Tim Ryan

Mr. RYAN of Ohio

Mr. RYAN of Ohio. I thank the gentleman from New Jersey. I always learn something when he is around. This bill, we ask: How does it affect the country? And it only makes good sense that if we are reducing health care costs over time, that will reduce the deficit; because the government is so intertwined with Medicare and Medicaid and veterans' benefits and everything else, taking the health care system and putting in these fixes and including everybody in the system so that they don't run up health care costs, and fixing the waste in Medicare and those kinds of things, at the end of the day will be very, very beneficial for the deficit. I have got a district in northeast Ohio. Very specifically, Mr. Speaker, I just want to state what this bill is going to do for those people in Ohio who have been for 30 years in a recession, for the most part. They lost the steel industry, lost the rubber industry, and lost a lot of the manufacturing in the United States and have been hurt very, very badly. I wish this was in place 30 or 40 years ago and it would have saved a lot of people from a lot of suffering over time. This bill alone will improve coverage for 355,000 citizens in the 17th Congressional District. This particular bill will give tax credits and other assistance for up to 180,000 people. There a lot of people in my district who have a family of four, make about $50,000 a year. That family, under this bill, will get a $5,800 tax cut for them to be able to afford health insurance. Last year alone in the 17th Congressional District, we had 1,700 families, neighbors of mine--this is all throughout the country--who went bankrupt because of the health care system. Because of health care issues, they went bankrupt, and many of those people had health insurance. They actually had health insurance and still went bankrupt. How many kids, how many families, how many parents had to file for bankruptcy in this country last year because of the current health care system that we have here? So 53,000 young adults in the 17th Congressional District will be able to stay on their parents' health insurance because we extend it up to 26 years old. This bill will guarantee 9,300 people in the 17th Congressional District will no longer be able to be denied health insurance because of a preexisting condition. This is where the rubber meets the road. I mentioned about the $250 that the Medicare part D recipients will get this year, a $700 savings in Medicare part D next year. They will save $3,000 by 2020. So this is a bill that has great significance. We will have enough money in this bill, just in my congressional district, for four new community health clinics. We already have a few sprinkled around, but four new community health clinics so people can go and get the kind of preventive care that we are focused on in this bill. Hospitals will save $11 million. This bill is a good bill. Is it a perfect bill; not even close. Nothing is perfect. We are all imperfect here, so why would we create something that is perfect? But we have extended it. We implement things over time so we have an opportunity to tweak things. As the gentleman from New Jersey said, this reduces the deficit by $1.2 trillion over the next couple of decades. That's what this is all about for our kids and our grandkids, to have the kind of future that we want. So I think it is an important piece of legislation. I am excited about it. If I can say lastly--because the Ohio State Buckeye's basketball game is coming on and we have to do our part, Mr. Boccieri and I, to make sure that we root them in as much as we are rooting in the health care bill this weekend--I want to say this, and I don't mean to be glib or arrogant, but I want to be honest. I look forward to the campaign in November. I looked forward to going out and talking to the constituents in my district and around the State of Ohio about what is in this bill. And I very much look forward to the Republican Party running on a platform of repealing this bill, repealing the ban on preexisting conditions for children, repealing the ban for preexisting conditions on adults, repealing the tax credits for small businesses, repealing the tax credits for someone in Niles, Ohio, who makes $50,000 a year and will get $5,800. I want to have that debate. I want to have the debate where the Republicans come up and they say we need to repeal that and we need to make sure that our seniors, we continue to keep the doughnut hole wide open. We don't want to close it. I look forward to that debate and look forward to the debate saying that we should keep the lifetime caps in and keep the status quo. So it is going to be an exciting time in our country. And as I heard one of my colleagues say, we are debating real issues here. And we have an opportunity to talk about what is in this bill and how it is going to benefit the American people. I will then yield back the balance of my time.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. I appreciate the opportunity to come up and continue the discussion on health care from a little different perspective than my friends on the other side have been giving the American people. I want to talk about the need for health care reform in the United States of America and what we need to do here in the Congress to get it done. We had a nice discussion yesterday in Cleveland with the President of the United States. I've been one who has said that if we're going to do this, we need to do it. We have got other issues that we're dealing with simultaneously now with jobs, passing a second jobs bill. My community back in northeast Ohio has benefited a great deal from the original stimulus package that has passed here. But we need to continue the work of getting the American people back to work. And in the short term, that means job packages, that means financial reform so we should bring some integrity back. But in the next week or so, we have to pass this health care bill. And I know there's been a lot of controversy surrounding this bill. There's been an extended discussion over the course of the last year or so on this issue. We have talked about all of the issues, and now it's time for us to have a vote in the House of Representatives--hopefully here in the next week--and pass this bill so that we can move the country forward and start addressing the other issues with regulatory reform on Wall Street, trying to bring some discipline back to the financial system. It's also allowing us to go back and continue to focus on the jobs issue. But under this bill, you talk about long-term economic growth as we try to be competitive in the United States, globally competitive competing with China, competing with India. The American businessperson now has an anchor strapped around their neck in the form of health care costs. And if we think that we can continue to grow our economy, hire American workers, make the proper capital investments, make the investments in technology, if our businesses are asked to compete while dealing with the health care system that over the last 5 years has increased over 120 percent for small business people, we are asking our small business owners to go into the shark-infested waters of the insurance market so that they can cover their citizens, their workers, and then ask to compete on the global playing field. They can't do it. The small business people are screaming for health care reform. Now, you want to get into an ideological battle, but what we are trying to deal with on this side of the aisle are practical, pragmatic solutions to the problems that are facing us, looking at the facts, looking at the issues that are facing our country, and addressing those issues in a bipartisan way. I know many on the other side have said, well, we have been locked out of the debate. I want to know one time when the last President spent 7 hours sitting around a table with people from both parties to discuss any issue, let alone health care. President Bush never sat down, Madam Speaker, for 7 hours. President Bush never came to our caucus and had the kind of discussion and question and answer that President Obama had a few months ago when he went to the Republican Caucus. And I think this shows why he is the President of the United States, by dealing directly with their questions. He was able to do that and has included the Republicans and tried to include the Republicans every single step of the way. But the Republicans are getting their marching orders from their pollsters and their consultants. And one of the memos was leaked early last year, as many of us remember, that said to the Republican Caucus, do not let Obama pass health care, because he will succeed, and the Democrats will succeed, and you will be in the minority for decades. That is what their consultants told them. So right from the get-go, our friends on the other side of the aisle had no interest in being part of the solution here because their pollsters were telling them that they had to defeat this bill before we even knew what the bill was. Our friends on the other side were calling it socialism and government-run medicine before we even had a bill to actually look at and discuss. So they got the media machine all cranked up, got everybody all fired up before we even had something to talk about. So fast forward through a long discussion, long talks where we included both sides of the aisle to try to solve these problems, and now we have a solution. We have a compromise that President Obama has submitted for us to vote on. And we continue to get some numbers, hopefully here tonight, on the exact scoring, but we are close, we know give or take a few bucks where we are at, and we know that this bill will cover 30 million more Americans and this bill has a number of issues in it that are going to benefit the American people. Let's look at some of the issues, some of the pieces of this legislation that will be implemented within the year. Small business tax credits, the President's proposal will allow small businesses tax credits up to 35 percent. We close the doughnut hole in Medicare. Now our seniors have $2,000, $3,000, where it's covered through Medicare part D, and then they fall into a doughnut hole for months and months and months until part D picks back up again several thousand dollars later. Our Medicare recipients have to come out of pocket. We close that hole up. We close that doughnut hole up. We end the rescissions so that insurance companies can't kick you off the rolls once you get sick. We eliminate insurance companies from being able to deny people coverage because they have a preexisting condition. That is in this bill. We have a provision in this bill that says no child can be denied health insurance because they may have a preexisting condition. We eliminate the lifetime caps of policies so that when someone in your family gets sick and they need coverage, that all of a sudden the insurance company can't say, well, you have spent your allotted amount of money, you're on your own. It is our moral responsibility to prevent millions of Americans from getting hurt, from getting hurt under the current health care system. And there is no denying it: free preventative care under Medicare under this provision, free Medicare under private plans in this piece that we are putting together here. Also for people who are 55 and older, between 55 and 64, this creates a temporary reinsurance program until we get the exchange up and running to help offset the cost of expensive health claims for employers that provide health care benefits for those people between 55 and 64 years old. That's what's in this bill. Those are the things that just come online this year. And the improvements will continue. This is a good bill. Is this a perfect bill? Of course it's not. But we have people on the left saying it doesn't go far enough and voting against the bill, and we have people on the right saying it's socialized medicine. But if it were socialized medicine, people on the left would be voting for it. This is a pragmatic bill, a pragmatic solution to the health care crisis in the United States of America. And our friends on the other side of the aisle and our friends in the insurance industry say that we should start all over, we should start from scratch, get out a blank sheet of paper. Well, maybe the insurance industry should start from scratch and go back to 1992 and '93 and revoke all of their increases that they have given to the American insurance consumer over the last 20 years or so, rescind all of those increases. You start over. Let the insurance industry start over, and then maybe we can consider starting over. But people in my district over the last few months, few days, few weeks, were getting 20, 30, 40, 50 percent increases. Small businesses are almost going bankrupt because of the increase of 50 percent to their health care costs. This fixes it. This allows small businesses to go into the exchange, to get tax credits so that they can provide insurance for their employees. Now, some of those things that I read, and I know a lot of our friends on the other side say that people don't want this, here is the poll that says American people don't want this. And I'm the first to recognize and acknowledge that we probably haven't done a very good job of telling the American people what's in this bill. And that was the essence of Speaker Pelosi's comments about when you pass the bill you'll find out what's in it, meaning that when we pass the bill, the rhetoric and the fiction that has surrounded this bill for the longest time will fall away, and there will be a document that we can all point at, and the American people between now and November will be able to look at what has passed. We know what's in this bill. We've been debating this for a month. I like how our friends on the other side in one breath say we're trying to jam it through, and then you look, and the American people are tired of the debates. But you can't have it both ways. Now all of those things that I mentioned, here is a Kaiser poll: tax credits for small business, 73 percent of the American people more likely to support the bill. Tax credits are in the bill. In fact, these are all in the bill. Insurance exchanges, 67 percent of the American people support the insurance exchanges. The ability to keep what you have, 66 percent of the American people are more likely to support this bill if you can keep what you have. You can keep what you have in this bill. Ban preexisting condition denials, 63 percent are more likely to support this provision of banning preexisting conditions denials. Expanding Medicaid, which is what we do, 62 percent; dependent coverage through 26 which means if you're 26 or under, you can stay on your parents' insurance. How many people support it? Sixty percent. Closing the Medicare doughnut holes, as I mentioned earlier, 60 percent; subsidy assistance to individuals, 67 percent more likely to support the bill. So we have not done a good job of messaging this bill, but I will tell you what is going to happen. We are going to have an election in November, and I'm looking forward to it. I'm looking forward to the debate because in the debate our friends on the other side are going to want to repeal this piece of legislation. They are going to run their campaign in November about repealing health care reform. So they are going to have to go out and run commercials saying, those small businesses tax credits are up to 35 percent, we want to repeal them. The ban on preexisting conditions, we want to repeal that. The ban that says no kid, no child can be denied because they have a preexisting condition, they're going to run a campaign in the fall saying, we want to repeal that. The lifetime caps that we're going to eliminate so you can get coverage no matter how sick you get, our friends on the other side are going to run an election saying, we want to repeal that. The subsidies that people are going to get so that they can afford health insurance, our friends on the other side are going to run a campaign in November saying, we want to repeal that. Helping people 55 to 64 get reinsured, they're going to want to repeal that. Closing the doughnut hole in Medicare, I can't wait to go to the senior centers in my district when this has already been implemented and we've started to close that doughnut hole and the seniors have seen some of the progress, and we go in there and we say, our opponents want to repeal that provision where we closed up that doughnut hole. Let's have this debate. Let's have this discussion. Let's do it. That's what this is all about. We implement our agenda, then we go out and defend it. And we know what happened. The 8 years, more like almost two decades, 14 years, 12 years actually, that our friends on the other side were in charge, and then with President Bush controlling the House, the Senate, the White House, our Republican friends on the other side had an opportunity to implement their political philosophy. House, Senate, White House, we got their supply side economics, we got their foreign policy, we got their health care policy, we got their energy policy and we got their education policy. And look what happened. We got their Wall Street policy, and look what happened. We had a collapse of the financial markets, we had college tuition balloon through the roof, we had energy costs balloon throughout the roof, we had health care costs balloon through the roof, the collapse of our economic system, a prescription drug bill that was not paid for with a doughnut hole you could drive a truck through, and a foreign policy that forced us to a war, an elective war in Iraq. All of these things were implemented when our friends were in charge. And we had elections on those. And now we are going to pass health care, and we are going to pass our agenda and you look and you see what happened with this stimulus package, the economy is starting to open up, trying to straighten up Wall Street. But we know we can't move forward until we get health care costs under control. We know small businesses are never really going to be able to grow at the pace and the capacity that they need to grow to with this health care anchor hanging around their neck. Now, I believe that, and many of us on this side of the aisle believe, the government has a moral mission, a mission, a moral mission to protect its citizens. Whether it be terrorists or criminals on the street, there is a moral mission to the government to protect people. And that doesn't stop at the borders. That doesn't just stop with the issues of crime. That responsibility hits every aspect of our society. And if we have an industry that is hurting people, then we have a responsibility to step in and push back that industry and say enough is enough. You're hurting people. In our country, the government has a moral mission to stop that from happening. That is what this debate is all about, yes, the role and the responsibility of government. And the government is not allowed to just completely step aside while industry abuses happen and happen and happen. And that is what this debate is about. That is what this bill of rights, health care bill of rights is all about. And our friends on the other side say, We are for this stuff. They say, We are for it. You pull it out; we are for it. Well, that is interesting, because we had some votes over the last day or so in committee. This is the House Budget Committee that is starting to pass the legislation that is going to be needed. Here we go. Protecting Medicare for America's seniors and closing the prescription drug doughnut hole, 15 Republicans voted against it. Closing the doughnut hole, voted against it. If you talk to them, Well, we are for closing the doughnut hole. We have got to close the doughnut hole. Protecting Americans from insurance caps, as I just talked about, and banning annual and lifetime limits on health care coverage, 15 Republicans voted ``no,'' we don't want to do that. Holding health insurance companies accountable, 15 Republicans voting ``no.'' Bringing down the cost of health insurance for everyone and providing tax credits to small businesses, all of them voted ``no.'' Every Republican on the Budget Committee voted ``no'' for giving tax credits to small business people. I mean, this is the equivalent of our friends on the other side who all voted against the stimulus package, and then they go back to their districts when money is coming in and they say, This bridge, this road, this money is going to create jobs in our district. But you voted ``no'' against the stimulus package. Don't tell anybody. That is the kind of thing that has been going on in Washington. That is called the old Potomac two-step. The old Potomac two-step. So we have these provisions in this bill that, when you pull them out and you explain them to the American people, have anywhere from 57 to 73 percent. This is what the American people have been crying out for. And when this bill passes, we are going to have a lot to campaign on and run on. But our friends on the other side like to talk a little bit about polarizing issues. One of the most recent polarizing issues that they have tried to pull out is the issue of abortion and trying to say that this is going to publicly fund abortions. Well, we have a letter here from, I believe, 25 or so of the top pro- life citizens in our country: Joel Hunter, senior pastor of Northland Church. I believe he was head of Focus on the Family at one point; Jim Wallis from Sojourners Magazine; a lot of evangelical and Catholics; the former associate general secretary of the U.S. Conference of Catholic Bishops, all saying that this Senate health bill upholds abortion funding restrictions. The Catholic Health Association, 600 Catholic hospitals. I went to Catholic school for 12 years. I know where the Catholic church and the Catholic hospitals stand on the issue of public funding for abortions, and believe me, believe me, I had a lot of nuns and a lot of priests and a lot of brothers going to Our Lady of Mount Carmel, in Warren, John F. Kennedy High School, and I will tell you that those nuns and those administrators who run Catholic hospitals, 600 of them, would not support this legislation if they believed that there was public funding for abortion. And I think the head of the Catholic hospitals said that--we are all pro-life, but they believe that the language in the Senate bill, some of the language that we kicked around here early on in the House version, will sufficiently prevent public funds from being used for abortions. That is 600 Catholic hospitals saying that. That is not me saying that. That is not the Democrats say that. This is Joel Hunter and a variety of others who are professors of Christian formation and disciplines, discipleship, Pentecostal, theological seminary, Leadership Institute, Loyola University, University of Dayton, Duquesne. These are some of the leaders. Jim Wallis from Sojourners; Ron Sider, Evangelicals for Social Action; Catholics and Alliance for the Common Good, on and on and on. But our friends on the other side, because I know, I was getting calls in my office today, getting people all hopped up on the abortion issue. Let's look at the facts. Let's look at what is in this bill, and we are going to have that debate. And just like the discussions in August about death panels and we are going to kill people's grandparents and all that nonsense that we heard in August, where did that go? It dissipated. It just disappeared because it wasn't the truth. And so it just faded away. And all of these arguments that our friends on the other side are making now are just going to fade away because they do not reflect the facts. What reflects the facts are the things that we are trying to deal with here. Now, look at some of the stuff that we are trying to address. Between 2009 and 2010, monthly prices in the doughnut hole increased by 5 percent or more for half of the top 10 brand-name drugs. So increased by 5 percent or more for monthly prices for these drugs that most of our seniors get. Now, from 2006, full negotiated prices for top brand-name drugs between 2006 and 2010, and I will just use some of the percentages here: Plavix, for example, 25 percent. Lexapro went up 25 percent; ADVAIR, 32 percent. Unbelievable increases in prescription drugs. And we are asking our seniors to continue to pay these increases that happen when they fall into the doughnut hole. So, Madam Speaker, we have got a moral responsibility because so many people are being hurt in our country today, and I stand here this week as we stand on the brink of passing a significant piece of legislation that is not perfect, and I don't think anybody says it is. We are all human here in this Chamber and in the Senate. The President and his team, we are all human. We are going to make mistakes. It is not going to be perfect. But what we are doing is moving forward in a significant way. One of the huge issues we have in this country is that we have millions and millions of Americans who don't have health care, so what they do is they show up at the emergency room and have no money. They are not on Medicaid. They are not on Medicare. They don't have private insurance. They are not a veteran, so they go into the emergency room when they get sick. This is what happens. Not only is that inhumane and not only, I would think, do we have some kind of moral duty as elected officials in the United States to say, you know, that is just--I have got a problem with that. That is just not right. What do we do? We have got to do something. So this bill is an attempt for us to do that, to step in and help people, empower them to be able to afford insurance, and create a system where they are able to afford their health insurance and go into this exchange and be able to afford insurance. Because some people say, Well, I don't want to pay for those people. I got mine and I got my health insurance and I am cool. I have got a job and it is all right. But you are already paying for them, because what happens is four or five uninsured go into the hospital, go into the emergency room, costs a lot of money but don't have any way to pay for it, and then you walk in behind them and you have your insurance card. Guess who is paying for their treatment that they didn't pay anything for? You are and the next guy who walks in with an insurance card and the next person. These costs all get shifted and so you see these huge increases. So we have a system where we don't prevent anything. We wait until people get deathly sick, go into the emergency room, stay there for a week instead of getting a $20 prescription that would have saved us all a boatload of money. This is not a discussion about whether the government is going to run the health care industry or the insurance companies are going to run the health care industry. This is about doctors running the health care industry. This is about making sure doctors don't have to call up the insurance companies and haggle with them over what is covered and what is not covered. It is 2010 in America. We are the wealthiest country on the planet, and we have the most dysfunctional health care system going. Yes, we have got tremendous high-end care. But if you were setting up a system, you wouldn't certainly say to 30 million people in your country, Just wait until you get absolutely deathly sick, then show up at the emergency room and we will take care of you then. That is not how you would set it up. And our friends on the other side love to have this discussion about we are losing your freedom. You are losing your freedom. You are not losing your freedom. How free are you when you are sick and you can't get anybody to take care of you? How free are you then? How free are you when you want to leave your job and go get another job, but you can't because you have a preexisting condition or your spouse has a preexisting condition or your child has a preexisting condition and you are stuck? That is not our idea of freedom. How free are you if you want to go start a business and create wealth and jobs in the United States, but you can't because you have a preexisting condition? How free are you as a small business person? If you are just the average small business person, you had a 126 percent increase over the last 5 or 6 years. Now, how free are you to run your business the way you see fit, to make the investments that you want to make into capital, into technology, into worker training, into wages for your workers, more into the pension plan for workers, hire more workers? How free are you? And these folks that can't afford health care and they get a lot sicker than they would normally have gotten, what kind of quality of life is that? Life, liberty, pursuit of happiness. These things mean something. And when you talk about what the Founding Fathers meant when they said life, liberty, and the pursuit of happiness, they meant that government has the responsibility, a moral responsibility to protect people's lives, liberty, and their ability to pursue happiness. And when we have a system in place now where an industry is limiting that freedom, reducing that quality of life, the government has an obligation to protect them so that they can be free, and that is what we are doing with this piece of legislation. I mean, look at what is happening here, the issues that we are addressing. Think about this. This is what is in the bill. This big bogeyman that you hear about on Fox News that is going to end western civilization as we know it if this thing passes has a 35 percent tax credit for small businesses. It says that children cannot be denied health insurance because the kid has a preexisting condition. It is going to say that the lifetime caps that people have on their insurance will be eliminated so, no matter what, kids will get covered. It will extend coverage so that young people can stay on their parents' insurance until they are 26 years old. If they are getting out of college and want to go on to get an advanced degree or they hit a rough patch with the job market or they are trying to figure things out, you are not going to be booted. And how many parents aren't going to have to worry about that anymore? Free preventative care under private plans, free preventative care under Medicare so we can prevent a lot of these problems from happening. If you are 55 to 64, there will be a reinsurance opportunity for employers who are employing people 55 to 64 to make sure that those people have coverage. The doughnut hole will be closed over time so that senior citizens can afford their prescription drugs. And when you look at all these things, from time and time and time again, these are very popular among the American people. Tax credits for small businesses, 73 percent more likely to support. Insurance exchanges, 67 percent. Keep what you have, 66 percent. Ban preexisting conditions, 63 percent. Medicaid expansion, 62 percent. Dependent coverage through 26, 60 percent. Close the Medicare doughnut hole, 60 percent. Subsidy to individuals, 57 percent. And all of these things, as we start to vote on them, our friends on the other side say, Well, we are for those. So in the last day or so the House Budget Committee was working on this legislation and they had some opportunity to vote on these issues, and so I just want to share with Members of the House how our friends on the other side on that committee voted. Protecting Medicare, closing the prescription drug doughnut hole, 15 Republicans voted against that. Protecting Americans from insurance caps, banning annual and lifetime limits on health care coverage, 15 Republicans voted against that. Holding health insurance companies accountable; 15 Republicans voted against that. Bringing down the cost of health insurance for everyone and providing a tax credit to small businesses; 15 Republicans voted against that. These are the basic provisions of our health care reform bill that between 57 and 73 percent of the American people support. This is not Medicare for all. This is not single-payer. There's no public option in this bill. Many of us on this side don't like some of that--the fact that those aren't in there. But this is a significant step forward, some basic reforms, and when we have 15 members of the Budget Committee on the Republican side consistently vote against tax credits for small business to get health care, you know they're doing it for one reason: They're doing it for politics. Madam Speaker, this is all about politics. Go back to the memo that someone left somewhere in some room that the press got a hold of that told the Republicans, Do not let Barack Obama pass health care reform. Do not let them. Do not let the Democrats get this big victory because you will be in the minority for another decade or two. And so right out of the gate they had no interest, Madam Speaker. Our friends on the other side had no interest in cooperating. No interest in adding to the debate. They were against this bill before there was even a bill written. They were calling it socialism before there was one item printed on this piece of paper here telling us what was on this bill. That's not what the American people want. The American people want us to sit down, work together--no one is going to get everything they want--and pass something and move it forward that's going to help the American people, that's going to allow us to meet our moral obligation to protect the American people, to protect those kids who are being denied because of a preexisting condition, to protect those seniors who fall into the doughnut hole, to protect those families who get denied because of a preexisting condition, to protect those families who hit a lifetime cap and get thrown out on their own. This is what this is about--to help empower thousands of small businesses who've got the anchor around their neck because they get 20, 30, 40 percent increases in health care. That's what this bill is about. It's about protecting our citizens, it's about empowering our citizens, it's about making our citizens freer than they are today when they're trapped in this ungodly health insurance system that hurts many of them. We can't stand by and stick our finger up in the air and see which way the wind is blowing and allow millions of people to go get hurt, and then 30, 40, 50 years from now go sit on the rocking chair. Our children are going to ask us what we did when we were in Congress. What did you do to move the country forward? And we're going to say what? We failed. We didn't muster up the courage to make the tough votes. We didn't have the ability to look through the clouds and the smoke and the mirrors, look past the bogeymen that have been created on this bill. I love it. I love how these arguments have just fallen apart, from death panels, now abortion. They're saying everything is publicly funded abortion here. And 600 Catholic hospitals are endorsing the bill. Now how do you say that this is public funding for abortion when 600 Catholic hospitals have endorsed this piece of legislation? So our friends on the other side need to go to all these 600 hospitals and all the sisters that are there, intimately involved in the health care of their patients, and all of the Catholic administrators of all of these hospitals and say, You're pro-abortion. Good luck having that argument. It's a phony argument that's being created for politics, just like the death panels were, just like the illegal immigrants were going to be covered under this bill. All of those issues have been demagogued in this House and across this country to try to scare legislators and the American people. And the dust is going to settle, and we're going to be able to look back on this vote. I look forward, Madam Speaker--I will tell you this--I look forward to the debate in the fall discussing with the American people exactly what is in this bill. I look forward to talking to my Chamber of Commerce, my friends in small business, that they're going to get a 35 percent tax credit, and they're going to be able to go into this exchange and negotiate with a bunch of other small business people, thousands, to have some bargaining power to reduce their health insurance costs. I look forward to going into a debate saying, You know what was in this health care bill? We made sure that no insurance company could deny any child because they have a preexisting condition. No insurance company could deny a citizen of this country because they have a preexisting condition. That our seniors are going to get more prescription drug coverage. That our citizens, when they hit a catastrophic health event in their life, that there won't be any lifetime caps or limits to how much they can be covered. Madam Speaker, that is what this health care debate is about. No matter how many times our friends on the other side try to say they want to work with us, they have been given the opportunity to sit down and work. And they say they're for a lot of these things but, again, already in committee, peeling out the votes, closing the prescription drug hole in the Budget Committee, 15 Republicans voted ``no,'' we don't want to close the doughnut hole. Protecting Americans from insurance caps, banning annual and lifetime limits on health care coverage. This is the vote. That's all the vote was on. Fifteen Republicans from the Budget Committee voted ``no,'' we don't want to protect Americans from the caps and ban annual lifetime limits. Holding health insurance companies accountable, 15 Republicans said, No, we don't want to hold them accountable. Bringing down the cost of insurance, providing a tax credit to small businesses, 15 Republicans voted ``no'' for a tax credit for small business because their consultants and pollsters told them they couldn't let this bill pass. So out of 15 Republicans on each one of these votes, a majority of the Republicans on all of these votes, out of the 15, voted ``no,'' we don't want to do it. In some instances, it was close to all of the 15. Madam Speaker, we have an opportunity here to make history. But that's not why we're doing it. We're doing it because this government, from its inception, this government from its inception has had a moral mission; a moral mission to protect and empower its citizens. And when an industry and their unsavory business practices are hurting the American people, we have a moral obligation to intervene. And we have a moral obligation to empower by making sure that our citizens are free to go in and have expanded choice, that they are free from an insurance company saying, You're off the rolls now because you got sick. You're empowered because you can be healthy and get access to care and you can experience the liberty that this country has provided--life, liberty, and the pursuit of happiness. That's what this bill is about, and I look forward to having an opportunity to continue to advocate for it. With that, Madam Speaker, I yield back the balance of my time.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Thank you, Mr. Speaker. I appreciate the opportunity here to respond to some of the criticisms that have been made here, unjust as they seem to be to me, and try to straighten the record out just a little bit. It is our belief on this side of the aisle that the United States Government and the government of many of our States have a moral mission to protect our citizens, a moral mission to empower our citizens, and a moral mission to improve the lives of many of our citizens. The issue of health care reform to us on this side of the aisle is a moral issue, and it is an economic issue. When we see throughout our country the level of abuse that has been put upon the people of this country through the insurance system, that, my friends, that, Mr. Speaker, is a moral issue. Nobody is saying that this health care reform bill is a perfect bill. Nobody says that it is going to be a panacea, that it is going to fix all of our problems in this country. But this is a major step forward for our country. And we have as a country a moral obligation to stand up between what the insurance industry is doing to the American people, somebody has to intervene. And there is nobody left because average people who are in Ohio or Iowa or some of these other States have no recourse. They cannot battle the insurance industry. This has been going on for years and years and years, where the insurance industry kicks people off the rolls when they need coverage or when they get sick, when they deny people coverage because they have a preexisting condition; and so they therefore can't get any insurance at all. And they have created a system here over the past few years, past 5, 10 years where we see 20, 30, 40, 50 percent increases in health care costs for individuals and small businesses, and large businesses in many instances and the government. So we have a situation where we are that far from addressing one of the great moral issues of our time. And we are that far from addressing an economic issue that will continue to strangle the economy of the United States of America if we fail to act. Now, I think it is very convenient for our friends on the other side of the aisle and those in the insurance industry to say let's start again. Let's start all over. Let's start from scratch. Well, if the insurance industry wants to go back and revoke 10 years of increases that they have bestowed upon the American people, if they want to start over, then maybe we will start over. If they want to eliminate all of the increases that they put on the American people, eliminate them all. Let's go back to 1995 or 1994 rates, or even just cost of living from 1994 or 1995 when we tried to do this the last time. Why don't the insurance companies start over, Mr. Speaker, and go back and erase their increases that they put on the American people. Then we may consider starting over. Now, for those people, Mr. Speaker, who have been listening to this debate, they need to recognize that maybe this process isn't pretty, and maybe we could have done a better job explaining what is going on. And many people, and our friends on the other side were talking about polls, and at the same time would lament the fact that we are governing by polls. So when you look at what has happened over the course of the past few years and what has happened to average people--I want to find the poll that we had here when you pull out the issues from the poll. So the general consensus is, do you want the health care? And they hear on the news, Mr. Speaker, about different things that are going on and they say, well, it doesn't sound like such a good idea. But then when you pull out specific provisions of this bill, of this health care reform proposal, most of those issues, most of those reforms poll at 60, 70, or 80 percent support. Are you for getting rid of preexisting conditions and allowing insurance companies to not cover you because you have a preexisting condition? Sixty-seven percent of the American people support that. Do you support eliminating lifetime caps so that when you get sick and you really need the insurance, you can get it? Sixty to 70 percent of the American people support that. Do you support not being able to deny every child in the United States of America because of a preexisting condition? Seventy, 80 percent of the American people support that. Do you support giving small businesses tax credits to cover their workers? Significant support for that. So we are moving forward with a proposal that addresses the major needs of the American people. When you ask seniors, are you for closing the doughnut hole? More than a majority of seniors say, Yes, that is something that what we want included in the health reform proposal. And it is included in here. And many of these reforms will go in effect within the next year. And so when we pass this, Mr. Speaker, and our friends campaign in November about repealing this, they are going to have to go to all the moms and dads in the country and say, No, you know how your child, if they get sick or you want to get insurance, they can't be denied because of a preexisting condition, they want to run a campaign saying, No, we want to repeal that. Our friends on the other side of the aisle, when we say, You can't be denied coverage for a preexisting condition, they are going to want to run a campaign saying, No, we want to repeal that. When we close the doughnut hole and start moving in the direction of fully closing the doughnut hole that the Republican Party put in here when they passed the prescription drug bill that they didn't pay for, we had to borrow money from China to pay for it, and it has a doughnut hole in it, and we attempt to close it, our friends on the other side of the aisle are going to run a campaign in November saying, We want to repeal the closure of the doughnut hole. Those are the issues that are in here, that are in this reform proposal, and these are the issues that are going to bring some justice to the health care industry in the United States of America. This isn't about whether the government is going to run health care or the insurance industry is going to run health care. This is about whether doctors can make decisions. And our friends on the other side want to talk about life and liberty. Let's talk about life and liberty. Let's have this debate. You want to talk about freedom? How free are you when you are sick and you can't afford health insurance? You can't get out of bed to go to work. You have to give up your job because you don't have health insurance. How free are you? I cannot be convinced that the Founders of this great country thought that freedom is somehow the government not protecting individual citizens from underhanded practices from a corporation. I can't believe it. I believe that the definition of freedom is about being healthy and empowered in 2010 in America. And if there is a corporation or an industry that is limiting your freedom by their underhanded practices, then the government has a moral responsibility to intervene and to protect the individual citizen and protect the rights of the individual citizen. Let's have this debate all day long, Mr. Speaker, telling me some boogie man is being created here that is going to come in to Washington, D.C. My one friend said nationalizing our bodies. One of our friends on the other side said that this was about nationalizing our bodies. What? Talk about fear mongering, Mr. Speaker. Nationalizing our bodies? This is about protecting individuals in the United States of America who can't protect themselves, and the government has a moral obligation to do it. If it is a foreign terrorist, moral obligation to do it. If it is crime in the streets and our cities, moral obligation to do it. If it is an unruly industry that has underhanded business practices, moral obligation to stop it. That is what we have here. That is why we are here. That is how this country was founded, to protect the individual freedoms. To say to small business people, You have to go out into the shark- infested waters to try to get health insurance and have 40, 50, 60 percent increases and do nothing about it because of some warped concept of freedom that is made up, how free is that business person who takes money continually out of wages, out of capital investments into their factories, into their machine shops, into their businesses, into their technology, into training their workers? They are not free to make good business decisions. They probably have all kinds of good ideas about what kind of investments they would rather be making than paying to some health insurance company that doesn't give us value added. You want to help manufacturing in the United States of America? Help fix some of the health care burdens that our manufacturers are plagued with day in and day out. And how many factories were shuttered because they couldn't make the capital investments because they had to put so much money into health care? How many? We have seen the decline in manufacturing over the last 10 or 20 years. We have seen stagnant wages over the last 10 or 20 years because businesses had to absorb health care costs while simultaneously trying to compete with China and India and manufacturing all over the globe. And our friends on the other side want to start all over. And they want to tell all these people who are getting denied because they have a preexisting condition we need to start all over and wait another hundred years to do it, or at least another 15 years, the last time someone had the courage like President Clinton had to try to do this. We have an obligation to fix these problems. We didn't get sent here to take polls. We were sent here to do the right thing. And it is my hope that this week--you know, it was great today. We were in Cleveland with the President. And he was in the middle of his speech, and he said something like, What we need, or, We need, and there was a pause. And a woman shouted out, ``We need courage.'' We need courage. That is what people are feeling. They feel like there's no one there to help them. They get stuck in situations where they don't have anywhere to turn. And imagine the United States Government passing a law that says, when you get sick, you can't get kicked off your insurance. That is what is in this bill. That is why, when you look at the lists of faith-based organizations who are supporting this bill--Sojourners, Network, Catholic organizations, Evangelicals for Social Action, Jim Wallis at Sojourners, Catholics in Alliance for the Common Good, New Evangelical Partnership for the Common Good, former Associate General Secretary for U.S. Conference of Catholic Bishops, Sisters of Mercy of the Americas. Boston College professors, University of Dayton professors, Marquette University professors. On and on and on and on. Then, this weekend a huge endorsement for this bill. As my friends on the other side were talking about the abortion issue, 25 pro-life Catholic and evangelical leaders have endorsed this bill, and this weekend the Catholic Hospital Associations endorsed this bill. Do you think the Catholic Hospital Associations of America would endorse this bill if this was a pro-abortion bill? This is the pro-life bill. This may be the most pro-life bill that has passed this House in 20 years. How do we define life? How many people die too early because they are sick and they can't get the proper care? How many people have a reduced quality of life because they can't get proper health care? Aren't those pro-life issues? They most certainly are. And to have the Catholic Hospital Association endorsing this bill, and then to come out and fearmonger, Mr. Speaker, on the abortion issue is wrong. It is wrong. Twenty-five pro-life Catholic and evangelical leaders, strong, nationally recognized endorsing this bill, because this is a pro-life bill, and we should support it as a pro-life bill. We talk a lot about freedom, too. How many people in America today are out there locked in a job that they probably don't like all that well, that they probably would rather go work somewhere else or maybe, even better, start their own business? But they can't leave their current employment because they know if they go out into the free market and they try to get their own insurance, that they won't get covered because maybe they have a preexisting condition or maybe their spouse has a preexisting condition or maybe one of their kids has a preexisting condition. So our friends on the other side say, Start over. Don't do that, don't give that person who got an idea and wants to start a business in America and take a chance--don't help them. Are we providing the kind of environment for someone to express, have the freedom to express their energy and their talents in America? No. We are limiting it if we don't fix this health care system. We are limiting it. We have a moral obligation as a country to allow each and every individual in this country to express their talents and their skills in this country. We have the opportunity here in the next week or so to make this happen. We have never been so close, extending insurance to 30 million Americans who currently don't have it. A lot of people say, too, as we talk about this bill that they don't want to pay for these 30 million people. It is important that we recognize that we all are already paying for these people who don't have health insurance. You see, our friends on the other side--and I sat here and I watched them, and I listened very carefully, and they were picking these fringe issues to try to incite. They were talking about abortion, which, okay, I am sure they believe strongly in that. I do as well. I have a pro- life voting record. But when you have the Catholic Health Association and you have 25 national Catholic and evangelical leaders supporting this bill, it becomes very difficult to scare the American people about that issue. They don't want to talk about preexisting conditions. They don't want to talk about making sure kids don't get denied. They don't want to talk about tax cuts, tax credits for small businesses to provide health care insurance. Of course not. They don't want to talk about how the Democrats are going to close the doughnut hole. They don't want to talk about how seniors will not have to pay for any preventative care at all in Medicare. They don't want to talk about how this bill is deficit neutral, how it actually reduces the deficit. They don't want to talk about how this bill extends the life span of the Medicare program. They don't want to talk about any of that stuff. And it goes back to the original memo that one of their top pollsters gave them in the spring that said: Do not let Obama pass health care reform. Do not let him. You will be in the minority for a long time. And so they will do anything they can, anything in their power to try to prevent this President from passing health care legislation. It is good to know, Mr. Speaker, because they are rooting against the President. They are rooting against the President. If the President fails, we all fail. He has extended his hand, taken all of the Republican ideas, put many of them into the health care reform proposal, and there still are Republicans who won't vote for it. Just like in the stimulus package, we had to put $300 billion in tax cuts in the stimulus bill because that is what the Republicans wanted, and we didn't get any Republican votes, because there is no benefit for the Republican side to support the President, to support the American people, because politics has gotten in the way. So we have all of these issues that are going to go into effect within the year. Within the year small business tax credits, up to 35 percent of premiums, will be immediately available to firms that choose to offer coverage, closing the part D doughnut hole. Immediate help for the uninsured now to create an interim high-risk pool. End rescissions so insurers can't drop people from coverage when they get sick. No discrimination against children with preexisting conditions. Are you going to vote against that? Go ahead. Extends coverage for young people up to their 26th birthday, so all the young people in our country will now be able to stay on their parents' insurance until they are 26 years old. So if you want to go to grad school, you will be able to stay on your parents' health insurance. Times are tough now. You may not be able to find work, or at least find work with some decent health care. You can stay on your parents' insurance until you are 26 years old. Bans lifetime limits on coverage. Bans restrictive annual limits on coverage. Free preventative care under Medicare. This is a reform proposal that we should have passed 30 years ago. Those are the moral issues. But the economic issues are just as profound, just as great. Small businesses have seen a 126 percent increase over the last 5 or 6 years, and the projections as we move forward are even higher for families and small businesses: Up, up, up, and away will their health care costs go if we do nothing. And, as we said, they want us to start over. How about the insurance companies start over? How about the insurance companies repeal 10 years of increases and they start over? Maybe that would be fair. Wouldn't that be nice? We want to start all over in this country, come together and figure something out. Repeal 10 years of your health care increases. Free preventative care under all the new health care plans, new independent appeals process. Help for early retirees, which is something that is huge, I know, in Ohio. Creates a temporary reinsurance program until the exchange is available to help offset the cost of expensive health claims for employers that provide health benefits for retirees age 55 to 64. Billions of dollars for community health clinics, and it increases the number of primary care doctors by making huge investments, making sure that we get that done. The Republicans didn't do anything to address any of these issues for 10 years. Now, all of a sudden, they are late to the game, and they still won't support it. They say, Well, we are for repealing preexisting conditions. They are not going to vote for this bill. We are for tax credits for small businesses. They are not going to vote for this bill. We are for closing the doughnut hole. They are not going to vote for this bill. We are against preexisting conditions, making sure that any child doesn't get denied coverage because of a preexisting condition. They are going to vote against this bill. We are for children allowed to stay on their parents' insurance until they are 26. They are going to vote against this bill. We're for increased competition. They're going to vote against this bill, because they've been told by the people who guide their political decisions, their pollsters, the cottage industry in Washington that tells political parties what to do, they have been told, Do not let the Democrats succeed in this. And we have asked time and time and time again for their suggestions. The President has taken many of them, implemented them into this bill, and they keep moving the yardstick further and further down because they don't want to support this because their political leadership, their pollsters, their lobbyist friends say we can't do it. We can't let them get a win. And it's not about the Democrats winning. This is about the people in our districts who are getting hurt; that are getting hurt by the current practices. And when you see the number of faith-based organizations supporting this legislation--Evangelical, Catholic, Jewish, Muslim, Buddhists, I mean, the spectrum of faith-based organizations in the United States of America are supporting this. And they all say, Is it perfect? No. Of course not. This is a body made of human beings who are flawed and make mistakes. But this is a tremendous step forward in our country--monumental, historic. I'm proud to be here today. I'm proud to support this bill. I'm going to be even prouder after it passes and we can point to X, Y, and Z, as I am tonight, exactly what is in here and exactly what the benefits are. I'll be honest with you: I'm excited to run a campaign in November talking about this. I want to see the campaign where all of the stuff that I just listed is the debate in the fall. And our friends on the other side and our TEA Party folks who haven't done anything in 10 years to try to address any of these problems are going to want to repeal a ban on preexisting conditions for kids--children; a ban on preexisting conditions for adults, saying that you shouldn't be able to stay on your parents' health insurance until you're 26. They're going to run a campaign saying that we should expand the doughnut hole instead of closing the doughnut hole, which is what we're doing in here. They're going to run a campaign saying that we want to repeal the tax cuts that we have given to small businesses to try to make this happen. We want to repeal the subsidies that people are going to get to help them pay for insurance. It's going to be a heck of a campaign. And they're going to scream socialism like they have been doing for 7 years. They screamed about it. This is the same party, Mr. Speaker, that just a few years ago, when I first got in the Congress, the early part of this first decade, wanted to privatize Social Security. You don't hear anybody here saying they want to get rid of Medicare. I remember, we sat on this floor, Congresswoman Wasserman Schultz, Kendrick Meek, and myself. Started when we first got in Congress. The first issue we were addressing was President Bush's idea to privatize Social Security. Now, imagine a year and a half ago if you had dumped your 401(k) or your Social Security was looking like your 401(k) and you had nothing to draw upon. That's the kind of vision we're getting from the other side of the aisle. We're talking about tax cuts for small businesses and individuals so that employers can provide health care and jobs. That's what this is about. Our friends on the other side did not act. They led to what is happening here today, and we have got the consequences of their inaction that we're forced to deal with today. We have got a lot of issues to talk about. This is not going to be the last time we're on the floor. We're going to be here all week talking about these issues. But, again, our government has a moral mission, a moral responsibility to protect our citizens and to empower our citizens. This health care reform bill is about protecting our citizens. It's not about government-run; it's not about insurance-run. That's a false debate. This is about making sure that doctors and patients and families make their own health care decisions. That's what this is about. This is about making sure that seniors have an extended Medicare program by making sure we rid it of waste, fraud, and abuse. This is making sure that our seniors have prescription drug programs. This is making sure that our government protects individuals from the practices of the insurance company, being denied a preexisting condition; that we protect our citizens from, when they get sick, their insurance company says to them, We can't cover you any more. That's what this reform bill is about. And those protections will empower and stimulate and allow the American people to express their talents in the marketplace. How many business people are going to have more money in their pocket to reinvest back into their business, into the technology, into the capital improvements? How many families are going to have more money to send their kids to college, to go on a family vacation, to make sure their kids can go to graduate school? How many people who are locked into jobs now and fear starting their own business are out there? We don't know. It's a hard thing to quantify. But there are thousands of them. Who's the next Bill Gates who has a spouse that maybe has a preexisting condition so they're stuck in a cubicle somewhere and can't start their own business? How many children in our country have been denied health insurance because they have a preexisting condition? How many people are in a hospital right now, right now, because they didn't get the proper health care that they needed? And so their problems, their issues, their health concerns got worse and they ended up in the hospital. We have a moral obligation to step up to bat and to make this happen. This reform bill is a good piece of legislation. And I recognize that there are some outlets, some people who want to maybe not be quite as straightforward with the facts that are presented here in this bill, and they want to touch upon those same issues of abortion and immigration, all the issues that have been addressed in this bill. When you have 25 national pro-life Catholics and Evangelicals organizations endorsing this bill, when you have the Catholic Hospital Association endorsing this bill, you can honestly say that the abortion issue has been taken care of and that this is a pro-life bill. Because the idea of pro-life is very broad and should have a very broad interpretation. Quality of life, shortened life spans, those are pro-life issues. Shortened and reduced quality because they don't have the proper health care, those are pro-life issues. Freedom to invest in your business, start your own business, those are issues that our Founding Fathers talked about a great deal. So we do have a moral obligation to pass this piece of legislation. When we pull out all of the parts of this bill, you will see that the American people support this. And the American people want this legislation. Here it is. I will read them real quickly. They would be more likely to support the reform if it has tax credits--these are all issues that are in here--if it has tax credits to small businesses, 73 percent more likely to support; if it has insurance exchanges, 67 percent more likely to support; if you can keep what you have, which is exactly how this is set up, 66 percent more likely to support the reform; if you ban preexisting conditions and denials, 63 percent; Medicaid expansion, 62 percent; dependent coverage through 26 years old, 60 percent; close the Medicare doughnut hole, 60 percent; subsidy assistance to individuals, 57 percent. These are all things that are in the bill. These are all things that are in the bill and are all the reasons why we need to pass it. This is a basic human rights issue. This will be the most significant pro-life piece of legislation that has passed this House in a long, long time. This will be the most historic piece of legislation that has passed this House in a long, long time. I yield back the balance of my time.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Mr. Speaker, I move that the House do now adjourn.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Madam Speaker, I ask unanimous consent that Representative Eric Paulsen of Minnesota be removed as a cosponsor of H.R. 4529.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Mr. Speaker, I move that the House do now adjourn.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Mr. Speaker, I move that the message of the President be referred to the Committee of the Whole House on the State of the Union and ordered printed.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Madam Speaker, the Ohio Lawn Care Association recently announced Christopher Guerra, of Highpoint Lawn Service in Stow, as the recipient of its first-ever Ohio Lawn Care Applicator of the Year Award. The new annual award recognized Guerra for his dedication to customer service and 7 years of work experience at Highpoint. He was presented a plaque by OLCA Publicity Committee Chair, Rob Palmer, Weed Pro, Ltd. at the OLCA annual meeting Dec. 8 during the Ohio Turfgrass Conference & Show. Guerra was selected from five finalists including: Matt Dixon, Buckeye Ecocare; Fred Hoyt, Custom Lawns; Matt Netzley, Fitzwater Tree & Lawn Care; and Dan Paolini, Weed Man Lake County. Guerra was nominated by Highpoint President John Prusa, who commended Guerra for his productivity and personal, caring service to a loyal customer base while completing his education and earning a degree from the University of Akron. Several complimentary letters from customers accompanied his nomination. The Ohio Lawn Care Applicator of the Year Award, sponsored by Dow AgroSciences, is a new award to be presented annually by OLCA. To apply, one had to be a member company of the association and could only be nominated by a company owner, manager or supervisor. Nominees were required to have a state of Ohio applicators license with a minimum of two years experience. OLCA represents nearly 500 professional lawn care companies throughout Ohio, and is committed to promoting and protecting the lawn care industry in Ohio. For more information about OLCA or the Applicator of the Year Award, call 800-510-5296; email info@OhioLawnCare.org; or visit www.OhioLawnCare.org.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Madam Speaker, it is an honor again to be here on the floor of the House of Representatives to talk about the issues of the day and talk about changes that have happened in our country over the course of the last year due to the leadership of President Obama and the Democratic Congress. I know in today's world, in today's media-driven world where we like to talk about and have fights about different issues and let those fights kind of permeate society, sometimes it is very difficult for us as leaders in the country to talk directly to our constituents and to the American people about some of the changes that have been put in place. If we look at just a little over a year ago, in the fall of last year, October of 2008, the difficulties facing our country, on the economic side, the collapse of the stock market, the collapse of the job market, Wall Street run amuck, no regulations, no rules, fancy packaging of different accounting schemes and creative financial packages that ultimately led our country to one of the greatest crises we have had since the Great Depression. And were it not for the programs that were started during the Great Depression, it would have been the Great Depression. And if it weren't for extraordinary acts on behalf of the Federal Government to support the banking industry, and I remember getting calls from local businesses, local banks, community banks, saying we need to do something, things are collapsing, we had a vote here on the floor to pass billions of dollars worth of aid to the banks and the vote failed and the stock market dropped 800 to 900 points. Subsequently we came back and passed it and took a lot of political heat for it. Months later, under the leadership of President Obama after he was sworn in, we passed the stimulus package. In January of last year, we had 700,000-plus jobs that were lost in January of last year. And every economist was saying, Presidential candidate McCain's top economist was saying, the top Democratic economist, were all saying there was a $2 trillion to $3 trillion hole in the economy, and we have to fill that hole. And the only entity left to put some money into the economy is the Federal Government. Thus, the stimulus package--which quite frankly I didn't think was big enough. We put the stimulus package in place. Now let's fast forward a year. Nobody is happy, of course. I represent Youngstown and Warren, Ohio, and they have the worst unemployment rates in the entire State. A lot of that has to do with the manufacturing base and losing manufacturing jobs. But the bottom line is this: in November, we lost thousands of jobs as opposed to 750,000 jobs. And I think in December, the numbers are not completely official, but 70,000 or 80,000 jobs were lost in December. So from 750,000 in the month of January to only losing 80,000 in December-- nobody is happy with that, but we are clearly moving in the right direction. When you look at the fact that the stock market is up 55 to 60 percent since it bottomed out, we are clearly moving in the right direction. Now, a lot more has to be done, and I think we have got to make some tremendous investments, but one of the things that is strangling the economy right now is health care costs on businesses and health care costs on families. And so the health care reform proposal is here to say that even if you don't morally believe that we should cover every American, we can all make those arguments from a religious perspective or values arguments or ethical arguments that we maybe need to do that, let's set that aside and let's talk economics and let's talk about the fact that if we do nothing, health care costs will continue to strangle small businesses in the United States, will continue to further increase their grip around the throats of families in the United States, and all we hear when we go back to our districts is about the cost of health care. This is President Obama's attempt and the attempt of the Democrats to try to fix this problem. By doing absolutely nothing, we are going to see an $1,800 a year increase in the average family of four's health care costs next year, and then another $1,800 the following year and another $2,000, and it will just keep escalating to the point where it eats up the whole family budget and you are paying more and getting less in coverage, really. So it is eating up the whole family budget. There is less money to spend on tuition or go on vacation or increase your family's quality of life, maybe move into a better neighborhood, a better school district. All of these things are not available to families because of the increased cost of health care. So doing nothing allows that to continue because we are afraid to make tough political decisions. We didn't get elected to come to this body, Madam Speaker, to make the easy decisions. We didn't run just to make sure that we got elected in 2 more years. We got hired by the American people to solve very difficult, very complex problems. And we are attacking those problems because that's the mission that they gave us. We set out to do it with energy, and we set out to do it now with health care reform. Let me just say finally before I kick it to my friend, who people all across the country now know of because of his heroic works in Haiti, if we do nothing in 10 years, $1 of every $5 in the United States of America will be spent on health care. And in 30 years, $1 of every $3 will be spent on health care in the United States of America. That is unsustainable. That is an unsustainable road for us to go down. People will look 10 years from now and 20 years from now and 30 years from now and they will ask, Who was representing western Pennsylvania when they had a chance to tackle health care reform? Who was representing Connecticut and who was representing northeast Ohio when the bell rang to step up and make these changes? I yield to my friend from western Pennsylvania.

Mr. RYAN of Ohio. We've got to make the investments that we have to make as a country. Our infrastructure around the country needs a huge shot in the arm. Trillions of dollars need to be invested in roads and bridges, high-speed rail all across the United States, airports. This all needs to be done. Our ports, waterways, those kinds of investments have been neglected for years and years and years, and we need to continue to make those investments here as well. We have to ask those people who end up making tremendous profits from those enterprises to step up and help, who have been very successful over the course of the last few years. And I don't think we should run from the fact that we need to ask them. There has been a shift towards the middle class paying more and more of the share of revenue that's coming into the Federal Government. We need to reduce that for the middle class and ask those who are benefiting in a very big way. I want to make one final point as we begin to close here and have a few minutes left on the issue of energy. I think it is important, as we talk about health care and health care costs, we need to also address the issue of how we are going to produce and generate energy here in the United States. This is our number one national security issue that we have in this country. We send $1 billion a day out of this country through our gas pumps into foreign countries, oil-producing countries who don't like us all that much and cause us tremendous geopolitical strife day in and day out and distract us from what we need to be doing. We need to make sure that we create an energy system in the United States that takes that money and keeps it here in the United States of America to refurbish our homes, our businesses, our commercial buildings here in the United States, to make sure that we pump that money into battery technology, smart cars, smart grids, energy- efficient homes, energy management systems. This is the future of the United States of America. Last week, we had a conference here where we met with several CEOs in these energy management systems now working for Wal-Mart, Home Depot, Costco, saving them 20 to 25 percent on their energy costs. Those are savings that companies like those can reinvest back into their business. But if you ask the CIA, you talk to the Joint Chiefs of Staff, this is a national security issue. Why would we want to depend on foreign sources of energy to supply our own military here in the United States? We address our national security issue, we create jobs here in the United States, and we help to address the carbon issue here causing global climate change. These are the issues that we need to tackle as a country, and we can't be afraid to do it. We can't be afraid, Madam Speaker, to make the tough decisions, to push the tough policies, to make sure that 10, 20, 30 years from now when people look back and say, What did they do in 2010, 2009 in the United States Congress to try to address some of these problems, we can say we answered the call, we made the tough decisions, and the country was better off for it. With that, I yield back the balance of my time.

Mr. RYAN of Ohio. I would like to say that this just didn't happen. We didn't just end up here a couple of Octobers ago and all of a sudden things just happened. Our government was controlled by a conservative, neoconservative ideology for most of the first decade in this century. From 2000 to 2008 they controlled the White House, and 2000 to 2006 they controlled the Congress. They implemented their economic philosophy, hook, line, and sinker. It got implemented. They controlled all of the levers of government. They passed their supply-side economics. They cut taxes for the wealthiest, saying that will stimulate the economy and everything will take care of itself. Deregulate Wall Street; everyone will be honest with each other, no one would possibly do anything wrong if we are not watching them, and they will behave themselves. They forgot to factor in that people get greedy when you don't watch them, and that is what happened on Wall Street. So my point on top of what the gentleman just said is this didn't just happen. We had leaders in Washington, D.C., who implemented an extreme ideology. That ideology got implemented here in the United States Congress. It was their ideology that was governing or not governing Wall Street. It was the lack of investments in jobs, education, health care that needed to be made. And all of a sudden fast forward a few years, the Ponzi scheme ends, the house of cards collapses, and it is not just Wall Street that has problems, it ripples throughout the economy, and now we have in some cities 15, 20 percent unemployment. We have health care costs zooming out of control, energy costs zooming out of control, we continue to be dependent on foreign sources for our energy, which is a national security issue, because these problems weren't addressed. And the initiatives that we have put forth over the last year have begun to shift the trends at least away from losing hundreds of thousands of jobs a month to only losing 80,000, from 700,000 to 80,000. From the stock market ending up at 6,500 a year ago now up to over 10,000, up 55 percent. So things aren't perfect, but they certainly are moving in the right direction. And if we can get the health care plan implemented, start reducing costs for businesses that they have money to free up to invest into their small businesses, into their capital, into their machinery, into their workforce, into their technology, then I think we can begin to really drive the economy forward and put the middle class back front and center where they belong. I yield to my friend.

Mr. RYAN of Ohio. There is no question about it. No question about it. And I think one of the important issues that we need to talk about as a country too, along with the health care and along with a lot of the decisions that our friends on the other side made that put us here, we need to remember this in context not only of the last year, but I think of the last couple of decades. Because the arguments we are hearing today about socialism, and here comes big government and all these other things were the same arguments that they made against President Clinton in his initial budget that he passed in 1993 when he first got in. It was the same claims. And I think they passed it without any Republican votes in the House, and Democrats had to carry the water. And look what happened in the nineties. And that is what I say even to my Republican friends who we like to tease each other back home in the district. I said how is your 401(k) doing now since President Obama has been in? Is it doing a little better than it was when President Bush was in? I think it was. So you take that number that Bush had, the same thing with President Clinton, 20 million new jobs created in the 1990s because of the Democratic economic proposals. You had the bottom 20 percent of people, their wages grow for the first time in a long, long time prior to that. You saw budget deficits turn into budget surpluses. What we are trying to say here is there is always going to be a neoconservative Republican extreme faction that is going to say whatever we are doing is somehow going to make the sky fall. But the reality is these are sound economic principles, these are sound investments, sound reforms on health care, energy, and the like. I yield to my friend.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Madam Speaker, I demand a recorded vote.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Mr. Speaker, we're happy again to kick off another edition of the 30-Something Working Group in which we will try to bring some facts and some analysis to the floor of the House of Representatives. I can't help but get up after having to sit through what our friends on the other side were talking about a little bit. And it's interesting, Mr. Speaker, as we see some of our Republican friends have a very short memory as to what transpired here. And I have been fortunate enough to be here over the last 7 years and was able to watch President Bush with the Republican-controlled House, a Republican- controlled Senate, a Republican Supreme Court, many State legislatures and the State Governors' Mansions were controlled by the Republicans. In Ohio, I know that of course was the fact. Run up huge budget deficits, start wars, cut taxes for the top 1 percent, take their eye off Wall Street, ignore health care, continue to support and subsidize the oil economy, push globalization, not enforce our trade laws--all with a rubber stamp from the Republican Congress. And then all of a sudden in 2008, 2009 the bottom falls out. Wall Street collapses. We see the stock market collapse, credit locks up. On and on and on. And our friends on the other side act like that just happened by happenstance. And now, in order to try to address those issues, we have to make some very difficult decisions as a country and come together as a country. And we get people ignoring the previous 8 years, when anybody who is being realistic can see how we got here. And all we want to do now is have a conversation about how we move forward and how we use this and see this as an opportunity to address some of the major structural changes that we have in the United States of America. And there are two major ones in our economy that have been like an albatross around the necks of small business people all over our country and big businesses all over our country, and that is health care and that is energy. And so this Congress has stepped up to bat to address two of those major problems without a lick of help from the Republicans, not a lick of help. And at the end of the day, they're going to be on the wrong side of history, like they were for Social Security and Medicare and civil rights and a lot of the other major issues that really gave us things to be proud of in this country. And so as we move forward with the House bill on health care--and now the Senate is opening up debate and having debate on the health care bill--we are trying to address the concerns of the American people. And I want everyone, Mr. Speaker, to understand the issues that we have taken up here as a Democratic Congress. And this is all with the understanding that we know that the unemployment rate is too high, there are too many people out of work. There is a lot more work to be done. But if you look at the previous 8 years prior to President Obama, you will see an administration that completely catered to Wall Street and Big Business in the United States of America, whether it was a trade agreement, whether it was immigration laws, whether it was health care, whether it was energy. You could bet your bottom dollar that President Bush was on the side of Big Insurance, Big Pharmaceutical, Big Oil, Big Agricultural, right down the line. And when we came in as Democrats, we began to change that. And all you have to do--and they say you can judge someone by their enemies-- the Democratic Party took on the Big Oil interests. The Democratic Party is taking on the insurance industry. The Democratic Party is the one party getting the banks out of the student loan business. And all of these sweetheart deals that were set over the last 8 years are on their way out the door. And President Obama got stuck with a heck of a mess, there is no question. A heck of a mess. But in America, we have to live in reality. I know some people on the other side may not necessarily agree with that or like that, which is fine. But we are the majority party, and we have to deal with reality without illusions and deal with the facts that are at hand. And here are the facts: if we do absolutely nothing with health care, the average family of four next year will have an $1,800 increase, $1,800. And then the following year it will be another $1,800, and the following year it will be another $1,800. That's reality. Everyone is agreeing on that If we do nothing, human beings, American citizens in this country, will continue to get denied coverage by insurance companies because they have a preexisting condition. That preexisting could be you were involved in a domestic violence situation; that preexisting condition could be infertility, or as we even heard, spousal infertility. You're denied. Diabetes. Cancer. That's if we do nothing. If we do nothing, just in my congressional district in northeast Ohio we will have 1,700 families go bankrupt next year because of health care costs--if we do nothing. And on and on and on right down the line. An inhumane, costly, expensive, inefficient health care system. And so we chose to take on the big fight. We chose to make a human decision to say this problem needs to be fixed, it needs to be addressed, and we know it's politically risky but we know we're going to do it because there are too many people in the country, Mr. Speaker, who need us to act and not sit on the sidelines where it is safe. It would have been nice, we could have just said, You know what? We're going to play it safe. We're not going to do anything that's going to upset anybody or get FOX News riled up or Rush Limbaugh or Clear Channel, the right wing talk radios. We're just going to play it safe. But at the end of the day, history would not be very good to us because they would have said, What did they do in Washington, D.C., when this decision, these hard decisions needed to be made 10 years ago? And our kids and our grandkids would say, Jeez, Mom. Jeez, Dad, you were in Congress during the very difficult time. We needed some big decisions to be made. What did you do when you were there? And you can look proudly at your kids and say to them, I did nothing. I played it safe. I sat on my hands because I wanted to get reelected or I was afraid that Rush Limbaugh would make fun of me. The reforms that are coming out of this House of Representatives--as I have said when I am back home in Youngstown, Ohio; in Niles, Ohio; in Warren, Ohio; in Ravenna; in Kent and Portage County; Akron--these reforms are for our people, our people who have struggled and fought and got zero wage increases over the last 30 years, who've got to haggle with the insurance company, get denied, get ignored while they're on their death bed, lose their job, lose their pension. That is wrong, Mr. Speaker. Wrong. And we're going to do something about it. So let's just take what happens when health care reform passes. There will be some time until the exchange gets set up and, you know, whether there's a public option and what it looks like. That may take a couple of years. But immediately what happens is that no longer in America will you get denied coverage because of a preexisting condition. Never again. If you have a child, a son or daughter, who is under the age of 27 years old, they can stay on your health care insurance. So all of those young people in their early and mid-20s who can't get health insurance or can't afford health insurance can stay on their parents' health insurance. That gets implemented immediately. If you have a health care catastrophe in your family--and being a Member of Congress, we get these calls, and we are out in the public and we meet these people at the fairs, at the festivals, at the bowling alley, at the bingo halls, at the civic events--there will be a cap on how much you can pay out of pocket per year on health care costs so that we can eliminate people in the United States of America going bankrupt because they had a health care catastrophe. And all of our friends on the other side of the aisle who talk about family values and everything else voted against that. Voted against it. So when you look at the health care reform bill, it is a values issue. It is a family values issue that we need to address. And our budgets and our investments speak to that, speak to our values and what we care about and what we stand for. And when you look at it, AARP's endorsed it, the American Medical Association's endorsed it, the Catholic Bishops had nothing but good things to say about it. And even the Business Roundtable, the top CEOs in the country, said that the health care reform bill in 2019 will save them $3,000 an employee, $3,000. Now, you can argue with me, you can argue and call people ``liberal'' and ``socialist'' and pull out all of the names that our friends on the other side have been using for the last 60 or 70 years in their rebuttals to policy initiatives by the Democratic Party, but you can't argue with the Business Roundtable saying that it's going to save them $3,000 per employee. And aren't we tired of getting calls from small business people telling us about all of the increases, all of the rate increases? And I just got a call the other day from a health care provider talking about this issue and another from a health care business person who said he just got in the mail a 50 percent increase for his business. He had one person out of a couple hundred get sick. Pushed the number up. Next thing you know, he goes from paying $600,000 a year to next year he is going to have to pay a million dollars a year. And he said, Timmy, I may have to shut the doors. I may have to shut the doors. That's what we're trying to prevent. How can we have any sustained long-term economic growth if we don't take care of the health care issue in this country? If we keep strangling our small business people? And I understand that there may be some small business people that maybe disagree with any extension of the role of government in any area. But there is nothing left to control the massive insurance industry in the United States of America unless we do what the people have always done when we needed to address a big problem in this country, and that is join together through our elected officials who we send to Washington to help us. We need to ask them to get together and solve this problem, and that is what is happening. And we see the insurance industry and the extreme right wing of the Republican Party, the neoconservatives, continue to be offended. Nobody here wants to hurt anybody. Nobody here wants to destroy America. We are here to help, and we are here to address these problems collectively as a country. We have people on the other side of the aisle, because Rush Limbaugh says they shouldn't, they won't even work with us. Getting rid of preexisting conditions, letting people be on their parents' insurance until they are 27, limiting how much out-of-pocket you can spend, making sure that they can't knock you off the rolls after you have insurance coverage, these are some basic things that we should all be able to agree upon. Mr. Speaker, we are doing it. And the same issue happens with energy, to where we send in this country $750 billion a year in wealth out of our country through the gas stations that go to oil-producing countries: a $750 billion wealth transfer right out of our country. And a couple of years ago, Mr. Speaker, we spent about $115 billion out of the Defense Department escorting ExxonMobil and Big Oil ships in and out of the Persian Gulf. So if you do the math, the Persian Gulf oil that ends up in your gas tank should really be $1.50 more because of the subsidies that the American taxpayer has paid to provide the security of these ships going in and out of the Persian Gulf. Now in addition to that, subsidies for oil companies, tax credits and tax cuts to go and continue to drill, so completely subsidizing Big Oil and the oil economy. And what Democrats have said is, how do we put together an energy policy that will take some of the $750 billion and instead of letting it go offshore and out of our country, how do we direct it back into the United States, and at the same time reduce CO2 and at the same time resuscitate manufacturing in the United States of America through our windmills, through our solar panels, using natural gas that is here in the United States. We don't have the kind of oil that some of these other countries do. And why do we prop up these dictators and these royal families who have no concern for our well-being, when we can use the need for energy and make it work for us and put together a system and a national policy that is pro-American. There is not a bigger, more patriotic piece of legislation in the United States of America's House of Representatives right now than the energy bill that passed this House. What kind of national security plan is it for us to continue to send money that goes to these kingdoms that fund terrorist organizations that don't like us when we could be putting steel workers to work making the 400 tons of steel that go in the windmills or resuscitate manufacturing in the United States of America by making sure that our people manufacture the 8,000 component parts that go into a windmill. To me that makes a good deal of sense. And both of these issues in the long term are jobs programs. Does anybody have a better idea, Mr. Speaker, on how to stimulate manufacturing in the United States? I can't think of one. We have tried to cut taxes on the top 1 percent and hope something trickles down, and that means they will invest back in America and will create jobs in the United States. That didn't work. It did not work. The Republicans had the House, the Senate, the White House. They implemented the whole George Bush economic policy, and it didn't work. And here we are today. I know our friends like to be critical of the stimulus bill, but in January we lost 750,000 jobs. Now we are still losing a couple hundred thousand jobs a month, but it is not quite as bad. We are trending in the right direction, and we do need to put together a jobs program. We do need to invest in the transportation and put thousands and thousands of people to work. We need to do that. We need to make those investments. There is no question about it. And we need to get back to a moderate, balanced, prudent, wise, economic policy and tax policy here in the United States. The old Keynesian economic theory that asked some of the wealthiest people in our country to pay a little more in the good times, cut taxes in the bad times and increase social spending to stimulate the economy and smooth out these rough edges, worked for a long time in this country. It led to the construction of a great middle class, balanced investments in education and transportation and roads and bridges. It is time for us to get back to that. In the Mahoning Valley in the 17th Congressional District, we are putting together what is a very smart, balanced, economic policy locally where we are making the proper investments and laying the proper groundwork. What we are trying to do locally is to line up with where the national policy and the national trends are going. You had to be sleeping if you can't tell that the world is moving towards green technology, green energy. The hedge funds, the big money people are all moving in that direction. The scientists, the engineers, all moving in that direction. All of the research moving in that direction. And so there is health care reform and what that will do for our local community, and there is energy. And so we have been fairly fortunate amidst all of the economic problems and the high unemployment, that we are seeing back home seeds that are beginning to sprout, and that once credit loosens up, we will see long-term economic growth. But we need our national policies, Mr. Speaker, to shape us as a country and push our economy in the right direction. The big decisions that are being made here through the Obama administration are sound. I think we are making some smart long-term decisions, and it will pay off in the long run. We see it in sports all of the time where you can start a game or start rebuilding your program, whether it is college football or basketball or the NBA or whatever the case may be, where you see a great coach start to implement the plan and you don't necessarily start winning all of the games right away. You saw it with Bill Walsh in San Francisco, and you see it with the Patriots and the Steelers. It doesn't always start off with the Super Bowl. And for the Browns, Mr. Speaker, it has been a rough road, but we are going to get past it. It has been a difficult time to have been a Cleveland Browns fan. But the bottom line here is we are in a rebuilding process. We are laying the groundwork. We are making the fundamental decisions necessary to allow for long-term economic growth. When you look at health care and 30 million more people that are going to have health insurance, we are going to need docs, we are going to need nurses. There is going to be a total reinvigoration of health care information technology. Just, for example, I was at the National College a few days ago in Youngstown, Ohio. They have programs primarily in health, health information technology and some business entrepreneur classes. The college opened up with 50 people. It now has 850 kids from Youngstown and Campbell and Struthers and Warren going to this school to learn health information technology. Now here we have people, young and middle-aged, looking at where the economy is going and what they need to be doing. And so the huge investment in health information technology in the stimulus bill, the investment that we will be making in health care by making sure that everybody is covered and coordinating all of these different systems, is going to be an opportunity for many of these young kids who are doing what we asked them to do: Go to school and get educated and do the right thing, and you will be rewarded. And so in 10 years, Mr. Speaker, in 2019, 2020, we will look back on these decisions that have been made in this Congress and we will see that we have eliminated a lot of human suffering because of what we have done with the health care system. We will see that we have reined in costs for the insurance companies, and that has allowed small businesses to reinvest back into their own companies and give pay increases to their workers as opposed to covering all of the health care increases. We will see people who believe that a compassionate government can exist to advocate on their behalf. A lot of people say, I am afraid of the government. It is not the government you need to be afraid of; it is the big insurance company you need to be afraid of. It is the Big Oil companies you need to be afraid of. And we are taking them on. Ten years from now, it is going to be looked back upon as one of the turning points in our Nation's history, like Medicare and like civil rights, and like a lot of the great programs that have been established to help our people. Average Americans are getting represented in this government. We will look back on our energy policies, and we will see that we have reduced our dependency on foreign oil. We have given people hope. We have reestablished America as an innovative leader in the world, and it will help with health care reform and lift up the middle class because we need to start making things again in the United States. We need to start making things again. And with windmills and wind turbines, these are things we can't ship in from China. We have to make them here. We are, and it is going to put middle class people back to work. So those two major issues are going to unleash the creativity needed, the American spirit needed, the American independence needed. I am proud of what is happening here. I am proud of what is happening in the United States. I know it is difficult. I know it is tough. I know it is noisy, Mr. Speaker, but these things are happening for us in the United States. When it is all said and done and that parent goes to get health insurance, or some young person goes to get health insurance, and they call the insurance company, and they have diabetes or cancer, the insurance company cannot deny them. Their parents are going to say, Did you know there was a day 5 years ago where you would have gotten denied coverage? And 20 or 30 years from now, our kids will say, You've got to be kidding me. That really happened in America? And we look back on the civil rights movement today. Our generation says, You've got to be kidding me. White people and black people weren't allowed to drink out of the same water fountain? That's how we're going to look back. Did we really, as a country, do that? And it is shameful that that happened in this country. Those are the same exact feelings and sentiments that we are going to have here in the United States years from now. And we will say, Did we really deny people health care? We really had people die because they couldn't afford health care when the treatment was available and the technology was available? We really let that happen? This is a turning point in our country's history, and I'm proud to be a part of it.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Madam Speaker, it is my great honor to stand before you today in recognition of Technical Sergeant Robert E. Horner. Robert will retire this December after more than 34 years of service to our country. Robert enlisted with the U.S. Navy in September 1975. He served aboard the USS John F. Kennedy as an Aircraft Bosun Mate in the Atlantic Theater. In October 1979 he transferred to the U.S. Navy Reserve. He continued with the Navy Reserve until he transferred to the Air Force Reserve as a Propulsion Mechanic in 1983, at the 911th Air Force Reserve, Pittsburgh, Pennsylvania. His service to our country continued through the gulf war and the war on terrorism; from 1995 through the present he served as Propulsion Mechanic before moving to the Aerial Spray Maintenance with the 910th Airlift Wing, Youngstown, Ohio. Robert continued his military service even through heart surgery in 1992. His distinguished career is punctuated by over a dozen awards and decorations, including the Meritorious Service Medal, the Air Force Achievement Medal, the Humanitarian Service Medal, and the Military Outstanding Volunteer Service Ribbon. Robert demonstrates an exemplary commitment to his community even aside from his military service. In 1993 he accepted a commission for the West Farmington Police Department, and served the village of West Farmington for 8 years. In 2002 he was made Police Chief, and he continues at this post today. Robert's current responsibilities as Technical Sergeant with the 910th Airlift Wing includes supervision of 12 reservists in the maintenance and operation of the Modular Aerial Spray System, the only full-time, fixed-wing aerial spray unit within the Defense Department. Madam Speaker, Technical Sergeant Robert Horner has dedicated his life to serving his country and his community. In recognition of his many efforts on behalf of the American people, I ask that you and all of my distinguished colleagues join me in commending him for his lifetime of service and dedication.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Think about it. Just in the 17th Congressional District, 14,000 small businesses will now be better off because they're going to be negotiating with more and other small businesses to try to bring down prices. And 12,300 small businesses in my congressional district will be getting tax credits as an incentive to compensate for this; 43,000 people will now have insurance that didn't have insurance. We have, in Youngstown, a hospital that just filed bankruptcy. Now all of a sudden every single person that walks through that door will have health insurance instead of that cost being passed on to everyone else. I can't help but to think about the gentleman that you were just talking about who had to spend through his kid's college fund. If these reforms were in place, that person's amount of out-of-pocket expenditures would be limited to 10 or 12 percent of that family's income. So they wouldn't have had to go into the college fund. Our friends on the other side voted against that. So we have got to go back to our constituents and defend every vote that we have made here. And that is, to me, significant. The preexisting condition, not being kicked off your insurance because you get sick, being able to stay on your parents' insurance until you're 27 years old, all of those are significant steps in the right direction, not to mention on Medicare part D by extending and having consistent drug coverage throughout the course of the entire year instead of interrupted coverage, which is happening now. I got a letter from a doctor this summer who was telling me about a patient that he had that met her limit on part D. And I can't remember at this point exactly what the issue was with her, but they had to take her from the drug of choice to a cheaper drug because she couldn't afford it. So, in June or July when she met her cap, they had to switch prescriptions because she couldn't afford the one that he had her on. She ended up getting sick. They switched prescriptions again and again, and she ended up in the hospital for a week or two. It's the perfect example of why would you not just--how much cheaper would it have been for the taxpayer to consistently pay for those prescriptions throughout the course of the year instead of her going into the hospital for a week or 10 days or 2 weeks and having Medicare pay for that? It just doesn't seem like a very smart investment on behalf of the taxpayer.

Mr. RYAN of Ohio. I'd be happy to yield.

Mr. RYAN of Ohio. Reclaiming my time, litigation has been projected to have only 1 percent effect on the costs of overall health care spending.

Mr. RYAN of Ohio. One percent of cost. And there is no real way to quantify--reclaiming my time--no real way to quantify this number. But when you're talking about billions and billions and billions of dollars, again, that's to my point, is that the Republican plan is to just kind of nibble around the edges and maybe we'll try to do this a little bit here and a little bit there, but at the end of the day here's the reality. Since we have gotten in office and with President Obama, but before that, we took on the banks and yanked them out of the student loan business because they had a sweetheart deal. As you said, with Medicare part D, where all of this money is going to the pharmaceutical companies, we are reforming that provision as well. Now we're taking on the insurance companies. With the energy bill, we took on the oil companies, where they're getting subsidies. And just a couple of years ago we spent $115 or $120 billion dollars in escorting ExxonMobil ships in and out of the Middle East so that they would be safe to further supplement and subsidize the oil industry. We took on the oil industry. Increased minimum wage, increased Pell Grants. We made steps to make investments. But the bottom line is this health care reform bill is about economic development in the United States of America.

Mr. RYAN of Ohio. Over 10 years.

Mr. RYAN of Ohio. It's not just Chris Murphy from Connecticut or me or Nancy Pelosi. Here's from the Business Roundtable. CEOs of the Nation's largest businesses released a report on the impact of health care legislation moving through Congress and that, ``Key components of health care reform could slow the growth of health care costs and offer real savings for companies and their employees.'' According to the Business Roundtable Hewitt study, many of the legislative reforms currently in the health reform bill could reduce costs by as much as $3,000 per employee by 2019. This is the Business Roundtable. This is not the Democrats. This is the CEOs of the Nation's largest businesses. As you said, CBO, Business Roundtable, this is what we're trying to fix. And when you have the CEOs of the Nation's largest businesses saying that this reform will save us $3,000 per employee by 2019, and you have hundreds and hundreds and hundreds, if not thousands of employees, that money is going to go to wages, investments, technology. On and on and on these investments will be made, not sit around and do nothing. Republicans just came--in the last week, finally, they had a proposal. We've been debating about health care for all this time and they were in control of every major branch of government from 2000 to 2006. Didn't do anything about health care. Now we're coming to try to fix it.

Mr. RYAN of Ohio. The idea here is that this is how this bill will extend Medicare's life an additional 5 years, in part because of cost savings and a variety of others. But we are going to have healthier people going into the Medicare program. Right now we have people that are 55, 60 years old, and we see a lot of them in our communities, the older manufacturing communities. You work until you're 55, you work until you're 60, and then all of a sudden, the company goes bankrupt or they lay you off or they move the factory to Mexico or to China or whatever the case may be. I have met several of them, have talked to them on telephone town halls. One woman I remember in particular was 60 years old. She did not lose her job, but lost her health care coverage. The company could no longer afford it. So now she is 60. She makes $32,000, $35,000 a year, can't make it, can't afford health care coverage. She said, I'm going to wait until I get on Medicare. So here you have someone who is 60 years old, probably has some issues because everybody at 60 has issues. Now a physician won't manage those problems that she has. She is going to go without any care, any treatment, any kind of management whatsoever. So she is going to go into Medicare at 65 much sicker than she would have went in if she had decent health care where her problems could have been managed and not become chronic to the point where they could cost the Medicare system thousands and thousands, tens of thousands of dollars, hundreds of thousands possibly, depending on what the issue is. So you have a healthier person going into the Medicare program that's going to extend the life of Medicare. What kind of system is this, 60 years old, you have worked your whole life, and they say, Sorry, you're on your own; we will pick you up at 65. Thanks for everything. You lost your health care. That is not right. That is not right, Mr. Speaker, and that is what this whole program is trying to fix.

Mr. RYAN of Ohio. Yes. And it has all been fear-based. One of our colleagues on the other side said the tea baggers are beyond, they're beyond scared; they're terrified now. They are terrified because of the budget. Where were these people when President Bush and the Republican Congress and House and Senate were cutting taxes for millionaires and starting two wars and spending money left and right and running up the deficit? And now they're terrified because we're saying we want to help small businesses, we want to help citizens in the United States be able to afford health care? We're taking on the insurance industry, Mr. Speaker. What is so difficult about this to understand? They have been ruling the roost in the country for how long? And we're stepping in after an election in 2006 where the American people were fed up, an election in 2008 where President Obama won, and basically, a huge election, and he talked as a centerpiece of his campaign about health care reform. And here we are. I'm sure our districts aren't that much different, manufacturing, a lot of immigrants came over the last 100, 150 years to our States, and a lot of middle class people, and our people don't get on a bullhorn and scream about their problems that they have in their family. They have a lot of pride, but they just want to muscle through it. But they want an element of fairness in the system. And so they will, as I said, and I don't know if you were here or not, they will grab me at the restaurant and thank me for my vote and say, I hope it passes, or I hope it pulls through. But they are not going to call Rush Limbaugh and call in and talk about how their daughter is sick and the problems they had and go on and on. But when I stood at the Canfield Fair or, this weekend, going into a restaurant or getting my hair cut, whatever the situation was, they would grab me and they would quietly say, thank you. God, is this going to pass? Is this really going to happen? That's what average people are saying here today. These situations that go on all across our country, and to turn a blind eye to it, and the Republican proposal doesn't even cover everybody. It was like, here is our proposal. Great. You cover another million people. Boy, that is really going to bring down the pressure on the emergency rooms. And this is pretty simple. I talked about the reforms. If you make $89,000 a year or less, you are going to get credits, subsidies, to help you pay for your insurance so that family will have more money to spend in other parts of the economy. Instead of health care eating a huge chunk of the economy up, they will have money to pay for their kids' college education, to make investments to buy a new car, to keep the auto industry going, buy a new refrigerator, buy a new house. Literally, if you think about just an $1,800 increase next year in health care bills, if we get health care costs under control, imagine the amount of money these families and small businesses are going to have to spend in buying durable industrial goods.

Mr. RYAN of Ohio. I appreciate that. The gentleman makes the point that what this is all about is jobs. This is an economic development bill. This is about allowing these businesses to reinvest back into their small businesses. It is not a coincidence that as health care is eating up more and more of the businesses' budget, that wages have been stagnant over the last decade or two because the small business owner does not have the ability to both eat the increases in health care and give the requisite amount of pay increases to the workers. It's either or. So over the last decade, it has been all health care, all the time. And sometimes they have passed on a smaller portion of that on to their employees where they are asking for more of a co-pay, higher premiums and the whole nine yards. But now, what we are saying is if we can get these costs under control, those small businesses can reinvest back into technology, back into the new machines, back into the wages, back into the training, back into more benefits and other kinds of benefits, maybe retirement benefits, for their workers instead of being stuck in this cycle of health care, health care, health care, health care and no reinvestment back into the business.

Mr. RYAN of Ohio. Mr. Speaker, I appreciate the opportunity to try to clear the record here a bit and talk a little bit about our health care reform proposal that passed the House of Representatives a little more than a week ago and talk about the benefits to the American people. I would like to respond to a couple of the concerns that were made by the other side over the course of the last hour. It's very interesting to me because I was here over the last 7 years and was here during the last part of the Bush administration. I was here 2002, 2003, 2004, 2005, 2006, 2007, 2008 and watched as our friends on the Republican side cut taxes for the top 1 percent, the wealthiest 1 percent of Americans, continued to spend money with a reckless disregard for the national debt, for deficits, started two wars, borrowed the money from China to pay for the wars, borrowed money from China to compensate for tax cuts that went to the top 1 percent of the wealthiest Americans. And here we are a couple of years later, and our friends on the other side are concerned about the deficit and the debt. It was President Bush's appointees to the SEC that gave a blind eye to what was happening on Wall Street. Wall Street collapses, and the $780 billion and $800 billion that we had to spend to stabilize the economy was under President Bush's watch. It wasn't under President Obama's watch. We've spent the last 9 months cleaning up the mess that was made over the last 8 years. Now, this is not to assess blame. We're all in this boat together. We're all in this together. I recognize that. But you can't cause all these problems, because the Republicans controlled the House, Republicans controlled the Senate, Republicans controlled the White House, Republicans controlled the Supreme Court. They pulled every lever of government, ran up the deficit, ran up the debt, started two wars, blowing money left and right, giving tax cuts to the wealthiest, and then we wonder why we ended up where we are today. No regulation of Wall Street. The economy collapses. Tax revenues go down. Now, I'm not saying that what we have done over the last 8 or 9 months has been to wave some magic wand and all of these problems have gone away. I represent northeast Ohio. Our unemployment rate is at 15 percent in some of our cities. But we can say very objectively that the money that was spent going to Wall Street, the stimulus package has at least stepped us away from the cliff that we were on--and we were on a cliff ready to fall off as a country--as an economy we have been able to stabilize that. Now, I'm not happy with what the banks are doing. I don't think anybody is. I think it's important to move more money back to community banks and let's stimulate lending at the local level. That's how we're going to recharge and revive our economy. And that would be the direction that ultimately we need to go in. But you certainly can see that we were losing jobs at 700,000 a month and now we're still losing jobs, still too many; but it's at 200,000- plus a month. So we're at least trending in the right direction. But I've got to tell you, Mr. Speaker, I get a real kick out of these fellows on the other side who caused all of these problems and then now complain how we're trying to fix them. And make no mistake: this discussion about health care, as our friends earlier were talking about, their assumption and presumption was that the health care system is working just fine. It's not costing us a lot of money, not really hurting many people, everyone has access, no rationing today, all of which is not true. We have health care growing at a 9 percent clip. We have the GDP growing at a 3 percent clip. You continue to do the math, and you'll find out that in 10 years, $1 of every $5 in our economy will be spent on health care. You will find out that if you take that out another couple of decades, 30 years, $1 in every $3 will be spent on health care. That is unsustainable. Unsustainable. And to think if we do nothing, which is basically what the Republican proposal was, to just keep kind of doing what we're doing, it doesn't cover more people, doesn't take care of a lot of the human rights issues that were involved here--if we continue doing what we're doing, the average family in America will pay another $1,800 a year in health care next year and then another $1,800 the following year and another $2,000 the following year. And we will continue down a road where this continues to eat up the whole family budget. I have a member of my staff who has an Aetna 7-D health care plan. In 2007 his copay was $237 a month. In 2008 it went up 22 percent. In 2009 it went up 9.7 percent. And in 2010 it went up 80 percent. Now, this is a Federal employee; and this is happening all throughout our economy, all throughout our country. So from 2007 to 2010, a 142 percent increase for Gene Crockett from Niles, Ohio. Now, our friends on the other side: just keep doing what we're doing, things are okay, things are fine, we'll get to it. This is change. And this is obviously a difficult process, but we are moving forward, and it passed the House in a historic vote here a couple of weeks ago, and we will continue moving in that direction so that the Gene Crocketts of the world and the average people around the country who see this eating up more and more of their budget will get some relief. I was amazed over the last week I was home when I'd be at a restaurant and people, real quiet, would kind of look at me and say, Thanks for your vote on health care, Congressman. You know, real quiet. And that's how this debate has been in this country. And the polls are bearing it out. The AARP poll that just came out showed significant support for this. Another poll I was just looking at a little bit earlier, significant support for some of these provisions, because we take care of the bread-and-butter issues of the health care situation we have in this country. If you're a kid or you're 27 years old or younger, if this reform passes, if some of these provisions in the House version stay in, if you're 27 years old or under, you can stay on your parents' insurance. If you have ever been denied insurance coverage because you have some preexisting condition, this reform will end that practice. That will no longer happen to anyone in the United States of America ever again. And our friends on the other side voted against it. I was getting my hair cut last week and was talking to the owner of the hair salon, and she said, you know, you need to pass this health care reform. We need help. I heard the story about her daughter who just started working with her and the daughter had asthma growing up, went to get insurance, and she had to sign basically an agreement with the insurance company saying that if she goes to the hospital because of asthma that the insurance company will not pay for that hospital visit. So the girl has asthma. She's paying a lot of money a month, hundreds and hundreds and hundreds of dollars a month, to get insurance. And the one thing that she is probably going to need her insurance for the insurance won't cover. Now, does that make any sense, to continue with a system that takes your money but will not cover you? That doesn't sound very fair. And that process, that provision, that practice will be eliminated. Done. No more. My friends on the other side voted against that. Also in the House version, the 27 years old and the preexisting condition provisions happen as the bill is passed; so that will start immediately. The exchange and some other things start in 2013, but those two provisions start immediately. So the American people will see the benefits of that rather quickly. Another provision in this bill says that there will be limits to the amount of money a person or family can spend a year. In the House bill it was about 12 percent of your income, which is still a lot. So if you make $50,000 or $60,000 a year, if you have a health care catastrophe in your family, after you pay $5,000 or $6,000 out of pocket in health care, you're done paying for the rest of that year. So families in America will no longer go bankrupt because they have a health care catastrophe in their family. Now, if that is not a human rights issue, I don't know what a human rights issue is. And that is exactly what this bill does. So, no matter what, families in this country will not go bankrupt because of health care situations in their family. And if you look at my district alone, 17th Congressional District, it stretches from Akron through Kent, Ravenna in Portage County, Warren and Niles in Trumbull County, and Youngstown, Ohio, in Mahoning County, the old Steel Belt. Just last year, in my district, 1,700 families went bankrupt because of health care, 1,700 families. And what this provision will do is eliminate that. That will no longer happen as it happens here today in the United States of America. So, our friends on the other side are three for three now. They voted against extending insurance to kids or allowing kids to stay on their parents' insurance until they are 27 years old, they voted against that. We said that you can no longer be denied coverage because of a preexisting condition, diabetes, cancer, heart disease, asthma. We put an end to that practice. Republicans on the other side, except for one courageous soldier down in Louisiana, all voted against it. And those two provisions will start immediately upon this bill's going into effect. The limiting of 12 percent of your income that could be paid out of pocket per year on health care expenses, so that we don't have people go bankrupt, passed in the health care reform. Every Republican, save one courageous soldier down in Louisiana, voted against it. Our friends on the other side were talking about small business, small businesses being affected by this. Eighty-six percent of small businesses will be exempted from this legislation. But they will be able to go in to the health insurance exchange and all of a sudden have a lot more bargaining power than they had before, because they would call their health care folks up and say, what do you got? What's the package? How many employees do you have? Ten, 15, 20. An average increase, or the increase over the last 6 or 7 years, has been about 120 percent increase for small businesses. This allows these small businesses, Mr. Murphy, to go into the exchange, to pool their numbers, to get better negotiating power, more negotiating power and better rates, because of their ability to pool with each other. And that will reduce health care costs for small businesses. At the end of the day, it's going to be the small business folks who will see this health care reform as a real step into trying to help them control health care costs so they can reinvest back into their company. I yield to the gentleman from Connecticut.