house. please help those who labor here to recognize how you are present in their service and leadership. guide them as they seek to be effective for the good of all your people. loving god, may our leaders be alert to the cares and hurts and challenges of our citizens and our communities. help these leaders choose well, directions and actions that benefit those likely to be left out and all who express and strengthen our nation's values which are our greatest assets. may we hear and pursue your sacred message, merciful god, that we be women and men with the capacity of peacemakers, realistic and also deeply thoughtful and wise. finally, gentle god, bring to those who serve here a participation in your own gifts, such as rich insight and also joy in their care for the well-being of our country and the world. amen. the speaker: the chair has examined the journal of the last day's proceedings and announces to the house his approval thereof. pursuant to clause 1 of rule 1 the journal stands approved. for what purpose does the gentleman from texas rise? mr. burgess: mr. speaker, pursuant to clause 1, rule 1, i demand a vote on agreeing to the speaker's approval of the journal. the speaker: the question is on agreeing to the speaker's approval of the journal. those in favor indicate by saying aye. those opposed no. in the opinion of the chair, the ayes have it. the journal stands approved. the gentleman from texas. mr. burgess: mr. speaker, i object to the vote on the grounds that a quorum is not present and i make a point of order that a quorum is not present. the speaker: pursuant to clause 8 of rule 20, further proceedings on this question are postponed. the pledge of allegiance today will be led by the gentleman from texas, mr. johnson. mr. johnson: please join me. i pledge allegiance to the flag of the united states of america and to the republic for which it stands, one nation under god indivisible, with liberty and justice for all. the speaker: the chair will entertain up to five requests for one-minute speeches. for what purpose does the gentleman from texas rise? mr. johnson: mr. speaker, i ask unanimous consent to address the house for one minute and to revise and extend. the speaker: without objection. mr. johnson: mr. speaker by all accounts, president obama seems hell-bent on striking a nuclear deal with iran, a deal that would hurt our national security interests and sell out our proven ally and friend israel. let's be clear, iran is a foe, not a friend. just consider last week iran's supreme leader said death to america. the regime has blood of american soldiers on its hands and iran is working overtime to expand influence in the region. mr. speaker, iran is determined to be a nuclear power, period. unfortunately the president seems intent to ignore the majority of american people who believe this deal would not prevent iran from gaining a nuclear weapon. mr. speaker the president's going rogue. that's wrong. he needs to stop. nothing less than our national security is at stake. i yield back. the speaker pro tempore: the gentleman yields back. for what purpose does the gentlewoman from florida seek recognition? ms. wasserman schultz: i ask unanimous consent to address the house for one minute and to revise and extend my remarks. the speaker pro tempore: without objection, the gentlewoman is recognized for one minute. ms. wasserman schultz: thank you, mr. speaker. it is with great pride that i rise today to recognize the 100th anniversary of the city of miami beach. in florida's 23rd congressional district. incorporated on march 26 1915, miami beach took its place on the map with only a handful of residents. now home to nearly 100,000 people, the city of miami beach has not only grown in population but in reputation. this vacation paradise is internationally recognized tourist destination, visited by millions each year. a hub for business fine dining and entertainment. this week miami beach celebrated iths centennial with 100 hours of showcasing its history and all that the city has to offer, culminating in an ocean-front concerts by gloria estefan, barry gibb and andrea bocelli. it is an honor to represent miami beach. i thank the city commission and the city staff for the many accomplishments that's made miami beach a wonderful place to live work. i yield back. the speaker pro tempore: the gentlewoman yields back. for what purpose does the gentlewoman from kansas seek recognition? ms. jenkins: i ask unanimous consent to address the house for one minute and to revise and extend my remarks. the speaker pro tempore: without objection, the gentlewoman is recognized for one minute. ms. jenkins: thank you. i rise to congratulate the wichita state shockers with their victory over the jayhawks this weekend. the shockers and coach gregg marshall prevailed just as my friend, congressman pompeo predicted. in kansas, we are proud of our state's rich basketball tradition, from james naismith to dean smith to adolf rupp to jim smithson to wilt chamberlain. i could go on and on and on. however, as two proud kansas schools, the real victor here is the state of kansas. we love the competition, but after the game's over we're all one big family. my daughter currently attends wichita state. i attended k. state and i represent k.u. so i know full well the pride we have in all our teams. so as the shockers move on for the sweet 16 for the second time in three years, i wish them the best of luck tonight and beyond. i yield back. the speaker pro tempore: the gentlewoman yields back. for what purpose does the gentleman from california seek recognition? >> i ask unanimous consent to address the house for one minute. the speaker pro tempore: without objection, the gentleman is recognized for one minute. >> i thank you, mr. speaker. i rise because the majority is making worse the one issue that can kill humanity as a species, climate change. mr. lieu: the budget exacerbates our dependence on foreign oil and the unsafe fuels of the 19th century but there is a better way. we need to produce more energy-savings appliances and machines that are designed, manufactured and installed by american workers. we need to invest on things that never go away such as wind and biofuels. it is time to do what's best for america, not what's best for coal companies. let me end by saying, go ucla. thank you. the speaker pro tempore: the gentleman yields back. for what purpose does the gentleman from texas seek recognition? >> mr. speaker, i ask unanimous consent to speak for one minute. the speaker pro tempore: without objection, the gentleman from texas is recognized for one minute. >> mr. speaker, i rise today to draw the american people's attention to nasa astronaut scott kelly as he prepares to make history tomorrow when he embarks on a year-long mission to the international space station. as the proud representative of johnson space center in houston, texas, i had the pleasure of meeting mr. kelly several times to discuss his historic mission. this will mark the first time that an american has spent an entire year continuously in space. on the eve of this important moment, i'd like to thank mr. kelly for his heroic commitment, leadership and dedication to advancing america's human space flight program. mr. babin: his mission to the international space station provides a tremendous boost to our human space flight program while furthering our understanding of the effects of the longer term exposure to weightlessness that has on the body. this understanding will pave the way for crude missions to mars. on behalf of a proud american public, scott, we wish you all the best and thank you. mr. speaker, i yield back. the speaker pro tempore: the gentleman's time has expired. for what purpose does the gentleman from california seek recognition? >> mr. speaker, unanimous consent to address the house for one minute. the speaker pro tempore: without objection, the gentleman is recognized for one minute. >> mr. speaker, this is california aerospace week. california is rich in our history of flight. in my district alone we have seen the sound barrier broken for the first time the ultimate air speed record set and many other flights from the f-80 through our beloved f-22. mr. knight: we have also seen my district build all of the space shuttles, all of the b-1's, all of the b-2's and most of the fighters that fly over our friendly skies. our state has had an over 100-year history in flight and aerospace week culminates that production and that test. our state and my district have continued to put america in lead over the skies and we will continue to do so in the future. mr. speaker, i yield back. the speaker pro tempore: the gentleman yields back. for what purpose does the gentleman from oregon seek recognition? >> mr. speaker, i ask unanimous consent to address the house for one minute and to revise and extend my remarks. the speaker pro tempore: without objection the gentleman is recognized for one minute. mr. walden: we can provide certainty for health care providers and seniors to fix the s.g.r. for seniors and help schools in rural counties. i commend my colleagues for their work with me. it is two years' funding for the secure rural schools program. now this is like one of those cans of fix a flat, if you will. it's an emergency repair on the side of the road to solve a short-term problem when what we really need is pearmnant fix for our forested counties. but this is an emergency, and what we're doing here today is providing that lifeline to our schoolchildren and the classrooms and our rural -- in our rural counties that are under rural and forested land and make sure the local law enforcement have the resources they need. and in my own state of oregon, protecting some counties from going bankrupt because of lack of languagement, lack of activity on our federal lands. so i remain fully committed to working on forestry legislation that puts people back to work in the woods, reduces the threat of wildfire and provide self-sustaining counties and the people in them. i just hope this time with a new senate we'll be able to move forward and i yield back. the speaker pro tempore: the gentleman's time has expired. for what purpose does the gentleman from pennsylvania seek recognition? >> i seek unanimous consent to address the house for one minute. the speaker pro tempore: without objection, the gentleman is recognized for one minute. >> thank you, mr. speaker. mr. speaker, i rise to comment on the budget that was passed yesterday out of this house by the republicans. i come from scanton pennsylvania, the birthplace of our vice president and i vice president is often heard to say people talk about family values all the time, family values this, family values that, and he says, look, don't talk to me about your values. show me your budget and i'll tell you what your values are. mr. cartwright: this republican budget was something that i could not support because it will have the effect of cutting over a million jobs over the next year, and even worse than that, it will turn medicare into effectively a voucher program. a voucher program if you're on medicare and you need treatment and they give you a voucher you better hope that that voucher covers the services you need. otherwise, you're out of luck. so if your values include increasing jobs and employment in this country and taking care of our seniors, that republican budget was not the one to vote for. i yield back. the speaker pro tempore: the gentleman yields back. for what purpose does the gentleman from texas seek recognition? mr. burgess: mr. speaker, by the direction of the committee on rules, i call up house resolution 173 and ask for its immediate consideration. the speaker pro tempore: the clerk will report the resolution. the clerk: house calendar number 18, house resolution 173 , resolved, that upon adoption of this resolution it shall be in order to consider in the house the bill h.r. 2, to amend title 18 of the social security act to repeal the medicare sustainable growth rate and strengthen medicare access by improving physician payments and making other improvements, to re-authorize the children's health insurance program, and for other purposes. all points of order against consideration of the bill are waived. the amendment printed in the report of the committee on rules accompanying this resolution shall be considered as adopted. the bill, as amended, shall be considered as read. all points of order against provisions in the bill, as amended, are waived. the previous question shall be considered as ordered on the bill, as amended, and on any further amendment thereto, to final passage without intervening motion except, one one hour of debate equally divided among and controlled by the chair and ranking minority member of the committee on energy and commerce and the chair and ranking minority member of the committee on ways and means, and two, one motion to recommit with or without instructions. section 2, on any legislative day during the period from march 27, 2015, through april 10, 2015, a, the journal of the proceedings of the previous day shall be considered as approved, and b, the chair may at any time declare the house adjourned to meet at a date and time, within the limits of clause 4, section 5, article 1 of the constitution, to be announced by the chair in declaring the adjournment. section 3, the speaker may appoint members to perform the duties of the chair for the duration of the period addressed by section 2 of this resolution as though under clause 8-a of rule 1. section 4, each day during the period addressed by section 2 of this resolution shall not constitute a calendar day for purposes of section 7 of the war powers resolution 50 u.s.c. 1546. section 5, the committee on financial services and the committee on ways and means each may, at any time before 5:00 p.m. on april 6, 2015 file reports to accompany measures. . the speaker pro tempore: the gentleman from texas, mr. burgess, is recognized for one hour. mr. burgess: thank you, mr. speaker. mr. speaker, during consideration of this resolution, all time yielded is for the purposes of debate only. i now yield the customary 30 minutes to the gentleman from massachusetts, mr. mcgovern, pending which i yield myself such time as i may consume. the speaker pro tempore: the gentleman is recognized. mr. burgess: mr. speaker. i further ask unanimous consent that all members may have five legislative days to revise and extend their remarks. the speaker pro tempore: without objection. mr. burgess: mr. speaker, house resolution 173 provides for consideration of h.r. 2, the medicare access and chip re-authorization act of 2015 under a closed rule reflecting the careful, intricate bipartisan negotiations which brought this legislation to the floor. the rule provides for one hour of debate equally divided amongst the chairs and ranking members of the committees on energy and commerce and ways and means. as is customary, the rule allows the minority to offer a motion to recommit on the bill. finally, the rule provides for the customary district work period authority. this bill h.r. 2, resolves an issue that many of us have worked on for our entire congressional careers. this bill reflects years of bipartisan work, work across committees, and even work across the capitol with the other body. we brought together members of all ideological groups, as well as diverse outside groups. we coalesced around a policy that will help patients, doctors, providers to get out from under the constant threat of payment cuts under the medicare sustainable growth rate formula. everyone agrees, medicare sustainable growth rate formula has got to go. today we are considering a bill to realistically accomplish that goal. the s.g.r. formula was enacted as part of the balanced budget act of 1976 -- 1997 in an attempt to restrain federal spending in medicare part b. we now know that is not working. the s.g.r. consists of expenditure targets which apply a growth rate designed to bring spending in line. since 2002, the s.g.r. formula has resulted in a reduction in physician reimbursement rates. however, even though congress has consistently passed legislation to override the formula, these patches have resulted in hundreds of billions of spent funds that could have gone to improving the medicare system. if congress were to let the formula continue physicians would face a 21% reduction in reimbursement rates on april 1. the sustainable growth rate's unrealistic assumptions of spending and efficiency have plagued the health care profession and medicare beneficiaries for over 13 years. the bill before us repeals the sustainable growth rate formula. avoiding potentially devastating across-the-board cuts slated to go into effect next week. we do so at a cost lower than what congress has already spent or is likely to spend over the next 10 years. the congressional budget office has found that enacting h.r. 2 will cost less than if we patch this formula over the next 10 years. the bill before us today provides five years of payment transition that allows improved beneficiary access, and allows medicine to concentrate on moving to broad adoption of quality reporting and most importantly allows congress to move past the distraction of the s.g.r. formula and begin identifying medicare reforms that can further benefit our citizens. this will also allow providers the time to develop and test quality measures and clinical practice improvement activities which will be used for performance assessment during phase 2. during the stability period physicians will receive annual increases of one half of one percent. it seems small, but it is above what has been provided over the past several years. the quality measures if implemented -- are implemented in what is called the merit based incentive payment system that. will be evidence based and developed through a transparent process that values input from provider groups. quality reporting will measure providers against their peer rather than a one-size-fits-all generic standard. providers will also self-determine their measures. the bill consolidates three reporting programs into this incentive payment system easing administrative burdens, and furthering the congressionally established goals of quality resource use, and meaningful use. the new reimbursement structure ensures continued access to high quality care while providing dogs with certain and -- docs with certainty and security in their reimbursement. they will be aware of the benchmark they are competing against and all like current law all pentz from those not meeting the benchmark will go to those who do. keeping the dollars in the medicare system. provider standards will be developed by professional organizations in conjunction with existing programs and will incorporate ongoing feedback to physicians further ensuring that opt minimal care is -- overwhelm at this minimal care is provided to patients. physicians will be encouraged to participate in the process through data reporting, eligible professionals who use to opt out of the fee-for-service programtarian payment models will be available. these alternative payment models may include a patient centered medical home, whether they are in primary or specialty care, bundled care, or episodes of care. qualifying practices that move a significant amount of their patients in to these alternative payment models could see a 5% quality bonus. by encouraging alternative payment models and care coordination, this legislation will foster and facilitate innovation. it is important to note that while taking these important steps toward ensuring quality care, the bill specifically states that these quality measures are not creating a federal right of action or legal standard of care. mr. speaker from beginning to end, this bill is about access. access for our seniors, access for those who utilize the nation's 9,000 community health centers, and very importantly, the over eight million children who receive their care at some point during the year through the children's health insurance program. the bill also addresses health programs that have become known as extenders. most extenders -- most are extended for two years under the bill, and by resolving the s.g.r., congress will have the ability to commit itself to working through these policies in the future. the bill also puts into place important structural reforms to medicare that are the first steps towards starting the medicare program on the really long-term trajectory towards fiscal stability. the bill is consistent in its themes throughout. payment stability. reduce and streamline the administrative burden. increase predictibility and providers interactions with the centers for medicare, medicaid services. build transparency into the systems. encourage innovation of deliver riff services. keep providers in the driver's seat. most importantly we provide access to care for our nation's patients. america's providers agree. i want to give you some quotes here. the american osteopathic association views this bipartisan legislation as a clear and definitive approach toward comprehensive-reforms in our health care system for children, seniors, and nation's physicians. here's one from the american academy of family physicians. this legislation is the result of bipartisan negotiations that have produced legislative responses to some of our nation's most pressing health care issues. america's essential hospitals praise this bill stating this legislation represents the first truly bipartisan major health care legislation in years, please do not let this opportunity pass you by. approve h.r. 2. this is just a small sampling of the close to 800 organizations spanning the political spectrum who have come together to endorse this bill. from primary care to specialists to surgeons to organized nursing, our nation's hospitals and everyone in between have supported this policy. for that reason, i encourage my colleagues to vote yes on the rule and yes on the underlying bills. i reserve the balance of my time. the speaker pro tempore: the gentleman reserves the balance of his time. the gentleman from massachusetts is recognized. mr. mcgovern: thank you, mr. speaker. i want to thank the gentleman from texas, mr. burgess, for the customary 30 minutes. i also want to thank him for his work on this legislation. i ask unanimous consent to revise and extend and i yield myself such time as i may consume. the speaker pro tempore: without objection. the gentleman is recognized. mr. mcgovern: mr. speaker for far too long congress has shirked its responsibility when it came to permanently fixing the sustainable growth rate formula. since its inception, our nation's doctors and hospitals were held hostage to a misguided funding formula that was included as part of the balanced budget act of 1997. i voted against the balanced budget act back then when i was a new member of congress. it was plain to me that the medicare cuts and proposed financing included in that bill were simply impossible to sustain. i'm glad that 18 years later congress is finally doing the right thing and preeling the sustainable growth rate formula and replacing it with a payment system based on value. it is past time that we repeal this misguided formula that has wreaked havoc throughout our health care system. year after year after year congress, whether controlled by democrats or republicans was forced to temporarily patch this formula. year after year after year congress did the bear minimum providing a temporary fix without addressing the real problem and permanently repealing the formula. today, congress is finally doing the right thing. that alone is worth supporting. but this bill does more than just repeal the sustainable growth rate formula, instead it provides a clearly defined schedule of payment adjustments that will give physicians and health care providers the stability they need while ensuring quality and value in the services patients require. in addition h.r. 2 also provides critical funding through september 2017 for our nation's community health centers. funding that was initially provided under the affordable care act. it also provides support for the children's health insurance program or chip. i have already started to hear from hospitals in my district about why this bill is good for them and good for their patients. umass memorial medical center in my hometown is one of the nation's most distinguished academic health care systems and is the safety net hospital for all of central massachusetts. the folks there are pleased to see that the delay in additional cuts to safety net hospitals and the delay in the implementation of the two midnight rule. this bill is not perfect. nothing around here is ever perfect. but this is the result of long and careful bipartisan negotiation. even though there are many very positive aspects of this bill, there are some provisions that are more problematic and i would be remiss if i didn't mention some of them. most troubling is the inclusion of a hyde amendment and its application to the funding for community health centers. it's important to clarify that this language is not a permanent extension or codification of the hyde amendment. it only applies to the funding for community health centers and expires when that funding expires. it does not affect nonfederal funds. in fact, it is the same language that has been included in annual appropriations bills for nearly three decades. let me be clear, i do not support the hyde amendment, however the language in this bill mirrors both president obama's executive order and the language included in the annual appropriations bills. and i wish the chip extension was for four years rather than two. but in this environment, i think that we have a two-year extension is a good thing. is an accomplishment. is a step in the right direction. mr. speaker this is an important accomplishment and i want to thank both speaker boehner and leader pelosi for their work in reaching this compromise. a deal that will finally enable this house to move away from annual doc fix patches and toward providing stability and certainty for medicare physicians. and patients. i'm encouraged by the process taken to reach this agreement. for a congress that i might say accurately has been called broken, hopeless, helpless, a congress plagued by gridlock and extreme partisanship, this bill represents what i hope will be a renewed commitment by my friends in the majority to work across the aisle with democrats to address some of our country's most pressing issues. it is and has always been the way congress passes important substantive and even historic legislation. this place can work when we work together. just look at what this house has done over the past few weeks. we responsibly kept the department of homeland security open. and now we are on the verge of passing an incredibly vital bipartisan bill to repeal the sustainable growth rate, fund community health centers, and re-authorize chip. i hope this bipartisan approach is contagious. i hope this is not the exception and becomes the rule. every member represents the same number of constituents. and every voice in this house needs and deserves to be heard. today thanks to the leadership of leader pelosi and speaker boehner and so many others, we are doing something that we can feel good about. something more than a campaign slogan. something that is more than red meat for the political base. this is something that will help seniors kids, and low-income families. it deserves our support. before i reserve my time, mr. speaker, i would like to ask unanimous consent to insert into the record the statement of administration policy which begins with the following the administration supports house passage of h.r. 2 because it would reform the flawed medicare physician payment system to incentivize quality and value, and would make reforms that could help slow health care costs growth and would extend other important programs such as health care coverage for children. . with that, mr. speaker, i verve my time. the speaker pro tempore: the gentleman reserves. the gentleman from texas is recognized. mr. burgess: i'd like to yield two minutes to the gentleman from louisiana, mr. fleming. the speaker pro tempore: the gentleman is recognized for two minutes. mr. fleming: i rise in support of h.r. 2. as a family physician who's been in private practice since 1982, i've seen a lot of things happen with medicare. and this idea of sustained growth rate, or sustainable growth rate, s.g.r., that came up in 1997 a republican idea, is not only flawed, it's idiotic. it requires physicians to control throughout the country the entire volume of services that are provided, something that is absolutely impossible to do. it actually has had the opposite effect that was desired and actually increased the amount of activity because of the loss of the economic foundations that make a system work. now, what this repeal of s.g.r. will do is, number one, it will actually show what the cost of this is. we've been hiding it like a shell game for years with temporary patches that last, oh maybe a year, sometimes less. not only will this balance or pay for itself in the second decade, but it actually begins to lower that cost even in the first decade and it does it using several mechanisms but two important reforms that my colleagues need to know about. number one, it reforms medigap policies which gives patients skin in the game. it makes patients once again a part of the decision team so that they, by having some element of price sensitivity, can work with the doctor to decide what is necessary and what is not what is affordable and what is not. also, it asks higher income seniors to do their share. remember, the current medicare system is a highly subsidized system for everybody including warren buffett, a $40 billion billionaire, gets his health care subsidized. i ask that you support this and i yield back. the speaker pro tempore: the gentleman yields back. the gentleman from massachusetts is recognized. mr. mcgovern: i yield two minutes to the gentleman from california mr. bera. the speaker pro tempore: the gentleman is recognized for two minutes. mr. bera: this is an important step forward. for over a decade we've had this flawed formula that has put the security of seniors' health care access at risk. now, i want to applaud dr. burgess, i want to applaud the bipartisan doctor caucus. you'll hear from a lot of doctors in congress that this is a step forward, because when we took our oath to practice medicine we took an oath to put our patients first and this is a good bill that puts our patients first. our seniors folks that have worked their whole lives and now in retirement need that security of being able to see their doctor and this bill repeals a flawed formula that's been patched for 17 times over the years and replaces it with a better formula, a formula that moves us away from this fee for service model and moves us towards practicing higher quality care putting our patients first. it's not a perfect bill. like many, i'm disappointed to see the hyde amendment included in this bill. i always stood against the hyde amendment and against other attempts to restrict a woman's right to make their reproductive health decisions. the hyde amendment's a temporary rider that expires every year and we, along with many women across this country, look forward to the day when it will end. but that said i came to congress to put people first, came to congress to work across the aisle in a bipartisan way to put our country first, and this is a great attempt and, again, i applaud the doctors in congress. i applaud the members of the energy and commerce committee, the members of the ways and means committee, the speaker and the leader of the democratic party here in the house of working together to put people first. this is a good bill. 7.4 million patients will still have access to karat community health centers. -- care at community health centers. pregnant women will have access to the chip program. 49 million patients are enrolled in medicare and another 10,000 baby boomers enroll every day. this is a good thing. mr. mcgovern: i yield the gentleman an additional one minute. mr. bera: we've got to honor the promises we made to our constituents, to the people of america. we've got to honor the promises that we made to our patients as doctors. this is a good bill. i look forward to voting and passing this bill today and continuing to move america forward. thank you. i'll yield my time back. the speaker pro tempore: the gentleman yields back. the gentleman from texas. mr. burgess: thank you, mr. speaker. at this time i would like to recognize the gentleman from michigan, dr. benishek, for one minute. the speaker pro tempore: the gentleman from michigan is recognized for one minute. mr. benishek: thank you, mr. chairman. thanks for all your good work on this piece of legislation. mr. speaker i rise today in support of the rule for h.r. 2. since the current flawed medicare payment rate was enacted in 1997, congress has kicked the can down the road and passed 17 different patches to avoid devastating cuts to medicare. these patches have cost the taxpayers almost $170 billion, more money than it will cost to permanently fix this problem right now. today we have the opportunity to actually fix a major problem and pass meaningful legislation that will keep -- help keep medicare solvent and ensure that seniors are able to get the medical care they deserve. as a doctor who's taken care of patients in northern michigan for more than 30 years, i know how terrible it would be if we failed to act today and how seniors would bear the brunt of that failure. well today's legislation may not be perfect, it is a bipartisan compromise to ensure that medicare continues to provide necessary health care for my constituents in northern michigan. i urge all of my colleagues to support this commonsense and long overdue fix. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back. the gentleman from massachusetts. mr. mcgovern: i yield two minutes to the gentleman from california mr. aguilar. the speaker pro tempore: the gentleman from california is recognized for two minutes. mr. aguilar: thank you, mr. speaker. and i want to thank the gentleman from massachusetts. this bipartisan compromise will address -- that we will address this afternoon over s.g.r. will strengthen medicare by lowering costs and ensuring seniors have a doctor of their choice. while this agreement has important provisions, including critical programs to help low-income seniors families and children, it does fall short in a few ways. as a member of the pro-choice caucus, i'm disappointed this deal ignores the need for women to have access to their health care providers and includes an anti-choice provision. today's bill falls short of measures to increase women's access to necessary health measures and annual examines for critical health care. the hyde amendment, this is clearly another attack to block access for reproductive care. the inclusion of this language is disappointing because it permits anti-choice language in an otherwise pragmatic bipartisan compromise in exchange for community health center funding. i plan to support this bipartisan compromise because it solves long-standing problems and is a step in the right direction. thank you and i yield back the balance of my time. the speaker pro tempore: the gentleman yields back. the gentleman from texas. mr. burgess: mr. speaker, may i inquire as to the time remaining? the speaker pro tempore: the gentleman from texas has 18 1/2 minutes remaining. and the gentleman from massachusetts has 21 minutes. mr. burgess: thank you, mr. speaker. mr. speaker at this time i'd like to recognize the gentlelady from california, ms. walt -- mrs. walters, for three minutes. the speaker pro tempore: the gentlewoman from california is recognized for three minutes. mrs. walters: i rise in support of h.r. 2 the medicare access and chip re-authorization act, a bill to repeal and replace the sustainable growth rate. this bill prevents an historic opportunity for congress to end the doc fix and comprehensively reform the medicare physician payment system once and for all. s.g.r. has been broken for over a decade and congress has passed a temporary patch for this law 17 times. the price of putting up a permanent fix has cost the taxpayers almost $170 billion and masks the insolvency of medicare. according to the nonpartisan congressional budget office, mr. burgess' legislation to repeal s.g.r. would save $900 million over the next decade compared to freezing payment rates for physician services. after a decade of congress patching the flawed s.g.r. formula, it's finally time to permanently repeal and replace the system once and for all. i urge my colleagues in the house and the senate to pass this bill and finally fix the doc fix. mr. speaker, i yield back the balance of my time. the speaker pro tempore: the gentlewoman yields back. the gentleman from massachusetts. mr. mcgovern: mr. speaker i'd like to ask unanimous consent to insert the following statements in the record in support of h.r. 2. a statement by the massachusetts hospital association, a statement by the massachusetts medical society, a list of a number of groups that are supporting h.r. 2 the american hospital association, sciu, and i would also like to submit the statement by network. network is a national catholic justice lobby and they are all in support of this bill. the speaker pro tempore: without objection. mr. mcgovern: and as i said, it's not a perfect bill, but it represents i think a major accomplishment. i'd like to inquire from the gentleman how many additional speakers he has. mr. burgess: mr. speaker, we have no additional speakers at this time. i'm prepared to close after the gentleman closes. mr. mcgovern: then i'll take this opportunity to close our side of the debate, mr. speaker. i yield myself the remaining time. the speaker pro tempore: the gentleman is recognized. mr. mcgovern: let me begin by thanking all those who have been involved in this. compromise. especially speaker boehner and leader pelosi. i want to thank mr. burgess. i want to thank all the members of the energy and commerce committee. i'm grateful to the staffs of all the relevant committees for all the work that they put into this. i especially want to also acknowledge the incredible work of the staff who work in the legislative counsel office. they don't always get thanked but they do so much of the work around here, not only on important and complicated legislation, like what we're debating here today but on all legislation. and so we are grateful to them. i don't really know what else to say here except that i'm happy we're doing something and i'm happy that we are actually putting forward a bill, a bipartisan bill that will help a lot of the people who most need help. as mr. burgess said, this bill -- you know, in reality, is about access. making sure our senior citizens have the access to the doctors and the health care that they want. and we are making that possible through this bill as well as helping countless children and low-income families in supporting our community health centers. this has been an incredible week. it's hard to believe. first, we read that ted cruz signs up for obamacare. now we have this bipartisan compromise on the doc fix. it re-authorizes chip and provides money to our community health centers. and who knows? if this is contagious, maybe next week we'll deal with climate change. i'm feeling good as we close this week. again, i hope this is coming attractions about what we can see in the future. more bipartisan cooperation, more give and take and if we follow what we did here we actually can accomplish a lot more for the american people. and i think that would be a good thing. so with that i -- let's get this done and i yield back the balance of my time. the speaker pro tempore: the gentleman yields back. the gentleman from texas. mr. burgess: mr. speaker, i yield myself the balance of the time. the speaker pro tempore: the gentleman from texas is recognized. mr. burgess: mr. speaker, today's rule provides for consideration of legislation addressing the pernicious sustainable growth rate formula, the most threatening risk for access to care for our seniors. the committees' work represented in h.r. 2, the base policy of h.r. 2 has the backing of the house and senate negotiators and all three committees of jurisdiction. i certainly want to thank the speaker and the minority leader and their staff for building on the policy work accomplished by the committees to present a political pathway forward for this bipartisan bill. i thank the chairman and ranking members of the house committees on energy and commerce, the committee on ways and means as well as the senate finance committee for coming together for our nation's doctors and seniors. i must note that chairman upton, chairman pitts, chairman ryan, chairman brady and former chairman camp as well as ranking members pallone, gene green, ranking member sandra levin, -- sander levin and waxman. i'd like to thank all of those who labored on this issue for years. i know i missed some but i want to mention a few who have dedicated themselves for getting us here. some have left or switched their roles but their work from the beginning deserves recognition. certainly i want to thank clay, robert horn rien long dr. joe owe shay, dr. steve ferra, eddie garcia, tiffany ariel, brent baker, brian sutter, matt hoffman aaron richardson and j.p. on my staff. i also want to thank the unsung heroes at the house legislative council, namely jessica shapiro jesse cross. every success we've had at each point in this process was further than we had ever come before, and that involved a lot of work, a lot of negotiation and a lot of overwhelming desire to see the process through to the end. ultimately if this is a package that can go to the white house, all of this will be worth it. i certainly do look forward to passage and hope that given the positive signs evidenced over the past several days the other chamber will quickly embrace this package and ultimately get this badly needed policy into law. . i want my colleagues to support the rule and underlying bill. for that reason i yield back the balance of my time and move the previous question on the resolution. the speaker pro tempore: without objection, the previous question is ordered. the question is on adoption of the resolution. so many as are in favor say aye. those opposed, no. the ayes have it. the roogs is agreed to -- resolution is agreed to. without objection the motion to reconsider -- mr. burgess: on that i request the yeas and nays. the speaker pro tempore: the yeas and nays are requested. those favoring a vote by the yeas and nays will rise. a sufficient number having arisen, the yeas and nays are ordered. members will record their votes by electronic device. this is a 15-minute vote. [captioning made possible by the national captioning institute, inc., in cooperation with the united states house of representatives. any use of the closed-captioned coverage of the house proceedings for politi >> the house is considering the bill that would replace medicare payments for doctors in order to prevent an expected cut to those payments which will happen on march 31, the budget office says the deal would increase the deficit by $141 billion over 11 years and is voting on the rule for debating this measure. we are expecting an hour of general debate on the bill to follow. legislative work today would be the last for the week and for the next couple of weeks as congress begins a two-week break for spring. the house will not be in session tomorrow. in the senate today, lawmakers finishing up work on the 2016 republican budget plan. formal debate ends at noon and continuous voting on more than 60 amendments. voting is expected to last until midnight or beyond with final passage of the budget at the end of the vote series. see the senate live on c-span2. ♪ the speaker pro tempore: on this vote the yeas are 402. the nays are 12. five answering present. the resolution is adopted. without objection, the motion to reconsider is laid on the table. the house will be in order. the house will be in order. the house will come to order. members, take your conversations off the floor. for what purpose does the gentleman from pennsylvania seek recognition? mr. pitts: mr. speaker, pursuant to house resolution 173, i call up h.r. 2 and ask for its immediate consideration in the house. the speaker pro tempore: the clerk will report the bill. the clerk: h.r. 2, a bill to amend title 18 of the social security act to repeal the medicare sustainable growth rate and strengthen medicare access by making other combrosks to re-authorize the children's health insurance program and for other purposes. the speaker pro tempore: pursuant to house resolution 173, the amendment printed in house report 114-50 is considered adopted. the bill, as amended, is considered as read. the bill shall be debatable for one hour equally divided among and controlled by the chair and ranking minority member of the committee on energy and commerce and the chair and ranking minority member on the committee on ways and means. the gentleman from pennsylvania, mr. pitts, and the gentleman from new jersey, mr. pallone, the gentleman from texas, mr. brady and the gentleman from michigan, mr. levin, will each control 15 minutes. the house will be in order. the chair recognizes the gentleman from pennsylvania, mr. pitts. mr. pitts: mr. speaker, i ask unanimous consent that all members may have five legislative days to revise and extend their remarks and to include extraneous material on h.r. 2. the speaker pro tempore: without objection, so ordered. mr. pitts: mr. speaker, i yield myself such time as i may consume. the speaker pro tempore: the gentleman is recognized for as much time as he wishes to consume. mr. pitts: mr. speaker, i rise today in support of h.r. 2 the medicare access and chip re-authorization act of 2015 sponsored by congressman burgess of texas. mr. speaker, i rise in support of h.r. 2, the bill i just referenced. four years ago, upon taking leadership of the energy and commerce health subcommittee, i made it one of my goals to end the patchwork of doc fixes and repeal the sustainable growth rate. now we are here on the floor of the house with a bipartisan policy and a bipartisan set of pay fors. there were many who thought this day would never come. we are replacing the s.g.r. once and for all with a system that allows greater freedom for physicians to practice medicine. we do this without threatening access to health care for seniors. instead of unrealistic price controls, we are instituting a contive process to make our -- cooperative process to make our health care dollars go farther. we are also replacing a portion of the projected savings with real equipment reforms. reforms that could -- entitlement reforms. reforms that could reduce spending by $295 billion in the coming decades. let's not make the mistake of saying that this is saving medicare. the bill makes important reforms that put the program on a better path. but there's much work to do before we achieve that goal. future generations of americans have understandable doubts about whether medicare will be there when they retire. they pay into the program just as my generation did but the current system of funding the frame will not deliver on that promise for them. the extraordinary progress represented by the bill before us today is the result of a vision for the future and years of hard work. that vision was wholeheartedly supported by speaker boehner, and there are many more to thank. chairman upton for his persistence and leadership. current ranking member pallone, former ranking member waxman for working with us to get a policy we could all agree on. also, dr. burgess, the primary sponsor of today's bill, and the vice chairman of the health subcommittee in the pew past congresses. i'd especially like to thank the dedicated staff that spent countless hours sacrificed weekends to make this happen. dr. john robert, josh trent clay, michelle rose ben yerg, heidi monica, my personal staff. we should see this bill as a first step towards strengthening and saving medicare. this can't be the end of the road. thank you, mr. speaker. i reserve the balance of my time. the speaker pro tempore: the gentleman reserves the balance of his time. for what purpose does the -- mr. pallone seek recognition? mr. pallone: mr. speaker, i yield myself such time as i may consume. the speaker pro tempore: the gentleman from new jersey is recognized for as much time as he wishes to use. mr. pallone: thank you, mr. speaker. i rise today in strong support of h.r. 2 the medicare access and chip re-authorization act of 2015. for more than 10 years congress has had to temporarily fix the flawed sustainable growth rate s.g.r. nearly 20 times since it was enacted. today is the last time i will have to talk about the broken s.g.r. the house has come together to fix it once and for all. this bill is the result of a lot of hard work by the house energy and commerce committee, ways and means, and senate finance committees and our leadership. many of our members have made important contributions to this bill and i want to thank them all for being so diligent. this bill not overwhelm repeals the s.g.r., it replaces it with a reform system that pays providers based on quality and value. it rewards health outcomes. it allows providers to give more could he focus o their patients. most porm it provides stability and -- importantly it provides stability and predictibility to the medicare program for years to come. this is good for doctors and good for seniors. this bill also extends critical funding for programs that improve the health and welfare of millions of children families, and seniors. it makes permanent the qualified individual program which helps low-income seniors pay their medicare part b premiums. it makes permanent the transitional medical assistance program which allows low-income families to maintain their medicaid coverage for up to one year as they transition from welfare to work. it includes $8 billion in funding for community health centers the national health service core, and teaching health centers. this funding will help serve 28 million patients and all three together strengthen access to primary and preventive health care in communities throughout america. the bill includes the fully funded two-year extension of chip maintaining all of the improvements in the affordable care act. but this is not just a two-year extension, it's a robust extension. it keeps the promise made to states by maintaining the 23% bump in federal matching rates and ensures that states in turn keep their promise to chip kids by leaving maintence in effort requirements for child enrollment through 2019 untouched. this bill is not perfect. i wish my republicans would have agreed to fund chip for four years. i also remain concerned about the provision that is affect medicare beneficiaries. but such is the nature of compromise. mr. speaker, i'm proud of the work of my committee and both of our leaderships. this agreement took courage from both sides but what we have accomplished is truly significant. it is balanced and a thoughtful product. i urge members to support it. i reserve the balance of my time. the speaker pro tempore: the gentleman from new jersey reserves his time. the chair recognizes the gentleman from pennsylvania. mr. pitts: mr. speaker, at this point i'm pleased to yield one minute to an outstanding member of the energy and commerce committee, the good advocate op health issues, the gentleman, mr. harper of mississippi. the speaker pro tempore: the gentleman from mississippi is recognized for one minute. mr. harper: thank you, mr. speaker. the medicare access and chip re-authorization act represents years of bipartisan effort to eliminate the fatally flawed sustainable growth rate formula and implement new payment and delivery models that will promote higher quality care while reducing cost. in addition to stabilizing the medicare program for our nation's seniors, the bill addresses the health care needs of children and low-income americans while promoting the long-term sustainability of the medicare program through significant structural reforms to the medicare program. there is no question, medicare must be modernized in order to avoid the program's projected financial shortfalls. republicans and democrats have worked together to advance a blueprint to begin to place medicare programs on a sound financial footing for both today's and future retirees. now is the time to end this failed policy once and for all and protect access to care for seniors. i urge my colleagues to support this legislation and i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from pennsylvania reserves. the gentleman from new jersey. mr. pallone: mr. speaker, i yield two minutes to the ranking member of our health subcommittee, mr. green. the speaker pro tempore: the gentleman from texas is recognized for two minutes. mr. green: thank you, mr. speaker. and thank my colleague for yielding to me and appreciate his leadership on this issue and many others in our committee. i rise in support of h.r. 2, the medicare access and chip re-authorization act. as an original co-sponsor of this landmark legislation, i urge my colleagues to support the bill. h.r. 2 will reform the flawed medicare physician payment system to reward quality and value over volume. make reforms to slow the growth of health care costs and extend other critical programs, including the children's health insurance program and the funding for community health centers. since 2003 congress has intervened 17 times to prevent steep payment cuts caused by the flawed s.g.r. formula in order to preserve seniors' access to care. repealing the s.g.r. is a responsible choice both physically and logically. more money now spent on short-term patches than the full cost of the permanent preeling of the s.g.r. we are closer than we have come ever to repealing the flawed s.g.r. formula and adding meaningful reform. i want to highlight the additional two years of funding for the community health centers program included in the package. these dedicated mandatory funds will avert a cliff set to take place in september. without this extension, funding for health centers would be slashed by 70%, and 7.4 million patients would lose access to care. also included in the agreement are funding for national health service cores and teaching health center program. both programs further the goals in improving and strengthening access to primary and vee pre-van hollenive care in our communities. like any good bipartisan compromise, the legislation strikes a balance and offers a set of viable solutions that we -- should have broad bipartisan support. i want to thank speaker boehner leader pelosi my colleagues on the energy and commerce committee and ways and means committee for their leadership in working across the aisle to craft this commonsense landmark legislation. thank you. i yield back my time. the speaker pro tempore: the gentleman yields back. the gentleman from new jersey reserves his time. the gentleman from pennsylvania. mr. pitts: i'm pleased to yield one minute to a member of the health subcommittee, dr. bucshon of indiana. the speaker pro tempore: the gentleman from indiana is recognized for one minute. mr. bucshon: thank you, mr. speaker. mr. speaker, today is a great day for america's seniors. after years of flawed medicare polcy, we are finally creating a stable system that ensures medicare patients will have access to their doctors. this new policy will move our medicare system to one that is based on quality of care that is provided to our nation's seniors. in fact, for the first time in decades, we actually achieve real structural reforms in the program that will help save this critical program for future seniors. i would also like to highlight that this legislation repeals c.m.s.'s policy to eliminate bundled surgical payments eliminating surgical payment budgets would force doctors to spend more time billing c.m.s. and could be used for caring for patients. i like to thank chairman pitts and also congratulate speaker boehner, minority leader pelosi, chairman upton, and ranking member pallone for putting politics aside and putting america's seniors first. i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from pennsylvania reserves his time. the gentleman from new jersey. mr. pallone: i yield one minute to the gentleman from oregon, mr. schrader. the speaker pro tempore: the gentleman from oregon is recognized for one minute. mr. schrader: thank you very much mr. speaker. i thank the gentleman for yielding. i'm proud to be here today. to support real bipartisan compromise to finally repeal and replace this flawed s.g.r. formula. like to give my congratulations to congressman burgess and frankly former congresswoman allyson schwartz, who worked hard for many years to make this a reality. this long-term solution will bring stability to medicare so seniors will be able to continue to see their doctors. mean mile while the bill also allows physicians to focus on value and quality of care rather than quantity of care. and extends, of course, the vital championship program. aiding so many children in this contry. -- country. although i prefer to see this bill completely paid for like many others, i recognize the nature of compromise means you don't get everything you want when you're a house member or senate member. i am glad as been pointed out that part of the cost of this bill is covered by implementing crucial reforms to medicare that help improve its solvency for future generation, certainly compared to our currentpolicy. i congratulate my colleagues on both sides of the aisle for coming together on this agreement. it's long overdue. greatly improve our system. and i hope we vote for this bill. thank you. i yield back. the speaker pro tempore: the gentleman yields back. the gentleman from in in reserves. the gentleman from pennsylvania. -- from new jersey reserves. the gentleman from pennsylvania. mr. pith: i'm pleased to yield one minute to the vice chair of the committee, the distinguished gentlelady fromtown trnings mrs. blackburn. the speaker pro tempore: the gentlelady from tennessee is recognized. mrs. blackburn: thank you, mr. chairman. i want to thank chairman pitts for the work he has done on this, as well as the other members of our committee. and i do rise today in support of h.r. 2. i think every one of us have constituents who are medicare enrollees who tell us the story and the stress that comes with not being able to see a doctor because they are no longer taking medicare patients. so what this does is go to the heart of the problem. the s.g.r. the sustainable growth rate. it was a big part of the problem, the sort of damocles, if you will. doctors never knew if they were going to get paid or what they were going to get paid or if it was going to be a double-digit or single digit cut. let's get that off the table and provide certainty. h.r. 2 is finally going to eliminate the flawed s.g.r. it will be replaced with commonsense legislation which will provide health care providers with the predictibility that is necessary to meet the needs of medicare enrollees. in addition, h.r. 2 takes an important step to reign in health care -- rein in health care spending, incentivizing doctors on quality as opposed to quantity. getting at part of the problem of our entitlement programs. i congratulate all involved and encourage a yes vote. i yield back. the speaker pro tempore: the gentlelady's time has expired. the gentleman from pennsylvania reserves his time. the chair recognizes the gentleman from new jersey. mr. pallone: mr. speaker, i yield one minute to the gentleman from new york, mr. engel. the speaker pro tempore: the gentleman from new york is recognized for one minute. mr. engel: thank you, mr. speaker. i rise in strong support of h.r. 2. i have always believed that our physician work force deserves to be fairly compensated. the flawed s.g.r. formula has failed to do this for over a decade. and it isn't right that physicians have faced looming medicare cuts year after year. therefore, i'm pleased that house democrats and republicans have come together to craft a fair bipartisan compromise that was long-standing and expensive problem. mr. speaker, the american people want us to end gridlock. they want us to meet in the middle. we are doing that today. i want to commend speaker boehner and leader pelosi. while i would have liked to have seen a four-year extension of chip funding, and i am upset that unnecessary hyde language has been attached to much needed community health center funding overall this is a good agreement. medicare beneficiaries, their firstans, children and entire health care system will benefit from seeing chip and health center funding extended, s.g.r. repealed and reimbursement incentivized. i urge my colleagues both here in the house and senate to support this compromise legislation. the medicare access and chip re-authorization act of 2015. i yield back. . the speaker pro tempore: the gentleman from pennsylvania is recognized. mr. pitts: mr. speaker at this time i'm pleased to yield one minute to the chairman of the doc caucus and who should be recognized for his tireless efforts to build support for this bill, dr. roe from tennessee. the speaker pro tempore: the gentleman is recognized. mr. roe: i rise in strong support of h.r. 2 which will per nantly repeal the s.g.r. formula and replace it with meaningful reforms to ensure seniors' access to medicare. this is one of the most important things we've accomplished since i've been in congress and i couldn't be prouder of the work done by house energy and commerce commerce and the house g.o.p. doctors caucus. i want to thank speaker john boehner and leader pelosi whose leadership this would not have happened. this -- helps pave the way for entitlement reform by making important structural changes to the program. that's an important point. people over the years have referred to this as a doc fix, but it really should be called as the senior fix. the cuts cut by s.g.r. was so severe had they been allowed to go into effect, access would have been curtailed. after 12 years, 17 patches $170 billion spent to keep -- keep a flawed formula from doing lasting damage to medicare, we're finally acting in a responsible manner in a way that should give the american people renewed confidence in congress' ability to act on important americans. i thank all involved and with that i yield back the balance of my time. the speaker pro tempore: the gentleman's time has expired. the gentleman from pennsylvania reserves his time. the gentleman from new jersey. mr. pallone: mr. speaker, i yield one minute to our democratic leader, ms. pelosi, and thank her for what she accomplished here today working with the speaker. the speaker pro tempore: the gentlelady from california is recognized. ms. pelosi: thank you, mr. speaker. i thank the gentleman for yielding. i thank him, mr. pallone, i thank him and mr. levin, our ranking member on energy and commerce committee and the ways and means committee for their leadership and cooperation on this issue as well as the chair and -- the chair of the ways and means committee, mr. upton, and ways and means committee on the republican side as well. but this is a day that we really have to salute our staff. they have worked so hard. it was my honor to work with speaker boehner on this important issue to do what we came here to do, to legislate. we are the legislative branch. we are legislating. we are working together to get the job done for the american people. speaker boehner's staff, especially charlotte, ivanik, who is extremely knowledgeable about health policy, was smart and fair about all this. my staff was a strong voice for the concerns of seniors and the children and the rest in those discussions. ed grossman, house legislative counsel for all the members they churned up, ed had to translate what that the possibility is, 24/7, making the technical team at c.m.s. and h.h.s. 24/7 for many days. holly harvey and tom browly and team at the congressional budget office having to score every change of idea that we may have had. again staffs both at the ways and means committee on both sides of the aisle and the energy and commerce committee. i take the time to recognize them because in recognizing them i really want to recognize the work that is done by staff on all that we do here. all these individuals, again, have been working 18-hour days over the past few weeks and we thank them for their tireless work -- hard work. this package includes many important victories for low-income seniors, children and families. there are four -- there are many reasons to support this bill. four i'd like to point out. we are strengthening the quality of care for many older americans with additional funding for initiatives that help low-income seniors pay their medicare part b premiums. we've added almost $750 million for training more urgently needed nurses and physicians. we have secured the health care for poor children with two-year extension of health insurance program at the same rate set by the affordable care act. many people wanted more, as did i. that does not diminish the importance of the two-year extension. lastly, we have secured critical funding for community health centers over the next two years, expanding a vital investment in underserved communities. i'm proud to rise in support of this historic bipartisan package. it represents a bold, necessary progress for our country. it's not just about having -- enabling our seniors to see their doctors, which is the main purpose -- original purpose of the bill. it's about how we can increase performance and lower costs. it's about value, not volume of service. it's about quality, not quantity of procedures. and this legislation is transformative in how it rewards the value, not the volume. so i'm proud to support it. at long we will replace the broken s.g.r. formula transition medicare away from a volunteer boifed system, ensures ack -- volume-based system ensures accuracy of care. we will give them the confidence they will see the doctors they want to see and like liberating them from the shadows of needless annual crisis. as a woman in women's history month i'm very proud of what the legislation means to women and their health issues. for these and other reasons i urge my colleagues to vote aye. it was my privilege to work with the speaker in a bipartisan way on this legislation. i hope it will be a model of things to come. with that i yield back the balance of my time. the speaker pro tempore: the gentlelady from california yields back her time. the gentleman from new jersey reserves his time. and the gentleman from pennsylvania is recognized. mr. pitts: thank you, mr. speaker. and i join in thanking the minority leader for her role in achieving this bipartisan compromise. it's really historic. i think this is appropriate it's happening on her birthday. i join my colleagues in wishing her a happy birthday today. mr. speaker, could i inquire of the time remaining? the speaker pro tempore: the gentleman from pennsylvania has eight minutes remaining. and the gentleman from new jersey has 7 1/2 minutes remaining. mr. pitts: thank you, mr. speaker. at this time i'd like to yield one minute to the gentleman from florida, mr. bilirakis another member of the health subcommittee. the speaker pro tempore: the gentleman from florida is recognized for one minute. mr. bilirakis: thank you, mr. speaker. i rise to support h.r. 2, to repeal and replace the s.g.r. this bill will replace the s.g.r. with a merit-based incentive payment payment system or mips. healthier people utilize less health care which means a lower cost to the taxpayer. nearly 150,000 seniors live in my district. this bill gives them certainty that their doctor will see them. it provides seniors with better care. h.r. 2 includes a two-year extension of the community health centers funding, which is very important to my constituents. this bill is pro-senior, pro-doctor and pro-patient. this is a historic moment nearly 20 years in the making. we have a chance to make a huge difference for seniors. the benefits of repealing the s.g.r. are clear. support this bill. thank you. i yield back. the speaker pro tempore: the gentleman from florida yields back his time and the gentleman from pennsylvania reserves. the gentleman from new jersey is recognized. mr. pallone: mr. speaker, i yield one minute to the gentlewoman from florida, ms. castor. the speaker pro tempore: the gentlelady from florida is recognized for one minute. ms. castor: well, i thank the gentleman from new jersey for yielding me time and i rise in support of this important bipartisan landmark bill. our parents and grandparents who rely on medicare and the doctors that take care of them can breathe easier today because of this bill. medicare will be stronger and it will be more efficient. we're going to put modern into modern medicine by transitioning the medicare health system to one that focuses on quality rather than quantity. and i'd like that my colleagues on the energy and commerce committee, chairman upton and ranking member pallone, mr. pitts and mr. green and speaker boehner and minority leader pelosi for also adding into this important package new assurance for children across america, for our community health centers the state children's health insurance program now gets a very significant boost along with our health centers that take care of so many of our neighbors. thanks again to the professional staff to our -- the great public servants in the obama administration. i urge a yes vote on this important landmark bill and yield back. the speaker pro tempore: the gentlelady yields back her time. the gentleman from new jersey reserves. the chair recognizes the gentleman from pennsylvania. mr. pitts: mr. speaker, i'm pleased to yield at this time one minute to another valued member of the health subcommittee the gentlelady mrs. ellmers from north carolina. the speaker pro tempore: the gentlelady from north carolina is recognized for one minute. mrs. ellmers: thank you, mr. speaker. and i just want to extend my thank you to all of the members who have worked so hard both on the energy and commerce committee, but my democratic colleagues across the aisle those who we're working with in the senate. and i just want to say to the american people, don't look now but we are actually governing. and this is what the american people want to see. you know, i have a speech here to read, but i'm actually go to go off-line and tell you from my heart what this means for our seniors. this is about certainty. this is about governing. this is about giving solutions to a problem. yes, it comes with a price tag. but when we continuously look at things from a one-dimensional perspective on something so important as health care, it is so multidimensional we can't stop ourselves from moving forward. imagine a year from now where we'll be when we are not trying to come up with another billion-dollar band-aid to continue the s.g.r. failed formula when we can actually be looking forward for solutions in health care, continuing our work on 21st century cures and showing our seniors and every american family in this country how important it is in the work that we're doing. thank you, mr. speaker, i yield back the remainder of my time. the speaker pro tempore: the gentlelady from north carolina yields back her time. the gentleman from pennsylvania reserves, and the gentleman from new jersey. mr. pallone: mr. speaker, i yield one minute to the gentleman from north carolina, mr. butterfield. the speaker pro tempore: the gentleman from north carolina is recognized for one minute. mr. butterfield: thank you, mr. speaker. thank you, mr. pallone. this is a good day for medical providers and for our seniors. this is also a good day for the house of representatives. this is bipartisanship its best. with the passage of h.r. 2 seniors will no longer have to worry about losing their physicians. providers will have the certainty to continue to serve their medicare patients, but this bill, mr. speaker, is about more than fixing medicare. it's all -- it also includes a two-year extension of the chip program, that's children's health insurance program, and funding for community health centers that is set to expire this fall. both programs are vital to the low-income vulnerable and rural communities that i represent in north carolina. the chip program covers more than eight million children across the country, including many in my state. it helps provide health coverage to children who are not eligible for medicaid but cannot afford other insurance. the community health center program funds 1300 health centers across the country. without this extension, the program would expire and care for 7.4 million patients would be jeopardized. supporting this bill is about providing access to care for the most vulnerable americans. i urge my colleagues in the house and the senate to vote yes on h.r. 2. thank you. i yield back. the speaker pro tempore: the gentleman yields back. the gentleman from new jersey reserves. the gentleman from pennsylvania is recognized. mr. pitts: mr. speaker, very pleased at this time to yield one minute to our speaker who deserves a lot of credit in coming up with this bipartisan compromise. thank you mr. speaker. the speaker pro tempore: the speaker of the house is recognized. the speaker: let me thank my colleague from pennsylvania for yielding. let me say a big thank you to chairman upton and chairman ryan and mr. pallone and mr. levin and their staffs for all of the work that's gone in to this product. also, i want to thank wendall with leader pelosi's staff charlene mcdonald for mr. hoyer's staff and of course charlotte ivanic on my team, all who worked together to create this product we have today. thanks to their hard work and the work of this house, we expect to end the so-called doc fix once and for all. many of you know we've patched this problem 17 times over the last 11 years and i decided about a year ago that i have had enough of it. in its place we'll deliver for the american people the first real entitlement reform in nearly two decades. i think it's good news for america's seniors who will benefit from a more stable and reliable system for seeing their doctor. it's good news for hardworking families who will benefit from a stronger medicare program to help care for their elderly parents. it's good news for the taxpayers who, according to the c.b.o. and a number of other fiscal experts will save money now and well into the future. . that means it's especially good news for our kids and grandkids. today it's about a problem much bigger than any doc fix or any deadline. it's about beginning the process of solving our spending problem. it's about strengthening and saving medicare which is at the heart of that problem. normally we would be here to admit that we are going to kick the can down the road one more time. but today because of what we are doing here we are going to save money 20, 30, 40 years down the road. not only that, we are strengthening medicare's ability to fight fraud waste, and abuse. as was mentioned earlier, this bill also extends the children's health insurance program for another two years. and extends the authorization for community health centers for another two years. my colleagues, this is what we can accomplish when we are focused on finding common ground. but we can't become complacent. we know we got more serious entitlement reform is needed. it shouldn't take another two decades to do it. frankly, i don't think we've got that much time. but i'm here today to urge all of our members to begin that process. the process begins by voting yes on h.r. 2 today. i yield back. the speaker pro tempore: the speaker of the house yields back his time. the gentleman from pennsylvania reserves his time. and the gentleman from new jersey is recognized. mr. pallone: mr. speaker, i yield two minutes to the gentlewoman from colorado, ms. degette. the speaker pro tempore: the gentlelady from colorado is recognized for two minutes. ms. degette: thank you, mr. speaker. i rise today to support h.r. 2, the medicare access and chip re-authorization act. as this legislation was under negotiation, several of our colleagues tried to add unnecessary language that would have expanded the hyde amendment to embed this harmful policy into the affordable care act and the public health services act. thanks to commitment of leaders for women's health care rights, we secured important changes to this language. current appropriation policies concerning the use of funds at community health centers will not change. and when funding -- when the funding in this bill for community health centers, the national health service corps, and teaching health centers expires, so will the funding restrictions. also, this language is freestanding and it does not amend the affordable care act or the public health services act. let me be clear i oppose the hyde amendment. it is backwards policy because it denies full reproductive coverage to poor women who need it the most of everybody in this society. but this bill does not restrict their access any further than current law. and the pro-choice caucus will continue to fight for health parity in this country for all women. in the meantime, we have a bill here that has real advances in finally fixing the physician reimbursement. and extending the important children's health program. and extending the special diabetes funding that helps so many americans. and that gives $7 billion to extend the important community health centers for the next two years. i'm proud of the work we did in a bipartisan way. i want to thank the majority and i want to thank my colleagues on my side of the aisle for working together and only showing as the speaker just said what we can do when we really do the job that congress is supposed to do. i urge support of this legislation and i yield back the balance of my time. the speaker pro tempore: the gentlewoman yields back the balance of her time. the gentleman from new jersey reserves his time. the gentleman from pennsylvania is recognized. mr. pitts: may inquire of the time remaining on both sides? the speaker pro tempore: the gentleman from pennsylvania has five minutes remaining. and the gentleman from new jersey has 3 1/2 minutes remaining. mr. pitts: thank you, mr. speaker. at this time i'm very pleased to yield two minutes to the prime sponsor of the legislation who deserves a great deal of credit for where we are today, dr. burgess. the speaker pro tempore: the gentleman from texas is recognized for two minutes. mr. burgess: and i want to thank the chairman of the subcommittee on health, on energy and commerce. mr. speaker, i omitted one of the people that should have been thanked earlier in my remarks, from the house legislative counsel, michelle, who worked so hard on the language that is before us today. mr. speaker, a year ago i came to this floor, we had a similar vote, and i talked about how important it was to send a positive message because last year it was the key that would get us through the door. guess what mr. speaker? this year not only will the key get us through the door, we are going to knock the darn door down. we do need a strong vote today. we saw it evidenced on the rule. i urge all my colleagues to get behind this legislation. may not have been everything you want. may not have been what you would have done if you done it by yourself, but this is a collaborative body. this is the work of a collaborative body. now we need to send it over to the world's greatest deliberative body. let them deliberate for only a short period of time because of the thunderous approval that has come from the people's house. mr. speaker it is time to end the s.g.r. let us never speak of this issue again. i yield back the balance of my time. the speaker pro tempore: the gentleman from texas yields back his time. and the gentleman from pennsylvania reserves. the gentleman from new jersey. mr. pallone: mr. speaker, i yield three minutes to our democratic whip, mr. hoyer. the speaker pro tempore: the gentleman from maryland is recognized for three minutes. mr. hoyer: as an aside i was insidelined clinde to get up and ask that the gentleman's words be taken down. of course when we do that we do it in a different context. those words, we would all be happy today. whether we are for or against, the congress is working today as the american people would have the congress work. speaker boehner, leader pelosi, our extraordinary staffs on both sides of the aisle, and members have come together and dealt with some difficult issues. and as the gentleman, dr. burgess indicated, and i have worked with him on schip for a very, very long period of time as i recall, and we are making progress. we are not where we all want to be, but we are making progress. mr. speaker, i rise in support of this bill and thank the democratic leader as well as speaker boehner, ranking member pallone and levin, and the chairman of the committee, mr. pitts, and others, for getting us to where we are today. this bill will permanently replace the broken medicare sustainable growth rate formula. that, frankly, i have been working to get rid of for almost a decade. if not longer. it has created uncertainty and stability in the medicare program for over a decade. i'm pleased that the parties why able to come together and craft a bipartisan bill that will ensure seniors' access to their doctors and incentivize high quality, high value care. i'm also glad that this bill includes a robust re-authorization of the children's health insurance program known as chip which has been a bipartisan success story. this is an issue, mr. speaker, i worked hard on as majority leader. i'm glad we are moving forward today in a bipartisan way that recognizes how important the chip program is for children and for families. another major component of this bipartisan compromise is the $7.2 billion in funding for community health centers. who serve some of our most needy citizens. this centers in my home state of maryland and throughout our country, provide essential health services for millions of underserved families. that's good for all of us. this is, of course, as i said not a perfect bill. no compromise is ever perfect from everybody's perspective. there are some parts i and other democrats would have liked to see improved, just as there are some parts my colleagues on the other side of the aisle would change. but this compromise will provide much needed relief and certainty to seniors, children, and families. i urge all of my colleagues to support this effort. it will be a good day for the congress of the united states. and it will be a good day for america. i thank all of those whose leadership, members and staff, who got us to this point for the work that they have done. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from new jersey reserves. the gentleman from new jersey has 30 seconds remaining. the gentleman from pennsylvania is recognized. mr. pitts: how much time on both sides left? the speaker pro tempore: the gentleman from pennsylvania has four minutes remaining. the gentleman from new jersey has 30 seconds remaining. mr. pitts: mr. speaker, i reserve. the speaker pro tempore: the gentleman reserves. mr. pitts: we're ready to close. the speaker pro tempore: the gentleman from new jersey. mr. pallone: mr. speaker, i yield myself the 30 seconds left. i want to recognize one person in particular. ira bernie, a career civil servant who for more than 30 years has worked tirelessly on medicare issues at c.m.s. there's not one medicare bill in this time he has not been a part of. his hard work and technical knowledge have been instrumental in supporting our work here in congress. i want to thank ira and all those on both sides of the aisle who worked so hard to make this day possible. as this is an incredibly significant bill and i urge my colleagues to support it. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from pennsylvania. mr. pitts: mr. speaker pleased to yield one minute to our distinguished majority leader. the speaker pro tempore: the gentleman from california is recognized for one minute. mr. mccarthy: i thank the gentleman for yielding. i would like to yield 30 seconds to my friend on the other side of the aisle. mr. hoyer: i thank my friend. i forgot to articulate and i should have. i want to congratulate fred upton. he's my friend. fred upton is the chairman of the energy and commerce committee. fred upton is one of those members in this house who represents this institution so well because he is committed to working in a bipartisan fashion. we find ourselves sometimes not able to do that. but i want to say thank you to mr. upton from michigan for his leadership and his commitment to making sure this institution works as the american people want it to work. i thank my friend, the majority leader, for yielding. the speaker pro tempore: the gentleman from california is recognized. mr. mccarthy: thank you. reclaiming my time. i thank the gentleman for his words. i hope all that are watching today that this is a pattern of what works inside washington. in washington, mr. speaker there's a common cycle. you have a problem, you kick the can down the road. you hit a cliff then you rush to a short-term fix that doesn't fix the problem. then the cycle starts all over again. this isn't a good way to govern. with this cycle problems usually get worse. a lot of times the short-term fixes get packed and add ons that increase the size of government and cost people more and more. you know, we have seen that with this doc fix again and again. 17 times over the last decade. every single year i have served in this body, less than a decade that's been the solution. to kick the can down the road. but today the house will vote on a bipartisan bill to end the cliff for good. stop the cycle, and most importantly, provide stability to the medicare program for the seniors than their doctors. this is a big moment for congress. and i think we should all realize it. the bill before us today will once and for all repeal and replace the flawed medicare physician payment system. it will move us away from the volume based care to care based on quality, value, and accountability. everyone knows that we need to reform programs like medicare to save it for the future. but for so long nothing has been done in this house. that is until today. today marks the first step of what i hope will be many more to save our safety nets from collapse and to ensure it for future generation. these reforms are permanent. they are bipartisan, and they lay the foundation for medicare that lasts. we wouldn't be here to make all these big reforms without a lot of hard work. first, i want to thank the doc caucus. there's many times i was in a meeting with frustration. wanting to find a solution. the first place to find a solution is policy. and they spent their time together to find thatpolicy. then it was how are we going to pay for it and how can we move forward? that's where the leadership of chairman and chair people come through and fred upton, paul ryan. they not only helped build with the doc caucus, they led their own committees. today when this vote is taking place, it will be different than others. people aren't going to sit and watch the sides to wonder whether it gets there and how close does it pass. people are going to watch how overall big vote it's going to be. after this vote today, we will go back to our districts. we'll go back to our district hopefully in a different thought, in a different time. that he -- that, yes, we can solve a profblet yes, we can pick a problem that has lasted over a decade that every congress before it has kicked it down the road. no, we found common ground. we found the ability to come together to solve something that many believed we could not. we hope the senate will see the same value. but today is a good day. today should not be the last day. we should look for the other problems, and there are many, of a way we can solve them permanently like we will do today. i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. and the gentleman from pennsylvania is recognized and has three minutes remaining. mr. pitts: mr. speaker i'm very pleased at this time to close, to recognize the chair of the energy and commerce, mr. upton a master of bipartisan compromise and deserves a great deal of credit for being here today. . . the speaker pro tempore: the gentleman is recognized for the remainder of the time. mr. upton: couldn't be bipartisan if we didn't have people on both sides of the aisle to get things dfpblet i appreciate all the leadership on this side -- things done. i appreciate all the leadership on this side and this side to get this to a finish point today. today we do come together. we really do. republicans and democrats, to finally, finally fix medicare's broken payment system. protect seniors' access to care and, yes, strengthen medicare and extend the children's health insurance program. for way too long the so-called s.g.r. has been an ax over medication physicians and the seniors they care for. it has sparked crisis after crisis for nearly 20 years. forcing this congress to pass some 17 temporary measures to undo its faulty math and protect seniors' access to their trusted doctors. those 17 patches also served as a ready-made vehicle for bigger government and today we put a stop to that gravy train, leave the s.g.r. in the past and begin to put medicare on the right track. this bill is good for seniors, and for doctors. who treat them. we repeal the flawed s.g.r. formula and replace it with a bipartisan, bicameral agreement on a new system that promotes innovation and higher quality care. it removes the hassle and worry that so many seniors and physicians face from the cycle of repeated patches. we also take steps to strengthen medicare for current and future seniors with structural reforms which will not only produce cost savings today but the c.b.o. has confirmed those savings will grow over time. and the budget that we passed last night fully accounts for the cost of those permanent reforms. this package also extends millions benefits for millions of low-income families and children by extending the children's health insurance program for two years. this program provides high-quality, affordable coverage for roughly eight million children and pregnant women and has been an example of sound bipartisan success. i want to thank the bill's sponsor, dr. burgess, for his leadership on this issue from day one. he came to congress to solve this problem and today we have a bill with his name on it to do just that. also i commend the great subcommittee chair joe pitts, four years ago we embarked together on this effort to end the s.g.r. and the hard work has brought us to this point. i want to thank full committee and health subcommittee ranking member, mr. pallone my good friend and mr. green for working again across the aisle from day one. we wouldn't be standing here together if we hadn't started together. big thanks to the folks of the staff. paul and noel. finally i want to thank my friends in the wavepls committee and our -- ways and means committee and our leadership on both sides from john boehner and kevin mccarthy to nancy pelosi and steny hoyer. we are together getting this done. this is a long time coming. most of us came to congress to fight for our nation's kids. seniors and their -- kids seniors and their families. today's vote is a defining moment for this congress and for medicare. those who vote no are not only voting against seniors, but against the future of the critical safety net. that's why we all need to vote yes. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. the speaker pro tempore: the gentleman from texas, mr. brady and the gentleman from michigan, mr. levin, will each control 15 minutes. the gentleman from texas is recognized. mr. brady: thank you, mr. speaker. i rise on behalf of chairman paul ryan, chairman of the ways and means committee, in support of h.r. 2, a bill led by dr. michael burgess and joined by many of our colleagues, both here in the house and support throughout the country. and this bill is critical because of this problem. imagine you're a senior you desperately need to see a doctor but you learned that there are no local doctors who can treat you because they simply can't afford to treat medicare patients. or they have been, throughout the years, faced each year with a 10% 20% 30% cut in reimbursements and as a small business, they've rethought their relationship with medicare and are no longer frankly, able to do that. that scenario has been played out across this country for far too long. and if there is any group in america who needs to see doctors they know and who know them, it's our seniors. this bill takes the first real permanent step to ensuring our seniors can see local doctors when they need to see them. and takes the first real step in saving medicare, not just for these seniors, not just for the next generation, but for generations to come. i commend the work that's been done by the leaders of the ways and means committee, chairman ryan, chairman fred upton of the energy and commerce committee, our physicians caucus, led by dr. phil roe and dr. john fleming as well as those in this chamber who have come together to make this historic step today. so this is about helping our seniors, this is about taking those first reforms permanently to save medicare and it really is about ending a formula and a reimbursement that simply works against our seniors. the flawed -- they call it the sustainable growth rate it dictates huge cuts to our physicians through medicare. congress had to intervene 17 times in recent years to stave off these cuts with short-term fixes. and this flawed formula regularly threatens access to care for seniors and districts -- and really distracts congress from making real reforms that are needed. the bipartisan agreement that we face today would repeal that s.g.r. once and for all and replace it with a value-based system that provides certainty to our seniors and really finally reimburses doctors, just not on the number of procedures but on the quality they provide. and determine not by -- determined not by washington but by our local practitioners themselves. this reform alone, if that were the only thing this did would be significant, but it begins to move us away from that flawed fee for service system. and it does it in a way that a sole practitioner in rural pennsylvania as well as a doctor in a major institution in downtown houston, can both practice to their highest capability and continue to practice until they decide to retire, not until medicare or some flawed formula encourages them to retire early. in addition, this bill has two important reforms and i think critical reforms to strengthen medicare programs and offset the cost of this measure. similar reforms have been included in the house republican budget for years. this is a bipartisan effort. worked together and with absolute dedication to making sure medicare is around for our seniors. first it restricts first dollar measures in medigap plans. this will really strengthen programs over the years. second, the agreement includes increased means testing for premiums in medicare part b and d, our doctors and our medicines, with the wealthiest seniors playing higher premiums -- paying higher premiums. i want to make clear this bipartisan reform alone will not save medicare, but they take us in the right direction for the very important first step. and the savings from this will grow over the long-term. the alternative we refuse to act, not pass, is yet another cycle of short-term fixes, leaving behind bipartisan structural reforms to medicare and delaying the opportunity to actually save this program for our seniors. so, today we end the s.g.r. we begin the important reforms, we stand up for seniors who need to see doctors. with that mr. speaker, i reserve the balance of my time. the speaker pro tempore: the gentleman from texas reserves his time. the chair recognizes the gentleman from michigan, mr. levin. mr. levin: thank you very much. i yield myself such time as i shall consume. the speaker pro tempore: the gentleman is recognized for as much time as he wishes to use. mr. levin: well, this is indeed a rare event. it was an event really waiting to happen. because a year ago our committee ways and means, chaired by dave camp, alongside the energy and commerce and senate finance committees reached a bipartisan bicameral agreement to move the physician reimbursement system to one based more on quality, not quantity. and this helped pave the way for the package in front of us today. negotiated with the key help of the speaker and our leader. the s.g.r. has been hanging over our heads for more than a decade. we have paid close to $170 billion in short-term patches and with each patch it becomes harder to find offsets, putting seniors and our health care system increasingly at risk. and this is being done, and i emphasize that, while maintaining the basic structure of medicare. talk otherwise is mistaken. our approach to paying for this reform is a reasonable one. we are paying for additional benefits but not to dig out of the hole created by the flawed budget formula. this package includes a number of improvements across the health care landscape. it fully funds a two-year extension of chip, at the increased level of funding that we included in the affordable care act. it permanently extends the qualifying individuals program, that pays medicare premiums for low-income seniors. it permanently extendses the transitional -- extends the transitional medical assistance program which helps medicaid beneficiaries transitioning back to work to keep their insurance. it secures $7.2 billion in funding for community health centers ensuring that seven million americans that depend on these establishments for care can get it. and it makes progress in fighting fraud and abuse in medicare. what i'd like to do, it will take a little more time, is to thank the staff. we don't do that enough. so i want to thank wendell, charlene, charlotte emily, tiffany clay and matt, and of course the ways and means committee health staff, particularly amy hall and erin richardson. and we need to thank the excellent drafters from the house legislative office, led by ed grossman who i think is here today. along with the centers for medicare and medicaid services office of legislation. particularly ira bernie, who is known for his deep knowledge of medicare, who helped put the package together in a technically sound manner. and the c.b.o. health team, led by tom bradley who worked expeditiously to meet our timetable. and i want to close my remarks by paying tribute to a member who is not with us today, who worked for years on these issues, john dingell of michigan. for the years he put in protecting and strengthening medicare, medicaid and chifment including trying -- chip. including trying to fix s.g.r.. we're fixing s.g.r. today and we are strengthening medicare, medicaid and chip. so this is a day where there is common ground and today we stand on it. i reserve the balance of my time. the speaker pro tempore: the gentleman from michigan reserves his time. the gentleman from texas is recognized. mr. brady: mr. speaker, our next speaker is a successful small business person who has provided health care to more than 100 employees for years. a key leader of the ways and means committee, i yield two minutes to the gentleman from pennsylvania mr. kelly. the speaker pro tempore: the gentleman from pennsylvania is recognized for two minutes. kell kell i thank the gentleman -- mr. kelly: i thank the gentleman. this is not so much a doc fix as a senior fix. while our lives are usually defined by wins and losses, i would think that really in our lives we remember the losses far more than we remember the wins. and the reason i say that is i have been there for the birth of my four children, i've celebrated the birth of our 10 grandchildren. those are great moments. but i've also sat by the bedside of my mother, my sister, my father as they -- as they lay dying and were transinging. those losses are things that you can -- transitioning. those are losses -- those losses are things that you can never regain. wouldn't you love to be there with them to give them peace of mind? this bill gives them peace of mind, mr. speaker. that's what this bill does. it is a senior fix. and i would tell you that when i watched people as they have passed, both friends and family , what they want at their bedside at that that time, they want to have their faith with them so they know they're surrounded by their god, they know where they're going is best, and they know that somehow their future is going to be ok. they also want the comfort of knowing that their family is there with them. helpinging them get through the toughest parts -- helpinging them get the -- helpinging them get through the toughest parts -- helping them get through the toughest parts of their life and they want their doctor. they want to know that the person they've always gone to for their health care is going to be there and not taken away because some government program didn't work. i would say, as we sit in america's house, whether we're republicans or democrats, and our gallery is filled with people, we are people representing people, in the best interest of people. . this is a fix for the most vulnerable. i can think of nothing that we could do that is more important than giving peace of mind to those who have given so much to us as families, as states, and as a country. this is a brilliant piece of legislation. while it may not satisfy all, it serves the needs of so many. i thank you so much. i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from texas reserves. and the gentleman from michigan is recognized. mr. levin: i now yield three minutes to the gentleman from washington who is ranking on the house subcommittee, mr. mcdermott. the speaker pro tempore: the gentleman from washington is recognized for three minutes. mr. mcdermott: i ask unanimous consent to revise and extend my remarks. the speaker pro tempore: without objection. mr. mcdermott: mr. speaker, today is in a sense an historic event we are finally putting to rest a problem that's festered around here for as long as i have been here. every year as the deadline approached, providers faced draconian cuts, congress passed an 11th hour patch, that delayed the implementation of s.g.r. doctors patients nobody, congress didn't like it, nevertheless 17 times we have made temporary fixes. we spent $174 billion in inadequate ways dealing with the real problem the s.g.r. was all about, which is cost control. now this is a first step today. we can celebrate but we have to go on because cost control is still a question, and we have replaced s.g.r. with a system that we hope will make medicare pay for value rather than for volume. that's not an issue that's for sure. we know that we are trying it. i thought of franklin delano roosevelt, i'll try something, if it doesn't work, i'll stop it and try something else. that's really where we are today is looking at the future of cost control in health care. the most important thing, though, today is that we got back to regular order. that we got back to something where the republicans put this in 16 years ago, some of us voted no because we knew it wouldn't work. but we had all our 17 years. now we come together to fix it together. and we have to fix things together in this house. compromise is the essence of what we have here. my friends on the other side, just so you understand, i already had a phone call from a group in washington state who told me they are going to take me off the board if i vote for this. so it isn't as though this is a nice thing for one side or the other side, it's a compromise. where some people get what they want. some people don't get what they want. some people think it's not enough. some think it's too much. that's the essence of compromise and that's how the congress has to work. it's what's going to have to work with the a.c.a., the affordable care act, it's going to have to work on transportation. it's going to have to work on a whole series of issues if we as a congress are going to function on behalf of the american people. this is a great day. this ought to be a unanimous vote today. when you look at all the things that are in it and all the things we have dealt with, it ought to be unanimous. and my view is that when you reach a compromise, that's the kind of thing you can expect. because nobody in this house ever gets all they want. nobody has a right to say it's my way or the high way. and when we do that, we damage the american people. we have been damaging the health care system with these patches spending all that money, and not getting what we want. we hope this is the start of a better day for cost control in health care. everyone should vote for this. the speaker pro tempore: the gentleman's time has expired. the gentleman from michigan reserves. the gentleman from texas. mr. brady: our next speaker is a former u.s. attorney. his district in pennsylvania has a large number of seniors. he's a champion in health care. i'm proud to yield one minute to the gentleman from -- two minutes, the gentleman from pennsylvania, mr. meehan. the speaker pro tempore: the gentleman from pennsylvania is recognized for two minutes. mr. meehan: thank you, mr. speaker. mr. speaker, i rise today in strong support of the medicare access chip re-authorization act of 2015. this is the product of several years of sustained bipartisan work and today we can finish the job. this is a vitally important, critically important piece of legislation for seniors because it's going to strength yield back the balance of my time and preserve the medicare -- strengthen and preserve the medicare program. and put an end to the perennial drills that threaten seniors' access to high quality care, the care they deserve. h.r. 2 is a result of bipartisan compromise. i'm sure my friends on both sides of the aisle as my good friend from oregon identified, can agroo that it isn't perfect. but i'm -- can agree that it isn't perfect. but i'm happy to say it extends funding for the children's health program. just like seniors, we need to make sure our kids have access to care. we continue to support community health centers that provide quality care for those of lesser means. since 2002, congress has passed 17 patches to avert the s.g.r.'s draconian cuts. these patches avoid crisis, but they don't do anything to preserve or improve the medicare program for current and future seniors. i'm delighted together we can finally forge a lasting solution. this isn't just good for seniors' care and for our health care work force, it's a sign that partisan differences in washington can be bridged to address our biggest challenges, and i urge my colleagues to support this legislation and i hope the senate will send it to the president and get it signed quickly. mr. speaker, i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from texas reserves. the gentleman from michigan is recognized. mr. levin: how much time is there, please, on both side? the speaker pro tempore: the gentleman from michigan has eight minutes remaining. the gentleman from texas has seven minutes remaining. mr. levin: it's my pleasure to yield two minutes to the gentleman from oregon, mr. blumenauer, a distinguished member of our committee. the speaker pro tempore: the gentleman from oregon is recognized for two minutes. mr. blumenauer: i appreciate the gentleman's courtesy as i appreciate his leadership in this. i sat on the floor for the entire debate from the commerce and ways and means and it's really exciting. i was one of those people that didn't vote for the balanced budget agreement back in the day. i have been frustrate bide this as much as anybody. hi legislation that just simply reset the baseline. but actually this is better. it's better because we have had ways and means, commerce, finance come together for several years, develop a reform that will strengthen opportunities for better payment. it's better because we have seen the minority leader and speaker of the house come together to empower the committees to do their job. i was struck by the words of majority leader mccarthy when he said, this is a good day. and he thinks that this will not be the last day. i sincerely hope that that's the case. that it signals opportunities to go forward. i like the fact that we have added in things here like the chip, we have even got secure rural schools. it makes a big difference for people in the west. i'm hopeful that we can step forward. we have another cliff that's facing us in two months. the transportation cliff. people are talking about 17 extensions here. fixes. we have 23 extensions of the transportation system. i would hope that we could take the same spirit of cooperation bipartisanship, listen to people in the outside world, organized labor the afl-cio, contractors, local government, environmentalists, and who are speaking with one voice, congress, get your act together. give us funding to be able to fund the transportation bill for the first time in years, and rebuild and renew america. put people to work. show the same sort of bipartisan cooperation that i find really invigorating today. and i hope the next thing we do is the ways and means committee the committee of jurisdiction, steps forward to solve the transportation problem. it's even easier than the s.g.r. thank you. i yield back. the speaker pro tempore: the gentleman from oregon yields back his time. the gentleman from michigan reserves. the gentleman from texas, mr. brady. mr. brady: our next speaker has spent more than 40 years in health care as a nurse, small business owner member of the physicians caucus here and a key leader on the ways and means committee. i'm proud to yield a minute and a half to the gentlewoman from tennessee, mrs. black. the speaker pro tempore: the gentlewoman from tennessee is recognized for a minute and a half. mrs. black: thank you, mr. speaker. i thank my colleague and someone who's worked tirelessly on this issue and leader on our health care committee. i rise in strong support of the medicare access and chip re-authorization act of 2015. this bipartisan legislation offers a permanent solution to strengthen the medicare program that our nation's seniors and their doctors rely on. it would repeal the flawed s.g.r. formula that dictates draconian cuts to medicare reimbursements, and it does so in a fiscally responsible way that provides important offset savings. since 2003, congress has spent $170 billion on short-term fixes. to stave off these cuts without making real reforms that are needed. this cycle does nothing to address the real problems in our entitlement spending. i have been a nurse for more than 40 years and i know you can't put a band-aid on a problem that needs to be corrected by surgery. the problem impacted by these looming cuts where my patients and colleagues are affected. i urge this body to end the s.g.r. crisis once and for all. adopt these structural reforms and help us move forward together to strengthen medicare for today's seniors and tomorrow's retirees. thank you. i yield back. the speaker pro tempore: the gentlelady from tennessee yields back her time. the gentleman from texas reserves. the gentleman from michigan is recognized. mr. levin: now i yield two minutes to the gentleman from new jersey, mr. pascrell, a very vocal member of our committee. the speaker pro tempore: the gentleman from new jersey is recognized for two minutes. mr. pascrell: i got to say this to leader brady chairman brady, and leader levin. you guys did a great job keeping us together. i think the word that i'll take away is what dr. burgess said about a collaborative effort. i mean if someone came down from mars today into this chamber they would be shocked the camaraderie. this is great. this is a good dealing. you got to admit it's a good dealing. i know it's before palm sunday, but i got a good dealing today. on thursday. this effort i think, establishes a very good precedent for revitalizing the integrity of this congress. this institution. we here, mr. brady, mr. levin, we here got out of our echo chambers. we love to hear ourselves, you know that. it's part of the d.n.a. of being a congressperson. we got out of those echo chambers and we actually listened to each other. that's shocking. that's shocking. if we can rise above our home -- own attempts to be ideologues, we can accomplish a hell of a lot here. for the people of the united states. they deserve no less. the repeal and replacement of s.g.r. ends the constant looming of deep payment cuts to medicare physicians. which, as we have heard, jeopardizes the participation in the program. and jeopardizes seniors' access to their doctors. as a result of this law our medicare payment system will finally be rooted in the quality of services provided as opposed to the quantity. results rather than fee for service. i must say, mr. speaker i urge my colleagues to vote for this legislation. it's good for america. i yield back. the speaker pro tempore: the gentleman's time has expired. the gentleman from michigan reserves. the gentleman from, mr. brady from texas, is recognized. has four minutes remaining. mr. brady: mr. speaker, i'm proud to yield one minute to a new member of congress who is passionate about health care reforming medicare, and helping seniors, the gentleman from florida, mr. curbelo. the speaker pro tempore: the gentleman from florida is recognized for one minute. mr. curbelo: i thank the gentleman for yielding. mr. speaker, i rise today in strong support of h.r. 2, the medicare access and chip re-authorization act of 2015, and would like to thank the ways and means and energy and commerce committees for taking bold leadership on such a critical issue. the sustainable growth rate is a budget cap on physicians services passed into law in 1997 to control spending. unfortunately the s.g.r. formula is fundamentally broken and since 2003 congress has spent nearly $150 billion in 17 separate short-term passes to prevent significant medicare reimbursement rate cuts. this is debt tramental to providing our seniors and doctors with the confidence they deserve. this bill before us today repeals the outdated formula and replaces it with a new permanent system that rewards quality and value and guarantees stability to medicare beneficiaries and the physicians providing their treatment. most of all, mr. speaker, i want to thank our leaders for allowing us to have this special moment. . today the american people have a congress that they deserve a congress that is focused on advancing an agenda that can make the american people proud. let us continue walking down this path together. thank you, mr. speaker. the speaker pro tempore: the gentleman's time has expired. the gentleman from texas reserves. the gentleman from michigan has four minutes remaining. and is recognized. mr. levin: thank you so much. now two minutes to the gentleman from illinois, mr. davis, another active member of our committee. the speaker pro tempore: the gentleman from illinois is recognized for two minutes. mr. davis: thank you very much, mr. speaker. you know, it takes a lot of time, energy effort, hard work and study to become a physician . and i think they ought to be adequately compensated for the services they provide. especially when they serve the most needy health population in our country. our senior citizens. we call in the doctor fix, but it's really not about the doctors. it's about fixing health care it's about chip, it's about community health centers that serve more than 23 million low and moderate income citizens. each and every year. it's about the national health service corps training physicians, it's about the home visiting program. i represent a district that has 24 hospitals, four outstandinging medical schools -- outstanding medical schools. so we train and educate many doctors, nurses and other health personnel. so it's not just a good day for the doctors. it's a good day for health care and it's a good day for america. and i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from michigan reserves. mr. brady from texas is recognized. mr. brady: mr. speaker, i yield myself 30 seconds and would like to enter into the record a list of over 100 health care organizations throughout america, and growing, who support the passage of this legislation today. and i would like to point out that these represent a physician -- represent physicians and healt care providers who truly -- health care providers who truly want to treat our seniors that can't today because of the way medicare pays them. so we start with a fresh start and i enter into the record these lists. the speaker pro tempore: without objection, so ordered. mr. brady: i reserve. the speaker pro tempore: mr. levin from michigan is recognized. mr. levin: i now yield one minute to the distinguished member from texas, ms. jackson lee. the speaker pro tempore: the gentlewoman from texas is recognized for one minute. ms. jackson lee: i thank the distinguished gentleman from michigan and my friend from texas and what a celebration of members coming together, republicans and democrats. mr. speaker, i stand on this floor to ensure and insist that i am here to protect seniors and to ensure that the vote taken today does not undermine the protection of medicaid and medicare in particular. medicare for our seniors and that any vote does not in any way hinder those and provide a burden for those who cannot pay. this provides a pathway for providing for our medical providers with the s.g.r. fix, it provides seniors with quality health care services so they can go to the doctor they want, and, yes, it provides quality funding for our children and for our low-income families. it supports our federally qualified health clinics and coming from the city of houston, with the texas medical center, there are a lot of doctors, and those doctors serve the poor. they serve seniors, and i want to make sure they're able to do so. and the chip program will be protected. that has been a vital program to provide for those families, for our children to be healthy. let me agree with my colleague. this is good for america, i'm delighted to support this and we're going to help physician-owned hospitals and look forward to a better day. i yield back. the speaker pro tempore: the gentlelady's time has expired. the gentleman from michigan reserves his time. and the gentleman from michigan has two minutes remaining. the gentleman from texas is recognized. mr. brady: mr. speaker, i know mr. levin has additional speakers. i'll reserve everybody -- reserve at this time. the speaker pro tempore: the gentleman from texas reserves. the gentleman from michigan. mr. levin: to my good friend, are you ready to close? mr. brady: yes, sir. mr. levin: so am i. the speaker pro tempore: the gentleman from michigan. mr. levin: i yield myself the balance of our time. the speaker pro tempore: the gentleman is recognized for the two minutes remaining. mr. levin: this is an important moment. you know, as i look back, it's been decade after decade of a struggle for health care for all americans. a real struggle. today we have legislation that covers kids from infancy through seniors throughout their years. that's the importance really of these provisions. and so i simply want to express i think, the feeling of so many of us on this side. so we have this moment of coming together, and i hope in the days ahead that these notes of harmony will not be disturbed by notes of disdense. we owe more in all the bodies, all the institutions -- and all the body, all the institutions owe it to the people of this country to continue on this path. so what should be a right is a reality. i don't think anybody in this institution can imagine going to bed any night worried about having health care. and the same for their families , their kids and their grandchildren. so i hope we will take this few minutes, these few minutes, when we come together and to reassert the importance in this country of joining together so that everybody from birth until their last days have the ability to have what is so precious, the ability to have access to health care. i hope that's the significance of this vote i hope as a result it will be a very strong vote and i think it's a vote for health care for every american. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from texas, mr. brady, is recognized for the 4 1/2 minutes remaining. mr. brady: thank you mr. speaker. i will close at this time. there's nothing wrong with being passionate about your ideas and principles and nowhere is that more evident than in health care. when you can find, though, common ground on those principles, it thank help our seniors, encourage our -- that help our seniors, encourage our doctors to treat them and make reforms to help medicare for the long-term, we ought to do that. and that's what this bill does. but it just isn't a common ground as far as our lawmakers, we have dedicated staff who came together to work out the tough issues for us as well. and on behalf of ways and means committee chairman paul ryan, and myself, i'd like to thank our staff on the ways and means , health subcommittee, matt, brett, amy and erin, for their tremendous work. speaker and former speaker pelosi also led the effort to find this common ground and for speaker boehner, charlotte, and for leader pelosi wendell, we thank you. as well as legislative counsel. and for the congressional budget office, tom and holly contributed greatly to this day. the other day my neighbor, who just retired from continental, now united, walked over to my front porch and told me that, after years of seeing his local doctor, his local doctor can't see him anymore because he can't afford to treat medicare patients. the other day it was a tough winter for illnesses. i had an ear infection and my local doctor, i've known since he started his practice, snuck me in at 6:00 at night. his staff had been there since 8:00 in the morning working, they just looked infrastructureled. he said, look, he doesn't drive a fancy car, doesn't live in fancy home doesn't have a fancy office. he just wants to help treat patients. but this formula makes it harder and harder for him. my main physician told me the other day he's 66, would like to practice for five more years, he said, i think probably just one more year. he said, i can't handle the way medicare pays today. look, we can't allow that to continue. today, simple question on this bill, will you stand with our seniors who need to see a local doctor and a doctor they know? will you stand with their doctors who want to treat our seniors, who don't want to retire early or sell out to a larger institution? will you take the first real step to save medicare for long-term? that's the question we face today and on behalf of chairman ryan and those who have come together on this bill, i urge a yes vote on this measure. and i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. all time for debate has expired. pursuant to house resolution 173, the previous question is ordered on the bill as amended. the question is on engrossment and third reading of the bill. those in favor say aye. those opposed, no. the ayes have it. third reading. the clerk: a bill to amend title 18 of the social security act to repeal the medicare sustainable growth rate and strengthen medicare by improving physician payments and making other improvements to re-authorize the children's health insurance program, and for other purposes. the speaker pro tempore: the question is on passage of the bill. those in favor say aye. those opposed, no. the ayes have it. mr. brady from texas. mr. brady: mr. speaker, i ask on this measure the yeas and nays. the speaker pro tempore: the yeas and nays are requested. all those in favor of taking this vote by the yeas and nays will rise and remain standing until counted. a sufficient number having arisen, the yeas and nays are ordered. members will record their votes by electronic device. pursuant to clause 8 of rule 20, this is a 15-minute vote on pass and of the bill. -- passage of the bill. which will be followed by a five-minute vote on agreeing to the speaker's approval of the journal if ordered. this is a 15-minute vote. [captioning made possible by the national captioning institute, inc., in cooperation with the united states house of representatives. any use of the closed-captioned coverage of the house proceedings for political or commercial purposes is expressly prohibited by the u.s. house of representatives.] the speaker pro tempore: on this vote the yeas are 392 the nays are 37. the bill is passed. without objection, the motion to reconsider is laid on the table. pursuant to clause 8 of rule 20, the unfinished business is the request for a recorded vote on growinging -- agreeing to the speaker's approval of the journal which the chair will put de novo. those in favor say aye. those opposed, no. in the opinion of the chair, the ayes have it. the journal stands aproved. the house will be in order. members, please remove conversations from the floor. the chair will now entertain requests for one-minute speeches. for what purpose does the gentleman from pennsylvania seek recognition? mr. thompson: request unanimous consent to address the house for one minute revise and extend. the house is not in order. the speaker pro tempore: the gentleman will suspend. the house will come to order. without objection, the gentleman is recognized for one minute. mr. thompson: thank you mr. speaker. moments ago the house passed an historic piece of bipartisan legislation that will put an end to the flawed medicare sustainable growth rate, so the called doc fix, and extend the children's health insurance program. for more than a decade, congress has used a band-aid to address the sustainable growth rate rather than offering permanent reforms. having served in a nonprofit health care setting for nearly three decades, i experienced first-hand the uncertainty and anxiety that patients and their providers experienced annually, wondering if the dra to enian cuts to reimbursements would occur. this bipartisan permanent resolution will replace the sustainable growth rate with a more stable system that will ensure our seniors do not lose access to their health care providers. mr. speaker, this legislation's by no means perfect but it is a move in the right direction for children, seniors and our medical providers. thank you mr. speaker, i yield back the balance of my time. the speaker pro tempore: for what purpose does the gentleman from maryland seek recognition? mr. hoyer: mr. speaker, i ask unanimous consent to address the house for one minute and to revise and extend my remarks. the speaker pro tempore: without objection. mr. hoyer: thank you mr. speaker. mr. speaker the house is coming to order. mr. speaker, we just passed a bipartisan bill that addressed an issue, as the previous speaker said, that needed to be addressed. yesterday mr. speaker, the supreme court handed down a decision alabama legislative caucus vs. alabama, which should give every member pause voting protections are no longer needed to ensure that americans can register and vote. the court found that alabama legislators may have drawn congressional districts after the last census in a manner that diluted the voting strength of african-american citizens. the court raised disturbing questions, mr. speaker, about how african-americans are represented in alabama's congressional districts and returned the case to a lower court for federal consideration. mr. speaker, we're a nation that prides itself on its unflinching willingness to confront its sins of voting suppression that kept millions of americans from participating equally for generations. on the same day the court ruled, we marked the 50th anniversary of the selma marches finally reaching montgomery. such anniversaries are reminders of how much or how little progress we made to realize the principles and rights embodied in our constitution. with that in mind, mr. speaker, i urge us to proceed as we did today in a bipartisan fashion to restore the voting rights act to its full force and effect to protect all americans , and i urge my colleagues to work together to bring the bipartisan voting rights amendment act to the floor and restore the full power of the voting rights act without delay. we acted in a bipartisan fashion today. let's do it tomorrow on the voting rights act, and i yield back the balance of my time. the speaker pro tempore: without objection, the gentleman from california is recognized. for what purpose does the gentleman from california seek recognition? >> i seek unanimous consent to address the house for one minute. the speaker pro tempore: without objection, the gentleman is recognized for one minute. mr. mcnerney: mr. speaker, i rise today to celebrate the 20th anniversary of brain awareness week. last week neuro scientists from around the world reached out to students and the public to help illustrate the wonders of the human brain. since 1996 organizations around the world have come together during brain awareness week to inform us about brain research and brain awareness about brain disorders and diseases that affect nearly 100 million americans. the national science foundation has supported a number of projects that have led to the discoveries of neuroscience. these include gene editing that allows scientists to understand the biological origins of complex brain disorders and provide new potential treatments. in another front, increasing the resolution of optical microscopes has allowed scientists to view the brain in more detail and help them understand alzheimer's and parkinssons disease. i urge my colleagues to join me in supporting brain awareness week and support researchers in your own districts who are working to improve public health worldwide. mr. speaker, i yield back. the speaker pro tempore: for what purpose does the gentlelady from texas seek recognition? without objection the gentlelady is recognized for one minute. ms. jackson lee: mr. speaker, we just witnessed an opportunity that should not be singular and that is the coming together of members of the united states congress to address some very important issues. i've already spoken on the importance of providing for the children's health insurance program that this legislation, h.r. 2 has provided for and is securing medicare for our seniors and ensuring that our federally qualified health clinics, the very clinics i advocated for so many years ago and we've seen a growth to them and to the ones in my congressional district, they opened the doors to low income and those without insurance in years past. we are trying to get in front of the issue and the crisis of health care in america. but i want to make sure that as we pass this legislation we do not forget physician-owned hospitals which are prevalent in the state of texas, and many in my neighborhood. these are doctors who have sacrificed to open the doors of hospitals in low-income areas, and it is important for c.m.s. to make sure that their applications are expeditiously and efficiently reviewed and they have the opportunity to expand. this is language that we put into the affordable care act so the doors of these hospitals can remain open to the sick and those who are in neighborhoods where the access to health care is not strong. i ask my colleagues to continue to push forward on good health care in america and to help physician-owned hospitals in the way they should be under the affordable care act. i yield back. the speaker pro tempore: for what purpose does the gentleman from texas seek recognition? >> mr. speaker, i ask unanimous consent to address the house for one minute. the speaker pro tempore: without objection, the gentleman is recognized for one minute. mr. veasey: mr. speaker, i rise today to honor the life of a longtime friend, mary edwards, state democratic executive committee woman and board member for tarrant county stonewall democrats. mary was born in clarksville, a little town next to paris and moved to fort worth with her family when she was a kid. she dedicated her time to helping others and making a difference to anyone she came across. i can personally attest to this as mary was very active in the community, very engaged. in particular, she will be remembered for her work with longtime state representative, now former state representative, juan bernam. she served in various roles in the committee. she was very active in the lgbt community very proud of her work and a member of the communication workers of america and she was very active in the neighborhood that she lived in. my heart felt sympathy goes out to her younger brother and her niece who she greatly adored. and i can tell you personally that it's going to be sad to go to the democratic meetings and pull up into the parking lot and not see mary's big red truck there, but i can attest to you that while mary was here on this side she did everything she could to make life better for others and truly, truly cared for the community. mr. speaker, i yield back the balance of my time. the speaker pro tempore: the gentleman yields back. for what purpose does the gentlelady from texas seek recognition? ms. johnson: to address the house for one minute. the speaker pro tempore: without objection, the gentlelady is recognized for one minute. ms. johnson: thank you mr. speaker. i ask unanimous consent to address this house for one minute and to revise and extend my remarks by record. mr. speaker, the u.s. congress relies upon inspector generals, i.g.'s as a key component of the federal accountability community. when i.g.'s themselves engage in illegal, unethical and inappropriate behavior, congress has an obligation to investigate them. in the last congress, the committee on science, space and technology launched a bipartisan investigation of the department of commerce's inspector general. the evidence the committee obtained regarding his personal misconduct and professional mismanagement of this office is overwhelming. any one of the multiple issues highlighted in my extended remarks would be sufficient to justify the removal of this i.g. this serious step is made necessary but the abundant and deeply disturbing evidence that are making public today. it gives me no pleasure to provide this account to the congress but i believe it is my obligation to report on what we have found. i thank you, mr. speaker, and i'll be placing any extended remarks in the record at this point and i yield back. the speaker pro tempore: the gentlelady's time has expired. for what purpose does the gentlelady from new jersey seek recognition? without objection, the gentlelady is recognized for one minute. mrs. watson coleman: thank you mr. speaker. i haven't been in this office very long but it doesn't take long to pick up certain patterns of my republican colleagues. they find a way to hamstring immigration reform or prevent women from getting their right to choose at every possible opportunity. in the case of the s.g.r. fix, a very important bill that i am proud to have also voted for, republicans have chosen the latter. at the risk of pointing out the obvious mr. speaker, this is 2015. we can talk to our tv remotes. we have phones that show us in 3-d the nearest restaurants and printers that print prosthetic limbs. in 1973, motorola gave us the world's first mobile phone. 1973 was also the first time there was any question whether or not a woman had the right to make her own decisions about her health, according to the u.s. supreme court. i am not the youngest member of congress, but i am one of the newest and so i'd like to take this opportunity to invite my republican colleagues to join me in the 21st century. moving forward, i urge my colleagues to stop waging war on women's right to make their own choices. thank you, sir, and i yield back my time. the speaker pro tempore: the gentlelady yields. for what purpose does the gentleman from maryland seek recognition? mr. sarbanes: to address the house for one minute and to revise and extend my remarks. the speaker pro tempore: without objection, the gentleman is recognized for one minute. mr. sarbanes: mr. speaker, i rise today to mark the 194th anniversary of greek independence, to recall the day that greek people established modern greece as a free and independent nation. america's founding fathers drew upon the example of the ancient greeks in forming our constitutional republic. the relationship between greece and the united states is based on shared democratic values and respect for individual freedom. the spirit that guide the greek people in securing their freedom nearly 200 years ago resides with them still. today, greece faces tremendous challenges. we all acknowledge that, but i am confident that greece will ultimately overcome its economic and humanitarian crisis and thrive again. a strong greece will be able to take full advantage of new opportunities that are emerging in the eastern mediterranean and to move forward as a vital economic and cultural resource for a critical region of the world. as we say each year when celebrating greek independence day -- i yield back. the speaker pro tempore: the gentleman yields back. for what purpose does the gentlelady from florida seek recognition? ms. wilson: i ask unanimous consent to address the house for one minute. the speaker pro tempore: without objection, the gentlelady is recognized for one minute. ms. wilson: mr. speaker april 14 will mark one year since boko haram kidnapped over 200 nigerian school girls. since the school girls' kidnapping, boko haram has continued to torment and commit atrocities. boko haram has declared their allegiance to isis. they're beheading, raping their victims. rampant upon their use of social media and making surprise attacks to inflict maximum casualties and spread fear. mr. speaker, just this morning abc news reported that boko haram is using hundreds of civilians as human shields and the terrorist group reportedly abducted another 500 women and children just 48 hours before the nigerian presidential elections. nigerian officials remain very concerned about boko haram's impact on saturday's presidential election. president obama issued a statement calling for calm in nigeria. we cannot stand by mr. speaker, while boko haram aligns itself with isis. mr. speaker, i call on my fellow members of the house to join me in condemning the actions of boko haram. we will be watching what happens in nigeria closely, and by tweeting #bringbackourgirls, #joinrepwilson the world will known we have not forgotten. tweet, tweet tweet. i yield back the balance of my time. the speaker pro tempore: the gentlelady's time has expired. the chair lays before the house the following personal request. the clerk: leave of absence requested for mr. payne of new jersey for today. the speaker pro tempore: without objection, the request is granted. for what purpose does the gentleman from illinois seek recognition? >> mr. speaker, i ask unanimous consent that the committee on house administration be discharged from further consideration of house joint resolution 10 and ask for its immediate consideration in the house. the speaker pro tempore: the clerk will report the title of the joint resolution. the clerk: house joint resolution 10, joint resolution providing for the reappointment of david m. rubenstein as a citizen regent of the board of regents of the smithsonian institution. the speaker pro tempore: is there objection to consideration of the joint resolution? without objection, the joint resolution is engrossed, read a third time and passed and the motion to reconsider is laid on the table. the gentleman from illinois. mr. davis: mr. speaker, i ask unanimous consent that the committee on house administration be discharged from further consideration of house resolution 171 and ask for its immediate consideration in the house. the speaker pro tempore: the clerk will report the title of the resolution. the clerk: house resolution 171 resolution electing members to the joint committee of congress on the library and the joint committee on printing. the speaker pro tempore: is there objection to the consideration of the resolution? without objection, the resolution is agreed to and the motion to reconsider is laid on the table. . the gentleman from illinois. mr. davis: mr. speaker, i send to the desk a concurrent resolution and ask for its immediate consideration. the speaker pro tempore: the clerk will report the concurrent resolution. the clerk: house concurrent resolution 31, resolved that when the house adjourns on any legislative day from thursday, march 26, 2015, through friday, april 10, 2015, on a motion offered pursuant to this concurrent resolution by its majority leader or his designee, it stand adjourned until 2:00 p.m. on monday, april 13, 2015, or until the time of any reassembly pursuant to section 2 of this concurrent resolution, which ever occurs first. section 2, a, the speaker or his designee, after consultation with the minority leader of the house, shall notify the members of the house to reassemble at such place and time as he may designate if, in his opinion the public interest shall warrant it. b, after reassembling pursuant to subsection a, when the house adjourns on a motion offered pursuant to the subsection by its majority leader or his designee the house shall again stand adjourned, pursuant to the first section of this concurrent resolution. the speaker pro tempore: without objection, the concurrent resolution is agreed to and the motion to reconsider is laid on the table. the gentleman from illinois. mr. davis: mr. speaker, i send to the desk a concurrent resolution and ask for its immediate consideration. the speaker pro tempore: the clerk will report the concurrent resolution. the clerk: house concurrent resolution 32, resolved that when the senate recesses or adjourns on any day from friday, march 27, 2015, through monday, march 30 2015 on a motion offered pursuant to this concurrent resolution by its majority leader or his designee, it stand recessed or adjourned until noon on monday, april 13 2015, or such other time on that day as may be specified by its majority leader or his designee and the motion to recess or adjourn or until the time of any reassembly, pursuant to section 2 of this concurrent resolution, which ever occurs first. section 2, a, the majority leader of the senate or his he is -- designee after concurrence with minority leader of the senate, shall notify the members of the senate to resameble at such place and time as he may designate if, in his opinion, the public interest shall warrant it. b after reassembling, pursuant to subsection a when the senate recesses or adjourns on a motion pursuant to this subsection by a majority leader or his designee, the senate shall stand recessed or adjourned pursuant to the first section of this concurrent resolution. the speaker pro tempore: without objection, the concurrent resolution is agreed to and the motion to reconsider is laid on the table. mr. davis: mr. speaker. the speaker pro tempore: the gentleman from illinois. mr. davis: i ask unanimous consent that when the house adjourns today on a motion offered pursuant to this order, it adjourn to meet at 1:00 p.m. on monday, march 30, 2015, unless it sooner has received a message from the senate transmitting its concurrence in house concurrent resolution just addressed in which case the house shall stand adjourned pursuant to that concurrent resolution. the speaker pro tempore: without objection. the chair announces the speakerers -- the speaker's appointment, pursuant to section 3056 of the carl levin and howard p. buck mckeon national defense authorization act of fiscal year 2015, public law 113-291 in the order of the -- and the order of the house of january 6 2015, of the following individuals on the part of the house to the commission to study the potential creation of a national women's history museum. the clerk: ms. wright of arlington, virginia, the honorable marlin musgrave of colorado. the speaker pro tempore: the chair announces the speaker's appointment, purr subte to sections 5580 and 5581 of the revised stats 20, united states code, 42-43, and the order of the house of january 6 2015, of the following members on the part of the house to the board of region enlts of the smithsonian -- regents of the smithsonian institution. the clerk: mr. sam johnson of texas, mr. cole of oklahoma. the speaker pro tempore: the chair announces the speaker's appointment pursuant to 22 united states code 276-l and the order of the house of january 6, 2015, of the following members on the part of the house to the british american interparliamentary group. the clerk: mr. crenshaw of florida chairman, mr. latta of ohio, mr. aderholt of alabama, mr. holding of north carolina, mr. whitfield of kentucky, mr. roe of tennessee. the speaker pro tempore: under the speaker's announced policy of january 6, 2015, the gentleman from illinois, mr. schock is recognized for 60 minutes as the designee of the majority leader. schock schock thank you mr. speaker -- mr. schock: thank you mr. speaker. six years ago i entered this chamber and raised my right arm to take the oath of office as a member of the united states house of representatives. i remember feeling so excited about the opportunity that lied ahead. i remember vividly this chamber and all that it meant to me and to the country. the men and women debating the issues of the day, not always agreeing, but always fighting without pie -- without apology for what they believed in. over the past six years i've come to understand that this institution is far more bigger than any one person and that freedom itself is even more important than this institution. some of the world's greatest debates have occurred right here in this chamber, for what happens here effects more than just the people of my district or even my country. over those six years, i've done my best to contribute constructively to the process and to serve the people of my district and high country. my guiding principle halls been rooted in the belief that -- has always been rooted in the bloof that washington should only do what people cannot do for themselves. i fought awe and opposed the billion-dollar stimulus bill the government takeover of our health care and the massive new regulations put on small businesses. but more importantly, for the people of my district, so that -- i fought that their voice would be heard and respected among my colleagues. i heard that voice in every vote that i have cast. but i also knew that being in the majority was key to making a difference. and so i'm proud of the work i've done to contribute to a republican majority here in congress. to begin to scale back the overreaches of a bloated federal government and to begin to bend the curve on out-of-control spending. that has only happened because of a republican majority and i'm proud to have played a role in building it. during this time, i saw how slow the federal government can be and how frustrating congress can get. i also learned that one man can make a difference. working with my republican colleagues and across the aisle with my democrat friends, we've been able to pass legislation that helped businesses across america create millions of jobs. some of them have been located in my home district, but many more across this great country. there was, is and will be so much to do and i'm honored to have played a small part in making a real difference. but these accomplishments come with some frustrations as well. that this body doesn't move quickly enough or as efficiently as it could to confront the challenges facing our country. i regret that i won't be here when we finally pass a smarter, simpler tax code so that every hardworking taxpayer in my district and across the country will know that washington not only cares about them, but respects them and their sacrifice. and i will miss joining my colleagues in saving and strengthening social security and medicare, that will directly improve the quality of life for millions of americans for generations to come. to my constituents back home the good, hardworking taxpayers whom i've had -- been lucky enough to call friends, i will never be able to thank you enough for the opportunity you gave me to serve. together we have tackled some of the big problems at home, like economic development projects helping businesses expand improving our locks and dams along our riverways, and so much more. projects that have helped improve the quality of life in our community. we've also tackled some small problems. but big problems to the people who have been facing them. folks looking for help adopting children overseas or simply trying to get answers from an unresponsive bureaucracy here in d.c. solving those individual cases has been extremely fulfilling. and i'm particularly grateful to have played a role in helping so many veterans get the respect they deserve and the benefits that they earned. i'm proud of the good work that my team has delivered to the tens of thousands of constituents who have turned to our office for their time in need. my staff delivered for me because they delivered for you every day, 24/7. i was never more excited than the day i walked into this chamber six years ago. i leave here with sadness and humility. for those whom i've let down, i will work tirelessly to make it up to you. i know that god has a plan for my life the good book tells us that before i formed you in the wombers i knew you -- womb, i knew you. i also know that every person faces adversity in life. abraham lincoln held this seat in congress for one term. but few faced as many defeats in his personal business and public life as he did. his continual perseverance in the face of these trials, never giving up, is something all of us americans should be inspired by especially when going through a valley in life. i believe that through life's struggles, we learn from our mistakes and we learn more about ourselves. and i know that this is not the end of a story, but rather the beginning of a new chapter. thank you for the honor to serve. i look forward to keeping in touch with my friends in this chamber and my friends across the 18th district. may god continue to bless this awesome institution and the important role that it plays for america and the rest of the world. with that i yield back the balance of my time. the speaker pro tempore: the gentleman from illinois yields back. under the speaker's announced policy of january 6, 2015 the gentleman from georgia, mr. woodall, is recognized for the remainder of the hour as the designee of the majority leader. mr. woodall: thank you mr. speaker. i appreciate your yielding me the time and i'd like to start our time tonight by yielding to my friend from florida, mrs. wilson. ms. wilson: thank you so much, representative woodall, for this honor. i'm indetsed to you forever. thank you. i just finished making a speech about boko haram and girls who were kidnapped in nigeria. five of them are in the gallery today and i thought to recognize them and ask you who are listening to please tweet #bringbackourgirls tweet, #joinrepwilson. these young ladies were kidnapped and they have the courage, the courage to come to america to continue their education. they're right there in the gallery. thank you, mr. speaker, thank you representative woodall. thank you. mr. woodall: mr. speaker, as you know, this is the conclusion of budget week here. i sit on the budget committee. i enjoy budget week. it's a statement of our values as a nation. where you put your money is where you're putting your emphasis. a lot of folks don't want to put their money where their mouth is. we have a lot of mouths in this town. this is the week where everybody gets to put their money where their mouth is. one of those issues that we've been struggling with has been the issue of transportation funding. i come from a very conservative district in georgia, mr. speaker. one of the counties, i only represent two, one of those counties -- counties just voted to tax itself with a $200 million bond initiative to widen a highway. because we're the fastest growing county in the state and we sit in traffic hour upon hour upon hour. it's not that conservatives don't want to tax themselves it's that conservatives don't want to tax themselves and then throw that money down a rat hole. if we can develop a trust that if you tax a family $1, that they will get $1's worth of services needed services, desired services for that $1, we have a very different relationship with the federal government. mr. speaker, i have up here a reference to article 1 section 8le, clause 7 of the united states constitution, which says that congress shall have the power to establish post offices and post roads. commerce, at the time of the writing of our constitution mr. speaker, took place through the post office and those post roads, it was an obligation that our founding fathers recognized to develop routes of commerce so that goods could travel, so that messages could travel, so that people could travel. i say that because too often the conversation in washington devolves into, should we spend money at all or should we spend obscene amounts of it that we have to borrow from our children? that's not the conversation that we're having we have a constitutional obligation to maintain establish and maintain the post roads, those corridors of commerce around this nation, the federal government took that responsibility on in one of the great building projects of our history, building the eisenhower interstate highway system. . i want to build things, mr. speaker. my community is doing fine back home, that my county is doing fine back home, that my state is doing fine back home and for some reason we think from the 435 of us gathered together we're going to come up with a better idea about how to serve my community back home than my community back home has about how to serve that community. i think we get off track there. i think we get into those unconstitutional uses of power establishing post roads. one of those things our founding fathers asked the federal government to do because quite simply no one else can build an interstate highway system. it does no good for georgia to have 12 lanes going to the alabama border if alabama doesn't have a road when we get there. this is a collaborative decision and rightfully so. so how do we fund these highways, mr. speaker? we fund them primarily through what's culled the highway trust fund -- called the highway trust fund and the highway trust fund is funded through taxes on users of the highway system. i am a huge fan of user fees. if you don't like to sit in traffic every morning, if you want to build an extra lane on your highway, as we are in forsyth county, you should pay to build that extra lane on your highway. you shouldn't ask someone in highway to pay to build the road in georgia. we should build the road in georgia. users of the roads should pay for the roads. that's what we do here. you can't see is the graph of how the highway trust fund is funded. it's a gas tax, 18.4 cents that comes out of every grl of gas that americans buy. that gas tax is primarily the funding mechanism but we also tax diesel, so all the truckers that are on the road, every time you're driving down that two-lane highway and you wished the guy in front of you was going a little bit faster, just know that he's paying a lot in taxes while he's on that road. he's helping to build that road. diesel tax is higher than gasoline taxes, but because there are fewer diesel vehicles on the road, bring in less revenue. we also have a tax on all trucks and treglers. we have a tax on this blue line on heavy vehicles and a tax on tires. again, all of these taxes come together, not to tax for one -- one group of people to pay for another but to tax users of our roads to pay for our roads. it's been a system that has served us fairly well in this nation. but we haven't raised that gas tax since the early 1990's. in the early 1990's we set the gas tax at 18.4 cent a gallon and we haven't raised it since, mr. speaker. i'm not in favor of raising taxes. i'm in favor of paying less taxes. i'm in favor of taking on more of that responsibility back home. again, in the case of post roads we have to take on this responsibility. and the reason i'm having this special order tonight, mr. speaker, is because the highway trust fund expires in may. we have about two months to sort out all of the challenges of how do we fund the interstate highway system going forward and for folks saying we've been funding to with 18.4 cents gas tax, the question is why isn't it good enough today? the answer is, it may be good enough. the buying power has declined each and every year. of course it has. the price of a big mac has gone up over the last 20 years. the price of a car has gone up over the past 20 years. the price of a home has gone up. the price of building roads has gone up. so the purchasing power that we're getting for our gas tax has gone down and down and down and down. right now we're getting about 60% of the value out of that gas tax that we were getting when it was last changed in the early 1990's. now, what's the impact of that? well, it's not just that the value of the purchasing power's going down the mileage we're getting in our cars is going up. my first car mr. speaker, i don't know what your first car was, mine was a 1971 volcanos wagon camper. i had -- volkswagen camper. i had 14 horsepower to drive me anywhere i could go. if i coasted downhill and only used the accelerated uphill, i'd max out about 35 miles an hour but i could get 14 miles a gallon if i tried. if i tried to drive that camper as efficiently as i could i could get 14 miles to the gallon. today mr. speaker, i'm driving a chevy volt. most of it is free. it's coming off the battery. when i do have to turn on the electric generator in that chevy volt, i'm getting 40 miles to the gallon. just in my lifetime, the fuel efficiency is either tripled based on an engine or no gas tax at all because i'm using electricity. this is what's happened. you go back to 1975 mr. speaker, this is the average miles per gallon that passenger cars and light trucks were getting. you get in the last half of the last decade you see that fuel efficiency is driving sharply forward and the obama administration wants to drive that fuel efficiency even higher. i'm in favor of using private industry to create more efficient solutions. i'm in favor of being able to reduce the fuel costs of families across this country, but what that's going to do as families are buying fewer and fewer gallons of gasoline is that highway trust fund is going to get smaller and smaller and smaller. take a look what's happened with the highway trust fund, mr. speaker. the -- beginning back in, i'd say in the early 1990's, when folks were buying lots of gasoline and fuel costs were relatively low, the economy was doing -- was doing well, we were running a trust fund surplus. again, all of this gas tax money is coming in from all of these sources. we were spending it on those priorities that we have in the interstate highway system. some of those priorities were building new interstate highways. some of those priorities were maintaining old interstate highways. some of those priorities were simply widening part of the interstate highway system, but we operated with a bit of a surplus in the transportation trust fund. the reason this conversation has to happen today mr. speaker, is that folks returning to their districts for two weeks, where they're going to be hearing from folks who are sitting in that traffic, where they're going to be sitting from folks whose contracts to build those highways are about to expire, they're going to hear from their governors and their state legislators who are no longer able to let the contracts for needed projects. why? because the money is expiring in two months. we're starting to run a trust fund deficit. there's not enough money coming in to meet the current needs. now, mr. speaker i don't really enjoy talking about the current needs. i didn't run for congress to be in the maintenance business. i ran for congress to be in the transformation business. i'm more than a little embarrassed what we're talking about here is how do we maintain and improve the eisenhower interstate highway system. eisenhower was long gone from office before i was even born. we're talking about how to maintain this infrastructure. i'd like to be in the driverless cars infrastructure business. i'd like to be in the hypersonic jets infrastructure business. but where we are, because the calendar dictates it, is in the how do we continue to maintain safe highways just two months from now. you can't see these tick marks, mr. speaker, but we're talking in the ballpark of $50 billion a year that goes into this effort. thousands and thousands and thousands of miles of interstate highways around the country. about $50 billion a year. the deficits are running down ultimately by the end of our 10-year budget window to almost $130 billion in highway deficits. have to find a way to meet those needs. we had a hearing in our committee just the other day, the transportation committee, mr. speaker. and i want to quote the mayor of salt lake city. he was there on behalf of the national league of cities. this is not a notoriously conservative organization. mayors are a practical bunch by nature. they have to respond to the needs of all of their citizens. they are a relatively liberal bunch by nature. but he says this. i can tell you as someone who's spent a career working as a nepa planner and lawyer -- nepa is the environmental policy act. that's what -- that's what federally regulates all environmental decisions across the country, particularly as it relates to construction. he says working as a nepa planner and lawyer, that what's happened with what i view as an absolutely great environmental law -- the national environmental policy act -- is truly unfortunate. we've gone from processes that should be a year or a year and a half to processes that are five to seven years in many big transportation projects. time is money mr. speaker, in transportation projects. there's not a member in this chamber who wants to see environmental degradation in this country. there's not a member in this chamber that wants to see the skies less blue or the grass less green. every member in this chamber cares about children and grandchildren and the next generation. but here we have an advocate for the environmental protection laws that are available to us in this country and he says something has gone awry. we wrote this wonderful law in order to protect our environment but now instead of being able to complete needed projects in a year or 18 months with litigation, special interest groups, these processes get dragged on for five, six or seven years and that time means more money out of the highway trust fund in order to complete that project. so what are we going to do mr. speaker, about these coming trust fund deficits? well, one thing we can do is help to address the policy failures that are delivering less than a dollar's worth of value to my constituents and your constituents for their dollars -- dollar's worth of gas tax. if i could build a project today with that dollar i can get a dollar's worth of value out of it. if i have to litigate the issue for seven years, the value of that dollar is going to erode. we can change the law and we can do so in a bipartisan way that absolutely respects all of our commitments to environmental protection but allows us to complete these needed tasks. i tell you what doesn't help global warming mr. speaker and that's folks sitting in atlanta highways for an hour every day not moving. if you were concerned about the use of fossil fuels in this country, i promise you that having people move slower in atlanta is not helping. we need those folks to be able to move more quickly to their goal. we will reduce emissions as a result. what else can we do, mr. speaker, as a body? what i have here -- and i just chose the state of georgia because it's that area that i know best. these are the georgia statewide designated freight corridors. i live right up here just outside of atlanta, mr. speaker. i'm right off i-85, that's interstate 85, federal interstate 85. and that's designated as a freight corridor. our use of the roads is not just to get two and fro the grocery store of course. not just to get to and from school. but for farmers to get their produce from iowa to our grocery store, for manufacturers to get their products from the computer factory in california to our schools. we have a national interest in these freight corridors. one of these freight corridors runs out i-16. it runs out to the port of savannah. the port of savannah mr. speaker, i don't know if you know, it's the fastest growing container port in the country. container port being those ports that specialize in getting those 18-wheeler cargo containers off the ships onto a chassis, living goods to where they need to go. pastest growing container port in the country it sits right here at the end of i-16. we have major construction projects to get those products out of those ships out across the southeastern united states. so this map of red lines, mr. speaker, not only represents interstate highways but also federal roads. i have u.s. 1 mr. speaker. u.s. 1, mr. speaker as you may know runs about -- goly we're about 2 1/2 miles from this building. about 2 1/2 miles west from this building, you're going to hit u.s. 1. well, u.s. 1 runs all the way down the eastern coast from the great northeast all the way down to florida. it's a federal transportation corridor. . what's not on this list mr. speaker, for example, is highway 29. u.s. highway 29. it runs right past my house. it's a u.s. highway. it consumes u.s. transportation dollars. and while once upon a time it was a major corridor for moving nationally important equipment freight, produce today it has become a side corridor. my question is, if we are limited with our dollars, can we be more discriminating in choosing which roads have a national importance? i told you the tale for the county i represent, mr. speaker, having $200 million bond initiative to expand its major highway. georgia 400 is its major highway. we don't need the federal government to take care of every single square inch of pavement in this contry. when we -- country. when we talked about establishing postal roads in 1787, there was the understanding if this was a major thorough fair, they had not contell nated pavement at all, but if -- contemplated pavement at all but if this was major thorough fair, we might have a federal interest in it. not so anymore. i talked about u.s. 1, mr. speaker. u.s. 1 is right out here about 2 1/2 miles away, but just between washington, d.c., and baltimore mr. speaker, the federal government, with federal tax dollars, collected from all across the nation maintains three separate federal roads. we main taint baltimore-washington parkway, which is a national park service road. we represent -- we take care of u.s. 1, and we take care of interstate 95. those roads are never more than five miles from each other, and yet because tradition dictates it we are spending national dollars to maintain three relatively duplicative pieces of highway. we have to have that conversation. maybe there's a reason unbeknownst to me why it is we can't just maintain one of those roads. why we have to maintain them all. but the federal government doesn't have to do everything for everybody, mr. speaker. we just have to make sure that those interstate corridors are being maintained. those primary national designated freight corridors are being maintained. it's ok to leave the rest to communities and states to handle. want to give you an example. not picking on anybody in particular. these projects go on all across the country, mr. speaker. but you can see someone's home right here, got some holly bushes out in front, little maple tree here that's been planted on the right of way. what you see here, brand new curbs and sidewalks and about a 3 1/2-foot bike lane that we spent a million federal dollars to build. i'm glad, assuming this family wants a giant curb and big sidewalk and bike lane in their front yard, i am glead they were able to get it -- glad they were able to get t i'm glad we are planting maple trees in the rye of way there. we are not moag the grass in that space, but i hope the community takes on that chal -- mowing grass in that space but i hope the community takes on that challenge. this is not an interstate highway system. this is a small, small road somewhere in america that a million dollars' worth of federal taxpayer dollars are going to beautify a street. mr. speaker, that comes from a project -- from a program called the transportation alternatives program. over the last two years, mr. speaker that's been more than a billion dollars. a billion dollars going towards these kinds of projects. almost $2 billion. let me tell you what kinds of big, important federal projects kind of rising to that constitutional level of building post roads for commerce. well anything that you build that relates to a sidewalk counts. anything that you create relating to bicycle infrastructure counts. if you can find some traffic calming techniques -- don't know what a traffic calming technique is but if you can identify one mr. speaker, we can pay for it out of this multibillion dollar trust fund. the construction of turnouts overlooks, and viewing areas. mr. speaker, you do not want to be behind me when i'm riding through a national park. you do not want to be behind me when i'm going down that beautiful highway in virginia running all the way down to the great state of georgia because i am driving slowly, sucking it all in and turning in to every turnout along the way and taking pictures. i love a good drive, particularly in the fall. but i promise you i do not need one taxpayer dollar paying for one turnout on one highway so that i can get a better picture. we've got an entire georgia transportation tourism board mr. speaker. if we need a turnout in the great state of georgia, if it's going to bring more tourist traffic to our area, if we are going to allow us to put in a small restaurant where folks can stop and eat and enjoy our beautiful scenery, we'll build that because tourists will demand it and it will grow our economy. in a time where trust fund dollars have been eroded by inflation, in a time where we know we don't have enough money coming in to maintain our current interstate highway system, in a time that we are talking about raising taxes on the american consumer in order to provide those resources, isn't it also time to end the nonfederal priority spending that is currently embedded in the federal gas tax like turnouts? mr. speaker, one of the projects that was built with that multibillion dollar trust fund was down in the great state of georgia. it's called the silver comet trail. the truth is that we only have one really good long bike trail in the entire metropolitan atlanta area. it is the silver comet trail and it's fabulous. it is absolutely fabulous. you go out there on any beautiful day you're going to have joggers walkers, bike riders. folks will be pushing strollers. it is a festival of humanity there on that bike trail. wonderful, wonderful way to spend your day. we spent $3.7 million federal dollars so that my neighbors and i could have a fabulous biking and walking trail in our backyard. wasn't my idea. i wasn't in congress at the time. we have to ask ourselves is it worth raising taxes on the american driver, on american industry that uses our roads so that more local communities can build more fabulous bike trails in their own backyard? i don't ask my colleagues, mr. speaker whether bike trails are valuable or not. i believe them to be so. i ask my colleagues whether or not metropolitan atlanta, the most prosperous major metropolitan city in the entire southeastern united states, can afford to build its own bike trails or whether or not we need to call on the rest of the nation to aid us in that effort. mr. speaker, i've got another project here, it was only $60,000. isn't that sad? when we get into this place, we start talking about projects that are only thousands and thousands of dollars. because when you're managing a $3.8 trillion budget, mr. speaker, it's hard to keep track of the thousands. that's why we don't want a big federal budget. we don't want to be in the business of wasting money. $60,000 went to a project called pet-a-flag. this is in a small downtown area out west. and there's a crosswalk going across the street. folks are concerned about pedestrian safety. there are pedestrian tragedies every year in this contry, every year in my community. certainly want to do everything we can to stop them. the $60,000 program goes to each end of a crosswalk and it puts yellow flags in big pucts on each end of the crosswalk, mr. speaker, so that when you're prepared to walk across the street, you can grab one of these flags and you can wave it as you cross the street. the street is two lanes. but you can wave it as you cross those two lanes to make sure that drivers coming down that low-speed limit thorough fair don't run in to you. -- thorough fare don't run into you. i like that's fabulous. i love a good parade, mr. speaker. i love waiving flags. my question to you is, with all the challenges facing this chamber, we've got social security that's going bankrupt. we've got medicare that's going bankrupt. we live in a dangerous world with isis and russia. iran. is the priority for the--- for the tax dollars we have confiscated from the american people is the priority to spend $60,000 of those tax dollars to have buckets on flags on both sides of a two lane street so pedestrians can waive them as they cross? if folks love parades as much as i do mr. speaker, that local community can put those flags in place. a federal grant program not necessary to do so. got an article here, mr. speaker, from just last month. it's talking about this program that allows these grant dollars to go out for all these none high priority federal purposes. -- nonhigh priority federal purposes. they cite a $112,000 grant for a white squirrel sanctuary. for quite squirrel sanctuary. mr. speaker, i have nothing against white squirrels. i will slow down when i am driving as the gray squirrels in my community cross the street. but i have no interest in confiscating federal tax dollars that were intended to maintain a critically important national highway infrastructure and having a local community who views that as free money spend it to create a white squirrel sanctuary. mr. speaker, these dollars are going to build board walks in our beach communities. they are going to resurface bike trails. they are even going to buy driving simulators at car museums. because that kind of is perfect riff -- perfect riff rally related to transportation. the atari 600 you could do the night driving program. today, we can spend $198,000 federal it gas tax dollars to buy driving simulators to go into museums. so that when folks come by they can experience after they have driven on the ratty roads that were unmaintained to get to the museum, they can have a wonderful driving experience inside the federally taxpayer paid simulator. mr. speaker i don't fault museums for wanting simulators communities wanting bike trails i don't fault communities for wanting flag waiving cross walks. i fault this congress for facing a fiscal challenge with how do we complete our constitutional responsibility to maintain our roads and even have the discussion of raising tax dollars before we have completed making the current accounts more effective more efficient and more accountable. mr. speaker, i do not value members who simply talk about everything that's wrong and make no recommendations about how to fix it. we need to narrow the number of roads that qualify for federal support. we need to prioritize what are those roads that fall into that constitutional responsibility, and which ones obviously do not? prioritize that spending. take care of only those mission critical roads. leave the rest to local communities. number two deal with our environmental regulations that are slowing needed construction. not abolish our environmental regulations, not ignore our environmental stewardship responsibilities, but recognize that advocates for the environment, advocates for the nepa act, as the mayor of salt lake city suggested, even those add vow realize we have gone far afield from what was intended, years of expense and delay, for projects that we ought to be able to complete in a year and 18 months streamline that. that's two. number three, take all these feel-good projects that every one of us has heard of in our district all the feel good projects, those projects that don't have anything to do with major national thorough fares, those projects that don't have anything to do with our constitutional responsibility to maintain our interstate corridors, and abolish those all together. . they did a poll among young people, when you get that first job at 16 and turns out the government gets its share, you are making $5 an hour and get a lot of new voters because folks realize the importance of having your voice heard. the largest tax that 80% of american families pay, mr. speaker, is that payroll tax that's taken out of that pay check, that fica line. largest tax that americans pay goes to fund social security and medicare. a poll among young people, more people believe they would see that in their lifetime. mr. speaker, you cannot break promises to taxpayers in that way. we have serious responsibilities in this chamber. they do not include feel-good projects in local communities. they do not include squirrel sanctuaries and flag-wheask projects. what they include is include maintaining those interstate corridors. as we gather together to re-authorize the surface transportation bill, as we gather together to sort out the diminishing value of the highway trust fund, let us come together to restore some of that faith with the american taxpayer that we will be accountable that we will be efficient and we will be effective in the use of every one of their taxpayer dollars. we cannot ask them for more until we have proven to them that we have used responsibly what they sent to us yesterday. mr. speaker, we've talked transportation on the surface level. i want to briefly talk transportation at a port level. i mentioned the port of savannah the fastest growing container port in the world. you can't see here on the map, i have one of those container ships coming into the port of savannah. these giant cranes it's amazing how quickly they can load and unload these giant container ships. funding for these kinds of nationally important projects, these kinds of projects that deliver value to the american taxpayer, that allow them to get the goods and products that they want from around the globe into their local markets for a lower cost, we are dredging the savannah river in order to expand this port so it can happened will the new ships that are going to come through the panama canal. these ships are giant. if you haven't been to see them you can take a look. they can bring in three times more cargo in one ship and taking a multi week voyage across the pacific ocean, that's a big deal. $700 million is what this project is going to cost and going to benefit the entire eastern seaboard but going to benefit georgia more than most places, why? because we are going to have workers, our rest stops are going to be full and gasoline stations will be full. funding 40% of it out of our local coffers. put your money where your mouth is. thinking about those delays that run up costs. we started talking about doing this in the late 1990's. we got federal approval to begin last year. this was not a $700 million project 17 years ago when we wanted to begin it. but we couldn't begin it 17 years ago. we have only been able to begin it now. about $100 million is going to go out the door to get this project under way ffment all goes well, we can finish it in about five years, but we are going to have to have that federal-state partnership for these projects that are not uniquely federal or not uniquely state, we need to have both entities putting skin in the game to make these projects successful. mr. speaker, what we're talking about is $100 million from the state coming this year. about $100 million come fringe the feds next year. as we talk about how to prioritize funding, how can we get together to squeeze out those projects that are of local import and leave those to local dollars and local concerns and include these projects that are of national import to make sure we get them done on time and under budget? mr. speaker back in the envelope that folks doing the construction at the port have done tell us that it's about $174 million annually in lost benefits that this project is delayed. lost benefits on the one hand, added costs on the other. i'm always skeptical when someone says, if you spend a dollar, you get $18 in return. we have $18 trillion and a lot of funny numbers go on in this washington, d.c. math game that folks play. but undenbly, if we cannot compete at a global level, if american products begin to cost more to export relative to their foreign competitors because we can't handle the big ships, american workers will lose american consumers will lose. these are national priorities that bring people together. i want to set expectations on how we are going to get this done. i want to go back, 1996 is when we first had this conversation. completed first study of getting this done the first conditional approval at the federal level 1999. 2012, folks finally made the decision, south carolina and georgia sorted out their issues in may of 2013. final permit projects came out in july 2013. state of georgia, funding, 266 million and another round of bond initiatives will go out this summer. mr. speaker, 2019 is when this project is expected to be done. a project that could have started in 1997. a project that could have been done by 2003. a project that could have been a nation-leading project so that american goods could get out to the world in a competitive way as the ships come online for us to be ready as a nation, what could have been a story of planning ahead and of success, has become a story of decades' long delay and being behind. mr. speaker, those are not academic conversations but conversations represented with dollars and cents, it is american productivity lost and international competitiveness lost, item after item after item after item. we are in the midst of a surface transportation re-authorization bill and highway trust fund we are in the midst of an f.a.a. authorization bill and funding mechanisms. water resources development bill again as we were last year developing our water resources. the question in this chamber, mr. speaker, is never will we be involved in generating american productivity or will we not the question is we will be involved but on what and how. let us move these low-priority projects off of the federal budget off of the federal taxpayer and back into local hands where they can be accomplished more quickly more efficiently lower dollar costs. and before we decide to raise taxes on the american people, let us ensure every single dollar that we raise today is getting a dollar's worth of value for a dollar worth of tax. i'm proud to be on the transportation committee. we have big things in store for this year. they will be collaborative things. these are not republican or democratic concerns these are american concerns. these are concerns of america's most deliberative and engaging body, the united states house of representatives. with that i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. under the speaker's announced policy of january 6 2015, the chair recognizes the gentleman from ohio, mr. chabot, for 30 minutes. mr. chabot: thank you very much, mr. speaker, and i will not take that much time. mr. speaker, there seems to be a lot of bad news these days and negative stories, but i would like to take this opportunity to highlight some uplifting stories from the cincinnati area, the area that i happen to represent here. first i would like to congratulate a cincinnati broadcasting legend on a storied career. a week from tomorrow, friday, april 3, cincinnati will say good-bye to a long time morning show tim scott, after more than 47 years on the radio in cincinnati. he has been synonomous with mornings as hundreds of thousands, if not millions of the residents of cincinnati started their day listen to him cover politics, local news, entertainment and sports. he covered every story in a style uniquely his own. his excellence was recognized back in 2002 when he won large market personality of the year. and he has been a pillar of the community helping out with charities and community service organizations activities i'm sure he will continue. and he has become a staple of the opening day parade for the cincinnati reds who i hope have a great year this year. i want to congratulate jim scott on his outstanding career. mornings in cincinnati will not be the same without him. mr. speaker, cincinnati is also been blessed by the inspiring stories of two young ladies battling pediatric cancer and i would like to take a moment to thank each of them for the example that they have provided and the hope that they've given to millions. i would like to talk about lauren hill. for those who haven't heard lauren's story, there aren't words to describe in the face of insurmountable odds. she loves to play basketball, a sport she planned to play in her college years. unfortunately, lauren was diagnosed with a rare form of inoperable, terminal brain cancer, d.i.p.g. and doctors weren't sure how long she would live. for most people, the story would end there, but not for lauren. she was determined to play in a college basketball game and back on november 2, she joined her teammates on the court in front of a soldout crowd at xavier cincinnati, she scored the opening basket. but that wasn't enough. she wanted to dedicate her remaining time to raising awareness of pediatric cancer and through lay-ups for lauren and other efforts, she has helped raise over $1 million for research to combat pediatric cancer. i would like to believe each one of us is put on this earth for a reason and it's clear to me that lauren's purpose was to inspire a city and a nation and to raise awareness for a terrible disease. a purpose she has fulfilled with dignity and grace, that is an inspiration to me and countless others. i'm deeply grateful for lauren's spirit and the example she has provided for our community and for our nation. our thoughts and prayers are with lauren and with her family. but lauren is not the only young lady with cincinnati ties inspiring our nation. we have also been blessed to learn the story of lea still, the four-year-old daughter daughter of devon still. lea was diagnosed with a rare form of pediatric cancer. faced with this devastating news, devon still was determined to help his little girl. part of his effort was to use their story to help raise money to combat pediatric cancer and give hope to other families facing the same trug -- struggle they were. the cincinnati been gals and the nfl agreed to donate the proceeds of sales of devon's number 75 jersey to cincinnati children's hospital, which by the way is the number one children's hospital in the nation in combating pediatric cancer. together, they raised also over $1 million for pediatric cancer research. while that is certainly great news, the story has an even happier ending. yesterday, i along with millions of others, were thrilled to learn that lea's cancer was in remission. . she should remain in our thoughts and prayers but that was wonderful news and reason to be grateful. may god bless all three of the remarkable people that i just talked about. and, mr. speaker, i yield back the balance of my time. the speaker pro tempore: the gentleman yields back. under the speaker's announced policy of january 6, 2015 the chair recognizes the gentleman from texas, mr. gohmert, for 30 minutes. mr. gohmert:00 thank you -- mr. gohmert: thank you, mr. speaker. first of all i want to address the bill we passed today. it's something that needed to be addressed. it was a problem that's been growing for about 16 years or so. the cut that was put into law it's been changed 17 times just in the last 16 or so years. making cuts to health care providers. we have caused some health care providers to retire early. the $716 billion that obamacare took from medicare in order to supposedly fund $30 million or so that we were told didn't have insurance, now we have cost millions their health insurance policy they liked. and i say we. not a single republican voted for that bill. but it has cost americans millions of americans, the doctor that they wanted to use, we have seen promise after promise that was made about obamacare that was broken. absolutely wasn't true. then we find out that there were advisors around the white house that we are advising all along. they are not going to be able to keep their insurancepolicy. they are not going to be able to keep their drfments maybe we want to change the way that kind of thing is said. did major damage and continues to do major damage to health care. so on top of that overlay, we had these ongoing cuts to the health care providers that if we didn't step in each year and temporarily pause them, it would have put so many health care providers out of business made it extremely difficult for americans to get the health care they need. even more than it already is. even more than obamacare has jeopardized. so something needed to be done. my friend, dr. mike burgess, had pushed through a fix, a remedy last year, 63 pages. very well thought out. he's a very of bright, terrific doctor. and a great congressman. and a friend. and we have spent a lot of time this week talking about the fix to the cuts to reimbursement for physicians. and the bill today on the good side provided permanent fix. if this became law, if the senate passed what we did, it stops the slowle it deletion of some health care providers' efforts and work. but this provides a framework from which medicare can be reformed for the future. but it's valued at $175 billion, and the best estimate we've got again is that $140 billion of the $175 billion is not offset with any cuts anywhere else. this would be a straight addition, $140 billion, to our children and grandchildren's enormous debt. what some refer to as intergenerational theft. it does have henry hyde language protecting against federal funds be used for abortion. i've always thought the world of henry hyde. and was honored to overlap with him two years. and his work in standing for the unborn children, the most innocent among us, is just an extraordinary life's work that he did. i don't know that federal funds for abortions for people on medicare is as big an issue as some might think, but the hyde language is in there. puts it in the tax code. that's a big deal. some of my democratic friends were not big on that. and there's also re-authorization for chip. there's the secure rural schools. our rural schools, especially those in -- that have national parks have been cheated for many years. from the income that they were supposed to have by giving up land they couldn't tax anymore. by giving up other sources of revenue from the land. they agreed to allow land to be used or become national forests. they were to be reimbursed by freeze from the sale of timber. but we have a forest service, administration, and i -- not just this one, it's been going for a while, where production has either slowed dramatically or completely been eliminated. even though pine trees where i live, entirely renewable resource, you plant them you're ready to harvest them 15, 20 years. we are not talking sequoias. just talking a renewable resource. it's well managed in east texas and other places around the country. but since production has stopped and we are buying so much lumber from other countries now, not good for america, not good for our trade imbalance, but it's been federal government policy and it is -- it has put schools in an extremely detrimental position, especially in rural areas, especially in areas where there have been national forests. so nice to have another band-aid, so to speak, to address that issue. it should have been in here. it should have been done before now. on the other side, getting back to $140 billion that's not offset by cuts anywhere else. adding it to the intergenerational theft. and it also concerns me -- we had 212 republicans today that voted for this s.g.r. fix, it would have been so easy to have enough of an adjustment into this bill that we could have had six more republicans. and it would have been able to pass without any republican leader begging for support from the democrats without coming to support from conservatives. we saw what the vote on d.h.s. funding, where 167 republicans voted against it because it didn't keep our promise to stop the illegal and unconstitutional amnesty that d.h.s. had done, as ordered by the president, and there were 75 republicans. some of whom are very conservative, but they did vote with the speaker on that bill. and with the majority of democrats to pass that funding. but i think that gives us an indication that out of the republican conference the massive portion of the republican conversation represents very conservative districts -- conference represents very conservative districts. there are republicans that, thank god, we have that are from more moderate iras -- areas, but somewhere between 1/4 and 1 vsh 3 perhaps 1/3, perhaps, but it just seems like this today is one of those bills where we would be better off if we played -- if we negotiated a deal among the republicans and go through regular order. that's what we promise. you put us in majority, we'll go through regular order. we'll have hearings on this entire bill. there will be open opportunities to discuss it, to amend it, to have legislative hearings before you even do the votes on it in committee. and we didn't do that. the bill was filed two days ago. on the 24th. i'm sorry yeah, it was filed march 24. we had a couple days with this bill. that's not adequate for something this important. it does add some means testing for seniors. it adds -- it appears very clear it's going to cost health care providers to have to add more clerical workers, people that don't do health care, they just do paperwork, so there will be more costs. we just didn't have a chance to adequately investigate the terminology of this bill and long-term effects it will have on health care. it's kind of important. this also came one day after we voted for a budget. that was important to get to the point where we could have reconciliation that lets us deal with important issues like obamacare. we passed a budget easily and we had a number of different buggets budgets we could vote for -- budgets we could vote for. i thought tom price did a good job of marshaling the efforts on that. the point is most of us were so focused on the budget through the vote yesterday that we really had one night to prepare on this s.g.r. with actual language that was filed on tuesday. i was good with the 63 pages dr. burgess had used last year, but there were over 200 pages. i really don't know the long-term effects of what we did. and that is why, though i have been lamoring for an s.g.r. fix i couldn't -- clamoring for an -- clamoring for an s.g.r. fix, i couldn't vote for it. we don't know what harm we may have done in that bill. we know we did some good, but we don't know what harm. we should have had more time to analyze this and take the language back to our physicians our health care providers, and say you're the one doing this. you're the one trying to save lives, enhance lives. what will this do to you? what will this language do to you? then come back and have the vote. i appreciate the work for those that have been spending so much time on the -- what's often referred to as the doctor fix. definitely needed that as another fix. this is more permanent. we don't know what the senate will do. and that's another one of our problems. there's some rather breathtaking news that has come out today about what the obama administration has done in the way of damage to the nation of israel. sounds like this action was extremely petty in an effort to slap israel without proper regard for the fact that they are the most important ally we have anywhere in the middle east. and one of the very most important allies we have in the world. . it's just breathtaking what was done and to put this in perspective, this article, march 23 from joel pollock says owe baum' -- obama's chief of staff earned ralkous chairs from the left-wing audience on monday when he attacked israel's occupation of the west bank, quote an occupation that has lasted almost 50 years must end end quote. j street was founded to disrupt the close u.s.-israel alliance and serve as an alternative to the american -- israeli public affairs committee, the powerful pro-israel group. well, that's interesting if we use the rationale about the israel occupation and how it must end, then that would mean that at the turn of the 20th century, if he had been around clammering for on behalf of this president around the end of the 1800's, he would have been saying it's time to end america's occupation of texas. had he been around in say 1823 speaking for president obama back then, had he been president then used the same reasoning, he would have been saying it's time for the occupation of our 13 colonies to stop and we give all the land back to england. this is no time for the 13 colonies to continue to occupy what we're calling the united states. it's time to give that back to england. it was theirs originally. french had some at one time and different claims, but basically quit occupying the united states and give this all back to england. it's time to give the rest of the united states, if he had been around if the early 20th century time to give back all the west to whoever had it before mexico, spain, whoever who may have claimed it. but that's not the way the world works. that's not the way the united states worked. native american tribes were constantly taking each other on different parts of the country taking over other's land, that's going on in the world. when you have a group of people living in the nays of israel saying that we refuse to ever recognize israel's right to exist, we want to wipe the jewish people off the map and wipe israel off the map, then that's not a nation that you sit down with. and when you have a nation like iran that is doing -- they make clear even as of last week that the top leaders in iran won't -- want death to america. well, apparently when this administration hears a religious fanatic that has killed american soldiers killed american civilians, has been at really -- been at the lead of killing americans wherever they could find them and have an opportunity to kill them. and want to wipe israel off the map as the little satan and wipe america off the map as the great satan and have continued to pursue nuclear weapons. and while this administration was rushing and continued to rush to talk to the leaders in iran it leaves some of us aghast of how blind the administration can be as to who is our friend and who is our enemy. but it was dennis mcdonough speaking to the group found to disrupt the close relationship between u.s. and israel, and he fired them up saying the occupation lasted almost 50 years must end, but it reminded me, oh yeah, i remember another speech he gave and this transcript is from the white house website, this was march 6 2011 and dennis mcdonough, the same guy who thinks we need to run israel out of the land of israel, he said this, and i'm quoting from the speech from the white house website. thank imam for your very kind introduction and welcome. i know that president obama was very grateful that you led the prayer at last summer's dinner at the white house, which as the president noted, is a tradition stretching back more than two centuries to when thomas jefferson hosted the first iftar at the white house. and let me interject here, glowing praise for the imam. this is the imam who was president of the islamic society of north america. islamic society of north america, background on them, they were named as a co-conspirator to fund terrorism in the largest prosecution in the united states's history for funding of terrorism. this was in the united states district court in dallas, in short referred to as the holy land foundation trial. they were the main defendant. the list of unindicted co-conspirators from that trial the council on islamic relations, the islamic society of north america and the north american islamic trust. these co-conspirators were not tried in the first round of prosecutions in dallas under the bush administration. but in november of 2008, all five defendants were convicted on a massive number of charges of supporting terrorism. the evidence utilized in the first round of the prosecutions some that participated would be used in another trial against other unnamed co-conspirators if they were successful in getting the first convictions, which they did. however, before the convictions were finalized, there was an election. president obama was elected president and we got a new attorney general and they decided despite what the evidence showed despite what the courts had found, they are not going to prosecute the islamic association of north america. care has a lovely building down the street from us here. i can see care from my window. but in the case in dallas care nate and isna they filed pleadings that the judge remove their names as co-conspirators in supporting terrorism. the judge reviewed the evidence and ruled that their names would not be struck as co-conspirators because there was plenty of evidence to support them as co-conspirators supporting terrorism. they appealed that to the fifth circuit court of appeals of the united states and the fifth circuit in their order confirmed that there was a case made that the entities care, nate and isna those associations had strong associations with hamas it's palestinian branch which was specifically designated as a terrorist organization by the u.s. government. so any way the organization here that the federal courts found had plenty of evidence to make a case against them as supporters of terrorism, have become partners with this administration. and that's why dennis mcdonough was getting the acclaim for demanding israel leave part of the israeli territory he was there back in 2011 giving praise to the imam thanking him for his wonderful prayers at the white house. this is a guy that's president of what two federal courts have said had plenty of evidence to show they are co-conspirators in supporting terrorism. and this business about oh, the long tradition going back to thomas jefferson and iftar at the white house that is the celebration during the month of august or after the fasting during the month of august for the religious observance of muslims, and it's the feast after the fasting. and if you go back to what they say was the first iftar under thomas jefferson doesn't appear to me that he was having an iftar dinner and wanted a dinner with the muslim leader and couldn't do it until the fasting was over. kind of like hearing people saying haveing thomas jefferson having a copy of the koran. he was a negotiator with pirates as to why they kept capturing the united states navy, but seamen and holding them for ran some. they had so many -- ransome. they had so many of our sailors we were paying a massive part of our budget for ransome to get them back. jefferson was one who negotiated and apparently asking why do you keep attacking? we don't have a navy. we are not a threat to you. and he was reportedly told in our religion we believe that if we die while attacking you, we go to paradise. jefferson was so well read and didn't think you could go to paradise if you killed people. got his english translation of the koran and his ultimate reaction was to send the united states marines to the shores of tripoli because he realized there isn't going to be any negotiation to deal with these radical people and only way to physically is to beat them in a fight to the finish and kept them off our backs. and that is dennis, speaking for the president in 2011, and then we know that the white house is doing everything it can to bend over backwards. the state department, iran, what can we do for you? we find out today they are going to have centrifuges spinning in their secret facility and they are going to let them keep having centrifuges spin there. and look they will do anything to get them to sign some kind of an agreement. bending over backwards but can't spare a minute to meet with the leader of israel, can't spare, the president, vice president or someone from the cabinet to come listen to netanyahu. oh no. but today, this outrage has come to light that the united states the obama administration has declassified a document that reveals israel's nuclear program to the world especially to iran and to those who want to destroy israel. so they will know exactly what they're after, what they're up against. this what has happened, what has come to light today this administration declassifying a document obviously, it's a slap at netanyahu. it's a slap at the israeli people from coming out in droves to support a group of representatives that this president doesn't approve of. so we are betraying this great ally of ours, israel. . if you believe the bible, judgment will be coming our down on our country for what our elected officials have done with israel. if you don't believe the bible, use common sense. when you betray your most trusted ally in this torn apart middle east, then you're going to have problems galore. i talked to leaders in those countries -- i can't now because the speaker won't allow me to go overseas to talk to them. if you don't support the speaker, that's fine, i'm fine with that. because he canceled my trip this weekend i'm going to be on fox news so thank you, mr. speaker. but somebody needs to stand up to them. this betreille is going to -- betrayal is going to do more damage in the world than the ♪ ity little act that was intended -- the snotty little act that was intended to slap at netanyahu and the israeli voters could possibly imagine. now if you believe dollar lessons worth noting in the bible, you could go back to king his kaija who entertained the babylonian leaders. if you believe the account in the pl bible, god sent hosea to his kaija -- to hezekiah, and said what did you do? he said, we met with these lovely, wonderful leaders from babylon so we showed them all of our treasure and then in the most correct translation he adds, and we showed them all of the defenses we have in our arsenal. isaiah basically says because you've done that you fool you will lose the country he gets to ask him, could i avoid losing it on my time. but this is the kind of thing that brings down nations and it was petty and it was a betrayal and people need to be called to account for it. i yield back. the speaker pro tempore: the gentleman yields back. for what purpose does the gentleman from texas seek recognition? mr. gohmert: pursuant to the house of -- order of the house of today i move that the house do now hereby adjourn. the speaker pro tempore: the question is on the motion to adjourn. those in favor say aye. those opposed, no. the ayes have it. the motion is agreed to. accordingly pursuant to the previous order of the house of today, the house stands adjourned until 1:00 p.m. on monday, march 30 2015, unless it sooner has received a message from the senate transmitting its adoption of house concurrent resolution 31 in which case thele house shall stand adjourned pursuant to was he set up by church hill or the someone in the admirality. i found no smoking memo and believe me i would have found a smoking memo fit existed. there was nothing from church thoil jackie fisher or somebody else saying let's let the louis taina go into the irish sea nothing like that exists. >> sunday night, at 8:00 eastern and pacific, on c-span's "q&a." >> president obama son the road today in birmingham alabama, to deliver marks on the economy at lawson state community college. we'll have live coverage starting at 4:10 eastern on c-span. yesterday a senate committee examined efforts to treat and cure alzheimer's dwesms heard about where researchers are in terms of developing a cure, the effectiveness of current treatments and think need for more funding to study the disease. also appearing before the committee was former model, actress and restaurateur bae smith. senate collins of maine chairs the committee. this is just under two hours. >> this hearing will come to order. we have convened this afternoon's hearing to assess our nation's progress in combating alzheimer's disease since the enactment of the national alzheimer's project act which i co-authored with then-senator evan bayh in 2011. i don't need to tell the people in this room what a devastating disease alzheimer's is. it exacts a tremendous personal and economic toll on the individual, the family, and our society. in addition to the human suffering it causes alzheimer's costs the united states more than $226 billion a year. including $153 billion in costs to medicare and medicaid. these costs will skyrocket as the baby boom generation ages. already, our nation's most costly disease -- already our nation's most costly disease, alzheimer's is projected to cost more than $1.1 trillion in 2050 if nothing is done to change its current trajectory. alzheimer's is also one of our nation's leading causes of death. the c.d.c. lists alzheimer's as the sixth leading cause of death overall and the fifth leading cause of death for those 65 and older. other estimates put the mortality rate much higher, at number three, right behind cancer and heart disease. moreover, in most -- and most frustrating, alzheimer disease is the only one of our nation's deadliest diseases without an effective means of prevention, treatment or a cure. it is now estimated that nearly one in two of the baby boomers reaching age 85 will develop alzheimer's. as the consequence, chances are that the members are my generation will either be spending our golden years with alzheimer's or caring for someone who has it. in many ways, alzheimer's has become the defining disease of this generation. if we are to prevent alzheimer's from becoming the defining disease of the next generation it is imperative that we dramatically increase our investment in alzheimer's research. just take a look at this chart. at a time when the united states is spending an astonishing $226 billion a year to care for people with alzheimer's, we are spending less than .3% of that amount. less than $600 million a year on research. and believe it or not, that's an increase that many of us have worked for. you can barely see the expenditure level on that chart. alzheimer's treats -- receives funding that is clearly disproportionately low compared to its human and economic toll. look at the second chart. we currently spend $5.4 billion per year for cancer research, $3 billion a year for research on h.i.v.-aids, and $2 billion for cardiovascular research, all investments that have paid dividends. these investments in research for other diseases have yielded tremendous results. patients have access to new treatments. death rates for some diseases are decreasing. yet at the same time, mortality due to alzheimer's is escalating dramatically. surely we can do more for alzheimer's and other diseases of dementia given their tremendous human and economic price. fortunately, there is promising research that holds hope for alzheimer's patients and their families. the rerge -- research community is poised to make important advances through clinical trials and investigating new therapeutic targets. but adequate funding is critical to its -- to advance this research. the national plan to address alzheimer's disease has as its primary goal prevent and effectively treat alzheimer's disease by 2025. to meet that goal, the chairman of the advisory committee on alzheimer's research care and services, dr. ron peterson, whom we will hear from shortly told our committee last congress that we will need to devote at least $2 billion a year to alzheimer's research. well, at first blush that may seem like a lot of money. but when you compare it to that $226 billion that we're spending caring for people with alzheimer's, it's less than 1%. and that's the context that we need to put it in. and that's why i've introduced a resolution with several of my colleagues stating that the senate will strive to double the amount of funding that our country spends on als himmers in fiscal year 2016 and develop a plan to meet the target of $2 billion over the next five years. this afternoon, or perhaps tomorrow, the budget is on the floor today i also will be offering an amendment to the budget, which i'm pleased to say is co-sponsored by my ranking member, senator mccaskill, as well as senator warner, senator too many mi and senator -- senator toomey and senator manson. we will be calling on the budget for that investment. this is an investment we must make to alleviate suffering and to prevent our health care programs from going bankrupt. i want to acknowledge all of the advocates -- who are here today from all over the country. we need your help, we need you to educate members of congress, and we hope that your presence today will be a powerful statement to all of our colleagues that they, too need to help us solve this devastating disease. senator mccaskill. senator mccaskill: thank you. i want to thank the chairman for her commitment to this issue. i think it speaks volumes to the people of this room that the chairman has scheduled this hearing so early in her tenure as chair of this committee. that should be a signal to you that she is committed and i can assure her and you that i, too, am committed to the issues that she has eloquently outlined in her opening statement. i think that with the chairman as an advocate on your behalf we are in a very good place. i also want to thank all of you for being here today. from all across the country. your spirit is inspiring, you have faced enormous personal challenges years of frustration, pain, sorrow, moments of hopelessness, and yet you find the strength to come here from all over the country and make your voices be heard. it is democracy at its finest hour as far as i'm concerned. i look forward to hearing the testimony today from a member of the witness panel that is from the missouri delegation here in washington today, kim stinley. i'll have an opportunity to introduce her more thoroughly in a few moment bus she's here as a caregiver and her experience in navigating the medical, financial and housing systems, i think, is probably representative of many of you in this room. i look forward to hearing her testimony and seing what we can do specifically to help those who are helping care for those with this serious disease. at one pointmark people believed that alzheimer's disease is a normal part of the aging process and treatment options were hopeless or unnecessary. we now know today that that's just flat wrong. if we make the investments now, we can in fact make treatment effective and we can make those treatments available to millions of americans and in fact citizens of the world. effective treatments are necessary to alleviate the tremendous human, economic and medical toll that this disease poses on our nation's families. we need to do something soon because this is a crisis. the cost for alzheimer's patients is set to reach $1 trillion, over $ trillion in 2050. think about that $1 trillion. that is not a sustainable cost for individuals families, or our federal budget. family care givers are on the unsung heros of the alzheimer's epidemic. they provide the largest portion of care for individuals with the disease. care givers typically experience more stress, anxiety and loss of productivity as a result of their increased responsibilities. while family care givers provide support for their loved ones for as long as they can many patients in the later stages of the disease require round the clock care and are moved to nursing homes. according to the c.d.c., nearly half of all nursing home residents in the united states have residents with alzheimer's disease. and with a few long-term care financing options, many families in fact, probably most families, depend on the medicaid program for their nursing home funds. it is estimated that 28% of the medicaid budget is spent on long-term care services. much of that for alzheimer's patients. i know that ms. stinley can speak of some of the challenges of accessing medicare and help for her hom. by the way, he mom worked hard all her life and retired with a pension but that was not enough to cover the high cost of nursing home care. it is important that we're talking about these issues this week because this is a week we're voting on the budget. i'm worried for our country and for families like ms. stinley's because the budget we are currently debating does massive cuts to medicaid. nursing home care and other health care services for seniors and disabled would be slashed by $5.4 billion in missouri alone. under the budget we're currently debating. these are middle class families that would be devastated by these cuts. i also want to echo the statements of the chairman about research. government investment in medical research has allowed our nation to be a beacon to the world for hope. for medical advancement. for being the country that is looked to. and that adds to our national security. because we are seen as such a leader in the world on medical research. funding the national institutes of health has flattened and suffered over the previous years. i am hopeful that the amendment that i am co-sponsoring with the chairman will be a moment of bipartisan agreement that we cannot continue to shirk our responsibility in the united states to advancing medical research there is no area that is more deserving of a -- of additional $s for medical research than alzheimer's. all that said, those are problems facing families once they have learned of the dige diagnosis. yesterday the alzheimer's association released their 2015 facts and figures report that found that about half of all people with alzheimer's disease that are care givers are not even aware of their diagnoses. that is incredibly troubling. we can't go back to the old days when people were not properly informed of their diagnosis in a misguided attempt to spare them the truth. not only are many individuals not being alerted but many believe the mortality rate for alzheimer's patients is much higher than projected. a study done by researches at rush university medical center found that als him sers likely the third leading cause of death following closely behind cancer and heart disease. we need to tackle the crisis head on and provide families such as years with as much support as think we canism look forward to thearg testimony from our panel of witnesses about how we can confront the looming challenges and plan for reaching treatment by 2025. thank you again for your leadership chairman collins. i want to thank all of you for being here today. senator collins: thank you, senator mccaskill. i should correct myself, senator moran is also a co-spon or sor of the amendment that we'll be offering to the budget for those of you from kansas out there. i just want to make sure i corrected the record. >> madam chair, may i be added as a co-sponsors? senator collins: absolutely. i'm so glad that senator till liss and ores have joined us, i know they care deeply about the issue. we now turn to testimony if the panel. i'm pleased that joining us today on the witness panel are barbara, better known as bea smith and her husband dan gasby. bae is a -- bea is a well known supermodel and covers fashion magazines. she's also an accomplished restaurateur for those of us who have eaten at her restaurant in union station. retailer actor and author. but nowhere are her grace, beauty and courage more evident than in her fight against early onset alzheimer's disease. dan gasby is an entrepreneur television producer, and entertainment executive and has stood by his wife's side every step of the way by sharing their story, ms. smith and her husband are helping to make a real difference and we thank you. next we'll hear from dr. richard hodis the director of the national institute on aging at the national institutes of health. dr. hodis also represents n.i.h. on the h.h.s. secretary's federal advisory council on alzheimer's disease research, cure, and services. he also coordinates the n.i.h. research efforts under the national plan to address alzheimer's. we will then hear from dr. ronald peterson, whom i mentioned previously he is the director of the mayo clinic, alzheimer's disease research center and the mayo clinic study of aging. in 2011, he was appointed to serve as chair of the advisory committee. kimberly stinley has already been introduced by our rarninging member. she's from st. louis and will be talking about the challenges that our nation's many care givers of alzheimer's patients face every day. we welcome you as well. and finally, it is a great pleasure to welcome to the committee dr. heidi wireman who is with us here today. for more than 10 years she has served as the geriatric physician at maine medical center in portland, maine, and she specialized in the challenges that both physicians and care givers face when caring for an alzheimer's patient. again, it's truly touching to see the sea of purple gathered in the hearing room today but it's also a stark reminder of how many individuals and families' lives are affected by alzheimer's system of i i want to thank the advocates who have traveled to washington. we look forward to hearing from the testimony and we will start with bea smith. ms. smith: thank you all for having us here today. i haven't been spending a lot of time down here but i'm getting back on the saddle these days. so, it's been a tough time for me because i do have early onset alzheimer's disease and i'm here because i want to make a difference. i'm here because i don't want anybody else to have to go through this. i'm here to ask you to make a difference, not just for the five million americans who have alzheimer's and their care givers but for the future generations who will face that. this has been -- this has been something that is very new to me because i've been so healthy for such a long time that i've never had anything like this, but what i'm going to do is i'm going to fight. i'm going to do exactly what i can to be the best and to be better than the other person that i really even was so that -- there are lots and lots of people out there who are probably feeling the way i'm feeling. like this should never have happened to me, that type of feeling. i'm sure there are many people but there are many problems out here also. so i feel that i'm ready to work. i'm ready to do what i have to do to be the best that i can be and to help as many people that i can help. if i have to tell somebody that they shouldn't do something because, i'll do it and they'll tell me i want to do it or i don't want to do it. but it's important to me, it's always been health and wellness has been something that has been a big part of my life and a part of helping young people. and so today i'm excited to be here i'm happy to be here and i thank you very much. i've got a lot to do in my future and i'm going to do it and i'm going to do it the best way ai can and if i can help people and they can help me and we can do it together, that's fine. however we do it, we just have to do it. senator collins: thank you so much. mr. gasby. mr. gasby: thank you, senator collins. i want to thank you for having me ranking member mikulski. i love my country. i'm proud to be an american. i'm a kid from brooklyn and i never thought i would have an opportunity to try to make a difference. s the one time that i know that i can make a difference because i've seen what my wife has gone through. i've seen a woman who virtually could do everything, who could sing who could dance, who could look at food and taste it and then cook it exactly the way it could be in a cookbook. who did a television show who did a hundred radio and television commercials. who basically always gave back. and now has to wait and -- has to wait for people to help her. i'm reminded of the song that, of all people, jay-z and kanye west wrote and it's -- there's a lyric in there, called "the paint ain't cheap." and this -- the paint ain't cheap for the five million americans who are suffering with alzheimer's disease. the paint's not cheap for the 15 million care givers that each and every day, every waking hour, have to struggle as we do. as a couple. my best friend. watching her get up, try to do things, look me in the eye and say, honey, i'm broken. and when you see someone that you know knows that they can't do what their body and mind have told them for 55, 60 years, you realize that you've got to try to step out step up and make a difference. i'm here to tell you that the pain is not cheap because if we don't do something now the price we're going to pay 10, 15 years down the road, by 2050 when it's estimated that 15 million people will have alzheimer's and as you so accurately said the cost will be over $1 trillion. the greatest resource that we have in our country is our intellectual ability. the greatest resource that we have in our country is a two-party system a democracy at work. the greatest resource we have is what we learned from generation to generation that we passed down. when you have alzheimer's, what you have is people lose that perspective. people in their 40's now, 50's. 50's and beyond. you lose the ability to give people behind them the sense of accomplishment, the sense of understanding, and the sense of hope. you know, we have a modern day social tsunami this is what alzheimer's is when you look at it, when you look at what my wife has gone through, when you look at what is ravaging the african-american community, i'm twice as likely to have alzheimer's as my caucasian counterparts. when you look at the fact that within that community, my community, we're getting tested and treated and found at a later stage so the chances of being able to retard or hand they will situation is going to be more costly than ever, you realize that we've got to stop it right now. now, we've invested millions of dollars, billions of dollars, as you said earlier in heart disease, and cancer, but we pay a pittance to alzheimer's disease. and we know that by using a pet scan we can determine that there's am lloyd -- that there's amyloyd beta plak in the -- plaque in the game, we -- in the brain, we can take better care of ourselves so we can help slow down the progress, so we can develop the means and methods to make a difference. i'm here today because i believe in america. you know, 30 years ago if you walked around with a telephone, you had it on your back. and today, when you walk around it's in your hand. i know that we can take the gene code and break it down that used to take forever to even figure out we had genes and now we understand the differences in different population groups. i know that drug trials make a difference in different populations that will help the efficacy of drugs, testing and treatment and bringing positive, powerful new medicines to market. i know that we have within the breadth and depth of this great country the people who are committed. last night i was at the alzheimer's dinner. and i saw a thousand people plus who all know that the pain from alzheimer's is not cheap. but what i saw there last night was a team. i saw a group of people from the deep south to the far west, from the heartland of america to new england. all looking each other in the eyes and saying, you know what? we're at the tipping point and we're going to push this thing over system of i come here today to tell you i don't believe in big government. i believe in good government. and i know that what's happening in this committee is going to change the face of the alzheimer's community. last night i sat at a table with 10 other people and there was a young boy there. his name was tyler. and while we were talking about all the things that were going on and we were listening to lisa genova who wrote the book for "still alice," i was looking at him and all i could think was, here's a 12 or 13-year-old that if i said to him right now what's a ka set deck? he'd go huh? if i said to him, what's an eight-track, he'd go what? i want that young man that young boy tyler to, when his kids are his age, he can look back and say, i remember when we conquered alzheimer's, and the kids are going to say what? huh? we have it with within our capacity here in this country to make that difference. and i want to be part of it. not just for her but for the future tylers in this country. thank you. senator collins: thank you both for such eloquent testimony. senator collins: thank you so much. dr. hodis. dr. hodis: let me begin by thanking you for the opportunity to be here and for the support you, congress and the administration provided to n.i.h. and the research. dr. hodes: and for the opportunity to be part of what we're doing. i'd like to spend the next few minutes to give some examples of the state of research in alzheimer's disease. the state which gives us great hope more than ever before, that what we're seing now will lead to improvements and the ability to treat and cure alzheimer's disease. if we can move to the next line this probably needs no elaboration. this is referred to by chairman collins, but it's an illustration of where we stand now in terms of the number of people affected by alzheimer's 5.1 million or 5237b9 million and the projected increase, two to three-fold if we don't change course. and to the right in the bar the estimates of cost, already showing alzheimer's disease to be the most expensive illness in this country. it's imperative we succeed in changing this trajectory. next slide. some examples of what were alluded to. dan gasby referred to imaging as an indication of the ways in which we gain insight into what's going on with alzheimer's disease, not possible a few years ago. these are scans that look at amyloid a beta and tau. things that are seen in 1906 that until recently were only identifiable at autopsy. you see the slides here, cognitively normal individuals with relatively little. the next slide, individuals with alzheimer's. you can see the increase in both plaques and tang unless those brains. but the situation is even more complex and challenging that that. if we look at the next slide, here's another individual, cognitively normal who has accumulations of amyloid and tau into the brain. and we're gaining insight into these as potentiallierly stages of the disease, before symptoms, potentially before they're irrespo -- irreversible damage done so we can intervene and prevent symptoms. and the next slide another illustration of progress made. apologize for the difficulty in reading it. it's a time course of genetic discoveries. it shows in the early 18990's, we discovered the genes that were -- 1990's, we discovered genes responsible for rare forms of alzheimer's. and then there were several years didn't discover anything knew but then we got the genes that we understand. remember those genes that cause als himmers in families? we're able to identify in these families including this family shown, a family in south america, identifying years and decades before we know they have the idea. -- disease. bottom slept a relatively normal scan of individuals in the -- in their 20's whether they have the gene or not. to the right individuals who didn't inherit the gene look relatively normal whereas to the bottom right, those gene carriers who are already showing signs of disease decades before symptoms. and it's in these individuals we're beginning to do prevention studies before damage and loss of cognitive function occurs with hope that we can make a difference. next slide. just to emphasize that these studies are being done in great and novel partnerships with public and private sector investing to the common goals of identifying new targets for alzheimer's disease and studies to have treatments and conditions where we can monitor changes and tell early in the course of the studies whether there's success or not in these interventions. next slide. to turn to another important aspect even as we search for cures and early insights into the molecular diagnoses. we recognize the importance of doing all we can for those living with the disease and those who care for him. s the example of a caregiver study, reach, designed to look at interventions to make life better for people with alzheimer's and those who care for them and the study as any other clinical trial was judged to be a success. it was enormously successful. allowed people to live at home longer. prevented against the increase risk in disease in care givers. and it's now being done through the v.a. and the administration on aging nationwide in an effort to decrease the burden of those who take on the most important job of caring for those living with alzheimer's disease. next line. final -- next slide. finally, just want to illustrate under the aegis of the national plan which has provided a new and intensitied -- intensified focus, the goal of curing and preventing alzheimer's by 2025 along with equally important goals about care and tracking progress through time. i thank you for the opportunity to give you this brief summary of some of the reasons for real excitement and optimism and look forward to address anything questions you may have. thank you. senator collins: thank you very much. dr. peterson, welcome back. dr. peterson: thank you, chairman. good afternoon chairman collins, ranking member mccaskill and members of the special committee on aging. i'd like to thank the committee for the opportunity to discuss the importance of alzheimer's disease and also commend senators collins and klobuchar for introducing the resolution to double the funding for alzheimer's disease research in 2016 and achieve the goal of increasing the annual research budget. in 2010, congress passed and the president intined -- signed into law in 2011 the national alzheimer's act, requiring the secretary of health and human services to generate the first plan for this country to address alzheimer's disease. the advisory council completed recommendationers in 2015 plan in january. the primary goal of the plan as dr. hodes just mentioned is to effectively treat and prevent alzheimer's disease by 2025. this goal is but a short 10 years away. an essential feature of the recommendation submitted to the secretary and the congress includes the recommendation that the federal government spend at least $2 billion a year in research on alzheimer's disease. as chairman collins has indicated, this figure is -- pales in comparison to what we spend on cancer, hiv-aids and cardiovascular disease yet in those diseases there have been significant progress made with n reducing the number of deaths per year. yet the annual death rate for alzheimer's is escalating. again, alzheimer's disease is an incurable dised or we are no survivors. in 2013, united kingdom prime minister david cameron used the final ovepbt the g8 presidency to host a summit on dementia. in preparation of that -- for that, we wrote a column for "the lancet," asking that member countries consider spending 1% of their annual care budget on research. in 2014, the united states spent $226 billion caring for people with alzheimer's disease. and if we were to spend 1% of that figure on research, we would reach the $2 billion figure recommended by the advisory council and senator collins. last week in geneva, switzerland, the world health organization sponsored the first minute steerl conference on global action against dementia. at that meeting, i presented some figures similar to what dr. hodes has just shown as to what the current number of individuals with als himmers are in this country, what they're projected to be by 2050. then we superimposed the scenario of what if we delayed the onset of the disease by five years? how would those numbers be impacted? another scenario would be what if we were able to slow the progression of the disease? we might have the same number of individuals, but more people with a lesser degree of impairment. or preferably, doing both of those. in a recent resport from the alzheimer's association, it is projected that if a treatment were to be introduced by 2025 that would delay the onset of alzheimer's disease by five years, that treatment would reduce the number of individuals affected by the disease by 5.7 million by 2050 and save all the payers including medicare, medicaid and families more than $220 billion within the first five years. as recommended by the advisory council if the government were to invest $2 billion per year, the country would recoup this investment within the first three years after a treatment became available. all of the economic models converge on this point. they indicate that the savings to the federal government would more than capture the increased investment in research in a relatively short period of time with an effective therapy. i would like to commend my colleagues at the department of health and human services for their work toward enacting the national alzheimer's plan thus far. great strides have been accomplished in coordinating federal agencies and improving federal capabilities with respect to alzheimer's disease. however, a great deal of work needs to be accomplished since we are not close to our goal of effectively treating and preventing the disease by 2025. i can say with confidence that the research community is poised to make a significant contribution toward the goal of -- if adequate funding were available. as outlined by dr. hodes of the national institutes on aging, he and his staff have established milestones for the execution of the plan and now with the passage of the alzheimer's accountability act, our work -- are working diligently to proprepare a professional judgment budget to submit to congress outlining expenditures necessary to accomplish the goals set forth in the national plan. we cannot wait until there's a more convenient time to increase funding for this disease. projections indicate that alzheimer's disease will bankrupt the health care system as we know it today. we simply cannot afford to spend the aforementioned over $1 trillion a year as projected in 2050 to care for individuals with alzheimer's disease. the impact on individuals and families is enormous. the cost to society is unsustainable. we appreciate the difficult constraints under which the federal government is currently operating. but our patients and families cannot wait. with 10,000 baby boomers turning 65 on a daily basis, problem is not going to be resolved by itself. we are all poised to make a difference given the opportunity and considering there was a recent report of a new and promising drug made at an international meeting last week in nice france, we are encouraged that something is in the pipeline. ultimately, it will be up to the individuals such as those on this committee to make very difficult decisions regarding funding for alzheimer's disease and related disorders going forward. we call upon congress to make bold decisions to alter the cost of this disease now so that it is not a burden to the next generation and proid -- providing them with an intractable situation. the national plan to address alzheimer's disease hasest tablied a blueprint to make this possible and we need your support. i appreciate the opportunity to address the committee. thank you. senator collins: thank you, doctor. ms. stinley. ms. stinley: good afternoon. on behalf of the 15.7 million care givers for individuals living with alzheimer's disease and other demen shah, thank you for the opportunity to -- dementia thank you for the opportunity to testify before you today. ms. stemley: aleds him sers a deadly -- a progress i have and ultimately fatal disease. the men and women living with alzheimer's are your friends your neighbors some may even be your family members. they are business leaders, school teachers, store clerks and construction workers. they are both republicans and democrats. and my beloved mother, dorothy stemley is one of them. i am honored here today to share our story. and discuss issues facing people with alzheimer's and their care givers. i find the more vocal i am about how this disease has impacted my family, the more i hear from other people who have gone through or are going through similar situations. today, my mother is living in the skilled nursing facility in missouri. and i'm confident that she is receiving appropriate care and she's in the right setting. however, getting to this point was a challenge. and there are many families out there who never get the care and support they desperately need to face this terrible disease. for several years, my mother and i were in denial about the changes in her behavior. i did a great job rationalizing unusual incidents and she did an even better job hiding others. with all the rationalizing and denial came -- but all the rationalizing and denial came to an abrupt halt when i received a phone call from a stranger telling me my mother was in the middle of martin luther king drive in columbus. alone and confused she slept all night in her car on the side of the street. my mother was a long way from home and that day marked the beginning of our journey with alzheimer's. my mother's diagnosis was the result of three different evaluations. neurologists perform a number of blood and cognitive tests on her, ultimately concluding that it was in fact alzheimer's disease. so there i was, an only child, caring for my single mother, who had alzheimer's. i knew then that the world we had shared was no longer and at the age of 30 i was thrown into a world that was completely foreign to me. a world of alzheimer's disease and i felt completely lost. after her diagnosis we didn't receive much information from her doctors about the disease or much advice on what to do next. a friend of mine recommended looking online for help. i found the alzheimer's association, which was the first time light began to shine through the darkness. i was able to learn about the disease what the digedige know sis meant for myself and my mother as well as what our next steps should be in considering options for her care. i also learned how to cope with all the emotions i was feeling throughout the whole process. this is important because the stress of -- stress of being a caregiver was only compounded by the stress that i faced at work. my physical health started to suffer. i would wake up in the middle of the night with back spasms and my back pain was so severe that my own doctor recommended i make a lifestyle change just to maintain my own health. i did. and now i exercise three times a week and i have been eating a healthier diet. however, the emotional part of it continues to be very difficult for me and when i see my mother now it feels like day one every single time. at the time she was diagnosed my mother was living aloan. she exhibit -- alone. she exhibited other warning signs that raised concerns about her safety. for example, she started a fire in her condo one day and although no one was hurt, i knew then it was time to consider other living arrangements for her. we moved her into a seniors independent living apartment which provided her with the security hospitality and social outlet that she needed. she was able to live there on her own for another four years until her memory loss progressed to the point where additional care and attention were needed. the next step was my own personal nightmare coming true. moving my mother to the skilled nursing facility where she currently lives today. although my mother worked for 33 years and retired with a healthy pension, the high cost of long-term care exhausted her funds. we needed the medicaid program to afford the long-term care and i am very grateful for the assistance. based on my experience i know i'm not the only one who has had difficulty getting help after learning about an alzheimer's diagnosis. i have experienced firsthand the gaps in our health care system when it comes to dealing with this disease. far too many physicians are not familiar with how to properly advise patients and their care givers after an alzheimer's diagnosis. it took a friend's adrice, not my mother's health care provider, and finding the alzheimer's association for us to even get basic information about what to expect next. no one could ever feel as lost or no one should ever feel as lost as i felt back then there is no treatment for alzheimer's disease, however, there are many things that can be done to improve a family's ability to cope with the disease especially immediately following a diagnosis. this is why the hope for alzheimer's act which was reintroduced this week, is critically needed. the hope act would ensure that families like mine who are facing an alzheimer's diagnosis are provided with care planning services to help guide them through their next step. to some extent, i feel blessed. i eventually found the resources and support i needed to manage my mother's condition and my own well being. if hope had been around at the time of my mother's diagnosis, i'm certain that i would have felt much less alone in this fight in the beginning. until a cure is found we must work to support the family, the care givers and people with the disease immediately following the diagnosis. we need care, we need help. which is exactly what the hope for alzheimer's act would provide. i've also had the opportunity to speak with many researchers about the current progress that has been made toward the development of a cure for alzheimer's. i'm disheartened because i realize that despite progress, we still have a very long road to walk. seeing advancements in other areas as the result of strong federal investment and research makes me think of the opportunity that exists for scientists to develop a truly ground breaking treatment for this disease. one that could spare millions of families the same heartache i feel every time i see my mother. i always say that alzheimer's disease is one of the worst out there. i implore you and all of your congressional colleagues to work to provide additional funding. for alzheimer's research. research is the only way we can truly create a world without alzheimer's. i thank you for the opportunity to testify today. i appreciate the support of the committee and its focus on improving the lives of those affected by alzheimer's disease. if there's one thing i would ask that you would take away from my testimony, it would be that alzheimer's disease not only impacts a diagnosed person but those that love them very dearly. thank you so much. senator collins: thank you very much for giving us your per spisket. -- your perspective. dr. wireman. >> good afternoon, chairman collins, ranking member mccaskill and the distinguished members of the special committee on aging. dr. wierman: i'm pleased to be here to give you my thoughts on working with people with dementia and their care givers. i'm a geriatrician in maine and clinically my work is focused on demen shasm i evaluate individuals and work with their families at our outpatient geriatric center and i work with the hospital working to prevent complications for older adults that are hospitalized as the medical director for the hospital i work to prevent delirium. it changes the trajectory of their dementia in a negative fashion. dementia really is a looming crisis for our state and the nation. maine has the oldest median age, nearly six years older than the average median age in the united states, which means we have fewer working age individuals to help care for our older adults and particularly those with dementia as their disease progresses. projections for maine are that the 65 and older population is the only population that's going to grow in the next 10 years. our total population will remain flat at about 1.3 million, but we currently have about 37,000 individuals diagnosed with dementia and it's projected to increase by nearly 50% to about 53,000 in five years. dementia is an epidemic and it will have dire consequences on our economy, our health system and our family structure if we do not act now to do something. it stresses our state in many ways including increased burden on care givers both paid and unpaid. lack of state housing. needs for transportation in our rural state. and a health care system haas already overburdened. in maine about 2/3 of patients with dementia die in nursing homes. we have fewer younger people which means fewer formal and informal care givers to help. within our health system at maine health we are experiencing significant challenges already finding suitable living environments for hospitalized patients with dementia when they can no longer be cared for at home. this results in patients remaining at the wrong level of care in an acute care hospital when what they need is an environment designed to care for them with their chronic and progressive dementia. this puts a lot of stress on families, on the patients themselves, as well as the medical community providing the care. it creates a tremendous financial burden. diagnosis and treatment of patients with dementia is not a routine part of clinical training for most providers and staff and many care settings. it's critical that our prie primary care system become prepared to deal with cognitive assessment and care planning to provide resources that individuals and their families need to deal with this progressive disease. currently dementia is a chronic, terminal illness and we need to prepare our health care system and communities to provide planning and support to patients once diagnosed, even as we search for that cure. i would like to take a moment to share a couple of stories. i have utilized student m's for these stories. i first met mr. and mrs. keller about 10 years ago when i diagnosed mr. keller with mild cognitive impairment. sadly, his disease p

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