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Providing for Consideration of H.R. 1217, Repealing Prevention and Public Health Fund

Location: Washington, DC


Ms. FOXX. Madam Speaker, House Resolution 219 provides for a structured rule providing for consideration of H.R. 1217, which repeals the Prevention and Public Health Fund and rescinds any unobligated funds.

Republicans are on the floor today to fulfill part of our Pledge to America that we would cut spending and we would repeal the Democrats' health care bill passed a year ago. On January 19, this House passed H.R. 2 to repeal ObamaCare completely. The ruling liberal Democrats in the Senate, however, have so far refused to consider H.R. 2, but House Republicans remain undeterred. We will repeal ObamaCare piece by piece if that is what it takes.

Because the liberal elites knew their government takeover of health care was unpopular and would likely have consequences at the ballot box, they included $105 billion in mandatory taxpayer spending in the law itself to protect their favorite programs.

Let me take a moment to explain the difference between ``discretionary'' and ``mandatory'' government spending

First, it's important to remember that the Federal Government does not have any money of its own, as it has only what it takes in taxes from hardworking Americans or money that it borrows from foreign creditors and our future generations. We are currently borrowing 43 cents of every dollar that the Federal Government spends.

Discretionary spending is appropriated by Congress annually and therefore subject to congressional oversight and review. Discretionary spending allows Congress to be wise stewards of the taxpayers' money by not funding ineffective or duplicative programs. However, what is called mandatory spending funds programs for people who meet certain criteria and occurs irrespective of congressional appropriations and must be spent whether we have the money or not.

The most recognized mandatory spending programs are Medicare, Medicaid, and Social Security, which operate on autopilot and have not been subject to congressional oversight from year-to-year as funds automatically stream from the Treasury to anyone who qualifies, that is, meets the criteria for a particular benefit.

The bill before us today, H.R. 1217, would repeal a portion of mandatory ObamaCare spending and eliminate a slush fund established for Health and Human Services Secretary Kathleen Sebelius. This slush fund, known as the Prevention and Public Health Fund, will automatically receive $1 billion when fiscal year 2012 begins in October of this year with automatic increases every year until it reaches $2 billion annually in fiscal year 2015.

However, there's a very important distinction between this funding and that for Medicare and Social Security in that this funding does not state eligibility criteria.

The liberal elites in Washington think they know how to spend the taxpayers' money better than individual taxpayers and gives Secretary Sebelius $2 billion a year until Congress acts to repeal her authority to spend without accountability.

Republicans are rejecting this slush fund by considering this bill which would repeal the fund and take back any money that has not already been spent this year. The slush fund is not subject to the annual appropriations process and therefore would not be subject to yearly congressional oversight.

The money will be made available to the Secretary regardless of how she chooses to spend it and whether or not the programs being funded are actually effective.

Again, this is not like Medicare and Social Security. There are no criteria for the spending of this money.

It's important to point out that this bill does not cut any specific program, because the slush fund is used by the Secretary to increase spending above congressionally appropriated levels for whatever program the Secretary chooses.

My colleagues across the aisle will argue that this money is being used to train primary care physicians, to prevent obesity, and to encourage healthy lifestyles. What they won't tell you is that they have absolutely no idea how the money is being used, because they abdicated the authority of Congress to an unelected bureaucrat.

The simple truth is that the money is just as likely to be spent on elective abortion as it is for any other purpose.

In the Democrats' dissenting views from the House Energy and Commerce Committee report, they say without mandatory spending for this slush fund, the programs will not be adequately funded. Well, Madam Speaker, that's what the whole process for appropriations is all about. If the programs need more money, it's up to them to come and justify that.

However, they sang a different tune when liberal House Democrats rammed through a government takeover of health care in November of 2009. They created this slush fund but made it subject to the regular appropriations process. That meant it was subject to yearly congressional oversight and direction for how the money would be spent.

But when the ruling liberal Democrats in the Senate sent over their version of the health care bill, which became law, the slush fund had been made mandatory. The liberal elites claim they put in a safeguard because part of the section creating this slush fund states that Congress has the authority to direct how this funding is spent. Well, as any high school junior civics student could tell you, Congress always has the authority to direct, redirect, repeal, or increase funding. Congress can always pass a new law to change the direction of any funding stream. That's our job as legislators. The need to state explicitly that we have the authority to direct spending in a slush fund is pointless.

The simple truth is that we have a spending crisis in this town in large part due to mandatory spending that operates on autopilot. Instead of working to address our unsustainable spending habits, the ruling Democrats refused even to offer a budget resolution last year or pass a single appropriations bill. The liberal elites failed to lead despite having unchecked control of all levers of power in Washington.

I brought a chart with me today to help illustrate the fact that mandatory spending is out of control in Washington. Madam Speaker, let me show you that because of mandatory spending being on autopilot, by the year 2050 the mandatory spending will absorb all revenue coming into the Federal Government, all tax revenue coming into the Federal Government. That simply is unsustainable. We cannot operate our country when we let three programs take up all of the money that comes into the Federal Government. Something has to be done. And yet the Democrats want to add another program to this, which would speed up this process. We don't need that.

As Washington liberals ignored the growing autopilot spending crisis, adding more unaccountable mandatory spending in the hands of unelected bureaucrats, House Republicans are now working hard to protect the future for our children and grandchildren by restoring congressional oversight of spending.

Now, I am sure many Americans are wondering how a slush fund with a clever title would be spent and why it must be put on autopilot. Let me give you an example. Pitt County, in my home State of North Carolina, received funding from this fund to fix prices at convenience stores so that healthy foods would be less expensive and, therefore, supposedly more attractive to the consumer. In addition, the Pitt County Health Department now plans to use some of this money to put up signs indicating the location of public parks, bike lanes, and alternate transportation.

Although I am certainly not opposed to parks or healthy eating habits, it seems quite clear that the Founders of this country did not intend the Federal Department of Health and Human Services in Washington, DC, to use taxpayer money to subsidize granola bars or purchase signs for bike lanes or parks.

The Federal Government has no business paying for local and community initiatives such as these, especially when we are borrowing 43 cents of every dollar the Federal Government spends to pay for it. The new House Republican majority is ready to lead this country out of our debt crisis. And it starts with voting for this rule and the underlying bill, which will save taxpayers $16 billion.

With that, Madam Speaker, I reserve the balance of my time.

Mr. HASTINGS of Florida. Madam Speaker, I thank the gentlelady for yielding me the time, and I yield myself such time as I may consume.

Obviously, this measure amends the Patient Protection and Affordable Care Act and seeks to repeal those provisions that establish and appropriate funds to the Prevention and Public Health Fund. It also rescinds any unobligated balance appropriated to the fund.

As I listened to my friend from North Carolina, two things jumped out at me immediately. One is her usage and the ruling Republican majority House Members' usage of the term for the Affordable Health Care Act as ObamaCare. I said earlier in the Rules Committee I guess I could call it HastingsCare, because I supported--as did many Members of this Congress who are still here and some who are not, on both sides of the aisle--health care provisions for America long before any of us knew Barack Obama's name.

When it's used the way that it is, it's in some manner attempting to be demeaning of the President. He does not bear the sole responsibility for the Affordable Health Care Act. I would assume some of that responsibility. And what I would say is he and many others in this body did not go far enough in that we did not establish universal health care for all Americans in this country.

The other thing that jumps out on this particular matter, calling it a slush fund and then allowing that it is going to be in the hands of an unelected bureaucrat. It puts us in a strange position in the House of Representatives when my colleagues with the ruling majority of the House of Representatives have sought and been successful in eliminating the opportunities for Members of Congress on both sides of the aisle to seek to have appropriations earmarked for respective undertakings in their congressional districts. Rather, they would eliminate those earmarks and--guess what?--put it in the hands of unelected bureaucrats.

So I find it inconsistent to make the argument on one hand, and then on the other hand say, Oh, it's okay for the unelected bureaucrats to have some opportunities to spend our money. Quite frankly, I take umbrage with that. I think I can do a better job defining a need for a treatment plant in Belle Glade than can an unelected bureaucrat.

The burden of chronic diseases, such as cancer, diabetes, heart disease, hypertension, and stroke, present a significant public health challenge to all of our communities and our Nation as a whole. In my home State of Florida, over 10 million cases of seven chronic diseases--cancer, diabetes, heart disease, hypertension, stroke, mental disorders, and pulmonary conditions--were reported early on in this decade at the cost of about $17.6 billion in treatment, and resulting in $68.7 billion in lost productivity and economic cost.

Simply put, we have a sick care system, not a health care system. Tens of millions of Americans are suffering from health conditions that could possibly be preventible. This is further exacerbated by the continuing rise of health care costs. Despite the fact that chronic diseases are responsible for seven out of 10 deaths among Americans each year and that they account for 75 percent of our Nation's health care spending, less than 3 percent of our health care spending goes to preventive health care services and health promotion.

As you know, the Affordable Care Act, or the HastingsCare Act, or the Hastings and ObamaCare Act, or the Hastings and Obama and DemocratCare Act created the Prevention and Public Health Fund in order to assist State and community efforts in preventing illness and promoting health. The Prevention and Public Health Fund represents an unprecedented investment of $15 billion over 10 years to help prevent disease, detect it early, and manage conditions before they become severe. It aims to transform the focus of our system of care from primarily treating illness to maintaining long-term wellness by leveraging the power of preventive medicine.

Through the Community Transformation Grants program, for example, the fund empowers State and local governments and partners to implement community prevention interventions that help reduce chronic disease and health care disparities.

In fact, the fund is already being used in all 50 of our States and the District of Columbia to prevent smoking, increase physical activity, reduce alcohol and drug abuse, increase immunizations, train the Nation's public health workforce, prevent the spread of HIV/AIDS, and help control the obesity epidemic in our country.

In addition, the Prevention and Public Health Fund provides funding for States to help develop a health insurance exchange by 2014. Footnote there: We should have had a public option, where consumers will have access to a new market of more affordable, quality health coverage, as well as funding for up to 400 school-based centers in order to provide a safety net and improved access to care for children.

Since the enactment of the HastingsCare, ObamaCare, DemocraticCare, RepublicansDon'tCare measure last year, the Department of Health and Human Services has awarded approximately $21.98 million in grants to organizations in Florida alone through the Prevention and Public Health Fund to help improve wellness and prevention efforts, including more than $9.3 million for community and clinical prevention, more than $3.1 million for public health infrastructure, and more than $9.4 million for primary care training.

If we are to reduce health care costs, we must improve the health of all Americans. Investing in proven preventive measures can significantly reduce the risk of developing these diseases, improving people's lives and saving money.

According to a report from Trust For America's Health entitled ``Prevention for a Healthier America,'' investing just $10 per person per year in proven community-based programs that increase physical activity, improve nutrition, and prevent smoking and other tobacco use could save our Nation more than $16 billion annually within 5 years.

This is equivalent to and potentially greater than the amount as estimated by the nonpartisan Congressional Budget Office by which H.R. 1217 reduces direct spending over a 10-year period. Furthermore, a public opinion survey by Trust for America and the Robert Wood Johnson Foundation found that 71 percent of Americans favor an increased investment in disease prevention.

The Prevention and Public Health Fund is supported also by nearly 600 national organizations, including the American Diabetes Association, the American Heart Association, the American Lung Association, Families USA, and the AIDS Institute.

H.R. 1217, on the other hand, is nothing more than an attack on affordable health insurance, primary care and safety net care for children. This bill is yet another feeble attempt by the ruling majority Republicans to disrupt, dismantle, and ultimately destroy the HastingsCare, ObamaCare, DemocraticCare, RepublicansDon'tCare bill one piece at a time, including those programs that have already been funded and are helping millions of middle class, elderly, and working poor Americans and their families as we speak.

The misinformation that pervades the health care debate in this country never ceases to amaze me at all.

My friends on the other side of the aisle, the ruling Republican majority, would have the American people believe that the Prevention and Public Health Fund is a slush fund for the Secretary of Health and Human Services to spend money freely without congressional oversight. This is simply not true. A specific funding amount is allocated for prevention efforts through the fund each year during the fiscal year period: $500 million in 2010; $750 million in 2011; $1 billion in fiscal year 2012 and so on up to $2 billion beginning in 2015.

This gives the Secretary, whomever she or he may be, under Republicans or Democrats, the flexibility and health care providers the funding certainty that they need to implement prevention and public health interventions that help Americans make healthier decisions for themselves and their families. The Prevention and Public Health Fund is the first and only Federal program with dedicated ongoing resources specifically designed to improve the public. It represents our commitment to preventing illness and investing in our Nation's long-term physical and fiscal health.

Let me say this, Madam Speaker: Every day that I awaken, I start my day by trying to figure what can I do to follow the scriptural mandate to help the least of us. I am curious whether my friends in the ruling majority have the same feeling.

Madam Speaker, I reserve the balance of my time.

Ms. FOXX. I would just like to point out one small thing to my colleague from Florida. Yes, I do begin wondering every day wondering how I can make life better for other people. But I want to say that there is no accountability whatsoever in this provision of the bill, and we want accountability for every penny of money that we are spending on behalf of the American taxpayers.

Madam Speaker, I yield such time as she may consume to the gentlewoman from North Carolina (Mrs. Ellmers).


Ms. FOXX. I yield myself such time as I may consume.

Mr. Speaker, we are here today to save taxpayers money by cutting wasteful government spending. The program that we are cutting out we cannot be sure does anything for preventative health care. It has designated that, but there is no idea as to where the money is going to be spent. Republicans certainly want to see Americans do a better job of preventing disease and of making their health care better, but what we fear is that this money may be used for elective abortions, so we are also here today to speak for those who cannot speak for themselves.

This slush fund directs the Secretary of Health and Human Services to invest in prevention and primary care by funding programs and initiatives under the Public Health Services Act. Title X of the Public Health Services Act provides funding for the abortion industry, including organizations like Planned Parenthood, which is the largest abortion provider in the country.

Mr. Speaker, my colleagues across the aisle and the liberals in Washington have really outdone themselves to ensure their favorite constituencies are provided for in their new health care law. This slush fund is yet another Democrat trick to use taxpayer money to subsidize elective abortion. Despite what they may have you believe, supporters of taxpayer-funded elective abortion cannot honestly claim this money cannot be used for elective abortion under Title X. The liberal Democrat elites relinquished all authority over this slush fund to Secretary Sebelius. For far too long, abortion providers have used Title X money to subsidize their operating costs, thereby subsidizing elective abortion.

We've heard a lot of misinformation being circulated in Washington this week about Planned Parenthood, the largest elective abortion provider in the country. As I pointed out in the Rules Committee last night, one of my colleagues across the aisle said that Republicans were ``here to kill women'' and compared us to Nazis.

Liberal Democrats maintain that women will lose access to preventative care if the government stops funding for the abortion industry. What they are not telling you is that Planned Parenthood has almost $1 billion in net assets and reported $737 million in revenues for its most recent filing year. Any big abortion organization making $737 million a year should be able to function without taxpayer subsidies, Mr. Speaker. This is not about women's health or access to preventative care. Through Federal and State Medicaid programs, low-income women have access to family planning and preventative health services at hospitals, doctors' offices and community health centers nationwide.

Another claim Planned Parenthood makes is that 97 percent of the 3 million patients they served in fiscal 2008 received preventative care services and that only 3 percent received abortions. These supporters of taxpayer-funded abortion ought to check their math. According to their own facts sheet for March 2011, Planned Parenthood clinics performed 332,278 abortions in fiscal year 2008. If they saw 3 million patients and performed 332,278 abortions, that means at least 11 percent of the services provided were abortions.

If they cannot be trusted regarding this simple math, what else are they hiding from the American people, Mr. Speaker?

Another astounding statistic I would like to share is that 97.6 percent of pregnant women who received services at Planned Parenthood clinics received abortions. Only 2.4 percent of pregnant women received only prenatal or adoption referral services at Planned Parenthood.

Elective abortion is not health care, Mr. Speaker. This is not about preventative health care or about improving access to primary care. This is about subsidizing the big abortion industry. If this slush fund remains unchecked, the Secretary could fund whatever program she chooses to the tune of up to $2 billion a year. That kind of money can purchase a lot of elective abortions, which strikes at the consciences of so many tax-paying Americans.

Again, I urge my colleagues to vote in favor of this rule and the underlying bill.

I reserve the balance of my time.


Ms. FOXX. Mr. Speaker, I feel I have to respond somewhat to my colleague from Florida on some of the points that he made.

He said that it is the law of the land that no Federal Government money can be used to fund abortions. I know my colleague from Florida has been here a lot longer than I have been, and I know that he understands the difference between discretionary spending and mandatory spending, and I know that he knows that the Hyde amendment is only on appropriations bills. And as I explained earlier, Mr. Speaker, the appropriations bills are what we call discretionary spending, and that what the Democrats did in the health care bill was to put this $2 billion in that bill and call it mandatory spending, which is not subject to the annual appropriations process and therefore does not have the restriction of the Hyde amendment to apply to it.

So I would like to ask my colleague from Florida if he can guarantee on his own word to the American people today that nothing from this $2 billion that is put in for mandatory spending--it's on automatic pilot--would ever be spent for abortions.

Would the gentleman answer that question?

Mr. HASTINGS of Florida. Of course I will. Will the gentlewoman yield?

Ms. FOXX. I yield to the gentleman from Florida.

Mr. HASTINGS of Florida. I thank the gentlelady for yielding.

Please, let's have a clear understanding that no dollars from this fund are going to be used for abortions.

Ms. FOXX. Can the gentleman guarantee that?

Mr. HASTINGS of Florida. I don't have any opportunity to guarantee whether or not I'm going to be alive in the next 30 seconds, let alone tell you what may happen. But if you ask my belief, and yours was your belief that it may be used is what you said, my dear friend, all I'm saying is it is not going to be. And the law enunciated through Henry Hyde, and almost verbatim has been included in the Affordable Care Act, precludes the use of money for abortions.

Ms. FOXX. I would like to reclaim my time, Mr. Speaker.

The gentleman has just made my point. He cannot guarantee that this money will not be used for abortions, and neither can anyone else. And that is the point that we are making, Mr. Speaker. There is no accountability for this $2 billion. It is a slush fund for the Secretary of Health and Human Services. And it is wrong, Mr. Speaker, for us to take the hard-earned money of American taxpayers and give it to the Secretary with no accountability and with the distinct possibility that the money could be used to fund abortions.

The liberals ruling Washington the past 4 years have failed to address out-of-control mandatory or discretionary spending. In fact, under their control, discretionary spending has increased 84 percent in just 2 years.

As I mentioned earlier, discretionary spending is the money Congress decides annually to spend on programs with inherent congressional oversight. Mandatory, or autopilot, spending is the money that is automatically pulled from the Treasury without regular congressional oversight. I'm not sure, Mr. Speaker, when that decision was made for Congress to abrogate its responsibility, but it's a weasel way out. We should be looking at every dollar every year, because that's our responsibility.

Our debt and the liberals' insatiable appetite for perpetual government spending increases are sending America into a tailspin. In response to the complete lack of leadership and fiscal responsibility, House Republicans have been very aggressive in reducing wasteful government overspending, which is the real source of breathtaking budget deficits and private sector unemployment.

Now, Mr. Speaker, I would like to point out a chart that comes, I believe, from the Joint Committee on Economics, and it shows what happens when you increase government spending and when you decrease government spending when you're talking about private sector job creation. Every dollar the government takes from the private sector is one less dollar to be spent for private sector innovation and job growth. The government can create only government jobs.

In addition, Mr. Speaker, to the 13.5 million Americans counted in the official unemployment rate, more than 900,000 Americans have stopped looking for a job because they think no jobs exist for them. I want to point out here that, again, when we saw increased government spending, you see a decrease in private sector jobs. When you see decreased government spending, you see an increase in private sector jobs. That's what the Republicans want to do. Americans want jobs. They want to work. We need to cut government spending and allow the private sector to grow.

More than 45 percent of Americans seeking work have been unemployed for more than 27 weeks. Real problems demand real solutions, Mr. Speaker. The track record in the House in 3 short months demonstrates that the new House Republican majority has heard the American people and is acting to provide the relief and solutions they deserve. Less government spending is crucial to encouraging private sector job creation and reducing unemployment. And where better to cut possible government spending than where money could be used for abortions?

With that, Mr. Speaker, I reserve the balance of my time.

Mr. HASTINGS of Florida. Mr. Speaker, I'm very pleased to yield 3 minutes to my good friend from California (Ms. Matsui), a former member of the Rules Committee that we miss.

Ms. MATSUI. I thank the gentleman from Florida for yielding.

Mr. Speaker, I am in strong opposition to the rule and the bill before us today.

In 2008, I introduced legislation to create a Prevention and Wellness Trust Fund. Much of what I see in the Prevention and Public Health Fund resembles the goals in my legislation. I introduced the legislation and fought for these preventive care provisions during the Energy and Commerce Committee debate on the health care law. I believe investing in preventive health care is vital to helping Americans access the care they need to stay healthy, reduce their health care costs, and ease the burden on our overcrowded emergency rooms.

Mr. Speaker, we spend more than $2 trillion annually on health care, more than any other nation on Earth. Yet tens of millions of Americans still suffer from preventable and chronic diseases. In fact, approximately 75 percent of the Nation's health care expenditure is spent on treating chronic conditions. These conditions account for seven of 10 deaths in America.

For too long, the health delivery system in our country has been focused on only treating people after they get sick, not before. Prevention has been a luxury, if not an afterthought. Studies have shown that regular access to primary and preventive care can help keep people healthier, help avoid chronic conditions, catch diseases earlier, and therefore help lower costs.

Sacramento resident Tyler, an active teenager, was a picture of model health. One day he noticed that he was having heart problems during football practice. Taking precautions, his parents took him to a doctor to run tests and found that he had a cardiac abnormality. Today, after taking the necessary preventive steps, Tyler is healthy. Thankfully, he sought preventive measures early, which kept his condition from worsening and likely saved his life.

Not every story ends as happily as Tyler's, though. Millions of Americans every year are diagnosed with chronic diseases because they did not have such access to preventive care. That is the focus of this fund, to improve prevention. This funding will reduce individual and taxpayer cost while saving lives. However, that fact is being overlooked by my colleagues on the other side of the aisle. This bill before us will have a devastating effect on the future health of America, both in terms of our physical health and for our fiscal responsibility.

In order to truly improve both our health and our health care in this country, we must focus on prevention. I urge my colleagues to oppose this rule and the underlying bill.

Ms. FOXX. Mr. Speaker, I just want to point out again that Republicans would like to see more preventive care. However, the example that my colleague from California used says nothing about this bill because there is nothing in here to guarantee that this money will go to preventive care, absolutely nothing. There is no accountability in this legislation.

With that, Mr. Speaker, I reserve the balance of my time.


Ms. FOXX. Mr. Speaker, I yield myself the balance of my time.

I would just like to say in response to my colleague from Florida that I think this rule and the underlying bill have a lot more to do with elective abortions than they do with government contracting.

Mr. Speaker, we have discussed at great length today why Secretary Sebelius does not need a slush fund set on autopilot. The American people expect their elected representatives to be wise guardians of their hard-earned dollars. They vehemently objected to the ruling Democrat agenda of Federal overreach into their daily lives and sent a clear message to Washington last November: Government must be responsible and accountable.

All across America, American families are tightening their belts, cutting their budgets and living within their means. It's time Washington did the same.

For these reasons and many more, I urge my colleagues, I urge my colleagues to vote for this rule and the underlying bill so we can restore congressional spending oversight and save the taxpayers $16 billion over the next 10 years.


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