1. How Congress Works Insiders Guide to the 112 th Congress 1 Katherine Hayes, JD Associate Research Professor

2. How Congress Works: Learning Objectives Who are the leaders in Congress? What are the roles of committees in Congress? What are the major health committees and subcommittees? Roles of Congressional agencies 2

3. Congressional Leaders - House Majority party – party with more than half of congressional seats 3 Minority party – party with less than half of congressional seats

4. House Floor Leaders Speaker Majority leader – majority partys floor leader Majority Whip – assist majority leader Minority Leader – minority partys floor leader Minority Whip – assists minority leader Chapter 9 Section 2 4

5. Speaker of The House Overall leader Member majority Party In charge of nearly everything that occurs in House 5 John Boehner (OH) Speaker of the House

6. House Majority Leaders 6 Eric Cantor (VA) Majority Leader Kevin McCarthy (CA) Majority Whip

7. House Minority Floor Leaders 7 Nancy Pelosi (CA) Minority Leader Stenny Hoyer (MD) Minority Whip Jim Clyburn (SC) Assistant Minority Leader

8. Senate Majority Floor Leaders Dick Durbin (IL) Majority Whip Harry Reid (NV) Majority Leader 8

9. Senate Minority Floor Leaders Jon Kyl (AZ) Asst. Minority Leader Mitch McConnell (KY) Minority Leader 9

10. President of the Senate Vice President is President of the Senate 10 Joe Biden

11. Committee Membership Committee leaders (Chairs) are members of majority party Majority gets over half the seats on a committee 11

12. Seniority System System where committees assignments given to those with the longest time in Congress Committee chairperson usually committee member in the majority with the most time in Congress (although not always) Minority is usually called ranking minority member or vice chair 12

13. Key House Committees House Budget Committee House Appropriations Committee Authorizing Committees –Energy & Commerce –Ways & Means

14. House Budget Committee Budget Resolution – Not sent to President –Hearings on fiscal year (FY) federal budget – agency heads and interested parties testify on funding levels for federal programs –Mark-up of Budget Resolution - drafts budget resolution for current FY 2011 –Manages budget resolution on House floor

15. Members House Budget Committee Republicans Paul Ryan (WI-01), Chairman Scott Garrett (NJ-05), Vice-Chairman Mike Simpson (ID-02), Appropriations Designee John Campbell (CA-48) Ken Calvert (CA-44), Appropriations Designee Todd Akin (MO-02) Tom Cole (OK-04), Appropriations Designee Tom Price (GA-06), Ways & Means Designee Tom McClintock (CA-04) Jason Chaffetz (UT-03) Marlin Stutzman (IN-03) James Lankford (OK-05) Diane Black (TN-06), Ways & Means Designee Reid Ribble (WI-08) Bill Flores (TX-17) Mick Mulvaney (SC-05) Tim Huelskamp (KS-01) Todd Young (IN-09) Justin Amash (MI-03) Todd Rokita (IN-04) Frank Guinta (NH-01) Rob Woodall (GA-07)*, Rules Designee Democrats Chris Van Hollen (MD-08), Ranking Member Allyson Schwartz (PA-13) Marcy Kaptur (OH-09) Lloyd Doggett (TX-25), Ways & Means Designee Earl Blumenauer (OR-03), Ways & Means Designee Betty McCollum (MN-04) John Yarmuth (KY-03) Bill Pascrell (NJ-08) Mike Honda (CA-15) Tim Ryan (OH-17) Debbie Wasserman Schultz (FL-20) Gwen Moore (WI-04) Kathy Castor (FL-11) Heath Shuler (NC-11) Karen Bass (CA-33) Suzanne Bonamici (OR-01)

16. House Appropriations Committee Sets subcommittee allocations for subcommittee for each fiscal year 12 Subcommittees Health-related Subcommittees –Labor HHS – Medicare, Medicaid, Public Health, including funding for 330 grants

17. Members House Appropriations Subcommittee – Labor, HHS Republicans Denny Rehberg, Montana Jerry Lewis, California Rodney Alexander, Louisiana Jack Kingston, Georgia Kay Granger, Texas Michael K. Simpson, Idaho Jeff Flake, Arizona Cynthia M. Lummis, Wyoming Democrats Rosa L. DeLauro, Connecticut Nita M. Lowey, New York Jesse L. Jackson, Jr., Illinois Lucille Roybal-Allard, California Barbara Lee, California

18. House Energy & Commerce Committee Public Health Service Act (CDC, NIH, HRSA, Private insurance) Section 330 grants Food and Drug Administration (Drugs and devices) Medicaid and Child Health Insurance Program – FQHC payments Medicare – FQHC Payments –Part B (physician and outpatient hospital, home health, etc.) –Part C (Medicare Advantage – private private insurers offering all Medicare benefits) –Part D (private insurers offering prescription drug coverage)

19. Members House Energy & Commerce Republicans Fred Upton (MI) Joe Barton (TX) Cliff Stearns (FL) Ed Whitfield (KY) John Shimkus (IL) Joseph R. Pitts (PA) Mary Bono Mack (CA) Greg Walden (OR) Lee Terry (NE) Mike Rogers (MI) Sue Myrick (NC) John Sullivan (OK) Tim Murphy (PA) Michael Burgess (TX) Marsha Blackburn (TN) Brian P. Bilbray (CA) Charles F. Bass (NH) Phil Gingrey (GA) Steve Scalise (LA) Bob Latta (OH) Cathy McMorris Rodgers (WA) Gregg Harper (MS) Leonard Lance (NJ) Bill Cassidy (LA) Brett Guthrie (KY) Pete Olson (TX) David McKinley (WV) Cory Gardner (CO) Mike Pompeo (KS) Adam Kinzinger (IL) Morgan Griffith (VA) Democrats Henry A. Waxman (CA) John D. Dingell (MI) Edward J. Markey (MA) Edolphus Towns (NY) Frank Pallone, Jr. (NJ) Bobby L. Rush (IL) Anna G. Eshoo (CA) Eliot L. Engel (NY) Gene Green (TX) Diana DeGette (CO) Lois Capps (CA) Michael F. Doyle (PA) Jan Schakowsky (IL) Charles A. Gonzalez (TX) Tammy Baldwin (WI) Mike Ross (AR) Jim Matheson (UT) G. K. Butterfield (NC) John Barrow (GA) Doris O. Matsui (CA) Donna Christensen (VI) Kathy Castor (FL) John Sarbanes (MD)

20. House Ways & Means Committee Internal Revenue Code (Insurance deductibility, exclusion and tax credits) Medicare –Part A (hospitals and other inpatient providers) –Parts of part B (outpatient hospital, home health, not physicians) –Part C (Medicare Advantage – private insurers offering all Medicare benefits) –Part D (Private insurers offering prescription drug coverage)

21. Members House Ways & Means Republicans Dave Camp, MI, Chairman Wally Herger, CA Sam Johnson, TX Kevin Brady, TX Paul Ryan, WI Devin Nunes, CA Pat Tiberi, OH Geoff Davis, KY Dave G. Reichert, WA Charles W. Boustany Jr., LA Peter J. Roskam, IL Jim Gerlach, PA Tom Price, GA Vern Buchanan, FL Adrian Smith, NE Aaron Schock, IL Lynn Jenkins, KS Erik Paulsen, MN Kenny Marchant, TX Rick Berg, ND Diane Black, TN Tom Reed, NY Democrats Sander Levin, MI Ranking Member Charles B. Rangel, NY* Fortney Pete Stark, CA Jim McDermott, WA John Lewis, GA Richard E. Neal, MA Xavier Becerra, CA Lloyd Doggett, TX Mike Thompson, CA John B. Larson, CT Earl Blumenauer, OR Ron Kind, WI Bill Pascrell Jr., NJ Shelley Berkley, NV Joseph Crowley, NY

22. Key Senate Committees Senate Budget Committee Senate Appropriations Committee Committees of Jurisdiction –Finance –Health, Education, Labor & Pensions Senate Rules Committee

23. Senate Budget Committee Reports Budget Resolution –Holds hearings on fiscal year (FY)budget – Agency heads and interested parties testify on funding levels for federal programs –Drafts budget resolution for current fiscal year (FY 2011) –Manages budget resolution on House floor

24. Members Senate Budget Committee Democrats Kent Conrad, (Chair) South Dakota Patty Murray, Washington Ron Wyden, Oregon Bill Nelson, Florida Debbie Stabenow, Michigan Benjamin L. Cardin, Maryland Bernie Sanders, Vermont Sheldon Whitehouse, Rhode Island Mark R. Warner, Virginia Jeff Merkley, Oregon Mark Begich, Alaska Chris Coons, Delaware Republicans Jeff Sessions Alabama Charles Grassley, Iowa Mike Enzi, Wyoming Mike Crapo, Idaho John Cornyn, Texas Lindsey Graham, South Carolina John Thune, South Dakota Rob Portman, Ohio Pat Toomey, Pennsylvania Ron Johnson, Wisconsin Kelly Ayotte, New Hampshire

25. Senate Appropriations Committee Sets subcommittee allocations for subcommittee for each fiscal year 12 Subcommittees Health-related Subcommittees –Labor HHS – Medicare, Medicaid, Public Health –Agriculture – FDA –Others (Military Construction/VA, Defense, Legislative Branch)

26. Members Senate Appropriations Subcommittee on Labor, HHS Democrats Tom Harkin (Chairman) (IA) Daniel Inouye (HI) Herb Kohl (WI) Patty Murray (WA) Mary Landrieu (LA) Richard Durbin (IL) Jack Reed (RI) Mark Pryor (AR) Barbara Mikulski (MD) Sherrod Brown (OH) Republicans Richard Shelby (Ranking) (AL) Thad Cochran (MS) Kay Bailey Hutchison (TX) Lamar Alexander (TN) Ron Johnson (WI) Mark Kirk (IL) Lindsey Graham (SC) Jerry Moran (KS)

27. Senate Finance Committee Tax Code (exclusion, deductibility and tax credits) Medicaid and Child Health Insurance Program – FQHC payments Medicare (parts A, B, C and D) – FQHC payments Maternal and Child Health Block Grant

28. Members of Senate Finance Committee Democrats Max Baucus, (Chair), MT John D. Rockefeller IV, WV Kent Conrad, ND Jeff Bingaman, NM John F. Kerry, MA Ron Wyden, OR Charles E. Schumer, NY Debbie Stabenow, MI Maria Cantwell, WA Bill Nelson, FL Robert Menendez, NJ Thomas R. Carper, DE Benjamin L. Cardin, MD Republicans Orrin Hatch, (Ranking), UT Chuck Grassley, IA Olympia J. Snowe, ME Jon Kyl, AZ Mike Crapo, ID Pat Roberts, KS Michael B. Enzi, WY John Cornyn, TX Tom Coburn, OK John Thune, SD Richard Burr, NC

29. Senate Health, Education, Labor & Pensions Committee Public Health Service Act (Section 330 grants) Food and Drug Administration ERISA

30. Members of Senate HELP Committee Democrats Tom Harkin (IA), Chair Barbara A. Mikulski (MD) Jeff Bingaman (NM) Patty Murray (WA) Bernard Sanders (I) (VT) Robert P. Casey, Jr. (PA) Kay R. Hagan (NC) Jeff Merkley (OR) Al Franken (MN) Michael F. Bennet (CO) Sheldon Whitehouse (RI) Richard Blumenthal (CT) Republicans Michael B. Enzi (WY), Ranking Lamar Alexander (TN) Richard Burr (NC) Johnny Isakson (GA) Rand Paul (KY) Orrin G. Hatch (UT) John McCain (AZ) Pat Roberts (KS) Lisa Murkowski (AK) Mark Kirk (IL)

31. How a Bill Typically Moves through Congress Committee hearing on an issue or specific legislation Committee mark-up and reporting of legislation Floor consideration Identical legislation must be passed by both houses before being enrolled and sent to the President for signature

32. Conference Committees Ad hoc committee established for the specific purpose of resolving differences between House-passed and Senate-passed legislation. Appointed by leadership in each party and in each body. Develop conference agreement that must be voted on by each body. Alternatives to conference committee – pass back

33. Congressional Agencies Congressional Budget Office Government Accountability Office Library of Congress MedPAC – Medicare Payment Advisory Commission MACPAC – Medicaid Payment Advisory Commission Others

34. Library of Congress: Congressional Research Service Independent Research arm of Congress Different from GAO in that they are usually more research oriented than investigative. Seen as balanced and well-respected by Congress and staff

35. Congressional Budget Office Official Scorekeeper of the Congress Provides cost-estimates on legislation considered by Congress In most cases, CBO must determine the cost to the federal government prior to floor consideration of legislation.

36. Government Accountability Office Congressional watchdog Comptroller General – Gene Dodaro Independent research and oversight of federal programs Provides studies, reports and recommendations to Congress

37. MedPAC Medicare Payment Assessment Commission Made up of 17 commissioners Make recommendations to Congress (Senate Finance, House W&M, House E&C Committees)

38. MACPAC Medicaid & CHIP Payment Assessment Commission –Advises Congress re: Medicaid and CHIP –17 commissioners –Authorized under PPACA –First report March 15, 2011