From the Congressional Record Online through GPO
(Mr. HOYER asked and was given permission to address the House for 1
Mr. HOYER. Mr. Speaker, it is my pleasure to yield to the gentleman
from California (Mr. McCarthy), the majority leader.
(Mr. McCARTHY asked and was given permission to revise and extend his
Mr. McCARTHY. Mr. Speaker, before I begin, I do want to wish
everybody a happy St. Patrick's Day.
Mr. Speaker, on Monday, the House will meet at noon for morning hour
and 2 p.m. for legislative business. Votes will be postponed until
On Tuesday and Wednesday, the House will meet at 10 a.m. for morning
hour and noon for legislative business.
On Thursday, the House will meet at 9 a.m. for legislative business.
Mr. Speaker, late votes are likely in the House on Thursday, and
Members are advised to adjust their schedules accordingly.
Mr. Speaker, the House will consider a number of suspensions next
week, a complete list of which will be announced at close of business
In addition, the House will consider several critical pieces of the
Republican plan to repeal and replace ObamaCare:
First, H.R. 372, the Competitive Health Insurance Reform Act,
sponsored by Representative Paul Gosar, creates competition in the
healthcare market by eliminating antitrust protection for insurance
Next, H.R. 1101, the Small Business Health Fairness Act, sponsored by
Representative Sam Johnson of Texas, allows small businesses to pool
together and purchase plans, an important step toward purchasing health
care across State lines.
Finally, Mr. Speaker, we will consider the FY 2017 reconciliation
bill, also known as the American Health Care Act. This bill eliminates
the many taxes and mandates of ObamaCare. It gives patients enhanced
tools to take control of their healthcare decisions, and it expands
choice so Americans are free to pick the plan that is best for
themselves and their families.
Mr. Speaker, it is known that ObamaCare is failing, and we have a
responsibility to provide Americans relief. These bills are the result
of much deliberation and hard work, and their passage will help create
a competitive marketplace that provides high-quality care at an
Mr. HOYER. Mr. Speaker, I must hasten to add that the gentleman from
California added a little comment that “it is known.” I don't share
that view, Mr. Speaker, that it is known that the Affordable Care Act
In fact, we had a hearing yesterday when the former Director of the
Congressional Budget Office appointed by Democrats testified on the
Affordable Care Act and testified on the American Health Care Act. Lo
and behold, Mr. Speaker, Mr. Elmendorf agreed with the present CBO
Director. In other words--and everybody in America ought to be pleased
on this because they all are asking for bipartisan--the former Director
appointed by Democrats of the CBO agrees with the Republican Director
of the CBO, who just came down with his advice and counsel to the
Congress just a few days ago.
That ought to give pause to those who are pressing to pass a bill,
which would result in the loss by 24 million Americans of their
insurance and would result in the increased costs to almost every
American of their insurance.
Now, yes, there are some Americans who would choose not to have
health care. Then they would get sick or they would get in an
automobile accident or something else would happen where they would
require medical care, and they would not be able to pay for it. Guess
what? We would all pay for it.
That is what was happening before the Affordable Care Act. It is
still happening with some who choose either to pay their contribution
toward health--some people call it a penalty; I call it a
contribution--to meet their personal responsibility, as the Heritage
Foundation suggested, of having provisions that, if they get sick, they
will be able to pay for it.
Now, last week, Mr. Speaker, the majority leader had some quotes from
people who did not like the Affordable Care Act. At this hearing that
we had, we had a number of people, and I want to quote some of them:
I certainly never imagined I would have a child who would
rely so much on a government program like Medicaid.
This child, Mr. Speaker, suffers from Rett syndrome, which is a
neurology disorder that strikes mostly young girls with normal
development for the first 18 or 24 months of their life. Then their
development is arrested and, in fact, in some respects, there is a
retreat in their abilities.
She went on to say:
Medicaid provides skilled nursing care, which allows us to
raise our daughter, Caroline, in our home instead of a
hospital or institution.
Of course, a hospital or institution would be far more expensive, Mr.
She went on to say:
This allows my husband and me to hold jobs and take care of
other family needs. The House Republican plan for Medicaid
would put my daughter's life at risk, and my family is
That was Marta Conner, mother of a child with Rett syndrome covered
I titled yesterday's hearing: The hearing that the Republicans
refused to have on the American Health Care Act or the Affordable Care
This quote is by a doctor:
In public debate in Congress, the actual people can be
obscured by graphs and numbers. But, ladies and gentlemen,
every day in clinic, I am one-on-one with the real people,
real Americans who could take steps closer to health or
suffer more with this Congress' decision. I urge you and your
colleagues to reject the American Health Care Act and,
instead, strengthen the Affordable Care Act.
To that extent, Mr. Speaker, as the majority leader knows, that
testimony joined hundreds in the medical field: The American Medical
Association, associations of physicians with particular skill sets, of
hospitals, of insurance companies, of patients, of providers, of urban
hospitals, suburban hospitals, rural hospitals, and literally hundreds
of people intimately involved in the healthcare system who are urging
us not to pass the American Health Care Act and to leave in place but
improve the Affordable Care Act.
Mr. Speaker, I have indicated to many on this side of the aisle that
we are prepared to work to improve any piece of legislation that has
been passed and particularly a piece of legislation which affects so
many Americans. Unfortunately, we have not had that opportunity since
this bill, the Affordable Care Act, was first considered and passed.
This week, the Congressional Budget Office released their estimate
and impacts of the House Republicans' bill to repeal the Affordable
Mr. Speaker, as the majority leader knows, President Trump, in this
body and at that rostrum, promised insurance for everybody that is much
less expensive and much better. He has not offered such a bill. The
American Health Care Act certainly does not provide that.
In fact, the CBO--both Republican and Democratic directors--opined at
least 24 million people will lose their insurance and, by 2026, there
will be 58 million people in America without health insurance.
Mr. Speaker, the majority leader has indicated this bill will be on
the floor next week. I hope that everybody takes the opportunity to
read the CBO report and the testimony given in yesterday's hearing on
the bill. It was the first and only hearing that was held on the bill
that will be on the floor. Previous hearings on the Affordable Care Act
are not good, and previous hearings that there are alternatives out
there don't deal with the bill that is going to be on the floor next
Wednesday or Thursday.
Senator Susan Collins has said of the bill that is going to be on the
It should prompt the House to slow down and reconsider
certain provisions of the bill.
She was referring, of course, to the CBO report.
Senator Bill Cassidy from that liberal leftwing bastion of Louisiana
Can't sugarcoat it. Doesn't look good. The CBO score was,
shall we say, an eyepopper. I also hope it was a thought
And Senator Rob Portman, who served in this body for many years,
I am concerned about the Medicaid population. That is the
biggest part of coverage for Ohio.
That is why their Governor, a Republican, and Rob Portman, a
Republican who served on the Ways and Means Committee, is urging
caution and has great reservations about the bill that has been
announced to come to the floor.
Mr. Speaker, I would like to ask the majority leader whether or not
he can confirm whether changes will be made to the repeal bill, that is
the American Health Care Act, that was reported out of the Budget
Committee, whether he can confirm whether or not the repeal bill will
be changed before it comes to the floor.
Mr. Speaker, I yield to my friend.
Mr. McCARTHY. Mr. Speaker, I thank the gentleman for yielding.
And his question, based upon scheduling, and I know there were a lot
of questions in there, so please let me work through and try to answer
all of his questions.
The last question was in regard to the bill itself, and we are
working through the process. It will be in the Rules Committee. As the
legislative process works, there are always ways that you refine the
bill, and I expect that there will be some elements that get refined
inside the Rules Committee before it comes to the floor.
You had about five different questions there if I may follow all the
way through. First, you talked about, and I was happy to hear--I wrote
it down--you are glad to work to help to improve the bill--because when
we were in the more than 26 hours of Energy and Commerce, the
amendments the Democrats offered, we spent a couple of hours on just
the one amendment about a hashtag of renaming the bill. So there is a
change in attitude. I appreciate that from the other side of the aisle
because we are always willing to work with you.
Mr. HOYER. Reclaiming my time, just to clarify, Mr. Speaker, that the
bill to which he is referring is not the bill to which I was referring.
I was referring to the Affordable Care Act and improvement of the
Affordable Care Act.
He is now referring to the American Health Care Act which, we think,
bears no resemblance to the Affordable Care Act.
Mr. McCARTHY. But you are not willing to help with it, then?
Mr. HOYER. Of course, with the Affordable Care Act. We think the bill
that has been, as I said, Mr. Speaker, offered will devastate many
individuals, millions and millions and millions of people in this
country. We have said that pretty clearly.
But more importantly, the CBO Director, appointed by Republicans,
said that in his report, which was, by the way, Mr. Speaker, given
after, after it was considered in either one of the
committees, either the Energy and Commerce Committee or the Ways and
They did not wait for the CBO report. My opinion, Mr. Speaker, they
did not wait for the CBO report because they knew how devastatingly
negative the CBO report would be to the legislation they were
Mr. Speaker, I yield to my friend.
Mr. McCARTHY. Mr. Speaker, I thank the gentleman for yielding to me,
and I ask if he would let me finish through.
Mr. HOYER. I certainly will do that.
Mr. McCARTHY. It seems as though the gentleman has a little short-
term memory of how they brought the Affordable Care Act and the CBO
report when it came before us. It was not brought before us until it
came right before the floor.
But let me follow through on all your questions because my response
back was, I was actually excited to hear that Democrats wanted to work
with us, that their attitude has changed from when we were in committee
and they had amendments going forward, that it was no longer going to
be hashtag amendments, it was actually going to be productive
amendments; and I thank you for having that change of attitude.
Mr. Speaker, I am proud of the transparent process we have taken in
the House, and I think this needs to be reminded to all the American
As I mentioned last week, our healthcare bill is the result of 113
hearings. I know the gentleman on the other side of the aisle, he is
proud of the 72 hearings they had before they did the Affordable Care
We have now marked up this bill in three separate committees, with
over 18 hours of debate in Ways and Means, and over 27 hours of debate
in Energy and Commerce, and the countless amendments from both
Republicans and Democrats.
By the time we vote on the floor, this bill will have been publicly
available online for 3 weeks. Now, it is only 127 pages. That is a far
contrast to the 2,700-plus pages, if you want to compare it to
So far, nearly 590,000 people have visited our website, and over
200,000 have downloaded this legislative text.
So, Mr. Speaker, that means more people have read our healthcare bill
than went to Woodstock. I call that transparency. Republicans have been
committed to repealing and replacing ObamaCare for years, and so now I
think it is time to act.
The gentleman also commented about the CBO. Well, I am actually
excited that you had another person who confirmed what the CBO said
because what the CBO says about this bill is it will lower the deficit
by $337 billion.
It will also reduce premiums by 10 percent by 2026, and it will
secure major entitlement reform by capping Medicaid spending, giving
States certainty and flexibility, saving taxpayers $880 billion, and
making the program solvent for future generations, because that was a
concern in one of the letters.
Now, Mr. Speaker, those are the facts. With regard to the coverage
numbers, the CBO reports that most of that increase would stem from
repealing the penalties associated with individual mandates. Let me
repeat that. Most of the increase would stem from repealing the
penalties associated with the individual mandate.
Now, that makes sense to me, because if we no longer force Americans
to buy something they do not want, one-size-fits-all health care, they
will naturally choose not to buy it.
But, Mr. Speaker, I know the gentleman across the other side of the
aisle argues with me about the knowledge that everybody knows ObamaCare
is failing. I would ask the gentleman to visit one-third of the
counties in this country that only have one option.
Or why don't you go to Tennessee, where the President just was
because, you know, 16 counties in Tennessee have no option. But
ObamaCare will penalize you for not having health care when you can't
even buy it.
But if ObamaCare was working so well, why do more people accept the
penalty or the exemption than actually buy ObamaCare? That is a number
that is quite interesting. That is why I am encouraged to see our plan
will decrease the average premiums that people have been asking for.
Now, our goal is not just to sign up people for insurance. Our goal
is to get America better health care.
Now, the gentleman also commented and had letters--and I love to read
letters. I love to listen to constituents because that is what our work
should be. And you read a letter when it came to Medicaid. And I would
not scare people, I would actually talk to that individual.
Medicaid is on an unsustainable path. In one 10-year window, it will
cost $1 trillion.
Mr. Speaker, the gentleman on the other side knows what $1 trillion
is because that is about the entire amount we spend on discretionary
spending. From all of the appropriations that we go through, that would
take up everything we have.
Well, we know that is not sustainable, so we should do something
about it. That is why we had a meeting with 18 Governors, Republicans
and Democrats. And the number one thing they told us, give us
flexibility to be able to manage. That is exactly what this bill does.
But I like to read some letters. Here is one from Colleen from
I just received the notice for my 2017 health insurance
policy. It will skyrocket, not by the advertised Maryland
State average of 20 to 25 percent but, rather, by 60 percent.
In addition, my deductible is going up 45 percent. Since the
inception of ObamaCare, my policy has increased 75 percent.
I am a 63-year-old female in excellent health who takes no
medication. My only benefit from the ACA has been two
mammograms, which I paid $12,600 in premiums to get. What a
disaster of a program.
I will be voting Republican this year, in the hope of
finally getting the ACA repealed. I just hope it happens
before my checkbook goes on life support.
Or the letter to the editor from Carl in Lusby, Maryland:
I can't afford my health insurance now under ObamaCare.
It's been a burden on our joint income, which is just above
the limit for qualifying for subsidies; and for 2017, I am
facing a 61 percent rate increase.
I'm faced with either paying a premium that will bankrupt
me and my wife, or paying the tax penalty at the end of the
year, which will also be unaffordable. And there are probably
several million Americans who are in the same boat as I am.
You know what, Carl? We listened to you. We listened, and now we are
going to lead. We have moved a bill from the legislative process to the
rules, what it says, for reconciliation. We have done hours of debate
in three other committees. We will continue the process, as the rules
say. We will go to the Rules Committee and then we will come to this
floor. And for those who have written, change will come.
Yes, the Republican-appointed CBO Director and the Democratic CBO
Director, as the gentleman, Mr. Speaker, from across the aisle says,
agree that the premiums will go down, as so many Americans have asked
for. We will put Medicaid on a sustainable path.
We will give Republican and Democrat Governors flexibility so they
can manage their States in a better form. And most importantly, we will
give America exactly what they asked for, the freedom to choose their
own health care, the options of having more so they can direct what
they want and desire, at the same time, having a lower cost.
So I welcome the gentleman for his questions. I know that wasn't
about scheduling, but I think this is too important, because those 113
hearings we listened to the people before us, and we promised we would
act, and we are keeping that promise as we move forward.
Mr. HOYER. Mr. Speaker, I thank the gentleman for his information.
People, I am sure, listening to this colloquy must get confused because
they hear one representation from somebody who sounds pretty
reasonable, my friend, Mr. McCarthy, and then they hear exactly the
opposite from me. So they will have to make a judgment.
The bill that is going to be on this floor next week was introduced a
week ago Monday. It was marked up less than 42 hours later.
My friend, the majority leader, Mr. Speaker, said: I love to listen
to constituents. Not a single constituent on his side of the aisle or
my side of the aisle, Mr. Speaker, had the opportunity to testify on
this bill. Not a single one of my constituents, or the majority
leader's constituents, had the opportunity to know what the CBO said
was going to happen; that 24 million people
would lose their insurance, 14 million next year; that Medicare would
be put at risk; and Medicaid would be gutted by 2021. Not a single
constituent was listened to because they had no opportunity to come and
say: this is what I think.
The testimony to which I referred was yesterday. I don't know the
dates on the letters that the gentleman just read, but perhaps they
were just within the last few days.
But I will tell that 63-year-old woman that what this bill does, if
you got a 60 percent increase, will up that by 66 percent because you
are going to go from a 3-to-1 ratio to a 5-to-1 ratio on which seniors,
and 63 years of age, regrettably, from my standpoint, are referred to
as seniors. The bill that is going to be considered will allow the
insurance company to do a 5-to-1 ratio, rather than a 3-to-1 ratio, so
that 60 percent is going to go up by 40, maybe get to 100 percent.
Mr. Speaker, the American people know about transparency. That means
they can see something.
The gentleman says: Well, now it is online. Yes, they had 40 hours,
give or take, to see this bill from Monday night to Wednesday, when it
was marked up, and it was marked up and passed in the Ways and Means
Committee in the dead of night, sort of like they passed the
prescription drug bill, at 5:59 in the morning. The majority leader
wasn't here. I was here. Perhaps there is a predilection to middle of
the night. By the time the Energy and Commerce Committee passed it,
they had been in session for over 24 hours and were bleary-eyed.
As I told him last week, Mr. Speaker, my folks were not up at 4 a.m.
watching the Energy and Commerce Committee. And I would tell him
further that--he said the bill was now online and people had an
opportunity to read it. Perhaps, Mr. Majority Leader, Mr. Speaker, that
is why the Affordable Care Act has now got more support from the
country than it has had at any time since its existence; where there
are 49 percent of Americans who now like the Affordable Care Act.
Perhaps the reason that is happening now is because they have had the
opportunity to see the alternative that the Republicans have offered
and are offering on Wednesday.
This bill that they offered is going to significantly raise--I will
tell Colleen--her out-of-pocket expenses.
And, yes, under their bill, the CBO says that perhaps the premiums
will go down. Why will the premiums go down? Why does insurance go up
and down? Because the risk goes up and down; and the greater the risk,
the more the cost. But if you don't allow people who are sick people to
get into the system because they can't afford it, then the risk goes
down. When the risk goes down and you shut people out of the system and
24 million people are out of the system, yes, of course, the rates go
down because you are insuring the healthy.
Now, Americans know that very well because they know they have
automobile insurance--which, by the way, they are mandated to have in
almost every State, if not every State. Why are they mandated to have
it? So the rest of us are protected when we have an accident or we are
protected from our rates going up because there is not a broad spectrum
of the insured so that the risk can be minimal for the insurance
So I say to my friend that CBO has told the truth. The Americans are
seeing that, and they don't like that. I would urge those on the other
side of the aisle to be very careful when they vote either Wednesday or
Thursday on this bill because this bill is going to have a very
detrimental effect on the American people.
Now, I understand there are going to be two other bills. There are
going to be four bills on the floor, as I understand it. Can the
gentleman inform us of when we will see the details of this additional
I yield to the gentleman.
Mr. McCARTHY. I ask the gentleman which bills he is referring to?
Mr. HOYER. The third bill and the fourth bill.
Mr. McCARTHY. Those will be later in the month. Next week we will
have two of those up that you referred to.
Mr. HOYER. Are they available now to be reviewed prior to them coming
up later in the month?
I yield to the gentleman.
Mr. McCARTHY. Yes. The committee has marked them up.
Mr. HOYER. Lastly--and I know you are glad to hear that comment, as
are the folks waiting to do 1-minutes--we have received a letter from
Secretary Mnuchin on March 8. It was directed to the Speaker, Mr.
Leader, and like most Secretaries of the Treasury, he is hoping that we
will pursue financially responsible and confidence-building policies.
I won't read the whole letter, but he says in the last paragraph:
“As I said in my confirmation hearing, honoring the full faith and
credit of our outstanding debt is a critical commitment. I encourage
Congress to raise the debt limit at the first opportunity so that we
can proceed with our joint priorities.”
Mr. Speaker, I ask the majority leader whether that is going to be
scheduled in the near term because, on March 15, we met the debt-limit
extension. This administration and every previous administration have
taken steps to prolong the time before we default by using extra
mechanisms so that we are, in effect, not investing in the retirement
system or something else and paying our debts.
I have indicated publicly, Mr. Speaker, and I reiterate here, that I
will urge my side to support a debt-limit extension if it is clean.
What I mean by “clean,” if it does not incorporate something that is
not agreed to and there is not a consensus on. By that I mean, simply,
if there are things that we have a consensus on that need to be passed,
certainly including those in the debt-limit extension would not be
objectionable. But if there are items in that bill designed to force us
to vote for what is a responsible policy but takes something that we
obviously very strongly disagree with, we will not do so.
So my questions to the majority leader are: A, can we expect a clean
debt-limit extension? B, can we expect that in the near term, as
Secretary Mnuchin requests, so that we can put that matter behind us
and not undermine confidence in our fiscal posture as a nation?
I yield to my friend.
Mr. McCARTHY. I think we both agree that responsible fiscal policy is
important to our country's ability to succeed, and that includes
honoring the full faith and credit of the United States. We expect to
continue working closely with Secretary Mnuchin to ensure that America
is on the right path to a strong fiscal future.
We know the amount of debt that has been added in the last 8 years
has been tremendous. I know that the gentleman, when he looks to what
we do next week--to be able to lower premiums, save more than $300
billion of the deficit, and let people have more choice--that is also a
Now, I do not have any immediate action to announce, but we will
relay any information to the Members as we move forward.
I thank the gentleman.
Is that going to be your last question?
Mr. HOYER. It will probably be my last question. I have an additional
Mr. McCARTHY. Before I depart, though, I would like, Mr. Speaker, to
wish my friend from the other side of the aisle a very happy St.
Patrick's Day. I do apologize. I feel bad, when we look at the
basketball round, what happened to Maryland; but if you look at NIT,
Cal State Bakersfield is still on the march, so I have another team you
can root for.
Mr. HOYER. Mr. Speaker, I ask that the gentleman's words be taken
down. I have never had such a vicious attack made on me.
But I must admit I was deeply disappointed last night. My
congratulations to the young men at Xavier and their coach, but my, my,
my, I was disappointed in the quality of our play. We have got a great
group of young people playing, but it was not their night.
I am sure that I will pick another team sometime as the March Madness
continues. What I would hope, though, is we would not have March
Madness on this floor next week.
Mr. Speaker, I yield to the gentleman.
Mr. McCARTHY. There will be no upsets.
Mr. HOYER. I guess the answer to that question, Mr. Speaker, is what
will determine an upset. Will the American people be upset? Will the
Republicans be upset? The answer to that question remains in the hands
of our Republican colleagues, because what I want to do in observation,
I disagree with all three of the propositions that the majority leader
said in his closing statement.
This is not going to reduce the budget. Yes, on its face, they give a
$600 billion tax cut to the wealthiest in America. Where do they take
it from? Medicaid, some of the poorest people in America. That is where
that money comes from.
Premiums are going to go up. Deductibles are going to go up. You can
quote me on this 2, 3 years from now. I don't think your bill is going
to pass. But if it did pass, that is what would happen. You won't be
able to test me because I don't think the bill is going to pass. It may
pass this floor, but it will not become law.
The majority leader's statement, Mr. Speaker, that that is what the
American people are expecting, I disagree with that. What the President
of the United States said he was going to give to the American people
is insurance for everybody. The majority leader ignores the 24 million.
He hasn't spoken about that. He spoke about some other observations in
the CBO report, as did Speaker Ryan. I don't blame him. I would try to
point to some positive indicators myself.
I think this is going to up the deficit, it is going to up costs, and
it will decrease the insured and make hospitals have more uncompensated
care. We will have this debate next week, Mr. Speaker.
But on the last issue, I would hope, Mr. Leader, that we do agree on
fiscal responsibility. I happen to believe, as you know, the debt limit
issue is a phony issue, a totally political issue. It has been used as
a political issue on both sides of the aisle. There should be no
question but of course the United States is going to pay its debt, of
course the United States is going to pay people whom it has bought
things from, and of course it is going to pay people moneys that they
have been promised. Of course it is going to do that. This is not about
new spending. It is about spending that we have already incurred.
I would urge the majority leader to bring a clean bill to the floor.
I will work with him. We will get the overwhelming majority of
Democrats to vote for that. Let's not blame one another for the debt.
There is plenty of opportunity to do that, and both sides are guilty of
Mr. Speaker, if the gentleman has nothing further he wants to say, I
yield back the balance of my time.