Date: 2014-03-13
Speaker: JACKSON LEE (democrat)
Chamber: H

I thank the gentleman. The Jackson Lee amendment that was not allowed would have ensured that. notwithstanding any provision of this act. no delay in the application of any provision of the Affordable Care Act would have occurred. It would have called for some studies about Medicare providers. It would have given us real information. Jackson Lee amendment No. 2 would have required the Secretary to submit a report on cost savings. The real point is. between skewing the water rights of people and the SGR. this rule should be opposed. We should get back to the drawing board. Cant we all get along and work together on the right kind of legislation for water rights? More importantly. Mr. Speaker. our doctors deserve better. and I will say to them. you will get better from us. Mr. Speaker. I rise to speak in strong opposition to the Rule for H.R. 4015. the SGR Repeal and Medicare Provider Payment Modernization Act of 2014. Let me say first that I am a strong supporter of providing adequate compensation to our physicians who serve Medicare patients. It is important for our seniors to know that Medicare will be there when they need it. But it is equally important that there are physicians who are willing to attend to them without going broke. That is why we have a Sustainable Growth Rate or "SGR." Medicare reimbursement enables rural physicians and hospitals to remain open for business. As with any business. medical clinics and physician offices have payrolls to meet. bills to pay. and expenses to meet as they become due. If revenues are not sufficient to cover costs. the business will not long survive. Thus. it is critical that we not disrupt timely and adequate payment to Medicare providers. The problem with H.R. 4015 is what happened in the Rules Committee. The Rules Committee. on a party line vote. added language to the Rule for H.R. 4015 that would delay the Affordable Care Acts implementation of the individual mandate. I oppose the Rule for two reasons: It corrupts what would otherwise be a strongly supported bipartisan bill to sustain physician reimbursement rates for medical services approved under Medicare. and It is another attempt by the Republicans to mislead the public regarding the Affordable Care Act. The Jackson Lee Amendments offered to the Rules Committee for H.R. 4015 would have improved the bill by removing the uncertainty that physicians would not keep the reimbursement rates they now have for treating patients under Medicare. Jackson Lee Amendment #1 would have ensured that notwithstanding any provision of this Act. no delay in the application of any provisions of the Affordable Care Acts individual mandate can take effect before January 21. Jackson Lee Amendment #2 would have required the Secretary of Health and Human Services to submit a report to Congress on the impact of the Medicare provider payments on the diversity and availability of physicians and hospitals to underserved rural and urban communities. Jackson Lee Amendment #3 would have required the Secretary of Health and Human Services to submit a report to Congress on the cost savings associated with people no longer using emergency rooms or acute care facilities as their primary means of obtaining health care. Jackson Lee Amendment #4 would ensure that the bill cannot be construed or interpreted to permit or require a delay in the application of the Affordable Care Acts individual mandate. I know that many predicted that the Affordable Care Act would cause havoc on the nations health care system. But it is not the ACA that is causing havocit is the 50 desperate but futile attempts by the Tea Party to scuttle a law that has been passed by Congress. signed by the President. upheld by the Supreme Court. The most threatening actions to our nations healthcare system by Tea Party Republicans are their attacks on Medicare. In 2014. according to the Kaiser Foundation 16% of the nations people have medical insurance under Medicare: Texas has 12% of its residents insured under Medicare. Arkansas. Florida and Vermont have 19% of their residents insured under Medicare. and West Virginia and Main have 21% of their residents insured under Medicare. Kentucky. Mississippi. Missouri. Ohio. Oklahoma. Oregon. South Dakota. Tennessee. Wisconsin. Ohio. Oklahoma. and Oregon have 18% of their residents insured under Medicare. Every state has more than 10% of their residents insured by Medicare. The uncertainly created by the majority regarding Medicare reimbursement over the last several years has forced physicians to reevaluate continuing their medical practice and frustrated hospitals working to make budget projections over several years into the futurethis is critical to business decision making. Because of uncertainty created by Medicare physician reimbursementphysicians and hospitals have been forced to close their offices. reduce services. or merge. When patients find they cannot keep their physician or that their options for health care are being affectedit is not because of the Affordable Care Act. Our nation has taken a momentous step in creating a mindset that good health is a personal responsibility with the enactment of the Affordable Care Act. The health care law did not automatically enroll all citizens into the program. it was specifically designed to be an optin process. There are tens of thousands of visitors each day to the website and despite problems with the initial rollout of the online health insurance registration process. millions have enrolled and experience the peace of mind that comes from having affordable. high quality health insurance that is there when you need it. I have held many events in my District to inform and connect people with Navigators and Community Health Centers and send a strong message to my constituents encouraging them that now is the time for them to obtain affordable. accessible. and high quality health insurance for themselves and their families. So it is puzzling that with less than 70 legislative days remaining in the Second Session of the 113th Congress. we are still seeing attempts to end the Affordable Care Act. The fact that a bill that is critical to the provision of payments to physicians that treat Medicare patients is not safe from the politics of the moment is troubling. I ask my colleagues to support Medicare patients and their physicians by rejecting this Rule.