Pete Stark

Mr. STARK

Mr. STARK. Madam Speaker, I rise today to pay tribute to Kevin Dowling, who is retiring from the Hayward, California City Council after 26 years of public service. Over the course of his career, he has served on many Council commissions and intergovernmental agencies, including the Hayward Economic Development Committee, City Council Commercial Center, Hayward Youth Commission, Hayward Economic Development Committee, and the Alameda County Transportation Improvement Agency. Mr. Dowling has been a Hayward resident since 1962. He received his high school diploma from Moreau Catholic High School in 1980 and graduated with a Bachelor of Science degree from Santa Clara University in 1984. Before becoming a council member for the city of Hayward, Mr. Dowling served as an aide to Alameda County Supervisors Gail Steele and Alice Lai-Bitker. He was Alumni Director for Moreau Catholic High School and Development Director for Eden Information and Referral. He serves as Development Director for the Boys and Girls Clubs of San Leandro. Mr. Dowling has been a vital part of many projects in the city of Hayward, including downtown redevelopment and neighborhood improvements. His leadership and exemplary public service have made an impact in Hayward and beyond. He is retiring from the City Council at the end of his term on July 13, 2010. I join the city of Hayward in expressing appreciation for his many years of public service.

Mr. STARK

Mr. STARK. Madam Chair, I rise today in support of legislation that continues Congress's commitment to making our economy greener while creating good jobs. The ``Home Star Energy Retrofit Act'' (H.R. 5019) will provide immediate incentives for consumers who renovate their homes to become more energy efficient. This will create good paying jobs while saving families money. The average American household spends $2,100 per year on energy costs. Nearly 25% of that can be saved through efficiency upgrades. Unfortunately, many families cannot afford to make the changes needed to achieve savings. Using rebates will bring these upgrades within reach for 3 million families. Up-front rebates of up to $3,000 will be provided for the installation of insulation, windows, doors, air and duct sealing, and water heaters. This will not only save families money and reduce energy usage, it will also create an estimated 170,000 jobs in construction, manufacturing, and retail. The legislation also provides seed money to States to support loans to consumers to finance energy efficiency home renovations. As we are witnessing in the Gulf Coast, our addiction to fossil fuels has real and sometimes disastrous consequences. We must become more efficient and transition to an economy based on clean energy. We must continue to enact policies that invest in clean and renewable energy and energy efficiency and we can do so in a way that creates good- paying jobs. I urge all of my colleagues to vote yes.

Mr. STARK

Mr. STARK. Mr. Speaker, the service men and women serving overseas have born the brunt of the cost of the wars in Iraq and Afghanistan. The Caregivers and Veterans Omnibus Health Services Act ensures that when they return, they will obtain the quality treatment and health care they deserve. This legislation addresses many of our veterans' most urgent needs. Record numbers of service men and women returning home are suffering from posttraumatic stress, and this bill ensures that mental health services are more accessible. The bill ensures that women don't get second-class health care by expanding coverage for women's health, including care for newborns. The bill also eliminates health care copayments for veterans who are catastrophically disabled. Many politicians use the slogan ``support the troops'' when they mean ``support this war.'' This bill actually supports our troops--by providing them the care and support services they need when they return home. I urge my colleagues to support this bill.

Mr. STARK

Mr. STARK. Mr. Chair, I rise today in support of protecting our Nation's estuaries by passing the Clean Estuaries Act (H.R. 4715). I am fortunate to represent a district that borders the San Francisco Bay. A healthy and clean bay is central to the economic prosperity and quality of life of my constituents. Since 1987, the National Estuary Program has promoted comprehensive planning efforts to clean up and preserve estuaries. The legislation before us today would reauthorize and strengthen the National Estuary Program, providing additional assistance to communities to protect their waterways. In my community, the National Estuary Program supports the San Francisco Bay Estuary Partnership. This partnership brings together diverse stakeholders and has created dozens of projects that support a thriving bay. For example, at the Eden Landing Ecological Reserve in Hayward, hundreds of adult and student volunteers are restoring shoreline habitat by removing invasive plants and planting native marsh grasses. In addition to improving water and habitat quality, this project is also teaching children about the bay and how to protect it. The Estuary Partnership is also working with local governments in my district to promote and replicate proven bay-friendly best management practices to decrease run-off pollution into the bay. By passing the Clean Estuaries Act, we can ensure that these initiatives and hundreds of similar efforts around the country will be continued and expanded. I urge all of my colleagues to vote ``yes.''

Mr. STARK

Mr. STARK. Mr. Speaker, I rise in support of the Senate amendments to H.R. 4851, the Continuing Extension Act of 2010. As its title suggests, this bill continues a number of vital programs affecting people's health and economic wellbeing. It deserves strong bipartisan support. I'd like to highlight several key components. On the economic front, the legislation will ensure that hundreds of thousands of workers can maintain their unemployment benefits by extending and fully funding both the Emergency Unemployment Compensation and Extended Benefits programs for an additional 2 months. It also continues the $25 per week supplementary payment for all unemployment recipients. With regard to health care, this legislation will continue the temporary COBRA premium assistance program through May 31 of this year. This program was created in the American Recovery and Reinvestment Act and provides a 65 percent COBRA premium subsidy for workers who have been involuntarily terminated. The subsidy is available for up to 15 months. This program has allowed workers who've lost their jobs during the recession to maintain their families' health insurance as they search for new employment. It is an important program and I am pleased to support this extension. I also look forward to pursuing legislation to extend this program through the end of the year. The bill also protects Medicare for our senior citizens and people with disabilities by forestalling a 21 percent payment cut to Medicare physicians. Passage of this bill provides a reprieve until the end of May, but isn't a long term solution. With regard to Medicare physician payments, the House passed legislation late last year that would have permanently solved our ongoing dilemma with the sustainable growth rate, SGR, physician payment formula in Medicare. Our legislation, H.R. 3961, would have created a new formula that emphasized primary care and encouraged physicians to join together in accountable care organizations to provide more efficient higher quality care. I am committed to continuing to work with my colleagues in Congress, the Administration, and the physician community to eliminate the SGR and move to a revised payment formula that ensures that physicians are fairly compensated and enhances quality and efficiency in Medicare. These programs are too important to let a few Republican Senators hold them hostage month by month. I urge my colleagues to vote yes to extend these vital programs now and to work with us on a bipartisan basis for longer term solution on them all.

Mr. STARK

Mr. STARK. I thank the gentlelady for yielding. Madam Speaker, since 1985, I have worked for today as we finish our job to enact health care reform in America. This reconciliation bill provides affordability of insurance premiums for low- and middle-income Americans. We've delayed the impact of the Cadillac tax plan on health benefits and ensured that changes are financed in a fair manner. The reform bill signed into law by President Obama is a historic step for our Nation. These bills provide health security for all families. The people with no coverage are guaranteed affordable coverage. Those who currently have insurance will find that coverage improved and more secure. I am honored to have helped to get us to this point. I look forward to working with all of my colleagues and the administration as we implement this vital new law. Today, we join all modern countries in providing quality, affordable health care to all. It's a great day for America. If I didn't think they'd take down my words, I would want to say ``yippie.'' Madam Speaker, the staff of the Committee on Ways and Means, as well as staff from the other Committees, leadership offices and support agencies, logged countless hours to make this legislation a reality. We owe them our thanks for their efforts to bring us to this day. Current and former staff from my office and from the Committee on Ways and Means who worked on this legislation over the past year include: Janice Mays, John Buckley, Cybele Bjorklund, Debbie Curtis, Chiquita Brooks-LaSure, Jennifer Friedman, Geoff Gerhardt, Tiffany Swygert, Drew Crouch, Marci Harris, Tom Tsang, Drew Dawson, Ruth Brown, John Barkett, Mark Schwartz, Matthew Beck, Lauren Bloomberg, Brian Cook and Cameron Branchley. Because this legislation was really a product of three committees, I'd like to also recognize the health staff of the Committees on Energy & Commerce and Education & Labor. We are truly indebted to the staff of the House Office of Legislative Counsel--Ed Grossman, Jessica Shapiro, Megan Renfrew, Henry Christrup, Wade Ballou, Lawrence Johnston and others in the office that I may have missed--who turn our ideas into legislative language. Finally, I'd like to recognize and thank the very capable analysts at the Congressional Budget Office and Joint Committee on Taxation. Doug Elmendorf, Phil Ellis, Holly Harvey and the rest of the CBO team, as well as Tom Barthold and the JCT professional staff, have worked tirelessly to provide guidance, technical assistance and key analyses of the costs and effects of the various proposals during consideration of health reform legislation over the past 15 months. On behalf of the Committee on Ways and Means, thank you all.

Mr. STARK

Mr. STARK. Mr. Speaker, I, on behalf of myself and Ms. Slaughter, rise to speak about the Independent Payment Advisory Board, IPAB, which is a new executive branch body created in the Senate-passed health reform bill and charged with constraining Medicare spending. The IPAB is given unprecedented power to make sweeping changes to the Medicare program without going to Congress for approval. I and many of my colleagues in the House are concerned about some of the specific provisions and procedural changes included in section 3403 of H.R. 3590. Since its inception in 1965, Medicare has guaranteed access to health care for 115 million Americans who would otherwise find it nearly impossible to obtain affordable health insurance in the private market: senior citizens, people with disabilities, and those with end-stage renal disease. Medicare is a critical part of this nation's social compact, and it is our obligation as elected representatives of our constituents to protect and preserve the program now and in the future. The health care reform legislation fulfills this responsibility by making a number of substantial improvements to Medicare, including provisions that improve benefits, extend solvency by at least 9 years and winnow out waste, fraud and abuse. As part of the effort to make improvements to the Senate-passed bill, key chairmen and Members of the House and Senate, along with the administration, were also working on a number of important and necessary changes to the IPAB policy. Unfortunately, the Senate Parliamentarian indicated that any attempt to improve IPAB in the reconciliation bill would be ruled out of order, and could jeopardize the status of the entire reconciliation bill. Since we were unable to make any changes to the IPAB as part of the reconciliation bill, I would like to identify critical improvements that need to be made in subsequent legislation. Many of these changes had been agreed to by our colleagues in the Senate, as well as the administration, and I look forward to working with them to ensure they are enacted in the near future. While IPAB is designed to help control growing costs in Medicare through swift implementation of payment and delivery reforms, the actions of the board will be driven by the need to meet targets for Medicare cost growth. As we have seen with prior attempts to control health care spending, limiting spending to arbitrary and unrealistically low growth caps is a recipe for failure. In order for IPAB to have any real hope of controlling Medicare cost growth without threatening access to care, as is required, the growth targets must be rational and realistic. The current spending targets mandated by IPAB are neither. They fail to fully take into account the three variables that drive health spending growth: price, volume of services, and intensity of services. The target only accounts for price growth, and does so at an unrealistically low rate. Controlling costs in the health care system is important, and I am committed to doing so. In fact, Medicare growth has typically been below private sector health care cost growth. However, the growth targets established by IPAB need to be revised and increased to reflect a more realistic expectation about how much growth can be slowed in order to ensure continued access to care and a strong program infrastructure in the future. The IPAB policy as written by the Senate also tips the balance of power too far in favor of the executive branch. In the event that IPAB cannot agree on Medicare recommendations required by the targets, the Senate bill requires the Health and Human Services Secretary to make recommendations instead. Like IPAB's proposal, the Secretary's proposal would become law unless Congress passes an alternative. It is one thing to give an independent board of health care experts such sweeping power to change the Medicare program, but it is quite another to give that power to a partisan political figure who reports directly to the President. I say this not as a negative comment directed toward our current Secretary or President, but a general concern about whether we should empower one person with the ability to make such potentially sweeping changes to the Nation's signature health program. Furthermore, by placing unprecedented procedural barriers to congressional consideration of alternatives to the IPAB or secretarial proposals, the bill attempts to virtually lock Congress out of the process of making changes to Medicare. In the event IPAB or the Secretary mandates implementation of draconian cuts to Medicare, Congress will encounter procedural barriers to changing those recommendations in a meaningful way. Thus, in order to maintain a proper balance between Congress and the executive branch, all parties had agreed to use a sequestration process to meet the mandated savings targets should IPAB fail to make recommendations on how to meet those targets. Instead of the decisions going to the executive branch, the onus would fall on Congress to arrive at thoughtful ways of reducing spending. If Congress failed to agree on ways to reduce spending, sequestration would go into effect. But it would be my hope and expectation that this would not happen, and that Congress would instead be spurred to action by the threat of sequestration. Another important flaw with IPAB that needs to be addressed is the fact that it ignores the broken system used to update Medicare physician payment rates. Under current law, the sustainable growth rate formula will require physician payment rates to be reduced by more than 30 percent over the next decade. Yet, the IPAB could decide to make additional cuts on top of those already set to take place. The House has passed legislation that would make comprehensive permanent reforms to the physician payment formula, but that bill has not been taken up by the Senate. As such, all parties agreed that physician payment rates should be off limits to IPAB until the sustainable growth rate is replaced with a permanent, stable way of updating payments to physicians. I also want to clarify legislative intent with regard to one issue in IPAB. Section 1899A(c)(2)(A)(iii) of the Social Security Act, as added by Section 3403 of PPACA, states that in the case of IPAB proposals submitted prior to December 31, 2018, IPAB shall not include any recommendations that would reduce payment rates for providers that receive an additional market basket cut on top of the productivity adjustment. The rationale for this provision is that these providers are already facing extra downward adjustments in their payments and thus should not be subject to ``double jeopardy'' by also being subject to IPAB recommendations which will further reduce spending. In creating this exclusion, it is the intent of Congress to exclude all payment reductions applicable to providers captured by this language in all the relevant years. Therefore, in the case of inpatient hospitals, the provision excludes from IPAB recommendations payment reductions applicable to hospitals including payment reductions for indirect medical education under 1886(d)(5)(B), graduate medical education under 1886(h), disproportionate share hospital payments under 1886(d)(5)(F), and capital payments, as well as incentives for adoption and maintenance of meaningful use of certified electronic health record technology under 1886(n). In addition, further clarifications are needed to ensure that IPAB is empowered to seek savings or payment improvements for all items and services provided to Medicare beneficiaries. There are smaller, but no less important additional improvements that I believe need to be made. Changes made to the Medicare program by IPAB are granted broad exemption from judicial review. We should remove this exemption to ensure that IPAB is not above the law and its actions can be reviewed in a court of law. The legislation also prevents IPAB from making changes that would increase premiums or ration care, but it is important to include the specific protections that are scattered through the Social Security Act. Medicare law contains an array of beneficiary protections that are designed to ensure that seniors and people with disabilities have access to affordable care. The IPAB should not be permitted to make changes to these key beneficiary protections. Finally, as the legislation is written, IPAB would be required to reduce spending above the growth targets resulting from unforeseen and unavoidable health events, such as a flu pandemic, hurricane, or act of terrorism. Increases in spending from these kinds of catastrophic events should be excluded from the overall spending targets.

Mr. STARK

Mr. STARK. Mr. Speaker, This is a historic day. We have worked to enact health reform in America for decades. President Johnson took a major step when he signed Medicare into law in 1965 and guaranteed every American age sixty-five and over quality, affordable health care. Forty-five years later, we are about to extend that guarantee to all Americans. It isn't the bill I would have written. However when it comes to legislating health insurance reform in America, we will not get everything each of us want. This bill is a compromise that bridges the differences among us. I am proud to support this legislation and urge my colleagues to do the same. This bill builds a solid foundation. It will: Extend coverage to 95 percent of all Americans. Assure affordability of health insurance by providing tax credits and cost-sharing assistance to families up to 400 percent of poverty. Halt abuses of the health insurance industry--forcing them to compete on quality, not just their ability to avoid covering needed health services. Guarantee a standard benefit package for all Americans with an annual cap on out-of-pocket spending. No family should go bankrupt because of medical expenses. Create a new marketplace, called an Exchange, where people will be able to comparison shop among health insurance plans. Require that insurance plans spend at least a certain percentage of their premium dollars on benefits and end discrimination by health status, gender, occupation. Help senior citizens by filling the Republican Medicare prescription drug donut hole--ensuring that Medicare beneficiaries will be able to afford their medications year-round. We are joined in support of this legislation by a coalition of patients, doctors, nurses, hospitals, businesses, labor unions, children's advocates and senior citizens. President Obama has worked tirelessly to achieve this goal and he deserves much of the credit. There are components I wish had turned out differently and I pledge to continue working to improve them. In particular, I have some concerns about Medicare. I oppose the inclusion the Independent Payment Advisory Commission, called IPAB. Some of my colleagues support this Commission because it shields them from having to take tough votes when it comes to cutting Medicare provider payments. It's my experience that Congress always does what is needed to protect and strengthen the Medicare program. IPAB is a dangerous provision. By statute, this Commission would be required to hold Medicare spending to an arbitrary and unrealistic growth rate. It is a mindless-rate cutting machine that sets the program up for unsustainable cuts. That will endanger the health of America's seniors and people with disabilities. It is an unprecedented abrogation of Congressional authority to an unelected, unaccountable body of so-called experts. I intend to work tirelessly to mitigate the damage that will be caused by IPAB. I am pleased that this legislation reduces government overpayments to private health insurance plans in Medicare and that our reconciliation negotiations improved on those savings. It still should eliminate the overpayments. I support the choice of private plans in Medicare, but I don't support wasting taxpayer dollars on corporate subsidies to achieve that goal. Plans that can meet or beat Medicare should be allowed to participate. Those that can't should be excluded. We've got more work to be done here. We also lost a provision in the House bill that ensured Medicare beneficiaries in private plans would never pay higher cost-sharing for Medicare services than if they were enrolled in traditional Medicare. I'll be working with the Administration to see that they move forward with steps in their authority to resolve that disparity. I am disappointed in the lack of a public health insurance option. This provision fell victim to the strength of the insurance industry lobby. It would have saved taxpayers money, enhanced competition, and increased efficiencies. That it isn't in this bill does not mean it can't be added in the future. These flaws are what one must expect when bringing a bill through the US Congress that touches more than one-sixth of our economy. In the past, we've allowed health reform to fail because of similar imperfections. We, can't let that happen now. Our vote today will determine whether we finally provide affordable, quality health care to all Americans. I am proud to rise in support of this legislation, and I urge my colleagues to join me in voting yes.

Mr. STARK

Mr. STARK. Madam Speaker, I rise with my colleagues, Mr. Moran of Virginia and Ms. Watson of California, to end a part of our immigration system that has denied protection to those who need it the most. The Restoring Protection to Victims of Persecution Act ends the practice of barring asylum claims by those who have been in our country for more than a year. Enacted as part of the Illegal Immigrant Reform and Immigrant Responsibility Act of 1996, the one-year bar to asylum has failed. Instead of preventing fraudulent asylum claims as intended, the one- year limitation has turned away individuals who would most benefit from sanctuary. A disproportionate number of these immigrants are women who are the targets of gender-based persecution, including domestic violence, female genital cutting, and ``honor'' crimes. Although the law includes exceptions to excuse those who are determined to have valid reasons for applying for asylum after one year, adjudicators routinely deny applicants who meet these exceptions. People who are attempting to care for their children, hide from their abusers, cope with past trauma, and deal with the challenges of surviving in a new country are repeatedly and arbitrarily denied asylum status because of missing the one-year deadline. Once denied, an applicant has only two other possibilities for safety: to petition for withholding of removal or to seek protection under the Convention Against Torture. Both these forms of relief demand an applicant surmount a much higher standard of proof than asylum and never provide them permanency or allow reunification with family members. I.also thank my colleague, Mr. Ortiz, for introducing a comprehensive immigration reform bill that includes language to end the one-year bar. I hope that by giving this issue its own legislation, Congress can move swiftly to help these victims who are being turned away every day. Since its enactment in 1996, more than 35,000 people have been denied asylum solely because of the one-year bar. As a country, we pride ourselves in our advocacy for democracy and human rights around the world. Please join us in supporting this bill so that we can prove we are as good as our word.

Mr. STARK

Mr. STARK. Madam Speaker, I rise today in support of H. Con. Res. 248 to bring our troops home from Afghanistan. Despite the wishes of the people who voted him into office, President Obama is escalating the War in Afghanistan. It's now up to Congress to end the war. This resolution would invoke the War Powers Resolution of 1973, and remove troops from Afghanistan no later than the end of the year. This war has no clear objective. We have spent $258 billion on the War in Afghanistan, with billions more to come this year. American soldiers and their families are paying a greater price. Over 1,000 soldiers have died, and over 5,000 have been wounded in action. According to the UN Assistance Mission in Afghanistan, Human Rights Watch, and other humanitarian organizations, tens of thousands of Afghan civilians have been killed. It is time for Congress to assert its constitutional authority over matters of war and bring our troops home. I urge my colleagues to support this resolution, so that we can focus on diplomacy and infrastructure development that will bring a lasting peace to Afghanistan.

Mr. STARK

Mr. STARK. Madam Speaker, I rise today to pay tribute to Dr. Steven D. Chan, a pediatric dentist who resides and practices in Fremont, California. Dr. Chan was recently elected as a Regent of the American College of Dentists, the oldest national honorary organizations for dentists in the country. During his service as Regent, Dr. Chan will represent Regency 7, which comprises California, Nevada, Arizona, New Mexico and Hawaii. The College recognizes meritorious contributions to the Dental Society and the profession of dentistry. Dr. Chan serves on the Executive Committee of the California Society of Pediatric Dentistry and is past president of the California Dental Association. He is founder of the California Dental Association Foundation. The Foundation was formed as the philanthropic affiliate of the California Dental Association in 2001 with the mission to improve the oral health of Californians. Dr. Chan formerly served on the Fremont Library Commission and is active in the Fremont community. I am confident Dr. Chan will serve admirably in his newly elected role as Regent. I wish him every success.

Mr. STARK

Mr. STARK. Madam Speaker, I rise today to pay tribute to Chuck Mack of the International Brotherhood of Teamsters. On January 15, 2010, the Teamsters Joint Council 7 will host a Testimonial Dinner in San Francisco, California, honoring Chuck's exemplary career in the labor movement. Chuck joined the Teamsters in the summer of 1960 as a Del Monte seasonal worker, and continued as a loader and driver for Garrett Trucking for four years. In 1966, Chuck was elected business agent at Teamsters Local 70 and was re-elected in 1969. In 1971, at the request of the Teamster leadership, Chuck served as a lobbyist in Sacramento for the California Teamsters Public Affairs Council. He returned to Local 70 the following year and was elected secretary-treasurer and served in that capacity until June 2009. He became president of Joint Council 7 in 1982 and served in that position until June 2009, making him the second longest-serving Joint Council president. In 1998 he was elected vice president of the International Brotherhood of Teamsters Western Region. He was re- elected to this office in 2001 and 2006. Chuck was appointed IBT director of Port Division in 2003 and remained in this position until June 2009. As port director, he built a powerful coalition of labor, community, environmental and interfaith groups to fight for economic justice for drivers and environmental justice for communities. Since 1981, he has served as a Western Conference of Teamsters Pension Trustee and became co-chair in 2009. Chuck Mack's commitment to labor and to the welfare of others has earned him the deep respect of his members and others. To quote Chuck, ``the most rewarding part of this job has always been the members. Meeting with them one-on-one and listening to what they have to say, providing strong representation so that they have good jobs with good wages, good health care and a strong pension . . . jobs that provide for them and their families.'' I join Chuck Mack's colleagues and friends in honoring his contributions and his continuing service.

Mr. STARK

Mr. STARK. Madam Speaker, I rise to oppose yet another increase in war and defense spending. I have never voted for a Defense Appropriations bill. I will not start today. Throwing more money toward a war in Iraq that should never have been started and a war in Afghanistan that should be over diminishes our ability to address the real issues impacting families. War spending already swallows over 50 percent of our discretionary budget. This bill will add $11 billion to an already bloated Defense budget, as President Obama eyes billions more for a troop increase in Afghanistan. There are good things in this bill. I helped write provisions that will extend COBRA subsidies and prevent pay-cuts to Medicare physicians. The bill also extends unemployment benefits at a time when Americans are struggling to find jobs. While I support these provisions, I cannot support a bill where the good provisions are dwarfed by the $636.3 billion outlay for defense. The right priorities for Congress are addressed in another bill we will consider today, the Jobs for Main Street Act (H.R. 2847). This legislation would put people to work rebuilding our country. It would invest in building schools, improving our transit systems, and upgrading our water infrastructure. It would prevent the lay-offs of teachers, police, and firefighters. The Jobs for Main Street Act also would provide better protections for laid-off workers than the provisions in the Defense bill. It would extend emergency unemployment insurance benefits for an additional six months, and allow millions to maintain health care by expanding the COBRA subsidy to 15 months and extending the eligibility period to June 30th. This is the type of escalation our country needs. Congress should not be giving more money to the Pentagon to wage war. We should be focused on creating jobs, providing health care for all Americans, and improving our education system. That is why I am voting for the Jobs for Main Street Act and against the wasteful Defense Appropriations bill.

Mr. STARK

Mr. STARK. Madam Speaker, pursuant to House Resolution 976, I call up the bill (H.R. 4314) to permit continued financing of Government operations, and ask for its immediate consideration.

Mr. STARK. I yield myself such time as I may consume. (Mr. STARK asked and was given permission to revise and extend his remarks.)

Mr. STARK. This bill is necessary to allow the government to keep operating past the new year so that we can adjourn for the year. The Treasury Department has told us we will reach our current limit on the national debt on December 31--Happy New Year. Unlike past years, the Treasury Department has informed us they don't have the ability to maneuver and buy more time, so the United States would begin to default on its debt if we do not act. The bill would raise the debt limit by $290 billion, enough to last through February 11. Unfortunately, we will have to revisit this issue early next year. I wish we could have avoided that, but to do so, we would have had to resolve differences with the Senate over a budget commission and a statutory PAYGO. With the Senate preoccupied on other matters, that would be impossible before the holidays. Even if the Senate were to pass the larger debt limit increase we sent over to them, we would still have to act again next year. It's important that we do this, as I said, to keep the government running. I don't like to raise the debt limit, but I do like being in the majority, and I do like seeing us pay our bills because we have an international obligation to many of our creditors. I reserve the balance of my time.

Mr. STARK. Madam Speaker, I ask unanimous consent that the distinguished committee member of Ways and Means, Mr. Neal of Massachusetts, be allowed to control the time for our side.

Mr. STARK

Mr. STARK. Madam Chair, I rise to support the Wall Street Reform and Consumer Protection Act because it is time that the Wild West of financial ``innovation'' had a sheriff. Just over a year ago, I stood on this floor and twice voted against President Bush's taxpayer-funded bailout of Wall Street. I would cast the same votes again. I hope that this legislation will mean that taxpayers will never again be on the hook for the reckless behavior of financiers. This legislation will help to end ``too big to fail'' by providing dissolution authority to regulators. Instead of being bailed out with tax dollars, a company like AIG would be dismantled in an orderly and fair process. Shareholders would be wiped out and executives dismissed. This would be paid for, not with tax dollars, but by an assessment on financial firms. The ideal solution would be the reinstatement of the Glass-Steagall Act, preventing the merger of commercial and investment banks. However, I am glad that this bill at least enables swift intervention and provides a financing mechanism so that bailouts will be a thing of the past. In addition to being forced to pay for the excesses of Wall Street, consumers have been preyed upon by financial services companies. These companies have profited from unfair and abusive lending practices, including steering families into subprime mortgages. Regulation has been lax or non-existent and there is no single entity charged with looking out for consumers. With the formation of a Consumer Financial Protection Agency an agency will, for the first time, be charged with ensuring that families are not exposed to toxic financial offerings. Finally, I wholeheartedly support the so-called ``cram down'' amendment, to allow courts to reset the principal for home mortgages in bankruptcy proceedings. This judicial discretion is allowed for every other type of debt--a reminder of the double standard that has too frequently separated average families from Wall Street. I urge all of my colleagues to put consumer interests over those of the Big Banks. Let's finally start policing Wall Street. Vote ``yes.''

Mr. STARK

Mr. STARK. Mr. Speaker, I rise in opposition to the permanent extension of the 2009 estate tax. The American people have more pressing concerns. Our priority should be to create jobs, enact health reform, and extend unemployment insurance and COBRA assistance, not provide gifts for the wealthiest 7,000 Americans. I favor a 1-year extension of current law, and then we can consider the estate tax in the context of all of the expiring Bush tax provisions. This provision should not be given priority over helping those who can't find affordable health coverage or have lost their home or their job. Now is not the right time for this legislation. Let's pass a 1-year extension and get back to the issues that are truly important to the American people--creating jobs and assisting struggling families. I urge a ``no'' vote.

Mr. STARK

Mr. STARK. Mr. Speaker, I yield myself 3 minutes. (Mr. STARK asked and was given permission to revise and extend his remarks.)

Mr. STARK. Mr. Speaker, I would like to place in the Record a letter from the American Medical Association and a list of over 150 supporters of H.R. 3961, among which are the American College of Obstetricians and Gynecologists, the Iowa Medical Society, the Texas Medical Society, all of whom I think place Hippocrates ahead of Sarah Palin in terms of their assessment of what should be done. I would further begin in addressing my dear friend from Texas in some of his inquiry earlier by quoting from the ranking member of the Health Subcommittee on the Ways and Means Committee back last July when he said he believed Members on both sides of the aisle agree that there is a need for a long-term fix for the Medicare physician payment. All 15 members, Republican members, of the Ways and Means Committee voted basically for the fix we're talking about today. Let me make no mistake about blame and where we are. It may come as a surprise to our side of the aisle we make mistakes. In 1997 we made a mistake in setting the formula by which we would automatically limit the increase that doctors get paid. Well, we're here today trying to correct that mistake. You've said so, correctly, that it's the same formula plus 2 percent for primary care, 1 percent for other physicians, some other plans to help encourage primary care doctors to come into practice. Hopefully, we've done it right, and recognizing if we don't correct it, we're talking about hundreds of billions of dollars by postponing. So we have postponed, whether on either side of the aisle, we have postponed correcting a mistake that we should have done earlier. That's where we are today. No place else. And I hope that we can get the continued support to do that. I hope we don't have to come back and keep addressing it. I see not correcting it increases the amount we will have to pay in the future. So there is plenty of blame, as the gentleman suggested, to go around. We could have fought harder to correct it earlier. We didn't and that's where we are today. Literally every major medical society in the country has suggested that we do it this way, and I urge my colleagues to join with me, hopefully with my 15 colleagues on the Ways and Means Committee who haven't changed their mind, and support H.R. 3961 today so we can put this behind us. Then we can go on and have some really spirited debate about whether they do a better job in Texas or California of reforming medical care. That will be more fun. But today let's fix this. Pass H.R. 3961, go home and have a wonderful Thanksgiving holiday, and come back to work on health care reform. American Medical Association, Chicago, IL, November 19, 2009. Hon. Dave Camp, Ranking Member, House of Representatives, Washington, DC. Dear Representative Camp: Thank you for your letter of November 18, 2009, regarding the pending Congressional consideration of H.R. 3961, the Medicare Physician Payment Reform Act of 2009. We appreciate your agreement that having physicians face annual cuts due to the flawed SGR is unacceptable and your support for the intent of the legislation. As you know, it is the same policy supported by every Republican on the Ways and Means Committee during the mark-up of H.R. 3200. We are disappointed, however, that you and your colleagues do not support the bill. As you know, the SGR was put into place by the Balanced Budget Act of 1997, which originated in your committee. At that time, the AMA wrote numerous letters to Speaker Gingrich and your committee leadership warning that limiting growth in physician services to GDP would inevitably lead to sharp cuts in physician reimbursement and a crisis in access to care for our nation's seniors. Previously we had supported legislation that would have allowed growth at a rate above GDP. As predicted, the SGR did result in a 4.8% cut to physicians for the year 2002. Congress declined to intervene and that cut went into effect. In subsequent years, Congress did step in to prevent additional cuts from occurring. The Consolidated Appropriations Resolution of 2003, the Medicare Modernization Act of 2003, the Deficit Reduction Act of 2005, the Tax Relief and Health Care Act of 2006, the Medicare, Medicaid, and SCHIP Extension Act of 2007, and the Medicare Improvement for Patients and Providers Act of 2008 each provided temporary relief for seniors and their physicians from pending cuts. What these bills did not do, however, was make any progress toward fixing the problem. Instead, Congress fell into a comfortable rhythm of kicking the can down the road and putting off real reform to some unspecified point in the future. In 2005, physicians faced a cut of 3.3% which was averted by the MMA. At that time, the Congressional Budget Office reported that the cost of just a ten-year freeze in physician rates was $48.6 billion. Just four years later, the pending cut stood at 21.5% and the cost of a ten year freeze stood at $285 billion. The AMA believes that this cycle must come to an end. Anything short of permanent reform will not be supported by the AMA. Every year that Congress ``pays- for'' a temporary solution, the cost of permanent reform climbs higher still. These are obligations to our seniors which the Medicare program has already made. To pretend that they will not be incurred is unrealistic. To continue to grow the size of the problem is irresponsible. As for the implication that the recent action by the Administration to remove drugs from the SGR are ``budget gimmicks to hide the true deficit impact,'' we are reminded of a letter you signed on May 21, 2004, to the Bush administration calling the policy of including drugs in the formula ``our greatest concern'' regarding the magnitude of the SGR problem. That letter was also signed by other members of your committee. On June 16, 2004, Representative Cantor sent a similar letter with Representative Pryce urging that CMS ``remove prescription drug expenditures from the Sustainable Growth Rate (SGR) determination.'' The Congressional Record is replete with statements by members from both sides of the aisle calling for permanent reform. What is missing, however, is the result. The record shows temporary patches and a ballooning problem. The AMA does not support any motion to recommit that would have a temporary fix. How steep will cuts be after those four years? How many hundreds of billions of dollars will it then cost to fix this problem? Medical liability reform remains among the highest priorities of the AMA and all physicians. However, when Republicans controlled both chambers of Congress and the White House, capping damages could not be accomplished. We fail to see why you believe it is possible today. With less than seven weeks before Medicare rates are cut more than 21%, we need solutions that can be achieved quickly. This should not be a partisan issue. Both sides of the aisle have professed a desire to permanently address this issue. The opportunity to advance permanent reform through passage of H.R. 3961 cannot be missed. We urge all members to vote for H.R. 3961. Sincerely, J. James Rohack. H.R. 3961 is supported by a wide range of organizations representing patients, doctors and other providers, including: AARP; Air Force Association; Air Force Sergeants Association; Air Force Women Officers Associated; Alliance for Retired Americans; AMDA--Dedicated to Long Term Care Medicine; American Academy of Allergy, Asthma and Immunology; American Academy of Child and Adolescent Psychiatry; American Academy of Cosmetic Surgery; American Academy of Dermatology Association; American Academy of Facial Plastic and Reconstructive Surgery; American Academy of Family Physicians; American Academy of Hospice and Palliative Medicine; American Academy of Neurology Professional Association. American Academy of Ophthalmology; American Academy of Pain Medicine; American Academy of Pediatrics; American Academy of Sleep Medicine; American Association of Clinical Urologists; American Association of Hip and Knee Surgeons; American Association of Neurological Surgeons; American Association of Neuromuscular and Electrodiagnostic Medicine; American Association of Orthopaedic Surgeons; American College of Allergy, Asthma and Immunology; American College of Cardiology; American College of Chest Physicians; American College of Emergency Physicians; American College of Gastroenterology. American College of Obstetricians and Gynecologists; American College of Osteopathic Internists; American College of Osteopathic Surgeons; American College of Physicians; American College of Radiation Oncology; American College of Radiology; American College of Rheumatology; American College of Surgeons; American Gastroenterological Association; American Geriatrics Society; American Logistics Association; American Medical Association; American Medical Group Association; American Osteopathic Academy of Orthopedics; American Osteopathic Association. American Psychiatric Association; American Society for Clinical Pathology; American Society for Gastrointestinal Endoscopy; American Society for Metabolic and Bariatric Surgery; American Society for Radiation Oncology; American Society for Reproductive Medicine; American Society for Surgery of the Hand; American Society of Addiction Medicine; American Society of Anesthesiologists; American Society of Cataract and Refractive Surgery; American Society of Clinical Oncology; American Society of Hematology; American Society of Nephrology; American Society of Ophthalmic Plastic and Reconstructive Surgery; American Society of Plastic Surgeons. American Society of Transplant Surgeons; American Thoracic Society; American Urological Association; AMVETS; Arizona Medical Association; Arkansas Medical Society; Army Aviation Association of America; Association of American Medical Colleges; Association of Military Surgeons of the United States; Association of the United States Army; Association of the United States Navy; California Medical Association; Chief Warrant Officer and Warrant Officer Association of the U.S. Coast Guard; College of American Pathologists; Colorado Medical Society. Commissioned Officers Association of the U.S. Public Health Service, Inc.; Congress of Neurological Surgeons; Connecticut State Medical Society; Contact Lens Association of Ophthalmologists; Emergency Department Practice Management Association; Enlisted Association of the National Guard of the United States; Fleet Reserve Association; Florida Medical Association Inc.; Gold Star Wives of America; Hawaii Medical Association; Heart Rhythm Society; Idaho Medical Association; Illinois State Medical Society; Indiana State Medical Association; Infectious Diseases Society of America. International Society for Clinical Densitometry; International Spine Intervention Society; Iowa Medical Society; Iraq and Afghanistan Veterans of America; Jewish War Veterans of the United States of America; Joint Council of Allergy, Asthma and Immunology; Kansas Medical Society; Kentucky Medical Association; Louisiana State Medical Society; Maine Medical Association; Marine Corps League; Marine Corps Reserve Association; Massachusetts Medical Society; MedChi, The Maryland State Medical Society; Medical Association of Georgia. Medical Association of the State of Alabama; Medical Group Management Association; Medical Society of Delaware; Medical Society of the District of Columbia; Medical Society of the State of New York; Medical Society of Virginia; Michigan State Medical Society; Military Chaplains Association of the United States of America; Military Officers Association of America; Military Order of the Purple Heart; Minnesota Medical Association; Mississippi State Medical Association; Missouri State Medical Association; Montana Medical Association; National Association for Uniformed Services. National Committee to Preserve Social Security and Medicare; National Guard Association of the United States; National Medical Association; National Military Family Association; National Order of Battlefield Commissions; Naval Enlisted Reserve Association; Nebraska Medical Association; Nevada State Medical Association; New Hampshire Medical Society; New Mexico Medical Society; Non Commissioned Officers Association; North Carolina Medical Society; North Dakota Medical Association; Ohio State Medical Association; Oklahoma State Medical Association. Oregon Medical Association; Pennsylvania Medical Society; Renal Physicians Association; Reserve Enlisted Association; Reserve Officers Association; Rhode Island Medical Society; Society for Cardiovascular Angiography and Interventions; Society for Maternal-Fetal Medicine; Society for Vascular Surgery; Society of Critical Care Medicine; Society of Gastrointestinal and Endoscopic Surgeons; Society of Gynecologic Oncologists; Society of Hospital Medicine; Society of Interventional Radiology; Society of Medical Consultants to the Armed Forces. South Carolina Medical Association; South Dakota State Medical Association; Tennessee Medical Association; Texas Medical Association; The Endocrine Society; The Retired Enlisted Association; The Society of Thoracic Surgeons; United States Army Warrant Officers Association; USCG Chief Petty Officers Association; Utah Medical Association; Vermont Medical Society; Veterans of Foreign Wars; Washington State Medical Association; West Virginia State Medical Association; Wisconsin Medical Society; Wyoming Medical Society. Mr. Speaker, I reserve the balance of my time. Announcement by the Speaker Pro Tempore

Mr. STARK. Mr. Speaker, at this time I'm delighted to yield 1 minute to the gentleman from Texas (Mr. Doggett).

Mr. STARK. Mr. Speaker, I am pleased at this time to recognize a distinguished member of the Ways and Means Committee, Mr. Neal of Massachusetts, for 1 minute.

Mr. STARK. I'd like to recognize Mr. Blumenauer from Oregon for 1 minute, but pending that, I yield myself 30 seconds to respond to my distinguished colleague and ranking member of the Ways and Means Committee that we debated this back in July, and that all of us agreed and voted for the fix that we're talking about today. And I hope that we could continue that. It was done on a bipartisan basis at that time. It was probably the only part of the bill that was bipartisan, but we did all vote for it and voted for exactly what we're talking about today, and I hope we could get those votes again. I yield to the gentleman from Oregon (Mr. Blumenauer).

Mr. STARK. Mr. Speaker, could I inquire as to the remaining time on either side?