Jim McDermott

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, I continue to reserve the balance of my time.

Mr. McDERMOTT. Mr. Speaker, can you tell us how much time remains?

Mr. McDERMOTT. Is the gentleman ready to close?

Mr. McDERMOTT. Mr. Speaker, I yield 2 minutes to the gentleman from Massachusetts (Mr. Capuano).

Mr. McDERMOTT. Mr. Speaker, I yield myself such time as I may consume. It is an old political tactic to use confusion. We have watched for almost 4 years the Republican Party try to confuse the American people about the Affordable Care Act. It was the worst thing that was ever going to happen on the face of the Earth. We would have storms, hurricanes, unemployment, wars, and famines, all because of the Affordable Care Act. Well, we are up here today with yet another attempt to confuse people about the 40-hour workweek and whether or not we are going to cause people to lose their jobs. On page 125 of the CBO report on the budget outlook for 2004 to 2024, it says: In CBO's judgment, there is no compelling evidence that part-time employment has increased as a result of the ACA. Everything you have learned out here about losing jobs is not true. There is nothing in the law that says people have to shorten the workweek. I don't know if anybody on the other side understands the free enterprise system. Businesses are run by entrepreneurs who decide what kind of product they are going to produce. They hire people to do that. They decide the hours. They decide the pay. They decide everything. You keep saying that ObamaCare came in and it is forcing these entrepreneurs in America to cut their employees' wages and hours. There is no such thing in the law. That is not true. In fact, my colleague from Washington State (Mr. Reichert) just said, Mr. Speaker, that people's hours were already being cut before ObamaCare. It is not ObamaCare that decides how much somebody works. It is the person who runs the company. If he doesn't care about his employees and doesn't want to give them health care, that is one thing. There are people like that, but there are a lot of people who would like to give health insurance to their people, and we are trying to help them do that with the subsidies in this bill. Let me come to one other issue, and that is this whole question of women. I have flown back and forth across the country every week, 35 flights a year, for 25 years, and I know most of the flight attendants on United Airlines between Seattle and Washington, D.C. I can't tell you how many of those women are working because they get health care benefits. Their husband has a job, but has no benefits, and if they don't have their job, they simply won't have health care in their family. United Airlines has been through two bankruptcies. They have lost pay increases. They have lost their pension rights. The only thing they have left is that health care benefit, and that is what is holding the family together. I am sort of interested to watch what happens to the older flight attendants I know, to see whether they leave flying, because they would like to. Their husband has a job, but before, he couldn't get health insurance, and now, he can under the Affordable Care Act, and they can quit working. When the CBO talks about people working less, it is because the job lock is gone. People are not locked into their jobs because of the fact that they can't get health insurance anyplace else. It makes it available for any American. The fact is that the cuts you are seeing--if you see employers that are going to take people down from 40 hours a week to 39 so that they can avoid giving benefits, take a look at the morals. I wonder if that person goes to church and talks about how they take care of the poor and the weak and the sick and all the rest. No, no. You can't have it both ways. You cannot cut your people down 1 hour just to get out of giving them benefits, and that is what you are suggesting is going to go on in this country. I don't think that badly of owners of businesses myself. Now, there may be some people out there looking for a way to get around the law, but this law doesn't make anybody do anything, and this law is going to create more problems. You hear 1 million people are going to lose their health care benefits, and that is not good. This whole idea of continuing to undermine this law by confusing the American people, and making them think it bad isn't working. 1.7 million joined. Labor Market Effects of the Affordable Care Act: Updated Estimates Overview The baseline economic projections developed by the Congressional Budget Office (CBO) incorporate the agency's estimates of the future effects of federal policies under current law. The agency updates those projections regularly to account for new information and analysis regarding federal fiscal policies and many other influences on the economy. In preparing economic projections for the February 2014 baseline, CBO has updated its estimates of the effects of the Affordable Care Act (ACA) on labor markets. The ACA includes a range of provisions that will take full effect over the next several years and that will influence the supply of and demand for labor through various channels. For example, some provisions will raise effective tax rates on earnings from labor and thus will reduce the amount of labor that some workers choose to supply. In particular, the health insurance subsidies that the act provides to some people will be phased out as their income rises--creating an implicit tax on additional earnings--whereas for other people, the act imposes higher taxes on labor income directly. The ACA also will exert conflicting pressures on the quantity of labor that employers demand, primarily during the next few years. How Much Will the ACA Reduce Employment in the Longer Term? The ACA's largest impact on labor markets will probably occur after 2016, once its major provisions have taken full effect and overall economic output nears its maximum sustainable level. CBO estimates that the ACA will reduce the total number of hours worked, on net, by about 1.5 percent to 2.0 percent during the period from 2017 to 2024, almost entirely because workers will choose to supply less labor-- given the new taxes and other incentives they will face and the financial benefits some will receive. Because the largest declines in labor supply will probably occur among lower-wage workers, the reduction in aggregate compensation (wages, salaries, and fringe benefits) and the impact on the overall economy will be proportionally smaller than the reduction in hours worked. Specifically, CBO estimates that the ACA will cause a reduction of roughly 1 percent in aggregate labor compensation over the 2017--2024 period, compared with what it would have been otherwise. Although such effects are likely to continue after 2024 (the end of the current 10-year budget window), CBO has not estimated their magnitude or duration over a longer period. The reduction in CBO's projections of hours worked represents a decline in the number of full-time-equivalent workers of about 2.0 million in 2017, rising to about 2.5 million in 2024. Although CBO projects that total employment (and compensation) will increase over the coming decade, that increase will be smaller than it would have been in the absence of the ACA. The decline in full-time-equivalent employment stemming from the ACA will consist of some people not being employed at all and other people working fewer hours; however, CBO has not tried to quantify those two components of the overall effect. The estimated reduction stems almost entirely from a net decline in the amount of labor that workers choose to supply, rather than from a net drop in businesses' demand for labor, so it will appear almost entirely as a reduction in labor force participation and in hours worked relative to what would have occurred otherwise rather than as an increase in unemployment (that is, more workers seeking but not finding jobs) or underemployment (such as part-time workers who would prefer to work more hours per week). CBO's estimate that the ACA will reduce employment reflects some of the inherent trade-offs involved in designing such legislation. Subsidies that help lower-income people purchase an expensive product like health insurance must be relatively large to encourage a significant proportion of eligible people to enroll. If those subsidies are phased out with rising income in order to limit their total costs, the phaseout effectively raises people's marginal tax rates (the tax rates applying to their last dollar of income), thus discouraging work. In addition, if the subsidies are financed at least in part by higher taxes, those taxes will further discourage work or create other economic distortions, depending on how the taxes are designed. Alternatively, if subsidies are not phased out or eliminated with rising income, then the increase in taxes required to finance the subsidies would be much larger. CBO's estimate of the ACA's impact on labor markets is subject to substantial uncertainty, which arises in part because many of the ACA's provisions have never been implemented on such a broad scale and in part because available estimates of many key responses vary considerably. CBO seeks to provide estimates that lie in the middle of the distribution of potential outcomes, but the actual effects could differ notably from those estimates. For example, if fewer people obtain subsidized insurance coverage through exchanges than CBO expects, then the effects of the ACA on employment would be smaller than CBO estimates in this report. Alternatively, if more people obtain subsidized coverage through exchanges, then the impact on the labor market would be larger. Why Will Those Reductions Be Smaller in the Short Term? CBO estimates that the ACA will cause smaller declines in employment over the 2014--2016 period than in later years, for three reasons. First, fewer people will receive subsidies through health insurance exchanges in that period, so fewer people will face the implicit tax that results when higher earnings reduce those subsidies. Second, CBO expects the unemployment rate to remain higher than normal over the next few years, so more people will be applying for each available job--meaning that if some people seek to work less, other applicants will be readily available to fill those positions and the overall effect on employment will be muted. Third, the ACA's subsidies for health insurance will both stimulate demand for health care services and allow low-income households to redirect some of the funds that they would have spent on that care toward the purchase of other goods and services--thereby increasing overall demand. That increase in overall demand while the economy remains somewhat weak will induce some employers to hire more workers or to increase the hours of current employees during that period. Why Does CBO Estimate Larger Reductions Than It Did in 2010? In 2010, CBO estimated that the ACA, on net, would reduce the amount of labor used in the economy by roughly half a percent--primarily by reducing the amount of labor that workers choose to supply. That measure of labor use was calculated in dollar terms, representing the approximate change in aggregate labor compensation that would result. Hence, that estimate can be compared with the roughly 1 percent reduction in aggregate compensation that CBO now estimates to result from the act. There are several reasons for that difference: CBO has now incorporated into its analysis additional channels through which the ACA will affect labor supply, reviewed new research about those effects, and revised upward its estimates of the responsiveness of labor supply to changes in tax rates. Effects on Retirement Decisions and Disabled Workers Changes to the health insurance market under the ACA, including provisions that prohibit insurers from denying coverage to people with preexisting conditions and those that restrict variability in premiums on the basis of age or health status, will lower the cost of health insurance plans offered to older workers outside the workplace. As a result, some will choose to retire earlier than they otherwise would--another channel through which the ACA will reduce the supply of labor. The new insurance rules and wider availability of subsidies also could affect the employment decisions of people with disabilities, but the net impact on their labor supply is not clear. In the absence of the ACA, some workers with disabilities would leave the workforce to enroll in such programs as Disability Insurance (DI) or Supplemental Security Income (SSI) and receive subsidized health insurance. (SSI enrollees also receive Medicaid; DI enrollees become eligible for Medicare after a two-year waiting period.) Under the ACA, however, they could be eligible for subsidized health insurance offered through the exchanges, and they cannot be denied coverage or charged higher premiums because of health problems. As a result, some disabled workers who would otherwise have been out of the workforce might stay employed or seek employment. At the same time, those subsidies and new insurance rules might lead other disabled workers to leave the workforce earlier than they otherwise would. Unlike DI applicants who are ineligible for SSI, they would not have to wait two years before they received the ACA's Medicaid benefits or exchange subsidies-- making it more attractive to leave the labor force and apply for DI. Possible Effects on Labor Supply Through Productivity In addition to the effects discussed above, the ACA could shape the labor market or the operations of the health sector in ways that affect labor productivity. For example, to the extent that increases in insurance coverage lead to improved health among workers, labor productivity could be enhanced. In addition, the ACA could influence labor productivity indirectly by making it easier for some employees to obtain health insurance outside the workplace and thereby prompting those workers to take jobs that better match their skills, regardless of whether those jobs offered employment-based insurance. Some employers, however, might invest less in their workers--by reducing training, for example--if the turnover of employees increased because their health insurance was no longer tied so closely to their jobs. Furthermore, productivity could be reduced if businesses shifted toward hiring more part-time employees to avoid paying the employer penalty and if part-time workers operated less efficiently than full-time workers did. (If the dollar loss in productivity exceeded the cost of the employer penalty, however, businesses might not shift toward hiring more part-time employees.) Whether any of those changes would have a noticeable influence on overall economic productivity, however, is not clear. Moreover, those changes are difficult to quantify and they influence labor productivity in opposing directions. As a result, their effects are not incorporated into CBO's estimates of the effects of the ACA on the labor market. Some recent analyses also have suggested that the ACA will lead to higher productivity in the health care sector--in particular, by avoiding costs for low-value health care services--and thus to slower growth in health care costs under employment-based health plans. Slower growth in those costs would effectively increase workers' compensation, making work more attractive. Those effects could increase the supply of labor (and could increase the demand for labor in the near term, if some of the savings were not immediately passed on to workers). Whether the ACA already has or will reduce health care costs in the private sector, however, is hard to determine. The ACA's reductions in payment rates to hospitals and other providers have slowed the growth of Medicare spending (compared with projections under prior law) and thus contributed to the slow rate of overall cost growth in health care since the law's enactment. Private health care costs (as well as national health expenditures) have grown more slowly in recent years as well, but analysts differ about the shares of that slowdown that can be attributed to the deep recession and weak recovery, to provisions of the ACA, and to other changes within the health sector. Moreover, the overall influence of the ACA on the cost of employment-based coverage is difficult to predict--in part because some provisions could either increase or decrease private-sector spending on health care and in part because many provisions have not yet been fully implemented or evaluated. Consequently, CBO has not attributed to the ACA any employment effects stemming from slower growth of premiums in the private sector. Effects of the ACA on the Demand for Labor The ACA also will affect employers' demand for workers, mostly over the next few years, both by increasing labor costs through the employer penalty (which will reduce labor demand) and by boosting overall demand for goods and services (which will increase labor demand). Effects of the Employer Penalty on the Demand for Labor Beginning in 2015, employers of 50 or more full-time equivalent workers that do not offer health insurance (or that offer health insurance that does not meet certain criteria) will generally pay a penalty. That penalty will initially reduce employers' demand for labor and thereby tend to lower employment. Over time, CBO expects, the penalty will be borne primarily by workers in the form of reduced wages or other compensation, at which point the penalty will have little effect on labor demand but will reduce labor supply and will lower employment slightly through that channel. Businesses face two constraints, however, in seeking to shift the costs of the penalty to workers. First, there is considerable evidence that employers refrain from cutting their employees' wages, even when unemployment is high (a phenomenon sometimes referred to as sticky wages). For that reason, some employers might leave wages unchanged and instead employ a smaller workforce. That effect will probably dissipate entirely over several years for most workers because companies that face the penalty can restrain wage growth until workers have absorbed the cost of the penalty-- thus gradually eliminating the negative effect on labor demand that comes from sticky wages. A second and more durable constraint is that businesses generally cannot reduce workers' wages below the statutory minimum wage. As a result, some employers will respond to the penalty by hiring fewer people at or just above the minimum wage--an effect that would be similar to the impact of raising the minimum wage for those companies' employees. Over time, as worker productivity rises and inflation erodes the value of the minimum wage, that effect is projected to decline because wages for fewer jobs will be constrained by the minimum wage. The effect will not disappear completely over the next 10 years, however, because some wages are still projected to be constrained (that is, wages for some jobs will be at or just above the minimum wage). Businesses also may respond to the employer penalty by seeking to reduce or limit their full-time staffing and to hire more part-time employees. Those responses might occur because the employer penalty will apply only to businesses with 50 or more full-time-equivalent employees, and employers will be charged only for each full-time employee (not counting the first 30 employees). People are generally considered full time under the ACA if they work 30 hours or more per week, on average, so employers have an incentive, for example, to shift from hiring a single 40-hour, full- time employee to hiring two, 20-hour part-time employees to avoid bearing the costs of the penalty. Such a change might or might not, on its own, reduce the total number of hours worked. In the example just offered, the total amount of work is unaffected by the changes. Moreover, adjustments of that sort can take time and be quite costly--in particular, because of the time and costs that arise in dismissing full-time workers (which may involve the loss of workers with valuable job-specific skills); the time and costs associated with hiring new part-time workers (including the effort spent on interviewing and training); and, perhaps most important, the time and costs of changing work processes to accommodate a larger number of employees working shorter and different schedules. The extent to which people would be willing to work at more than one part-time job instead of a single full-time job is unclear as well; although hourly wages for full-time jobs might be lower than those for part-time jobs (once wages adjust to the penalty), workers also would incur additional costs associated with holding more than one job at a time. In CBO's judgment, there is no compelling evidence that part-time employment has increased as a result of the ACA. On the one hand, there have been anecdotal reports of firms responding to the employer penalty by limiting workers' hours, and the share of workers in part-time jobs has declined relatively slowly since the end of the recent recession. On the other hand, the share of workers in part- time jobs generally declines slowly after recessions, so whether that share would have declined more quickly during the past few years in the absence of the ACA is difficult to determine. In any event, because the employer penalty will not take effect until 2015, the current lack of direct evidence may not be very informative about the ultimate effects of the ACA. More generally, some employers have expressed doubts about whether and how the provisions of the ACA will unfold. Uncertainty in several areas--including the timing and sequence of policy changes and implementation procedures and their effects on health insurance premiums and workers' demand for health insurance--probably has encouraged some employers to delay hiring. However, those effects are difficult to quantify separately from other developments in the labor market, and possible effects on the demand for labor through such channels have not been incorporated into CBO's estimates of the ACA's impact. Effects of Changes in the Demand for Goods and Services on the Demand for Labor CBO estimates that, over the next few years, the various provisions of the ACA that affect federal revenues and outlays will increase demand for goods and services, on net. Most important, the expansion of Medicaid coverage and the provision of exchange subsidies (and the resulting rise in health insurance coverage) will not only stimulate greater demand for health care services but also allow lower-income households that gain subsidized coverage to increase their spending on other goods and services--thereby raising overall demand in the economy. A partial offset will come from the increased taxes and reductions in Medicare's payments to health care providers that are included in the ACA to offset the costs of the coverage expansion. On balance, CBO estimates that the ACA will boost overall demand for goods and services over the next few years because the people who will benefit from the expansion of Medicaid and from access to the exchange subsidies are predominantly in lower-income households and thus are likely to spend a considerable fraction of their additional resources on goods and services--whereas people who will pay the higher taxes are predominantly in higher-income households and are likely to change their spending to a lesser degree. Similarly, reduced payments under Medicare to hospitals and other providers will lessen their income or profits, but those changes are likely to decrease demand by a relatively small amount. The net increase in demand for goods and services will in turn boost demand for labor over the next few years, CBO estimates. Those effects on labor demand tend to be especially strong under conditions such as those now prevailing in the United States, where output is so far below its maximum sustainable level that the Federal Reserve has kept short-term interest rates near zero for several years and probably would not adjust those rates to offset the effects of changes in federal spending and taxes. Over time, however, those effects are expected to dissipate as overall economic output moves back toward its maximum sustainable level. Why Short-Term Effects Will Be Smaller Than Longer-Term Effects CBO estimates that the reduction in the use of labor that is attributable to the ACA will be smaller between 2014 and 2016 than it will be between 2017 and 2024. That difference is a result of three factors in particular--two that reflect smaller negative effects on the supply of labor and one that reflects a more positive effect on the demand for labor: The number of people who will receive exchange subsidies-- and who thus will face an implicit tax from the phaseout of those subsidies that discourages them from working--will be smaller initially than it will be in later years. The number of enrollees (workers and their dependents) purchasing their own coverage through the exchanges is projected to rise from about 6 million in 2014 to about 25 million in 2017 and later years, and most of those enrollees will receive subsidies. Although the number of people who will be eligible for exchange subsidies is similar from year to year, workers who are eligible but do not enroll may either be unaware of their eligibility or be unaffected by it and thus are unlikely to change their supply of labor in response to the availability of those subsidies. CBO anticipates that the unemployment rate will remain high for the next few years. If changes in incentives lead some workers to reduce the amount of hours they want to work or to leave the labor force altogether, many unemployed workers will be available to take those jobs--so the effect on overall employment of reductions in labor supply will be greatly dampened. The expanded federal subsidies for health insurance will stimulate demand for goods and services, and that effect will mostly occur over the next few years. That increase in demand will induce some employers to hire more workers or to increase their employees' hours during that period. CBO anticipates that output will return nearly to its maximum sustainable level in 2017 (see Chapter 2). Once that occurs, the net decline in the amount of labor that workers choose to supply because of the ACA will be fully reflected in a decline in total employment and hours worked relative to what would otherwise occur. Differences From CBO's Previous Estimates of the ACA's Effects on Labor Markets CBO's estimate that the ACA will reduce aggregate labor compensation in the economy by about 1 percent over the 2017- 2024 period--compared with what would have occurred in the absence of the act--is substantially larger than the estimate the agency issued in August 2010. At that time, CBO estimated that, once it was fully implemented, the ACA would reduce the use of labor by about one-half of a percent. That measure of labor use was calculated in dollar terms, representing the change in aggregate labor compensation that would result. Thus it can be compared with the reduction in aggregate compensation that CBO now estimates to result from the act (rather than with the projected decline in the number of hours worked). The increase in that estimate primarily reflects three factors: The revised estimate is based on a more detailed analysis of the ACA that incorporates additional channels through which that law will affect labor supply. In particular, CBO's 2010 estimate did not include an effect on labor supply from the employer penalty and the resulting reduction in wages (as the costs of that penalty are passed on to workers), and it did not include an effect from encouraging part-year workers to delay returning to work in order to retain their insurance subsidies. CBO has analyzed the findings of several studies published since 2010 concerning the impact of provisions of the ACA (or similar policy initiatives) on labor markets. In particular, studies of past expansions or contractions in Medicaid eligibility for childless adults have pointed to a larger effect on labor supply than CBO had estimated previously.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, apparently, Winston Churchill once said: Americans will always do the right thing but only after they have tried everything else. Then again, Churchill never tried to get the doc fix passed in the United States Congress. For 10 years, we have been trying to fix the sustainable growth rate in Medicare, and for 10 years, we have kicked the can down the road with 17 different short-term patch votes. The Protecting Access to Medicare Act of 2014 is a mixed bag of some important compromises, like ensuring that there is an accurate valuation of services of the Physician Fee Schedule; some problematic provisions, such as the end- stage renal disease policy; and some provisions that have never been vetted in front of the Congress, in front of committees--at all. More importantly, this bill represents our 18th failure to rebuild the bedrock of the Medicare program, our 18th failure to provide America's seniors with the safety and security of a permanent fix to the SGR. That is why the AMA is voting ``no'' on this bill. That is why most physicians' groups are strongly opposed to this bill. Last night, my office was flooded with messages from various physician groups. I, for one, still believe in finding the will to do what is right. I, for one, am dedicated to the principle of seizing the moment and accomplishing big things on behalf of the American people. We thought we were going to do it this time. When it comes to this mixed-bag piece of legislation, cooked up in the dead of night, put on the Web at 2 minutes before midnight a couple of days ago, revised several times since--not much more than 48 hours ago this stuff started--I vote ``no.'' Enough with trying everything else. It is time to do what is right--a permanent doc fix that is argued, debated, agreed upon. It is what our seniors need. It is what our doctors need to help them manage their practices. It is what our Nation needs and deserves.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, I rise today to commemorate Girl Scout Day, the anniversary of founding of Girl Scouts of the United States of America (GSUSA). On March 12th, 102 years ago, Juliette Gordon Low held the first Girl Scout meeting with the vision of empowering women through service, education, and community. The Girl Scouts have continued to build on their decorated legacy by instilling their values into the young women who will grow up to be the leaders and thinkers of future generations. For over a century, the GSUSA has successfully spread the principles of egalitarianism through its leading role in the women's movement. The GSUSA has been at the forefront of many social justice movements as a result of its longstanding commitment to diversity and inclusion. Recently, they joined with other leaders to call attention to unfair double standards and stereotypes of women in leadership roles by launching the ``Ban Bossy'' campaign. I applaud the GSUSA for highlighting the workplace in this regard, and for demanding equality in all areas of society. The 18-member organization that Juliette Gordon Low started in 1912 has seen participation of over 60 million women, including 2.3 million current active members. I thank the GSUSA for all its active involvement in Washington's 7th district and communities throughout America. I am proud to take part in Girl Scout Day, and I wish the GSUSA continued success for years to come.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, this 51st attempt to repeal the ACA by stopping the individual mandate is part of the long-term propaganda campaign done by the Republicans to destroy the health care plan that the President put together. They know that we agree on the policy--everybody here agrees on the policy--but they put a poison pill in it. They knew that this amendment of how to pay for it--that is, by delaying the mandate--would kill any Democratic support in the House. They have no intention of passing this bill. This bill is directed at the propaganda campaign to the people at Koch Brothers and at FOX News so that anybody who is watching this will get the idea that somehow it is a bad bill. The fact is that people are benefiting every single day. The AARP and the American Medical Association have denounced this bill because they want the SGR--the doctors' payment reform--to go through, and they know that the Republicans have designed this to fail. A mandate that has been supported even by the Tea Party--before the Tea Party said ``we have got to be against it''--is what is at issue here. Doctors and health insurance companies will not be able to operate if you don't have an individual mandate. The Republicans said this. The Heritage Institute said it. Everybody said it, but they want to kill it. This is an alternative universe that we are creating with this propaganda campaign. We see wild claims about people who live in inner cities in that they are somehow worthless and that they don't want to take care of their families and feed them, and we hear things coming out of the Speaker's office that clearly aren't true about the ACA. Let's suppose that actually happened. What would happen if we repealed and destroyed the ACA today? We would get rid of 13 million people on the rolls by 2018. We would take away health insurance. Health insurance premiums would rise 10 to 20 percent by 2018. Millions of Americans would not be able to afford the health care they need. This is a failure of leadership. They would rather run a propaganda campaign to hold onto the House. We watched in Florida just in the last week when $13 million, I guess, was spent on that campaign to tar the Affordable Care Act. That is what this is all about. No one should be the least bit confused. That is not what America wants. America wants health security. Vote ``no'' on this bill.

Mr. McDERMOTT

Mr. McDERMOTT. Madam Speaker, I yield myself such time as I may consume. Madam Speaker, today is a little like ``Groundhog Day.'' The Republican leadership has come out here and tried to decide what the weather is going to be, and they are going to get the same answer that they have gotten 49 times before. They can pass it from here, but it is not going to change anything. We have seen this poorly designed, sadly staged GOP political theater before--50 times. This is the 50th vote of this Tea Party, Koch brothers-led Congress to crash the Affordable Care Act. It is a waste of time and resources, and ignores the facts. Americans want affordable health care, and ACA delivers it to them. ACA has saved lives and brought down our spending. New fraud measures, including new authorities imposing payment suspensions and more rigorous-provider enrollment procedures put into law by ACA, helped the Federal Government recover $4.3 billion in taxpayer money from individuals and companies that tried to defraud the health care programs. The ACA is delivering historic results for the American people, and yet the Republican leadership is hell-bent on a 50th stroke. Regardless of the fact that our economic system remains stuck in neutral, nothing has been done about jobs, unemployment insurance, raising the minimum wage, and so forth. If that was all that was going on here, this would still be insulting and absurd. The bill under consideration today, H.R. 4118, is virtually identical to H.R. 2668, a bill passed on the 17th of July, 2013. The Republicans have already passed this bill to delay the individual mandate, something the CBO knows will result in higher insurance premiums. So beyond wasting time and engaging in stunts designed to make the producers of FOX News happy, Republicans want to return Americans to the days before ACA, when a cancer victim couldn't get covered and seniors couldn't get their prescriptions; to the day when wage workers who had paid hundreds of dollars out of pocket went without; to the days of ever-changing lists of preexisting conditions when companies tried to drop coverage. The real business of the Congress should be to stand up for those Americans and millions more like them. That is what the American people want. That is what the American people deserve. That is why they want us to vote ``no.'' Jim McCrery, in March, 2000, said in an article in Atlantic Monthly that an employer mandate and an individual mandate was essential. I can't understand the Republicans saying we don't want everybody to play. We don't want everybody according to their ability to be in. Why are you so eager to let people out the door because they are going to wind up in the emergency room? Have no doubt, they will be getting health care, but they won't be paying for it. You are saying: That's okay with us, we like people who are free riders. That is not America. We are all supposed to do our part, and that is why everyone here should vote ``no.'' I reserve the balance of my time.

Mr. McDERMOTT. Madam Speaker, I yield 3 minutes to the gentleman from Illinois (Mr. Danny K. Davis).

Mr. McDERMOTT. Madam Speaker, I yield 3 minutes to the gentleman from Oregon (Mr. Blumenauer).

Mr. McDERMOTT. I yield the gentleman an additional minute.

Mr. McDERMOTT. Mr. Speaker, may I inquire as to the time remaining?

Mr. McDERMOTT. Mr. Speaker, I reserve the balance of my time.

Mr. McDERMOTT. Is the gentlelady from Kansas ready to close?

Mr. McDERMOTT. Mr. Speaker, I have one Member who is in transit, but let me say a few things until he gets here. I have been in Congress for 25 years, and I have listened to the Republicans talk about what we ought to do about health care. They have never brought a bill to the committee--a chairman's mark--for us to mark up and bring out on the floor. Now, if you have a solution for the fact that health care costs are the biggest costs driving bankruptcy in this country, where is it since you don't like what we have here? When I was younger, I lived through the implementation of Medicare. The American Medical Association--everybody--was just up and down, and it was the worst thing. If we put in Medicare, it was going to be the end of the world, and we would never have health care again in this country. We went on and on and on like that. They so poisoned the well that, when people went out to actually recruit people to get into the Medicare program, people said: I am not going to have any of that socialistic medicine in my house. That is what it was called. That is what people were doing in 1964 and 1965. This is a rerun of that very same movie. The Republicans want to kill the idea and leave the American people out there on their own. It is probably the single best example of the difference between the Republicans and the Democrats. The Democrats have put something out here, and we are trying to help all Americans. Is it perfect? There isn't anybody on my side who would say it is. If we had had some hearings in the Ways and Means Committee, the subcommittee could have done a whole bunch of things--there are all kinds of problems out there--but there haven't been any hearings on this bill, on how to fix it. I talked to Bill Frist some months ago. He said: Jim, there is no reason to repeal it. You ought to fix it. Make it work. Make it work for the American people. One of the interesting things that I hear over and over again--and it must be confusing to folks at home--is that the President said: If you like your health care, you can keep it. Now, implicit in that is that it will still exist. The President didn't say: I am going to tell the insurance companies you have got to keep those plans out there. That wouldn't be the free enterprise system, what you have. You don't like the free enterprise system. As soon as the President passed this bill, immediately, we had people in the insurance industry pulling down plans all over the country, sending out mailings, saying: You have lost your health care coverage. I sometimes wonder if global warming--or climate change--is really not because of Obama's health care. I hear that it is the cause of every evil--of people losing jobs. I don't know. Whatever is going on in the country, it is because of ObamaCare. That is foolishness. When you are trying to change a program for 20 or 30 million people, you are bound to have some problems. We are having them, and we are working them out. It was awful at the beginning, and it is better now. It is better today than it was 3 months ago, and it will be. It will continue to improve because the American people need it. They absolutely need it even with the foolishness coming out of here, of trying again to convince the American people to get rid of this. I had a woman in my district who was an opera singer. She went to Germany, and she got into the German health care system. Instantly, boom, you are in. Anybody who goes to Germany is in. Her daughter got leukemia. Her daughter was treated for leukemia, and she went into remission. The mother finished her contract and came home to the United States. She could not find an insurance company anyplace in this country that would give her insurance for her daughter--none. Now, that is what you want to go back to. You want to go back to the time when a parent can't find an insurance company that will take care of his kid, and that is the kind of thing that we have been watching for as long as I have been in Congress and before that, and this bill has begun to stop that. We had lifetime limits. Some cancers eat up a lot of money real quickly. Bone marrow transplants are $125,000 or more, and people wind up being unable to purchase the medication. All of that is covered by this bill, and you are saying to people: No, we want to go back to 1930. We like the Dust Bowl. We like the hard times of the thirties. We don't want any of this stuff. In my view, this is a perfect place for Democrats to vote ``no,'' and Republicans, of course, will vote ``yes,'' and the American people will make a judgment in the next election. I yield back the balance of my time.

Mr. McDERMOTT. Mr. Speaker, on that I demand the yeas and nays.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, on rollcall No. 89 I was delayed getting to the vote. Had I been present, I would have voted ``yes.''

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, Washington State's economy depends on its thriving ports. And yet, for too long, funds collected to maintain our Nation's waterways have been diverted elsewhere. In spite of urgent needs for maintenance, historically, less than half of the collected amount has actually been spent each year. As a result, American ports are struggling to make the infrastructure investments they need to support American businesses. Since the original enactment of the Harbor Maintenance Tax (HMT) in 1986, global shipping has undergone considerable change. Current policy incentivizes maximum use of foreign ports to import US-bound goods in order to bypass the HMT on which our ports are so dependent. Annually, this amounts to $30 million in losses to maritime infrastructure, with losses expected to increase if current trends continue. This status quo is inequitable, unsustainable and unacceptable. Today, I introduced the Maritime Goods Movement Act of the 21st Century to address this growing state and national concern. This legislation will replace the HMT with a new user fee that will provide for the full expenditure of revenue collected to benefit waterways and freight, ensure that all US-bound cargo is treated equally regardless of point of entry, and provide federal support to address critical freight needs at our Nation's largest ports and intermodal freight choke points. Congress has struggled for years to ensure that our Nation's waterways are funded with little to show for its efforts. It's time to move forward with a solution that will ensure that American ports remain competitive while meeting the realities of global shipping in the future.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, American taxpayers and Pacific Northwest ratepayers have little to show for the more than $11 billion they have spent on salmon recovery efforts in the Columbia and Snake River Basin. Since being listed for protection under the Endangered Species Act in the early 1990s, most of the thirteen native salmon and steelhead species remain near the depressed levels that triggered their protected status in the first place. The value of these fish populations is undeniable, holding major economic, environmental and cultural significance to the Pacific Northwest. Even now, at their historically low levels, salmon add over a billion dollars to the region's economy and constitute a vital part of communities throughout the Northwest. While continuing our efforts to protect salmon and steelhead populations is critical, it is clear that our current approach is not working. Over twenty years and $11 billion later, their vulnerable status remains virtually unchanged. Four Biological Opinions have been rejected by the courts as insufficient for fish survival. Last month's latest BiOp represents little change from the previous version, stoking the possibility of renewed court challenges. It's time to reevaluate our failed efforts and consider the best approach forward, including the possibility of removing four dams on the lower Snake River. Last century, over 1,100 dams were removed throughout the country. Last month marked the start of the removal of yet another dam: the Rockford Dam on Iowa's Shell Rock River is being breached, among other reasons, to restore fish passage to 21.5 miles of the river. The legislation I am re-introducing today, the Salmon Solutions and Planning Act, commissions studies to focus our efforts so that all factors are taken into account when considering dam removal. Our salmon recovery efforts must be informed, cost effective, and successful. Inaction is not an option. We must use the best available science to protect this vital American resource before it's too late.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, American taxpayers and Pacific Northwest ratepayers have little to show for the more than $11 billion they have spent on salmon recovery efforts in the Columbia and Snake River Basin. Since being listed for protection under the Endangered Species Act in the early 1990s, most of the thirteen native salmon and steelhead species remain near the depressed levels that triggered their protected status in the first place. The value of these fish populations is undeniable, holding major economic, environmental and cultural significance to the Pacific Northwest. Even now, at their historically low levels, salmon add over a billion dollars to the region's economy and constitute a vital part of communities throughout the Northwest. While continuing our efforts to protect salmon and steelhead populations is critical, it is clear that our current approach is not working. Over twenty years and $11 billion later, their vulnerable status remains virtually unchanged. Four Biological Opinions have been rejected by the courts as insufficient for fish survival. Last month's latest BiOp represents little change from the previous version, stoking the possibility of renewed court challenges. It's time to reevaluate our failed efforts and consider the best approach forward, including the possibility of removing four dams on the lower Snake River. Last century, over 1,100 dams were removed throughout the country. Last month marked the start of the removal of yet another dam: the Rockford Dam on Iowa's Shell Rock River is being breached, among other reasons, to restore fish passage to 21.5 miles of the river. The legislation I am re-introducing today, the Salmon Solutions and Planning Act, commissions studies to focus our efforts so that all factors are taken into account when considering dam removal. Our salmon recovery efforts must be informed, cost effective, and successful. Inaction is not an option. We must use the best available science to protect this vital American resource before it's too late.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, while we fool around again with a lot of minor bills here today, we refuse to deal with the ones that we ought to be dealing with. We need to be involved in passing things that create jobs. Now, the production tax credit is an absolute no-brainer. We have used it for years and years. As long as I have been in the Congress it has been here, and the wind industry is dependent on it. It is 3,000 jobs in my State, and thousands of jobs across this country. We passed it in the nineties. We let it expire. We lost all the jobs, and we are doing it again. Now, climate change ought to be impressing people that we have to move away from fossil fuels and look for alternative energy, and this is the way we are going to do it. In the 20th century, we invested in aerospace and microchip industries through the production tax credit, and we made all the advances of the Internet and everything else on the basis of these Production Tax Credits. The 21st century is going to be about alternative energy, and this House dawdles around, attacking the IRS, and trying to repeal the ACA and all of this. Why don't you make it a suspension bill? It would pass in a minute.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, here we are back in the theater of the absurd. The Republicans are wasting valuable time and resources on political theater, crafted to make the producers at FOX television happy while they should be moving forward with the country's business. There have been six separate investigations. Not a single shred of evidence has been found demonstrating political motivation or White House involvement in the IRS grouping of the tea party applications by name. Now, one of my colleagues is a physician. He is from Louisiana. He has operated many times. You do not begin surgery until you know what is going on with the patient. We have six investigations which found no reason to operate, no reason to pass this legislation. Yet here it is. Ironically, the real trickery of this is this bill. It is designed to protect Karl Rove's Crossroads GPS and the Koch Brothers of Houston from exposing where the money that they put into the political process is being used. Everyone knows what a 501(c)(4) is about. You give the money to the organizations. They don't have to report your name to anyone, and then the organizations can use it any way they want. Now, if an organization goes to the IRS and says, ``we want a 501(c)(4),'' the IRS should ask a few questions, don't you think, if they are going to give an exemption from the American people, from those people paying the taxes who put it in there? Karl Rove and all of his cohorts ought to pay taxes if they are going to use it for the political process, and it is the IRS' job to find that out. It is the same with liberal groups. Any group that comes in has to explain what it is going to do with the money. We have had six investigations, but now we have a bill without any conclusion from any committee or any investigation that there is a problem. The floor of the House should not be the stage for the Republicans to work out their November election strategy and funding. If Republicans really want to work on behalf of the American people, they should get serious and roll up their sleeves. The production tax credit ought to pass out of here as a unanimous consent. There are a thousand things that ought to be happening here today instead of this silly bill, which will have no effect. It is not going through the Senate. The President isn't going to sign it. It is simply political theater to give the directors at FOX TV things to put on television. If you intend to do something real, you can, but this bill is not real. It is simply to reignite the baseless allegations against the White House.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, I rise today to introduce the Access to Hearing Healthcare Act of 2014. This important legislation will allow Medicare beneficiaries the option of going directly to a qualified audiologist for hearing and balance diagnostic tests. Medicare presently requires that beneficiaries with hearing loss or balance disorders obtain a physician referral before seeing an audiologist. This referral requirement differs from other federal health agencies, including the Department of Veterans Affairs (VA) and the Office of Personnel Management, which allow patients to directly access audiologists. Hearing impairment is one of the most common conditions affecting older Americans, with approximately 33 percent of adults aged 60 and over and 40-50 percent of those aged 75 and over with hearing loss. Hearing loss among senior citizens, if left untreated, can result in isolation and depression. We need to ensure that Medicare beneficiaries can obtain audiology services in a timely manner. 1 ask that my colleagues support this important legislation.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, I rise today to introduce the Homeowners Tax Fairness Act. In 2012, the 49 state attorneys general announced that they had completed negotiations with the country's five largest mortgage servicers to settle claims arising from mortgage fraud and wrongful foreclosures. The settlement, which amounts to over $25 billion, is the largest settlement this country has seen since the 1998 Master Tobacco Settlement. This historic settlement will allow hundreds of thousands of distressed homeowners to stay in their homes through enhanced loan modifications and principal reduction, and it will also provide payments to victims of unfair foreclosure practices. Unfortunately, under current law, those settlement payments would subject the homeowners and servicemembers who receive them to additional tax burdens. For instance, homeowners receiving relief in the form of mortgage debt forgiveness and direct cash payments for wrongful foreclosure could be subject to Federal income tax. Moreover, additional tax would be owed on the payments made to servicemembers who were wrongfully foreclosed on while deployed overseas. To prevent that injustice, the Homeowners Tax Fairness Act would extend the exclusion for debt forgiveness on a primary residence and exclude the relief payments from income for homeowners and servicemembers. This bill also considers the particularly egregious actions taken by the five largest banks in violation of the Servicemembers Civil Relief Act. Over the past three years, the five largest servicers violated the law and wrongfully foreclosed or overcharged mortgage interest on servicemembers, many of whom were deployed overseas in combat zones. Accordingly, the Homeowners Tax Fairness Act not only excludes this relief from income to servicemembers, but denies these banks the ability to deduct these payments from their Federal income taxes. The estimated 1.7 million homeowners eligible to benefit from this settlement deserve to receive the full benefit of this relief--relief that was negotiated in good faith by the States, the banks, and the Federal Government. Collecting Federal income tax on relief for struggling homeowners is not only bad policy, but is simply the wrong thing to do. As we move forward from one of the worst recessions in American history, we must be vigilant and provide as much help to the American people as possible. This bill will do just that, and will ensure that our homeowners and servicemembers get every bit of relief they deserve.