Joseph Pitts

Mr. PITTS

Mr. PITTS. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise today in support of H.R. 1190, the Protecting Seniors' Access to Medicare Act of 2015. Mr. Speaker, the bill before us today repeals the Independent Payment Advisory Board, IPAB, one of the most ominous provisions in the sweeping overhaul of health care known as the Affordable Care Act. The stated purpose of IPAB is to reduce Medicare's per capita growth rate. The Board is to be made up of 15 unelected, unaccountable bureaucrats--by the way, you can't have a majority of docs on the Board--who will be paid $165,300 a year to serve 6-year terms on the Board. This panel of 15 unelected and unaccountable government bureaucrats is tasked with reducing Medicare costs through arbitrary cuts to providers, limiting access to care for seniors. If Medicare growth goes over an arbitrary target, the Board is required to submit a proposal to Congress that would reduce Medicare's growth rate. These recommendations will automatically go into effect, unless Congress passes legislation that would achieve the same amount of savings. In order to do so, Congress must meet an almost impossible deadline and clear an almost insurmountable legislative hurdle. The Board has the power to make binding decisions about Medicare policy, with no requirement for public comment prior to issuing its recommendations, and individuals and providers will have no recourse against the Board because its decisions cannot be appealed or reviewed. In other words, the Board will make major healthcare legislation essentially outside the usual legislative process. The Board is also limited in how it can achieve the required savings. Therefore, IPAB's recommendations will be restricted to cutting provider reimbursements. In many cases, Medicare already reimburses below the costs of providing services; and we are already seeing doctors refusing to take new Medicare patients--or Medicare patients at all--because they cannot afford to absorb the losses. Any additional provider cuts will lead to fewer Medicare providers, and that means that beneficiary access will suffer. Seniors will be forced to wait in longer and longer lines to be seen by an ever- shrinking pool of providers or have to travel longer and longer distances to find a provider willing to see them. Clearly, Medicare growth is on an out-of-control trajectory that endangers the solvency and continued existence of the program. IPAB, however, is not the solution. Mr. Speaker, the House voted 223-181 in 2012 to repeal the Independent Payment Advisory Board. Today, H.R. 1190, Protecting Seniors' Access to Medicare Act of 2015, enjoys the support of 235 of our House colleagues who have signed on as cosponsors. The time has come for the House to once again repeal this flawed policy, and I urge all of my colleagues to support H.R. 1190. I reserve the balance of my time.

Mr. PITTS. Mr. Speaker, at this time, I am pleased to yield such time as he may consume to the gentleman from Florida (Mr. Bilirakis), a valued member of our Health Subcommittee.

Mr. PITTS. Mr. Speaker, I would say to the distinguished minority whip, I do support Ex-Im Bank and urge my leaders to act on it. We are together on support of that. Let me just mention a few things to correct the record. Number one, we had Secretary Burwell before the committee earlier this year and Dr. Larry Bucshon, on our Health Subcommittee, asked her specifically, when the IPAB cuts would begin to take effect. She said in 2019. In fact, the President's own budget request would begin the cuts of IPAB in 2019. Now, you don't have to have the members of the IPAB appointed in order to have the cuts. The law, IPAB, designates the Secretary of HHS with the authority to make those cuts. To overcome those cuts, you really have to have two-thirds votes in the House and the Senate, with commensurate cuts from somewhere else in Medicare to replace those cuts that you are overcoming. So this is a Board that has tremendous power that will deal with provider payments and cuts. We just dealt with the SGR, the sustainable growth rate, in a bipartisan manner. We acted to repeal the sustainable growth rate that required cuts to provider payments for seniors, and it was supported overwhelmingly. But if you liked the SGR, you will love IPAB. This is the SGR on steroids. It will be very difficult to overcome these 15 unelected bureaucrats, experts, whatever you want to call them--it can't be a majority of docs, by the way--or the Secretary, whoever makes the recommendations. We use the prevention fund as a pay-for, taking funds from the prevention fund until 2025 to reach the $7.1 billion. But this prevention fund gets $2 billion every year, beginning this year and every year ad infinitum. So $2 billion in 2015, 2016, '17, '18, '19, '20, '21, '30, '31, '40, '41. Every year, the Secretary gets $2 billion to use at her sole discretion. She doesn't have to use it for public health purposes. She has sole discretion on how this money is used. Would you like to know some of the things she has used the money for so far? Well, $450 million was used for the Navigator program and implementing the Affordable Care Act; $400,000 has been used for pickle-ball; $235,000 for massage therapy, kick boxing, and Zumba classes, whatever that is; $7.5 million on promoting free pet neutering; $3 million for the New York Department of Health to lobby for the passage of a soda tax; money for gardening projects, fast food, small businesses, bike clubs. Rather than spend money on questionable projects, lobbying campaigns for higher taxes, and for Affordable Care Act media campaigns, H.R. 1190 would rather use these funds to protect Medicare seniors and their health care because the money for the operation of IPAB, for these salaries, for their travel, for all their expenses comes directly out of the trust fund moneys for seniors, used for seniors and those with disabilities. That is wrong. We are constraining. We are not repealing the prevention fund to pay for this, but we need to constrain the use of that fund. And good public health policy ought to come before the Congress, not be at the sole discretion of this one Secretary or czar or however you might want to term it. So, Mr. Speaker, I am pleased to speak in favor of this legislation, H.R. 1190, and I urge the Members to support it. I reserve the balance of my time.

Mr. PITTS. I reserve the balance of my time.

Mr. PITTS. Mr. Speaker, I yield myself the balance of my time. While the programs enumerated by the gentleman from Maryland are laudable, there is nothing in the prevention and public health fund that guarantees that these will be funded or that they are priorities. It is at the sole discretion of the Secretary as to what she would allocate the funds for. And rightly, these kinds of funds should come before Congress, and Congress should approve these kinds of public health funds. I might mention that CBO estimates that H.R. 1190, the Protecting Seniors' Access to Medicare Act of 2015, as amended, would have no budgetary effect on fiscal years 2015-16. It would reduce direct spending by $1.8 billion over the 2016-2020 period, and reduce the direct spending by $45 million over the 2016-25 period. With that, Mr. Speaker, I urge Members to support H.R. 1190, the Protecting Seniors' Access to Medicare Act, and repealing IPAB. I yield back the balance of my time.

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

Mr. PITTS

Mr. PITTS. Mr. Speaker, with the Supreme Court about to rule on the legal definition of marriage, I rise in support of States like Pennsylvania that have defined marriage as between a man and a woman. The Commonwealth of Pennsylvania was founded on religious tolerance by William Penn. In Europe, whoever was most popular and powerful in a given place and time tried to force minorities to violate their beliefs, and that was why so many different groups of people came to America and particularly to Pennsylvania, religious minorities such as the Quakers, the Amish, the Mennonites, the Moravians, and others. Philadelphia has the most synagogues per capita of any city in the United States. Pittsburgh and Harrisburg also have significant Jewish populations. Pennsylvania continues the tradition of respecting each other, even when they disagree. We hear a lot of talk about diversity these days, but many of those same people who tell us they want diversity are also trying to force their views on others by law. States that, through the democratic process, have defined marriage should not be overridden by five Federal unelected judges.

Mr. PITTS

Mr. PITTS. Mr. Speaker, the bill before us today expands an annual regulatory schedule for Medicare Advantage (MA) payment rates so that stakeholders have the necessary time to review and provide feedback to ensure seniors continue to have access to quality, low-cost plans of their choosing. H.R. 2507, the Increasing Regulatory Fairness Act of 2015, was introduced by my colleague, Representative Kevin Brady (TX), Chairman of the Health Subcommittee of Ways and Means, and I cosponsored along with Mike Thompson (CA), Pete Sessions (TX), and Kyrsten Sinema (AZ). This bipartisan, commonsense legislation will facilitate greater understanding and collaboration between industry stakeholders and regulators, and will offer a greater opportunity for public input in the establishment of policies affecting the MA and Part D plans. Since 2006, when the Medicare Modernization Act's official implementation, and the Medicare Advantage/Part D call letter and rate notice were around 16 pages long, a two-week comment period may have been adequate. Today, however, that document has grown to nearly 150 pages--and the comment period--still just 15 days--is simply not enough time for plans that now serve one-third of the Medicare population to analyze and gather substantive comments on increasingly complex policy changes. This bill would increase that comment period to 30 days, a strong step towards regulatory fairness for the successful Medicare Advantage/Part D programs. Expanding this comment period allows for a fair amount of time in which both stakeholders, as well as Members of Congress and Committees, have sufficient time to understand the policy implications and formulate comments, if they so choose. More time equals better, more thoughtful policies. Mr. Speaker, by approving this legislation, we will be giving seniors, insurance plan providers and other interested stakeholders adequate time to comprehend and provide comments on proposed changes to Medicare Advantage plans. This is an important and necessary legislative change and I urge all of my colleagues to support H.R. 2507.

Mr. PITTS

Mr. PITTS. Mr. Speaker, as the House debates giving guidelines to the President on opening up American trade, I rise to urge the President to secure a verifiable nuclear agreement with Iran. America's response to Iran's nuclear program will be the most important foreign policy decision in a generation. This problem grows more urgent by the day. On June 1, The New York Times reported that Iran's nuclear stockpile had grown by 20 percent over the previous year and a half. Secretary of Energy Moniz revealed that Iran was 2 to 3 months away from a nuclear weapon in April, which was 2 months ago. A nuclear agreement without verifiability is not an agreement at all but an act of faith in the worst state sponsor of terrorism in the world. I want to remind the President that he has repeatedly said that a nuclear- armed Iran is not a challenge that can be contained and that the United States will do what it must to prevent Iran from obtaining a nuclear weapon. I hope that this will not be another vanished red line for the President, who has also said, ``As President, I don't bluff.''

Mr. PITTS

Mr. PITTS. Mr. Speaker, on behalf of myself, the Honorable David E. Price, and the Congressional Moldova Caucus, the Republic of Moldova is a friend of the United States of America, and a partner country of the North Atlantic Treaty Organization. Like Ukraine and Georgia, Moldova is part of a strategically significant segment of Eastern Europe that looks toward Europe for a promising and prosperous future. The full integration of Moldova into the European Union is also in the strategic interest of the United States. As has been the case with other Eastern European nations that fully integrated into the European Union, integration will help Moldova develop new economic opportunities and contribute to the overall security and stability of the region. The Republic of Moldova signed an Association Agreement with the European Union in 2014 and is currently implementing its ambitious Free Trade Agreement (DCFTA). Moldova also reached a visa liberalization agreement with the EU. As the EU Summit in Riga convenes, we call on our allies in Europe to fully engage the Republic of Moldova and to chart out its bid for accession into the Union under the terms of the Lisbon Treaty. A failure to fully recognize the aspirations and legal rights of the Republic of Moldova in its application only stands to promote the false narrative that Moldova, along with Ukraine and Georgia, falls into an `exclusive sphere of Russian interests in Europe', and runs counter to the democratic values of the United States and Europe. Congress and the Obama Administration should continue to support the Republic of Moldova in its statecraft, economic and security capabilities. Progress demonstrated by the Republic of Moldova on a sustained path towards Western integration should be recognized. For example, despite Moldova's entering into an Association Agreement with the European Union, the Russian Federation continues to ban imports of Moldovan products, exert pressure on the Moldovan people, and disseminate propaganda to the Moldovan people. The Russian Federation continues to maintain a substantial military presence in Transnistria, in violation the Russian Federation's commitments at the Istanbul Summit. The Russian Federation continues to use this military presence--along with its fuel exports and intelligence assets within Moldovan territory--to continually destabilize the region. Smaller and more fragile states across the globe face increasing pressure, destabilization and aggression from larger, totalitarian governments. These states are susceptible to falling into `regional spheres of influence' without sustained, consolidated efforts of support by the world's democracies. Last Congress, the House and Senate both passed resolutions calling on the Obama Administration to support the Republic of Moldova's capabilities in reforming its judicial sector, fighting corruption, and reforming economic markets. In addition to continuing in these important reforms, we urge the Obama Administration to work in bilateral and multilateral forums to monitor human rights abuses in the region and help advance U.S. investment in Moldova's energy markets to lessen its dependence on Russian sources. We are struck by the Moldovan people's demonstrated commitments to free markets, democracy, and the rule of law. The United States must continue to serve as a leader in the community of Western nations by supporting the people of Moldova in their commitment toward integration.

Mr. PITTS

Mr. PITTS. Mr. Speaker, I rise today in support of the Pain-Capable Unborn Child Protection Act, which would restrict the practice of abortion after the sixth month of an unborn child's life. Today marks the second anniversary of the conviction of Dr. Kermit Gosnell of Pennsylvania, who ran a late-term abortion mill in Philadelphia. Despite media silence about the case, we were able to learn that Dr. Gosnell regularly delivered third-trimester babies and then snipped their spinal cords, their necks, with scissors. He used unclean instruments, spreading infections among the women he treated, hospitalizing many of them, if he even allowed an ambulance to be called. Most of his victims were poor. One mother, a Ms. Mongar, died in the process. It seems that some Members of this body want to regulate things like lightbulbs and rainwater and farm dust, but leave women helpless before the Dr. Gosnells of the world, late-term abortionists driven by profit, undeterred by the painful death of countless innocent lives. We must protect these women and children by passing the bill.

Mr. PITTS

Mr. PITTS. Mr. Speaker, on this day that the Supreme Court is hearing oral arguments on marriage, I want to read a quote. I believe marriage is not just a bond but a sacred bond between a man and a woman . . . I am committed to the sanctity of marriage, to the fundamental bedrock principle that exists between a man and a woman, going back into the mists of history as one of the foundational institutions of history and humanity and civilization . . . its primary, principal role during those millennia has been the raising and socializing of children for the society into which they become adults . . . Every State reserves the right to refuse to recognize a marriage performed in another State if that marriage would violate the State's public policy. Indeed, the Supreme Court has long held that no State can be forced to recognize any marriage. That is what the case law has held . . . the Supreme Court has historically held that States do not have to recognize laws of other States that offend their public policy, it is assumed that any challenge would be futile. Mr. Speaker, that was Hillary Clinton in 2004. She was right.

Mr. PITTS

Mr. PITTS. Mr. Speaker, pursuant to House Resolution 173, I call up the bill (H.R. 2) to amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and strengthen Medicare access by improving physician payments and making other improvements, to reauthorize the Children's Health Insurance Program, and for other purposes, and ask for its immediate consideration in the House.

Mr. PITTS. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days to revise and extend their remarks and to include extraneous material on H.R. 2.

Mr. PITTS. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise today in support of H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015, sponsored by Congressman Burgess of Texas. Mr. Speaker, I rise in support of H.R. 2, the bill I just referenced. Four years ago, upon taking leadership of the Energy and Commerce Health Subcommittee, I made it one of my goals to end the patchwork of doc fixes and repeal the sustainable growth rate. Now, we are here on the floor of the House with a bipartisan policy and a bipartisan set of pay-fors. There are many who thought that this day would never come. We are replacing the SGR, once and for all, with a system that allows greater freedom for physicians to practice medicine. We do this without threatening access to health care for seniors. Instead of unrealistic price controls, we are instituting a cooperative process to make our healthcare dollars go farther. We are also replacing a portion of the projected savings with real entitlement reforms, reforms that could reduce spending by $295 billion in the coming decades. Let's not make the mistake of saying that this is saving Medicare. The bill makes important reforms that put the program on a better path, but there is much work to do before we achieve that goal. Future generations of Americans have understandable doubts about whether Medicare will be there when they retire. They pay into the program just as my generation did, but the current system of funding the program will not deliver on that promise for them. The extraordinary progress represented by the bill before us today is the result of a vision for the future and years of hard work. That vision was wholeheartedly supported by Speaker Boehner, and there are many more to thank: Chairman Upton, for his persistence in leadership; current Ranking Member Pallone and former Ranking Member Waxman for working with us to get a policy we could all agree on; also Dr. Burgess, the primary sponsor of today's bill and the vice chairman of the Health Subcommittee in the two past Congresses. I would especially like to thank the dedicated staff that spent countless hours and sacrificed weekends to make this happen: Dr. John O'Shea, Robert Horne, Josh Trent, Clay Alspach, Michelle Rosenberg, Heidi Stirrup, and Monica Volente, on my personal staff. Finally, we should see this bill as a first step toward strengthening and saving Medicare. This can't be the end of the road. Mr. Speaker, I reserve the balance of my time.

Mr. PITTS. Mr. Speaker, I am pleased to yield 1 minute to the gentleman from Mississippi (Mr. Harper), an outstanding member of the Energy and Commerce Committee and a good advocate on health issues.

Mr. PITTS. Mr. Speaker, I am pleased to yield at this time 1 minute to the gentlelady from North Carolina (Mrs. Ellmers), another valued member of the Health Subcommittee.

Mr. PITTS. Mr. Speaker, I am pleased to yield 1 minute to the gentleman from Tennessee (Mr. Roe), the chairman of the Doctors Caucus, who should be recognized for his tireless efforts to build support for this bill.

Mr. PITTS. Mr. Speaker, I am pleased to yield 1 minute to the gentleman from Indiana (Mr. Bucshon), a member of the Health Subcommittee.

Mr. PITTS. Mr. Speaker, I am pleased to yield 1 minute to the gentlewoman from Tennessee (Mrs. Blackburn), the vice chair of the Energy and Commerce Committee.

Mr. PITTS. Mr. Speaker, I join in thanking the minority leader for her role in achieving this bipartisan compromise. It is really historic. I think it is appropriate that this is happening on her birthday, and I join my colleagues in wishing her a happy birthday today. Mr. Speaker, could I inquire of the time remaining.

Mr. PITTS. Mr. Speaker, I yield 1 minute to the gentleman from Florida (Mr. Bilirakis), another member of the Health Subcommittee.

Mr. PITTS. Mr. Speaker, I am very pleased at this time to yield 1 minute to the gentleman from Ohio (Mr. Boehner), our Speaker, who deserves a lot of credit in coming up with this bipartisan compromise.

Mr. PITTS. Mr. Speaker, I am very pleased at this time to yield such time as he may consume to close to the gentleman from Michigan (Mr. Upton), the chair of the Energy and Commerce, a master of bipartisan compromise who deserves a great deal of credit for being here today.

Mr. PITTS. Mr. Speaker, I am pleased to yield 2 minutes to the gentleman from Texas (Mr. Burgess), the prime sponsor of the legislation, who deserves a great deal of credit for where we are today.