Transcripts For CSPAN2 House Ways And Means Committee Holds

CSPAN2 House Ways And Means Committee Holds Markup On ACA Replacement Bill March 9, 2017

Thank you mr. Chairman. Substance abuse affects tens of millions of americans. According to the hhs, more people die from drug overdoses in 2014 then any on record. Substance abuse has grown across multiple groups including women, privately insured and those [inaudible] Substance Abuse affects the wealthy and the poor and the urban. Its one of the first goals of the congress the Republican Leadership demonstrated its concern to drug test americans prior to then receiving federal funds. Indeed every republican member of the committee voted to allow widespread testing prior to getting their own earned benefits. The statement made clear that the republicans wanted to help identify people with problems to empower them to get the help they need. My amendment with representative sanchez would extend this approach to the beneficiaries of the 157. 6 billion windfall in the subtitle. Given that all the republicans on the committee voted to allow drug testing of all 2. 1 million workers receiving unemployment only get an average weekly benefit of 344 an average benefit of only 5,000. I feel strongly our committee should apply the same requirement to the 400 wealthiest taxpayers who will receive an average 7 million apiece per year from this deal. There will be a lot more temptation and access. Moreover, these beneficiaries are in a much better position to pay for the expensive highquality Treatment Services than the unemployed. My amendment simply requires these beneficiaries who will receive huge sums of money from the federal government to have a clean drug test each year prior to receiving their benefits. Given that my republican colleagues who often cited their commitment to helping those with drug problems identified that they have a problem so that they can receive treatment i hope my amendment will receive broad bipartisan support with an understanding that if it is good for the goose, then it ought to be good for the gander. I yield back the balance of my time. Does the gentleman wish to continue the point of order . Reservation is withdrawn. Does anyone wish to speak on the amendment . You are recognized to speak on the amendment. As a former special prosecutor serving on the committee, theres obviously probable cause search and seizure concerns about the amendment but given the preamble to the godfather behind every Great Fortune there lies a cry and i think there is a prima facie case of probable cause has been mac in this case and therefore we have no Fourth Amendment concerns unlike what you passed through earlier this year by requiring a Fourth Amendment search on poor people with no shoving at all of any criminal activity. So i think we are to support this out of common decency. I yield back. Anyone else wishing to speak on the amendment . Questions on the amendment offered. All those in favor signify. Those opposed . The noes have it. Roll call vote is requested. The clerk will call the roll. [roll call] [roll call] [roll call] [roll call] [roll call] [roll call] [roll call] [roll call] [roll call] [roll call] [roll call] the clerk will report the vote. The amendment is not agreed to. Are there additional amendments to the nature of the substitute . If there are no further amendments questions on the options of the amendment . All those in favor . Opposed . The amendment is agreed to and i will now recognize mr. Johnson with a purpose of offering a motion. Removed the committee transmit the print related to the repeal of the Investment Income taxed as amended to the House Committee on the budget in response to the reconciliation instructions. All those in favor say that i . In the opinion of the chair the motion is agreed to as amended transmitted to the House Committee the roll call is required and requested and the clerk will call the roll [roll call] [roll call] [roll call] [roll call] [roll call] [roll call] [roll call] [roll call] [roll call] [roll call] the clerk will report the vote the committee will show the order transmitted into the Committee Without objection asked to stop the authorized to make technical changes and members have two additional days to file with the Committee Additional views. The final order of business is the budget reconciliation relating to the repeal and replace the pulp related tax policies without objection the motion will be considered as read in at any point i offer an amendment to nature the substitute distributed in advance along with a green sheet explaining it and without objection it shall be considered as read open for amendment at any point and consider the amendment allow the chief of staff of the joint committee on taxation to provide the technical description of the amendment in the nature of the substitute and ask members of the questions so after the presentation. Thank you, chairman and members of the committee here before you are three joint committee documents, 14, 15, which described the underlining Committee Print and the nature of the substitute and 16 which is the revenue table for all of the positions covered in 14 and 15. I will try to go through the items quickly on the revenue table. The first series of items related to the present Exchange Premium credit under the Affordable Care act and the first provision would provide there is a full recapture of the excess payments. Theres also positions to make some modifications in transition to the Exchange Premium credits in particular providing that catastrophic only policies can apply and Premium Exchange credits can be utilized on the individual market. Those features would be effective for 2018 and the use of credits for policies that provide abortion benefits but also ineffective in 2018. There is a change in the fare family share contributions would be effective in 2019. After 2019, the Premium Exchange credits would be repealed. In the present law theres a smallbusiness credit for those businesses that offer Group Health Coverage to their employees. This applies at a rate of up to 50 for taxpaying businesses and up to 35 for taxexempt organizations like the Exchange Premium transition is a modification that provides coverage related to abortion wouldnt be allowed effective 2018. Smallbusiness credit itself would be repealed after 2019. The proposal before you would repeal the employer mandate and it would delay further the application of the excise tax known as the cadillac tax. It was sunset the delay after december 31 so the tax would come in 2025. Under present law, there is overthecounter medicine that are not prescribed or eligible for medical expenses for purpose of distribution and qualifying distributions from Health Savings account, flexible spending arrangements, Health Reimbursement arrangements in the proposal before you would make those overthecounter purchases qualifying expenditures regardless whether there is a prescription provided or not. The proposal would further reduce the increase penalty for distributions from non qualifying distributions from the hsa in the present while penalty 20 for both in qualifying distributions and it would return the penalty to the levels of 10 in the case of 15 in the case. Under present law for 2017 theres a limit on the maximum payment through the Health Flexible spending arrangement in the cafeteria plan proposal to repeal the limit. Under present law theres 2. 3 excise tax on medical devices. It is a moratorium in 2017 the proposal would repeal the tax in its entirety. The proposal would permit any deductions as qualifying medical expenses that are attributable to purchases of prescription medicine regardless of whether there is any subsidy received under Medicare Part d. The proposal would make permanent the 7. 5 above which the taxpayer may claim itemized deductions for medical expenses. It would repeal the additional 0. 9 tax on the earned income thats contributed to the Health Insurance trust fund that is applicable that income levels above 200,000. Lastly the proposal would increase maximum concretions to Health Savings accounts and allow both spouses to make contributions coordinating it into the same Health Savings account and it would also provide an extended grace period between the time which a Health Savings account is established and a high deductible plan is purchased. That describes a very brief while crew of a number i would be happy to answer in more detail. Any questions the members might have . You can see before you on 16 the line estimates for each position ive outlined into the total reflected on this table. You are recognized. I just want to say to my colleagues im trying to remember when we consider provisions of this importance advice1. Im not quite sure what the majority has in mind giving it this way when we could meet tomorrow in the daylight. I think you expect first of all you want to do this before the cbo report and also you think there wont be much attention to this with the press gone or tired. So i just want to indicate dont expect us to be asleep or to be inactive. Weve just begun to fight this bill. The public increasingly cares about this issue, and you can expect more town Hall Meetings that you wont want to go to. There is a distribution table on this provision that comes to 117 billion, right . You and some others have asked about the distribution. You are referring to the repeal of the 0. 9 healthinsurance tax. Work you distribute lets move this along. I want to show will everybody look at this . I heard of mr. Roskam talk about the issue of the growth or the opposite. I would ask the clerks to distribute the document and in the meantime stop if you could. No, go right ahead. The issue isnt whether we want growth. Its whether you want to refer to the top down economics. It hasnt worked before. This table shows in 2020 this is the distribution. Of the 11. 644 billion in 2020, 5. 829 goes to people with income over 1 million. Thats the distribution of this. Dont tell us you care about income inequality when you vote for this. And you just have heard the beginning of this. Its part of a 600 billiondollar loss revenue while millions will lose their way in terms of Health Insurance. Let me ask you about the tax credit. Thats part of this, right . Yes. Here we are considering a replacement for the tax credit that has been so vital at 1 00 in the morning. The Kaiser Foundation has analyzed the difference between the tax credits proposed in the republican bill and the premium tax credits now available under the aca. If it is found that the average tax credit under the republican bill would be 36 less than under the aca. If you have any different information . I cannot make that comparison for you. The credit amounts i went to quickly through the table, the credit amounts as you can see they varied b vary by age and ts starting at 2,000 per person i want to ask one other question. Do you disagree with this report that the average tax credit would be 33. 6 less than under the aca . I havent seen their reports so i shouldnt comment on it. Will let you take a look at the report and give us a response tomorrow if possible . [inaudible] we do need to try to follow regular order here find somebody to finish the question. Cpi plus one on the proposal. Please give us an analysis of that also. Mr. Thompson you are recognized. This provision reduces the monies that go into the of Medicare Trust fund over tenures. Is that correct . There repeal of the additional tax we estimate this is 117 billion. As i understand it the actuaries tell us that will reduce the financial longevity of the trust fund by three years . I have not seen or received a letter from the actual actuaries. I have no reason to dispute. If cbo was here with that be in their report to greg. I do not believe it is commenting on the of longevity of us unstressed fund as becky doesnt have the actuarial report by. About that was read into the wac record into the record and it is because it includes a loss of the interest can we assume 170 . If the actuaries have accounted for that balance i dont know what they assume for the revenue loss but it is reported as a loss of tax receipts to the trust fund. It is important Everybody Knows before we cast a vote that 170 billion hit three years less on the fiscal stability of the fund. If you vote for this you are telling your medicare constituency at home youre Cutting Three years on the financial viability of 170 billion. I yield back. Following along along the same line of thinking the president s press secretary said we should ignore the cbo is that your position that the figures should be ignored . Imitating my colleagues with uh joint committee of the us cbo does a professional job. That is what we thought you would say with the medicare actuaries as well. Guesstimate it is the 170 billion it that means a reduces the solvency by three years. But everybody remembers finally the proposals it is a difficult time and setting. About how this could impact medicare. And the passage of the Affordable Care act made medicare more solvent over a decade. So added to us solvency and increasing benefits with their essayed disagreement that many of us voted against the Medicare Advantage program to make the program hold because it seems to me on the face of this of mr. Thompson is correct will this reduce this . With this reduce solvency by three years . Day not familiar with the actuarys report but what i can report is but three seats are contributed to the Medicare Trust trust fund will fall by one his 17 billion over the 10 year period. But this all seems to be about tax cuts and not the health or wellbeing of americans older citizens. That is why i asked to be submitted for the record who has deep concerns and that this impact will be severe on Older Americans why aarp opposes this legislation and they think this point is probably the most moral point we can make in terms of what happens to over americans. So individuals can receive a tax break at the top end of the income scale . They know that the right. I yield back my time. Recognize myself. Besides revealing of damaging effects of the Affordable Care act replacement begins to restore state control so it can be better designed but also is seeks to restore the freemarket giving individuals the right at the heart of that from the one of the main differences limited to the qualified aliens. And the present definition but the term was first find in the regulations developed for the purposes of the eligibility in high risk pools of preexisting conditions. Some of qualified alien definition is much more narrow which was created the vacancy standoffish and. The unqualified alien definition is under 1641 for the purposes that you describe. Since this is a statutory definition is from Congress Rather than rule making . With eligibility and of that eligibility system that they are eligible to receive a advance payment and then what if the existing database related to the Affordable Care act . In terms of verification with the department of Homeland Security and it seems that the proposal that the irs will make a query to determine for the refundable credit that qualifies. Vat is the information that day verify. That is not the sole reason it is maintained. And always to fight the Obama Administration to resist efforts with the eligibility of income. Today we see the trump been ministrations partnership to empower them to take up that recommendation of the inspector generals to tighten up eligibility verification. I also believe they now have a partner in the tradition administration committed to ensuring that there is less fraud and more integrity in the system. Thank you. As i said at the outset, the criteria that might constituents want me to consider is both coverage stand quality anticosti and cost. Flu is cover that wont be covered . Dissect to will gain or lose coverage provided by this piece of legislation . Your question obviously is quite broad because you are asking how Overall Coverage affects the change in terms of the proposal before you. As mr. Brady was just indicating people that our eligible for this refundable credit our thoughts of citizens that our nationals of the United States and qualified aliens. Do not get a report as to who was covered by this plan quick. This is the analysis that has not been completed that the colleagues on the joint Committee Staff try to provide to uh Committee Budgetary effects of all proposals how that affects the Insurance Markets fixed. With your supposed to vote for the bill not knowing how the coverage will affect the redistrict . As i said before i do not have that information at the present time. Can you tell us if the reformers will make coverage more affordable or outofpocket cost quick. With the proposal envisions is that families if not covered by Group Insurance or military or specified coverages to look at the individual Insurance Market to enable them to afford insurance in the Insurance Market proposal that credits may be refundable or advanced payable. Does this proposal also reveal

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