield to our Chair, the Honorable Barbara Lee, the gentlewoman from California.

Ms. FUDGE. Mr. Speaker, CBC members are advocates for families nationally, internationally, regionally, and locally. We stand firm as the voice of the people. We continue to work diligently to be the conscience of the Congress. We are dedicated to providing focused service to citizens that elected us to Congress. The vision of the founding members of the Congressional Black Caucus--to promote the public welfare through legislation designed to meet the needs of millions of neglected citizens--continues to be the goal of our legislative work. Tonight, the CBC is going to focus all of its attention on health care. I am proud to serve on one of the three House committees that are working on health care reform legislation. I serve on the Education and Labor Committee. The other two committees are Ways and Means and Energy and Commerce. While each member of the CBC has his or her own area of concern, I will focus on two categories which directly affect the most vulnerable citizens: the poor and those with mental illness. I will examine how the House's health care reform bill, H.R. 3200, the America's Affordable Health Choices Act of 2009, assists these two groups. I will begin by examining the problems people with low incomes and those in poverty face while attempting to access our current and expensive and broken health care system. One quote comes to mind, Mr. Speaker. This statement was made by Dr. Martin Luther King, Jr., more than 40 years ago. Dr. King said, Of all the forms of inequality, injustice in health care is the most shocking and inhumane. Sadly, Dr. King's statement is still relevant today. Statistics prove that the high cost of health insurance causes or deepens financial hardships. The Service Employees International Union reported that in 2004, half of all people filing for bankruptcy cited medical costs as the reason; and in 2008, half of all home foreclosures were due, in part, to the high cost of coverage and care. The numbers also prove that the high cost of health insurance causes people to remain or become uninsured. Due to the high cost of health care coverage, one in six--or 43.6 million Americans--under the age of 65 do not have any type of health insurance. That comes from the Centers for Disease Control. The Children's Defense Fund reports that 9 million children are uninsured in America. Statistics demonstrate that the high cost of health insurance and lack of access to quality health insurance disproportionately affects African Americans. According to a new report issued in June of 2009 by the U.S. Department of Health and Human Services, minority and low- income Americans are much more likely to suffer from a chronic, debilitating illness than whites, and are far less likely to have the kind of coverage that will ensure quality care. For example, nearly half--or 48 percent--of black adults suffer from some form of chronic condition compared to 39 percent of all adults. Yet, one in every five black Americans lack health insurance compared to one in every eight whites. Considering the statistics that I mentioned, I'm glad to report that affordability and access to quality health care are two problems that are addressed by the America's Affordable Health Choices Act. Effective in 2013, assistance will be available for individuals and families that fall below the 133 percent to 400 percent of the Federal poverty level. Financial assistance will limit individual and family spending on premiums from a minimum of 1.5 percent of income for those with the lowest income and maxing out at 11 percent of income for those at 400 percent of poverty or more. Also effective 2013, people with incomes at or below 133 percent of poverty will all be eligible for Medicaid. In addition to the financial assistance provided by our bill, while vitally necessary, monetary help will only address part of the problem. Prevention and wellness measures need to be a part of the solution as well. Fortunately, there are measures that are included in our legislation to address this gap. I was speaking with a constituent the other day, Mr. Floyd Perry from my district, who was born in 1938. He is in good health and does not take any medication. Mr. Perry attributes his good health to preventative health care, and he wanted me to share with everyone that preventative health care works. H.R. 3200 authorizes additional funding for existing community health centers and creates community-based programs to deliver prevention and wellness services and waives cost sharing, both co-insurance and deductibles, for preventative services--which means that you will no longer have to pay for cancer screenings or adult and child immunizations or vision screenings or hypertension treatment. I would like to turn my attention just for a moment to citizens with mental health issues. In my most recent town hall meetings, many constituents were concerned about health insurance, the affordability and the coverage. Some questions were fairly general, of course, and others were fairly specific. One woman in particular was concerned about mentally ill felons who are released from jail without access to the medications they need to remain mentally stable. My constituent found that ex-offenders with mental and emotional problems are more likely to commit crimes again due to the lack of treatment. Fortunately, access to mental health care will be improved under the current House health reform bill, but the distinct needs of ex-offenders are not explicitly addressed. Among others, my office is currently working on this issue with Representative Rush of Illinois. The following statistics will help us understand the current problems felons and ex-offenders with mental illnesses face. According to the Bureau of Justice Statistics, at mid year 2005, more than half of all prison and jail inmates had a mental health problem, including more than 700,000 inmates in State prisons, more than 78,000 in Federal prisons, and almost 500,000 in local jails. More than two- fifths of State prisoners--43 percent--and more than half of local jail inmates--54 percent--reported symptoms that met the criteria for mania. About 23 percent of State prisoners and 30 percent of all local jail inmates reported symptoms of major depression. We also have problems with mental health hardships with our children. According to the American Academy of Child and Adolescent Psychiatry, while almost one in five children in the United States suffers from a diagnosable mental disorder, only 20 to 25 percent of affected children receive treatments for illnesses such as attention deficit hyperactivity disorder, eating disorders, depression, and substance use disorders. The Department of Health and Human Services reports that serious emotional disturbances affect one in every 10 young people at any given time, and our general population faces many more problems with mental illness. One in four uninsured adult Americans has a mental disorder, substance use disorder or both. Adults with serious mental illnesses die 25 years sooner than those who do not have mental illness. Almost 1 in 4 stays in acute care hospitals involve depression, bipolar disorder, schizophrenia, and/or other mental health and substance abuse disorders. Treatment for mental health and substance use disorder is very effective. Recovery rates for mental illnesses are comparable to and even surpass the treatment success rates for any physical health conditions. For example, up to 85 percent of people with depression who are treated with a combination of medication and therapy experience substantially reduced symptoms, enhanced quality of life and increased productivity. Mr. Speaker, I see I have been joined by my colleague and friend, the gentlelady from Texas, Ms. Jackson-Lee.

Ms. FUDGE

Ms. FUDGE. Madam Speaker, on Thursday, July 9th and Friday, July 10th, 2009, due to unavoidable circumstances, I missed the following votes: rollcall No. 520, making appropriations for the Agricultural, Rural Development, Food & Drug Administration and Related Agencies programs for fiscal year 2010; rollcall No. 525, making appropriation for the Department of State, foreign operations and related programs for fiscal year 2010; and rollcall No. 529, making appropriations for military construction, Department of Veterans Affairs and related agencies for fiscal year 2010. Had I been present, I would have voted ``yea'' on all of the aforementioned votes.