recognizes the gentleman from nevada. mr. horsford: thank you, madam

speaker. i ask unanimous consent that all members may have five legislative days in which to revise and extend their remarks and to insert extraneous material on s. 610. the speaker pro tempore: without objection. mr. horsford: thank you, madam speaker. i yield myself such time as i may consume. the speaker pro tempore: the gentleman is recognized. mr. horsford: i rise in mr. horse spored feather i rise in support of s. 610, the protecting american farmers from sequester cut which will extend additional relief to medicare provides for the 2022, to support provides for the the covid-19 public health emergency. in 2019, the centers for medicare and medicaid services made changes to how different physicians services were valued relative to one another in the medicare payment system. while physicians performing many primary care services saw and

increase in payments as a result of these changes, other providers saw fairly substantial reductions which were not phasedin that is why last year, congress provided a 3.75% increase in the medicare conversion factor as a transition to the providers that were most affected. this legislation continues that glide path. with a 3%, one-year increase in the medicare conversion factor providing a bump in payments. with the new covid variant emerging here in the united states, this will be important support for our frontline workers. this legislation also eliminates the medicare sequester, the 2% cut slated to take effect in january, and instead provides a glide path by fully eliminating the cut in the first quarter and phasing it down to 1% in the second quarter.

lastly, the legislation imposes a one-year delay on clinical laboratory reductions and a radiation oncology payment mod tole provide additional time to adjust to these policies. these commonsense provisions were also included in the legislation that i'm proud to have introduced earlier today along with my colleague, congresswoman schrier. these provisions have strong support from the medical community, physicians, and hospitals because those in the health care field recognize that we must ensure providers have the support that they need to care for patients as we continue to bat they will coves 19 pandemic. a letter from 20 surgical groups notice, and i quote, we urge congress to pass the protecting medicare and american farmers from sequester cuts act to mitigate the 2022 medicare payment cuts. this legislation will also provide a procedure for the

senate to raise the debt ceiling. this deal was struck by senate republican leader mcconnell. as much as my colleagues across the aisle may claim, this is not about new spending. increasing the debt ceiling will prevent us from defaulting on debt we already owe. it's about investments that congress previously improved. in fact, 97% of the current debt was accumulated before president biden assumed office. this vote is about protecting the full faith and credit of the united states of america. a default would spell disaster. nearly 50 million seniors could stop receiving social security checks for a period of time, troops could go unpaid, millions of families who rely on their monthly child tax credit, a tax cut, could see delays. our current economic recovery could reverse into recession

with billions of dollars of growth and millions of jobs lost. according to an analysis by moody's analytics chief economist mark zandy, the recession would wipe out as many as six million jobs and erase $15 trillion in household wealth. so i'm proud to stand in strong support of this bipartisan agreement that will end the specter of default looming over the american economy and the american people. i urge my colleagues to support this responsible measure and i reserve the balance of my time. the speaker pro tempore: the gentleman reserves. the gentleman from texas is recognized. mr. brady: thank you, madam speaker. i yield myself such time as i may consume. the speaker pro tempore: the gentleman is recognize. mr. brady p.c. today ought to be a rare day for bipartisanship on behalf of patients and health care providers across america. but sadly, it is another day for

democrats' partisanship. providing needed funding for our medicare providers, our local doctors and hospitals, especially as we recover from the pandemic is just commonsense. we should be on the same page. in fact we are. as early as a few hours ago. where republicans also introduced legislation to help our health care providers. but instead, democrats have decided to push a very partisan agenda that has led to crisis after crisis, including the one we address today. our border communities are overwhelmed. bidenflation is robbing american paycheck, the president has mishandled the economy so badly he's already nearly a million jobs short of his promises from his last $2 trillion spending binge. and now patients and doctors are being held hostage to pave the way for trillions more reckless spending that most americans don't even want.

regrettably, democrats are politicizing needed funding for americans' health care with the poison pill that provides the process for lifting this debt ceiling, absolutely unrelated. and using patients and access to local doctors as leverage to increase the national debt on our children and grandchildren. last month, knowing this was coming, republicans on the ways and means committee called for a hearing, a bipartisan hearing, to address the issues around our doctors. and our health care providers. and reimbursing. in a letter we wrote to our democrat colleagues who we believe share the same concerns and said, quote, if the stability of health care providers is in fact still a priority for you, let's hold a hearing so we can discuss a legislative solution going forward to maintain patient access to local providers. instead, once again, my democrat colleagues are choosing to go it alone because seemingly they're obsessed with spending taxpayer dollars wastefully.

we know there's bipartisan support for doctors. we should do a stand-alone bill. but the truth is house republicans can't support using patients and access to local doctors as leverage to increase the national debt on our children. we know there is bipartisan support for providers and we know this could stand alone as a bill. unfortunately, this is not the path our democrats have chosen. make no mistake this debt ceiling is being lifted to pay for trillions of wasteful socialist spending. this debt ceiling is limited -- is increased until 2023. all to accommodate trillions of wasteful spending. and americans know it. the committee for responsible federal budget has noted the president -- that president biden's build back better bill will cost nearly $5 trillion. while the president and others continue to claim falsely that this costs $0. unfortunately for the president

and for the taxpayers, who have to foot the bill, the "washington post" fact checker found this claim false and misleading. false and misleading. they said it takes some dubious gimmicks to help disguise the true cost of president biden's agenda. and these gimmicks are just to justify paying for absolute waste. democrats give away hundreds of billions of dollars to special interests and the wealthy. literally sending government checks to the top 1%. and the biggest corporations. democrats protect so-called green companies from their new minimum tax. wealthy individuals with up to half a million dollars in income every year enjoy their own green welfare including a 12.5 -- a 12,500 check from single moms and working americans so they can buy the wealthy a luxury electric vehicle.

democrats force -9d 0% of americans who don't join a union to subsidize the few who do. democrats provide special loopholes and tax cuts for special interests like trial lawyers. democrats would increase the $10,000 salt cap providing wealthy taxpayers with a windfall of a quarter of a trillion dollars to help the wealthy. two out of three millionaires get a tax cut, one out of three middle class families get a tax hike. where are their priorities? and democrats' tax and spending spree will more than double american's chances of being audited as it targets lower and middle income earners to make sure they pay, quote, their fair share. this proposal and that proposal will lead to an additional $1.2 million -- an additional 1 . 2 million i.r.s. audit focused on then middle class. we'll see billions of dollars in

taxes on main street small businesses. what does it men for americans? more than double the chance of being audited, not just for the rich. americans ought to take a step back and see what we're doing tonight as shameful. that's what it is. the democrats are threatening to hold up payments for local doctors and health care providers as they fight out of the pandemic so democrats can pay for measures they claim we need because of the pandemic. we've gone from never letting a crisis go to waste to never letting a crisis get in the way of waste. this debt ceiling didn't have to happen this way. house democrats have known this day was coming for two years. never bothered to pass a budget. never passed appropriations bill. failed to have any bipartisanship discussion. here we are at the last minute. madam speaker, commonsense americans will not let their doctors and health care providers being hold -- to be

held hostage to this debt ceiling crisis. we strongly urge a no vote on this bill. with that, i reserve the balance of my time. the speaker pro tempore: the gentleman reserves. the gentleman from nevada is recognized. mr. horsford: madam speaker, i now recognize the chair of the energy and commerce committee, the distinguished gentleman from new jersey, mr. pallone, for two minutes. the speaker pro tempore: the gentleman is recognized. mr. pallone: thank you, madam speaker. i rise in strong support of this bipartisan legislation that will continue to guarantee access to health care providers as we confront the covid-19 pandemic. nothing could be more important to our seniors than making sure that they have access to doctors during this time. and i heard with my colleague on the republican side -- what my colleague on the republican side said but i want to assure everyone that what we're talking about here is making sure our seniors can access a doctor. that there are doctors available to help them during the covid-19 pandemic. since the beginning of the

pandemic, congress has provided relief to medicare providers by waiving a 2% cut in payments created as part of sequestration. this legislation will continue waiving those cuts. it also protects medicare and other federal programs by preventing any cuts from occurring as a result of pay-go results. the legislation provides additional relief to health care providers by increasing payments under medicare's physician fee schedule next year and increasing reimbursements for lab and oncology services. we have to understand that provide verse to keep their doors open. labs have to be open. during this difficult time when providers are being stretched to the limit, labs, oncology service, everything is being stretched to the limb if congress does not take action now and pass this bill then some health care providers will face significant reductions in payment and that has an impact on our seniors on their ability to get services. so this legislation is important for the seniors. it's important for our

constituents. it has bipartisan and bicameral support and i urge my colleagues to join me in supporting it tonight. i yield back. the speaker pro tempore: the gentleman yields. the gentleman reserves. the gentleman from texas is recognized. mr. brady: thank you, madam speaker. i'm proud to yield one minute to the republican leader of the tax policy subcommittee, the gentleman from nebraska, mr. smith. the speaker pro tempore: the gentleman is recognized. mr. smith: thank you, madam speaker. here we are again, late at night, debating last-minute legislation needed to fix problems the current majority created. when considered alongside the ongoing covid pandemic widespread work force concerns and the cloud of uncertainty created by unnecessary vaccine mandates, it is clear the combined effects of upcoming medicare reimbursement cuts are a critical threat to our medical system. while i commend the efforts made over the last few days to draft solution which address the

concerns of health care providers, instead of coming together to pass a bipartisan compromise we again find the majority attaching controversial, unrelated material to this bill. tonight, the majority has chosen to jeopardize urgent relief for health care provide wears political gimmicks relating to the debt ceiling and pay-go issues we saw coming from miles away. i'm disappointed to see yet another erosion of the rules and precedents of congress. i urge all members to oppose this bill and i yield back the balance of my time. the speaker pro tempore: the gentleman from texas reserves. the gentleman from nevada is recognized. mr. horsford: i continue to reserve. the speaker pro tempore: the gentleman reserves. the gentleman from texas is recognized. mr. brady: thank you, madam speaker. proud to yield four minutes to the republican leader of the budget committee, the gentleman and member of the ways and means committee, the gentleman from missouri, mr. smith. the speaker pro tempore: the gentleman is recognized. mr. smith: thank you, madam speaker. i want to thank the gentleman from texas for yielding. what a mess, madam speaker.

truly what a mess. just about nine months ago, i stood on this floor when we were debating the biden bailout bill and i warned the gentleman from nevada how much his state, how much his seniors in his state, was going to lose and in medicare cuts. i said i said it state by state with everyone who spoke. everyone on that side of the aisle, madam speaker, they act like it wouldn't happen. they still wanted to spend $2 trillion. but guess what. reality has set in. and we're here and unless you try to wipe away the scorecard for your reckless spending, seniors are going to have cuts. why? because of a law that democrats

passed in 2010. the pay go act. nancy pelosi loved the act then. president obama signed that act into law, madam speaker. you guys just want to wipe the slate clean. madam speaker, we're here today for two reasons. first, because democrats blew up a bipartisan agreement this afternoon, this afternoon, and second is because there are looming cuts to seniors and farmers. and to programs that millions of americans rely on because of reckless democrat spending. republicans have warned since march that these cuts would happen. in fact, the $2 trillion biden bailout bill that democrats rammed through congress is what triggered a sizable portion of these cuts in the first place

under the paygo act. their bailout bill is the largest, it is the largest trawnch of spending -- tranch of spending ever added to a paygo scorecard in the history of congress. in the history of congress. the $2 trillion expenditure back in march. speaker pelosi said in 2009 that pay as you go budgeting, quote, will help return our nation to sound fiscal health, closed quote. it was president obama who signed paygo into law like i stated but now that democrats' deficit spending is forcing cuts, they're singing a much different tune. in fact, just today, just today the chairman of the house budget committee said, quote, about paygo, it has never been an effective tool of fiscal policy,

closed quote. so which is it? the fact is democrats should be working in a bipartisan way to protect seniors from these cuts. including those stemming from the budget control act sequester and the medicare physician fee schedule. but in typical fashion, democrats have decided to abandon bipartisanship and just kick the can down the road over and over again. we can stop these cuts but we should do it in a responsible way. one that addresses wasteful spending and puts in place some commonsense reforms. how about rescinding money from the biden bailout bill that is fueling inflation? maybe congress kotiten up our laws -- could titan up our -- tighten up our laws. or put commonsense work requirements in place for federal programs so american businesses can rope.

legislation i've introduced today does just that. and i would hope my colleagues across the aisle would support this effort to save seniors -- the speaker pro tempore: the gentleman's time has expired. tom brady i yield an additional minute. the speaker pro tempore: diswrat is recognized. mr. smith: thank you, madam speaker. to save seniors and others from cuts. including those cuts democrats have directly caused with their reckless spending this year. since the beginning of this congress, house democrats have passed $7 trillion in new spending. we have an inflation crisis, a border crisis, an energy crisis and democrats also choose to create a debt limit crisis that they want republicans to spend solve. one party, one rule, this is what you get. well, we have been clear from the beginning. if democrats are going to pursue a partisan agenda that adds trillions to the debt, they can

find the votes to raise the debt limit themselves. republicans will not co-sign alone to enact a radical socialist agenda. i yield back. the speaker pro tempore: the gentleman reserves. members are reminded to direct their comments to the chair. the gentleman from nevada is recognized. mr. horsford: madam speaker, i just remind the gentleman, when we talk about bipartisanship, this side of the aisle worked in a bipartisan way to pass a bipartisan infrastructure and jobs investment act that only 13 republicans on the other side voted in favor of. more than 200 republicans on the other side voted against. tonight we are providing a solution to protect the health care providers in my home state of nevada, in states all across the country, including in the prior speaker's home state of missouri. if he won't vote to fix that

problem, i will. because this is about solving a problem, not creating another one. i reserve the balance of my time. the speaker pro tempore: the gentleman reserves the balance of his time. the gentleman from texas is recognized. tom brady thank you, madam speaker. i'm proud to yield two minutes to the gentleman from texas, leader of the doctor caucus, who worked to put these solutions together, from texas, dr. burgess. the speaker pro tempore: the gentleman is recognized. mr. burgess: i thank my friend for yielding. look, i'm on the energy and commerce committee. i'm on the budget committee. i'm on the rules committee. but i'm also co-chair of the house republican doctors' caucus. last week the surgeon general of the united states asked if he could come and talk to us and we made that a bipartisan meeting. we included doctors -- democrats who are physicians as well in that meeting. the doctor was concerned primarily about physician burnout. he's encountered a lot of it since he's re-assumed his role

as a surgeon general, the nation's top doctor. we shared with the surgeon general, one of the principle drivers, yes, the pandemic has been a problem. cutting down elective surgeries in the pandemic and clogging the cash flow in offices was a problem. but one of the real drivers of physician burnout today is constant, constant and -- constant haggling and no solution over these cuts. a year ago we were here on this floor talking about a $9 -- a 9.4% cut in medicare reimuser about -- reimbursement rates. at the last minute god came out of the machine and saved the nation's doctors but here we are again. we knew this was coming. it wasn't a mystery. we could have had hearings, as ranking member brady has pointed out, we could have had hearings in our committee. but we chose not to. we chose to squander that time and now the surgeon general is concerned about burnout in the

nation's physicians corps and here's the problem. they're burned out because we won't answer their calls we won't solve their problems. we have an opportunity to do it. i ask for the rules committee for an amendment to -- let's divide the question. we don't have to do the debt limit and the doc fix at the same time. let's divide the question and let members have the freedom to vote on this issue and vote their conscience and let doctors all over this country know who stands with them and who is against them. i yield back. the speaker pro tempore: the gentleman reserves the balance of his time. the gentleman from nevada is recognized. mr. horsford: i reserve at this time. thank you. the speaker pro tempore: the gentleman reserves the balance of his time. the gentleman from texas is recognized. mr. brady: may i ask, is the gentleman prepared to close? mr. horsford: we have one further speaker. mr. brady: excuse me? mr. horsford: we have one further speaker. mr. brady: i would reserve at

this time. the speaker pro tempore: the gentleman reserves the balance of his time. mr. horsford: at this time -- the speaker pro tempore: the gentleman from nevada is recognized. mr. horsford: thank you, madam speaker. at this time i would yield one minute to the gentlelady from the great state of texas, representative sheila jackson lee. the speaker pro tempore: the gentlelady is recognized. ms. jackson lee: if there's one thing that we have heard so often, it's doctors who have sack tiesed during -- sacrificed during this period of pandemic, who maintained their offices and we often hear in public settings and private settings about the cuts that they're expecting and how much it will undermine the work that they do, their offices, expenses. i'm very glad that rather than talking, that the democrats are working together to ensure that the medicare sequester payments

will not occur and that we will protect against that, as we will do for the farmers. but here's the point. the pandemic continues, private doctors in private practice are trying to survive. this is a crucial decision and relief that is long overdue. i want to be able to say to my physicians, democrats care and we hope my colleagues on the other side of the aisle will do as much talking about doctors and medicine and health care as they will enacting. tonight we need to act. to provide the safety net for these physicians. i support this legislation, the supporting the health care providers during this covid-19 pandemic act. i yield back. the speaker pro tempore: the gentlelady reserves the balance of her time. the gentleman from texas is recognized. mr. brady: thank you, madam speaker. if the gentleman from nevada is prepared to close, i am as well. mr. horsford: i'm prepared to close. mr. brady: great, thank you. i reserve my -- yield myself such time as i may consume. the speaker pro tempore: the gentleman is recognized.

mr. brady: the claim we just heard, that only democrats want to prevent these cuts to our local doctors and the hospitals is just nonsense. democrats and republicans have worked hard together to extend the moratorium on sequester cuts on our providers, our doctors and hospitals, to provide a 3% payment to increase for our physicians, to make sure that in the administration's proposals to help increase reimbursement for primary care physicians, you don't cut the payment for specialty doctors who many of them were hurt so hard during covid. we also worked with our democrat colleagues to delay for a year the proposed cuts by this administration on our labs, in our oncologists and worked together to make sure other cuts didn't occur. and all that happened together,

but not at this time, and all that bipartisanship was all on track up until a few hours ago. my democrat colleagues decided they would hold this hostage, this health care reimbursements for doctors and hospitals hostage for their debt ceiling crisis that they created. it really is, i think, in a day and age where we've seen this one party rule for an entire year, the arrogance of this power go to their heads, it's unfortunate that they couldn't continue to work just like a few hours longer together with republicans to provide help to our physicians, our hospitals. this bill ought to be a stand-alone bill. we shouldn't never hold them hostage for their spending spree and socialist agenda. unfortunately that's what our democrat colleagues have done

today. we've introduced the legislation as republicans that mirrors our democrat colleagues because we believe so strongly together. unfortunately one party ruler to this -- rule tore this apart. that's why the the american public is going to return the majority of this house to republicans in the next election and why president biden's approval ratings is at a terribly low, the disapproval of 57%. it's unfortunate. we ought to be working together on that. i'd be glad to yield 15 seconds to the lady. the gentlelady. ms. jackson lee: i thank my good friend. the 15 seconds i will take. you can't provide for the doctors if you don't provide an increase in the debt ceiling. you know that. we have to pay our bills and paying the doctors and making sure that they are protected includes doing the action that we're doing. join us in doing that. mr. brady: thank you. reclaiming my time. our colleagues have known for two years this debt ceiling was

here. never passed a budget, never passed appropriations bill, let this crisis occur and built it time after time after time again when we could easily have come together. by the way, our democrat colleagues hold the house, they hold the senate, they hold the white house. they have the power to pass the debt ceiling and have had that time for the entire year. so to my democrat friends, you can try to sell this snake oil all you want but the truth of the matter is, you wrecked a bipartisan agreement for your debt ceiling crisis. that's what we're voting on today. republicans' support for health care providers. we won't allow them to be held hostage to this debt ceiling crisis. with that, i urge strong opposition to this bill and urge our democrat kreels -- colleagues someday to work with us. just work together on these issues. with that, i yield the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. the time of the gentleman from nevada is recognized. mr. horsford: thank you, madam

speaker. i'll just close by stating that yes, democrats are delivering. we're delivering for the american people. we're delivering in the time of a pandemic. we're delivering to restore public confidence in our public institutions and to help our economy recover. this bill is about important and responsible measures to deliver for the american people. when td the majority, they chose to spend their time giving tax cuts to the very wealthy and big corporations that provided little benefit to average americans and to small businesses. now, with democrats in charge, we are delivering for the american people. so i