`[Congressional Record Volume 155, Number 8 (Wednesday, January 14, 2009)]
[House]
[Pages H203-H216]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  PROVIDING FOR CONSIDERATION OF H.R. 2, CHILDREN'S HEALTH INSURANCE 
                  PROGRAM REAUTHORIZATION ACT OF 2009

  Mr. HASTINGS of Florida. Madam Speaker, by direction of the Committee 
on Rules, I call up House Resolution 52 and ask for its immediate 
consideration.
  The Clerk read the resolution, as follows:

                               H. Res. 52

       Resolved, That upon the adoption of this resolution it 
     shall be in order to consider in the House the bill (H.R. 2) 
     to amend title XXI of the Social Security Act to extend and 
     improve the Children's Health Insurance Program and for other 
     purposes. All points of order against consideration of the 
     bill are waived except those arising under clause 9 or 10 of 
     rule XXI. The bill shall be considered as read. All points of 
     order against the bill are waived. The previous question 
     shall be considered as ordered on the bill to final passage 
     without intervening motion except: (1) 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 (2) one motion to recommit.

  The SPEAKER pro tempore. The gentleman from Florida is recognized for 
1 hour.
  Mr. HASTINGS of Florida. Madam Speaker, for the purpose of debate 
only, I yield the customary 30 minutes to the gentleman from Texas, my 
friend, Mr. Sessions. All time yielded during consideration of the rule 
is for debate only.


                             General Leave

  Mr. HASTINGS of Florida. I ask unanimous consent, Madam Speaker, that 
all Members have 5 legislative days within which to revise and extend 
their remarks and to insert extraneous materials into the Record.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Florida?
  There was no objection.
  Mr. HASTINGS of Florida. I yield myself such time as I may consume.
  Madam Speaker, H. Res. 52 provides a closed rule for consideration of 
H.R. 2, the Children's Health Insurance Program Reauthorization Act of 
2009.
  I really am honored and privileged to have the opportunity to present 
this rule to the body. The rule provides 1 hour of debate, equally 
divided among and controlled by the chairperson and ranking minority 
member of the Committee on Energy and Commerce and the chairperson and 
ranking minority member of the Committee on Ways and Means.
  Madam Speaker, the SCHIP reauthorization bill of 2009 is a fiscally 
responsible way to revive our commitment to providing America's low-
income children with the quality health care they need and deserve. The 
bill authorizes $32.3 billion over 4\1/2\ years to cover the seven 
million children who currently rely on SCHIP, and extends coverage to 
more than four million low-income children who are currently living 
without health care. The bill offers comprehensive and wide-ranging 
care that includes mental, dental, prenatal, and maternal health 
services.
  The underlying bill also supports a multifaceted approach to 
increasing health insurance enrollment. It provides States with 
incentives to lower

[[Page H204]]

the number of uninsured children and authorizes $100 million in grants 
for new outreach programs in schools and community-based organizations.
  Additionally, the bill fights geographical health disparities by 
offering additional support to underfunded States that meet these 
enrollment goals, and improves reporting on State health conditions.
  Lastly, this bill has provisions that ensure that SCHIP prioritizes 
children who legally reside in the United States. The bill prohibits 
new waivers that would cover parents, phases out SCHIP coverage for 
parents and childless adults, and includes measures that prevent 
payments to unlawful immigrants.
  Madam Speaker, when all 50 States, the District of Columbia and five 
territories--and perhaps the sixth, the Northern Marianas, now that 
they're included--gave children health care under SCHIP, our government 
exemplified our Nation's commitment to equal opportunity. SCHIP has 
prevented millions of low-income children from suffering under our 
country's flawed health care system for over 10 years. And adequately 
supporting and expanding this valuable program is even more imperative 
during these hard economic times.
  Madam Speaker, the '08 financial crisis exacerbated our longstanding 
health care crisis. Last year, skyrocketing gas and food prices and the 
plummeting job market made it difficult for lower and middle income--
indeed, for all Americans--to finance their everyday needs, 
importantly, including health care.
  In a country where a large portion of people receive health care 
insurance through their employer, it comes as no surprise that when the 
economy and job markets plunge, the number of uninsured Americans 
soars, and children frequently pay the highest price. Even prior to 
last year's economic crisis, the number of children who depended on 
SCHIP and Medicaid was increasing.
  Madam Speaker, the facts are clear: One in nine American children are 
uninsured. And this issue hits close to home. Florida was ranked 45th 
in the Nation in terms of overall health. Like other low-ranking 
States, Florida has a large uninsured population and a high rate of 
child poverty. In fact, Florida has the second largest number of 
uninsured children in the country.
  Although these statistics are inexcusable, our current President's 
failure to address the alarming number of uninsured children in this 
country was and is an outrage. The President committed an egregious 
action, in my opinion, against our children when he repeatedly vetoed 
the bipartisan SCHIP Reauthorization Act of 2007. For many States, the 
annual funds allotted to State SCHIP programs were on the verge of 
depletion, and the welfare of millions of children depended on whether 
Congress and the President would agree to adequately finance SCHIP. 
President Bush's action sent a devastating message. The leader of the 
free world was willing to put the lives and welfare of millions of 
American children at risk.
  Now, in this new Congress, and with a new administration, we have the 
power, the political will, and the opportunity to make a different 
choice. Like-minded Democrats and Republicans and independents 
understand that fighting the epidemic of uninsured people in this 
country is a fundamental component of restoring our economy. We know 
that SCHIP and other health care programs decrease costly emergency 
room visits and invasive medical procedures. We know that extending 
health care insurance helps to combat the social, economic and health 
disparities that continue to divide our Nation and hinder our progress. 
And we know that healthy children are better equipped to compete in 
school and help America compete in the global market.
  Simply put, we cannot have a healthy economy without healthy people. 
And this must begin with our children. I urge adoption of this rule and 
passage of the underlying legislation.
  Madam Speaker, I reserve the balance of my time.
  Mr. SESSIONS. Madam Speaker, I want to thank the gentleman from 
Florida as we begin a new year and a new Congress with an opportunity 
to work not only with the gentleman, but also my colleagues from the 
Rules Committee, and you, Madam Speaker, during this new Congress. And 
I thank the gentleman for yielding me the time that he has done.
  Madam Speaker, I rise today in strong opposition to this rule and to 
the ill-conceived underlying legislation. I think the premise that I 
have heard my friends on the other side of the aisle talk about today 
of making sure that we just expand this program to meet every single 
need of every single child is not what this program was designed for, 
and a $35 billion expansion of the program will help bankrupt this 
country and the States that try and provide the services also.
  I do not support this bill or the way it has been brought to the 
floor either. My Democrat colleagues on the other side of the aisle who 
promised to be the most open and honest ethical Congress have once 
again given Republicans absolutely no say in the process, and they are 
completely disregarding President-elect Obama's promises to work 
together to solve the problems of this country.
  Today, House Democrats have once again chosen to force their own 
legislation through a biased rule that we are here debating on the 
floor of the House right now. This bill has been brought to the floor 
today without one committee hearing or markup. The current SCHIP 
program expires on March 31, and so I would ask my colleagues, why 
aren't we having hearings? Why aren't we having input from House 
Members? Why aren't we consulting Republicans in this process? In fact, 
Republicans only received the text yesterday morning. And today's rule 
once again limits the Republican opportunities for any chance of reform 
or ideas, confirming the Democrats' plans to govern this House without 
any input from Republicans.

                              {time}  1045

  Democrats over the past few years have demonized me and my Republican 
colleagues for not expanding the current State Children's Health 
Insurance Program to unprecedented levels, and they continue to cry out 
that Republicans are anti-children. I would like to remind them that it 
was a Republican Congress that initiated this program over a decade 
ago. It was begun to make sure that children that had no health 
coverage could gain that coverage.
  However, my colleagues and I recognized the need for SCHIP, and we 
see that we need to help low-income, uninsured children whose families 
earn too much to qualify for Medicaid but not enough to buy private 
coverage. For that reason SCHIP was created and today covers about 6.7 
million children in our country.
  However, today we find that the Democrats' proposed $35 billion 
expansion of a program that has not yet accomplished its original 
intent is now being taken to unprecedented levels by my friends on the 
other side of the aisle. My Democrat friends want to continue to push 
their government-run health care agenda even though this legislation 
moves some 2.4 million children who are currently on private health 
insurance to an inferior public program with less access.
  I'll repeat that. The numbers that my friends have been talking about 
of expanding this to children across this country, 2.4 million of them 
already have private insurance.
  That's a mistake. It's a mistake. So now what we're looking at is 
that Medicaid programs facing extreme shortfalls and physicians who are 
scaling back on Medicaid and SCHIP patients due to extremely low 
reimbursement rates will now take on these additional children.
  Why would we want to subject 4 to 6 million more children to this 
kind of care? Madam Speaker, it seems like my Democrat colleagues are 
putting their agenda first, not our American children.
  This legislation turns an innovative idea on its head by increasing 
government spending exponentially, leaving taxpayers to foot the bill 
when their budget gimmicks fail to create the necessary ability to fund 
properly these programs. This bill has no income limits for 
eligibility. None. And it allows coverage for families making up to 
$83,000 a year and has no annual authorization limit and allows States 
to decide who qualifies, leaving adults and illegal immigrants to 
compete against low-income American children.

[[Page H205]]

  Madam Speaker, it should be important that we should meet the current 
goals of the program and expectations before we expand that program. 
For that reason some of my Republican colleagues and I sent a letter to 
our new President-elect, President Obama, and Speaker Pelosi outlining 
what we think Republicans would like our Democrat colleagues to 
understand and consider before expanding the current SCHIP program. I 
would like to include this as part of our deliberations today.

                                Congress of the United States,

                                 Washington, DC, January 12, 2009.
     President-elect Barack Obama,
     Presidential Transition Office,
     Washington, DC.
     Hon. Nancy Pelosi,
     Speaker, U.S. Capitol,
     Washington, DC.
       Dear President-elect Obama and Speaker Pelosi: Thank you 
     for expressing your desire to work with us to address the 
     needs of the American people. We recognize that reauthorizing 
     the State Children's Health Insurance Program (SCHIP) is an 
     early legislative priority, and we hope that you will 
     consider this legislation to be one of the first 
     opportunities for bipartisan cooperation.
       During the last Congress, significant efforts were made in 
     an attempt to address concerns raised by House Republicans 
     about how the underlying bills would impact uninsured 
     children. Despite the progress that was made, there are still 
     a few outstanding issues that we hope you agree should be 
     addressed when we work to reauthorize the program this year:


               Serving Eligible Low-income Children First

       SCHIP is intended to serve those that are neediest first. 
     As low-income families continue to face more economic 
     insecurity, providing access to affordable health care 
     coverage, regardless of any job change or displacement, 
     should be our first priority. The legislation should demand 
     success from the states in enrolling poor and low-income 
     children below 200 percent of the federal poverty level, 
     especially those who are currently eligible for Medicaid and/
     or SCHIP, but are not yet enrolled. Demanding success from 
     the states could be as simple as requiring that states meet a 
     threshold of enrollment before further expansions. Nearly all 
     the states have demonstrated over the past year to the 
     Centers for Medicare and Medicaid Services that meeting this 
     standard is indeed possible.
       Furthermore, in the current economic environment, several 
     states have indicated that they will be experiencing 
     shortfalls that could impact their ability to provide 
     Medicaid benefits and services. Asking states to expand their 
     SCHIP program before they are able to finance their existing 
     Medicaid program would be a mistake. Expanding SCHIP to 
     higher income families will only exacerbate the real access 
     to care problem in the Medicaid program.


                           Citizenship Status

       We believe that only U.S. citizens and certain legal 
     residents should be permitted to benefit from a program like 
     SCHIP. We also think it is fair to say that both parties 
     believe that our immigration system is broken. That is why it 
     is so important that the legislation include stronger 
     provisions to prevent fraud by including citizenship 
     verification standards to ensure that only eligible U.S. 
     citizens and certain legal residents are enrolled in the 
     program.


                  Protecting Private Insurance Options

       We agree that those with private coverage should not be 
     forced into a government-run plan. SCHIP legislation should 
     focus expansion efforts on children who are currently 
     uninsured instead of moving children who have private health 
     insurance options into government-run health insurance. 
     Moving a child from private health insurance to government-
     run health insurance should not be part of your stated goal 
     of providing SCHIP for 10 million children, a number we 
     assume to be targeted towards low-income uninsured children.


                         Stable Funding Source

       In order to guarantee access to the program and long term 
     stability, SCHIP should be funded through a stable funding 
     source, not budget gimmicks. Further, the legislation should 
     not include extraneous provisions unrelated to SCHIP that 
     limit patient choice or prohibit access to quality medical 
     care. Our nation's Governors need a stable SCHIP program so 
     they may properly budget. Every American faces the crushing 
     burden of a declining economy. This should not be a time 
     Congress raises taxes, especially on the poorest Americans, 
     to finance program expansions as part of the SCHIP 
     reauthorization bill.
       We believe these to be critical elements to improve this 
     vital program that if fully incorporated would dramatically 
     increase bipartisan support for the legislation. Thank you 
     for the consideration of this request. We look forward 
     hearing from you and working with you towards a bipartisan 
     agreement.
           Sincerely,
         Robert Aderholt, Steve Austria, Michele Bachmann, Spencer 
           Bachus, Gresham Barrett, Roscoe Bartlett, Joe Barton, 
           Judy Biggert, Gus Bilirakis, Rob Bishop, Marsha 
           Blackburn, Roy Blunt, John Boehner, Mary Bono Mack, 
           John Boozman, Charles Boustany, Kevin Brady, Paul 
           Broun, Henry Brown, Ginny Brown-Waite, Michael Burgess, 
           Dan Burton, Steve Buyer, Ken Calvert, Dave Camp, Eric 
           Cantor, John Carter, Bill Cassidy, Jason Chaffetz, 
           Howard Coble, Mike Coffman, Tom Cole, Michael Conaway, 
           Ander Crenshaw, John Culberson, Geoff Davis, Nathan 
           Deal, David Dreier, Mary Fallin, Jeff Flake, John 
           Fleming, Randy Forbes, Jeff Fortenberry, Virginia Foxx, 
           Trent Franks, Rodney Frelinghuysen, Phil Gingrey, Louie 
           Gohmert, Bob Goodlatte, Kay Granger, Sam Graves, Ralph 
           Hall, Doc Hastings, Dean Heller, Jeb Hensarling, Wally 
           Herger, Peter Hoekstra, Duncan Hunter, Bob Inglis, 
           Darrell Issa, Lynn Jenkins, Sam Johnson, Walter Jones, 
           Jim Jordan, Steve King, Jack Kingston, Mark Kirk, John 
           Kline
         Doug Lamborn, Christopher Lee, Jerry Lewis, Blaine 
           Luetkemeyer, Cynthia Lummis, Daniel Lungren, Don 
           Manzullo, Kevin McCarthy, Thaddeus McCotter, Patrick 
           McHenry, John McHugh, Cathy McMorris Rodgers, Jeff 
           Miller, Sue Myrick, Devin Nunes, Pete Olson, Erik 
           Paulsen, Mike Pence, Joe Pitts, Todd Platts, Ted Poe, 
           Bill Posey, Tom Price, Adam Putnam, George Radanovich, 
           Hal Rogers, Mike Rogers, Thomas Rooney, Peter Roskam, 
           Paul Ryan, Steve Scalise, Jean Schmidt, Aaron Schock, 
           James Sensenbrenner, Pete Sessions, John Shadegg, John 
           Shimkus, Bill Shuster, Michael Simpson, Adrian Smith, 
           Lamar Smith, Cliff Stearns, John Sullivan, Lee Terry, 
           Glenn Thompson, Patrick Tiberi, Fred Upton, Greg 
           Walden, Zach Wamp, Lynn Westmoreland, Ed Whitfield, Joe 
           Wilson, Robert Wittman

  The first priority should be to make our Nation's poorest, uninsured 
children covered. This is the intent of the program, and we should 
fulfill that program and that goal. Currently, at least two-thirds of 
children who do not have health insurance are already eligible for 
Federal help through either SCHIP or Medicaid. We should enroll these 
children first before expanding to higher income brackets.
  The second priority is to ensure that SCHIP does not replace or 
significantly impact those who already have private health insurance 
with a government-run program. Last year Hawaii created a new 
government-financed program to fill the gap between private and public 
insurance in an effort to provide universal coverage for children. But 
State officials soon found that families were dropping private coverage 
to enroll their children in the government plan. The Governor of Hawaii 
terminated the plan when she realized Hawaii could not and should not 
subsidize the cost for children already receiving private health 
insurance.
  Madam Speaker, should this legislation pass, we know that 2.4 million 
more children will be ``crowded out'' from their private insurance plan 
and moved to SCHIP. In days where Congress is faced with a second $350 
billion bailout plan and a possible $1.3 trillion stimulus package, is 
the Federal Government in any financial shape to be financing health 
care costs for children who are already receiving private health 
insurance?
  Lastly, a citizenship verification standard is critical to ensuring 
that only U.S. citizens and certain legal immigrants are allowed to 
access the taxpayer-funded benefits, not illegal immigrants. The 
underlying legislation offers no safeguards to ensure American children 
come before illegal immigrants.
  Republicans understand how important and personal health care 
decisions are for individuals and families. We believe in freedom of 
choice, and allowing patients and doctors to make health care 
decisions, not government bureaucrats, is the direction we should go. 
Allowing for a tax credit or tax deduction for the purchase of health 
care insurance would give an individual or a family the choice of an 
affordable health care plan that fits their needs.
  Said another way, a family and their children should be able to 
choose their own doctor and go to that doctor day in and day out, not 
simply to have to shop to find what is then available through a 
government-run program. This would bring the ownership and control back 
to the individual and the family.
  Madam Speaker, additionally, if we allow individuals to purchase 
health insurance across State lines and let businesses and associations 
band together to purchase insurance, we guarantee choice, portability, 
and flexibility for families and employees. Rather than limiting choice 
like my Democrat colleagues, Republicans strive for quality, affordable 
health care for every single American.

[[Page H206]]

  Madam Speaker, another fatal flaw with this huge government expansion 
is how our Democrat colleagues are going to pay for this plan. The 
proposed budget uses gimmicks to comply with PAYGO rules, masking the 
true cost of the expansion. Democrats will increase taxes on cigarette 
packs by 61 cents to $1 and included taxes on cigars of up to $3 to 
come up with the majority of the $35 billion expansion. The problem is 
that this tobacco tax disproportionately burdens low-income Americans 
because the majority of smokers are young adults and individuals and 
families making less than 300 percent of the Federal poverty level. To 
produce the revenues that Congress needs to fund the $35 billion SCHIP 
expansion would require a tax for 22.4 million new smokers by 2017 or 
80 percent of the beneficiaries would lose coverage in 5 years. That 
means that we are going to tax these users and rely on that stream of 
revenue that will be diminishing very quickly. That is not a 
responsible way to fund the program.
  Eliminating physician ownership and health care practices is another 
way that the Democrats plan to pay for expansion. The current state of 
our community hospitals is in disarray. Community hospitals are 
overcrowded and understaffed. Physician-owned hospitals run more 
efficiently, have higher patient satisfaction and higher quality 
outcomes than their community counterparts. Yet my friends on the other 
side of the aisle want to eliminate that option for individuals. So 
while dumping children in a government-run health care plan, they also 
want to limit health care choices for everyone by eliminating 
physician-owned facilities.
  Rather than limiting choices, Congress should be in the business of 
creating more avenues and opportunities for individuals and families to 
find affordable insurance for their choices that provides them and 
leads them to quality care. This legislation does the opposite.
  I encourage my colleagues to oppose this rule and the underlying 
legislation.
  Madam Speaker, I reserve the balance of my time.
  Mr. HASTINGS of Florida. Madam Speaker, I am very pleased to yield 3 
minutes to the distinguished gentlewoman from California, my colleague 
and good friend on the Rules Committee, Ms. Matsui.
  Ms. MATSUI. I thank the gentleman from Florida for yielding me this 
time.
  Madam Speaker, I want to commend Chairman Waxman, Chairman Dingell, 
and Chairman Pallone for their efforts in crafting this bill.
  Madam Speaker, these are uncertain times. Families are struggling to 
make ends meet. Medical bankruptcy is on the rise.
  While the future may be cloudy, our responsibility to our Nation's 
children is clear. We are charged with ensuring that every child in 
America has affordable health care. Democrats in Congress take this 
responsibility seriously, Madam Speaker. So does President-elect Obama. 
And so do I.
  We take it seriously because of stories like the one told to me by a 
constituent of mine named Suzy. When Suzy's nephew was 1 year old, his 
mother no longer qualified for Medicaid. As a result, her little boy 
could not see a doctor for 6 months. Imagine 6 of anxiety and worry 
around high fevers, coughs, unexplained rashes, wondering if there was 
a serious illness involved. But once he was enrolled in SCHIP, Suzy's 
nephew got the care that he needed. Suzy put it best herself when she 
said, ``Children should never suffer because their parent or guardian 
cannot afford medical insurance.''
  That is why today's legislation is so critical, Madam Speaker. During 
one of the most uncertain periods in our country's history, it says to 
11 million of America's children that health care for you is 
guaranteed. It expands coverage for pregnant women and reverses 
arbitrary rules that keep needy children from health care they deserve. 
The Children's Health Insurance Program Reauthorization Act is a 
victory for millions of children and their families. It's also a 
victory for us as a Nation. For when more of our children grow up 
healthy, our country is strengthened and the American Dream is 
preserved.
  I urge each of my colleagues to support this legislation.
  Mr. SESSIONS. Madam Speaker, at this time I would like to yield 2 
minutes to the ranking member of the Rules Committee, the gentleman 
from San Dimas, California (Mr. Dreier).
  (Mr. DREIER asked and was given permission to revise and extend his 
remarks.)
  Mr. DREIER. I thank my friend for yielding.
  Madam Speaker, I will say that I don't know of a Democrat or a 
Republican who has not been inspired by President-elect Barack Obama's 
statement that he wants to reach out and work in a bipartisan way. I am 
convinced that he is very sincere in his quest to bring us together to 
deal with very important challenges that our Nation faces.
  What we're dealing with here today is a reversal, frankly, even 
before he takes the oath of office in 6 days, of exactly what he's 
trying to do. As my friend from Dallas has pointed out, this is a 
completely closed process, denying us, Democrat or Republican alike, an 
opportunity to participate. Let's look at the history of this program.
  The State Children's Health Insurance Program was put into place as 
we proudly in a bipartisan way worked to reform the welfare system in 
the mid 1990s. And what happened? We wanted to ensure that those who 
were on Medicaid as they gone onto the first rung of the economic 
ladder that they would have an opportunity to keep their children with 
the kind of health care that was needed. Our goal has been to ensure 
that the children of the working poor have access to quality health 
care.
  And yet this program, unfortunately, as Mr. Sessions has just said, 
takes 2.4 million children who are presently receiving private health 
care and it incentivizes them to go into a government program. It also 
takes the adults, people up to the age of 25, and allows them to be 
part of this program. It imposes a massive tax increase on hospitals, 
which I think is just plain wrong. And it's a program which creates the 
potential for people who are in this country illegally to benefit. Now, 
I know that there are statements that it won't, but many reports have 
indicated that that is a threat that is there. And it also creates an 
opportunity for the children of wealthy families, families earning in 
excess of $80,000 a year, to benefit from this program.

                              {time}  1100

  We need to have a good State Children's Health Insurance Program. 
This is not it.
  Mr. HASTINGS of Florida. Madam Speaker, I am very pleased to yield 1 
minute to the distinguished gentlewoman from Florida, my colleague on 
the Rules Committee, who is also going to be on the committee of 
jurisdiction real soon, and we are going to miss her on the Rules 
Committee, Ms. Castor.
  Ms. CASTOR of Florida. I thank my good friend and colleague from 
Florida.
  Madam Speaker, I rise in support of H.R. 2 and this rule that will 
provide millions of children across America with affordable health care 
at a time when families have been particularly hard hit by the economy. 
What good news for all Americans that one of the first bills President 
Obama will sign will be one that improves access to quality, affordable 
health care and reduces the cost of health care for families.
  More affordable health care is central to our economic recovery and 
it is fundamental for families. A healthy child is more likely to 
succeed in life. A healthy child is a healthy student. Healthy students 
become productive adults. A healthy child means more productive parents 
who do not miss work.
  Here we ensure that newborn babies receive the medical checkups and 
immunizations they need, ensure that toddlers and children are taken 
care of as they grow, ensure that we all save money through preventive 
care, particularly diabetes and asthma. Yet, despite all that we 
understand about the importance of healthy kids, millions of children 
and their families cannot afford----
  The SPEAKER pro tempore. The time of the gentlewoman has expired.
  Mr. HASTINGS of Florida. I yield the gentlelady an additional 15 
seconds.
  Ms. CASTOR of Florida. Families are working hard to make ends meet, 
but

[[Page H207]]

they are coming up short when it comes to health care.
  I would especially like to thank Speaker Nancy Pelosi, who never gave 
up and kept her promise that in the first few days of a new Congress 
with a new President the health of America's kids and the pocketbooks 
of hardworking American families would be paramount.
  Suffering through President Bush's opposition over the past years has 
been very costly and we have lost ground. In Florida alone, over 
800,000 children lack health insurance, and that's the second highest 
rate in the U.S. It's more than the population of some States and it is 
growing. The lack of affordable health care for these working families 
is making it more expensive for everyone.
  Families are working hard to make ends meet, but they are coming up 
short when it comes to health care. This bill makes it easier for 
parents by eliminating costly bureaucratic red tape. When more kids 
visit a doctor's office for medical care, we also reduce the strain on 
crowded local emergency rooms and cost of health care for everyone.
  Mr. SESSIONS. Madam Speaker, you know, it's pretty incredible. A 
number of speakers that we've had here today sat through the hearing 
yesterday and understood that this bill is not going to become law 
anytime soon. Yet we are down on the floor of the House of 
Representatives touting how this will be the first bill that our new 
President, President Barack Obama, will sign; and yet, testimony in the 
Rules Committee yesterday, a full admittance that we don't know whether 
this is all going to make it or not. It will be interesting to see.
  Madam Speaker, at this time I would like to yield 2 minutes to the 
gentlewoman from Energy and Commerce, Mrs. Blackburn.
  Mrs. BLACKBURN. Madam Speaker, I do rise to oppose the rule and also 
to oppose H.R. 2 that is covered in this rule.
  One of the reasons is, indeed, the process. We have heard mention of 
it being a closed process and a closed rule, as indeed it is, and that 
doesn't speak to any type of bipartisanship. I had what I thought was a 
very germane amendment which was not allowed.
  Madam Speaker, what this would have done was to phase out coverage, 
phase out coverage for nonpregnant adults. Now, this bill is SCHIP, the 
State Children's health insurance Program. It is to cover low-income 
children. But we have a majority in charge in this House that is not 
taking this bill to the health subcommittee. It is not taking it to 
Energy and Commerce Committee. It is bringing it straight to the floor.
  In this bill that you will vote on is coverage, expanded coverage for 
adults. That, indeed, is unfortunate.
  As we have heard, there also are tax increases. There is a $70.8 
billion tax increase over the next 10 years in this bill. It is tobacco 
taxes. The Congressional Research Service, which is nonpartisan, calls 
tobacco taxes the most regressive of the Federal taxes. That is 
included as a pay-for in this bill for expanded coverage and changing 
of a block grant program that has worked successfully for low-income 
children, changing it to an entitlement program.
  There are a list of reasons to oppose this bill. Weakening of 
eligibility requirements, weakening of section 211, weakening of your 
proof of citizenship, proof of who you are, weakening those 
requirements. All of that dilutes the purpose of the SCHIP program. It 
dilutes the coverage of health care for low-income children.
  Oppose this rule. Let's do this right.
  Mr. HASTINGS of Florida. Madam Speaker, I am very pleased to yield 2 
minutes to my good friend from Ohio, the distinguished gentlewoman, Ms. 
Sutton, a member of the Rules Committee, also soon to be a member of 
the Commerce Committee and will be sorely missed on our Rules 
Committee.
  Ms. SUTTON. I thank the gentleman for the time and for his leadership 
on this critical issue.
  Madam Speaker, I rise in strong support of the Children's Health 
Insurance Reauthorization Act. This legislation is long overdue for our 
Nation's children.
  I want to share a story about a girl from my district that puts this 
issue all into perspective. I met Rose and her mother at an event one 
weekend back in my district in Ohio, and I will never forget the moment 
her mom introduced her to me. She looked up at me full of hope and she, 
in a moment, reached out and she hugged me.
  After Rose walked away, her mom explained to me that her daughter had 
cancer and was preparing for a bone marrow transplant. Before I could 
even digest what her mom was saying that their family was going 
through, Dawn, her mother, said, when are you guys going to pass SCHIP, 
because Rose has insurance, but there are a lot of kids in this country 
who don't, and they deserve the same opportunity for a future.
  Dawn was right, nearly 9 million children in this country do not have 
health insurance. Those kids need the same opportunity to have the 
health care that they need. In the midst of fighting cancer with her 
daughter, Dawn found the courage and compassion to look beyond her 
struggle to stand up for kids across this Nation without health 
insurance.
  I share this story with my colleagues because today we have the 
opportunity to look beyond all differences to finally pass this 
legislation. This bill will allow an additional 4 million children 
across this country, which includes 200,000 children in Ohio, to obtain 
health insurance.
  The urgency could not be more clear. With an ailing economy the 
population of uninsured is growing, and we know that a 1-percent 
increase in employment is projected to increase the number of uninsured 
by 1.1 million kids. In these difficult economic times, the least we 
can do is make sure that our children have access to the health care 
they need and deserve.
  I am pleased to report that Rose has received her bone marrow 
transplant and her eyes and her future are bright. Let's do the same 
for the rest of America's kids.
  Mr. SESSIONS. Madam Speaker, at this time I would like to yield 3 
minutes to the gentleman from the Energy and Commerce Committee, Dr. 
Gingrey.
  Mr. GINGREY of Georgia. I thank the gentleman for yielding.
  Madam Speaker, I rise in strong opposition to the closed rule, as 
well as the present form of the underlying legislation, H.R. 2, the 
Children's Health Insurance Reauthorization Act of 2009.
  It goes without saying that I am a strong advocate of the original 
SCHIP. In my nearly 30 years of being an OB/GYN doctor, I delivered 
over 5,000 children, and I know how important it is that the Federal 
Government play a role in providing health care to low-income kids.
  At the same time, we must pass legislation that first reaches those 
who are the most in need of assistance, those whose family incomes are 
between 100 and 200 percent of the Federal poverty level, the original 
intent of the bill.
  But, unfortunately, Madam Speaker, despite the spirit of 
bipartisanship that both President-elect Obama and Speaker Pelosi have 
espoused, this bill merely represents business as usual for the 
Democratic majority. Due to this highly restrictive closed rule, my 
Republican colleagues and I will not have the opportunity to improve 
the bill that will affect millions of children across the country and 
in our districts.
  I had such an amendment that was not made in order by the Rules 
Committee. My amendment would have addressed a very important problem 
with current law that H.R. 2 overlooks, the practice of States, 13 of 
them, using loopholes to allow people to disregard significant portions 
of their income to make them eligible for SCHIP and Medicaid as well. 
At the same time, some of these very States have been ignoring the 
children who demonstrate the most need for these programs, those 
between 100 and 200 percent of the Federal poverty level.
  Madam Speaker, my commonsense amendment would do this, it would 
institute a gross-income cap of 250 percent of the Federal poverty 
level for SCHIP and Medicaid eligibility, and it would limit any income 
disregards to a maximum of $250 a month or $3,000 a year. This 
amendment would grandfather in those individuals already receiving 
SCHIP and Medicaid funds so that we do not deprive current 
beneficiaries of health care.
  However, we are not going to get the chance, unfortunately, or any 
other thoughtful amendments that were offered by my Republican and 
Democratic colleagues, because the Democratic majority leaders wish to 
contradict the bipartisan spirit that they touted only a week ago.
  Therefore, Madam Speaker, I urge all of my colleagues to oppose this 
closed rule and the underlying legislation. We could have made it 
better with amendments from both Republicans and Democrats.

[[Page H208]]

  Mr. HASTINGS of Florida. Madam Speaker, would you be so kind as to 
inform both sides as to the remaining amount of time.
  The SPEAKER pro tempore. The gentleman from Florida has 18\1/4\ 
minutes remaining and the gentleman from Texas has 11\1/2\ minutes 
remaining.
  Mr. HASTINGS of Florida. Madam Speaker, I am very pleased to yield 
for his first floor speech to a gentleman that is going to be on the 
Rules Committee real soon, the distinguished gentleman from Colorado 
(Mr. Polis), for 1 minute.
  Mr. POLIS of Colorado. Madam Speaker, I can think of no more 
important issue to make my first floor speech on.
  I rise in support of the Children's Health Insurance Program 
Reauthorization Act, and I want to thank Speaker Pelosi, who has been 
an unrelenting champion of this issue. I also want to thank Chairman 
Rangel and Chairman Dingell for sponsoring the legislation in the 110th 
Congress, and Chairman Waxman for his leadership on this important 
issue.
  I have already received numerous letters and contacts from 
constituents who are worried about loss of health care coverage. We 
have heard from those who have lost their health care coverage or fear 
they could lose it because they can't afford it. The lack of affordable 
health care in this country for families is a problem we cannot afford 
to ignore.
  We must ensure that this legislation passes the House and Senate and 
reaches the new President's desk as soon as possible. This legislation 
would provide health care coverage for more than 11 million children. 
In Colorado, there are over 100,000 uninsured children who are eligible 
for SCHIP and Medicaid but are not yet enrolled. This is critical for 
our State and for our country.
  Children can't help what family they are born into. To ensure that 
every American has the opportunity to succeed, we need to make sure 
that children have access to health care insurance regardless of their 
family background. This is an opportunity to protect millions of 
children who do not have a voice and safeguard their future, and that's 
why I urge you to support this legislation.
  Mr. SESSIONS. Madam Speaker, at this time I would like to yield 1\1/
2\ minutes to the gentlewoman from Illinois (Mrs. Biggert).
  Mrs. BIGGERT. I thank the gentleman, Mr. Sessions, for yielding me 
this time, and I rise in opposition to the rule.
  Madam Speaker, as many of my colleagues know, I am a strong supporter 
of SCHIP and worked for many months during the previous Congress to 
bring Republicans and Democrats, both House and Senate Members, 
together to work out a compromise, bipartisan bill that would expand 
the program of SCHIP responsibly while ensuring that poor American 
children remain a top priority in all States.
  I know that I am not alone in supporting a renewal and expansion of 
this important program to serve more low-income children, and I know 
that Members on both sides of the aisle believe that SCHIP should cover 
our most vulnerable children first. These children are in families 200 
percent or lower of the poverty level.
  So last night I went to the Rules Committee with an amendment that 
would do just that, put poor children first, cosponsored by a number of 
my colleagues, and would do three things.
  First, it would require States to collect data on their success in 
covering these low-income children.
  Second, it requires that all States draft and implement a plan that 
works towards reducing the uninsured rate among low-income children. I 
would ask the Secretary of Health and Human Services to approve these 
plans if they are reasonable.
  Finally, I would ask States to reduce to 10 percent or less the 
uninsured rate among children and families, 200 percent and below the 
poverty level.
  Until States have met this 90 percent coverage goal, they would be 
prohibited from using SCHIP funds to provide benefits to newer 
populations at higher level incomes. This is a commonsense way that we 
can ensure that States are using taxpayer dollars wisely and getting 
health care to the kids that need it most.
  Mr. HASTINGS of Florida. Madam Speaker, I am very pleased to yield 2 
minutes to my good friend, the distinguished gentleman from Texas (Mr. 
Edwards) who, when this program had its inception in 1997, was an 
original cosponsor of this legislation.
  Mr. EDWARDS of Texas. Madam Speaker, on Monday, 2 days ago, I was 
visiting in a rural newspaper office in Glen Rose, Texas, in my 
district. I was discussing the Children's Health Insurance Program when 
one of the employees there, Lindsey Brewer, heard of our conversation 
and asked if she could say something.
  In deeply heartfelt words, Lindsey told me that her 9-year-old 
daughter, Amalie, has had leukemia for the past 2 years. You see, 
Lindsey and her husband both work, but like millions of hard working 
Americans, they don't have health insurance because their employers 
can't afford it.

                              {time}  1115

  Despite their modest combined annual income, with both parents 
working, their income of under $50,000, the Brewers were devastated to 
find out they were told they were ineligible for the CHIP program. The 
Brewers are two hardworking, loving parents, who through no fault of 
theirs or their daughter's are facing medical bills totaling $100,233 
and growing every single day.
  The Brewers don't want welfare. They want to work and be good role 
models for Amalie and her two brothers. That is why I consider CHIP to 
be pro-family and pro-work. I met Amalie this week after hearing her 
story. This is her photograph. She is a beautiful little third grader, 
making straight A's and working in karate class.
  This bill isn't about all the various rules and procedures that have 
been discussed. This bill is about Amalie Brewer and her future. It is 
about her family and their future. It is about honoring the values, the 
pro-work values of Mr. and Mrs. Brewer and millions of other parents 
like them.
  Madam Speaker, I would ask every Member one question before they vote 
on this bill today: If Amalie Brewer were your child or your 
granddaughter, how would you vote? I hope the answer is ``yes,'' 
because the Brewer family and millions of others like them are waiting 
to see how we vote.
  Vote ``yes'' on expanding the Children's Health Insurance Program. 
These families deserve no less.
  Mr. SESSIONS. Madam Speaker, at this time I would like to yield 1\1/
2\ minutes to the distinguished gentleman from Miami, Florida (Mr. 
Lincoln Diaz-Balart).
  Mr. LINCOLN DIAZ-BALART of Florida. I thank my friend.
  It is unfortunate the rule is closed. It is such an important issue 
we are discussing. For example, a new member of the majority party came 
before us in the Rules Committee, Mr. Kissell, with a very thoughtful 
amendment. It was rejected, not permitted for debate. That is 
unfortunate and unnecessary.
  Now, I had said last year, Madam Speaker, that I wasn't going to 
support a major expansion of SCHIP until legal immigrant children were 
included, because we should not discriminate against legal immigrants. 
I represent South Florida. I represent hundreds of thousands of 
immigrants. So I made clear, I am not going to support an expansion of 
SCHIP until they are included.
  Well, they are in the legislation that we are going to vote on today 
and so I am going to vote for it. I commend the leadership for having 
included it, and I think the Senate has to do the same. As I said 
before, it was a sine qua non for me. Until legal immigrant children 
were included, I wasn't going to support an expansion of SCHIP.
  So, it is a good day. We are going to have a vote on this program 
that is going to include thousands of children and their moms who 
unfairly have been excluded. And, by the way, that affects kids in 
school and the other children in school. When the children who are sick 
have to go to the emergency room or when they are sick in the 
classroom, they affect all the kids in the classroom. It just doesn't 
make sense. And they are legal in this country.
  Anyway, I am going to be supporting the legislation today.
  Mr. HASTINGS of Florida. Madam Speaker, I am pleased to yield 2 
minutes to my classmate and good friend,

[[Page H209]]

the distinguished gentleman from Michigan (Mr. Stupak), a member of the 
Energy and Commerce Committee.
  Mr. STUPAK. Madam Speaker, I thank the gentleman for yielding me 
time.
  I rise today in support of the rule on H.R. 2, the Children's Health 
Insurance Program Reauthorization Act, the CHIP program. The CHIP 
program was enacted under President Clinton with bipartisan support to 
help reduce the number of low-income uninsured children by expanding 
eligibility levels and simplifying the application process.
  In 2006, CHIP provided insurance to 6.7 million children. In 
Michigan, roughly 31,000 children are enrolled in MIChild, making 
Michigan one of the States with the fewest number of uninsured children 
in the country. Eighty-six percent of the children enrolled in MIChild 
are from working families that are unable to afford private health 
insurance for their children.
  Meanwhile, health care through the CHIP program is cost-effective. 
According to the Congressional Budget Office, it costs a mere $3.34 a 
day or $100 a month to cover a child under the CHIP program. 
Furthermore, CHIP is vitally important to children living in our 
country's rural regions. Of the 50 counties with the highest rates of 
uninsured children, 44 are rural counties, with many located in the 
most remote parts of our country.
  Today's legislation would reauthorize and approve the CHIP program to 
protect and continue coverage for 6.7 million children, plus an 
additional 4 million children that are eligible but are currently 
uninsured.
  During these difficult economic times, this legislation does not 
raise income levels for families whose children would be eligible for 
health care coverage. It is time to cover and support all of our 
Nation's children.
  Again, I support this legislation and urge all my colleagues to 
support the rule and the underlying legislation.
  Mr. SESSIONS. Madam Speaker, we believe we are in agreement with the 
gentleman from Florida (Mr. Hastings) that we will allow their side to 
catch up at this time.
  Mr. HASTINGS of Florida. Madam Speaker, can you tell me again how 
much time each of us has?
  The SPEAKER pro tempore. The gentleman from Florida has 13\1/4\ 
minutes remaining and the gentleman from Texas has 8\1/2\ minutes 
remaining.
  Mr. HASTINGS of Florida. Madam Speaker, I am pleased to yield 1 
minute to a new Member, the distinguished gentlewoman from the State of 
Ohio (Ms. Kilroy).
  Ms. KILROY. Madam Speaker, I thank the gentleman from Florida for 
this opportunity to rise today in support of the rule and H.R. 2, the 
reauthorization and expansion of the Children's Health Insurance 
Program, a program which has brought health care coverage to over 6 
million children.
  But there are also millions of children today whose parents do not 
have the financial ability to purchase health insurance. The parents of 
4 million children must worry each time a child is sick if they can 
afford to take that child to a doctor, if they can afford to treat that 
child's cancer or leukemia.
  My colleagues, many of you have children and know the anguish a 
parent feels when her or his child is sick. Imagine if you were also 
unable to obtain health insurance coverage to cover that illness.
  Our great country, which despite its economic problems is still a 
country of great wealth and resources, of compassion and community, can 
certainly come together in a bipartisan fashion to add 4 million more 
children to the Child Health Insurance Program.
  Mr. HASTINGS of Florida. Madam Speaker, I am very pleased to yield 
1\1/2\ minutes to yet another of our new Members on the Democratic 
side, the distinguished gentleman from North Carolina (Mr. Kissell).
  Mr. KISSELL. Madam Speaker, I rise today to offer my full support of 
SCHIP, but I also rise to question the funding of SCHIP as per the 
amendment I put forth to the Rules Committee last night.
  Having spent the last several years as a high school teacher in a 
rural poor county, I don't need to be told or to be reminded about the 
need of taking care of our children in terms of their health care. I am 
not here today as a spokesman for big tobacco or advocate of the 
cigarette industry. Indeed, I am here because I was elected to be a 
spokesman for working families.
  The funding that has been chosen to finance this bill with full 
implementation immediately will cost jobs and will cost revenues. At a 
time when our working families are struggling, at a time when we are 
going to be asked to consider measures how to create jobs and create 
funding, I would propose in my amendment instead of going to full 
implementation of this tax immediately, that we phase it in over 4 
years at 16 cents the first year, then 15 cents each of the following 
years.
  It is important to know that the children that are going to be 
affected by this bill positively is great, but there are also families 
that are going to be negatively impacted at a time when we should not 
be doing that.
  I worked in an industry where government actions in textiles cost 
thousands of jobs. Let's look for a way to soften this blow to our 
people.
  Mr. SESSIONS. We continue to reserve.
  Mr. HASTINGS of Florida. Madam Speaker, at this time I am very 
pleased to yield 1 minute to my classmate and good friend, the 
distinguished gentleman from Texas (Mr. Doggett), a member of the Ways 
and Means Committee.
  Mr. DOGGETT. What progress, when this Congress and our new President 
accord such a high priority to the health of our children. A healthy 
body, like an educated mind, is an opportunity that all children should 
share--an opportunity denied to over 1 million Texas children because 
of the failures of Governor Bush and culminating in the ignominious 
vetoes of President Bush.
  Good health care also means prevention, preventing the scourge of 
tobacco-related diseases. By hiking tobacco taxes today, we will reduce 
childhood nicotine addiction tomorrow. And this bill takes modest steps 
to reduce tobacco smuggling, while adding a new provision that I 
authored directing the Treasury Department to move forward promptly on 
more effective ways to reduce this serious public health and law 
enforcement problem.
  It is ironic that today, once again, the Republican leadership has 
one complaint: That we Democrats move too fast, to do too much, for too 
many young children across our country when it comes to health care. We 
plead guilty. And we will keep pushing to give these children the care 
they deserve.
  Mr. HASTINGS of Florida. Madam Speaker, I yield 1 minute to the 
distinguished gentleman from Georgia (Mr. Scott), my good friend who 
along with his fellows in the area of Georgia have been champions for 
children's health insurance.
  Mr. SCOTT of Georgia. Madam Speaker, what a great day this is, to be 
able to finally, finally, pass this much-needed bill.
  Madam Speaker, we have over 300,000 Georgia young people and children 
who desperately need this legislation. We worked hard in the past 
sessions to be able to get this bill passed, but to no avail. But now 
we will be able to get this passed, and hopefully it just might be the 
very first bill that our new President, President Barack Obama, will 
sign.
  But let me just tell you the improvements on this bill and what we 
have so the American people will know. It will eliminate the 5-year 
waiting period for low-income people insured to be part of the program. 
It will add 4 million new additional uninsured low-income children, to 
bring that total up to 11 million. There will be a 4\1/2\-year 
reauthorization period that extends all the way through 2013. It will 
add dental and mental health parity, which is so greatly needed, 
because so many of our health needs and diseases and challenges come 
when the teeth are not there.
  Madam Speaker, it is a great day. I thank the gentleman from Florida 
(Mr. Hastings) for his leadership on this and urge passage.
  Mr. SESSIONS. Madam Speaker, I yield 1 minute to the gentleman from 
Lewisville, Texas (Mr. Burgess).
  Mr. BURGESS. I thank the gentleman for yielding.
  Let me say at the start, I support the reauthorization of the State 
Children's Health Insurance Program. I supported it when I was a 
physician in private practice in 1997. I supported it in December of 
2007 when we provided the

[[Page H210]]

current 18-month extension. But what I don't support is the approach we 
are taking today of a closed rule.
  Ironically, the speaker prior to the previous speaker talked about 
how Republicans are concerned that the House is now moving too fast. I 
am not concerned that we are moving too fast. I am concerned that we 
didn't move when we had the opportunity, that is, the last 18 months, 
to try to improve the product and try to work through some of the 
problems that clearly some of us on this side have with the current 
bill.
  I am opposed to a closed rule. I think there are good ideas that come 
from the Republican side. I think our new administration that is going 
to be sworn in in less than a week's time has already said he welcomes 
ideas from both sides of the aisle. What a shame it is that our Rules 
Committee then cannot see fit to allow good amendments to come from 
either side of the aisle.
  I am also concerned about the stability of the funding in the 
underlying bill. I am concerned very much about looking to the 
physician-owned hospital as a source for the funding. Why do we impugn 
the motives of people who are inherently altruistic? What would we have 
done if Will and Charlie Mayo had come to us and said they wanted to 
start an enterprise, and we said no, you cannot do it; the Secretary 
will not authorize it because it is prohibited under the SCHIP bill?
  Mr. HASTINGS of Florida. Madam Speaker, I am very pleased at this 
time to yield 1 minute to the distinguished gentlewoman from the 
District of Columbia (Ms. Norton) who knows this issue extremely well.
  Ms. NORTON. Madam Speaker, I thank the gentleman for his kindness in 
yielding.
  However Members voted before, there has been a light year of change 
since. The world has been turned on its axis by a worldwide recession, 
leaving virtually no one untouched. Most Americans supported this bill 
even in a good economy. Imagine today, mortgage delinquencies, job 
losses, wholesale economic misery. We simply can't say ``no'' today.

                              {time}  1130

  America will help any child if he becomes sick enough. The only 
question is when. Prevent illness and catch it early, or wait until a 
child needs high cost hospital care.
  This bill covers only financially eligible children. Please vote for 
this rule.
  Mr. SESSIONS. Madam Speaker, at this time I would like to yield 2 
minutes to the gentleman from Lincoln, Nebraska (Mr. Fortenberry).
  Mr. FORTENBERRY. Madam Speaker, at the outset, let me say I believe 
that SCHIP is a very important program that provides quality health 
care coverage for millions of America's children. I support the 
program. I support its renewal, and I support its appropriate 
expansion. However, I do believe that this must be done responsibly, 
for instance, prioritizing America's most vulnerable children first.
  We must also guard against expanding the program to those who may not 
need it, or risk creating a program that encourages some families to 
unnecessarily drop their existing insurance coverage for the government 
program, a move that could jeopardize the program's intent for our 
neediest children.
  As we have learned, the State of Hawaii recently halted its universal 
child health care program, just 7 months after its inception, because 
high-income families were dropping private insurance so their children 
would be eligible for the government program.
  The amendment that I offered to the Rules Committee would give 
vulnerable families the same opportunities as others to purchase health 
insurance. It would offer eligible families the choice of retaining 
SCHIP coverage for their children or using SCHIP funds to obtain a 
health insurance plan for the entire family through premium assistance 
for their child.
  I believe families are in the best position to make health care 
choices for their children. They should be able to remain together 
under the same health care coverage if they so choose, and see the 
family doctor together.
  I am disappointed that I am hindered from offering this plan as an 
amendment, as I believe it would strengthen the current program by 
empowering family choices, simplifying the process of accessing quality 
care, making family plans more affordable, and saving taxpayer dollars.
  So, Madam Speaker, I will have to oppose this rule.
  Mr. HASTINGS of Florida. Madam Speaker, I am very pleased to yield 1 
minute to one of the original sponsors of the original SCHIP 
legislation, the distinguished gentlewoman from Connecticut, my good 
friend, Rosa DeLauro.
  Ms. DeLAURO. I rise in strong support of the Children's Health 
Insurance Program. In this transformational moment, we stand poised to 
reauthorize this bipartisan program which provides critical health care 
coverage to more than 6 million children who would otherwise go without 
care, including more than 13,000 in my home State of Connecticut.
  With an economy shedding jobs like never before, we have an economic 
and a moral responsibility to cover the most vulnerable among us. In 
this country, where 9 million children are uninsured, we cannot let 
another day go by without passing this legislation, a smart investment 
in children, in their health and in their success at school and in 
life. Dental, mental health care for children, coverage for pregnant 
women, more efficient administration, higher quality care for children, 
reducing childhood obesity, meeting our commitment to fiscal 
responsibility.
  The choice before us today is a simple one. It is about fulfilling 
America's promise as a place of hope, possibility and opportunity for 
our Nation's children.
  Mr. SESSIONS. Madam Speaker, at this time I would like to yield 2 
minutes to the gentleman from Louisiana (Mr. Scalise).
  Mr. SCALISE. Madam Speaker, I rise in opposition to the rule that 
we're discussing right now which prevents any amendments from being 
brought forward on this legislation. The reason that I've got some real 
concerns is that, Number 1, there's a big change in current policy that 
allows for verification of identity and of citizenship that's in 
current SCHIP law.
  What this bill does, H.R. 2 actually deviates very dramatically from 
that current law. It changes the legislation and takes away any ability 
for us to verify the citizenship of people that would be eligible for 
SCHIP.
  What that means to the average American people out there is that the 
taxpayers who will be footing this bill will be having to pay for 
illegal aliens that will now be able to get benefits under this bill 
that, under current law, they're not able to get because there is a 
verification process. Why would the leadership want to take away that 
verification process, opening the door for fraud and abuse?
  We know there will be fraud and abuse if this bill becomes law 
without the amendment that I brought forward last night that would 
change and revert back to current law. The current law allows for the 
verification and identification of citizenship. This bill takes that 
away.
  The Congressional Budget Office actually estimates that this change, 
the change in H.R. 2 that we'll be voting on later on, will cost the 
taxpayers up to $5 billion in illegal aliens being able to get SCHIP 
benefits that, under current law, are not able to get it because there 
is a verification process. We need to put that verification process 
back in place to make sure that the hardworking taxpayers out there, 
especially during these tough economic times, as people are paying 
those taxes to fund this program, what kind of message does it send to 
them, many of whom have no insurance of their own, that they're going 
to have to pay $5 billion of their hard-earned money, so that illegal 
aliens can now be eligible; not eligible necessarily under the law, 
because the law at least acknowledges that illegals shouldn't be able 
to get the money. But the verification has been taken away in this 
bill.
  Mr. HASTINGS of Florida. Madam Speaker, I am very pleased at this 
time to yield 1 minute to the distinguished majority leader of the 
Democratic Caucus, Mr. Hoyer, my good friend.
  Mr. HOYER. I must say, following the last speaker, I think the last 
speaker is absolutely wrong. I think he misrepresented very 
substantially the facts of this bill, which strengthens verification.

[[Page H211]]

  This administration, the Bush administration, will tell you that, and 
the governors will tell you that the current verification system is not 
working, and that, in fact, we strengthen, in this bill, the 
verification. And of course, although he made it clear that illegal 
immigrants are not included and are very specifically not included, 
this bill will make it easier and more facilitate ensuring that 
objective than the present law.
  Mr. SCALISE. Would the gentleman yield?
  Mr. HOYER. Very briefly.
  Mr. SCALISE. The elimination of section 211 is what I was referring 
to, and that's the section that even the Congressional Budget Office 
estimates, by removing that verification process, would open the door 
to about $5 billion of people who are illegal aliens now being eligible 
because that verification is taken away.
  Mr. HOYER. If, in fact, in other sections the verification process 
has not been strengthened, that may be accurate. I haven't seen the CBO 
report to which you refer. However, the strengthening will preclude 
that objective from happening, in my opinion.
  Madam Speaker, I want you to hear the story of Deamonte Driver. This 
is from the Washington Post from February 28, 2007.
  ``12-year-old Deamonte Driver died today of a toothache.'' 12 years 
of age. ``A routine $80 tooth extraction might have saved him. But by 
the time Deamonte's own aching tooth got any attention, the bacteria 
from the abscess had spread to his brain, doctors said. After two 
operations and more than 6 weeks of hospital care, the Prince George's 
County 12-year-old died.''
  If you want a picture of American health care, in all its excellence 
and in its failures, there it is: The best doctors, the latest 
technology, 6 weeks of hospital care for a sick boy, at the cost of 
$250,000, in a country that can't find $80 to fix a toothache.
  To paraphrase Adlai Stevenson, American health care swallows tigers 
whole, but it can choke to death on a gnat. We couldn't find $80, and 
in the end it cost us a quarter of a million dollars. More importantly, 
it cost us the life of a young man. A system that makes such errors on 
a regular basis is both financially foolhardy and morally 
insupportable.
  Yes, on a regular basis, Deamonte Driver's case may be extreme, but 
it was hardly unique. Every day, uninsured parents are foregoing much 
cheaper preventive care and using the emergency room as the first line 
of defense for their children's health. Ironically, the President of 
the United States, when he vetoed this bill, said that's exactly what 
they could do, intervene in the most expensive, last ditch intervention 
in health care. We're all paying for that. We are subsidizing those ER 
visits, we are dealing with the overburdened hospitals, and we are 
creating a sicker, less productive work force.
  Fixing American health care will take much longer than an afternoon, 
but if I could pass just one bill today, if I could find the most 
efficient use of our health care dollars, I'd ensure more children. I 
think 80 percent of Americans agree with us on that.
  One of the previous speakers, a physician on the other side of the 
aisle, was recognized to speak. I spent, Mr. Dingell spent, Mr. Bachus 
spent, Mr. Rockefeller spent, Mr. Grassley spent some 30 hours in 
meetings with that doctor trying to reach a compromise. There were a 
number of other people in that room. Ultimately, there was no, 
notwithstanding the changes we made in the bill, there was no 
willingness to compromise to ensure the children.
  There's no more medically pivotal time in life than that of a child. 
Make it through childhood without checkups, without a doctor's care, 
and you're still facing a lifetime of endangered health. Every other 
developed nation in the world seems to get that. Every other developed 
nation in the world provides its children with health care. Every 
developed nation makes sure all of its children are covered, with the 
exception of the United States of America.
  This bill brings into the State Children's Health Insurance Program 4 
million children not covered today because the President vetoed the 
CHIP bill, and we could not get 15 additional people in this body to 
override the veto. We got 45 on the Republican side of the aisle, and 
all the Democrats, but we couldn't get those extra 15. This bill brings 
in those 4 million children. It does what President Bush promised to do 
when he ran for re-election in 2004.
  Accepting the Republican nomination in 2004, President Bush said 
this: ``In a new term, we will lead an aggressive effort to enroll 
millions of poor children who are eligible but not signed up for 
government health insurance programs.'' That's what he promised.
  That's what the House and Senate have been pushing to do, what we 
passed legislation to do, and what the overwhelming majority of 
Americans have wanted to do for years.
  Madam Speaker, we've tried. President Bush vetoed similar bills 
twice. But we are confident that President-elect Obama sees the issue 
differently. The American people saw the issue differently. They wanted 
change. This bill is going to reflect their desire for and vote for 
change.
  This bill gives States permission to waive an arbitrary waiting 
period of 5 years to enroll immigrant children who are here legally.
  Is there anyone here who wants to check on a sick child and say, we 
know you're here legally, but you've got to wait 5 years? A 1-year-old 
or a 2-year-old, that's two or three times their lifetime. It doesn't 
make moral sense to deny those children health services when their 
parents already pay payroll taxes. It doesn't make public health sense 
to keep those kids from getting the basic care they need.
  As a parent, as a grandfather, and as a great grandfather, very 
frankly, I want my child in school with healthy children, from wherever 
they come. And it doesn't make economic sense to subsidize unnecessary 
emergency room visits.
  Madam Speaker, we all know that we're in a severe recession, and it 
makes this bill more vital than ever, because when we considered this 
bill last year, we hadn't lost millions of jobs. Millions of parents 
had not yet lost their health insurance. This legislation is more 
necessary than ever. More and more Americans are out of work.
  More and more family budgets are strained to the breaking point. 
Today, health coverage for kids could make the difference between a 
family's economic ruin and economic stability.
  As Yale University's Jacob S. Hacker writes, ``access to affordable 
health care could be an immediate lifeline for working families.''
  It is in our power to throw that lifeline today. It's the right thing 
to do. It's the right thing to do for our children. It's the right 
thing to do for our families. It's the right thing to do for our 
economy, and it is the morally correct thing to do.
  Pass this rule, pass this bill, let us send it to President Obama, 
and he will add the 4 million children, with our help, to health care 
in the richest land on the face of the Earth.

                              {time}  1145

  Mr. SESSIONS. Madam Speaker, the gentleman, the majority leader, 
indicated he had not had an opportunity to see the Congressional Budget 
Office report to the gentleman Mr. Waxman, dated January 13. I would 
like to insert this into the transcript of today's debate.

               Congressional Budget Office Cost Estimate

     H.R. 2--Children's Health Insurance Program Reauthorization 
         Act of 2009
       Summary: The legislation would authorize the Children's 
     Health Insurance Program (CHIP) through fiscal year 2013 and 
     increase federal funding for the program above current 
     levels. The bill would provide performance bonus payments to 
     states for enrollment costs resulting from specified 
     enrollment and retention efforts. H.R. 2 would establish a 
     child enrollment contingency fund to cover state CHIP 
     expenditures beyond the amount allotted in statute for the 
     2009-2013 reauthorization period. The bill also would add an 
     additional state option to use CHIP funding to provide a 
     premium assistance subsidy for children enrolled in a 
     qualified health insurance plan, provide additional funding 
     for outreach grants, and improve access to dental benefits 
     and mental health parity in CHIP plans.
       H.R. 2 includes other provisions related to the Medicaid 
     program and CHIP. These provisions include ones that would 
     allow states the authority to waive the restriction on 
     providing Medicaid and CHIP coverage to certain legal 
     immigrants before five years of

[[Page H212]]

     residency, provide an alternative citizenship verification 
     process for states when determining Medicaid eligibility, and 
     provide grants for increased outreach and enrollment 
     activities. Finally, the bill would increase the federal 
     excise tax on tobacco products.
       The effects on direct spending and revenues over the 2009-
     2013 and 2009-2018 periods are relevant for enforcing pay-as-
     you-go rules under the current budget resolution. CBO 
     estimates that enacting H.R. 2 would increase direct spending 
     by approximately $32.3 billion over the 2009-2013 period, and 
     by $65.4 billion over the 2009-2018 period. In addition, the 
     Joint Committee on Taxation (JCT) estimates that certain 
     provisions of the bill would increase federal revenues by 
     $31.3 billion over the 2009-2013 period and $64.7 billion 
     over the 2009-2018 period. Accounting for those effects and 
     other revenue effects stemming from provisions in H.R. 2, CBO 
     estimates that enacting the legislation would reduce deficits 
     by $1.1 billion over the 2009-2013 period and by $1.7 billion 
     over the 2009-2018 period.
       CBO has reviewed the nontax provisions of the bill (Title I 
     through Title VI, excluding section 311(a)) and determined 
     that they contain no intergovernmental mandates as defined in 
     the Unfunded Mandates Reform Act (UMRA). CBO has determined 
     that those provisions contain private-sector mandates on 
     group health plans and issuers of group health insurance. In 
     aggregate, the costs of the mandates on private entities in 
     the nontax provisions of the bill would not exceed the annual 
     threshold established by UMRA for private-sector mandates 
     ($139 million in 2009, adjusted annually for inflation).
       Estimated cost to the Federal Government: CBO's estimate of 
     the impact of H.R. 2 on direct spending and revenues is shown 
     in the following table. The costs of this legislation fall 
     within budget function 550 (health).

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                               By fiscal year in billions of dollars--
                                           -------------------------------------------------------------------------------------------------------------
                                             2009    2010    2011    2012    2013    2014    2015    2016    2017    2018    2019   2009-2014  2009-2019
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                               CHANGES IN DIRECT SPENDING
 
Estimated CHIP Allotments.................     5.6     7.5     8.5    10.0    12.4     1.0     1.0     1.0     1.0     1.0     1.0      44.9       49.9
Estimated Outlays.........................     2.4     4.5     7.3     8.5     9.7     7.1     5.9     6.3     6.7     7.1     7.8      39.4       73.3
 
                                                                   CHANGES IN REVENUES
 
Estimated On-budget Revenues..............     3.7     7.2     7.0     7.0     7.6     6.3     6.8     6.7     6.7     6.6     6.4      38.8       72.0
Estimated Off-budget Revenues.............       *     0.1     0.2     0.3     0.3     0.3     0.1     0.1     0.1     0.1     0.1       1.3        1.6
                                           -------------------------------------------------------------------------------------------------------------
      Total Changes in Revenues...........     3.8     7.4     7.2     7.2     7.9     6.6     6.9     6.8     6.7     6.7     6.5      40.1       73.6
 
                                                                 NET DEFICIT IMPACT \1\
 
Net On-Budget Effects.....................    -1.3    -2.8     0.3     1.6     2.1     0.7    -0.9    -0.4       *     0.5     1.4       0.6        1.2
Net On- and Off-Budget Effects............    -1.4    -2.9     0.1     1.3     1.8     0.4    -1.0    -0.5       *     0.4     1.3      -0.7      -0.4
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ Negative numbers denote a reduction in projected deficit; positive numbers denote an increase in projected deficits.
 
Notes: Components may not sum to totals because of rounding. * = between -$50 million and $50 million.

       Basis of estimate: H.R. 2 contains provisions that would 
     both increase and decrease direct spending, as well as 
     increase federal revenues. CBO estimates the net budgetary 
     impact of the legislation will be to reduce deficits by $1.1 
     billion over the 2009-2013 period, by $1.7 billion over 
     the 2009-2018 period, and by $0.4 billion over the 2009-
     2019 period.
     Direct Spending
       Provisions Affecting CHIP Benefits and Administrative 
     Costs. CBO estimates that H.R. 2 would increase CHIP outlays 
     on benefits and administrative costs by about $31.7 billion 
     over the 2009-2014 period and by $36.3 billion over the 2009-
     2019 period. The increase in CHIP outlays would be associated 
     primarily with increased funding to maintain current program 
     levels and allow states the option to expand their existing 
     CHIP programs. Under CBO's current baseline, funding for CHIP 
     allotments is assumed to continue at approximately $5 billion 
     each year after the program's scheduled expiration on March 
     31, 2009. H.R. 2 would increase CHIP allotments above that 
     level by a total of $43.9 billion over the 2009-2013 period. 
     In fiscal year 2013, the bill would provide two semi-annual 
     allotments of $3 billion, which are lower than the allotment 
     levels in the four previous years. The first semi-annual 
     allotment in 2013 would be accompanied by onetime funding for 
     the program of approximately $11.4 billion. (The 2013 funding 
     would total $17.4 billion, an increase of $12.4 billion over 
     the current baseline projection.)
       Because H.R. 2 would authorize CHIP through 2013, baseline 
     rules established by the Balanced Budget and Emergency 
     Deficit Control Act of 1985 call for extrapolating an 
     annualized level of program funding at the end of 
     authorization for the 2014-2019 period. Consequently, this 
     estimate assumes that funding for CHIP would continue at the 
     extrapolated annual amount of $6 billion ($1 billion per year 
     more than the current baseline amount).
       Performance Bonus Payments to States. H.R. 2 would provide 
     funding for performance bonus payments using a two-tiered 
     structure. Those bonus payments are designed to offset 
     additional enrollment costs resulting from specified 
     enrollment and retention efforts. To be eligible for those 
     bonus payments, a state must meet at least four enrollment 
     and retention criteria specified in the bill. The legislation 
     would establish a benchmark level above which states can 
     receive bonus payments for children enrolled in Medicaid. A 
     threshold separating the two payment tiers is set at 10 
     percent above the benchmark level. States that enroll 
     children who are in the first tier (above the benchmark level 
     and below the 10 percent threshold) would receive bonus 
     payments that are 15 percent of projected per capita state 
     Medicaid expenditures. States that enroll children in the 
     second tier (at or above the 10 percent threshold) would 
     receive bonus payments totaling 62.5 percent of projected per 
     capita state Medicaid expenditures. CBO estimates that 
     performance bonus payments would increase direct spending by 
     $4.4 billion over the 2009-2019 period.
       Child Enrollment Contingency Fund. H.R. 2 would provide 
     additional funding, to states to maintain their current 
     program levels over the 2009-2013 period. Such funding would 
     be available to states whose spending exceeds their 
     allotments in any fiscal year of the reauthorization period. 
     CBO estimates that the contingency fund would increase direct 
     spending by $0.8 billion over the 2009-2013 period (with no 
     impact after 2013).
       Medicaid Spending Due to Interactions with CHIP. CBO 
     expects an interaction between CHIP and the Medicaid program 
     under H.R. 2. There are three key components to that 
     interaction. CBO estimates that Medicaid spending would 
     decrease as additional funding is provided to CHIP. When 
     available CHIP funding is insufficient to maintain program 
     coverage levels, states may continue to receive federal 
     matching funds for some children at the lower Medicaid 
     matching rate. Therefore, additional funding for CHIP would 
     reduce the number of children shifted to Medicaid. Medicaid 
     spending also would increase as adults move from CHIP to 
     Medicaid coverage. Finally, the bill's bonus payments would 
     lead to increased enrollment of children in Medicaid, further 
     increasing Medicaid spending. CBO estimates that Medicaid 
     spending associated with these interactions would increase by 
     $22.1 billion over the 2009-2019 period.
       Verification of Declaration of Citizenship or Nationality 
     for Purposes of Eligibility for Medicaid and CHIP. The bill 
     would provide an alternative citizenship verification process 
     for states when determining Medicaid eligibility. Instead of 
     presenting satisfactory documentary evidence as required 
     under the Deficit Reduction Act of 2005, states could submit 
     the name and Social Security number of the individual to the 
     Commissioner of Social Security. The Commissioner would then 
     determine whether the name and Social Security number 
     provided by the state is consistent with information in the 
     records maintained by the Commissioner. If the information is 
     not consistent, the state would make a reasonable effort to 
     address the causes of the inconsistency. If the inconsistency 
     cannot be resolved, the individual would be disenrolled from 
     the program. The bill also would apply the verification 
     process to the Children's Health Insurance Program.
       Because this provision would enable more people to prove 
     eligibility for Medicaid, or enroll in Medicaid sooner, CBO 
     estimates that federal spending for Medicaid would increase 
     by $5.1 billion over the 2009-2019 period. CBO estimates no 
     changes in direct spending for CHIP resulting from this 
     provision. The bill also would provide an appropriation of $5 
     million to the Commissioner of Social Security to carry out 
     the Commissioner's responsibilities under the bill.
       Permitting States to Ensure Coverage without a Five-Year 
     Delay of Certain Children and Pregnant Women under the 
     Medicaid Program and CHIP. The bill would allow states to 
     waive the restriction on providing Medicaid and CHIP coverage 
     to legal immigrants before five years of lawful residency in 
     the United States. The bill would apply only to pregnant 
     women and children. CBO estimates that this provision 
     would increase direct spending under Medicaid by $3.9 
     billion over the 2009-2019 period.
       Medicaid Savings from Increasing the Tobacco Excise Tax. 
     CBO estimates that the increase in the tobacco excise tax 
     would reduce the number of smokers. A decline in smoking 
     among pregnant women would result in fewer low-birth-weight 
     deliveries. CBO estimates that as a result, federal spending 
     for Medicaid would decrease by approximately $0.2 billion 
     over the 2009-2019 period.
     Revenues
       Tobacco Excise Tax. The legislation contains provisions 
     that would raise several

[[Page H213]]

     types of excise taxes on tobacco. Those provisions include 
     language that would raise the federal excise tax on 
     cigarettes from 39 cents a pack to $1.00 a pack, and would 
     also increase taxes on other tobacco products. JCT estimates 
     that those provisions would increase revenues by $31.3 
     billion over the 2009-2013 period, by $64.7 billion over the 
     2009-2018 period, and by $71.1 billion over the 2009-2019 
     period.
       Estimated impact on State, local, and tribal governments: 
     CBO has reviewed the nontax provisions (Title I through Title 
     VI, excluding section 311(a)) of the bill and determined that 
     they contain no intergovernmental mandates as defined in 
     UMRA.
       An existing provision in the Public Health Service Act 
     would allow state, local, and tribal governments, as 
     employers that provide health benefits to their employees, to 
     opt out of provisions of the bill that amend that act. 
     Consequently, the bill's requirements on employers to comply 
     with provisions associated with premium assistance under the 
     Medicaid and CHIP programs would not be intergovernmental 
     mandates as defined in UMRA. The bill would affect the 
     budgets of those governments only if they choose to comply 
     with the requirements imposed on group health plans.
       CBO estimates that enactment of this bill would result in 
     additional net spending by states of about $9.7 billion over 
     the 2009-2013 period for the SCHIP program. In general, 
     state, local, and tribal governments would benefit from the 
     continuation of existing SCHIP grants, the creation of new 
     grants, and broader flexibility and options in the program.
       Estimated impact on the private sector: CBO has reviewed 
     the nontax provisions of the bill and determined that they 
     would impose mandates on the private sector as defined in 
     UMRA. CBO estimates that the direct cost of complying with 
     those mandates would not exceed the threshold established by 
     UMRA for private-sector mandates ($139 million in 2009, 
     adjusted annually for inflation).
       The bill would require group health plans and issuers of 
     group health insurance in connection with a group health plan 
     to permit employees to enroll in the group health plan if 
     they lose Medicaid or CHIP eligibility or become eligible for 
     premium assistance through Medicaid or CHIP. The bill would 
     also require employers to inform employees of potential 
     premium assistance opportunities, if available.
       Estimate prepared by: Federal Costs: Sean Dunbar, Robert 
     Stewart, Kirstin Nelson, Ellen Werble, and Grant Driessen. 
     Impact on State, Local, and Tribal Governments: Lisa Ramirez-
     Branum. Impact on the Private Sector: Keisuke Nakagawa, 
     Patrick Bernhardt, and Stuart Hagen.
       Estimate approved by: Peter H. Fontaine, Assistant Director 
     for Budget Analysis.

  Also, I would like to just retort to the gentleman that probably 
every other industrialized nation in the world does have children's 
health care coverage. It's socialized medicine, and they rank near the 
bottom of health care coverage. That's why America is the top, because 
we have a health care system that works, that includes private 
insurance that today we are trying to raid which we should not raid. We 
don't want to be at the bottom. We want to be at the top.
  Madam Speaker, at this time, I would like to yield 1\1/2\ minutes to 
the gentleman from Georgia (Mr. Price).
  Mr. PRICE of Georgia. Madam Speaker, we all commend the President-
elect for his vision of hope and of bipartisanship. It was with that 
same spirit of bipartisanship that the original SCHIP bill was adopted 
in the mid-1990s when Republicans and Democrats recognized together the 
need for assisting children in low-income families by providing access 
to health insurance. Remember? Probably not, because it was done 
quietly and proudly together. That's in stark contrast to now. With 
overbearing partisanship from the majority's cramming this highly 
charged bill through today and by ignoring vital problems, this bill 
will throw 2.4 million kids off private, personal health insurance into 
government-run bureaucratic medicine.
  You talk about immoral. This bill requires over 20 million new 
smokers, Madam Speaker--new smokers--in order to pay for it. How very 
cynical. That's a problem, because there were so many positive 
alternatives.
  I introduced with over 20 of my colleagues More Children, More 
Choices that would have provided up to $42,000 of coverage for the 
original children, premium assistance of up to $64,000 and then State 
flexibility beyond that.
  Bipartisan rhetoric is hollow if it is not followed with bipartisan 
action. This bill does not do that. It betrays the spirit of the 
President-elect, and it betrays all Americans.
  I call on the Speaker to begin an open and positive process, 
respecting all Members and respecting all Americans.
  Mr. HASTINGS of Florida. Madam Speaker, may I indulge you again to 
give us the remaining amount of time.
  The SPEAKER pro tempore. The gentleman from Florida has 5\3/4\ 
minutes. The gentleman from Texas has 1\1/2\ minutes remaining.
  Mr. HASTINGS of Florida. Madam Speaker, at this time, I am very 
pleased to yield 1 minute to the distinguished gentlewoman from 
Pennsylvania, yet another of our new Members, providing new dynamics 
and new direction, Mrs. Dahlkemper.
  Mrs. DAHLKEMPER. Madam Speaker, I rise in support of the rule and of 
the underlying bill, the SCHIP reauthorization bill, before us today.
  One of my priorities in running for Congress is to ensure that all 
eligible children have health care. I am pleased that this legislation 
will cover an additional 4 million children and will build on the 
current children's health program to provide care for expectant 
mothers, allowing our children to begin their lives with the best 
health outlook possible.
  Myself, I gave birth to one of my children without health care. It 
was due to my having a preexisting condition at the change of a job and 
with a new health care policy, and that preexisting condition was 
pregnancy. Certainly, this needs to end in our country. We need to 
start our children off on the best possible health outlook.
  This bill will also give incentive to States to increase enrollment 
so we can benefit more children and so we can provide them with the 
health care necessary for their growth and well-being.
  Madam Speaker, I encourage my colleagues to support this rule. It is 
certainly necessary for our children of this country and for the health 
of this Nation.
  Mr. SESSIONS. Madam Speaker, we reserve our time.
  Mr. HASTINGS of Florida. Madam Speaker, I am very pleased at this 
time to yield 1 minute to my good friend, the distinguished gentlewoman 
from Texas (Ms. Jackson-Lee).
  Ms. JACKSON-LEE of Texas. Allow me to thank the distinguished 
gentleman as well as the subcommittee Chair, Mr. Stark, and Mr. Pallone 
and also the committees of jurisdiction--Ways and Means and, of course, 
the Energy and Commerce Committee--for their thoughtful way of 
approaching this calamity in this country.
  Madam Speaker, let me quickly speak and suggest to you that the 
diversity of children that is uninsured is unbelievable: black, 1.7 
million; white, 3.4 million; Hispanic, 1.6 million; American Indian, 
132,000; Asian Pacific, 390,000. This is a crisis--a calamity--in 
America, and I support the underlying legislation.
  However, I work with my good friend from Oklahoma, Mr. Boren, to help 
us protect physician-owned hospitals. Here in my own community, St. 
Joseph's Hospital was on the verge of closing. I worked with them to 
keep them open. Interestingly enough, Harris County has 4.5 million 
people and only 16,000 beds. These hospitals are in the crux of serving 
the poor and the underserved.
  I only hope that, as we move forward, we can work closely with our 
good friends who have done the right thing, who are going to move this 
bill to be signed by our President to ensure that those hospitals 
remain open.
  Mr. Boren and I have an amendment of extension to 2010. I hope we do 
that. I will submit a letter from the Governor of Texas into the Record 
on this issue.

                                           Office of the Governor,


                                               State of Texas,

                                     Austin, TX, January 13, 2009.
     Hon. Joe L. Barton,
     House of Representatives,
     Washington, DC.
       Dear Representative Barton: In the next few days, the U.S. 
     Congress will address the pressing issue of funding the State 
     Children's Health Insurance Program (SCHIP). I urge you to 
     fight to protect the vital funding that has been allocated to 
     the state for its SCHIP program.
       SCRIP was developed by Congress as a program administered 
     by states to serve low-income and uninsured children. In 
     2000, Texas began enrolling children in a separate SCHIP 
     program that is fiscally responsible and focuses on serving 
     the targeted clients Congress originally authorized. Texas 
     maintains reasonable eligibility requirements, such as only 
     enrolling children whose families make less than 200 percent 
     of the federal poverty level (FPL). Some states experiencing 
     shortfalls cover families whose incomes are as

[[Page H214]]

     high as 350 percent of FPL and non-pregnant adults. As you 
     consider impending SCHIP reauthorization legislation, it is 
     imperative that Texas is not penalized for not taking these 
     liberties with its program.
       In addition, recent reports have indicated that 
     restrictions on physician-owned hospitals may be used to 
     offset SCHIP budget costs. Congress should not foreclose a 
     health service delivery access point in order to pay for 
     SCHIP state expansions. Texas has approximately 50 physician-
     owned hospitals, which provide critical services to thousands 
     of patients each year, employ more than 22,000 Texans and 
     have a reported net economic effect of nearly $2.3 billion on 
     the Texas economy. These hospitals play a vital role in 
     health care delivery in the state, a role that is rightfully 
     determined by the needs of Texas communities, not 
     governmental financing maneuvers.
       I ask you to consider the consequences of limiting 
     physician-owned hospitals in Texas as you seek to protect 
     Texas' SCHIP current and future allocations. Texas should not 
     be penalized for administering a fiscally responsible program 
     that serves a vital need for the low-income children in our 
     state.
       Please let me know how I can be of assistance. I look 
     forward to a positive outcome for the children of Texas.
           Sincerely,
                                                       Rick Perry,
                                                         Governor.
  Madam Speaker, I rise today in strong support for the ``Children's 
Health Insurance Program Reauthorization Act of 2009.'' We stand today, 
closer to helping 4 million children without health insurance. No 
longer will these children be forced to live with fear of getting sick.
  Today is a great day. Today we can bring 4 million children in to the 
fold. Today we can tell those 4 million children that are begging for 
help that ``Yes we can.''


                        NATIONALLY AND IN TEXAS

  There are an estimated 8.9 million uninsured children in America. 
Overall, about 11.3 percent of children in the United States are 
uninsured, but the percentage of uninsured children in each State 
varies widely. Based on a 3-year average, there were an estimated 20.9 
percent of uninsured children, under 19 years of age in Texas, 
representing 1,454,000 of the State's children.
  According to the Institute of Medicine, uninsured people are less 
likely to use preventive services and receive regular care. They are 
also more likely to delay care resulting in poorer health and outcomes. 
Texas has the highest uninsured rates of all 50 States and the District 
of Columbia, 2005-2007. Almost one-quarter, 24.4 percent, of Texans are 
uninsured compared to 15.3 percent of the general U.S. population.
  Data show that virtually all the net reduction in SCHIP enrollment 
has been among children in families with incomes below 150 percent FPL. 
The number of below-poverty children has dropped by more than 68 
percent and the number of children between 101-150 percent FPL has 
dropped by more than one-third since September 2003. I want to share 
with you just some of the scary health statistics that are affecting 
children: 74 percent of uninsured children eligible for SCHIP or 
Medicaid but not enrolled; 11 percent of uninsured children in families 
not eligible for Medicaid or SCHIP with incomes below; 15 percent of 
uninsured children in families with incomes over 300 percent of the 
federal poverty-level who are ineligible for Medicaid and SCHIP; 90 
percent of uninsured children that come from families where at least 
one parent works; 50 percent of two-parent families of uninsured 
children in which both parents work; 3.4 million uninsured children who 
are white, non-Hispanic; 1.6 million uninsured children who are African 
American; 3.3 million uninsured children who are Hispanic; and 670,000 
uninsured children of other racial and ethnic backgrounds.
  In the great State of Texas there is a young man named Jason who had 
SCHIP health insurance for years, and the coverage was life saving. 
When he was in a car accident over a year ago, SCHIP covered his 
treatment and all the medical bills. His family needs SCHIP because 
they cannot afford private health coverage. The parents work hard, but 
the father's employment in pest control is seasonal and provides only 
about $35,000 annually. Jason's mother is wheelchair-bound with 
multiple sclerosis and has significant health care expenses.
  When Jason lost SCHIP a year ago, his mother suspected they had been 
denied because of the 2003 Ford truck the family purchased so that she 
could transport her wheelchair. Prior to last year, she had never had 
problems renewing coverage and the family's income had not changed. But 
the income guidelines had changes.
  New SCHIP guidelines that took effect in December 2005 do not count 
children over 18 years of age as family members. Although their full-
time student daughter lives at home, she is not counted as part of the 
family, and, as a result, they are about $50 a month above the income 
limit for a family of three. So now the entire family is uninsured. 
This lack of coverage means that when Jason gets sick or hurt, they 
have to delay paying other bills to pay for medical care.
  Lack of coverage also has affected Jason's performance in school. He 
has been sick quite a bit in the past few years with allergies and has 
missed many days of school, because his eyes become swollen and he is 
unable to breathe. School officials had reprimanded the mother about 
his absences but now realize that Jason has some serious health issues.
  Finally we will be able to help people like Jason and assuage his 
mothers concerns. We are able to insure those who need it most.


                       PHYSICIAN-OWNED HOSPITALS

  Sadly, there is one portion of this bill I did have some trouble 
with, the restrictions on physician-owned hospitals. Yesterday, my dear 
friend from Oklahoma, Congressman Boren and I were able to voice a very 
real concern that we had with the prohibition on physician-owned 
hospitals.
  As the bill was originally written there was a provision in the bill 
that would have drastically affected the quality of care available to 
Houston residents and people in urban communities across the entire 
country.
  The exceptions that exist to grandfather in certain physician-owned 
hospitals is inadequate and will affect more than 85 hospitals that are 
currently in development and under construction. It will also restrict 
sales and transfers of many responsible physician-owned hospitals.
  In my district of Houston, Texas the population has grown close to 
4.5 million people and there are only approximately 16,000 beds 
available in the city. Eliminating physician ownership in general acute 
care hospitals would only contribute to this ever growing problem.
  While many specialty hospitals are accused of turning away uninsured 
and Medicaid patients and practicing only profitable healthcare, 
responsible physician-owned hospitals do just the opposite.
  Physician-owned hospitals like St. Joseph Medical Center in my 
district provide essential emergency, maternity, and psychiatric care 
for their patients. They delivered over 6,000 babies in 2008, of which 
3,700 were insured by Medicaid. Currently they provide $14 million in 
uninsured care in the Houston Market. A Houston Institution for 120 
years, St. Joseph Medical Center is also a major provider of 
psychiatric beds as it currently operates 102 of the 800 licensed beds 
in Houston.
  While Members of the Texas delegation have continued to support 
general acute-care hospitals and their future development; we still 
believe that general acute-care hospitals still need to be able to:
  Maintain a minimum number of physicians available at all times to 
provide service;
  Provide a significant amount of charity care;
  Treat at least one-sixth of its outpatient visits for emergency 
medical conditions on an urgent basis without requiring a previously 
scheduled appointment;
  Maintain at least 10 full time interns or residents-in-training in a 
teaching program;
  Advertise or present themselves to the public as a place which 
provides emergency care;
  Serve as a disproportionate share provider, serving a low income 
community with a disproportionate share of low income patients; and
  Have at least 90 hospital beds available to patients.
  This issue is of the utmost importance to me because I, like others 
in the Democratic Caucus, have hospitals and hospital systems such as 
University Hospital Systems of Houston in my district that would have 
been greatly affected by this provision.


                       ST. JOSEPH MEDICAL CENTER

  In 2006, St. Joseph Medical Center, downtown Houston's first and only 
teaching hospital was on the verge of closing its doors. When I learned 
that they were going to shut down this hospital and turn it into high-
end condominiums, I personally worked with the hospital board, 
community leaders, and local government to ensure this did not take 
place. Eventually, after I was assured that it would be responsibly 
managed and its doors would remain open, I was able to help a hospital 
corporation, in partnership with physicians, purchase the hospital and 
it has made the hospital the premier hospital in the region. St. 
Joseph's doors remain open and its qualified emergency room is 
responsive to a heavily populated downtown Houston.
  This formerly troubled medical center is now in the process of 
reopening Houston Heights Hospital, the fourth oldest acute care 
hospital in Houston. Without language that specifically addresses this 
distinction, this project too will come to an end.
  Sadly, it remains unclear if CHIP provides for physician-owned 
hospitals to still be considered grandfathered if they have a sale or 
transfer at the same ownership rate or at a different physician-
ownership rate.
  Between December 2007 and December 2008, the U.S. economy shed about 
2.6 million jobs, while Texas made significant gains. Texas' nonfarm 
employment registered a stable 2.1 percent growth rate over the year,

[[Page H215]]

even as the Nation's job losses reached their worst level since 2003. 
CBO forecasts the following: a marked contraction in the U.S. economy 
in calendar year 2009, with real, inflation adjusted, gross domestic 
product, GDP, falling by 2.2 percent; a slow recovery in 2010, with 
real GDP growing by only 1.5 percent; an unemployment rate that will 
exceed 9 percent early in 2010.

  The U.S. Bureau of Labor Statistics announced on November 21, 2009, 
that October's unemployment rate was 6.5 percent, a jump of 0.4 
percent, which was double what most economists expected, and its 
highest level in 14 years. The economy has now lost 1.2 million jobs 
since the beginning of the year, with nearly half of those losses 
occurring in the last 3 months alone, pointing to acceleration in the 
pace of erosion in labor markets. It is more important than ever in 
this economy that children's healthcare is not sacrificed.
  Madam Speaker, my faith is renewed in the process that is so often 
maligned in the media. Thoughtful and deliberate actions were taken to 
improve this legislation that would not only help the children of my 
district and many others across the Nation, but also it was able to 
address concerns that many of us, myself included have on these 
specialty hospitals.
  I look forward to a day when every child is covered and can play on 
football fields and jungle gyms without their parents fearing a 
bankrupting injury to their child. This legislation is piece of mind to 
4 million families and I will joyfully cast my vote for passage of this 
important legislation.
  There are currently 85 hospitals under development. An estimated 
$1,830,909,350 has been expended with $574,358,090 in outstanding 
financing. The addition of 85 more hospitals would also equate to an 
estimated 23,000 more jobs. In addition, of the 199 existing physician-
owned hospitals, 34 are under-going major construction with an 
estimated $357,500,000 in outstanding expenditures that could be 
affected by legislation.
  The following States reported hospitals under development:
  Arkansas--4 hospitals, all in District 3.
  Arizona--3 hospitals, District 3 (2 hospitals) and District 8.
  California--8 hospitals, Districts 2, 16, 18, 19, 45, 48, with 2 
Districts unknown.
  Colorado--3 hospitals, Districts 1, 3, 7.
  Florida--2 hospitals, District 20, with 1 District unknown.
  Iowa--1 hospital, District 4.
  Idaho--2 hospitals, District 1, with 1 District unknown.
  Illinois--1 hospital, District 14.
  Indiana--5 hospitals, District 2 (3 hospitals), District 9 (2 
hospitals).
  Kansas--4 hospitals, District 2, District 4 (2 hospitals), with 1 
District unknown.
  Louisiana--6 hospitals, Districts 1 (2 hospitals), District 5 (2 
hospitals), District 7, with 1 District unknown.
  Massachusetts--1 hospital, District 8.
  Michigan--2 hospitals, Districts 9, 12.
  North Dakota--1 hospital, District 1.
  Nebraska--2 hospitals, Districts 1, 2.
  Ohio--8 hospitals, Districts 1, 3, 7, District 9 (2 hospitals), 11, 
12, 13.
  Oklahoma--3 hospitals, Districts 1, 2, 5.
  Pennsylvania--3 hospitals, District 15, 19 with 1 District unknown.
  South Dakota--3 hospitals, all in District 1.
  Texas--51 hospitals, Districts 2 (3 hospitals), 3, 4, 5 (3 
hospitals), 6, 7, 8, 9, 10 (2 hospitals), 11, District 12 (4 
hospitals), 14, 15, 19, 20 (2 hospitals), 21, 24 (4 hospitals), 25 (3 
hospitals), 26 (3 hospitals), 27 (2 hospitals), 29, 30 (9 hospitals), 
31, 32 (2 hospitals), with 2 Districts unknown.
  Virginia--1 hospital, District 3.
  Wisconsin--2 hospitals, both District 5.
  Wyoming--1 hospital, District 1.
  Mr. SESSIONS. Madam Speaker, we continue to reserve our time.
  Mr. HASTINGS of Florida. Madam Speaker, I am very pleased to yield at 
this time 1 minute to a distinguished new Member who represents those 
10 miles from my home, Orlando, Florida (Mr. Grayson).
  Mr. GRAYSON. Madam Speaker, there is a power that we have as 
legislators that we don't often discuss, but it's there nonetheless. It 
is the power of life and death. The power is most apparent when we vote 
on wars, but it is apparent here today as well.
  Today, we vote on life versus death. There are 50,000 American 
children who died last year. More children in America die every month 
than the number of Americans who were lost on 9/11. Half of those 
children never reached their first birthdays. Thousands of them died 
from cancer. We need to do everything that we can to save them.
  I was a very sick child. I had to go to the hospital four times a 
week for treatment. If it weren't for my parents' union health 
benefits, I would not be here today for this vote.
  Study after study shows that, for life-threatening conditions, 
uninsured people are three times more likely to die than those who are 
insured. At this time, there are many, many parents in our country who 
cannot afford health care for their children, but we cannot let the 
problems of the parents descend on the children.
  By voting ``yes'' today, we save thousands of innocent lives. We 
won't know who they are. In fact, they won't know who they are, but 
they will owe their lives to our conscience. Please vote for SCHIP 
today. Vote for life.
  Mr. SESSIONS. Madam Speaker, we will continue to reserve our time.
  Mr. HASTINGS of Florida. Madam Speaker, I am very pleased at this 
time to yield 1 minute to the distinguished gentleman, my friend from 
Oregon, a member of the Ways and Means Committee, Mr. Blumenauer.
  Mr. BLUMENAUER. Madam Speaker, I am pleased to rise in support of the 
rule and of the underlying bill.
  This is the first step in this Congress that sends a signal of hope 
to people around the country. It is not just going to make a difference 
for 70,000 children in my State of Oregon and for 11 million children 
across America who will get health insurance. It was important in the 
last Congress that we had passed this bipartisan legislation, but 
unfortunately, the roadblocks in the White House and Republican 
Congress made that impossible to be enacted into law. If it were 
important in the last session, it is critical in this session with the 
economy in a free-fall, with families in desperate conditions and with 
health care fraying at the edges.
  This action today is showing the difference of the new leadership in 
the House, in the Senate and in the White House. Beyond the 70,000 
children in Oregon and 11 million children across the country, this is 
a signal to America about where our Nation is going. This signal of 
hope can come none too soon.
  Mr. SESSIONS. Madam Speaker, we will continue to reserve our time.
  Mr. HASTINGS of Florida. Madam Speaker, at this time, I inquire of 
the gentleman whether or not he is their last speaker. I am prepared to 
close, and I will be our last speaker.
  Mr. SESSIONS. I thank the gentleman. I have no further speakers and 
would yield myself the balance of my time to close.
  The SPEAKER pro tempore. The gentleman from Texas is recognized for 
1\1/2\ minutes.
  Mr. SESSIONS. Madam Speaker, I will be asking for a recorded vote on 
this closed rule.
  With the current program not expiring until March 31 of this year, we 
have seen enough Members question the underlying legislation, and I 
think we deserve an open and honest debate in the committees of 
jurisdiction before we take a vote on such a large expansion--$35 
billion more of government programs.
  This legislation spends billions of dollars to substitute private 
health insurance with government-run coverage. It enables illegal 
aliens to fraudulently enroll in Medicaid and in SCHIP. The bill 
creates the most regressive tax increase in American history, using 
funding gained from taxing the poor to pay for expanding SCHIP 
eligibility to higher income families. This legislation increases the 
number of adults on SCHIP, allowing even more resources to be taken 
away from the low-income, uninsured children who need it the most.
  Madam Speaker, this legislation moves us closer and closer to a 
government-run program and further and further away to access for 
quality health care of our choice.
  I encourage all of my colleagues to vote ``no'' on the rule and to 
vote ``no'' on the underlying legislation. We should ensure that SCHIP 
meets its original intent and that it covers the poorest children 
first.
  We have been very clear about saying that the Republicans in this 
body have asked for the opportunity to have regular order to discuss 
this issue in committee and have asked for the opportunity to have 
Republicans and Democrats present their ideas and hear them accepted 
for amendments before the Rules Committee. We object to the way that 
this Rules Committee has handled this issue.
  I yield back the balance of my time.
  Mr. HASTINGS of Florida. Madam Speaker, when I hear my good friend 
from Texas speak of regular order on this particular measure, it would 
presume, among other things, I guess, that

[[Page H216]]

no one in this body knows that there is a significant number of 
children who are uninsured and that this measure, once offered in 1997, 
did begin the process that today we wish to continue and that still 
does not complete the task that most of us feel is necessary in order 
to insure all of the children in this country.
  Madam Speaker, this is a good rule for a critically important bill. 
Although this bill cannot repair all of the flaws that are intrinsic in 
America's health care system, it undoubtedly serves as a strong and 
honorable prelude to facilitating comprehensive health care reform.
  Mahatma Gandhi, among many things, said that you can learn about a 
country's condition by looking at its most weak and vulnerable people. 
The alarming rate of uninsured and poverty-stricken children in this 
country tells us that the richest country on Earth is in poor 
condition.
  I urge my colleagues to vote in favor of this rule so that we may 
support a bill that will give millions of children the basic right to 
health so that they can become leaders and productive citizens.
  I urge a ``yes'' vote on the previous question and on the rule.
  I yield back the balance of my time, and I move the previous question 
on the resolution.
  The previous question was ordered.
  The SPEAKER pro tempore. The question is on the resolution.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.


                             Recorded Vote

  Mr. SESSIONS. Madam Speaker, I demand a recorded vote.
  A recorded vote was ordered.
  The vote was taken by electronic device, and there were--ayes 244, 
noes 178, not voting 11, as follows:

                             [Roll No. 14]

                               AYES--244

     Abercrombie
     Ackerman
     Adler (NJ)
     Altmire
     Andrews
     Arcuri
     Baca
     Baird
     Baldwin
     Barrow
     Bean
     Becerra
     Berkley
     Berman
     Berry
     Bishop (GA)
     Bishop (NY)
     Blumenauer
     Boccieri
     Boren
     Boswell
     Boyd
     Brady (PA)
     Braley (IA)
     Bright
     Brown, Corrine
     Butterfield
     Capps
     Capuano
     Cardoza
     Carnahan
     Carney
     Carson (IN)
     Castor (FL)
     Chandler
     Childers
     Clarke
     Clay
     Cleaver
     Clyburn
     Cohen
     Connolly (VA)
     Conyers
     Cooper
     Costa
     Costello
     Courtney
     Crowley
     Cuellar
     Cummings
     Dahlkemper
     Davis (AL)
     Davis (CA)
     Davis (IL)
     Davis (TN)
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Dicks
     Dingell
     Doggett
     Donnelly (IN)
     Doyle
     Driehaus
     Edwards (MD)
     Edwards (TX)
     Ellison
     Ellsworth
     Engel
     Eshoo
     Etheridge
     Farr
     Fattah
     Filner
     Foster
     Frank (MA)
     Fudge
     Giffords
     Gillibrand
     Gonzalez
     Gordon (TN)
     Grayson
     Green, Al
     Green, Gene
     Griffith
     Grijalva
     Gutierrez
     Hall (NY)
     Halvorson
     Hare
     Harman
     Hastings (FL)
     Heinrich
     Higgins
     Himes
     Hinchey
     Hinojosa
     Hirono
     Hodes
     Holden
     Holt
     Honda
     Hoyer
     Inslee
     Israel
     Jackson (IL)
     Jackson-Lee (TX)
     Johnson (GA)
     Johnson, E. B.
     Kagen
     Kanjorski
     Kaptur
     Kennedy
     Kildee
     Kilpatrick (MI)
     Kilroy
     Kind
     Kirkpatrick (AZ)
     Kissell
     Klein (FL)
     Kosmas
     Kratovil
     Kucinich
     Langevin
     Larsen (WA)
     Larson (CT)
     Lee (CA)
     Levin
     Lewis (GA)
     Lipinski
     Loebsack
     Lofgren, Zoe
     Lowey
     Lujan
     Lynch
     Maffei
     Markey (CO)
     Markey (MA)
     Marshall
     Massa
     Matheson
     Matsui
     McCarthy (NY)
     McCollum
     McDermott
     McGovern
     McIntyre
     McMahon
     McNerney
     Meek (FL)
     Meeks (NY)
     Melancon
     Michaud
     Miller (NC)
     Miller, George
     Mitchell
     Mollohan
     Moore (KS)
     Moore (WI)
     Moran (VA)
     Murphy (CT)
     Murphy, Patrick
     Murtha
     Nadler (NY)
     Napolitano
     Neal (MA)
     Nye
     Oberstar
     Obey
     Olver
     Ortiz
     Pallone
     Pascrell
     Pastor (AZ)
     Payne
     Perlmutter
     Perriello
     Peters
     Peterson
     Pingree (ME)
     Polis (CO)
     Pomeroy
     Price (NC)
     Rahall
     Rangel
     Reyes
     Richardson
     Rodriguez
     Ross
     Rothman (NJ)
     Roybal-Allard
     Ruppersberger
     Rush
     Ryan (OH)
     Salazar
     Sanchez, Linda T.
     Sanchez, Loretta
     Sarbanes
     Schakowsky
     Schauer
     Schiff
     Schrader
     Schwartz
     Scott (GA)
     Scott (VA)
     Serrano
     Sestak
     Shea-Porter
     Sires
     Skelton
     Slaughter
     Smith (WA)
     Space
     Speier
     Spratt
     Stark
     Stupak
     Sutton
     Tanner
     Tauscher
     Taylor
     Teague
     Thompson (CA)
     Thompson (MS)
     Tierney
     Titus
     Tonko
     Towns
     Tsongas
     Van Hollen
     Velazquez
     Walz
     Wasserman Schultz
     Watson
     Watt
     Waxman
     Weiner
     Welch
     Wexler
     Wilson (OH)
     Woolsey
     Wu
     Yarmuth

                               NOES--178

     Aderholt
     Akin
     Alexander
     Austria
     Bachmann
     Bachus
     Barrett (SC)
     Bartlett
     Barton (TX)
     Biggert
     Bilbray
     Bilirakis
     Bishop (UT)
     Blackburn
     Blunt
     Bonner
     Bono Mack
     Boozman
     Boustany
     Brady (TX)
     Broun (GA)
     Brown (SC)
     Brown-Waite, Ginny
     Buchanan
     Burgess
     Burton (IN)
     Buyer
     Calvert
     Camp
     Campbell
     Cantor
     Cao
     Capito
     Carter
     Cassidy
     Castle
     Chaffetz
     Coble
     Coffman (CO)
     Cole
     Conaway
     Crenshaw
     Culberson
     Davis (KY)
     Deal (GA)
     Dent
     Diaz-Balart, L.
     Diaz-Balart, M.
     Dreier
     Duncan
     Ehlers
     Emerson
     Fallin
     Flake
     Fleming
     Forbes
     Fortenberry
     Foxx
     Franks (AZ)
     Frelinghuysen
     Gallegly
     Garrett (NJ)
     Gerlach
     Gingrey (GA)
     Gohmert
     Goodlatte
     Granger
     Graves
     Guthrie
     Hall (TX)
     Harper
     Hastings (WA)
     Heller
     Hensarling
     Herger
     Hill
     Hoekstra
     Hunter
     Inglis
     Issa
     Jenkins
     Johnson (IL)
     Johnson, Sam
     Jones
     Jordan (OH)
     King (IA)
     King (NY)
     Kingston
     Kirk
     Kline (MN)
     Lamborn
     Lance
     Latham
     LaTourette
     Latta
     Lee (NY)
     Lewis (CA)
     Linder
     LoBiondo
     Lucas
     Luetkemeyer
     Lummis
     Lungren, Daniel E.
     Mack
     Manzullo
     Marchant
     McCarthy (CA)
     McCaul
     McClintock
     McCotter
     McHenry
     McHugh
     McKeon
     McMorris Rodgers
     Mica
     Miller (FL)
     Miller (MI)
     Miller, Gary
     Minnick
     Moran (KS)
     Murphy, Tim
     Myrick
     Neugebauer
     Nunes
     Olson
     Paul
     Paulsen
     Pence
     Petri
     Pitts
     Platts
     Poe (TX)
     Posey
     Price (GA)
     Putnam
     Radanovich
     Rehberg
     Reichert
     Roe (TN)
     Rogers (AL)
     Rogers (KY)
     Rogers (MI)
     Rohrabacher
     Rooney
     Ros-Lehtinen
     Roskam
     Royce
     Ryan (WI)
     Scalise
     Schmidt
     Schock
     Sensenbrenner
     Sessions
     Shadegg
     Shimkus
     Shuler
     Shuster
     Simpson
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Souder
     Stearns
     Terry
     Thompson (PA)
     Thornberry
     Tiahrt
     Tiberi
     Turner
     Upton
     Walden
     Wamp
     Westmoreland
     Whitfield
     Wilson (SC)
     Wittman
     Wolf
     Young (AK)

                             NOT VOTING--11

     Boehner
     Boucher
     Herseth Sandlin
     Maloney
     Sherman
     Snyder
     Solis (CA)
     Sullivan
     Visclosky
     Waters
     Young (FL)

                              {time}  1225

  Messrs. GINGREY of Georgia, BURTON of Indiana and REICHERT changed 
their vote from ``aye'' to ``no.''
  So the resolution was agreed to.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.

                          ____________________`