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Paul R.
Republican WI 1

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  • Protecting Seniors’ Access to Medicare Act of 2015

    by Representative Paul Ryan

    Posted on 2015-06-18

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    RYAN of Wisconsin. Mr. Speaker, pursuant to House Resolution 319, I call up the bill (H.R. 1190) to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board, and ask for its immediate consideration in the House.



    The Clerk read the title of the bill.

    The SPEAKER pro tempore. Pursuant to House Resolution 319, the amendment printed in part B of House Report 114-157 is adopted, and the bill, as amended, is considered read.

    The text of the bill, as amended, is as follows: H.R. 1190 Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Protecting Seniors' Access to Medicare Act of 2015''.

    SEC. 2. REPEAL OF THE INDEPENDENT PAYMENT ADVISORY BOARD.

    Effective as of the enactment of the Patient Protection and Affordable Care Act (Public Law 111-148), sections 3403 and 10320 of such Act (including the amendments made by such sections) are repealed, and any provision of law amended by such sections is hereby restored as if such sections had not been enacted into law.

    SEC. 3. RESCINDING FUNDING AMOUNTS FOR PREVENTION AND PUBLIC HEALTH FUND.

    Section 4002(b) of the Patient Protection and Affordable Care Act (42 U.S.C. 300u-11(b)) is amended-- (1) in paragraph (2), by striking ``2017'' and inserting ``2016''; (2) in paragraph (5)-- (A) by striking ``2022'' and inserting ``2026''; and (B) by redesignating such paragraph as paragraph (7); and (3) by striking paragraphs (3) and (4) and inserting the following: ``(3) for fiscal year 2017, $390,000,000; ``(4) for each of fiscal years 2018 and 2019, $487,000,000; ``(5) for each of fiscal years 2020 and 2021, $585,000,000; ``(6) for each of fiscal years 2022 through 2025, $780,000,000; and''.

    The SPEAKER pro tempore. The bill shall be debatable for 1 hour equally divided and controlled by the chairs and ranking minority members of the Committee on Ways and Means and the Committee on Energy and Commerce.

    The gentleman from Wisconsin (Mr. Ryan), the gentleman from Michigan (Mr. Levin), the gentleman from Pennsylvania (Mr. Pitts), and the gentleman from New Jersey (Mr. Pallone) each will control 15 minutes.

    The Chair recognizes the gentleman from Wisconsin.

    General Leave Mr. RYAN of Wisconsin. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and include extraneous material on H.R. 1190, Protecting Seniors' Access to Medicare Act of 2015, currently under consideration.

    The SPEAKER pro tempore. Is there objection to the request of the gentleman from Wisconsin? There was no objection.

    Mr. RYAN of Wisconsin. Mr. Speaker, I yield myself such time as I may consume.

    What we are bringing to the floor today is Dr. Roe's bill to repeal the Independent Payment Advisory Board. This is a bill that came out of the Committee on Ways and Means with a bipartisan vote. This is an agency that Members on both sides of the aisle believe does not have the right to exist, should not exist, and does not follow our democratic process.

    Let me explain why we are doing this. There is no greater example of the conflict of visions than this. ObamaCare created something called IPAB, the Independent Payment Advisory Board. It is a board of 15 people who are not elected or appointed.

    They have the power to cut Medicare's payments for treatment. They have a quota which they have to hit in order to find the same number to actually cut. Every year, a formula kicks in, and the 15 unelected bureaucrats [[Page H4529]] find where they are going to cut Medicare payments to providers to hit that quota.

    They can do all of this without Congress' approval. The idea, of course, is that unelected bureaucrats know best, unelected bureaucrats know better than patients, their doctors, or their representatives in Congress; they will know which treatment works the best because they are detached, they are distant, they are above the fray, they are not involved in the emotions or the personal relationships that such personal decisions like your health care ultimately involve.

    That is the big problem. They are totally unaccountable. They are divorced from reality. Health care is not a statistic. It is not a formula. It is not uniform. It is not cookie cutter. It is personal. It is individual. It is distinct.

    Every patient is different. This is why patients, along with their doctors, need to be put in charge of their health care. What IPAB would essentially do is ration health care. It would take control away from patients.

    Now, the other side says, Hey, no, not so fast; Congress can override them--but that is only with a supermajority vote.

    Mr. Speaker, we have seen this movie before. It never ends well. Seniors will suffer the consequences. Medicare is more than a program; Medicare is a promise. Seniors have worked hard; they have paid their taxes; they have planned on Medicare throughout all their working lives, and now that they are retired, it is something that they deserve, a secure retirement. It needs to be there, just like it has been for our parents.

    Think about what a Member of Congress will do. This Board of unelected bureaucrats will say, We are cutting Medicare X, Y, and Z ways to these providers for Medicare, which will deny services to seniors; and they will do it according to this formula that is in law.

    If Congress doesn't like it, then the law says Congress has to go cut Medicare somewhere else and overturn this ruling with a three-fifths supermajority vote in the House and the Senate--as if that would ever happen.

    All this thing has done, it is designed to basically go around Congress, go around the laws, and have unelected and unaccountable bureaucrats ration care for our seniors.

    This is wrong; it is undemocratic; it does not fit with our Constitution, and we think it ought to be repealed. That is why we are bringing this bill to the House.

    I reserve the balance of my time.

    House of Representatives, Committee on Energy and Commerce, Washington, DC, June 12, 2015.

    Hon. Paul Ryan, Chairman, Committee on Ways and Means, Washington, DC.

    Dear Chairman Ryan: I write in regard to H.R. 1190, Protecting Seniors' Access to Medicare Act of 2015, which was ordered reported by the Committee on Ways and Means on June 2, 2015. As you are aware, the bill also was referred to the Committee on Energy and Commerce. I wanted to notify you that the Committee on Energy and Commerce will forgo action on H.R. 1190 so that it may proceed expeditiously to the House floor for consideration.

    This is done with the understanding that the Committee on Energy and Commerce's jurisdictional interests over this and similar legislation are in no way diminished or altered. In addition, the Committee reserves the right to seek conferees on H.R. 1190 and requests your support when such a request is made.

    I would appreciate your response confirming this understanding with respect to H.R. 1190 and ask that a copy of our exchange of letters on this matter be included in the Congressional Record during consideration of the bill on the House floor.

    Sincerely, Fred Upton, Chairman.

    ____ House of Representatives, Committee on Ways and Means, Washington, DC, June 9, 2015.

    Hon. Fred Upton, Chairman, Committee on Energy and Commerce, Washington, DC.

    Dear Mr. Chairman: Thank you for your letter regarding the Committee's jurisdictional interest in H.R. 1190, the Protecting Seniors' Access to Medicare Act of 2015, and your willingness to forego consideration by your committee.

    I agree that the Committee on Energy and Commerce has a valid jurisdictional interest in certain provisions of the bill and that the Committee's jurisdiction will not be adversely affected by your decision to forego consideration. As you have requested, I will support your request for an appropriate appointment of outside conferees from your committee in the event of a House-Senate conference on this or similar legislation should such a conference be convened.

    Finally, I will include a copy of your letter and this response in the Congressional Record during the floor consideration of H.R. 1190. Thank you again for your cooperation.

    Sincerely, Paul Ryan, Chairman.

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