Henry Waxman

Mr. WAXMAN

Mr. WAXMAN. Mr. Chair, I would like to draw your attention to a letter from Secretary Sebelius on the impact of H. Con. Res. 34. The Secretary of Health and Human Services, Washington, DC, April 14, 2011. Hon. Henry A. Waxman, Ranking Member, House Energy and Commerce Committee, Washington, DC. Dear Ranking Member Waxman: We received your letter today requesting our assessment of the impact of the enactment of House Concurrent Resolution 35 (H. Con. Res. 35) on Medicare, Medicaid, and the other affected health programs at the Department of Health and Human Services. We have not yet had an opportunity to fully evaluate the extensive impact that the language of the resolution would have, but offer a few initial observations. As you know, the Affordable Care Act modifies and improves almost every Medicare payment system--including the inpatient hospital prospective payment system, the outpatient hospital prospective payment system, the physician fee schedule, Medicare Advantage plan payments, and prescription drug plan payments. If this resolution were enacted, the Centers for Medicare and Medicaid Services (CMS) would not be able to use any funds to carry out these payment provisions based on any rate calculated on the basis of provisions of the Affordable Care Act--which is to say virtually all rates. In a system in which millions of claims are paid each week, millions of claims would accumulate, which CMS and its contractors would be prohibited from paying. As a result, providers and suppliers of services to Medicare beneficiaries--many of which are small businesses--would experience significant disruption. H. Con. Res. 35 would adversely affect health care in rural areas as well. As an example, as a means to encourage physicians to provide services in rural areas, the Affordable Care Act established a new 10 percent bonus payment for primary care services furnished by primary care practitioners and for major surgical procedures furnished by general surgeons in shortage areas. Without available funding, CMS would no longer be able to provide the bonus to primary care and general surgery physicians for eligible services. The Affordable Care Act also gives CMS new tools to fight fraud and helps us move from a pay-and-chase system to a comprehensive prevention-focused strategy. By precluding the use of funds for such efforts, H. Con. Res. 35 would substantially impede CMS's proven and successful efforts to reduce fraud and waste in the health care system resulting in increased erroneous payments. H. Con. Res. 35 would effectively require CMS to cease enforcing new screening and enrollment standards, diminish CMS's ability to suspend payments when credible allegations of fraud are uncovered, and reduce resources that have been made available for investments in anti-fraud work. The Affordable Care Act also includes numerous other policies to make health care more affordable, accessible, and accountable for seniors, individuals with disabilities, children, and all other Americans, as well as businesses large and small. Its improvements are already woven into the fabric of our health care system. A broad prohibition on the use of funds would halt, among other things, the operation of the Early Retiree Reinsurance Program, the Pre-existing Condition Insurance Plan, and the health insurance rate review, consumer assistance, and health insurance Exchange grant programs. I hope this information is helpful. We would be pleased to answer any additional questions you may have. I have sent an identical letter to Ranking Member Levin. Sincerely, Kathleen Sebelius.

Mr. WAXMAN

Mr. WAXMAN. Mr. Speaker, it is with reluctance that I oppose this legislation. The President and Senator Reid worked as hard as they possibly could to blunt the extreme Republican agenda. As everyone knows, these spending cuts are before us today because the Republicans did not hesitate to resort to the most irresponsible tactics to try to enforce their radical agenda. While there are some program cuts I can support, others harm programs affecting millions of Americans. I am particularly concerned by the cuts to Community Health Centers ($600 million from last year's spending levels), Health Care Facilities and Activities ($338 million), Women and Infant Children programs ($504 million), Energy Efficiency and Renewable Energy programs ($438 million), Clean Water and Safe Drinking Water State Revolving funds ($997 million), Climate Change programs ($49 million), HIV AIDS, Viral Hepatitis, STD and TB Prevention ($730 million), LIHEAP (Low income energy assistance) ($390 million), U.S. Agency for International Development ($39 million), International Clean Technology Fund ($115 million), Highway Construction ($2.5 billion), and High Speed Rail ($2.9 billion). For all the effort made, these cuts in funding do not have any significant impact on the deficit. Because of the Republicans' ideological blinders, taxes and revenues get no consideration here. The deficit cannot be solved without addressing revenues, and the silence on this issue from the Republican Party is deafening. I also must register my profound objection to the rider attached in this bill that prohibits the District of Columbia Government from funding abortions. By what moral right does the Republican leadership override unilaterally the sovereign decisions taken by the government and people of the District of Columbia? This is shameful and deeply offensive and I hope Congress can find the strength ultimately to reverse it. Again, I believe President Obama and Senator Reid did the very best they could under near-impossible circumstances deliberately engineered by the Republican leadership. Unfortunately, this bill will inflict too big a price on many programs the American people and our country need. I must therefore vote against it.

Mr. WAXMAN

Mr. WAXMAN. Mr. Speaker, I rise today to honor the distinguished 55- year career of Los Angeles Unified School District (LAUSD) Superintendent Ramon Cortines. Superintendent Cortines began his career as an educator in 1956, teaching a class of 44 sixth graders, in Aptos, California. He taught at the elementary, middle and high school levels before becoming a school Administrator and ultimately serving as Superintendent of Schools in Pasadena, San Jose, San Francisco, New York City and Los Angeles. Superintendent Cortines is one of our nation's most experienced educators. He has advised every President or his Education Secretary since the Carter Administration, and in 1992 he chaired the Department of Education transition team for President Clinton. Cortines served as Superintendent of LAUSD briefly in 2000 and returned to the position in 2008, during which time he steered the district through unprecedented fiscal challenges while improving pupil attendance, school safety and student achievement. Upon his retirement today, I ask my colleagues to join me in recognizing the distinguished career of this dedicated public servant.

Mr. WAXMAN

Mr. WAXMAN. Mr. Chairman, I can't express my concern with greater alarm about this budget. It is a budget that's going to inflict terrible harm on Americans from all walks of life, while protecting the wealthiest taxpayers in America, both individuals and Republicans. Now, if I give the benefit of the doubt to the Republican sponsors of their budget proposal that they're sincere, they are speaking from an ideological point of view, they want to try a social experiment in this country. But if they fail to live up to what they say they're going to accomplish, there is going to be tremendous harm. We have a social contract with seniors to provide affordable, accessible, comprehensive health care under Medicare. And they want to take Medicare and end it, and tell those people to go to private insurance companies. We have estimates that the average senior will face cost increases of $6,000 when the program begins, and it could be over $11,000 per beneficiary in later years. But right away, to add insult to injury, they would reopen the doughnut hole under the part D prescription drug benefit, meaning people still have to pay all of the cost of their drugs, reversing what the Affordable Care Act provided. But most of their cuts are coming from the Medicaid program. They want to take Medicaid and turn it into a block grant. Medicaid accounts for 43 percent of total long-term care spending in the U.S. Most of it goes to seniors and disabled people who are in nursing homes. If the States don't have enough money in their block grants, are they going to dump these people? These are human beings, and you are playing with their lives. This means real harm will be inflicted where Medicaid spending is the greatest. By cutting reimbursement rates, Medicaid will lose providers. Nursing home quality and staffing levels will decline. Reject this budget. Don't experiment on the most vulnerable of our population. Mr. Chair, I strongly oppose the Republican Budget Resolution for fiscal year 2012. Their budget inflicts terrible harm on Americans from all walks of life--while protecting the wealthiest taxpayers in America, both individuals and corporations. I am particularly disturbed by what the Republican budget does to Medicare and Medicaid. There is no other way to put it: the Republican budget is the end of Medicare as we know it, and it is devastating for Medicare beneficiaries. Medicare is a social contract with our seniors to provide affordable, accessible, comprehensive health care. The Republicans want to turn Medicare over to the private insurance industry, with payments to seniors that will fall far short of what they need to get the health care they deserve. The Congressional Budget Office analysis of the Republican budget shows that, over the next decade, it will more than double beneficiary cost for new enrollees. The average senior will face increased costs of over $6,000 annually when the program begins. And all of that extra spending by seniors and people with disabilities will go to private health insurance plans. The transfer of seniors into private plans will raise costs by over $11,000 per beneficiary by 2030. To add insult to injury, the Republican budget reopens the donut hole under the Part D prescription drug benefit, increasing the burden on seniors starting today. For Medicaid, the Republican budget is even worse. Medicaid covers 60 million of the country's most vulnerable people, one in 3 low income children, 5 million seniors, and 10 million disabled individuals. It accounts for 43 percent of total long term care spending in the U.S. But the Republican budget cuts Medicaid in half by 2022, and turns it into a block grant for the states right away. And since the Medicaid block grant would grow by only 1 percent per year, while inflation is over 2 percent and health inflation and enrollment growth is even higher. This means real harm will be inflicted where Medicaid spending is the greatest: on seniors and individuals with disabilities in nursing homes and those receiving benefits to live independently in their home. By cutting reimbursement rates, Medicaid will lose health providers. Nursing home quality and staffing levels will inevitably decline. Medicaid cuts will mean job losses in the health professions. The Republican budget utterly fails the basic test of humane government. It is extreme, it is mean, and it must be defeated.

Mr. WAXMAN

Mr. WAXMAN. She also says about fraud, waste, and abuse: ``The Affordable Care Act also gives CMS new tools to fight fraud, and helps us move from a pay-and-chase system to a comprehensive, prevention- focused strategy. This resolution would substantially impede CMS's proven and successful efforts to reduce waste and fraud in the health care system, resulting in increased erroneous payments.'' This is a harmful resolution to the interests of the American people, and I urge my colleagues to oppose it.

Mr. WAXMAN. Mr. Speaker, this resolution would defund the implementation of the Affordable Care Act. This is just another way the Republicans are trying to repeal that law. The very first week of this Congress, they voted to repeal the health care law. They said they want to repeal it and replace it. We still have not seen what they propose. They are not proposing reforms to help the middle class. In effect what they would do is increase the number of uninsured in this country by 50 million people. This is a particularly reprehensible way to end health reform--to stop paying for its implementation. Americans are already benefiting from the law. Seniors are getting discounts on their prescription drugs. Adult children will be able to stay on their parents' insurance until 26. They would reverse the prohibition against preexisting condition denials for children, and they would stop allowing consumers access to preventive care with no cost-sharing. They pulled the rug out from under current State efforts to develop vibrant, competitive exchange marketplaces, which is the centerpiece for competition in insurance plans to give the consumers choice. But what is most distressing is the dangers it poses to Medicare, Medicaid, and the Children's Health Insurance Program, or health care safety net. According to a letter from Secretary Sebelius: ``The Affordable Care Act modifies and improves almost every Medicare payment system. If this resolution were enacted, the Centers for Medicare and Medicaid Services would not be able to use any funds to administer payments based on any rate calculated on the basis of provisions of the Affordable Care Act,'' which is to say virtually all rates. Medicare and Medicaid could grind to a halt. The Secretary goes on to say: ``This resolution would adversely affect health care in rural areas. CMS would no longer be able to provide the bonus payments to primary care and general surgeons for eligible services.''

Mr. WAXMAN

Mr. WAXMAN. Mr. Chairman, this bill represents the Republicans' newest line of attack to disrupt, dismantle, and to ultimately destroy the Affordable Care Act. Today, they are doing so by sacrificing longstanding bipartisan policies to push a narrow partisan ideology. For many years, Republicans have joined with Democrats in supporting programs to prevent disease, to promote health and, in turn, to cut health care costs. But today, the House will vote to end funding for the first and only Federal program with dedicated, ongoing resources designed to make us a healthier Nation. Every State in the Union is already benefiting from the resources made available from the fund to fight chronic and costly conditions, such as obesity, heart disease and diabetes. Repealing the prevention fund is a blow against seniors. In States like California, Michigan, Iowa, Maine, North Carolina, and Massachusetts, they are using these funds to train personal home care aides who assist the elderly with Alzheimer's disease and other disabling conditions. Terminating the prevention fund is not only extremely shortsighted; it will also prove to be fiscally irresponsible. The return on this kind of upfront investment--targeted resources to help keep people healthy for as long as possible--will over time save precious health care dollars. We need to preserve the prevention fund because it can serve as a cornerstone for a health care system that finally recognizes that preventing illnesses is as important as treating them. Until now, prevention has too often been just a mere afterthought. American families support prevention. They want programs to educate seniors to use preventive health services, such as mammograms and colonoscopies, which can help extend their lives; and they want programs that focus on preventing childhood obesity and diabetes, which will help their children to grow up healthy and strong. The American people want us to start working together to solve the real problems facing our Nation. I urge my colleagues to oppose this partisan and divisive legislation.

Mr. WAXMAN

Mr. WAXMAN. Mr. Speaker, I yield myself 4 minutes. Today, we are considering H.J. Res. 37, a resolution to invalidate the FCC's open Internet rules. We are debating this bill under the shadow of a shutdown of the Federal Government. The Republicans are holding the economic recovery and millions of jobs hostage to their extreme demands on the budget and their ideological demands on social and regulatory issues. And at such a moment of grave threat to our economic health, what are we doing on the floor today? The Republican leadership insists on bringing to the floor a bill that will end the Internet as we know it and threaten the jobs, investment, and prosperity the Internet has brought to America. This is an outrageous sense of priorities and policies. This legislation is a bad bill. This bill would give big phone and cable companies control over what Web sites Americans can visit, what applications they can run, and what devices they can use. The Internet may be the greatest engine in our economy today. American Internet companies lead the world in innovation. They have created over a million jobs. There is one overriding reason the Internet has fostered such innovation and economic growth: It is open. A kid with a brilliant idea can launch his or her own company out of their family garage. The FCC order protects the openness and vitality of the Internet. The resolution we are debating today would end it. The Republican proponents of the resolution will say the exact opposite. They will say they are trying to protect freedom of the Internet by stopping government regulation. How are the American people to know who is right? Well, the answer is easy. Just ask Google, Facebook, Amazon, Netflix, eBay, and the other companies in the Open Internet Coalition that depend on the openness and vitality of the Internet. They ask the FCC to act because ``baseline rules are critical to ensuring the Internet remains a key engine of economic growth.'' And they oppose this resolution because it would hurt consumers and innovation. They understand that in most parts of the country companies like Verizon, AT&T, and Comcast have a virtual monopoly over access to the Internet. The phone and cable companies are the gatekeepers to the information highway. Without regulations, they could choke off innovation by charging for the right to communicate with their customers. Consumer advocates, civil rights organizations, religious groups, and labor unions have exactly the same view. The committee has heard from 150 organizations urging Congress to keep the Internet open and defeat this bill. Even the companies that might benefit the most from this legislation do not support the resolution. In fact, AT&T and the cable industry support the FCC's orders because it provides greater certainty for investment. This bill is partisan. It is anti-innovation. And it threatens to transform the open Internet into a series of walled gardens controlled by the phone and cable companies. This is a bill that is not going anywhere. We shouldn't be wasting our time on this legislation when there's a threat that our whole government is going to be closed down because of the partisan and extreme views of the Republican majority. Mr. Speaker, I yield the balance of my time to the gentlewoman from California (Ms. Eshoo), and I ask unanimous consent that she be allowed to control that time.

Mr. WAXMAN. I was astounded by the comment of our friend on the Republican side of the aisle who is not on our committee. He said that the antitrust laws will protect us. Well, if you have a cable company or a phone company to choose, you are going to choose one or the other. Let's say the cable company has its own list of special programs that they want people to purchase. Well, they could easily stop Netflix. They could easily stop competitive programming. That is not an antitrust violation; that is a business opportunity. And what these rules propose to do is to not give anybody a business opportunity to deny the consumer the ability to access anything on the Web, which is the case today. These rules that we see the FCC doing are being put into place to make sure that somebody does not take advantage of the power they have in the market. We do that all the time. We regulate the securities agencies with the SEC because we don't want them to run amuck. I wish the SEC had acted to stop the economy from going over the cliff practically.

Mr. WAXMAN. We need to defeat this Republican proposal because it is not based on anything but an ideological point of view that government can do nothing right and business can do nothing wrong; and they, therefore, favor the big businesses. I say do not vote for this Republican proposal. It is not something that any constituency wants. It would confuse the situation. It would make life uncertain for all of the players, stakeholders and others, and it would deny consumers the freedom they now have.

Mr. WAXMAN

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

Mr. WAXMAN

Mr. WAXMAN. Mr. Chairman, I yield myself another 30 seconds. So we heard these claims that they are going to come in and regulate in areas where they're not seeking to regulate, nor have they in fact done it. A new source, emitting 100,000 tons of pollution, is equivalent to burning a train car load of coal per day. We hear concern from people from the coal-burning States, but they're not threatened unless there are new sources of that magnitude. The oil companies are not going to be regulated unless they are going to build a new source of that magnitude. Maybe they are fearful about other regulations, but that is no reason to support this bill.

Mr. WAXMAN. Thank you very much. I just want to point out, Mr. Barton, my very good friend who used to be chairman of the committee and was ranking member when I asked him to work with us on a bipartisan energy bill policy, he said, I don't believe there is such a thing as global warming. It doesn't exist, it's not a problem. Why spend any effort or money to find the solution? And now, while the gentlelady's amendment is saying at least study what will happen if you don't do anything in this area, and he said that's not needed either. I think at least we ought to know what the gentlelady is suggesting, and that is, what would be the long-term impact if we do nothing. I support the Jackson Lee amendment.

Mr. WAXMAN. Reserving the right to object, I would plead with my chairman to agree to an additional minute to each side because I think that there is an important issue that is being ignored in this particular amendment. Each side may not need to take up the 2 minutes.

Mr. WAXMAN. I ask unanimous consent that each side have 1\1/2\ minutes.

Mr. WAXMAN. Madam Chair, I have an amendment at the desk.

Mr. WAXMAN. Madam Chair, I yield 1 minute to the gentleman from Washington (Mr. Inslee).

Mr. WAXMAN. Mr. Chairman, I yield myself 3 minutes. Since the Clean Air Act was adopted 40 years ago, we have made steady progress in cleaning our air and protecting the public health and welfare. Today, however, the Clean Air Act is under attack and progress is threatened. The Upton-Inhofe bill is a direct assault on the Clean Air Act. Its premise is that climate change is a hoax and carbon pollution does not endanger health and welfare. But climate change is real. It is caused by pollution, and it is a serious threat to our health and welfare. We need to confront these realities, not put our heads in the sands. American families count on the Environmental Protection Agency to keep our air and water clean. But this bill has politicians overruling the experts at the Environmental Protection Agency, and it exempts our biggest polluters from regulation. If Upton-Inhofe is enacted, the Environmental Protection Agency's ability to control dangerous carbon pollution will be gutted. That's why health experts like the American Lung Association are opposed to this legislation. They know it is a polluters' protection act. It is anti-science, anti-environment, and anti-health. The Environmental Protection Agency made a scientific determination that carbon pollution endangers health and the environment. Our Nation's top scientists at the National Academy of Sciences agree with this finding and so do scientists around the world. Yet this legislation repeals that scientific finding. That's something no Congress has ever done. We need an energy policy based on science, not science fiction. With oil at $100 per barrel and rising, the Middle East in turmoil and a nuclear crisis in Japan, we urgently need clean energy policies. We need more vehicles that run on electricity, natural gas, and renewable fuels. We need more wind and solar power, and we need more energy efficiency. What we need is to work together to develop energy policies that reduce our dependence on foreign oil and protect the health of American families. Instead, we are pursuing a divisive, partisan bill that takes us in exactly the wrong direction. This extreme legislation won't pass in the Senate and, if it did, it would be vetoed by President Obama. It is a distraction from the imperative of developing new sources of energy that will break our dependence on foreign oil, protect our health and preserve our environment. Americans want clean air to breathe and sensible, science-based limits on carbon pollution. I urge all Members to oppose this legislation. I reserve the balance of my time.

Mr. WAXMAN. Mr. Chairman, I am pleased to yield 3 minutes to the ranking member on the Energy Subcommittee of the Energy and Commerce Committee, the gentleman from Illinois (Mr. Rush).

Mr. WAXMAN. Mr. Chairman, I am pleased to yield 3 minutes to the gentleman from Massachusetts (Mr. Markey).

Mr. WAXMAN. Mr. Chairman, I yield 1\1/2\ minutes to my colleague, the gentlewoman from California (Mrs. Capps).

Mr. WAXMAN. Mr. Chairman, that information is incorrect. I would like to see a letter that pertains to this EPA action. I think it might have been a letter related to a different piece of legislation. I am now pleased to yield 2 minutes to the gentlewoman from California (Ms. Eshoo).

Mr. WAXMAN. Mr. Chairman, I am very pleased to yield 2 minutes to the gentleman from Washington (Mr. Inslee). (Mr. INSLEE asked and was given permission to revise and extend his remarks.)

Mr. WAXMAN. Mr. Chairman, I am pleased to yield 2 minutes to a distinguished member of our committee, the gentlewoman from the Virgin Islands (Mrs. Christensen).

Mr. WAXMAN. For the purpose of a unanimous consent request, I yield to the gentleman from Texas (Mr. Green).