reconsider is laid on the table. [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] [captions copyright national cable satellite corp. 2017] >> when that on the second try, the house approved the health care law replacement. more debate in a minute. but first, a look at c-span's live coverage coming you up tonight. president trump is in new york city to commemorate the 75th anniversary of the battle of the corral sea. we'll have live -- coral sea. we'll have live coverage here on c-span. and a look at a few headlines in reuters. u.s. house repeals obamacare. bill faces higher hurdles in the senate. and in "the hill," g.o.p. senators say we're doing our own health care bill. and in the "washington times," trump scores victory as house passes g.o.p. plan to trash obamacare. back to the house floor now for more of the debate from before the house approved the bill. om mr. burgess: mr. speaker, i yield myself such time as i may consume. the speaker pro tempore: the gentleman is recognized.

mr. burgess: mr. speaker, after seven years we have heard the stories from our constituents, from our patients, from our friends, from our families who have suffered under the affordable care act. today, we'll have a chance to vote on a plan that will rescue and revitalize the market and lower costs and increase flexibility for patients to choose and keep a health insurance plan that works for them and their families. however, before we can do that, we have to pass a bill that will insure that members of congress and their staffs are treated the same way as the rest of america. so let's be clear. we firmly believe that members of congress should live by the same rules as everyone else. period. the bill we're considering now will make a simple technical correction to insure that the american health care act and its amendments apply equally to everyone when signed into law. over the last several months we

have worked thoughtfully and thoroughly with our colleagues in the senate to achieve our shared goal of repealing and replacing obamacare. throughout these discussions we have come to better appreciate and better understand the other chamber's reconciliation limitations. as a result, we have drafted the american health care act with constant awareness of what the slightest misstep may mean for the legislation's privileged status or that 51-vote threshold in the other body. some might say it's easier for a camel to go through the eye of a needle than to draft house policy to senate procedure, but we're confident that we have achieved that challenging fete. one -- feat. one of the limitations we have come to respect is no committee other than the senate committee on finance or the senate committee on health, education, labor, and pensions can receive

a jurisdictional referral. for example, if we were to cross-reference multistate plans established by the affordable care act, we would get a referral to the senate homeland security and government affairs committee because those plans are under the office of personnel management. so let's be clear, congressional health care operates as a small group plan within the district of columbia's shop exchange. this was a decision that was made by the obama administration. so for waivers impacting the essential health benefits of age rating, which impacts both the individual and small group markets, members of congress and our staffs would be treated the same. as far as community this impacts the individual market so no group plans or congress or our staff would be

impacted. even so in an attempt to be crystal clear, we are passing a bill out of fairness and transparency to ensure that congress operates under the same laws as private citizens. a principle that both republicans and democrats should support. my thanks to representative mcsally for her leadership on this issue. her bill helps deliver us a step closer to fulfilling our promise. today we will fulfill our promise to provide relief from the higher costs and dwindling choices for patients under the affordable care act. we will repeal and replace obamacare with a better solution. i reserve. the speaker pro tempore: the gentleman reserves the balance of his time. the gentleman from new jersey. mr. pallone: i remind my colleague from texas that his vote for the health care bill will take away protections for 4 ,536,000 with people with

pre-existing conditions in texas. i heard my colleague from texas talk about repeal and replace. this is a myth, the hoax, that the republicans and the president are trying to play on the american people. this is repeal. there is no replacement. the people are going to lose their insurance and pay more and have lousy insurance because they won't have any protections. we passed the affordable care act because the states were not doing the right thing. people couldn't afford insurance, they couldn't pay for premium, they were too high. we expanded medicaid and provided generous subsidies for those people who needed it. and under the old system where the states were in charge that people got lousy insurance if they could find it. sometimes they didn't have hospitalization and we insisted a package that included pre-existing conditions. and we said if you were paying a lot for co-pays and deductibles,

we would put limbs on those. we had community ratings. what are the republicans doing here today? they are getting rid of all that and want to go back to the old days and when they tell you that somehow they are going to be able to do this, the reason they can't do anything is because they repealed most of the pay-fors that pay for the subsidies that pay for the affordable care act. when they tell you we are going to give you extra money for this, high risk pools or help the states if they decide to have waivers, there is no money left here. there is no money to pay for subsidies or medicaid expansion. ot enough money to pay for high-risk pools because they they used it to pay for the affordable care act. they are going to the wild west of the states, ok? they are allowing states to waiver the essential benefits

package and saying to states they can charge whatever they want for the insurance because hey -- i yield myself 15 seconds. do not buy into this hoax. there is no money left and they want to go back to the old system. we corrected the problems of the old system. don't believe this cruel hoax. the speaker pro tempore: the gentleman from texas. mr. burgess: it's my pleasure to yield two minutes to the author of the bill, the gentlelady from arizona, representative mcsally. the speaker pro tempore: the gentlelady is recognized. ms. mcsally: i rise in support of my bill, a measure that eliminates double standards by preventing members being exempt. due to very arcane senate procedural rules and within the budget reconciliation process, it does not cannot apply to members of congress. to address this, i introduced this simple stand-alone two-page

bill that would exempt members of congress. in the military, the same code of conduct applies to the chain of command. as a lawmaker, any law we pass apply to our constituents must apply equally to members of congress. individuals who have the public trust must abide by the rules they make. my bill will ensure that congress abide by the laws they pass and are treated no differently. regardless of your vote, this is a bill that each and every single member of congress should support. i yield back. the speaker pro tempore: the gentlelady yields back. the gentleman from new jersey. mr. pallone: i remind my colleague from arizona her vote for this bill would increase eople with breast canceredly $4,450. i yield to ms. eshoo for 1 1/2 minutes.

ms. eshoo: i thank our ranking member. i think today is yet another sad day here in the house of representatives for the people of our country. because what is being brought forward is the same bill that we debated and went down because it was the weight of the problems and the cruelty of that bill. it's the same thing with a few more poison pills in it. people are going to have to pay higher premiums and deductibles and it's going to increase what comes out of their pockets. there is going to be less coverage, 24 million people will lose their coverage. that remains in this bill. and key protections are gutted, american people. ergency rooms, maturnt care, opioids, mental health care, a string of things you want in your insurance coverage,

including a crushing age tax for seniors. now there is the real pipockcrasi here. every single member of congress has been enrolled in the affordable care act. which one of you dropped out of it. if it was good enough for you, great, one person, two, big deal. it was good enough for you, but it's not good enough for your constituents. and you know what? who's standing with you? not the doctors in our country or the aarp, not nurses. not anyone. the speaker pro tempore: the gentlelady's time is expired. and members are reminded to direct their remarks to the chair. the gentleman from texas. mr. burgess: it is now my privilege to recognize the gentleman from kentucky vice chairman of the health subcommittee on energy and commerce, one minute. the speaker pro tempore: the

gentleman is recognized. >> i thank the gentleman for yielding. i rise today to urge my colleague to support the american health care act. a constituent of mine personally reached out to share her story. under obamacare the monthly premium rose to over $1,000 with a deductible of $12,000. when she fell and broke three ribs, she couldn't afford to go to the emergency room. she suffered for weeks until she could afford care and as she said, quote, i paid 50% of my income for something i am forced to buy but cannot use. in kentucky there are many counties with one health insurer on the exchange. that is not right. affordable health care is access to health care when you need it. i urge my colleagues to support the american health care act. and i yield back. the speaker pro tempore: the gentleman from new jersey.

mr. pallone: i want to remind my colleague from kentucky his vote will take away protections for 881,000 with pre-existing conditions in kentucky. and i would like to yield a inute and a half to mr. green. mr. green: it's appalling what is happening today on the house floor. it appears to be let's just pass a bill no matter what it does or who gets hurt with it. trumpcare is nothing more than broken promises and would mean higher health care costs for 24 million americans. key protections are gutted. older americans are hung out to dry. the end of medicaid and cuts in medicare. if trumpcare passes, americans with pre-existing conditions could be pushed off their insurance and sent into high risk pools that are not affordable. high risk insurance pools do not

work when e in the pool is a high risk. and i was a state legislator when we did that. you have to share the wealth. people will be left with higher costs. frightening future for americans who need dependable health care. there is an irresponsible reason why this vote is being rammed without even a congressional budget office estimate or opportunity for members to know what's in it. they don't want people figuring out the real consequences and devastation it would mean. history will not be kind to the people who support this awful bill. i urge my colleagues what is right and vote no. a i yield back. the speaker pro tempore: the gentleman from texas. mr. burgess: at this time, i'm pleased to recognize the gentleman from texas, mr. oles son, one minute -- olson. mr. olson: i thank my friend

from texas. when obamacare was passed in refused senate add -- to use obamacare as their personal insurance. what is good for the goose is good for the gander. my staff, my family and i have been on obamacare since day one. incredibly, the senate is at it again. they don't want the american health care act to apply to them because it's not right. they're special. in sum, they put a clause to exempt congress so they can filibuster the health care bill. t ain't hunting in 2017. if it is good for the american eople, our bosses, it's good that congress, us.

i urge my colleagues to be true public servants. vote for h.r. 2192. the speaker pro tempore: the gentleman from new jersey. mr. pallone: i remind my colleague from texas his vote r this bill could increase premiums for people with diabetes $5,100. the speaker pro tempore: the gentlelady is recognized. ms. degette: the american health care act was pulled from the house floor in march because the american people realized it was a deeply flawed bill. that bill would have ripped health care coverage away from 24 million of our constituents. for those lucky enough to maintain coverage, the bill would have raised premiums, deduct i believe so and out of pocket costs. the crushing age tax would force older adults to pay higher

premiums. what does the majority do? they made the bill worse. the mcargument thur amendment -- not only would this jeopardy dies insurance ability for one-third of americans with pre-existing conditions but let insurance companies deny coverage for maternity, for emergency rooms, for mental health and other essential benefits. and because the mcarthur amendment eliminates community ratings everybody's insurance costs would skyrocket. our republican colleagues are going to be sorry they rushed this bill to the floor before they got an amended c.b.o. score. when we get this and make no mistake, we will get this, they are going to find out many more millions of people are going to

be shocked to wake up to find out if this trumpcare bill passes, many millions more will lose their coverage. i urge a no vote on this poorly conceived legislation. the speaker pro tempore: the gentleman from texas. mr. burgess: i recognize the gentleman from florida, valuable member of the health subcommittee, mr. bilirakis for one minute. the speaker pro tempore: the gentleman is recognized. mr. bilirakis: thank you, mr. speaker. i rise today in support of h.r. 2192 to ensure members of congress and staff are not exempt from the american health care act. making good on our word, this legislation will be passed along side the american health care act and fixes a technical error made to comply with senate rules. in our country, lawmakers are not above the law. elected officials and the people we represent should have had the same health care period. as an original co-sponsor, i

believe this is common sense and it's straightforward legislation and it is necessary as a companion bill to the american health care act. it's really quite simple, congress should live by the same laws it creates. with the american health care act becomes law, members of congress and staff will have the same health care as the american people. i urge passage of h.r. 2192. and i yield back. the speaker pro tempore: the gentleman from new jersey. mr. pallone: his vote for the health care bill will take away protections for 3,116,000 people with pre-existing conditions in florida. i yield a minute and a half to on the gentleman from pennsylvania. mr. doyle: mr. chairman, for the past seven years, we have had 62 votes to repeal the affordable care act, but republicans have

never once put a plan on the floor for the american people. well, today, we all well, today we get a chance to go on the record from where we stand on this bill. this shameful cruel bill. here are the facts. 24 million americans are going to lose their insurance if this bill becomes law. over $839 billion gets cut out of the medicaid program. the essential benefit package in states wiped out n my state, it's taking care of people with mental illness and opioid addiction, gone. this takes $117 billion out of the medicare trust fund. this is a health care bill -- this is really a tax bill masquerading as a health care bill. the plan here is to take this money out of the health care system and use it for tax cuts.

that's what this bill's going to do. this creates a survival of the fittest health care for america. if you are young, if you are healthy, if you are wealthy this bill's for you. you are going to do ok. but woe if you are old, if you are sick, if you are poor, there's no coverage in this bill for you. if you have a young child with cancer, guess what? those benefits aren't going to be paid. you are going to run out of benefits. these high-risk pools are a sham. they are not adequately funded. this bill must be defeated. the speaker pro tempore: the gentleman's time has expired. mr. doyle: the american people will remember who voted for this bill today. the speaker pro tempore: the gentleman from texas. mr. burgess: let me yield myself two minutes. john sopko: the gentleman is recognized. mr. burgess: i wish to now peak to the underlying macarthur amendment that the mcsally bill is here to modify. the macarthur amendment

specifically would allow states to waive three of obamacare's costliest mandates. let me stress that again, it would allow states not require, to waive three of obamacare's costliest man ditz. essential health benefits, age rating, and community rating. in waiving these federal mandates health insurers would not be allowed, would not be allowed to discriminate by gender or pre-existing condition and no one would be denied coverage, period. here's how it works. a state may apply to waive essential health benefits or increase age rating ratio from the bill's underlying five to one ratio. they may may also change the way individuals who have not maintained continuous coverage are charged for their health care plan, but only if the state has a risk sharing program in place like the federal invisible risk sharing program established by the palmer-schweikert amendment. in order to receive a waiver, a

state must explain to the secretary of health and human services, how the program will reduce average premiums for patients, increase enrollment for residents, stabilize the state's health insurance market, stabilize premiums for individuals living with pre-existing conditions or increase the patient's health care options. t is important to note that in order for -- providing assistance to reduce premiums or other out-of-pocket costs, individuals who may be subject to an increase in their monthly premiums because they decide in a state with an approved waiver, pre-existing condition, or uninsured because they have not maintained continuous coverage and purchased health insurance for the individual market, for those individuals there will be $138 billion to assist with premium assistance. i reserve the balance of my time. the speaker pro tempore: the gentleman from new jersey. mr. pallone: i yield a minute

and a half to the the gentlewoman from illinois, miss sha do you i ask. the speaker pro tempore: the gentlelady from illinois is recognized for 1 1/2 minutes. ms. schakowsky: understand this. the republicans plan to exempt members of congress from the provisions of trumpcare until they got caught. so here are five numbers that show just how deadly and dangerous the republican bill is. 24 million, the number of children, adults, and veterans whose health insurance will be ripped away. $880 billion, the size of the cut, the cuts to medicaid, threatening health care and long-term care for 74 million people, pregnant women, and children, the elderly, and the disabled. $600 billion, that's the tax cut that goes to millionaires and billionaires and corporations. 758%, that's the premium

increase of 64-year-old making $26,000 a year will pay because of the republican age 17%, at's the% of americans who supported trumpcare before they made it worse. the republicans' attempt to improve trumpcare is like trying to douse a dumpster fire with gasoline. this bill is a disaster and anyone who votes for it does so at their extreme peril. the american people are watching. and they will not forget. i yield back. the speaker pro tempore: the gentleman from texas. mr. burgess: thank you, mr. speaker. i would point out within the state of illinois there were eight plans in 2015. there are five plans in 2017. with a 57% increase in premiums. it's now my pleasure to yield one minute to the gentleman from ohio, valuable member of the energy and commerce committee, mr. johnston.

the speaker pro tempore: the gentleman is recognized for one minute. mr. johnson thank you mr. chairman, mr. speaker for giving time to speak up. i, too, agree that members of congress should be subject to the same rules and laws that the american people are. and so i support my colleague, ms. mcsally, in this legislation. you know, i want to speak to the bigger, broader issue here. my colleague from pennsylvania said, what about that family with that kid that has cancer? where was my colleague and the friends on the other side of the aisle when obamacare resulted in millions of policy cancellations and millions of americans losing their coverage because of the broken promises? where was my colleagues and the democrats when millions of americans were forced out of work because of the job-killing policies of obamacare. let me tell you something, the american people remembered that

and that's what happened in 2010. we didn't hide in a backroom to get what we're doing today done. we have been working on it for six years. and we're going to get it done today. we're going to meet the promises that we made to the american people and starting today, obamacare is on its way out the door. i yield back. the speaker pro tempore: the gentleman's time has expired. the gentleman from new jersey. mr. pallone: mr. speaker, i remind my colleague from ohio that his vote for this bill will take away protections for 1,119,000 people in ohio with pre-existing conditions. now i yield a minute and a half to the gentleman from north carolina. the speaker pro tempore: the gentleman from north carolina is recognized for 90 seconds. mr. butterfield: thank you, mr. pallone. so you have been working on it for six years. my information is you posted this bill at 8:00 last night. the congressional budget office has not given it a score. they have not told the american people how much it's going to cost. or how many people it's going to affect. you skyrocketed premiums for hardworking americans who have pre-existing conditions, and

that's what my colleagues need to understand. if you are an average 40-year-old adult with a pre-existing condition and have diabetes, your premiums will rise $400 a month it is estimated. if you have rheumatoid art rye t. $800 a month. heaven forbid if you have some pre-ex-ising condition -- pre-existing condition involving cancer, the numbers go off the chart. you know and i know this bill will not seat light of day in the senate. this is a political stunt to save face with your right-wing base. you know it and we know it. if this wasn't so serious affecting the economy and the affordability of insurance, i would say go on and do it because you will lose your opportunity to serve in this house and you will ultimately lose the majority. don't do it. forget about politics. but think about the 24 million americans who will not be able to afford health insurance coverage. that's why the american medical association, aarp, nurses

association, and all the other stakeholder groups have pleaded with you. they have called your office. they have written you letters. they have written us letters. don't do it. i ask you to vote no on this ill-conceived legislation. i yield back. the speaker pro tempore: the gentleman's time has expired. the gentleman and members are reminded to direct their remarks to the chair. all times. the gentleman from texas. mr. burgess: mr. speaker, directed to the chair i would just make note of the fact that north carolina there were three plans offered in 2015. down to two plans in 2017. premium increase of 82%. it is now my pleasure to recognize another member of the energy and commerce committee, mr. walberg of michigan, for one minute. the speaker pro tempore: the gentleman is recognized. mr. walberg: mr. speaker, regardless of the myths being spun by the other side of the aisle, that refuse to read 129 pages of a bill, the affordable

care act is anything but affordable. my constituents have been asking for relief from this collapsing law for years. they can no longer afford to pay more for less. and refusing to act is not an option. under obamacare, out of a pocket expenses have skyrocketed. not just for people on exchanges, but for all patients. premium increases are nearly four times larger than previously projected. unfortunately, our colleagues on the other side of the aisle, mr. speaker, seem content with the current flawed system which puts the government in charge of people's health and promises coverage that is going away. let's vote to increase choice, lower cost, enhance protections, truly cover pre-existing conditions, and get washington out of the way so that patients and their doctors are once again at the center of health care decisions. mr. speaker, i yield back.

the speaker pro tempore: the gentleman's time has expired. gentleman from new jersey. mr. pallone: mr. speaker, i remind my colleague from michigan that his vote for this bill could increase premiums for those who are pregnant in chigan by 13,-- $13,7930 per year. i'd like to yield a minute and a half to the gentlewoman from california, ms. matsui. the speaker pro tempore: the gentlelady is recognized for a minute and a half. ms. matsui: talk. mr. speaker, republicans are turning their backs on the american people today. there are no guarantees with this bill. this bill will raise costs for families, hitting people nearing retirement with an age tax, and real coverage from millions of americans. if that wasn't bad enough, this revised trumpcare bill guts protections for people with pre-existing conditions. people like cameron who was diagnosed with cancer at 24 years old. because of the affordable care act he was able to access coverage and attend graduate

school. now, of course, he has a pre-existing condition. this is personal for cameron and millions more in this country. and they are not going to be silent as republicans rush this legislation through. mr. speaker, lives are on the line. i urge my republican colleagues to have the courage to vote no on this legislation. thank you. i yield back. the speaker pro tempore: the gentleman from texas. mr. burgess: mr. speaker, at this time i'm pleased to recognize another valuable member of the energy and commerce committee, member of the health subcommittee, mr. carter of georgia for one minute. the speaker pro tempore: the gentleman is recognized for one minute. mr. carter: mr. speaker, i rise today to urge my colleagues to support the american health care act. for the last seven years i have watched obamacare crush the health care system that i worked in for more than 30 years. thanks to obamacare we have an insurance exchange that has withered to where a third of the counties in our country have only one insurer. at home in georgia, 96 counties

have only one choice on the exchange. that's not a choice. obamacare has failed and the american health care act is critical to resuscitate our health care system and move it into a direction where patients, families, and doctors are making decisions. not the federal government and bureaucrats sitting behind a desk in washington. the american people need and deserve better. and that is why we must pass the american health care act. this legislation guts obamacare and rebuilds a system that would deliver the choice and control that patients need and deserve. all while ensuring that health insurers will not be allowed to discriminate by gender or pre-existing condition, and no one will be denied coverage, period. period. thank you, mr. speaker. i yield back. the speaker pro tempore: the gentleman from new jersey. mr. pallone: mr. speaker, i remind me colleague from georgia that his vote for the health care bill will take away protections for 1,791,000 people with pre-existing

conditions in georgia. now i yield a minute and a half to the vice ranking member of our committee, ms. castor. . the speaker pro tempore: the gentlelady is recognized for 1 1/2 minutes. ms. castor: i thank the gentleman for yielding. this bill will be devastating to families all across america. . this rips coverage from millions of americans. the last projection was 24 million. the new projection is going to be much higher. of bill shortens the life the medicare trust fund as we have more baby boomers requiring medicare. it imposes a huge age tax because it makes affordable insurance much less affordable if you are 50 or older. and the dirty little secret here that most people have not

discussed is the harm it does to the medicaid guarantee. for over 50 years in america, we said if you are disabled or a family member with alzheimer's or a child with a complex medical condition, you are not going to be destitute because your health care is so expensive. that is one of the fundamentals of medicaid. they take it away and go to the heart of the medical care that's provided under medicaid as well. it's shameful. it got worse. as we approach this day, they didn't have the votes, so they made it worse by going to the heart of the affordable care act, which ended discrimination against our neighbors with a pre-existing conditions and said essential health benefits not going to matter. what if you buy an insurance

policy and can't go to the emergency room. we have to vote against this power play that transfers all the money to the wealthiest in this country. vote no. the speaker pro tempore: the gentlelady is no longer under recognition and the chair would ask members to respect the gavel and the time yielded. the gentleman from texas. mr. burgess: i would point out that within the state of florida there were 10 insurance plans available in the individual market in 2015 and down to five plans in 2017. with a 20% increase. i recognize mr. collins of new york for two minutes. mr. collins: for the past seven years the american people have pleaded with their representatives in washington to repeal obamacare. today, every member of this body has the opportunity to do just that. e have the chance to eliminate

mandates and taxes that are suffocating our economy under obamacare premiums increased by 37% since 2014 and most have only one insurance provider. 4.7 million americans were kicked off the insurance coverage they wanted to maintain despite president obama's promise that if you like your health care plan, you can keep it. but today we have the chance to lower premiums, increase competition amongst insurance providers and improve access to health insurance for all americans. and we finally have the chance to formally reject an unprecedented government overreach into health care and take the first step towards giving patients control over their own health. in western new york, this bill will have even more profound benefits. the amendment that i authored with representative john faso

will relieve county governments in new york of $2.3 billion unfunded mandate forced on to county taxpayers by the governor of new york and will substantially reduce the tax burdens of property owners across new york state. this one provision of the american health care act will save taxpayers in the eight counties i represent over $470 million. this is a game changer for local new york governments and restores representative democracy at the level of government that makes the decision that should be responsible for raising those funds. i'm proud to stand up for western new yorkers whose voices have been silenced for too long and vote for the freedom, fiscal responsibility and local decision making this bill guarantees. i urge my colleagues to do the same. mr. pallone: i remind my colleague from new york his vote

will take away protections for 3,0 31,000 people in new york with pre-existing conditions. i yield to a champion from new york, ms. clarke. ms. clarke: i rise in strong opposition to the american health care act. this bill leaves 24 million americans without coverage and cause the uninsured rate in brooklyn, new york to skyrocket to over 12% and leaves over 400,000 in my district without coverage. because of the severe cuts to medicaid, this bill will put people in a terrible position of having to choose between being able to eat, being able to obtain medication or visiting their doctors. which one, mr. speaker, do you suggest they choose. for most americans, this is not the end goal but rather provides temporary support and for seniors, medicaid can mean the

difference between nursing home care and dying alone. i urge my colleagues to consider the harmful and deadly real-impact of this legislation and i oppose it. ask that we resist this, this cynical, very versus robin hood sham that takes from the poor and gives to the rich. as president lincoln said, you can fool some of the people all of the time and all of the people some of the time but you can't fool all of the people all of the time. this is a sham and we need to vote it down. thank you, mr. speaker. the speaker pro tempore: the chair will receive a message from the senate. the messenger: a message from the senate. the secretary: i have been directed to inform the house the house has passed with an amendment h.r. 534 an act cited as the house wants to compete and which the concurrence of the

house is requested. the speaker pro tempore: the gentleman from texas. mr. burgess: thank you, mr. speaker. at this time, it's my pleasure to recognize a valuable member of congress, fellow position, dr. dunn, for two minutes. the speaker pro tempore: the gentleman is recognized for two minutes. mr. duncan: i rise today once again in support of the american health care act. i do this as a doctor. mr. dunn: we are giving it back to the people. the american health care act will lower the costs and serve patients. this act eliminates ork's subsidies and mandates and defunds planned parenthood and puts medicaid on a budget and largest entitlement reform in a generation. without washington mandates driving up costs and limiting access to care, americans will

have the freedom to obtain quality health care plans that fit their needs at a cost they can afford. and all this talk about pre-existing conditions, this bill provides guaranteed issuance. let's not break our promise on repealing obamacare. we owe it to the people who september us here. i support the american health care act, mr. speaker, and i urge all members to do the same. the speaker pro tempore: the gentleman from new jersey. mr. pallone: mr. speaker, i remind my colleague that his vote could increase premiums for 090 a with asthma by $4, year. yield to mr. kennedy 1.5 minutes. contend contend what this -- mr. kennedy: what this bill does is make health care more expensive and the more you need it, the sicker, older or poorer your the further out of reach it

will be. doctors, hospitals and nurses and mental health community have spoken up and out against this bill. this bill just doesn't cut coverage or hike premiums but for a tax cut for the healthy. codifies a world view that is dead set in dividing america among the lines of who you love, where you come from or your faith or fortune. we see it in their tax plan, budget cuts, immigration policy and now in health care. in a world that scape goats the struggling and suffering that sees fault in illness, that rejeggets the most basic universal truth of human existence that every single one of us will be bought to our knees by a diagnosis we didn't expect, a phone call we can't imagine and a loss we cannot endure. so we take care of each other, because but for the gays of god

there go i one day and we hope we will be shown that mercy. it is the ultimate test confronting our country, no, sir the power we give the strong but the strength with which we embrace the weak. i yield back. the speaker pro tempore: the gentleman from texas. mr. burgess: may i inkire as to the time remaining. the speaker pro tempore: the gentleman from texas has 13 1/4. and the gentleman from new jersey has 11 1/4 remaining. mr. burgess: i yield two minutes to the gentleman from virginia a member of the energy and commerce committee. >> this bill guarantees access for all. and when i say access, let me be clear, it is access for all when you have insurance companies that they are pulling out, when you have counties across these united states that have no one able to provide the obamacare

insurance that's not access. when you have a situation where somebody comes up to you at the local county fair and says you have got to get me out of obamacare, it is killing me and killing our family's finances because we have a high deductible and high co-pay and my husband is very sick and may have a piece of paper, ladies and gentlemen, he may have a piece of paper, but it's not really health insurance when you can't really use it without having to sell off assets or worry about whether you can have a roofover our head any longer. this is not working. obamacare is not working. this bill will bring some sanity back to the system. it will take us a couple of years but the rates of insurance will in fact come down. and this business that we keep hearing that all these people are going to be without insurance, it's just fake news. it's not true. this bill does everything that

people want it to do, but gives them choices, not mandates from the federal government but choices about their health care and i have been interested to hear people saying, you are ram, inc. this through because the bill wasn't posted until last night. what wasn't posted until last night was the long-up ton. it is two pages. the mcsally bill is a page and a quarter. the mcarthur amendment, which has been out for over a week is about eight pages. they could have read it while we are standing here. they don't choose to erp read the bill or learn the facts or tell the american people. they want to scare the american people to make them this is a bad bill. this is a good bill. i urge everyone to vote yes. the speaker pro tempore: the gentleman from from new jersey. mr. pallone: his vote for the

health care would take away 331,.h care to 1, i was there for the 26 hour meeting we had at the energy and commerce committee and we didn't have an analysis from the congressional budget office either and accuse us of not wanting to know the facts. we would like to have it here. here we are on the floor without the analysis. through all the time, the sad thing we have not heard one real argument about how this would make it affordable for my families in san diego or anywhere in country. the health care system isn't perfect. there are problems with some insurance markets and not providing the insurance they should. that's not what we are doing. what we are doing is on the cusp of passing a bill that is opposed by doctors, nurses,

hospitals, patients and seniors and just about everybody bus it would make the problems worse, not better. a bill if it were to become law would rip health insurance coverage from at least 24 million americans and that's the congressional budget office. that is not fake news. that's the truth. would leave many america caps with pre-existing conditions without coverage they can afford or any coverage at all. this takes us one step closer where families go bankrupt and our emergency rooms are filled with mothers seeking basic care for their children. i refuse to accept that that is the best for the american people. and i'm voting no. mr. burgess: i'm pleased to recognize a fellow physician, the chairman of the house veterans affairs committee, the gentleman from tennessee, dr. roe. the speaker pro tempore: the gentleman is recognized. mr. roe: the american health

care act in no way changes existing regulations that allow a veteran who is eligible for but not nold in the department of veterans affairs system to purchase health insurance. language that would have codified that language was removed from an earlier version to comply with senate rules. removing language no way changes existing regulation or a veteran's eligibility to receive a tax credit. that was the exact same language in the a.c.a. no way affects a veteran to access tax credits. i'm disturbed that our colleagues in the minority would assert that it does in an effort to score political points against this legislation. . fear mongering has no place in they date. as chairman of the veterans' affairs committee, as a medical doctor, and as a veteran myself,

ensuring that veterans' health care is protected is my highest priority here in this congress. and i would not stand for language in this bill or any other bill that would compromise a veteran's ability to access care. with that i yield back the balance of my time. the speaker pro tempore: the gentleman from new jersey. for what purpose does the gentlelady from california seek recognition? >> i ask unanimous consent to express my opposition to this rally bankrupt bill and to insert this letter of opposition from the national rural health association into the record. the speaker pro tempore: without objection, the gentlelady's request will be granted. the gentleman from new jersey. mr. pallone: mr. speaker, i want to remind mee colleague that this could increase coverage for breast cancer. i would like to yield and a minute and a half to the gentlewoman from michigan, mrs. dingell. the speaker pro tempore: the gentlelady from michigan is recognized for 1 1/2 minutes. mrs. dingell: thank you, mr. speaker. i rise today in strong opposition to this misguided

legislation to repeal the affordable care act. this vote might be the single most important issue our congress deals with. it literally means life or death for too many people in our country. what we vote on today is ultimately a reflection of our values as a nation. i believe that we have a moral responsibility to take care of the most vulnerable among us. the nuns taught me that, the bible teaches us that. the sick, the poor, the elderly. and this dangerous bill does nothing to protect them. in fact, it will do more harm to our most vulnerable. 129 million americans suffer from a pre-existing condition. they are our neighbors, our friends, and for some, our family. they are the people attending their town hall meetings.

for me, i am a caregiver. i spend more time at the hospital and the doctor than i want to. and person after person comes up to me and tells me their story and begs me that they will not lose their insurance. healthy michigan let them go to the doctor for the first time. the affordable care act made a guarantee that we would not -- that someone with a pre-existing condition would be charged more than healthy people. and that coverage would be available to all. thank you. please vote against this shameful bill. the speaker pro tempore: the gentleman from texas. mr. bilirakis: mr. speaker, at this time i'm pleased to -- mr. burgess: mr. speaker, that the type i'm pleased to yield to the gentlelady from tennessee. the speaker pro tempore: the gentlelady is recognized for two minutes. mrs. black: thank you, mr. speaker. i'm always amazed when i start hearing conversations about the

affordable care act and how it's working so well today. i want to talk about two situations in my home state of tennessee. when the affordable care act that went place in the state of tennessee, we had a risk pool. the risk pool covered about 2,000 people. they were happy -- 28,000 people. they were happy with their care. they were happy with their providers and they were happy with the cost. it was patient-centered. they determined what best fit their needs. these were people with pre-existing conditions. happy with from where they were. and in one day -- happy with where they were. and in one day, because the federal government said you don't meet this and you don't meet that and you don't meet this, they lost their insurance. they're in the marketplace. i'm talking about two situations that have are very close -- that are very close to me, but these only represent a few of the many calls i get in my office. a good friend of mine has lupus. she went on the marketplace. for the first year she did pretty good. her premiums were pretty low. her deductible was reasonable.

but here's what she found. she couldn't keep her doctor. now, can you imagine someone who has had lupus for a number of years, it's controlled, and now she's told she can't keep her doctor. she had to find other doctors. which she was not happy with because she had a relationship. they didn't use the same treatment and care that she had received before. so she's not felt very healthy. but in the meantime, every year that it's renewed she calls me to say, my premiums have gone up. my deductibles have gone up. now it's more than what i was paying before where i liked what i had and i couldn't keep it. opposite what have the president then told everyone, if you like what you have, you can keep it. the second one is someone who has that same risk pool she lost her opportunity to get the medication -- pool. she lost the opportunity to get the medication she was receiving. an i.v. medication. she was very controlled. able to work, living a healthy lifestyle. she lost her opportunity to have

that medication. because instead of that medication only being $400 a month -- would you yield me one more minute? mr. burgess: be happy to yield an additional minute. mrs. black: because of that headcation being instead $400 a month, it was now $3,400 a month, which means no longer can she get her medication. when we talk about or the other side talks about how wonderful this system is, i implore them to come to our state. and talk to the people in my state. i'm a registered nurse. i know what it's like to take care of people that have health care conditions. that need to be in a risk pool. but let's do it the right way. let's give it to our states. let's allow this now to be used in a way that's parent-centered, the way it was working in my home state of tennessee, and i support this bill and i am looking forward to the vote later on this afternoon. i yield back the balance of my time. the speaker pro tempore: the gentleman from new jersey. mr. pallone: mr. speaker, i remind my colleague from tennessee that her vote for the health care bill will take away protections for 1,265,000 people in her state with pre-existing

conditions. now i'd like to yield 45 seconds to the gentleman from maryland, mr. sarbanes. the speaker pro tempore: the gentleman from maryland is recognized for 45 seconds. mr. sarbanes: i thank the gentleman for yielding. mr. speaker, president trump and the republicans are looking for a win. they want to put points on the scoreboard. but why would you want to win by taking health care coverage away from 24 million americans? why would you consider it a victory to raise premiums and co-payments and deductibles on millions of americans, including millions of older americans? and why would you view it as success to eliminate protections for pre-existing conditions? if i could vote against this bill 100 times, i would do it. if i could vote against it 1,000 times, for the thousands of my constituents that will be hurt by this bill, i would. it's wrong, it's immoral. and a it's inhumane. i yield back. -- and it's inhumane. i yield back.

the speaker pro tempore: the gentleman from texas. mr. burgess: mr. speaker, at this time i'm pleased to yield two minutes to the gentleman from kentucky, the vice chairman of the health subcommittee on the energy and commerce committee, two minutes. the speaker pro tempore: the gentleman is recognized for two minutes. >> thank you, chairman, for yielding, and thank you, mr. speaker. what i want to talk about is what's underlying in this bill, the traditional reform and medicaid. medicaid currently costs state and federal government $600 billion. it's estimated in 10 years in a decade, to cost $1 trillion. it's a system that's set up to implode on itself. mr. guthrie: what we want to do, let's fix the problem before we get to the critical point where the going to implode. and let's fix it now. and let's make it right. what we do is allow states to have the same money they had in 2016, the exact same money, with growth. growth would be the c.p.i., medical, and in some categories, plus-one. they also have growth in demographics and some people from states where people retire

to. what if i'm from a state where somebody lives in an area, then they move to my state when they're holder and typically cost more in the medicaid system? we adjust for that. it's in the per capita allotment. as they move, they would transfer. it's not a traditional block grant unless the state chooses to do so. so we're here reforming entitlement program, the first time since the 1990's. and it is ths a very sound -- and it's a very sound, it's a very solid way and a way that preserves and protects the program and it prevents the program in imploding on itself within a decade. mr. speaker, i yield back. the speaker pro tempore: the gentleman from new jersey. mr. pallone: mr. speaker, i remind my colleague from kentucky that his vote for the health care bill will take away protections for 881,000 people with pre-existing conditions in kentucky. now i'd like to yield one 911 the gentleman from california, mr. ruiz. the speaker pro tempore: the gentleman is recognized for one minute. mr. ruiz: thank you, mr. speaker. this bill is worse than a sham. it's worse than a sugar pill.

this bill is down right ugly. it's poison. as an emergency medicine doctor, i urge you to do no harm. and i urge everybody to do no harm. let's be clear. a vote for this bill is a vote for 24 million people to lose their insurance. a vote for this bill is to add an age tax to those 55 years old and older. a vote for this bill is to raise out of pocket costs for everyone with less coverage. a vote for this bill is to take away guarantees for emergency care, medicine, mental health, maternity care. a vote for this bill is to allow private health insurance companies to drop patients who have pre-existing illness. how, you may ask? let's say i see a patient with diabetes who doesn't have health insurance. private health insurance company can say, no, we're not going to cover you, why don't you go to state h-risk, high-cost, insurance pool that is way too expensive with no guarantee they will cover what they need. therefore they won't be able to afford it, they won't have coverage. they're going to go into financial ruin.

all of this in order to give $6 billion tax cuts to the wealthiest. i urge everybody to vote no. the speaker pro tempore: the gentleman from texas. mr. burgess: mr. speaker, at this time it is my great pleasure to recognize the chairman of the full committee on energy and commerce, the gentleman from oregon, mr. walden, for two minutes. the speaker pro tempore: the gentleman is recognized for two minutes. mr. walden: i thank the gentleman. i thank our colleagues who have worked so hard on this legislation, to try and rescue these failing insurance markets. we learned yesterday i think most of iowa now will not have a single insurer left on the exchanges. if you're one of the people out there in the counties across america, one out of three counties there are people who only have one option for insurance. we're trying to do here is fix this market so you have insurance to cover you. we believe that going forward with this piece of legislation, not only do we give more flexibility to states to innovate, they care about the people in their states. i know my home state of oregon does. and yet they're facing a shortfall right now that this

legislation would provide over $320 million to help fill. one of their proposals is to kick 350,000 people off of medicaid. this would help fill the gap. $320 million in the next two years to fill an d -- $ 82 million shortfall they have. thanks problem across our country. what we're trying to do here is reform obamacare, the affordable care act, in a way that will work going into the future, because otherwise people are going to be left with not only enormous rate increases in the premiums, but also you've seen an explosion in the cost of what they have to pay out of pocket. so there are places now, i've had people in my district say, look, i'm outside of that area where i get a subsidy and i'm paying full price. our premiums have gone up 50% in the last two years. my options have gone down from four or five to maybe one or two. maybe three. and it's getting worse. and they're threatening to pull out. and my out-of-pocket costs are so high i'm paying for something i can't even afford to use.

we're trying to fix and rescue this market. bring people in. you hear all these numbers on state by state. i'm not buying into that at all. they don't understand what our bill does. we're giving states authority, we're giving protections for people, and we're going to get this straightened out once and for all so that we have an insurance market that works, but more importantly, we have the health care delivery system that people can afford and that we can get quality health care when they go to see a doctor, between them and their doctor, without a bureaucrat in between. i yield back. the speaker pro tempore: the gentleman from new jersey. >> mr. speaker, i rise today to ask unanimous consent to express my opposition to this horrible bill and insert this letter of opposition from the national children's hospital into the record. the speaker pro tempore: without objection, the gentleman from new jersey. mr. pallone: mr. speaker, i remind my chairman that his vote for the health care bill will take away protections for 654,000 people with pre-existing conditions in oregon. and now --

mr. walden: will the gentleman yield? mr. pallone: i don't have any time. now i yield to the gentlewoman from washington, ms. jayapal, one minute. the speaker pro tempore: the gentlelady is recognized for one minute. ms. jayapal: i thank the gentleman for yielding. and for his leadership. mr. speaker, let's be very clear about where we are with trumpcare 2.0. this bill still strips 24 million americans of health care, cuts $880 billion from medicaid, and increases premiums format jort of americans. it still -- for the pajort of americans. it still has -- for the majority of americans. it still has an age tax and it still gives $1 trillion in tax cuts to the wealthiest millionaires, billionaires and corporations on the backs of working people who will pay more and get less. trumpcare 2.0 adds insult to injury because my republican colleagues would like to you believe that they're going to cover pre-existing conditions and that is just not true.

american people, be clear. this will not cover pre-existing conditions and 133 million americans with those pre-existing conditions will suffer. kids like james, an -year-old in my district who has -- 8-year-old in my district who has a brain tumor and literally stands to die if this bill passes. mr. speaker, hundreds across this country are calling our offices and weeping, we should all weep that this bill is coming to the floor. we should vote no. thank you, mr. speaker. i yield back. mr. burgess: i yield 20 seconds. mr. walden: i have to say the information we are being told even "new york times" has characterized as it being misleading when you say the people of oregon are going to be thrown off and that is not true. there is not a waiver request. you are making that stuff up. and i dispute it. it is misleading, it is wrong and i'm sorry it's happening on

this floor. the speaker pro tempore: the gentleman from new jersey. mr. pallone: mr. speaker, i want to remind my chairman that he represents more people on medicaid expansion than any republican in the country and this bill ends medicaid expansion. at this time, i would like to yield one minute to the the gentlewoman from ohio, ms. kaptur. the speaker pro tempore: the gentlelady is recognized. ms. kaptur: thank you very much. trumpcare is another false promise, actually, it's musical chairs. millions of americans will be left out, priced out, especially the old, the pregnant and mentally ill. health insurance means life or death. in this con cox, who is eligible, who will be left out, there is no budget score from the congressional budget office. republicans aren't guaranteeing affordable coverage. one-word change in your insurance policy can make a

gigantic difference. why not calculate the bill's true costs and how it will impact. one million people of ohio now have health insurance that didn't have it before. here we are at the end of our long voting week with a major proposal that will rip away the health insurance benefits and make them unaffordable. musical chairs is not the way to run the people's house nor life and death affairs of a nation. trumpcare sets up a cruel game of musical chairs. shame. shame. shame. the speaker pro tempore: the gentleman from texas. mr. burgess: i recognize the gentleman from kentucky, for one minute. mr. guthrie: i'm surprised a at my friends are defending the obamacare age tax which is a tax on young people. i'm the right demographic for it. people 26-34 pay more.

i'm 53 and three years, i will be 56 and my daughter will be 26. what we're asking her to do if we don't repeal this, if you are wanting to buy a house, start a family, get her family moving forward, we are going to say we want you to pay more for your health care so i can pay less. that's what they are doing, having parents pay more and we want our children as they start their families and start their lives, have more breaks and not a burden on them. we are giving tax relief to young people, people from 26 to 34 who can least afford the premiums we are putting on them. and i gentleman yield back. mr. pallone: mr. speaker, can i inquire about the amount of time that remains. the speaker pro tempore: the gentleman from new jersey has 2 lsh 4 and the gentleman from

texas has three minutes. mr. cicilline: this is the cruelest and most immoral thing i have seen the republican party to the american million people. republicans have been deceiving the american people for the last eight years. they don't care about working people and this bill proves it. they care about insurance companies and drug companies that fund their campaigns and the millionaires and billionaires that get huge tax cuts. don't try to tell me they care about factory workers. don't tell me they care about single moms who won't be able to put food on the table and don't tell me they care about cancer survivors who are going to pay $140,000 more. i don't know how anyone can look their constituents in the eye if they vote for this bill and shame on you. if you vote for this bill, there will come a day wrillh where you

will have to look at a friend or family member in the eye who is sick or dying and say i did this to you. don't do it. vote no. the speaker pro tempore: members are reminded to refer their remarks to the chair. the gentleman from texas. mr. burgess: at this time, i'm pleased to recognize the gentleman from south carolina for two minutes. the speaker pro tempore: the gentleman is recognized. mr. rice: i stand in support of the people who are being dragged down by this failing disaster called obamacare. since i first got to congress, i have consistently heard from people across the 7th district cross south carolina have been negatively affected. we were told premiums would go down by $2,500 per family and provide more choice. but what we have seen is exactly the opposite. 232,000 people of south carolina

plans were canceled. and premiums are up 28% this year. there is only one insurer left in south carolina and they are threatening to pull out. the law is getting divorce. this bill repeals harmful obamacare taxes across the board that drove up health care costs and transitions health care to a more competitive patient-centered insurance market. there are still fixes that need to be made to further improve health care, but this is a dramatic move forward from where we are today and the first step in moving america's health care from an unsustainable system to a sustainable one. the speaker pro tempore: the gentleman from new jersey. mr. pallone: i remind my colleague that his vote for the health care bill will take away protections for 822,000 people with pre-existing conditions in south carolina. and now i yield 45 seconds to the the gentlewoman from

florida. the speaker pro tempore: the gentlelady is recognized. >> i rise today to condemn this legislation that will rip away protections for millions of americans. i'm a breast cancer survivor. president trump promised americans like me at the we wouldn't be discriminated against. i'm not sure if republicans know what it's like to live every day of your life waiting for the other shoe to drop. with this bill, you yank that piece of mind we have with the affordable care act. this bill would allow states to segregate into different coverage and benefit solutions. high risk pools sends people into a death spiral, premiums go higher and coverage is spotty. i can only hope my colleagues come to their senses beforehanding americans a death sentence. people will die as a result of this bill. i yield back.

the speaker pro tempore: the gentleman from texas. mr. burgess: may i inquire --? the speaker pro tempore: 1.5 minutes remaining. i do want to thank -- mr. burgess: i want to thank the superior team we have in the house legislative council. they have put in men and women hours to draft this bill that is being considered in the house today. ed, jessica, michelle and jesse the heir devotion and to people of the united states in helping us draft this legislation. i reserve the balance of my time. the speaker pro tempore: the gentleman from new jersey. mr. pallone: i yield my remaining time to the gentlelady from illinois. >> mr. speaker how tragic it is before house republicans skip town, they will steal from

medicare, pass an age tax on older americans saying that children with pre-existing conditions and tell folks you have diabetes you are paying more. this morning i heard from doctors, hospitals and nurses from illinois, they know what has to be and not stripping 24 million americans is in the best interest. to my eight illinois republicans on the republican side of the aislef you vote yes, the eight of you own its aftermath and you own the 47,000 jobs you will kill and the health of the people of illinois who will be stripped their health insurance. let's kill this bill and work together to make health insurance acceptable for all. the speaker pro tempore: the chair reminds members to direct their remarks to the chair. that would be this chair.

the gentleman from texas. mr. burgess: mr. speaker, i yield myself the balance of our time. we are here today to correct a oblem with -- a problem with trying to draft senate rules with the house legislation recognizing the problem, representative mcsally from arizona has introduced a straightforward and practical bill to fix the problem. it is a simple two-page bill that when american health care act becomes law, members of congress, congressional staff will be treated the same way as every other citizen. it's only right and proper. i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. all time for debate has expired. the previous question is ordered on the bill. the question is on encombrossment and third reading of the bill. those in favor say aye. those opposed, no. the ayes have it. third reading. the clerk: a bill to amend the public health service act to eliminate state waiver

provisions to members of congress and congressional staff. the speaker pro tempore: the question is on passage of the bill. those in favor say aye. those opposed, no. in the opinion of the chair, the yes have it. who called? the gentleman from texas. mr. burgess: i request the yeas and nays. the speaker pro tempore: the request yeas and nays are requested. the yaped are ordered. pursuant to clause 8, rule 20, further proceedings on this question pib postponed.

the speaker pro tempore: pursuant to clause 1-c of rule 19, further consideration of h.r. 1628 will now resume. the clerk will report the title of the bill. the clerk: h.r. 1628, a bill to

provide for reconciliation pursuant to title 23 of the concurrent resolution on the budget for fiscal year 2017. the speaker pro tempore: pursuant to house resolution 308, further amendments printed in house 115-109 is adopted. 3/4 minutes was remaining. the entlewoman from -- chair recognizes the gentlewoman from tennessee. mrs. black: i ask unanimous consent that all members may have five legislative days to revise and extend their remarks on h.r. 1628. the speaker pro tempore: without objection. mrs. black: i yield myself such time as i may consume. the speaker pro tempore: the gentlelady is recognized. mrs. black: mr. speaker, i rise today in favor of the amendment

american health care act a bill that repeals the worst parts of obamacare and begins to repair the damage it has caused. this bill brings choice and competition back into the health care marketplace and puts health care decisions back into the hands of patients and doctors, where it be longs. it's been a winding road to get to this point but we are here to fulfill the promise we made to the american people. and i'll point out right now to those who say we should have moved on from health care reform, american families and individuals are suffering from rising costs and barriers to getting the care that they need right now. and under obamacare, the situation is getting worse every day. in iowa, just yesterday, one of saidast remaining insurers it will pull out of the obamacare exchanges leaving nearly all of the state's

residents with no available health insurance plan for the purchase under obamacare. and in a few of the iowa counties which are remaining insurers, that company is saying they might stop offering plans, leaving the entire state without an insurance plan available under obamacare. that's happening this very week. we need to repeal and replace obamacare. i applaud the members of this body who stuck with us during this process and worked hard to make the bill better. i myself had concerns about the bill as it was introduced. i worked hard to make sure that the bill truly reflected my ideals and the views and desires of my constituents. and when the bill came before the budget committee, which i chair, i urged my members to stay in the fight, and to work to improve the bill, rather than to stop it in its tracks.

you know what? our members just -- did just thatcht making recommendations that were -- just that. making recommendations that were included in the amendments. that message was heard loud and clear by members of our conversation who worked tirelessly to finalize a bill that truly reflects our vision for health care reform. throughout this process, our commitment to undoing the damage done by obamacare has remained steadfast. day after day my constituents call my office begging us to do something to save them from obamacare. and it's because obamacare is collapsing. in my state of tennessee, families are suffering. premiums have increased by 60%, while deductibles are so high that even if someone has an insurance card, it doesn't mean they have guaranteed care. there are parts of my state in tennessee that don't have a single insurance provider in the marketplace. and 2/3 of the counties have only one provider.

that's not competition, that's called a monopoly. while no legislation is perfect, this bill makes important changes to help american families get quality, affordable health insurance. it zeros out the mandates, it repeals the taxes, and it repeals the subsidies. it allows people, people to choose health insurance plans to meet the unique needs of their families. instead of purchasing a one-size-fits-all plan mandated by a washington bureaucrat. and it modernizes medicaid, a once in a lifetime entitlement reform, ending medicaid's open-ended, funding -- open-ended funding structure will play an important role. this is a particularly proud moment for me. i was working as a nurse in nashville in the 1990's when clinton administration pushed a single-payer pilot program on

tennessee called tenncare. i saw firsthand the negative impact of a government-run health care, and i saw costs rise and the quality of care fall. it inspired me to get involved in the public service. and when in 2009 and 2010 i saw those same principles being debated and eventually implemented on the national level, i thought my experience in tennessee could be valuable in the national debate. so in 2011 i sponsored the first piece of legislation that repealed a part of obamacare. and today we take the largest step yet in rescuing the american people from this damaging government-run health care system. i and many other members of this body have worked hard to make sure that this bill truly reflects our visions for health care reform. i for one cannot sit idly by and let this opportunity go to

waste. you know, governing is hard. but our constituents did not elect us to do what is easy. they elected us to do what is right. and i urge my colleagues to join me in voting yes on the american health care act, to rescue the american people from obamacare. thank you, mr. speaker, and i reserve the balance of my time. the speaker pro tempore: the gentlelady reserves the balance of her time. the gentleman from virginia. mr. scott: mr. speaker, i remind my colleague that her vote for this bill could increase premiums for people with breast cancer in tennessee by over $3,000 -- $38,000. mr. speaker, i yield myself such time as i may consume. the speaker pro tempore: the gentleman is recognized. mr. scott: let's begin with a few facts. since the passage of the affordable care act, costs have gone up at the lowest rate in 50 years. those with pre-existing conditions get insurance at the standard rate. instead of millions of people losing their insurance every year, 20 million more people have insurance. personal bankruptcies are down. 50 -- are down 50%. still all we hear are

complaints, press releases and promises about something better. but c.b.o. has debunked this propose albie pointing out that 24 million -- proposal by pointing out that 24 million fewer people will have insurance, costs will go up and insurance will cover less. so whatever you think about the affordable care act, this bill makes things worse. except for millionaires who get a tax cut. i reserve the balance of my time. the speaker pro tempore: the gentlelady from tennessee. mrs. black: thank you, mr. speaker. it's my honor now to yield a minute and a half to a fellow tennessean, a physician, and the chair of the veterans' committee. dr. roe. the speaker pro tempore: the gentleman is recognized. mr. roe: thank you, mr. speaker. seven years ago i stood right in this well to debate the a.c.a., costs.as to decrease we all agree with that. that's not what happened. in my district in the state of tennessee, over 1/3 of the counties have no place they can

buy insurance and multiple counties in my state, including the third largest, have no access. people willums have soared over -- premiums have soared over 60%. 1 of the 23 co-ops went -- 18 of the 23 co-ops went bankrupt, including the one in my state. no matter what verbiage you hear, nothing is this bill -- nothing in this bill changes how veterans are treated under the law. nothing. the criticisms are flat-out wrong. i'm a veteran, a doctor, and chairman of the veterans' affairs committee. it ain't going to happen. in my state, where i practice medicine for over 30 years, listen to this, 60% to 70% of the uncollectible debt now are people with insurance. so why do i support this bill? one, it protects pre-existing conditions. two, it puts patients ahead of special interests. and restores the physician-patient relationship. thirdly, it reforms medicaid so

that first class people don't get second class care. and repeals individual mandates so that 160,000 tennesseans don't get fined for a product they cannot afford. mr. speaker, this bill isn't perfect. but it's a huge improvement over obamacare and it's worthy of every member's support. with that i yield back the balance of my time. the speaker pro tempore: the gentleman from virginia. mr. scott: thank you, mr. speaker. mr. speaker, i remind my colleague that his vote for this bill could take health care protections away from over a million people in tennessee with pre-existing conditions. i yield one minute to the gentlelady from oregon, the vice ranking member of the committee on education and work force, ms. bonamici. the speaker pro tempore: the gentlelady from oregon is recognized for one minute. ms. bonamici: thank you, mr. speaker. today the house is voting on a harmful bill that puts the most vulnerable members of our community at risk. we know that millions will lose coverage. and the affordable care act protects people with pre-existing conditions. this bill does not.

high risk pools don't work. my constituents are scared. and so are people across this country. arden wrote to me, distraught because she and her daughter could lose coverage. arden took the loving step of adopting a child with special needs and now the support program they rely on is at risk of being terminated by this bill. this is a critical vote. i implore my colleagues to think about all the people, like arden and her daughter, and their communities. think about the millions across this country who risk losing coverage. and i implore my colleagues to do no harm. vote no on this harmful bill. i yield back. the speaker pro tempore: the gentlelady yields back the balance of her time. -- the gentlelady from tennessee. mrs. black: thank you. i yield to the gentleman from oregon. the speaker pro tempore: the gentleman from oregon is recognized for four minutes. mr. walden: i thank the chair and i'd now like to yield to my friend from florida for purposes

of a colloquy. the speaker pro tempore: the gentleman. >> i have heard from my governor, state officials, providers, about the challenges on the ground in florida. and what they're facing. the demographic issues in florida raise significant challenges for the state of florida and the medicaid program. particularly the state medicaid rogram that provides costs covering the elderly and the most disadvantaged in nursing home programs. as well as the rising costs associated with florida's aging population. as the process moves forward, florida's unique challenges must be recognized and accounted for as we relocate dollars, reallocate dollars for this important safety net program. mr. walden: i thank the gentleman from florida for not only raising this issue, but being a real partner in this legislation. i met with your governor as

well, who has been very helpful in the discussions. we believe that accounting for aging demographics of the medicaid program and broader population is an important factor we must consider to ensure that any medicaid reform is successfully implemented. i'm committed to working with you. the gentleman from florida, our colleagues in the senate, and the trump administration, to ensure florida's unique challenges related to an aging medicaid demographic are recognized and accounted for appropriately. mr. speaker, in the remaining part of my time, i'd just like to thank my colleagues for their work on this measure. making sure that people have access to affordable health care is essential and it's something i would say we all care about. we all care about family members who have suffered from cancer or other debilitating diseases, or afflictions. we're trying to find place here that works for all americans, where we have insurance markets that are actually available, where you can get an insurance product that works for you, that's affordable for you. we know that today in america

the insurance market and the individual market, that's a very small segment, 7%, of insurance in america, that's what we're talking about here today, that that market is collapsing before our eyes. in fact, in iowa i think they just announced 94 and 99 county, people there won't even have an insurance product they can try to purchase on the exchange. we've met a meth with governors, we've met with insurers, we've said, what do you need to do to interseed, to get this market back to where it works? the proposals contained in our legislation are designed to do exactly that. to get back to work where consumers have choices -- to where consumers have choices when they're required to buy insurance, to take care of their families, those choices need to be affordable. they're not now today. my own state of oregon, premiums have gone up 50% in the last two years. and meanwhile, the number of options you have to choose from has gone down and continues to go down. we haven't gone as far as some states where you have either no option in most areas of the state or just one.

but how far off is it? when insurers are failing, people losing their opportunity to get affordable health insurance. we take care of the disabled, we take care of the elderly. in fact, we plus-up to medical c.p.i. plus-one to make sure we take care of the elderly and the disabled in our medicaid program. by the way, that is probably more than most states are spending today. so we have thought this through carefully. we care about people and their medical conditions and their families. because we're all in this together as americans. and i think the bill we have before us today works. it works to take care of those most in need, it works to make sure that the people can get access to insurance. and i'll tell you what, it is a first step in a many-step process to also look at families who are dealing with opioid addiction and what we can do there. there are efforts at n.i.h., which we just supported yesterday, to fund medical research so that we can get to cures for those who have diseases and other afflictions. we are fully committed to

improving health care not only for americans, but around the globe, through innovation and scientific discovery. with that i yield back the balance of my time. the speaker pro tempore: the gentleman from virginia. mr. scott: mr. speaker, i remind my colleague that his vote for this health care bill will take away protections for over 600,000 people in oregon with pre-existing conditions. mr. speaker, i yield for the purpose of a unanimous consent request to the gentleman from california, mr. takano. mr. takano: mr. speaker, i ask unanimous consent to enter into the record a letter from the consortium of citizens with disabilities -- with disabilities. the speaker pro tempore: without objection. mr. scott: mr. speaker, i yield one minute to the gentleman from california. the speaker pro tempore: the gentleman is recognized for one minute. mr. takano: mr. speaker, there are seven million veterans who are eligible for v.a. care but not enrolled at the v.a. all of them could be denied access to the tax credits in this bill. and everyone in this chamber needs to understand how.

on page 10, line 6, of manager's amendment number 4, it states that an individual is not he will visible for tax credits if they're eligible for care as 500-f-1-a. .s. code this code specifically includes v.a. care. so this means that those seven million veterans who are eligible for v.a. care, even if they are not enrolled, would not have access to the tax credits in this law. this is not fear mongering, this is not hyperbole. this is the text of the bill we .re voting on today this bill jeopardizes health care for up to seven million veterans and everyone should oppose it. thank you and i yield back. the speaker pro tempore: the gentlelady from tennessee. mrs. black: mr. speaker, i reserve. the speaker pro tempore: the gentlewoman reserves the balance of her time. the gentleman from virginia. mr. scott: mr. speaker, i yield three minutes to the democratic whip, the gentleman from maryland, mr. hoyer. the speaker pro tempore: the gentleman from maryland is ecognized for three minutes.

without objection. mr. hoyer: mr. speaker, republicans now control all of our government. whatever happens to our health care system will be their responsibility. including what has already happened since january, with the destabilizing of our insurance markets and health plans, announcing rate hikes due to uncertainty. . they will be held accountable for what happens. americans will have the opportunity to see exactly where their representatives stand. this vote is a simple one. t votes to kick 24 million americans off of their health insurance coverage. i don't say that. c.b.o. says that, which is perhaps why we don't have a c.b.o. report on the amendment.

it includes 7 million people who are covered through their employers. it is a vote to make coverage unaffordable for one in four americans with pre-existing conditions and rationed care through high risk pools. it is a vote to impose an age tax on old americans. quite a hike. it's a vote to force americans to pay more for less to raise premiums 24% to 29% on average over each of the next two years. c.b.o. says that, not me. and no matter how republicans try to spin it, health care advocates from the a.m.a. to aa rmp p and everybody that foles have said that it ends protection for those with pre-existing conditions. it ends protections for those with pre-existing conditions.

it ends protections for those with pre-existing conditions and takes away essential health benefits like doctor visits and emergency room visits and prescription drugs. this will be an instructtive vote and republicans stand who don't want to lose their coverage and 75% saying fix it, don't repeal or stand with a president who wants to claim a victory but doesn't even know what his own trumpcare bill says. i recommend as a political strategist who are concerned about 2018, that you once again withdraw this bill. instead we ought to work together to make sure that the affordable care act works for all americans and deliver, deliver on the promise that president trump made and made from that podium when he said that he wanted insurance for

everybody. not kick 24 million off, for everybody. not make seniors pay more, for everybody. not to put medicaid at risk, for everybody. it's far less expensive and far better. i urge my colleagues come to your senses, defeat this bill. the speaker pro tempore: the gentlelady from tennessee. mrs. black: mr. speaker, i would like to remind the other side that if they read the bill they will see under section 137, it says no limiting access to coverage for pre-existing conditions. nothing shall be construed to limit access to health coverage for individuals with pre-existing conditions. i do not have time to yield. it is now my honor to -- it is

my honor to yield four minutes to the gentleman from texas, mr. brady, the chairman of the ways and means committee. the speaker pro tempore: the gentleman is recognized for four minutes. mr. brady: thank you, mr. speaker. i first want to thank chairwoman black for her leadership on this effort as well as well as chairman and walden for an incredible work. mr. chairman and on behalf of the ways and means committee, who worked along side you, i'm honored to speak in support of the american health care act because it guarantees coverage for those with pre-existing illnesses. it guarantees coverage for those with pre-existing illnesses. the bill takes decisive action and repeal all the damage done by obamacare and begin a thoughtful step-by-step process to deliver a patient-centered health care system not a washington-centered health care system. while obamacare has helped some, far more have been hurt by this

law. in more obamacare failures are piling up every day. just yesterday, aetna announced it will exit virginia's individual health market next year and not just the ork exchanges they are leaving behind, aetna will not offer any plans in the individual market in virginia. same thing is happening in iowa. and democrats, my friends on the democratic aisle have done nothing to stop this, nothing. but today, because of this bill, thousands of people will have hope for new plans to provide the health care coverage they need. millions of americans throughout the country are facing terrible options. people in texas have been hit particularly hard. between this year and last year, nine health care insurers have exited obamacare exchanges in the lone star state. no other state saw more insurers leave. for my familiar have made

incredible tough choices. you can't access affordable coverage tailored to what they need. and learned how to get by of the bigger than their mortgage payments and chose to pay out of pocket for the care they need or not getting care at all. under obamacare, receiving from luxury.ent has been a today with the american health care act, the republicans proposed we have an opportunity to provide immediate relief from this failing law. more than that, we can provide americans with real choices in health care, not the painful decision they are forced to live with under obamacare. under the ways and means committee area, this starts by repealing the law's crushing taxes and mandates and that's where ways and means takes action. under obamacare, the individual employer mandate penalties allow washington to strong arm you,

strong arm americans into an obamacare plan you do not want and can't afford. not anymore. we repeal the individual mandate tax penalties so americans have the right to make the choices. under obamacare, trillions of taxes were imposed. under the republican plan, those taxes are gone, taxes that burdened america's small businesses and families. and under our plan we provide increased health savings accounts so americans can save easier that hit them and we create a personal individual tax credit so americans can buy plans that are right for them and not what is right for government. health care premiums, they can choose a plan that can go with them from job to job or state to state. today is about taking on the

collapsing obamacare and replacing for the american people health care that they want, they can use and that they can afford, driven not by what washington wants, but driven by what american families need in their health care. i urge support. i yield back. the speaker pro tempore: the gentleman from virginia. mr. scott: i remind my colleague his vote for this bill could take away protections to 4.5 million people with pre-existing conditions in texas who might have access to coverage but if they have diabetes, their rates could go up by $5,000. i yield one minute to the gentlelady from north carolina. ms. adams: after his latest failed attempt to roll back the a.c.a., speaker ryan said obamacare is the law of the land. less than 50 days later, paul ryan shamefully is going against his word trying to ram trumpcare

down our throats. it's an embarrassment we are asting taxpayer dollars to don'tcare. trump and gives tax breaks and forces families to pay higher premiums and placing health care out of their reach and changes medicare as we know it and strips essential health benefits and protections for people with pre-existing conditions. what a pitiful display. trumpcare is so bad, republicans exempted themselves from it. they don't want trumpcare. the medical industry doesn't want trumpcare. democrats don't want trumpcare. why aren't republicans listening. the people don't want it and i won't support it. the speaker pro tempore: the gentlelady from tennessee.

mrs. black: i reserve. the speaker pro tempore: the gentleman from virginia. mr. scott: i ask unanimous consent to enter into a record a letter from common sense care action saying it jeopardizes the health of america's kids. the speaker pro tempore: woment mr. scott: i yield for the purpose of a unanimous consent request to the jam from new york, mr. jeffries. mr. jeffries: i enter a letter from f.c.i.u. which states it will leave millions without health insurance. mr. scott: i yield one minute to the gentleman from new york. the speaker pro tempore: the gentleman is recognized. mr. jeffries: house majority has once again made clear that under republican rule, the system is rigid. the fix is in. the deck is stacked against hard-working americans. and exhibit a is your reckless

republican health care plan. under trumpcare, 24 million americans will lose access to health insurance. under trumpcare, a draconian age tax will be imposed on people between 50 and 64. under trumpcare, costs will go up, premiums will go up, co-pays will go up, deductibles will go up. under trumpcare tens of millions of americans who are living with pre-existing conditions will be screwed. house republicans are out to destroy the american health care system as we know it. but you will be held accountable for the cruel and unusual punishment that you have decided to inflict on the american people. vote no against this draconian iece of legislation. the speaker pro tempore: apparently for the last time,

the chair reminds the members to direct their remarks to this chair. understood? the gentlelady from tennessee. mrs. black: i reserve. the speaker pro tempore: the gentleman from virginia. mr. scott: i ask unanimous consent to enter into the record an article in "consumer reports" dated may 2, 2017 entitled how the affordable care act drove down personal bankruptcy the speaker pro tempore: without objection. mr. scott: i yield to the gentleman from new jersey, mr. norcross. the speaker pro tempore: without objection. mr. norcross: a month ago this bill was abruptly that day because it wasn't harmful enough. it is so bad, it might actually pass. i don't have a lot of time to explain, but let me tell you two groups that are going to say thank you, it's the billionaires

and it's the undertakers. this bill will make health care more affordable. meanwhile it gives $600 billion -- excuse me $800 billion to the wealthy, to the billionaires. trumpcare brings us higher costs, less coverage, guts the benefits, crushing age tax and steals from medicare. and in my district alone, 43,000 people will lose coverage, 9,000 of those are children, elderly, the medicaid will be lost, close to 2,000. there is a reason they are trying to jam this down our throat. there is no c.b.o. score because they don't want to hear a score. let me make it plain. let's put this bill in a coffin and let's kill and bury this bill. the speaker pro tempore: the gentlelady from tennessee.

mrs. black: now my honor to ield 1 na minutes to mr. scalise, our whip. the speaker pro tempore: the gentleman is recognized. mr. scalise: i thank the chairwoman of the budget committee for yielding. i rise in strong support of this bill, mr. speaker, that finally provides relief to the american people across this country from the failures of obamacare. and just how bad is it failing? you don't have to look any further than what happened in iowa yesterday, they will have in 94 out of 99 counties nobody to write nurns for people that are in the obamacare exchanges. what do those who are opposed say to those people in iowa? what are the people that oppose this bill going to say to the millions of people with pre-existing conditions across the country who are being faced with double digit increases in

their health insurance every year? and by the way, premiums and deductibles as high as $10,000 which are creaming those folks that are struggling under the weight of this bill. what we are replacing it with with lower premiums and put patients back in charge of their health care decisions so elitists in washington up here won't tell you what you have to buy, you get to make that choice yourself and focus on plans that are good for your family at lower costs so you can be in charge and reforming the medicaid system, so that states have the ability to innovate and help low-income families. this bill is important, mr. speaker, to rescue the american people from a law that has failed. let's end the skyrocketing premium increases and lower costs and have patients in charge of their health care. .

the speaker pro tempore: the gentleman from virginia. mr. scott: for example, those with breast cancer could see their premiums go up by over $34,000. mr. speaker, i yield to the gentlelady from delaware for the purpose of a unanimous consent request. ms. blunt rochester: mr. speaker, i ask unanimous consent to enter into the record a letter from aarp which makes clear, health care will be sabotaged under this bill and health care costs for older americans will, quote, dramatically increase, end quote. the speaker pro tempore: without objection. mr. scott: thank you, mr. speaker. mr. speaker, i yield one minute to the gentlelady from delaware. the speaker pro tempore: the gentlelady is recognized. ms. blunt rochester: thank you. mr. speaker, i know in these polarized times we often forget that we are connected. and we are all connected to each other. a sick, uninsured employee effects the bottom line of a small business. uncompensated care in the emergency room, we all pay the bill. when a child from an uninsured family goes to school, with an

undiagnosed virus, not only does it impact his or her ability to learn, it impacts other kids and puts them at risk. we are all connected. as martin luther king so powerfully said, we may have come over on different ships, but we're all in the same boat now. mr. speaker, it's time we start rowing together. unfortunately this bill fails to recognize this. it still fails. that we're connected and that instead of bringing us together, this simply divides us, by providing less coverage, imposing an age tax, forcing people to pay more, and stripping key protections. i urge all my colleagues to vote no on h.r. 1628. thank you and yield back the balance of my time. -- thank you and yield back the balance of my time. the speaker pro tempore: the gentlelady from tennessee reserves. the gentleman from virginia. mr. scott: thank you, mr. speaker. mr. speaker, i yield one minute o the gentleman from illinois, mr. krishnamoorthi crish -- mr. crish -- mr. krishnamoorthi crish.

-- mr. krishnamoorthi. i could yield for the purpose of unanimous consent request first? the speaker pro tempore: sure. mr. scott: thank you. mr. krishnamoorthi: i ask unanimous consent to enter into the record a letter from the american medical association that states, quote, not only would the ahca eliminate health insurance coverage for millions of americans, the legislation would in many cases eliminate the ban against charging those with underlying medical conditions vastly more for their coverage. the speaker pro tempore: without objection. mr. scott: now i yield one minute to the gentleman from illinois. the speaker pro tempore: the gentleman is recognized for one minute. mr. krishnamoorthi: thank you, mr. speaker. the country will not remember what we say here today. but it will never forget what we do today, especially if we make the wrong choice and adopt this bill. the 159 million americans whose employer-sponsored health care could be cut would never forget. neither would the 24 million americans who would lose their coverage or the 52 million people with pre-existing conditions who would struggle to find health insurance again.

if this bill passes, mr. speaker, no cancer survivor denied coverage will forget, no survivor of sexual assault charged more for her ordeal will forget, and no parent struggling to afford emergency surgery for a newborn child could ever forget. they would not have that choice. but today we have one. we can choose to vote no and prevent millions of americans from losing their health care. we can choose the right path rooted in morality, decency and reason. i implore you, vote no. i yield back. the speaker pro tempore: the gentlewoman from tennessee. mrs. black: reserve. the speaker pro tempore: the gentlewoman reserves the balance of her time. the gentleman from virginia. mr. scott: mr. speaker, i yield for the purpose of a unanimous consent request to the gentleman from new york. mr. espaillat: mr. speaker, i ask unanimous consent to enter into the record a letter from -- which states this bill would cost millions to lose -- would

cause millions to lose their health coverage and return to the days when even inadequate coverage was unaffordable. the speaker pro tempore: without objection. mr. scott: mr. speaker, i yield one minute to the gentleman from new york. mr. espaillat: mr. speaker, i strongly oppose this bill. we all should. protecting a.c.a. is a top issue for my constituents. constituents like leslie who without the protections of the a.c.a. would not have gotten the treatment for leukemia that she was diagnosed with at the age of 22. leslie is now in remission thanks to obamacare. for leslie, the a.c.a. protections, like essential health benefits, were a matter of life and death. this republican bill would destroy those patient protections. under the a.c.a. in my district, 5% dropped in uninsured rates. subsidized based on region and income, not on age. medicaid expansion covering 156,000 people will be lost.

the president promised not to cut medicaid. this bill guts it by $880 billion. this bill is a gut punch to america. pregnant women seeking health care kicked to the curb. patients with pre-existing conditions, kicked to the curb. senior citizens who will have to pay for more less, kicked -- kicked to the curb. only 24 million people, including 6.5 million latinos kicked to the curb. the speaker pro tempore: the gentleman's time has expired. mr. espaillat: stop this bill. the speaker pro tempore: the gentleman's time has expired. the gentlelady from tennessee. mrs. black: i reserve. the speaker pro tempore: the gentlelady reserves the balance of her time. the gentleman from virginia. mr. scott: thank you, mr. speaker. mr. speaker, i yield for the purpose of a unanimous consent request to the gentlelady from california, ms. lee. ms. lee: thank you, mr. speaker. i ask unanimous consent to insert into the record the service employees international unions letter voicing strong opposition to the deadly american health care act for their two million members.

the speaker pro tempore: without objection. mr. scott: thank you. mr. speaker, i now yield for the purpose of unanimous consent request to the gentlelady from california, ms. waters. ms. waters: mr. speaker, i ask unanimous consent to enter into the record a letter from the association of american medical colleges which states, the treatment of essential health benefits and health status underriding the protections for many americans and would leave individuals with pre-existing conditions facing higher premiums and reduce access to vital care. mr. scott: thank you, mr. speaker. i yield one minute to the gentlelady from california. the speaker pro tempore: the gentlelady is recognized for one minute. ms. waters: thank you very much. i rise to caution those republicans who have been allowed themselves to be persuaded by this president and to -- into supporting this terrible bill, which would lead millions of americans -- leave millions of americans without health care and raise the costs