Jim McDermott

Mr. McDERMOTT

Mr. McDERMOTT. I thank the gentleman for yielding. Mr. Chairman, this amendment is just another devious Republican attempt to undermine efforts to end the decade-long scourge of rape and murder in Congo. I have been in Congo many times. I served in the State Department in Kinshasa. I know the area. And the gentleman's statement that there is no company that is able to do this is absolutely incorrect. There is a company in Coral Gables, Florida, Kemet Corporation. They certify every bit of their metal is conflict-free. It is possible to do. Now, why is this important? Well, all the 5 million people that have died in eastern Congo since Rwanda in 1992-93 have been from armed militias that are getting their money by taking minerals out of the ground and selling them abroad using slave labor. The way you enslave a man is to rape his wife in front of him, and then bring him down and chain him and make him dig up the minerals. That is what has been going on there, and it has been going on for a long time, and everyone in this room is benefiting from that. Everybody who has a cell phone has tin, tungsten, tantalum in it. And what this amendment is about is companies that will not go through the process. They do not want to do it. They want to get it from wherever it comes from. They don't care who it is. Now, you can't tell me, and I know enough about Boeing and a lot of other companies, that they know their supply chain right down to where it starts in the ground somewhere. Everything that is in a plane, they know where it came from. And for them to say they don't know where it comes from or I can't know is simply that they want to get it on the cheap and don't care about human value in central Africa. Now, the gentleman has given me the opening, which I didn't know if I would have, but his own church, the Christian Reformed Church in North America, their coordinator of office of social justice says defunding section 1502 and amendment No. 34 is immoral. It will result in violations and will undo work to our conflict-free mining in Africa. This is a long-time battle, and we have had no one come up with any other way to deal with this except to cut off the money to the militias. To say there is not armed conflict in eastern Congo is somebody who has got their head buried in the sand; because if you go over there, you know that there is conflict from Rwanda and Uganda and all the countries in that area, because this stuff is valuable and people want it, and they want it on the cheap.

Mr. McDERMOTT. I yield to the gentleman from Michigan.

Mr. McDERMOTT. Reclaiming my time, I get your point. You are saying that your church in wherever they are located, in Michigan or wherever, they are out of touch with what is going on on the ground. I am in touch with the people on the ground. There are groups like HEAL Africa, which have been operating a hospital in Goma, which has been filled with people that come from this whole process. And when you go over there and talk to them, they say the only way you are ever going to do it here is cut off the money, and that means saying to people you have got to know where that tin or tungsten or tantalum came from and was it gotten by using slave labor. If you are unwilling to do that, as a company, in the United States, you have no moral fiber. If you are not willing to say you will not use slave labor for the material that is in your product, in your cell phone--and believe me, it wouldn't be hard to get a boycott going in this country against some folks who want to, but nobody wants to come out in the open. This amendment gets slid in at the last minute every year. Senator Durbin, Senator Coons, Barney Frank, all of us worked on this. We have heard it all. And of course the SEC doesn't want to do it. They don't want to do anything that doesn't have to do with paper shuffling and letting the derivatives run through the economy. They simply have been given this because they handle the money. I urge my colleagues to vote ``no.''

Mr. McDERMOTT

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

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

Mr. McDERMOTT. Mr. Speaker, I yield myself such time as I may consume. I include in the Record an editorial from The Washington Post called, ``The Myth of Paul Ryan.'' [From the Washington Post, July 5, 2016] The Myth of Paul Ryan (By Katrina vanden Heuvel) It's also an apt descrtiption of the man Trump supplanted as de facto leader of the party--Romney's running mate in 2012, House Speaker Paul D. Ryan (R-Wis.). Indeed, years before Trump sold Republican primary voters on the myth of his own great success, Ryan sold a credulous Washington establishment on the notion that he was a serious thinker overflowing with political courage--a policy wonk uniquely willing to tackle tough issues such as entitlement reform. In the past month, however, it has become more obvious than ever that Ryan's reputation is worth about as much as a degree from Trump University. Let's review. After a fleeting flirtation with principle, Ryan kicked off June by endorsing Trump for president. Despite his previous indication that Trump would have to change course to earn his support, Ryan's endorsement came without any public concessions or reassurances from Trump It also came after The Post reported in late 2013 that Ryan was embarking on a personal crusade to steer Republicans ``away from the angry, nativist inclinations of the tea party'' and toward a ``more inclusive vision.'' A few weeks after bowing to Trump, Ryan did take a stand-- against the historic sit-in on the House floor led by civil rights icon Rep. John Lewis (D-Ga.) to demand a vote on gun legislation. Ryan derided the show of solidarity with victims of gun violence as a ``publicity stunt'' and warned ominously that in the future, ``We will not take this. We will not tolerate this.'' (But Ryan has said the House will vote on a GOP-sponsored gun bill this week.) Lastly, there is Ryan's supposed bread and butter: a policy agenda rolled out over the course of the month. Ryan put forward a health-care proposal that was hyped as the long-awaited Republican alternative to the Affordable Care Act, but the ``plan'' consisted largely of well-worn talking points instead of actual legislation. In a withering editorial titled ``Paul Ryan's flimsy health plan,'' The Post's editorial board described it as ``less detailed in a variety of crucial ways than previous conservative health reform proposals,'' while adding, ``The outlines that the speaker did provide suggest that it would be hard on the poor, old and sick.'' He also released a tax reform proposal that, according to the Wall Street Journal, ``isn't detailed enough for a complete nonpartisan congressional analysis to verify the effect on the budget and on households.'' The limited details he did provide, however, do not paint a pretty picture. It's not just that Ryan proposes to slash rates for the rich and corporations. He also wants to create a new loophole for ``pass-through'' income, which is a feature of Trump's proposal and the disastrous plan implemented by Kansas Gov. Sam Brownback (R) that has wrecked his state's finances. And perhaps most significantly, given his disavowal of his past ``makers and takers'' rhetoric, Ryan introduced an ``antipoverty'' plan that would severely weaken the safety net for those living in poverty. The plan, according to Politico, is mostly ``repackaged GOP proposals,'' including cuts to unemployment assistance, Head Start and federal Pell Grants. With Ryan's blue-collar home town of Janesville already suffering the consequences of corporate trade deals and other Ryan-backed economic policies that have eviscerated the city's manufacturing base, TalkPoverty editor Greg Kaufmann writes that Ryan's latest proposal demonstrates ``his enduring disconnect from the people struggling in his own district and across America.'' None of this is new. Ryan has been selling snake oil for years--promising to ``save'' Medicare by privatizing it, boasting that he could balance the budget with tax cuts for the rich and without any cuts to defense spending, pretending to be a pragmatist while embracing the extreme ideological dogmas of Ayn Rand and the religious right. But his unearned standing as a serious and courageous leader in a sea of cynical hacks has persisted nonetheless. Even today, there are those who sympathize with Ryan, suggesting that he is somehow a victim of Trump and right-wing Republicans in Congress when, in fact, his leadership--and failures thereof--helped pave their path to power. When he was nominated for vice president in 2012, I wrote that Ryan's vision for the country isn't courageous--it's cruel. While that remains true four years later, it's not only Ryan's policy goals that need to be exposed for what they are.

Mr. McDERMOTT. Mr. Speaker, June 22 was a historic day in this House. You could look at it from two different positions. One was it was the day that the Speaker was going to roll out, finally, after 2,000 days, his plan for health care in this country. Unfortunately for him, in the well of the House, the Democrats decided that, maybe, commonsense gun legislation was more important. This bill was supposed to come up that day, but, instead, it was put up for today, and then it was put up for tomorrow. It is important because this is the fundamental underpinning of the undoing of the ACA for this country. There was a feeling on this floor that it was more important to talk about commonsense gun legislation. People were out there, worried about it, and we stood around here again and again, bowing our heads, and said: ``Gee, we are feeling awful about this,'' and then went on with business; so the Democrats sat down and said: ``We are going to do something about this.'' The Speaker is the Speaker, and he is not to be denied, so here comes his bill again. He couldn't get it on June 22. We are revisiting this bill with the added benefit of some time to have actually looked at what the Republican healthcare plan is. The reviews are now in. The article I included from The Washington Post calls it a ``flimsy health plan,'' ``Paul Ryan's flimsy health plan.'' The American people don't understand what he is about to do to them. Medicare would be replaced by a voucher system. Medicaid would be cut radically. Consumer protections would be rolled back. Women would be denied the care they are entitled to. These are the same tired, harmful ideas that the Republicans have proposed time and time again. At the heart of this proposal is a dramatic shift of costs onto the patients. That means the wealthy will win and that the poor and the middle class will lose. H.R. 1270, which is knocking gun legislation off the agenda, is the first place they will begin the process of putting the Ryan plan into action. It is the first of a dozen bills that are required if they are serious about destroying the ACA and replacing it with their vision of health care for America. Like the rest of the Republican health debacle, H.R. 1270 is a harmful, poorly thought-out policy. This bill has three main parts, each of which will have damaging impacts on the Tax Code and on the healthcare system. The first is to expand the HSAs, the health savings accounts. Health savings accounts are used by fewer than 1 percent of Americans--0.7 percent of Americans use HSAs. If you are above $1 million, 6 percent use them. These are mechanisms for the rich to save money around healthcare costs. Few middle and working class Americans have the incomes necessary to even contribute to HSAs. The second thing it does is to repeal an important Affordable Care Act tax revenue provision and to put more money, tax free, in the hands of drug manufacturers--$20 billion for HSAs and $5 billion for the drug manufacturers in this country, as if they weren't making enough. We can't even have a meaningful hearing in the Ways and Means Committee on the costs of pharmaceuticals for Americans in the Medicare program. Of course, now that we have given away $25 billion, we have got to have a pay-for. Where will we get that pay-for? There is something in the ACA called the true-up process. Now, if you are somebody with an income of up to 200 percent of poverty and you are working and you get a subsidy from the government because you need it to afford to buy your healthcare plan, if something changes in your life during that year, there has to be a so-called true-up process. That is, you received too much in benefits, so you have to pay it back to the Federal Government. Now, when $175,000 people like us write a bill of a grand here, a grand there, it is not really a big deal; but when you are making $40,000 or $30,000 for a family of four or $50,000 for a family of four, $1,000 is a big deal. This was a provision in the Affordable Care Act that said, if you have to pay the government back, you have to pay some proportion, not all of it, because we know it would be a real hit at the end of the year to suddenly get a bill from the IRS for $1,000. It was a way to keep people able to buy health insurance. The CBO says 130,000 fewer Americans will have coverage because of this provision. That is how you pay for giving $20 billion to the top and $5 billion to the pharmaceutical manufacturers, and that is why some of us are going to oppose this bill. My belief is that, if you are serious about dealing with health care, you are going to have to write it down. Mr. Ryan put a beautiful talking point list out with not a single word of legislation. He will not write down what he really intends to do. You have to kind of intuit it and have to have spent your life thinking about this stuff to understand all of the intricacies of what he is up to. The really upsetting thing is that we ought to be dealing with gun legislation here. The American people are entitled to have us vote on gun legislation. I reserve the balance of my time.

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

Mr. McDERMOTT. Mr. Speaker, I yield myself such time as I may consume. I include into the Record a letter from the Executive Office of the President, a Statement of Administration Policy dated 21 June of 2016 on this bill where the President says, in the last line: ``If the President were presented with H.R. 1270, he would veto the bill.'' Statement of Administration Policy H.R. 1270--The Restoring Access to Medication Act of 2015--Rep. Jenkins, R-KS, and 39 cosponsors The Administration strongly opposes House passage of H.R. 1270, which would create new and unnecessary tax breaks that disproportionately benefit high-income people, increase taxes for low- and middle-income people, and do nothing to improve the quality of or address the underlying cost of health care. The Affordable Care Act is working and is fully integrated into an improved American health care system. Discrimination based on pre-existing conditions is a thing of the past. Thanks to the Affordable Care Act, 20 million more Americans have health insurance. And under the Affordable Care Act, we have seen the slowest growth in health care prices in 50 years, benefiting all Americans. H.R. 1270 would repeal the Affordable Care Act's provisions that limit the use of flexible savings accounts for over-the- counter drugs--provisions that help fund the law's coverage improvements and expansions. The bill also would provide additional tax breaks that disproportionately benefit those with higher income by expanding tax-preferred health savings accounts. These changes would do little to reduce health care costs or improve quality. To fund these new high-income tax breaks, H.R. 1270 would increase taxes paid by low- and middle-income families by removing the law's limit on repayment of premium tax credits available through the Health Insurance Marketplaces. Rather than refighting old political battles by once again voting to repeal parts of the Affordable Care Act, Members of Congress should be working together to grow the economy, strengthen middle-class families, and create new jobs. If the President were presented with H.R. 1270, he would veto the bill.

Mr. McDERMOTT. Mr. Speaker, it is very clear that this is, as Mr. Levin said, the 64th or 65th--I have lost count--effort to undermine the Affordable Care Act and to begin the process of sliding Americans away from Medicare and Medicaid and privatize the whole business and leave the American people in the loving hands of the insurance industry. We understand. Newt Gingrich said, when he became Speaker, that his number one goal was to get rid of Medicare; and the Republican Party has been doing that since 1994. I have been here the whole time and watched it over and over and over again. We have beaten it back, we have beaten it back, and we have beaten it back. The fact is that the American people are entitled to security in their health care. In every other industrialized country in the world, people do not worry about being bankrupted by their illness or an injury or whatever might happen to them. Health care is not something that you have very much control over. In fact, this idea that you can shop your health care; that somehow, as you are driving down the road and suddenly your heart has problems, you can stop and say, ``Well, let me get a phone book here and find the cheapest cardiologist to go to or the cheapest cardiac surgeon,'' that kind of shopping doesn't go on. We are not buying iceboxes here. We are designing a system where we are trying to help everybody. The Republican plan is simply pulling people away from that and forcing them into their own individual box. You take care of yourself. I have no responsibility for you whatsoever. That is the end of a civilized society when we stop caring about people in the society who have the most trouble dealing with the problems they face, not because they are weak or stupid. These people who are getting these benefits, buying their healthcare plan, are using that money because they don't have enough to do it on their own. Something changes in their life. One of their kids gets married. Suddenly they are no longer a deduction. So they have suddenly got to be in the true-up process, and we are going to take their money away from them because their kid got married. Now, my view is that everything about this bill is not in the best interest of the American people. Not only are they entitled to health security, they ought to have some security, and that means that we ought to have a process where everybody who wants to buy a gun ought to have to go through a background check. I was going home on the plane last week after what went on here, and a guy came down the aisle about the size of the man in the chair and said to me: ``I am a gun collector, and I got 25 guns and they are all registered, and they should be. And I am a Republican.'' This country understands the commonsense nature of the legislation that we should be considering today here. Instead, we get the beginnings of eroding the healthcare system. The Speaker is inexorably working toward it, and we will just have to keep fighting. I yield back the balance of my time. Ms. JENKINS OF Kansas. Mr. Speaker, as I said in my opening statement, this bill deserves bipartisan support. It seems that the main objection from my Democratic colleagues relates to the ObamaCare subsidy overpayments, and our desire to get back some of the money that our constituents have received either fraudulently or not under this law is just a commonsense approach. This is not a tax on poor Americans nor is it a Robin Hood-style break for rich Americans. Rather, it is a bipartisan offset that many of my friends on the other side of the aisle have voted for not once, but twice. It is a chance to fulfill our obligation to be good stewards of the dollars that hardworking Americans have paid in taxes. We must pass H.R. 1270 to protect taxpayers, reduce the deficit by more than $2 billion, and show that we can agree to change some bad provisions in ObamaCare that drive up costs, decrease access, and unwisely spend taxpayer dollars. I yield back the balance of my time.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, first of all, I want to say congratulations to Congressman Murphy. His persistence brought this bill to the floor, and it is important that this issue be discussed. We are all going to vote for this bill. It will go out of here unanimously. We are all going to vote for it. But it is a hollow promise if there is not some money in it. Now, I was in my training in Chicago, in 1964, when the first mental health money came from the Federal Government to Chicago, and it went all over the country. And if the Federal Government doesn't put money into this program that we are outlining in this very carefully constructed bill, we will be sending out a blank check. There will be nothing. It won't be worth anything. To think that State legislatures or somebody is going to find the money somewhere is simply not real. Now, this morning, Mr. Pallone and I sat on a conference committee on opioids. We are doing the same thing there. We know there is addiction, we know there are all kinds of problems all over the place, and we are passing a wonderful bill out with some nice words in it, but no money. And if you are not willing to put some money into a program like this, you are simply consigning the mental health people to the jail. I was the King County Jail psychiatrist in 1979 and I ran the second- largest mental hospital in the State of Washington. I had more patients every night in that jail than anybody except the guy running the State mental hospital down in Tacoma. And that is where the mentally ill are today. If you want to get them out of that situation and get them into treatment, you are going to have to put some money out into the community in a variety of these programs. Good programs. I like what is in them. But you have got to put some money where your mouth is. I will support the bill, and I want to hear the appropriations process next.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, this bill, H.R. 5210, the Patient Access to Durable Medical Equipment Act, delays the implementation of recent changes to durable medical equipment payments. For the past several years, Medicare has been reforming how we pay for DME, including items like oxygen tanks, walkers, or hospital beds. In much of the country, CMS uses competitive bidding to determine how much DME costs. But in some communities, primarily in rural areas, CMS pays under the DME fee schedule. Under this payment system, there is no competitive market to drive prices down. Nonpartisan, independent experts, including MedPAC and the Government Accountability Office, have warned us that Medicare is overpaying for DME through the fee schedule. To address this problem, CMS has been phasing in new payments that will reduce DME costs under the fee schedule based on competitive bidding pricing. These lower payments are scheduled to be fully phased in by July. Getting DME costs under control is critical. Higher prices result in increased Medicare spending and, even more importantly, they force beneficiaries to pay more out of pocket. At the same time, some DME suppliers and beneficiary groups have expressed concerns that lowering the price for DME too far could hinder beneficiary access to important equipment. To address this issue, the bill before us provides a compromise that will institute a temporary delay of the lower DME fee schedule payments for three months. This pause will allow us to gather more data on how the new payment rates impact beneficiary access. That being said, it's not entirely clear that this delay is necessary. CMS has already been carefully monitoring access to DME. Just this month, the agency released data showing that payment cuts have not caused any harm to suppliers or to beneficiaries. Even as we have significantly reduced spending, suppliers continue to accept the reformed payment rates, and there is no evidence that beneficiary access to high quality DME has been hindered. This bill will give us three more months to verify that this is the case. This is only a short-term freeze, and if the evidence continues to show that the new payment rates are working, there will be no reason for us to delay any longer.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, as I come to speak on the floor, I think I am in the House of the deniers. Now, in 2007, that liberal journal, National Geographic, had an article called ``The Big Thaw.'' And it says: ``It's no surprise that a warming climate is melting the world's glaciers and polar ice. But no one expected it to happen this fast.'' That was in 2007. That was 9 years ago. I was taken, along with Gerry Connolly, up to the Arctic with the Norweigian Government. They are worried about what is happening. This resolution is just burying your head in the sand. I think you are thinking that if you put your head in the sand long enough, it will go away and, when you pull your head out, it won't be there. The CBO just put a report out: Texas, Louisiana, and Florida are going to have hurricane damage that is unbelievable. FEMA already accounts for 45 percent of money spent on hurricane damage, $95 billion since 2000. Now, if you think the insurance companies are going to keep insuring against hurricanes, you have another thing coming. At some point, they are going to say: We are not doing hurricane insurance in Florida, Louisiana, Texas, and a whole bunch of other places. That is the economics. You say: Let's not pay anything right now, let's not change anything, let's not work on it. But if we don't work on it, we are going to pay later. I am old enough to remember a FRAM commercial on the television. It was an air cleaner on your car, and it said: Pay me now or pay me later. And this is what this is about today. Now, there are things going on in this country which just absolutely boggle my mind. In North Carolina, the assembly got together and they said: You know what? We are not going to spend any money to measure the sea levels. Now, you have hundreds of miles of coastline in North Carolina where the sea is rising and property values are going to be lost. We are talking money here. We are not talking soft, liberal stuff. This is real, and people don't want to even look at it. In Florida and Wisconsin, they took a novel approach and they said: We are not even going to use the words ``climate change'' in anything. Now, here in Congress, the climate deniers take many forms, from blocking the words ``social cost of carbon'' to directing the Department of Defense to ignore climate change. All the while, the DOD itself highlights the threat of climate change to national security. Republicans like to talk about national security.

Mr. McDERMOTT. If you are serious about talking about national security, you better start talking about the climate change that is going on in the world. Sea lanes across the North Pole are coming, boats are already coming, we are building the Panama Canal wider, and it is opening up on the north end of the globe. Now, this absurdity cannot last, and we have got to begin to do what Mr. Blumenauer suggested. There have to be hearings. Bob Inglis, I knew him when he was here. God, he was a wild-eyed liberal. I couldn't believe what a wild-eyed liberal he was. He came down here talking about a carbon tax. I had a carbon tax. Mr. Larson had a carbon tax. This is not a partisan issue, Democrat versus Republican; it is whether or not you are going to look at the science of what is happening on the globe. I urge people to vote ``no'' on this. You will come back and do it in a couple of years.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, I would like to acknowledge the staff who helped make the Helping Hospitals Improve Patient Care Act possible. First, I would like to thank the Democratic staff: Amy Hall, Sarah Levin, Melanie Egorin, Daniel Foster, JC Cannon, and Daniel Jackson. And on the Republican side: Emily Murry, Lisa Grabert, Nick Uehlecke, and Taylor Trott. I would also like to thank the staff at CMS: Ira Burney, Anne Scott, Lisa Yen. And the staff at the House Office of Legislative Counsel: Ed Grossman--Ed has been there for as long as I have been here, so any bill that gets out of here without Ed looking at it is a pretty rare bill--and Jessica Shapiro, who was instrumental in drafting this legislation and for years has taken a leading role in drafting countless other Medicare bills in the House. Finally, I would like to thank the staff of the Congressional Budget Office who worked on this bill: Tom Bradley, Lori Housman, Kevin McNellis, and Jamease Kowalczyk. We appreciate their hard work.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, I rise today to introduce legislation to protect the health regulations of the United States, and thereby the health of Americans, from the pernicious use of the Investor-State Dispute Settlement mechanism that exists in free trade agreements like NAFTA and the TPP. Abuses of the ISDS provision have already had harmful effects on the health of our Canadian neighbors, as an ISDS lawsuit essentially forced the Canadian government to abandon its ban of the gasoline additive MMT, a known human neurotoxin. My legislation, which amends the Bipartisan Congressional Trade Priorities and Accountable Act of 2015, known as the TPA, makes it explicitly clear that protecting the health of Americans is a paramount trade negotiating objective of the United States. As it stands today, the TPA falls short of this goal. During negotiations of the Trans Pacific Partnership, several nations demanded the ability to dismiss ISDS claims made against their tobacco control measures. This insistence was a tacit acknowledgment that companies use ISDS lawsuits to challenge reasonable state health regulations. But why only single out tobacco control measures? What about safeguards for other public health measures like lower drug prices under Medicare, food safety regulations, clean air and water regulations, or the Toxic Substances Control Act recently passed by Congress? The fact that a last minute ``tobacco carve-out'' was inserted into the TPP is proof that the trade negotiating objectives currently in TPA are not explicit enough to protect the health of Americans. The purpose of my legislation is to ensure that all health regulations in the United States are protected from unscrupulous abuses of trade arbitration mechanisms that fall outside of the United States justice system. My legislation instructs the United States Trade Representative to explicitly ensure that no trade agreement gives an investor group the power to hold the health of Americans hostage for monetary gain. Trade is important to our society, but it should not come at the expense of the health of Americans. I urge my colleagues to support this legislation.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, today I rise to draw attention to a development that remained largely unnoticed; discontinuation of the Fulbright Congressional Fellowship program run by the American Political Science Association (APSA). My office has regularly welcomed international fellows. We continue to host these talented professionals from different areas around the world. Between 2004 and 2008, I hosted two APSA-Fulbright Congressional Fellows from India; an academic, Medha Nanivadekar, and a New Dehli journalist, Prasad Venkateswara Kunduri. These Fellows brought a great deal of depth and perspective to the office at a time when relationship between United States of America and India was expanding like never before. Today, the U.S. and India are engaged across more than 60 fields. Prasad, in particular came at a time when we in the Congress were deeply engaged and debating the Civil Nuclear Deal with India. I valued his perspective and understanding of the intricacies of discourse within India on the issue as well as the impact the process could have on U.S.-India relations and domestic politics. During 2007-2008, Prasad spent a year in Washington, D.C. Since his return, he remains in contact with me and my office. He continues to share his experiences as a Fellow with his colleagues to promote a greater understanding of how the U.S. Congress works. When I have traveled to India he is engaged in events related to my trip. I continue to appreciate his perspective when working on issues related to India. Since we do not have a regular official delegation-level exchange program between the U.S. Congress and Parliament of India many of us travel to India as part of various programs organized by different groups or Co-Dels which include special events like one that retraced Martin Luther King's journey in India. Events organized by former Fellows like Prasad help bridge the gap between U.S. law-makers and people. These Fellows who come to Washington, D.C. and spend a year on The Hill, help create a relationship with U.S. law-makers, staff, policy planners, advocacy groups and colleagues in the program. What they take back enriches the United States' relationship with these communities. The Fulbright-APSA Congressional Fellowship Program was part of APSA's Congressional Fellowship Program. It was established over 60 years ago and remains a highly selective, non-partisan, early-to-mid career program devoted to expanding knowledge and awareness of Congress. The program enjoys a reputation for excellence among those concerned with the quality of government and the ways in which democracies function. The APSA-Congressional Fellowship ended after a five year run. Appreciating the initiative and contribution of the program, I urge the Fulbright Board to reconsider and fund APSA Congressional Fellowship.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, today I am proud to introduce the Medicare Dental, Vision, and Hearing Benefit Act of 2016. This legislation expands the Medicare benefit package to include comprehensive coverage of dental, vision, and hearing care. The Medicare program commemorated its 50th anniversary last year, and there are many reasons to celebrate this important milestone. Thanks to Medicare, 55 million seniors, patients with End-Stage Renal Disease, and people with disabilities enjoy the peace of mind and security that comes with health coverage. But there is still a tremendous amount of work that must be done to ensure that the coverage that Medicare provides truly meets the needs of all of its beneficiaries. Unfortunately, many gaps continue to exist in Medicare's covered benefits. These gaps force beneficiaries to shoulder burdensome out-of- pocket costs and, in many cases, to do without the care they need. One of the largest holes in the Medicare benefit package is the lack of coverage for dental, vision, and hearing care. In fact, not only does Medicare not pay for these crucial health services, but current law specifically excludes them from coverage. This is a shortsighted and harmful policy that has serious ramifications for beneficiaries. Lack of dental care is linked strongly with numerous health problems, including potentially fatal and costly conditions such as cardiovascular disease and oral cancers. Similarly, untreated vision disorders--which are among the most common and costly conditions facing the elderly--substantially increase the risk of expensive hospitalizations due to injuries associated with falls. And hearing loss, which is pervasive among beneficiaries, often leads to social isolation, depression, and cognitive impairments. Yet the majority of elderly Americans who need hearing aids do not have them-- in large part due to costs. It's time for Congress to recognize that Medicare must be expanded to address the full spectrum of beneficiaries' health needs. The Medicare Dental, Vision, and Hearing Benefit Act does just that. The bill repeals the outdated statutory exclusions that prevent Medicare from providing coverage of dental, vision, and hearing services and related supplies. It amends Part B to provide coverage of necessary health services, including routine dental cleanings, fillings and crowns, root canals, refractive eye exams, and exams for hearing aids. It provides coverage of items such as dentures, eyeglasses, contact lenses, low vision devices, and hearing aids as durable medical equipment, prosthetics, and orthotic supplies. And to control costs and facilitate implementation of these major reforms, benefits will be subject to reasonable limitations and will be phased in gradually in the years following enactment. All too often, policy discussions about Medicare focus on how much of the program to cut and how to further shift costs onto beneficiaries. This is the wrong approach. It's time for Congress to recognize that Medicare must be strengthened, not cut, and that benefits must be expanded, not scaled back. The Medicare Dental, Vision, and Hearing Benefit Act will make Medicare a stronger, fairer, and more comprehensive program for the 55 million beneficiaries it serves. I urge my colleagues to join me in working to enact this and other important expansions of Medicare now and in the future.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, occasionally we have an extra minute on the floor, and it makes sense to acknowledge some people that we trust and rely upon and we don't ever mention, so I would like to just say thank you to the Democratic staff: Sarah Levin, Melanie Egorin, Daniel Foster, JC Cannon, and Daniel Jackson; on the Republican side: Emily Murry, Lisa Grabert, Nick Uehlecke, Taylor Trott; to the staff at the CMS who helped put this bill together: Ira Burney, Anne Scott, Lisa Yen. And to the staff at legislative counsel: Ed Grossman--Ed has been there for as long as I have been here, so any bill that gets out of here without Ed looking at it is a pretty rare bill--and Jessica Shapiro is his assistant. The Congressional Budget Office gets in on these deals as well: Tom Bradley, Lori Housman, Kevin McNellis, and Jamease Kowalczyk. I am from Chicago. I should be able to pronounce a Polish name. We appreciate their hard work. Mr. Speaker, I yield back the balance of my time.

Mr. McDERMOTT. Mr. Speaker, I yield myself such time as I may consume. I rise today in support of the Helping Hospitals Improve Patient Care Act. This bill makes important changes that will help hospitals continue to provide high-quality care to patients as they implement the recent payment reforms. This is bipartisan legislation unique in itself that I am happy to have introduced with the gentleman from Ohio (Mr. Tiberi). I thank the chairman for his willingness to collaborate on this bill. I also thank the staff of the Ways and Means Committee for their hard work in helping us come to an agreement on language that Members of both parties can fully support. This final bill isn't perfect, but it is truly a bipartisan product that reflects the spirit of compromise. Whenever we head back to our districts, we all hear from our hospitals about the effects that our policies are having back home. Although we made a smart change to hospital payments when we passed the Bipartisan Budget Act last year, we are beginning to recognize the unintended consequences of the legislation. We did not really expect everything that is happening. Many hospitals that were in the process of constructing outpatient departments will be hit with unexpected payment cuts due to the BBA. In addition, many cancer hospitals would be harmed by the new payment rules. This bill fixes these problems in a narrowly tailored way that doesn't undermine the goals of the BBA. Moving forward, hospitals will no longer be encouraged to consolidate by buying up physician practices for the purpose of billing Medicare at an inflated rate. This is a good policy that is consistent with the recommendations of a GAO report that was released last year. But facilities that were under development when we passed the BBA, as well as cancer hospitals, will be protected from these changes. This isn't a giveaway to hospitals. The industry will pay the full cost. In addition, this bill makes refinements to the readmissions reduction program. To ensure that hospitals that serve a large number of low-income patients are not unfairly penalized, the bill will require CMS to make apples-to-apples comparisons between similar facilities. As we await additional data that will soon be available thanks to the IMPACT Act, this will ensure that the hospitals are not hit with undeserved penalties due to a flawed methodology. Finally, I am happy that we are also able to come to an agreement on a bipartisan improvement to the beneficiary enrollment process. Each year, thousands of people enroll in Medicare; and thanks to this bill, seniors will have more information about their benefit options when they become eligible for Medicare. Providing complete and easy-to- understand information is critical. The decisions that beneficiaries make when they enroll in Medicare have serious, long-term implications, including a potential lifetime penalty if they fail to sign up for part B. This bill will also help beneficiaries make informed decisions by improving the Welcome to Medicare package. I, again, thank my colleagues on both sides of the aisle for working together on this bill. I am pleased we were able to craft a bipartisan compromise, and I look forward to continuing to work together on these and other important issues in the weeks ahead. I reserve the balance of my time.

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

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

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, today, along with fellow Members of Congress, Erik Paulsen, Keith Ellison, and Dave Reichert, I am introducing bipartisan legislation to improve the Low Income Housing Tax Credit to ensure low-income families do not have to choose between stable, affordable housing and education. The Low Income Housing Tax Credit is a highly successful tool for financing affordable housing and one of the premier examples of the government leveraging its resources in order to maximize outcomes through public-private partnerships. Unfortunately, a well-intentioned limitation called the ``student rule'' currently forces some of the most in-need to choose between housing and education. The ``student rule'' was designed to prohibit Low Income Housing Tax Credit funds from being used to construct dormitories and to prevent college students, who often have temporarily low incomes, from utilizing resources meant for individuals and families with more serious and longer-term housing needs. Unfortunately, there are no exceptions for those who want to pursue full-time education and are truly in need of housing assistance. Because of this, students may lose access to Low Income Housing Tax Credit-funded housing units if they go to school full-time. Alternatively, if they choose to attend school part-time in order to keep their LIHTC housing eligibility, these students may lose access to grants, loans, and scholarships that are limited to full-time students. The unintended outcome of the ``student rule'' is to hold back truly low-income individuals trying to obtain an education. Our legislation adds two exceptions to the student rule; for formerly homeless youth and for formerly homeless veterans. Both of these populations are vulnerable to a return to homelessness. Ensuring they can go to school while maintaining access to affordable housing can help prevent this regression and promote financial independence. These small changes can provide immeasurable help and I hope all of my colleagues will join me in passing this legislation.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, I rise today to introduce the Medicare Beneficiary Enrollment Improvement Act. This bill provides newly- eligible Medicare beneficiaries with clearer, easier-to-understand information in their Welcome to Medicare package. This will help beneficiaries make better informed decisions regarding their options for receiving benefits through the Medicare program. The decisions that newly-eligible beneficiaries make have consequences that can last a lifetime. For example, individuals who opt out of Part B coverage during their initial enrollment period must pay a lifetime premium penalty of 10 percent for each 12-month period in which they were not enrolled. By reforming the Welcome to Medicare package, this bill makes a small but important improvement that will provide beneficiaries with the information they need to fully understand their options.

Mr. McDERMOTT

Mr. McDERMOTT. Mr. Speaker, I come down here to oppose this bill. I am not on the committee, but I was sitting in my office and it made me angry to hear people down here talking about H.R. 897. You put out a title that says Zika Vector Control Act. That sounds like a good thing. People ought to be happy we are going to control the specter that is out there. But it is a lie. This does nothing about Zika. It doesn't do anything with the research that the President has asked the money for. What it does simply is turn the applicators and the pesticide manufacturers loose on this country again. I have been here long enough to remember all of the problems with the bird eggs that had soft shells and the birds were dying. All these animals were dying all over the place because of DDT and all of the things that happen with that kind of application freely in this society. One of the things that you have to think about and what I would caution my congressional friends in the Republican Caucus of is that you ought to learn from history. Philadelphia was once full of malaria. Philadelphia was a malaria city. You kept the windows closed at night because you didn't want to get malaria. Now, what we are seeing today because of global warming is that moving north from the equator are the organisms that create disease. I heard somebody from Louisiana say: Oh, my God. We have got malaria. We have got all kinds of problems in Louisiana. You are going to have them. You can find evidence everywhere that these organisms are there. But the answer is not to let there be unrestricted and uncontrolled application of pesticides. That doesn't solve the problem because what it does is it creates another set of illnesses related to the effects of pesticides on human beings and on animals and on reproduction. So what you are doing is you are saying: Well, if you spread this stuff out on the ground and all over the water and people are going to get in contact with that water, there is no question about it, directly or indirectly, and you are going to have the other diseases that come from this. I won't give a whole long lecture on the effects of pesticides on people, but I will remind Members about something called Agent Orange. Guys like me who were around during the Vietnam war saw that stuff being sprayed all over the trees. People said: Oh, that doesn't do anything. It is just that the leaves drop off. Then we had an epidemic of physical illnesses that were secondary to Agent Orange. We told veterans for years: It is not a problem. It is not a problem. It was not that Agent Orange that got you. Then we found out that, in fact, it was, and we have been paying and paying and paying.