(House of Representatives - June 25, 2013)

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[Pages H4021-H4024]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

                              {time}  2050

  The SPEAKER pro tempore (Mr. Perry). Under the Speaker's announced 
policy of January 3, 2013, the Chair recognizes the gentlewoman from 
North Carolina (Mrs. Ellmers) for 30 minutes.
  Mrs. ELLMERS. Mr. Speaker, I rise today to discuss the upcoming 
implementation of ObamaCare.
  Prior to coming to Washington, I was a nurse for over 21 years, and 
I'm passionate about health care. My husband is a general surgeon, and 
he continues to practice in our hometown of Dunn, North Carolina. I'm 
very, very proud of that.
  A couple of years ago when the President was proposing his 
legislation to basically overhaul health care in America, my husband 
and I became very active speaking out. That was well before ever 
considering running for Congress. As a result, because of our passion 
and concern for this country and health care as a whole, I found myself 
winning my election and here fighting this fight. We continue with this 
fight, and we are 98 days away from the open enrollment process going 
into effect for ObamaCare. This is something that the American people 
have been sitting back and watching for quite some time, and there are 
many, many questions that remain to be answered.
  Mr. Speaker, a recent GAO study shined some light on some areas that 
we've been asking questions about for a very long period of time. 
Serving on the Energy and Commerce Committee, the Energy and Commerce 
Committee put forward a request to the GAO to find out where exactly 
are we in the implementation of ObamaCare, this takeover of America's 
health care affecting one-sixth of our economy and affecting jobs 
across this country. It's the number one reason today, Mr. Speaker, 
that employers are not hiring, because they're not sure of the effects 
that this will have once fully implemented.
  There again, this week, the nonpartisan Government Accountability 
Office put forward their findings. I just want to highlight some of 
those for you:
  States have yet to complete 85 percent of the required program 
activities. That means essentially, Mr. Speaker, that only 15 percent 
of what needs to be in place at the State level for ObamaCare is 
actually in place. Core functions of both Federal- and State-based 
exchanges have yet to be completed with less than 4 months before open 
enrollment, any other missed deadline threats, and timely establishment 
of exchanges. Exchanges are not in place, exchanges are not ready to be 
implemented, and yet we continue on this timeline path.
  HHS has not yet completed the critical steps needed to determine 
eligibility for credits and cost-sharing subsidies. There's much 
groundwork that still needs to be laid and implementation figured out, 
and we don't even have those answers from HHS.
  Key data-sharing agreements between the Federal exchange and its 
Federal and State counterparts are not complete.
  Consumer assistance and outreach activities to individuals and 
employers have yet to be implemented and have been delayed.
  It cannot simply be a political campaign on the road touting the 
virtues of ObamaCare that will implement this program. This is a major, 
major concern for all of us who know how important health care is.
  I can go on. There are many more pieces to the GAO report, which 
basically cites the fact that CMS is not ready. CMS is supposed to come 
in and help the States that haven't implemented yet or aren't ready. 
Where are they? They're not there. They're not acting. We have these 
questions, but who does this affect? What are the questions that need 
to be answered?
  This afternoon, I had the opportunity to go to National Children's 
Hospital and meet with some of the families there, very ill children, 
children dealing with diabetes, cancer. I got the opportunity to see a 
1-year-old who's waiting for a heart transplant. These are the children 
that will be affected by the implementation of ObamaCare. Why? Because 
research will be affected, because lifesaving cures and treatments will 
be affected.
  How can we implement a health care system that no one at this point 
can actually state will improve the quality of care of our health care 
system? It's very important that when we talk about health care and the 
takeover of health care that we separate the two issues: one, health 
care pay-for, health care insurance, health care coverage; and then 
health care itself. They both suffer as a result of ObamaCare being 
  We simply cannot stand by and allow this to happen. My colleague from 
Kentucky, he is here this evening as well, and he has some words. I 
yield some of our time to the gentleman from Kentucky.
  Mr. GUTHRIE. Mr. Speaker, I thank the gentlelady for yielding.
  It seems there's no shortage of red flags regarding ObamaCare. The 
one-size-fits-all health care law is proving to be disastrous for 
consumers, for employers and health care providers alike.
  Just last week, as my friend from North Carolina said, the 
nonpartisan Government Accountability Office warned:

       Because government officials have missed multiple key 
     deadlines to set up the new health insurance exchanges, there 
     is serious concern that the exchanges will not be ready in 
     October, as scheduled.

  Employers and families across Kentucky have expressed serious 
concerns about meeting the requirements of the law and wondering if 
they will lose their coverage, be forced to choose different providers, 
or be saddled with enormous new costs. Now these individuals are left 
with even more uncertainty.
  When talking with business leaders across my district, I hear a 
barrage of questions and concerns. Small businesses, the backbone of 
our economy, are likely the hardest to be hit. Some

[[Page H4022]]

local insurers say the law could put them out of business. One 
restaurant owner says it will be a challenge for the whole industry and 
many will be forced to lay off employees. Others simply say it will be 
difficult to insure all of their existing employees.

  A Gallup poll released last week showed that 41 percent of small 
businesses, the engine of our economic growth, have stopped hiring new 
employees because of ObamaCare. The same poll also showed that one-
fifth of those surveyed have reduced their workforce because of the 
  Citing the uncertainty, these business leaders don't know what type 
of insurance programs they might be able to implement or if they will 
have to alter the shape of their workforce. The uncertainty seems 
likely to continue given the striking, but not surprising, report from 
the GAO.
  The Government Accountability Office warns that the Center for 
Medicare and Medicaid Services still has many duties to complete across 
core exchange functions, including eligibility and enrollment. With 
enrollment less than 4 months away, these missed deadlines will likely 
result in even more confusion as Americans are prepared to be placed 
into the exchanges. It's no wonder that this law is so wildly unpopular 
and individuals fear being placed in exchanges.
  But it's not just families and businessowners who are left in the 
dark. Insurance companies don't know what to plan for when the 
exchanges open, and some are already fleeing the market.
  Aetna recently announced they will not participate in any statewide 
exchanges and they will exit the individual insurance market in 
California entirely. This mood can set a dangerous precedent: insurers 
not being willing to take the financial risk to meet the demands of 
ObamaCare and not participating in the exchanges altogether.
  With competition dwindling and individuals not knowing what they can 
expect in terms of coverage and cost, we are left with a very scary and 
unacceptable reality. There are simply too many unknowns in the law 
that completely overhauls our Nation's health care system. This has led 
to unintended and negative consequences for employers, patients, and 
  This law is not the solution to our Nation's health care problems, 
especially given the lack of information and tools available for 
implementation. Instead, we need to enact a patient-centered plan that 
lowers cost and ensures access for all Americans.

                              {time}  2100

  Mrs. ELLMERS. Mr. Speaker, continuing with our discussion about the 
implementation of ObamaCare, I think it's important, as my colleague 
from Kentucky has cited, that back home, in his district, many 
businesses, many individuals, many families are being negatively 
affected as this moves towards implementation.
  Tomorrow, in the Energy and Commerce Subcommittee on Oversight and 
Investigations, we will be holding a hearing that actually discusses 
the challenges facing our American businesses. Back in my district and 
actually testifying here tomorrow is one of my constituents, Mr. Steve 
Lozinsky, who will be here with his wife, Kathy. They actually own a 
business, Sparkle & Shine Cleaning Service. It's a family-owned 
business, and it's based in Apex, North Carolina. Sparkle & Shine was 
started in 1998 with one employee, and, today, it has over 240 
  Put simply, Sparkle & Shine cannot afford the $2,000 per employee 
fine attached to ObamaCare. My friend, my constituent, back home cannot 
provide the health care coverage. He employs low-income workers. They 
are entry-level jobs. They are hard workers. Many of these individuals 
actually served time in jail and are now on a second chance at life. 
Mr. Lozinsky and his wife, Kathy, have given these individuals a second 
chance, and now their jobs are in jeopardy because of this devastating 
health care law.
  To my colleague again from Kentucky, I'm sure that he also has many, 
many stories to share.
  Mr. GUTHRIE. We hear stories like that all the time when we're home.
  We had one in the Energy and Commerce Committee when we had a 
gentleman who had a chain of restaurants he's developing in New 
England, which isn't where I'm from, but he was before the committee. 
His testimony was that he had eight restaurants and planned to open a 
ninth, and he decided he had to wait because he has no idea what this 
health care bill is going to cost him when he has to provide health 
care for his employees. Of the net income of his eight restaurants, he 
estimated--if he could come up with it because, as we know, you still 
don't know exactly what the health care bill is going to look like. We 
know what the bill looks like, but what we don't know is what's really 
in it because the rules have not come out to say what you have to 
provide your employees. It's supposed to happen in October and be ready 
for January 1. So he has decided to just not open a restaurant until 
this gets implemented so he can then move forward. He said it's going 
to take half of his net income, he has estimated, if what's in the 
rules comes out.
  If you've ever been in business, it's something you always take home, 
but if you're growing a business, hoping to open a ninth, 10th, and so 
on and create a chain, the net income is what you put into the business 
to grow the business and move forward. It's half of his net income, 
according to his estimate and as best as he can estimate, because 
nobody knows the details of what's actually going to be required until, 
hopefully, we see it before October 1. It's just frustrating for him. 
It's frustrating for people. It's frustrating for employees.
  A guy stopped me in a store the other day. He just got a job at a 
retail store. He said, I was promised 40 hours, and I was just told I'm 
going to be working 29 hours. That's the new class of people working, 
particularly in retail. He was retired, and he was kind of looking for 
extra income, and he's going to be a 29er. That's a term that we hear 
quite a bit.
  So dealing with health care is something we absolutely have to deal 
with but not dealing with it in the way of this bill. They didn't try 
to cut costs, and it's actually implemented on top of the system even 
more, which is going to cost more. Employers are really concerned, not 
about being able to cover their employees, but they're concerned about, 
Are they going to be able to afford to stay in business and even have 
employees? That's the concern of most of them whom I hear talk about 
  I'm sure you hear the same. I know our good friend from Texas is now 
here on the floor, and I'd like to give this back to my friend from 
North Carolina.
  Mrs. ELLMERS. Just to follow up on some of the remarks that my 
colleague has made, in getting back to the issue of jobs and job 
creation, there was a recent Gallup Poll out this week that found that 
41 percent of small businesses have stopped hiring because of 
ObamaCare. That is a staggering number. Then to the point of good 
patient-centered health care, that is not what ObamaCare will provide. 
In fact, the CBO has estimated that 31 million in 10 years will still 
remain uninsured.
  So what are we doing? Why are we creating this system that will be 
broken from the start and on which we will only spend hard-earned 
taxpayer dollars trying to fix and plenty of time? Who will go without 
the good patient-centered health care that every American deserves?
  Mr. GUTHRIE. I don't think you were here when we were debating 
  Mrs. ELLMERS. I was at home, watching the TV, ready to put my foot 
through it.
  Mr. GUTHRIE. When we were debating it, the number was always 40 
million people uninsured. So we've completely upended the health 
insurance market and have put all this uncertainty into the economy. I 
think it's the biggest drag on the economy. Now, we haven't had growth, 
and we're going to have 31 million uninsured. That's not even by a 
bipartisan group. That's by the nonpartisan Congressional Budget Office 
that we're going to have 31 million people uninsured--all of this 
because we had 40 million uninsured and, after all of this, 31 million 
  So did we get our $1 trillion worth?
  Mrs. ELLMERS. That's a wonderful question.
  I have another constituent who has shared numerous times with me his 
concern for the implementation of ObamaCare.
  Jerol and Telia Kivett, from Clinton, North Carolina, owned, again, a 

[[Page H4023]]

owned business that was started by his father back in the fifties. This 
company makes church furniture--church pews for synagogues, funeral 
homes, churches. Jerol and his wife are so concerned about this mandate 
and are wanting and needing to avoid this government mandate that it 
makes it extremely expensive for him to do business. He at one point 
had 160 employees. He is now down to about 45 employees.

  As you can imagine, in order for him to continue to do his business 
in the way that he sees fit, in the way that was started by his father, 
how will he continue into the future doing business when he knows that 
working his way back up again in this awful Obama economy--for him to 
hit that 50th employee--will mean a penalty for him if he is not 
providing health care coverage for his employees? If he is able to 
provide that health care coverage, it will be devastatingly expensive.
  With that, I would like to welcome my colleague from Texas, 
Congressman Burgess, for a few comments as well for he is well-versed 
in health care and in, again, the devastation that ObamaCare will 
  Mr. BURGESS. I thank you for yielding. I really thank you for 
bringing this important topic to the floor tonight.
  Look, we are 6 months and 6 days away from the full-on implementation 
of the Affordable Care Act. We are 3 months and 6 days away from the 
open enrollment period of October 1. I just can't help but feel it's 
like a fast-moving train that's charging down the tracks, moving toward 
a head-on collision with the American economy, and it's going to be the 
small business that suffers the devastating effects of that head-on 
  We've had opportunities to talk to the people from the agencies to 
the extent that they will. I'm worried. I don't see how they can have 
that Federal hub up and running by October 1 and have it work the way 
it's intended the very first time, especially if they don't have time 
to test it before they turn it loose on the American people. I am very 
worried about what the world is going to look like after January 1.
  I've got to tell you, from the standpoint of a practicing physician 
of a small practice--we had five doctors in my practice--well, look. 
Remember when part D came? Maybe you don't. I was here on January 1 of 
2006. It was rough for the first several weeks, but there we were 
talking about the prescription drug benefit for seniors on Medicare, 
for maybe 42 million, 45 million people out of 310 million people. We 
were just talking about the prescription drug benefit, and that was 
difficult to implement.

                              {time}  2110

  There were pharmacists all over the country who basically did not get 
paid for the prescriptions that they filled for 1 month to 6 weeks, but 
they were able to keep going because they had other prescriptions, they 
had other business going on in their pharmacies. But this is going to 
be everything from tonsillectomies, to childhood vaccinations, to ER 
visits. If the cash flow is disrupted for even just a few weeks, the 
small businesses, which are medical practices in this country, will 
have a very difficult time enduring.
  More importantly--and you all have correctly addressed it--is the 
29ers and 49ers in this country, the people who are scared to add one 
more than 49 people to their employment rolls or the people who've had 
their hours now cut to 29 hours a week so that they will not require a 
health care benefit.
  That wasn't the way it was supposed to work. The gentleman from 
Kentucky nailed it right off. The people of America in 2009 were saying 
to us, Whatever you do, don't mess up the system that's working for 65 
percent or 70 percent of us. The other thing they said was, If you're 
going to do anything at all, please help us with costs. And what have 
we done? Exactly the opposite. We've messed up the entire system, and 
it's becoming more and more apparent every day. If you don't believe 
me, wait until a year from now or 16 months from now, and just see how 
bad it is.
  The other thing is we didn't do anything to help with cost. If 
anything, we've made it worse. By ratcheting up the demand side, not 
increasing the number of providers, we've guaranteed that prices are 
going to go up not just next year and not just the year after that, but 
for every foreseeable year in the future. And I know that's hard for 
people to estimate. I know the Congressional Budget Office can't give 
us a figure on that. Just do the arithmetic yourself in your head, on 
the back of an envelope and you'll be able to see that we are headed 
for a significant disaster.
  It's all well and good for me to criticize the administration and the 
way they've implemented this, but I've got to ask: Where are our 
Democratic colleagues? Where are the solutions that they're offering? 
Clearly we should do something to help the small business owner who is 
having to restrict employment hours to 29 hours a week. Surely we 
should do something to help that. Where are the solutions from the 
other side? They're nonexistent.
  We should do something to help that small employer who wants to grow 
beyond 49 employees, but is now frightened to do so. Where are our 
Democratic counterparts? Where are the people from the agencies coming 
to our committee and talking to us about how this might be managed or 
maintained? Why aren't they talking to us about their contingency 
plans? You know they've got them. You know they're over there at the 
Department of Health and Human Services right now talking about what if 
the Federal hub doesn't work, what if it doesn't work the way it was 
intended. We'll have to have a way of narrowing the scope, of confining 
the number of people we bring into this new ObamaCare environment. But 
they won't talk to us about that. The Democrats won't come forward with 
a solution.
  We're doing what we can to bring people's attention to this very 
important topic. To some it may be complaining; but if you don't think 
about it, you can't prepare. And If you're not prepared, it is the 
unprepared person who is really going to suffer in this new environment 
that, again, is created in 6 months and 6 days.
  I do thank the gentlelady for bringing this topic to the floor 
tonight. I think it is important that we continue to talk about it and 
we continue to talk about our ideas and our solutions. There are many 
out there. And people need to assess for themselves how they will be 
best served in this new environment that's brought by the 
administration, or perhaps it's not too late or perhaps there are some 
things we can do to alter that course, to move it off that center of 
destruction where it's aimed right now.
  I thank the gentlelady for having this tonight.
  Mrs. ELLMERS. Thank you to my colleague from Texas. His insight on 
this very important issue is vital to coming up with the solutions that 
we need.
  I do want to touch on one of the points that you were making, Dr. 
Burgess. Basically, I saw a report this morning put out by the 
Republican Study Committee that basically said that there was a study 
that is showing that we will have a shortage of 30,000 doctors within 
this country in 2 years. That is devastating.
  Mr. BURGESS. You know, you're in a medical family. I know because I 
hear it everywhere I go. Physicians all across the country are 
concerned. They don't know what they're getting into, and they don't 
know what the world will look like.
  As a consequence, like anyone else, they are reluctant to make those 
big decisions, they're reluctant to hire a partner, buy a new piece of 
equipment, open a branch office. They are like everyone else: they are 
in that hunker-down mode where so many small businesses have been for 
the last 4\1/2\ years.
  But without expanding the provider core, without expanding the health 
care manpower, you can pretty much predict that there is going to be a 
price spike because you know you're ratcheting up demand by increasing 
coverage, and at the same time you're not providing for areas where 
those people can be seen.
  What's really unfortunate, by some of the means with which coverage 
has been expanded, we already know that there are places in this 
country where it is hard to get a new patient appointment if you're a 
Medicaid patient. The reimbursement rate is so abysmally low that a 
provider can't possibly keep their doors open if they accept those

[[Page H4024]]

levels of payment. As a consequence, they don't. What are those 
patients going to do? They do what they've always done and go to the 
emergency room, which is the highest cost point of contact care that 
you can have.
  So instead of solving a problem that every Democrat here talked about 
4\1/2\ years ago, we've doubled down and made it worse. Again, as a 
consequence, the cost of care is going to go up and providers are going 
to drop out just because the frustration is going to get so high that 
it will simply not be worthwhile to continue in practice, or you'll go 
work in a practice environment where you simply don't have to put in 
the number of hours that you would in a solo or small-group practice.

  But we've really selected against those practitioners, those men and 
women who go to work every day early before the sun comes up and they 
work until after the sun goes down taking care of their patients. We're 
actually self-selecting against that very type of individual that we 
all knew, we all grew up with, we all look to as our leaders in the 
medical profession. It will be very difficult for those people to 
  We'll look to academic medical centers, perhaps to hospitals, perhaps 
to the government itself for that leadership, but it's not going to be 
the same thing.
  Mrs. ELLMERS. Thank you to the gentleman.
  I do want to take a moment to talk about another group of young 
individuals in this country, young Americans who are also being 
negatively affected as a result of the implementation of ObamaCare: our 
students who are paying back student loans.
  As we all know, July 1 student interest rates are scheduled to 
double, essentially. My staff and I have done some research on this. 
And if you all remember back in 2009, when President Obama was 
implementing the health care bill, they also took over the student 
loans in this country. That was for pay-for. And according to the 
Congressional Budget Office, over the next 10 years, $8.7 billion of 
that student loan payback will come from those student loans.
  Not only are we affecting health care in this country, but we are 
also affecting our young people, those individuals who are graduating 
from colleges around this country who may or may not have a job to go 
to, a job that they have prepared a career for; and yet they too will 
be paying for ObamaCare.
  Mr. GUTHRIE. That's a great point that I brought up when we were 
debating it back in 2009.
  What people don't realize, as it didn't get a lot of coverage, Mr. 
Speaker, is that the Federal Government took over the student loans.
  So you're going to hear a lot about student loans in the next few 
days because after July 1 the student loan rates are going to go up. 
The House was active. We passed a bill. It's in the Senate. I've heard 
the President talk about it.
  What people need to realize is that when the health care bill 
passed--as my friend just said, the Federal Government can loan money 
at a low rate because we can pretty much borrow from ourselves at a low 
rate. When we loan it to students, they pay a little over 3 percent; 
and the difference, the flow, comes back to the Federal Government, the 
profit from loaning to our businesses.
  Do you know where $8.7 billion of that is going to? To pay for the 
health care bill. Instead of taking $8.7 billion and giving it back to 
students who are struggling with affordability of college--I'm in that 
world right now because my son is leaving this summer to go off to 
college and I have a daughter in college. So most of the people that 
are peers of theirs that I see, we talk about the affordability of 
college. One of the things that we did is we took money that students 
are paying back on their student loans to pay for the health care bill. 
Instead of rebating it back to the students to put it in their pockets 
to pay for their loans, it goes to the health care bill.
  As we hear a lot of people on the other side and in the White House 
this week talk about health care and that the Senate hasn't passed a 
bill to deal with student loan interest rates that will go up, I want 
people to remember, Mr. Speaker, that $8.7 billion of what people are 
paying back in interest is going to fund the health care bill.

                              {time}  2120

  Mrs. ELLMERS. With that, I would just say that the good news for the 
House is that last month we passed the Smarter Solutions for Students 
Act, and now it lies with the Senate for passage as well.
  With that, Mr. Speaker, I yield back the balance of my time.