For the past five years Republican colleagues have systematically and deliberately sabotaged the implementation of the Affordable Care Act.

We need to fix this and let the CO-OPs operate on a level playing field with the for-profit insurance industry.

And so it would be similar to that program in Part D that we put in with the CO-OPs.

When did the CO-OPs discover that they were only going to get one-eighth, 12 percent of the money they expected?

Instead we will hear more of the same: complaints about problems they have created through their own sabotage and nothing constructive about how to make the system work better.

Why is it a problem? Everybody says it is a big problem; we have to got to get rid of this 96-hour rule.

Mr. Chairman, I realize you have given me a little extra time here. I would like to submit the CMS rules on the 96-hour rule for the record.

If Medicaid would expand, it would be over a $300,000 impact of Holton Hospital, where some years that is the difference of us being a profitable hospital or not.

80 percent of the hospitals that have announced recent closures are in States that chose not to expand Medicaid.

Their decision has left 4.3 million people without insurance, forcing hospitals, many of them which serve rural areas, to pick up the cost.

Time and time again, I hear from Republican colleagues about rural hospitals closing down, threatening access to health care for many communities.

I believe there is room for us to work together to address how we deliver health care to people who live in rural areas.