[Congressional Record Volume 140, Number 80 (Wednesday, June 22, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: June 22, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                        HEALTH CARE REFORM VOTES

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Illinois [Mr. Michel] is recognized for 5 minutes.
  Mr. MICHEL. Mr. Speaker, I submit for the Record the votes on health 
care reform which took place in full committee in the Ways and Means 
Committee and in the Education and Labor Committee on June 21, 1994:

       The following recorded votes were taken on June 21, 1994, 
     in the Committee on Ways and Means during consideration of 
     Acting Chairman Gibbons' substitute proposal for H.R. 3600, 
     The Health Security Act of 1994:
       An amendment by Mr. Thomas which would remove the Secretary 
     of HHS' authority to exclude Medicare Part B and C coverage 
     of prescription drugs for off-label uses, simply because the 
     Secretary has determined such use of the drug is not 
     medically appropriate. In order to be covered, off-label use 
     of a particular drug would still have to meet the following: 
     (1) FDA approval; (2) such use is supported by at least one 
     specified compendium and (3) the carrier managing the 
     Medicare coverage determines (with guidance from the 
     Secretary) that such use is medically appropriate, based on 
     supportive clinical evidence in peer reviewed medical 
     literature. Defeated 24 to 14.


                               democrats

       Mr. Gibbons, ``nay.''
       Mr. Rostenkowski, ``nay.''
       Mr. Pickle, ``nay.''
       Mr. Rangel, ``nay.''
       Mr. Stark, ``nay.''
       Mr. Jacobs, ``nay.''
       Mr. Ford of Tennessee, ``nay.''
       Mr. Matsui, ``nay'' by proxy.
       Mrs. Kennelly, ``nay.''
       Mr. Coyne, ``nay.''
       Mr. Andrews of Texas, ``nay.''
       Mr. Levin, ``nay.''
       Mr. Cardin, ``nay.''
       Mr. McDermott, ``nay.''
       Mr. Kleczka, ``nay.''
       Mr. Lewis of Georgia, ``nay.''
       Mr. Payne of Virginia, ``nay.''
       Mr. Neal of Massachusetts, ``nay.''
       Mr. Hoagland, ``nay.''
       Mr. McNulty, ``nay.''
       Mr. Kopetski, ``nay.''
       Mr. Jefferson, ``nay.''
       Mr. Brewster, ``nay.''
       Mr. Reynolds, ``nay.''


                              republicans

       Mr. Archer, ``yea.''
       Mr. Crane, ``yea'' by proxy.
       Mr. Thomas of California, ``yea.''
       Mr. Shaw, ``yea.''
       Mr. Sundquist, ``yea.''
       Mrs. Johnson of Connecticut, ``yea.''
       Mr. Bunning, ``yea.''
       Mr. Grandy, ``yea.''
       Mr. Houghton, ``yea.''
       Mr. Herger, ``yea.''
       Mr. McCrery, ``yea.''
       Mr. Hancock, ``yea.''
       Mr. Santorum, ``yea.''
       Mr. Camp, ``yea.''
       On an amendment by Mrs. Johnson of Connecticut to the 
     Sundquist amendment providing that the entire budget for 
     women's health services be kept budget neutral including the 
     benefits provided in the Sundquist amendment. [The Sundquist 
     amendment required the Secretary of HHS to promulgate 
     regulations (with the advice of the American Cancer Society 
     and the American College of Obstetrics and Gynecology) 
     setting forth the schedule for mammography, pap smears and 
     pelvic exams to ensure more frequent screenings based on the 
     latest medical research. The Sundquist amendment was 
     withdrawn.] Defeated 21-17.


                               democrats

       Mr. Gibbons, ``nay.''
       Mr. Rostenkowski, ``nay.''
       Mr. Pickle, ``nay.''
       Mr. Rangel, ``nay.''
       Mr. Stark, ``nay.''
       Mr. Jacobs, ``nay.''
       Mr. Ford of Tennessee, ``nay'' by proxy.
       Mr. Matsui, ``nay.''
       Mrs. Kennelly, ``nay.''
       Mr. Coyne, ``nay.''
       Mr. Andrews of Texas, ``nay.''
       Mr. Levin, ``nay.''
       Mr. Cardin, ``yea.''
       Mr. McDermott, ``yea.''
       Mr. Kleczka, ``nay.''
       Mr. Lewis of Georgia, ``nay'' by proxy.
       Mr. Payne of Virginia ``nay.''
       Mr. Neal of Massachusetts, ``nay.''
       Mr. Hoagland, ``nay.''
       Mr. McNulty, ``nay.''
       Mr. Kopetski, ``yea.''
       Mr. Jefferson, ``nay.''
       Mr. Brewster, ``nay'' by proxy.
       Mr. Reynolds, ``nay.''


                              republicans

       Mr. Archer, ``yea'' by proxy.
       Mr. Crane, ``yea'' by proxy.
       Mr. Thomas of California, ``yea'' by proxy.
       Mr. Shaw, ``yea.''
       Mr. Sundquist, ``yea.''
       Mrs. Johnson of Connecticut, ``yea.''
       Mr. Bunning, ``yea'' by proxy.
       Mr. Grandy, ``yea.''
       Mr. Houghton, ``yea'' by proxy.
       Mr. Herger, ``yea'' by proxy.
       Mr. McCrery, ``yea.''
       Mr. Hancock, ``yea.''
       Mr. Santorum, ``yea'' by proxy.
       Mr. Camp, ``yea.''

            Committee on Education and Labor--Full Committee


                   health care mark-up, June 21, 1994

       The following recorded votes were taken on June 21, 1994 in 
     the Committee on Education and Labor durng full Committee 
     consideration of Chairman Ford's mark, H.R. 3600, Health 
     Security Act of 1994:
       1. An amendment by Rep. Miller (FL) that would allow 
     working Medicare-eligible individuals and their spouses to 
     have the option to keep Medicare as their primary health 
     insurance. The amendment was defeated 
     15-27-1.


                               democrats

       Mr. Ford, ``nay.''
       Mr. Clay, ``nay'' by proxy.
       Mr. Miller of California, ``nay'' by proxy.
       Mr. Murphy, ``nay'' by proxy.
       Mr. Kildee, ``nay.''
       Mr. Williams, ``nay.''
       Mr. Martinez, ``nay.''
       Mr. Owens, ``nay'' by proxy.
       Mr. Sawyer, ``nay.''
       Mr. Payne, ``nay'' by proxy.
       Ms. Unsoeld, ``nay'' by proxy.
       Ms. Mink, ``nay.''
       Mr. Andrews, not voting.
       Mr. Reed, ``nay.''
       Mr. Roemer, ``nay.''
       Mr. Engel, ``nay'' by proxy.
       Mr. Becerra, ``nay'' by proxy.
       Mr. Scott, ``nay.''
       Mr. Green, ``nay.''
       Ms. Woolsey, ``nay.''
       Mr. Romero-Barcelo, ``nay.''
       Mr. Klink, ``nay'' by proxy.
       Ms. English, ``nay'' by proxy.
       Mr. Strickland, ``nay'' by proxy.
       Mr. de Lugo, ``nay.''
       Mr. Faleomavaega, ``nay'' by proxy.
       Mr. Baesler, ``nay.''
       Mr. Underwood, ``nay'' by proxy.


                              republicans

       Mr. Goodling, ``yea.''
       Mr. Petri, ``yea.'' by proxy.
       Ms. Roukema, ``yea.''
       Mr. Gunderson, ``yea.''
       Mr. Armey, ``yea'' by proxy.
       Mr. Fawell, ``yea.''
       Mr. Ballenger, ``yea.''
       Ms. Molinari, ``yea'' by proxy.
       Mr. Barrett, ``yea'' by proxy.
       Mr. Boehner, ``yea.''
       Mr. Cunningham, ``yea'' by proxy.
       Mr. Hoekstra, ``yea.''
       Mr. McKeon, ``yea'' by proxy.
       Mr. Miller of Florida, ``yea.''
       Mr. Castle, ``yea.''
       2. An amendment by Rep. Miller (FL) that makes clear that 
     nothing in the Act shall prevent Medicare-eligible 
     individuals from electing to continue receiving their health 
     benefits through the Medicare program, rather than through 
     either an employer health plan or another health plan 
     mandated by the State. The amendment was defeated 17-24-2.


                               democrats

       Mr. Ford, ``nay.''
       Mr. Clay, ``nay'' by proxy.
       Mr. Miller of California, ``nay'' by proxy.
       Mr. Murphy, ``nay'' by proxy.
       Mr. Kildee, present, not voting.
       Mr. Williams, ``nay.''
       Mr. Martinez, ``nay.''
       Mr. Owens, ``nay'' by proxy.
       Mr. Sawyer, ``nay.''
       Mr. Payne, ``nay'' by proxy.
       Ms. Unsoeld, ``nay'' by proxy.
       Ms. Mink, ``nay.''
       Mr. Andrews, not voting.
       Mr. Reed, ``nay.''
       Mr. Roemer, ``nay.''
       Mr. Engel, ``nay'' by proxy.
       Mr. Becerra, ``nay'' by proxy.
       Mr. Scott, ``nay.''
       Mr. Green, ``yea.''
       Ms. Woolsey, ``nay.''
       Mr. Romero-Barcelo, ``nay.''
       Mr. Klink, ``nay'' by proxy.
       Ms. English, ``nay'' by proxy.
       Mr. Strickland, ``nay'' by proxy.
       Mr. de Lugo, ``nay.''
       Mr. Faleomavaega, ``nay'' by proxy.
       Mr. Baesler, ``yea.''
       Mr. Underwood, ``nay'' by proxy.


                              republicans

       Mr. Goodling, ``yea.''
       Mr. Petri, ``yea'' by proxy.
       Ms. Roukema, ``yea.''
       Mr. Gunderson, ``yea.''
       Mr. Armey, ``yea'' by proxy.
       Mr. Fawell, ``yea.''
       Mr. Ballenger, ``yea.''
       Ms. Molinari, ``yea'' by proxy.
       Mr. Barrett, ``yea'' by proxy.
       Mr. Boehner, ``yea.''
       Mr. Cunningham, ``yea'' by proxy.
       Mr. Hoekstra, ``yea.''
       Mr. McKeon, ``yea'' by proxy.
       Mr. Miller of Florida, ``yea.''
       Mr. Castle, ``yea'' by proxy.
       3. An amendment by Rep. Armey to strike the provision in 
     the Chairman's mark requiring that the National Council on 
     Graduate Medical Education, in making allocations among 
     eligible programs for each medical specialty, consider (A) 
     the extent to which the population of training participants 
     in the program includes training participants who are members 
     of racial or ethnic minority groups, and (B) with respect to 
     a racial or ethnic group represented among the training 
     participants, the extent to which the group is 
     underrepresented in the field of medicine generally and in 
     the various medical specialties. The amendment was defeated 
     14-29.


                               democrats

       Mr. Ford, ``nay.''
       Mr. Clay, ``nay.''
       Mr. Miller of California, ``nay.''
       Mr. Murphy, ``nay'' by proxy.
       Mr. Kildee, ``nay.''
       Mr. Williams, ``nay.''
       Mr. Martinez, ``nay'' by proxy.
       Mr. Owens, ``nay.''
       Mr. Sawyer, ``nay.''
       Mr. Payne, ``nay.''
       Ms. Unsoeld, ``nay'' by proxy.
       Ms. Mink, ``nay.''
       Mr. Andrews, ``nay.''
       Mr. Reed, ``nay.''
       Mr. Roemer, ``nay'' by proxy.
       Mr. Engel, ``nay'' by proxy.
       Mr. Becerra, ``nay'' by proxy.
       Mr. Scott, ``nay.''
       Mr. Green, ``nay.''
       Ms. Woolsey, ``nay.''
       Mr. Romero-Barcelo, ``nay'' by proxy.
       Mr. Klink, ``nay.''
       Ms. English, ``nay'' by proxy.
       Mr. Strickland, ``nay'' by proxy.
       Mr. de Lugo, ``nay.''
       Mr. Faleomavaega, ``nay'' by proxy.
       Mr. Baesler, ``nay.''
       Mr. Underwood, ``nay'' by proxy.


                              republicans

       Mr. Goodling, ``yea.''
       Mr. Petri, ``yea'' by proxy.
       Ms. Roukema, ``yea.''
       Mr. Gunderson, ``nay.''
       Mr. Armey, ``yea.''
       Mr. Fawell, ``yea.''
       Mr. Ballenger, ``yea.''
       Ms. Molinari, ``yea'' by proxy.
       Mr. Barrett, ``yea.''
       Mr. Boehner, ``yea'' by proxy.
       Mr. Cunningham, ``yea.''
       Mr. Hoekstra, ``yea.''
       Mr. McKeon, ``yea.''
       Mr. Miller of Florida, ``yea.''
       Mr. Castle, ``yea.''
       4. An amendment by Rep. Becerra, as modified by Rep. 
     Cunningham, that would increase the vulnerable population 
     adjustment funding from the $800 million/year provided in the 
     bill to $2 billion/year. The Cunningham amendment, which was 
     accepted on a voice vote, requires that providers be 
     reimbursed from the vulnerable population adjustment fund for 
     costs incurred providing health services to illegal aliens. 
     The amendment, as amended, was adopted 27-13.


                               democrats

       Mr. Ford, ``yea.''
       Mr. Clay, ``yea'' by proxy.
       Mr. Miller of California, ``yea'' by proxy.
       Mr. Murphy, ``yea'' by proxy.
       Mr. Kildee, ``yea'' by proxy.
       Mr. Williams, ``yea.''
       Mr. Martinez, ``yea'' by proxy.
       Mr. Owens, ``yea'' by proxy.
       Mr. Sawyer, ``yea.''
       Mr. Payne, ``yea.''
       Ms. Unsoeld, ``yea'' by proxy.
       Ms. Mink, ``yea.''
       Mr. Andrews, not voting.
       Mr. Reed, ``yea.''
       Mr. Roemer, ``nay.''
       Mr. Engel, ``yea.''
       Mr. Becerra, ``yea.''
       Mr. Scott, ``yea.''
       Mr. Green, ``yea.''
       Ms. Woolsey, ``yea.''
       Mr. Romero-Barcelo, ``yea'' by proxy.
       Mr. Klink, ``nay.''
       Ms. English, ``yea'' by proxy.
       Mr. Strickland, ``yea'' by proxy.
       Mr. de Lugo, ``yea.''
       Mr. Faleomavaega, ``yea'' by proxy.
       Mr. Baesler, ``nay.''
       Mr. Underwood, ``yea'' by proxy.


                              republicans

       Mr. Goodling, ``nay.''
       Mr. Petri, ``nay'' by proxy.
       Ms. Roukema, ``nay.''
       Mr. Gunderson, not voting.
       Mr. Armey, not voting.
       Mr. Fawell, ``nay'' by proxy.
       Mr. Ballenger, ``nay.''
       Ms. Molinari, ``yea'' by proxy.
       Mr. Barrett, ``nay'' by proxy.
       Mr. Boehner, ``nay'' by proxy.
       Mr. Cunningham, ``yea.''
       Mr. Hoekstra, ``nay'' by proxy.
       Mr. McKeon, ``yea'' by proxy.
       Mr. Miller of Florida, ``nay'' by proxy.
       Mr. Castle, ``nay.''
       5. An amendment by Rep. Roukema to provide that a package 
     of benefits and services equivalent to those available under 
     the Federal Employees Health Benefit Plan (FEHBP) would be 
     considered as meeting the requirements of the ``comprehensive 
     benefit package'' under H.R. 3600. The amendment was defeated 
     15-27.


                               democrats

       Mr. Ford, ``nay.''
       Mr. Clay, ``nay'' by proxy.
       Mr. Miller of California, ``nay'' by proxy.
       Mr. Murphy, ``nay.''
       Mr. Kildee, ``nay'' by proxy.
       Mr. Williams, ``nay'' by proxy.
       Mr. Martinez, ``nay'' by proxy.
       Mr. Owens, ``nay.''
       Mr. Sawyer, ``nay.''
       Mr. Payne, ``nay'' by proxy.
       Ms. Unsoeld, ``nay'' by proxy.
       Ms. Mink, ``nay.''
       Mr. Andrews, ``nay.''
       Mr. Reed, ``nay.''
       Mr. Roemer, ``nay.''
       Mr. Engel, ``nay'' by proxy.
       Mr. Becerra, ``nay'' by proxy.
       Mr. Scott, ``nay.''

            SUBSTANTIVE PRINCIPLES BEHIND HEALTH CARE REFORM

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Missouri [Mr. Gephardt] is recognized for 5 minutes.
  Mr. GEPHARDT. Mr. Speaker, I rise this evening to talk about health 
care reform.
  And I rise to talk not about the politics of health care reform--not 
about the partisan horse race that dominates so much of this debate--
but to talk about the real, substantive principles behind health care 
reform.
  Ever since this debate began last fall, President Clinton and the 
Democrats in this Congress have been fighting for a health care plan 
that guarantees affordable coverage for every single American.
  That is our bottom line. The President has pledged to use his veto 
pen to make sure we do not stray from that fundamental principle.
  In the past week, we have been under increasing pressure to lower 
that bottom line.
  The lobbyists and the apologists want to overhaul our health care 
system, without guaranteeing coverage for everybody.
  The press and the pundits say we are losing the debate about 
guaranteed coverage. And as a result, we are losing the votes to make 
it happen.
  But I say: We are not losing the debate, because we have never had a 
real debate. For all the slogans and soundbites, we have never engaged 
in a serious discussion about why guaranteed coverage is critical to 
health care reform.
  That is why I am here tonight. The simple fact is, guaranteed 
coverage is not just another element of the plan. It is the very core 
of the plan. Without it, there can be no meaningful health care reform. 
And without it, our health care system will bring us to the brink of 
bankruptcy.
  Let us look at the facts.
  Health care costs are soaring past the rate of inflation. Since 1978, 
when I started speaking out about health care, the average cost of a 
family policy has skyrocketed--from $800 a year to more than $5,000 a 
year.
  Think about what that means to a family that's already struggling to 
get ahead--to pay off a mortgage, and put their children through 
college. It means that, at the rate we are going, they will just have 
to give up health care. They will have no other choice.
  The same is true for American businesses. The cost of health care for 
a single employee doubled between the mid-80's and the early 1990's.
  In 1990, because of these rising costs, General Motors spent more on 
employee health care than it spent on steel.
  So the question is not whether we should change our health care 
system, the greatest and most envied network of care in the world--the 
question is whether we have the courage to save it, and keep health 
care from drifting beyond the reach of hardworking, middle-class 
Americans.
  The only way to do that is by making sure that every single American 
has health insurance. There is simply no other way to make health care 
affordable for everybody--those who have insurance already, and those 
who have never had it.
  You see, when an uninsured American shows up at the emergency room, 
we do not turn them away--even if they cannot pay. That is what a 
compassionate society must do.
  But then who pays for the uninsured? Those of us who have insurance.
  The head of one major insurance company told me that uncompensated 
care accounted for almost half of last year's cost increases.
  The real losers under this cost-shifting scheme are the hard-working 
families and employers who take the responsibility to pay their own 
way.
  Did you know that a full third of employers' health care costs 
subsidize companies that do not bother to offer insurance?
  That is not health care--it is stealth care.
  It is a hidden tax that drives the cost of health insurance through 
the roof. Guaranteed coverage is the only way to stop it.
  And it will stop it in two ways. First of all, if we make sure that 
everyone has insurance, then everyone will have access to decent, 
ongoing, primary health care.
  It will save the lives of many who are now uninsured--and it will 
save the rest of us billions of dollars in the process.
  Second, by bringing everybody into the system, we'll make sure that 
those costs are spread fairly and evenly--no more free subsidies, no 
more hidden taxes.
  This would be a boon for businesses that provide health care today.
  After all, if you are in business, you are in business to compete. 
And free competition means you should not have to subsidize your 
competitors. Guaranteed coverage will level the playing field, once and 
for all.
  Some argue that health care reform will destroy jobs, by making it 
hard to start or run a profitable business.
  That is just plain wrong. By lowering the cost of health care for 
businesses that already provide it, we will free up tens of billions of 
dollars in private capital. The Congressional Budget Office has 
estimated that businesses would save $90 billion in the first year of 
the Clinton plan--with even greater savings in the years to follow.
  That is $90 billion that can be used to hire new employees, or 
increase wages, or invest in new research or equipment.
  Two highly respected private studies have estimated job creation in 
the hundreds of thousands. The Economic Policy Institute says that more 
than 250,000 manufacturing jobs will be created. The Employee Benefit 
Research Institute says 660,000 jobs will be created.
  And those figures are in addition to the health care jobs that would 
be created. The Brookings Institution estimates that 750,000 home 
health care jobs alone would be created--750,000.
  Small businesses, which now pay as much as 35 percent more than large 
businesses for health care, will get dramatic discounts. That may be 
why the Wall Street Journal called health care reform an ``unexpected 
windfall'' for small businesses.
  And what about those businesses that do not pay for health care 
today? Will they have to pay more?
  They will. To make the system fair, everybody has to pitch in. But 
when you look at the costs of covering workers in a typical small 
business, it is less than a modest minimum wage increase.
  Recent minimum wage increases have not destroyed jobs. Many 
economists believe they have led to higher employment. And the benefits 
of guaranteed coverage, the benefits of a system that is both fairer 
and cheaper than the one we have today, are well worth those extra 
pennies.
  This year, we have a real opportunity to change--a real opportunity 
to move this Nation forward, together.
  This Congress can undertake the most comprehensive reform of our 
health care system in the history of this Nation.
  I know that health care reform concerns many Americans. Change always 
brings a degree of uncertainty. We can never know if every number and 
target will be correct, if every assumption will work out the way we 
want it to.
  But then, 30 years ago, many wondered whether Medicare would succeed. 
Today, it has given millions of older Americans the gift of life, and 
hope, and faith in the future.
  Sixty years ago, people wondered whether Social Security was a good 
idea. Today, it is hard to imagine what America would be like without 
the reason and compassion of our Nation's retirement program.
  And let me tell you, a lot of us are grateful that, despite all of 
the partisan battle cries, both of those landmarks bills passed with 
broad bipartisan support.
  So let us join together in a partnership for real reform--as a matter 
of public policy, and as a matter of human decency.
  Let us make sure that no American's health is determined by their 
wealth.
  And let us make American health care work--for the dignity and 
security that all Americans demand and deserve.

                          ____________________