Phil Roe

Mr. ROE of Tennessee

Mr. ROE of Tennessee. I thank you. And thank you, Mr. Bilirakis, for being here. I appreciate your leadership on the committee, too. Why should I be concerned about this, and what experience do I have to say that if this is not fixed it will affect access and quality? I've had, I guess I could say, the misfortune in Tennessee of going through health care reform 20 years ago. What happened? What happened was we had a large group of people in our State who didn't have access to quality, affordable health care. We reformed our Medicaid program and opened it up. We had an open enrollment time where we were going to have these various plans compete against each other. It was very much like the public option I heard discussed during the debates 4 years ago. What happened? What happened to us was that our costs tripled in 10 years in that plan. It went up three times. And you can already see in the Affordable Care Act, even before it's been fully implemented, the estimates of costs have already doubled. The costs to patients are going up and the costs to businesses are going up. It didn't do what it had to do to really help solve the problem, which is lower the cost, bend the cost curve down. It did not do that. When we saw those costs go up, what did we do? We started cutting our providers, and we cut our providers and we cut our hospitals and our doctors and our nurse anesthetists and our nurse practitioners and PAs and so forth. Guess what happened? Access got cut off. They stopped seeing those patients. Now, our practice where we were, we, as an obstetrician as you were, we took everyone, because pregnancy is one of those conditions where you either are or you're not. We felt like if those folks needed care, we kept seeing those critical-care patients like that. But many elective-type things--orthopedics and dermatology and those kinds of things--got cut off, and people would have to drive hours to see a specialist. So I saw access get denied in that system when the cost of the whole system went up to where no longer the State could afford it. I've seen that happen. That's why patients should be worried. Dr. Gingrey, you and I know these numbers. We have 10,000 people a day hitting Medicare age. That's 3\1/2\ million people this year that are going to be Medicare age. These are new people on the plan with less money. And if we have more people and we're not producing more doctors, do the math. In 10 years, we're going to have 35-plus more people on Medicare, and who is going to care for those people? Another thing I want to bring up is that we're not just talking about how doctors are paid. We're talking about increasing quality. One of the measures we're going to look at when we look at the new payment formula--right now the way you and I were paid when we were in practice was a patient came in and you got a fee for that visit. That's called fee-for-service medicine. That's going to change. We're going to look at quality outcomes and measures. I'll give you an example about why that's important. One percent of our Medicare recipients use 20 percent of all Medicare dollars, so we have to look at how we manage the care of those patients better. For instance, with congestive heart failure, when someone leaves the hospital, we know that certain metrics are taking place: weights are taken every day, blood pressure and so on. If you check in with a provider, you can prevent rehospitalizations and save tremendous morbidity, mortality, and cost. It also increases the quality of life that patient has and the quality of care they receive. So doctors are going to be evaluated on the kind of outcomes we have and the quality of care we provide our patients, which we all agree should be done. I think coordinating care, hopefully, with better electronic records--and I could spend an hour talking about that. If we have a coordinated electronic system where, when you order a test at your office or the hospital, we have access to it so that test is not repeated and duplicated, that will make a huge difference in cost. I just had a duplicated test, myself, done. You may have, too, when you had your procedure. I had a surgical procedure done 2 weeks ago this last Monday, and there was some testing on myself that really didn't have to be done. But because of various rules and regulations and the inability to get that information easily, it was easier to repeat it and pay for it than it was to go find it. I think that happens to 300 million people. Actually, it is 47 million of us who get Medicare now. We need to do that, better coordinate that information with sharing and transparency.

Mr. ROE of Tennessee. I think correctly the Congress, in its constitutional authority, has overridden the SGR 15 times since 2002. I think that's the correct data. What this IPAB does in the Affordable Care Act--it sets the same metric. It has a very complicated formula, which is the same as SGR, and if you have expenditures above those projections, cuts will be made. There is no judicial review, no administrative review, and it takes a 60-vote margin in the Senate to override this. Let me tell you how important this is, what Dr. Gingrey just pointed out. Whether you agree with the plan or don't agree with the plan, there was a great article in the New England Journal of Medicine, one of our premier medical journals, that was published in June of 2011. I would recommend this for anyone to read as it will take you 30 minutes or less. They went back with the CMS and looked at the last 25 years and said, What if we had IPAB then? What would it do? In 21 of the 25 years, cuts would have occurred to providers--and I know exactly. Because of what I have seen in Tennessee, I know exactly what would happen. What would happen is you cut those providers right there. As you're seeing up there, Dr. Gingrey, I can tell you that, as to the access to care, that entire map of the United States right there would be a bright red because you would not have the providers to take care of those patients. That is a tremendous concern for me because it is current law. This year, those 15 bureaucrats are supposed to be nominated by the President. What happens if he doesn't nominate those 15 people? One person--that's the HHS Secretary, Secretary Sebelius--makes those decisions and recommendations. I hear it all the time. I go on the talk shows like you do, and they say, Well, in the bill right here, it says that you cannot ration care. That's true. This board can't ration care. What they can do is just not pay the providers. In 2017, I think, or in 2018, the hospitals are included in this. They're not included first, but they will be in 5 short years.

Mr. ROE of Tennessee. That is correct. And so much so that in California, what they're recommending, I don't know whether they've carried it out or not, but they've recommended expanding the definition of ``primary care'' to a lower-level provider, that would be a nurse or nurse practitioner or PA or this sort of thing, this sort of designation. I think the other thing, Dr. Gingrey, that we haven't talked about, and we probably should spend some time on, is the age of our practitioners. In our State of Tennessee--where you see that we're not quite as dire in need as Georgia, our friends to the south--the problem with it is that 45 percent of our practicing physicians in the State of Tennessee are over 50 years of age. I'm concerned that with the advent of the Affordable Care Act, the complexity of that, the frustration that I see when I go out and talk to our providers is that I'm afraid that many of them are going to punch the button for the door. I know in my own practice, where we have now about 100 primary care providers in my program, in my OB/GYN group, in the last several years we've had over 120 years of experience walk out the door and retire. That's not a good thing for the American health care system that just lost access. Quite frankly, the crux of it all is that access. If you do not have access, you will decrease quality, and you will increase cost. That is our concern. Ultimately, the cost will go up if our patients can't get in to see us.

Mr. ROE of Tennessee. That's correct, that number right there. That was avoided by a 1-year so-called ``doc fix.'' What has happened over the last 15 or so, 16 now, years is that the Ways and Means Committee line--now law--says we have to spend this much money, but we've actually spent this much. That is a deficit in spending that we've got to make up somewhere in our budget or add it to the budget deficit. Now, I go back to when I was in practice just 5 years ago now in Johnson City, Tennessee. Dr. Gingrey, I don't know about you, but I was having a harder and harder time finding primary care access for my patients that I had operated on, or maybe someone who had been my patient for 30 years--if she was 40 years old when I started taking care of her, in 30 years she's 70 years old and needed a primary care doctor. That was getting harder and harder and harder to do. Now, when you look at today's young medical students, we're having a much harder time convincing these young people to go into primary care. What is primary care? Well, it's pediatrics. If you want someone to take care of your baby, it's family medicine. It's also internal medicine and also OB/GYN. I certainly served as a primary care doctor, as Dr. Gingrey did for his patients, for many, many years. That would be the only doctor that they would see. But that's getting harder for our patients to do. And Dr. Gingrey, that's my primary concern--access for seniors to their doctors.

Mr. ROE of Tennessee. Well, the particular slide that Dr. Gingrey has down there is very telling. Basically what it says is that each year that we've recalculated what our physicians will be paid, we haven't met those metrics, which means that we have to cut. Well, what has Congress done? Well, Congress has realized that what we're talking about is not payments to doctors; what we're talking about is access to care for patients. What happens is if you go back to 2003--I think it was 2003--when there was a 5 percent cut in Medicare payments, we realized at that point right there that if you continue to do that, that access would be lost. So let's fast forward to 2013, what we're just facing. Doctors were facing a 26.5 percent cut, the providers were.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, on rollcall No. 46, had I been present, I would have voted ``Yea.''

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, on rollcall No. 47. Had I been present, I would have voted ``yea''.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. I thank the gentleman. I do want to say to the American people that 47 million people, including Dr. Gingrey and I, are on Medicare. We made a solemn promise to our seniors in 1965. When that program came out, it was a $3 billion program. Why was it put in place? Because many people retired from their business at that point in time, they no longer worked, and they had no access to care. Again, lack of access to affordable health insurance. It was a $3 billion program. There was no Congressional Budget Office at that time, but the estimators here in Washington said we believe in 25 years this will be a $12 billion program and maybe even balloon to $15 billion. The actual number in 1990 was $110 billion. Today, in 2013, it's going to be over $550 billion. Now, we've made a solemn promise to people who paid premiums--2.9 percent of their income, basically. The employer pays 1.45, and they pay 1.45. Of all the income you make, all of your paycheck goes to that. One of the things that we've discovered and found out is that we pay in, as I have--as the average person does--about $117,000 or $118,000 over a lifetime, a family does, but they get out over $300,000 in services. So we know we can't pay $100,000 in and get three times that much service out. What are the reasons? It's the same issue with Social Security. We have fewer and fewer people paying in and people living longer and longer and longer. By the way, each day in this country, over 10,000 baby boomers hit age 65. That's 3.5 million people a year who are getting to be about 65 years of age. You have to laugh at the lingo up here, when ``savings'' means that you take money out of something and when an ``investment'' means you spend it into something. So you have to learn the language up here to understand what people are talking about. About $700 billion was taken out of the Medicare program--savings-- and we've got 3.5 million more people being added every year. Well, you do the math. How they were going to control this cost was with a little plan called the Independent Payment Advisory Board. What that is is a board of 15 unelected bureaucrats who are appointed by the President and confirmed by the Senate. Here is a little tricky part of the legislation. The President is supposed to be appointing these people this year. If they are not appointed to that board, one person--one-- the Director of HHS, Kathleen Sebelius, has the power to enact all this. We have given that bureaucratic power to one person if those members and that board are not confirmed. Most people don't know that. I've heard all the pros about how wonderful this is. I go back to my scholarly journals, and I want to refer people to the New England Journal of Medicine. An attorney in the New England Journal of Medicine, Timothy Stoltzfus, wrote an article in June of 2011, not pro or con, but just about the Independent Payment Advisory Board. In addition, my friend Dr. Gingrey just said--and he is absolutely correct--that Congress changed this payment to doctors, the so-called SGR--the sustainable growth rate--so that patients would maintain their access to their doctors. We've had a retrospective look at the last 25 years. Let's say we fix SGR, like we're talking about, so that patients maintain their access. In a retrospective look in his report, the CMS actuary questioned--this is not me saying this--whether this goal is achievable to maintain these cuts, noting that the IPAB-targeted growth rates would have been met in only 4 of the last 25 years and would have approximated the sustainable growth rate, meaning that a cut would happen. We have almost no power to change this. Now, here is what I found interesting. In the bill, it's absolutely correct that you can't ration care, that you can't do any of those things. That's maybe true, but if patients don't have access to their doctors, you, in effect, have rationed care. It's that simple. This is what Peter Orszag said, the former Office of Management and Budget Director here in the Obama White House: The IPAB is the single biggest yielding of power to an independent entity since the creation of the Federal Reserve. That is an astonishing statement when you hear it. That's one of the reasons I'm so passionate about maintaining the decision-making power with patients and with their families and their doctors and not with some bureaucratic board up here and also, certainly, not with the insurance companies. I agree with that. Another comment that I've seen made: The Independent Payment Advisory Board puts important health care payment and policy decisions in the hands of an independent body that has far too little accountability. That's one of the things. You may like it or not, but we in Congress have been able to change these things, and it would require 60 votes in the Senate to do it. Quite frankly, with my good friends on the other side of the building here, you couldn't get 60 Senators hardly to agree whether the Sun came up in the east, so the benchmark is very, very high. Mr. Speaker, how much time do I have remaining?

Mr. ROE of Tennessee. I thank the gentleman for his comments. I felt a little deja vu there, Dr. Harris, after walking out of the delivery room after about 5,000 deliveries for some of the very reasons that Dr. Harris brought up. I'd now like to yield to my friend from Georgia, Dr. Gingrey.

Mr. ROE of Tennessee. I thank the gentleman. I'd now like to yield time to my good friend, Dr. Andy Harris from Maryland. Andy is an OB anesthesiologist. And I say this to my good friend: I spent a good bit of my adult life waiting for anesthesia to put my patients to sleep so I could operate. So I now yield to Dr. Harris.

Mr. ROE of Tennessee. Mr. Speaker, before starting this Special Order, I'd like to yield as much time as he may consume to my friend from Mississippi, Steven Palazzo. Sequestration Effects

Mr. ROE of Tennessee. I thank the gentleman. He is absolutely spot on. One of the reasons that he ran for Congress and I ran for Congress is to preserve this great program for our seniors out there, and I am absolutely committed to do it. Let me give a couple of facts before we end up. The actuary of the Medicare program--this is not me, this is the Medicare actuary--said that congressional action will be required to ensure that our seniors have continued access to care. In May 2012, he said it is reasonable to expect that Congress would find it necessary to legislatively override or otherwise modify the reductions in the future to ensure that Medicare beneficiaries continue to have access to Medicare services. This is not some right-wing Republican, this is the Medicare actuary, and we're not even talking about it. We have heard nothing from the President about how we preserve this great program other than we just keep doing what we're doing. That's not an honest, fair assessment of where we stand today. The sooner we deal with it, the more likely we are to come to a less painful solution to this. I do want to finish by saying that I appreciate the hour you've shown us, Mr. Speaker. We will continue this very, very important discussion on Medicare in the future, and I yield back the balance of my time.

Mr. ROE of Tennessee. I want to finish by spending the last little bit of time on Medicare. It is such an important part of our health care system. I want to strengthen this program--and I certainly know the folks on my side of the aisle and, I think, on the other side of the aisle want to--for future generations. We've made a promise to our citizens in this country that when they are at retirement age they'll have at least an affordable health insurance product available to them. Let me tell you, the funny thing I found out about myself when I turned 65 was, the day before, I had a health insurance plan. It had a prescription drug benefit plan; it had a hospitalization part; it had a part that paid for my physician services. The day I turned 65, I got a part A, a part B, a part C, and a part D I could have. Well, nothing happened except I got 1 day older. Why, when a person turns 65, wouldn't you just have a health insurance plan that offered you those various options in your plan? You should be allowed to pick what's in your best interest and need. Remember, in the Affordable Care Act, the Federal Government now decides what's an essential benefits package. You don't make that decision with your family and your doctor. A Federal bureaucrat makes that decision--what you must buy, a good or a service that you must purchase. Some of the facts I've mentioned already about Medicare, and one of the things that we have to do, I think, in Medicare--and I know my colleagues will confirm this--is that, currently, one in 10 physicians is not accepting new Medicare patients. In some areas, it may be as many as three in 10 primary care or as many as half won't. We have a huge shortage of primary care physicians in this country. We know that the hospital insurance trust fund is insolvent. It may run out of money as soon as 2016. I yield to my colleague, Dr. Harris.

Mr. ROE of Tennessee. I thank the gentleman. Mr. Speaker, we're going to take the next hour or so, the Doctors Caucus, Dr. Gingrey, myself, Dr. Harris, and we're going to speak about the Affordable Care Act, how we got where we are, the plan to save Medicare, and other health care issues. I came to this Congress after a 31-year medical practice in Johnson City, Tennessee, just a doctor out each day in east Tennessee taking care of patients; and I made a decision that I didn't like the direction that the country was headed in health care, and I wanted to run for Congress to be here for that reason. Well, it turned out that two Congresses ago we did have a debate on the health care issue. We have nine physicians in our health care caucus, and not one of us was consulted about that health care bill. Not one of us was brought in the loop and said, What do you think? Well, we had an extensive debate, I will admit, in the House. This bill was passed on a pure party-line vote in November of 2009; and on Christmas Eve, the Senate passed a bill that had not been vetted, had not been heard in the House, was not debated in the House, a completely different bill. But because of the rules in the Senate, it never got heard here and was not debated fully in the Senate. That bill was passed, it will soon be, 4 years ago--3 years ago, I mean. We thought that we'd have an opportunity after the Supreme Court looked at this--those challenges were brought to overturn this bill-- and we're going to spend the next hour explaining why we don't think it was the right prescription for the health care of the citizens of this country. I bring an extensive knowledge about a health care reform bill we did in our State of Tennessee. The biggest problem with the health care in this country is not the quality of care. Certainly, we can always do better, and physicians want to do better and have new techniques and new innovative medicines that we use. But the biggest problem with health care in America is the cost of that care. I got to see it every day in my practice, where going to the hospital could bankrupt families if they didn't have proper insurance, it was more expensive to come in, and so the number one driver was cost. Number two, there's no question we had a group of people who worked every single day of their lives and could not afford health insurance. It was not affordable for them. I would see it in my community where you would have, let's say, a carpenter who would work and during the winter they didn't get to work too much. They would work and maybe make $20,000 or $25,000 a year. Their wife may work at a local diner, maybe, and make $20,000 or $25,000. Together, where we live, they could make $40,000 or $50,000, maybe, in combined income and they could live okay. But they could not afford a thousand dollars a month for health insurance coverage. It was just out of their reach. And thirdly, we had a liability crisis in this country. So what did the Affordable Care Act actually do? Well, it did increase access. But it increased access mainly, the best I can tell, through a massive expansion of a failed system called Medicaid. The Medicaid system right now in this country is broken and needs to be reformed. We did not reform it with this bill. So that's one thing it did. Two, it did not touch liability. And we can go into that a little bit later. But the liability crisis still exists. My State of Tennessee has done something, as has the States of Texas and California. Other States have been successful in liability reform. And that has helped. But the President was here Tuesday night. We were all sitting in this Chamber. And amazingly, in the seat right below you here on the dais, the President said with a straight face that his bill, his Affordable Care Act, so-called ObamaCare, had lowered costs. I was astonished by that because it clearly has not done that at all. And let me just go through a few things. I serve as the chairman of the Health, Employment, Labor and Pension Subcommittee in the Education and Workforce Committee. So if you have a private health insurance plan, that issue, that plan will come through my subcommittee. Let me just go over a couple of things that we found. We've had numerous hearings over the past 3 years about this. And this is recent data right here. President Obama's health care law will push about 7 million people out of their job-based insurance coverage, nearly twice the current estimate. That was just in the last week or two, that estimate, according to guess who? The Congressional Budget Office. Not Phil Roe and not some Congressman. But the CBO believes that. So twice what they thought it would do. Spending on health care is up. And we estimate it's as much as $4,500 per family since this bill has come into play. That is not pushing the cost of health care down. So we see that. And one of the things that this bill did, I think which was good and bad, Mr. Speaker, is we allowed millions of young people under the age of 26 to be on their parents' health care plan. That sounded like a good idea. And if you have a mom and dad that paid for that, it probably is a good idea if they pay for. I know one of the great points of my life were when my three children got out on their own and paid their own health insurance. That was the biggest raise I probably ever got, them getting out of college and paying their own health insurance. But what happened was, the way the bill was written, actuaries can no longer charge the actual cost of that care. Let me give you an example. If a person my age is out buying an individual policy, it will cost about six times what a young person under 26 pays because actuarially I'm much more likely to need health insurance or need my health care plan. This bill only allows a 3-to-1. So that means a young person is going to pay two to three times, that person out there paying for that health insurance coverage, than they otherwise would have. I've had a good friend of mine who's in the health insurance market at home, and for all three of my children I bought them individual plans, and I specifically remember exactly how much I wrote the check for. He said, Dr. Roe, I was having these plans for about $100 a month, just a basic health care plan. Some less than that, depending on risk. Immediately after that bill passed, those rates tripled--they were $280 a month. All of a sudden now, if you're an individual, that isn't affordable. Most people don't have an extra $200 or $300 right now in a tight economy to do that. So we've made it less affordable for a lot of young people. More accessible but less affordable. I'd like to introduce my colleague and cochair of the Doctors Caucus and fellow OB/GYN physician from Georgia, my good friend, Dr. Phil Gingrey.

Mr. ROE of Tennessee. I think we all could stand here for hours talking about--I certainly could--the innovative new devices that I've used through laparoscopy that have helped patients shorten their length of stay, shorten their pain. I hope we don't go into the Middle Ages of health care in technology because we could spend literally hours talking about what we've seen. We're the place in the world that people come for this. Before I go back to costs, the estimates are that this device tax will cost 43,000 jobs. The fear is that we'll start producing these offshore and lose jobs in this country. That makes no sense whatsoever. Actually, it was Dr. Milton Friedman who said: If you want more of something, subsidize it; if you want less, tax it. That's a fairly simple concept. Back to the initial problem we have in health care, which is cost. Let me just go over a couple of things, and not just behavioral things. In a recent Gallup survey, the top concern cited by small business owners was rising health care costs. Remember, the President stood right here--and I listened to the debate and so did Dr. Gingrey--for hours on end about how this was going to lower the average person's health care insurance premium by $2,500 a year. Remember that? You remember that, Dr. Gingrey. I heard it over and over right in this well and right at this dais. Guess what? Exactly the opposite happened, which is exactly what we predicted would happen. It did not bend the cost curve down, and it's making it less successful and affordable for people. Anyway, on with this Gallup survey. So three-fourths, 74 percent, of respondents reported that rising health care costs were hurting their businesses; and 61 percent of small business owners, who are not hiring, point to worries about potential costs of health care as a reason for why they're not hiring. That ought to be a clear signal to everyone here that we need to deal with costs. What I should have stated at the outset of this hour is what we do not need to do. Health care decisions should be made between physicians, the family, and that patient. That's who should be making them. It should not be insurance companies and certainly not some bureaucrat here in Washington or some policy wonk up here that thinks they know what's best, as Dr. Harris just pointed out what is best for that patient. He saw and he knows what's best because that's what he's done for the last 30 years. I think our cost issue is clearly what we're not dealing with with this care. Are there good things in this bill? Sure. There are things in here that I like in the Affordable Health Care Act, and we can talk about that. Dr. Gingrey, I would like to yield to you at this point.

Mr. ROE of Tennessee. I thank the gentleman for yielding. Just to carry on with what Dr. Gingrey and Dr. Harris have brought up, let me share with you about affordability. When Dr. Harris was talking about young people, it's obvious that the President--I don't know who writes the check for health insurance in his home, but he hasn't looked at the check, whoever is writing it, if he hasn't figured out that costs have gone up. Dr. Harris, I may be a little more than a generation past where you are, but when I left, when I quit operating and doing obstetrics, I had an 8 percent primary c-section rate. You've seen that. And why did that happen? When I came back from the Army to Memphis, I trained at the University of Tennessee in Memphis. I had 2 years of training, and then I had to go in the military for 2 years and came back and finished my training. All the malpractice carriers left the State of Tennessee. In 1975, they all left. So the doctors and the Tennessee Medical Association set up an organization called the State Volunteer Mutual Insurance Company. This insurance company was a mutual company, so money that we didn't pay in came back to us at the end of a year. It wasn't owned by some stock-traded company. Strictly, it was just to give us malpractice liability insurance coverage, which I've kept until this day. In the entire time that that company has been in existence, over half the malpractice premium dollars have not gone to injured people. They've gone to lawyers, both plaintiff and defense lawyers. What a terrible system that is; to try to compensate someone who has actually been injured, we have no way to do it. Less than 40 cents on the dollar that we paid in for 35 years has actually gone to people who have been hurt. That's a terrible system. We need a better system. As Dr. Harris pointed out, when I started my practice, my malpractice premiums were $3,000 a year. Five years ago, when I left, a young physician who replaced me was paying $7,400. And guess what? The patients didn't get better quality and better access. They just got higher costs. So that's why we need to address that issue. I think you're spot on, Dr. Harris. I yield to the gentleman from Maryland.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, today I would like to recognize Mr. Daniel C. Reese of Tennessee's First District, who has been appointed Chairman of the Tennessee Department of Environment and Conservation Commissioner's Council on Greenways and Trails. This council is an organization that encourages our communities to utilize green spaces, promotes volunteerism in the community, and works hard to preserve our natural and cultural resources. Through his efforts on the council, Dan has set a great example for East Tennessee. A graduate of East Tennessee State University, Dan has dedicated his career to working for the people of the Great State of Tennessee. He is a member of the Tennessee Department of Transportation Depot Restoration Demonstration Project, and continues to volunteer his time and expertise to develop additional green spaces within our community. Mr. Speaker, I commend Daniel for his selfless contributions to our state and wish him the best as he continues to exemplify the Volunteer spirit.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, today I recognize the centennial anniversary of the Johnson City County Club in Johnson City, Tennessee. Since 1913, the club has been a driving force for social, recreational, and cultural development in Johnson City. Having grown from the vision of a few local leaders into an establishment that has touched many thousands of lives, the club has carried its traditions into the modern era. The Johnson City Country Club's centennial program began in June 2009 when a group of members envisioned the club to be more than simply a social and recreational entity. These members recognized that the club was sitting on a historic property that had influenced the growth of the city. As of November 15, 2011 the Johnson City Country Club was placed on the National Register of Historic Places in recognition of its rich history and contributions to society. The club serves as a home to numerous non-profit organizations and has collected funds for both World Wars and other conflicts. Its facilities have helped Johnson City youth develop in golf, swimming, and tennis. As a result, the golfing program at East Tennessee State University is considered one of the top programs in the Nation. Mr. Speaker, I commend the Johnson City Country Club for their significant impact on both Johnson City and Tennessee's First District. I wish them the very best in their centennial anniversary celebrations and hope to see continued growth in the club's role in the community.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. I thank the gentleman for yielding. First, Mr. Speaker, I want to thank Chris Smith for not just this year, but for over 30 years of advocating for life and making that one of his missions in life. Chris, thank you for what you have done not only for this Congress, but for our country, to make awareness. I really appreciate it. I can't thank you enough for what you have personally done and sacrificed. Exactly 40 years ago next month, I was a young doctor in training in Memphis, Tennessee, and I was drafted in the U.S. military and left the country to go to Southeast Asia for a tour of duty there. And something happened when I was gone. Roe v. Wade passed. It really passed, and I wasn't even aware of it because I was out of the country. I came back to my training, which had been interrupted by my military service, and realized something very fundamentally different had happened to America. As an obstetrician, I personally have delivered around 5,000 babies. In the 31 years I was in medical practice in Johnson City, Tennessee, a small town in northeast Tennessee, our group had delivered over 25,000 babies--25,000 children. I see these children now as doctors, lawyers, teachers, Sunday school teachers, soccer coaches, housewives, and farmers, you name it, bettering our community. I cannot imagine my community without these young people there. They are the future of this great Nation. As Dr. Harris mentioned, I saw when ultrasound went from when it was just a blob that you saw to being able to visualize the heartbeat 28 days or less post-conception. It's unbelievable to be able to see that. And to see this child develop is something that I can't explain to you how fulfilling that is to be able to see that happen. And to have a ``choice'' snuff that out is a law that we have to get right in this country. Thank goodness minds are changing. I look around this great room here, this great Chamber, and wonder what it would be like if different choices were made, the great people that I've met here in Congress that might not be here had a different choice been made. In this Chamber, we have a clear responsibility and duty for those that do not have a voice. The fourth President of our country, and the architect of the Constitution, James Madison, warned that the rights of the minority must be protected. The unborn children of America represent the greatest silent minority that there is. They are the most innocent among us and deserve the protection we afford all people in this great country. Life is a precious miracle from God that begins at conception. As a physician, I can personally attest after visualizing literally thousands of ultrasounds. We have to make our laws consistent with science of today. It's been mentioned before that one of our government's most important duties is to protect the most vulnerable among us, and I pledge to continue to remember and strive toward this as long as I breathe. I'm heartened that so many others today have chosen to do the same thing. And may God very much bless the 4 million women last year in this country who chose life, not a choice to terminate life.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. I have no speakers at this time. I continue to reserve the balance of my time.

Mr. ROE of Tennessee. Mr. Speaker, I object to the vote on the ground that a quorum is not present and make the point of order that a quorum is not present.

Mr. ROE of Tennessee. Mr. Speaker, I yield myself the balance of my time. I wish to conclude by saying, Ruth, congratulations, and thank you for all the hard work that you have done for both sides of the aisle and for the work you've done for the children of this Nation. I also want to thank Senator Landrieu and Congresswoman Bass, who is my next-door neighbor in the Cannon Office Building, and Ranking Member Miller for the work you've done for many decades for the children of this country, and Chairman Kline. I will conclude by just saying I'm proud to sponsor the Uninterrupted Scholars Act, and I urge my colleagues a ``yes'' vote. With that, I yield back the balance of my time.

Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may consume. I rise today in support of S. 3472, the Uninterrupted Scholars Act. The bill amends the Family Educational Rights and Privacy Act of 1974, better known as FERPA, to give child welfare agency caseworkers access to the educational records of foster children. This is an important bill that will help improve the quality of education for children in foster care. In 2008, Congress passed the Fostering Connections to Success and Increasing Adoptions Act, which tasked child welfare agencies with ensuring that children in foster care are enrolled in school. In carrying out this important mission, agencies are required to consider educational stability when identifying foster care placements and coordinate with local school districts to ensure that young people stay in their current school when placed in foster care or are immediately enrolled in a new school if that is in their best interest. Over the last 4 years, student privacy law has made it difficult to properly implement the educational stability provisions of the Fostering Connections law. For example, child welfare agents are unable to access student education records in a timely manner, if at all, to properly monitor student progress and coursework, or to get students enrolled in the proper courses if a transfer of schools is necessary. The Uninterrupted Scholars Act will correct these challenges. By allowing direct--and limited--access to the education records of foster kids, caseworkers can follow the students' education in a timely manner and help ensure greater success in school. The Committee on Education and the Workforce--and this Congress-- understands the importance of maintaining strong student privacy protections and supports the provisions included in FERPA. It is our responsibility to ensure a student's personal information, such as academic progress, placement or disciplinary records, is not shared with anyone other than officials directly involved in the student's education. For children in foster care, child welfare agents have a responsibility to look out for the education of their students and have a direct need to have access to these important records. The bill before us today narrowly grants caseworkers access to these important records. Mr. Speaker, S. 3472 is a narrow, but critical, step in helping children in foster care receive a better education. I urge my colleagues to support this bill and reserve the balance of my time.

Mr. ROE of Tennessee. I continue to reserve the balance of my time.

Mr. ROE of Tennessee. Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days in which to revise and extend their remarks on S. 3472.