[Congressional Record Volume 140, Number 116 (Wednesday, August 17, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: August 17, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                          HEALTH SECURITY ACT

  The Senate continued with the consideration of the bill.
  Mr. PACKWOOD. Mr. President, much has been said that the Mitchell 
bill does, in essence, not upset anybody's present plans, is not 
compulsory, or nobody has to change very much. It overlooks, however, 
three groups that between them have someplace between 35 million and 40 
million people covered with insurance, almost all of whom are satisfied 
with their current plans.
  First, employers with 500 or fewer employees who self-insure. I will 
explain the difference on that.
  You can cover your employees in, really, one of two ways: You can go 
out, buy insurance from Metropolitan Life or Continental Casualty or 
Blue Cross or Kaiser. They provide the benefits. You pay an insurance 
company to carry them.
  Or you can do what is known as self-insure. You think to yourself, I 
am a stable enough employer. Rather than paying premiums to an 
insurance company, I, the employer, will pay the benefits myself. I 
will run that risk. Sometimes on occasion the employer will say, I 
cannot afford a catastrophic loss, and maybe they will insure for a 
loss over $15,000 or $20,000 or $25,000 or even $100,000 and say we 
will pay under that amount. They do not worry about negotiating with 
the insurance company. They manage their own plan. They can have their 
own wellness policies. They do not have to live with others' dictates. 
You have about 20 million employees who get their insurance from 
businesses with under 500 employees who self-insure.
  Under the Mitchell bill, they will not be allowed to self-insure. 
That is out. They will have to buy through what is known as the 
community-rated pool. I am not going to get into a discussion of that 
tonight. But in essence it says, ``all small employers will have to be 
thrown in. Five hundred, it is not small--500 or less, it has that 
pool. It has an interesting--I do not know if it is an intended or 
unintended effect, certainly on California. But my guess would be on 
other States also. Because this rule of 500 or less also applies to 
cities and counties and fire districts and school districts. California 
has Los Angeles and San Francisco and Oakland and San Diego and San 
Jose. California in many respects is like many States of the Union. 
They have scores and scores and scores of towns that have 5,000, 
10,000, 15,000 people in them and they do not have 500 employees 
working for that town or that fire district or that school district. 
Yet they may be self-insured or they may buy insurance. They are out. 
They are going to have to come into this community pool.
  I think most local governments are unaware of that in this provision, 
because most States do have some kind of a program that allows all of 
the municipal employees in the State from all kinds, big governments 
and small governments, to insure through one plan.
  So there are 20 million people who are going to have to change.
  Second, you have, and we refer very frequently with acronyms around 
here, MEWA, M-E-W-A, multiple employer welfare arrangements.
  These are basically health plans that are offered by businesses, 
similar kinds of businesses. In my State, for example, the Timber 
Operators Council has a multiple employer welfare arrangement. We have 
about 26,000 enrolled people in it from all kinds of different 
companies--big companies, small companies. These are prohibited. They 
are out under the Mitchell bill. It does not matter what size they are, 
they are out. This has nothing to do now with the standard of 500. They 
have to go into the community pool, and buy their insurance.
  And then you have association plans--Association of Building 
Contractors, Cocoa-Cola Bottlers. Here you have a community of 
interest, maybe franchise employees, but they are all in the same 
franchise as opposed to a MEWA where you have all kinds of different 
businesses. They have some business relation. But here you will have--
Chamber of Commerce can have one, if they want. They are out. There are 
in some places between 10 and 20 million people in the multiple 
employer welfare associations and the trade associations that are now 
covered that will lose their form of insurance and have to go into the 
community pool.
  I do not think most of them know this yet. So when the argument is 
made there is not going to be much change under the Mitchell bill, 
there is significant change for roughly 35 to 40 million people--
employers with 500 or less, multiple employer welfare associations, 
trade associations--that are simply written out of existence and thrown 
into a common pot pool.
  Mr. President, I yield to the Senator from Texas--how much time would 
he like?
  Mr. GRAMM. I would like ten minutes.
  Mr. PACKWOOD. I yield 10 minutes to the Senator from Texas.
  The PRESIDING OFFICER. The Senator from Texas is recognized for 10 
minutes.
  Mr. GRAMM. Mr. President, let me thank my colleague from Oregon for 
yielding. I want to thank him for what he has done to let America 
understand the health care bill currently before us. I am a firm 
believer in the old Biblical admonition: You shall know the truth and 
the truth will make you free.
  I am convinced that the more the American people know about this 
bill, the more they are going to be against it. I think we are going to 
see the same phenomenon we saw with the original Clinton health care 
bill. With the original Clinton bill, the President's rhetoric was so 
reassuring and so wonderful that it took time for the American people 
to discover that there was no relationship between his rhetoric and the 
provisions of his bill. What we are finding here, as we look at the 
health care bill pending before us now, is that the rhetoric continues 
to sound good, but the actual bill language continues to be bad.
  Mr. President, I would like to focus on what the Nickles amendment is 
about. We know now the amendment is supported by the other side. They 
are not willing to defend the provision in the Mitchell bill that the 
Nickles amendment will strike, and for good reason: It is indefensible. 
But the amendment is important, nonetheless, because it focuses our 
attention on one of the two major issues in this debate.
  One issue, as we all know, is the incredible cost contained in the 
Mitchell health care bill, a bill that when fully implemented will cost 
the American people $194 billion a year. Except for Ross Perot, nobody 
knows what $1 billion is. I know eyes glaze over when people at home 
hear me say that this bill, by Senator Mitchell's own numbers, costs 
$194 billion a year when fully implemented. Their eyes glaze over when 
they hear that it provides taxpayer subsidies to 110 million people, 
when they hear that it sets up 45 new Government agencies, when they 
hear that it has over 170 mandates on people and local government and 
State government, when that hear that it imposes 18 new taxes to fund 
all of this new spending, and then it imposes costs directly on the 
consumer.
  But since nobody knows what $194 billion is, let me give you a number 
that people will understand. For every family of four in America, that 
is over $3,200 a year that they are going to pay in taxes and indirect 
costs imposed on them to fund the Mitchell bill.
  So the relevant question for people back home is not whether it be 
wonderful to give all these new benefits to 110 million people? 
Certainly it would be wonderful to provide these benefits. But the 
question that working Americans have to ask back home is, is providing 
these benefits worth $3,200 a year to me and to my family? And will the 
benefits be worth $3,200 a year to me?
  Mr. President, I believe that when the people who do the work and pay 
the taxes and pull the wagon in America--not the people who have 
organized groups here clamoring for the passage of this bill--but the 
people who are calling up our offices opposing this bill, the people 
who are writing in overwhelming numbers against this legislation, when 
these people come to understand that--when fully implemented--the 
Mitchell bill is going to cost their family roughly $3,200 a year, they 
will conclude that this bill will not be a good buy for them. They will 
still pay for their health insurance, and the new mandated benefit will 
be between $5,000 and $6,000. I am talking about new costs for all the 
new government created in this legislation. Most Americans I know, 
especially those in Texas, already think we have too much Government.
  The second issue is freedom. The second issue is whether this bill 
allows people to make choices? The President used to argue that his old 
bill preserved consumer choice. But the American people came to 
understand that under the original Clinton bill that was not so. If you 
did not work for the Federal Government--people in the Government were 
going to be treated differently than everybody else--or if you did not 
work for a company with 5,000 or more employees, which for a 1 percent 
tax could ransom you out of the system, your health insurance was going 
to be canceled and you were going to have to buy health care through a 
Government-run cooperative.
  And the final kicker that finally awakened America was the $10,000 
fine. I am sure my colleagues remember the $10,000 fine in the original 
Clinton bill imposed on anybody who tried to sell you private health 
insurance in competition with the Government.
  The President went on and on about how free choice existed in his 
bill. But because the President was so convinced people would buy, 
given the choice, a private alternative, he put a $10,000 fine in his 
bill to prevent people from going outside the Government program to buy 
private health insurance. Once people came to realize that, despite the 
fact that many of our colleagues for a long time denied that that 
provision was in the bill, the Clinton plan was deader than Elvis.
  The Nickles amendment has pointed out a new $10,000 fine, and this 
$10,000 fine is in the Mitchell-Clinton bill. It is a $10,000 fine 
imposed if you and your employer decide against the health insurance 
policy that the Government says you ought to have.
  Let me explain basically how this works, and if this is what free 
choice for you and your family is about where you are from, then 
probably you do not have a problem with the Mitchell bill. But if the 
American town in which you live--not Washington--does not define free 
choice this way, maybe you have a problem with the Mitchell bill.
  Under the Mitchell bill, the Government will tell you what has to be 
in your insurance. If you are a 64-year-old widower, the Government is 
going to tell you what coverage you will have to carry in your 
insurance policy. You will have to pay for pregnancy services and for 
newborn services. Even if you do not smoke and you do not drink, you 
are going to have to pay 12 percent more for alcohol and drug 
rehabilitation coverage. The Government is going to make you buy all of 
this insurance whether you want it or not.
  Second, if you and your employer are buying other benefits, the 
Government is going to tax those benefits. It is going to impose a 35-
percent tax on the benefit that you got in your health plan that the 
Government says you do not need. Then over time it is going to impose 
an income tax on you by treating your health benefit as income.
  For example, if you were in the 31-percent tax bracket, and you 
already had an insurance policy you liked better than the Government's 
plan without alcohol and drug rehabilitation coverage because you do 
not drink and you certainly do not use drugs, you will have to pay 12 
percent more for that coverage anyway. But if you your plan covers 
services you do want, like orthodontist care for your children, the 
company that provides that benefit to you is going to have to pay a 35-
percent tax on it, and if you are in the 31-percent tax bracket, you 
are going to have to ultimately declare it as income. You are going to 
have to pay a tax. So the Government is going to impose a 66-percent 
tax on that benefit.
  Now, tell me if in your hometown this is freedom of choice. The 
Government tells you what you have to have. Whether you want it or you 
do not want it, you have got to buy it. The Nickles amendment takes out 
the $10,000 fine for not buying it, but you are still required to buy 
it. If adopted, the Nickles amendment simply removes the $10,000 fine, 
but it is still illegal not to do it.
  Third, if you want health benefits the Government says you should not 
have, you can pay as much as a 66-percent tax on those benefits.
  I was thinking, Mr. President, what do I own that I would be willing 
to pay a 66-percent tax to keep. Well, I do not want to get in trouble 
by saying I own my children and I own my wife, but I do own my dog, and 
I would pay a 66-percent tax to keep my dog. But there is nothing else 
I own--and I am a U.S. Senator--on which I would choose or could afford 
to pay a 66-percent tax to keep. I would not keep my house if there 
were a 66-percent tax imposed on it. I would not keep my truck if there 
were a 66-percent tax imposed on it.
  Now, you could say that I am free to keep my benefit if I am willing 
to pay that tax. But am I really free? Is the average working American 
really free when you say you can keep it but you have got to pay a 66-
percent tax on it?
  I do not think so.
  The PRESIDING OFFICER. The Senator's time has expired.
  Mr. GRAMM. That is why this bill needs to be defeated.
  I yield the floor.
  Mr. SPECTER addressed the Chair.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. SPECTER. Mr. President, the manager on this side, Senator 
Packwood, has authorized me to speak up to 10 minutes.
  The PRESIDING OFFICER. The Senator is recognized for up to 10 
minutes.
  Mr. SPECTER. Mr. President, I have sought recognition to support the 
amendment offered by the Senator from Oklahoma because I think it is 
excessive and punitive in calling for a $10,000 penalty for each 
violation with respect to each individual, and that the appropriate 
remedy here comes from the incentives in the bill on the subsidies and 
not from this kind of a punitive measure.
  Having been involved for a long period of time as a district 
attorney, this kind of a punitive measure is very excessive compared to 
what we do when we talk about willful, deliberate criminal violations.
  Perhaps of even greater importance, Mr. President, than an analysis 
of the punitive measure here, is the limitation on choice, a limitation 
on what the free market does by way of having individuals and employers 
and insurance carriers fashion policies which meet the needs of 
specific people far beyond what can be contemplated by Government on an 
elaborate statute or by a national health board.
  The benefits which are outlined in the Mitchell bill on the benefits 
package do not include what some people might want to have if they are 
given freedom of choice.
  We are struggling through as this debate is proceeding to analyze and 
figure out exactly what the consequences of this bill would be. As I 
understand the bill there are limitations on the benefits package 
offered by the Mitchell bill on dental care, on vision care. There is 
no provision for chiropractic services, podiatry, and there is no 
provision here for long-term care.
  Now, some of these might be obtainable in a supplemental package, but 
why not allow people--employees and their employers--to structure a 
plan which people might want under what is called a cafeteria approach, 
which simply means that people can pick and choose from a longer list 
of options?
  If someone is not of childbearing age, why have the limitations which 
would be for people who are of childbearing age?
  This goes back to the amendment which was considered last night, the 
Dodd amendment, which was another example of bureaucratic limitations 
where the Government is going to tell people what they are going to 
buy, instead of allowing people to make their own choice for what their 
particular needs might be. The Dodd amendment provided that there could 
not be any policy sold which did not cover maternal care and child 
care. Now, that is fine for people who are of childbearing age, who 
need maternal care and who need child care. But if someone is out of 
that category, is beyond the age of giving birth or does not have that 
requirement, why should the Government mandate that no insurance policy 
can be sold unless it covers those kinds of services?
  Now, on its face, you would think that it really does not mean what I 
have just described, but as we analyzed this bill, as best we can 
figure it out, that is precisely what it does.
  Now, what is the rationale? What is the reason for that?
  The reason would be to require people who were in their seventies to 
have an insurance policy which provides for maternal and child care, so 
as to lower the cost for other people who may want those services. But 
in a democratic free society we really ought to let people choose what 
it is they want.
  The Congressional Budget Office--getting back to the Mitchell plan--
has estimated that the costs of the Mitchell plan are considerably 
higher. For example, on a two-parent family, the Mitchell plan would 
cost $5,883 contrasted with $5,565. This increased cost, which does not 
include any of the premium taxes in the Mitchell bill, is primarily for 
the cost on a group of services which many people may not want.
  The Mitchell plan also has total costs which are estimated, as best 
we can determine, at 30 percent higher than what the average American 
is currently paying, what employers are currently offering. So that an 
employer may be offering a lesser plan and be making up the difference 
to the employee in real wages.
   Under the Mitchell plan, if you offer any health care at all, it has 
to conform to the rigid proposal of the Mitchell plan. So that an 
employer might decide that he is going to offer nothing at all rather 
than pay 30 percent more. So instead of getting more health care, we 
are actually receiving less health care if that choice is made. The 
mandate, that is, the requirement that the employer have coverage, does 
not become effective until a later date if 95-percent coverage is not 
achieved in a given State.
  Mr. President, as I worked through the amendments and as I worked 
through the Mitchell plan, there is an amazing degree of complexity as 
opposed to the tradition in our society where an employer, in 
consultation with his employees, decides to offer a certain line of 
benefits. The employer then deals with an insurance company which can 
offer a wider variety of benefits than those which are enumerated in 
the Mitchell plan.
  Then you have the discretion in a national health board to make 
certain changes with the benefits under the Mitchell bill.
  We have all had experience in trying to deal with the bureaucracy. 
When individual needs, or an individual's desires, change, it would be 
nearly impossible to have to deal with a national health board. These 
are some of the inevitable consequences which arise when you have 
elaborate statutory requirements which establish rigid patterns instead 
of letting the market take care of itself, instead of letting people 
make their own individual choices.
  So why not have people with the option to choose a basic benefits 
package of long-term care instead of prenatal care, if somebody is in 
the 65 to 70 age category instead of being bound by what this statute 
provides?
  Similarly, with the Dodd amendment from last night where as a matter 
of statute there cannot be any cost-sharing requirements, it may well 
be that the Secretary of Health and Human Services might want to have 
some level of copayment. So that, if someone is very, very wealthy, 
they ought to have to contribute for services. Every time we turn 
around and take a look at the fine print, we discover that there are 
limitations on what people will be able to do by way of their own 
individual choice.
  The Nickles amendment, which focuses only on the penalty which is 
excessive, comes back, analyzes the underlying provisions where there 
is a basic benefits package, which may not suit a given individual or a 
given employer. And under the present system, that kind of choice might 
be allowable.
  As we speak, Mr. President, there are other plans which are in the 
process of being formulated, proposals by the so-called ``mainstream 
group'' where I have attended their meetings--some 19 Senators were 
present yesterday and today--trying to find something which is less 
bureaucratic than the Mitchell proposal, less bureaucratic than the 140 
new agency boards and commissions created by the legislation advanced 
by Senator Mitchell even more than the legislation proposed by 
President Clinton last October 27.
  There are other proposals which are under consideration. The so-
called Nunn-Domenici legislation which would be a much less onerous 
bureaucratic scheme. These proposals are designed to try to allow the 
maximum of choice so that people can buy the kinds of programs they 
want without having some rigid standard imposed by the bureaucracy, and 
by the Federal Government.
  So I support the Nickles amendment. I hope as we work through the 
complexities of the underlying legislation that we can improve upon it 
and give more people more choices with less rigidity and less 
bureaucracy.
  Mr. President, I ask unanimous consent that Senator Thurmond be 
listed as cosponsor to the Nickles amendment, and that I also be listed 
as a cosponsor of the amendment.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. SPECTER. I yield the floor.
  Mr. DeCONCINI addressed the Chair.
  The PRESIDING OFFICER. Who yields time?
  Mr. MOYNIHAN. All time is allotted on our side. Will Senator Specter 
yield 5 minutes on his side?
  Mr. DeCONCINI. Will the Senator yield 7 minutes?
  Mr. SPECTER. I do.
  The PRESIDING OFFICER. The Senator from Arizona.
  Mr. MOYNIHAN. Mr. President, may I ask that the Senator from 
Pennsylvania, Mr. Wofford, be added as cosponsor?
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Arizona is recognized.
  Mr. DeCONCINI. Mr. President, I thank my colleagues. I did not think 
the time had all been allotted on our side.
  I thank the Chair.
  (The remarks of Mr. DeConcini pertaining to the introduction of S. 
2401 are located in today's Record under ``Statements on Introduced 
Bills and Joint Resolutions.'')
  Mr. NICKLES. Mr. President, I yield myself such time as I may use.
  The PRESIDING OFFICER. The Senator has 14 minutes remaining.
  Mr. NICKLES. Mr. President, I have a couple comments about the 
underlying amendment. It strikes the section that imposes civil 
penalties up to $10,000 for violations of this section. And that 
section would include offering a plan other than the standard benefit 
plan as defined by the Government.
  It also has a couple of other sections that I want to let my 
colleagues know about, because I think I will try and do an amendment 
on this as well. Individuals that work for employers are prohibited 
from being offered a so-called alternative package. That is a package 
that has a high-cost deductible. Individuals can buy it, but employers 
cannot provide it for their employees. That is absurd. Yet, it is in 
this bill. It needs to be eliminated. I thought about doing that 
amendment first, but we decided to go with the fines. We need to remove 
that provision, which is on page 138.
  I noticed with interest that my colleagues say it is the fine print. 
It is fine print, but it is one of the reasons that we have said we 
need to spend a little time on this bill. This bill was introduced--or 
at least brought to the Senate floor Friday at 5 o'clock. I believe 
only a couple of copies were available. The copies were produced en 
masse, I guess, and available on Saturday. The majority leader wanted 
to vote on Saturday and Monday, and that did not happen. So he was 
insisting on a vote on Tuesday. Some of us were saying we were not so 
interested in voting, not because we wanted to filibuster or hold the 
bill up, we wanted to find out what was in the bill.
  This is a provision I found that troubled me, mainly because I was an 
employer. I had a self-insure plan, and I find out that if that plan is 
illegal, then if I tried to do some cost sharing on that self-insure 
plan, I would be subjected to a $10,000 fine per employee. We have 
about 65 or 70 employees. That is about $650,000 because I was not 
complying with this so-called section.
  I am delighted that we are going to be successful in cleaning up this 
one amendment, but we still have not removed the provision that would 
prohibit an employer from offering an alternative package, one that has 
a higher deductible. We need to fix that. We still have not fixed the 
fact that we are going to tell everybody in America, no matter how 
happy they are with their plans, frankly, they have to be replaced with 
a Government-designed plan, the so-called standard benefit package.
  I also want to respond to my colleagues who said some of these plans 
have standard benefit packages and some do not. The plan that I am a 
principal sponsor of is not a standard benefit package. It says, wait a 
minute, let us reform the Tax Code and give everybody a tax credit. 
That makes sense. If you are going to get the tax credit, you have to 
provide health benefits. We replaced the current income exclusion that 
excludes--if you are a generous employer and have health care, you do 
not have to pay a tax. That benefits people working for generous 
employers. But it does not do anything for anybody who does not 
subsidize the employees' health benefits, or anybody who does not have 
a job. The Tax Code, if it is going to help subsidize insurance, should 
be able to subsidize it for every American, whether they have a job or 
not. They need health care.
  So that was the purpose of our bill. Well, to qualify for the tax 
credit, you have to provide health care, and we said, basically, just 
any catastrophic plan that would cover basic hospitalization and 
physician services.
  Mr. President, as I mentioned, it is important to read the fine print 
because you might find something you do not like, like this enormous 
fine that was imposed if you did not comply with the dictates in the 
standard benefit package. Hopefully, we will take that out. I noticed 
in looking through the bill--and this will be subject to an amendment 
that I or one of my colleagues will offer. Maybe it will be a 
bipartisan amendment, and we can be successful in deleting this. I hope 
my friend from Massachusetts, who is on the floor, will join me in this 
amendment. That is section 10135 on page 1432. It says ``no loss of 
coverage.''

  In no case shall the failure to pay amounts owed under this act 
result in an individual or family's loss of coverage.
  In other words, individuals do not have to pay their premiums and 
they do not lose their coverage. That is an interesting concept. I 
think a lot of people will find out that is in the law. If you do not 
pay, you do not lose your coverage. I think that may be very 
attractive. It may encourage a lot of people not to pay.
  Who does pay? This bill calls for----
  Mr. KENNEDY. Mr. President, will the Senator yield on that point?
  Mr. NICKLES. Mr. President, let me finish my point and then I will be 
happy to yield.
  On page 1430, it says, ``The shortfall will be paid half by the 
family,'' and on page 1422 ``the other half by employers.''
  I think that is a ridiculous provision. It needs to be taken out. We 
have an amendment to take it out. I hope it can be done in a bipartisan 
fashion.
  This bill requires a lot of reading. I have been reading quite a bit. 
I have not read it all yet. I am still working on it. There is a lot of 
fine print and a lot of provisions in this bill that really do not make 
sense, that really do not work very well.
  Again, it is a conglomeration between the Labor Committee package and 
the Finance Committee package. We do not even have a report on the 
legislation. Most significant legislation that is reported out of 
committees has a committee report. The committee tells the Congress and 
tells the American people what it is comprised of. What does it mean? 
What does it mean in layman's language? We do not have that for this 
bill.
  So the American people really have not had an explanation. When I had 
a press conference yesterday and I said under the Clinton-Mitchell 
package as presently drafted you are subjected to a $10,000 fine if you 
do not have your plan conform to the Government's standard mandated 
package, that is fact. We are going to eliminate the $10,000 fine but 
still have not eliminated that standard, mandated package.
  So the cost of that package, which I alluded to earlier, is $5,888 
per family. That is enormously expensive. A lot of plans in Tennessee, 
a lot of plans in Oklahoma, a lot of plans all across the country are 
not that expensive.
  When I hear my colleagues say this bill does not have a mandate in 
it, an employer mandate, until the year 2000-something, I disagree 
because this is telling every employer that has a health care plan they 
have to have a very expensive health plan, one more expensive than many 
of them have today. And many employers are used to providing health 
care for employees. They want to continue to provide health care for 
employees. All of sudden now they are mandated the plan, the 
Government-defined package, which is enormously expensive, and they do 
not have lesser expensive options. They do not even have the option 
that individuals have as far as buying the alternative standard plan, 
one that has a bigger deductible. Individuals have that option under 
this bill, but employers do not.
  I think that is a serious mistake. Who pays? Someone might say you 
are doing that trying to protect employers. No, because, frankly, if we 
do not make it more affordable for a lot of employers, a lot of 
employees are going to lose their jobs. A lot of employees will see a 
reduction in their take home pay because the Federal Government is 
mandating the plan that costs $6,000 per family and that business does 
not generate enough economic reward for that to happen or economic 
return for that to happen.
  So the net result is either the individual loses the job, they have 
fewer employees, or have a reduction in pay. They do not get an 
increase or maybe even have a pay reduction to pay for this high 
Government mandate, this expensive plan.
  I think that is a serious mistake. So we have eliminated it. If we 
are successful with the amendment--I expect we will be--we will 
eliminate the $10,000-per-employee fine, or at least we will eliminate 
it when it goes through the Senate. I am always concerned what will 
happen when this bill goes to conference and what will come back. But 
we eliminate the penalty.
  But if we still mandate to employers, if you are going to provide 
health care, you have to provide the Government-designed plan, that is 
a mandate on all employers and in many cases it will dramatically 
increase their costs.
  I know a lot of employers who have health care for families that 
costs $2,400 or $3,000, and if you mandate they provide insurance that 
costs $6,000, you have just increased it. That is the same thing as a 
tax of $3,000 per family, or per employer. It is a tax on jobs. It will 
cost jobs, and that is a mistake.
  We have not remedied that with this amendment. We will eliminate the 
penalty, but we have not eliminated the mandate.
  What happens if we do not eliminate the mandate is a lot of employers 
will find that it is in their interest to drop the plan. There is 
nothing to keep them from dropping the plan, so they will drop the 
plan.
  What happens then? Well, unfortunately, when they drop the plan, a 
lot of those employees will go on subsidies, and the number of people 
who are subsidized under this bill rises by 57 million. I hope people 
are aware of that. Under this bill we will have 57 million more people 
on subsidies.
  What about those employers who drop the plan? They can come back 
later, and the employer can qualify for subsidies and Uncle Sam will 
start paying almost 50 percent of the employer's cost share of those 
premiums. So there is a great incentive for employers to drop plans, 
employees to go on subsidy, and then the employer to come back and be 
subsidized later.
  I think that is a serious mistake, and I hope we will not follow 
that.
  I am delighted and hopeful that our colleagues will adopt this 
amendment. At least eliminate this very punitive, unfair fine that is 
in this proposal of $10,000 per employee if you do not conform to this 
plan.
  Mr. President, I yield to the Senator from Kansas 3 minutes.
  The PRESIDING OFFICER. The Republican leader is recognized.
  Mr. DOLE. Mr. President, let me say that given the broad support for 
the Nickles amendment, obviously bipartisanship is still alive and well 
in the Senate.
  I think this is a very important amendment because they have been 
saying this plan is voluntary and what it boils down to is, if you do 
not volunteer for the one-size-fits-all standard benefits package, you 
can be fined $10,000 per employee.
  Let us get this straight. The bill as presently written tells 
employers who are already providing coverage to their employees--
coverage employees bargained for and may be completely satisfied with--
that maybe they are in the wrong and they should be punished. You must 
provide coverage that carries the National Health Board seal of 
approval. It is not enough that you are satisfied.
  I think the point that he is making with this amendment, I might say 
to the Senator from Oklahoma, is not that the fine is too high--it 
would be too high if it were 10 cents--it is just another example, it 
is just one small fix in this 1,400-some-page bill, that I do not think 
we will have time to fix. Every time we stumble across or someone reads 
about it and someone calls about it, oh, yes, that is right. We ought 
to fix this. And I just do not know how you do that in a few days.
  I also want to include in the Record--it may already have been 
included in the Record--that in the crime bill we use the word 
``criminal'' 437 times and 30 times in health care. We use the word 
``limit'' 211 times in the health care and 33 times in the crime bill. 
We use the word ``penalty'' 112 times in health care and 53 times in 
the crime bill. We use the word ``require'' 755 times in the health 
care bill and only 207 times in the crime bill.
  There are a lot of numbers in there. I thought maybe we were on the 
crime bill. This is the health care bill, right?
  I want to put in the Record these figures put together by the 
National Taxpayers Union, because they use all these restrictive words. 
The crime bill uses 1,361 restrictive words and the Clinton-Mitchell 
health care bill uses 1,488 restrictive words.
  Maybe the crime bill is not tough enough. I have to believe the 
health care bill is tough enough. If you violate or do not do this or 
do not do that, we have a penalty for you.
  I think we ought to put those in the Record because I think a lot of 
taxpayers might like to know what they might expect, if by some strange 
event this bill should pass.
  Mr. President, I ask unanimous consent to print this information from 
the National Taxpayers Union in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

               National Taxpayers Union Foundation--News


  restrictive language: the clinton-mitchell health care bill vs. the 
                      crime bill--august 15, 1994

       An analysis by the National Taxpayers Union Foundation has 
     uncovered a possible reason for last week's failure of the 
     crime bill and the grave difficulties for the Clinton-
     Mitchell-Gephardt health reform bills: the health bill is too 
     focused on criminalizing medicine, while the crime bill is 
     too focused on providing care and services to criminals. Word 
     counts on the different bills reveal that in many ways the 
     Clinton-Mitchell health bill introduced 10 days ago uses much 
     more restrictive language than the crime bill.
       Highlights on the textual analysis include:
       The ``Crime'' bill uses 1,361 restrictive words, while the 
     Clinton-Mitchell Health Care Bill uses 1,488.
       While the ``Crime'' bill uses the word ``limit'' 33 times, 
     the Clinton--Mitchell health care bill uses it 211 times.
       The ``Crime'' bill uses the term ``penalty'' 53 times, but 
     the Clinton-Mitchell health care bill uses it 112 times.
       While the ``Crime'' bill uses the term ``require'' 207 
     times, the Clinton-Mitchell health care bill uses it 755 
     times.
       The term ``restrict'' was found 3 times in the ``Crime'' 
     bill and 34 times in Clinton-Mitchell.
       ``Sanction'' was found eight times in the ``Crime'' bill 
     and 22 times in Clinton-Mitchell.
       The word ``violate'' occurs 63 times in the ``Crime'' bill 
     and 113 in Clinton-Mitchell.

    WORD COUNTS: CLINTON-MITCHELL HEALTH CARE BILL VERSUS CRIME BILL    
------------------------------------------------------------------------
                                             Clinton-                   
                                             Mitchell                   
                                            Health Care   ``Crime'' Bill
                                               Bill                     
------------------------------------------------------------------------
Ban.....................................               0               1
Criminal................................              30             437
Enforce.................................             104             221
Fine....................................              13              46
Limit...................................             211              33
Obligation..............................              44               9
Penalty.................................             112              53
Prison..................................              14             219
Prohibit................................              36              61
Require.................................             755             207
Restrict................................              34               3
Sanction................................              22               8
Violate.................................             113              63
                                         -------------------------------
      Total.............................           1,488           1,361
------------------------------------------------------------------------

       NTUF uncovered last week that besides substantial use of 
     this language of control, the Clinton-Mitchell health care 
     bill also imposes seven new federal racial, ethnic, and 
     geographic quotas on those going into medicine, and the 
     specialties; creates 109 new crimes and penalties (compared 
     with 89 in the original Clinton bill); and implements price 
     controls.
                                                 John E. Berthoud,
                                      Vice President for Research.
  The PRESIDING OFFICER. Who yields time?
  Mr. MOYNIHAN. Mr. President, I yield 5 minutes to the distinguished 
Senator from South Dakota.
  The PRESIDING OFFICER. The Senator from South Dakota is recognized.
  Mr. DASCHLE. Mr. President, let me just make sure everyone 
understands what it is this amendment does.
  First of all, it deletes the reference to $10,000. That is all it 
does. We have all cosponsored this particular amendment because we 
believe that there are other ways in which to achieve compliance, in 
the hope that we can begin working together on many of the issues. We 
will continue to find ways with which to try to work on many of these 
things together.
  Mr. President, I want to go back to, again, the concerns expressed by 
many of our colleagues on the other side with regard to Federal 
requirements. Let me read again from the bill offered by the 
distinguished Senator from Oklahoma. I have great admiration for him, 
but it is as clear as clear can be. They eliminate the entire exclusion 
for employer-provided health insurance in this bill, page 31, probably 
the single biggest tax increase of any bill offered on health this 
year. If we are going to eliminate the entire deductibility for 
employers for health insurance, I cannot think of a bigger tax increase 
than that.
  Second, I am reading now from the bill, subtitle B, federally 
Qualified Health Insurance Plan.

       A federally qualified health insurance plan is a health 
     insurance plan offered, issued or renewed on or after January 
     1, 1997, which is certified by the applicable regulatory 
     authority as meeting the minimum requirements of sections 112 
     and 113.

  Mr. President, if that is not what we are talking about here, 
benefits delineated, benefits required to be observed and adhered to, I 
do not know what is.
  Let us go to the bill offered by our distinguished colleague from 
Rhode Island, Senator Chafee. I am reading the following from page 217. 
They were talking earlier about the concerns about taxes and the fines 
imposed for failure to comply. Here is what Senator Chafee would 
propose. I am reading from the bill:

       There is hereby imposed a tax on the failure of any person 
     or plan to comply with the requirements of section 1004 or 
     1201. The tax is $100 a day for lack of compliance.

  Here it says the amount of the tax imposed shall be $100 per day, per 
employee.
  Mr. President that is a $35,000 tax per year for failure to comply. 
So I think we better understand.
  Mr. KENNEDY. Will the Senator yield?
  Mr. DASCHLE. Yes.
  Mr. KENNEDY. That means, if they had 10 employees, if they eliminate 
that for 10 employees, just that 1 employer, under this provision, it 
would be some $36,000.
  Mr. DASCHLE. That is what it says on page 217 and 218.
  Mr. KENNEDY. They describe that as a tax.
  Mr. DASCHLE. And they call it a tax. The point is, in fact, we do not 
disagree, necessarily, with the need for some compliance. The bottom 
line is, we all recognize that we have all written bills that state the 
importance of having some minimal expectation of what these plans will 
do. Why do we do that? We do that very simply because we have been told 
over and over again, ``If you fix one thing, take out the fine print. 
Take out the big surprises.''
  Let us make sure we do not pass a fine print guarantee here in the 
legislation we are passing. That is really what we are trying to do 
here.
  There are too many cases where people have been adversely affected by 
the surprises that they are encountered with every time they need their 
insurance. We want to take the surprises out. We want to make sure 
there is competition, not on how we can confuse the public but how we 
can take benefits side by side and compare them adequately, just as we 
did with medigap, just as we have done on other occasions, other 
consumer protections.
  We recognize the need for forthright information, for truth and 
honesty in marketing. And that really is what this standard benefits 
plan will do.
  Again, let me emphasize that is not the issue in this amendment. This 
amendment is simply one which deals with the $10,000 fine. We will deal 
with it. We will find other ways with which to ensure compliance. But 
let us make sure we all understand the importance of having minimal 
expectations for whatever plan we pass for health reform this year.
  Mr. MOYNIHAN addressed the Chair.
  The PRESIDING OFFICER. The Senator from New York.
  Mr. MOYNIHAN. Mr. President, my friend, the Republican manager, was 
generous in yielding time to the Senator from Ohio for discussions on 
another matter.
  Their time having effectively expired, I would like to yield the 
balance of our time to the Senator from Oregon.
  Mr. COATS. I do not know how much time we have, but I wonder if the 
Republican manager of the bill would yield me 1 minute.
  Mr. PACKWOOD. The chairman has been very generous in yielding the 
rest of his time. I just want to find out how much it is.
  The PRESIDING OFFICER. Four and a half minutes.
  Mr. PACKWOOD. I want to yield some time to respond for the Senator 
from Oklahoma. I yield 3 minutes to the Senator from Oklahoma and the 
remainder of the time to the Senator from Indiana.
  Mr. NICKLES. Mr. President, I would like to respond to my friend and 
colleague from South Dakota.
  He alluded again to our consumer choice plan. I appreciate the 
attention it has received today and I hope it receives a lot more.
  He said, ``Well, he eliminated the tax exclusion. That is a large tax 
increase.'' What he fails to mention is we replaced it with a tax 
credit, a tax credit that was more generous than the tax exclusion. The 
tax exclusion on health care applies to people who work for employers. 
And if your employer subsidizes your health care, you do not have to 
pay taxes on what they pay. It is a nice benefit, if you have a 
generous employer. But it does not do anything for somebody that does 
not have a job and it does not do anything for somebody that works for 
an employer that does not pay or subsidize your health care.
  So we say, let us replace that exclusion that has only been to a 
certain portion and make it a tax credit and make it universal, so I 
would like to correct my friend and colleague.
  Then we say, to qualify, you have to offer tax benefits, but we do 
not define the benefits. We let people choose whatever they want.
  Unfortunately, under the Clinton-Mitchell plan, you have to offer a 
Government-defined, mandated standard benefits package and if you offer 
something else, you are subject to a $10,000 fine. We are going to get 
rid of that $10,000 fine. But we still have the Government mandating 
that you have to provide a very expensive, extensive health benefit of 
about $6,000 per family, which, unfortunately, a lot of families cannot 
afford.
  I thank my friend and colleague from New York for yielding the time.
  Mr. President, I ask unanimous consent that Senator Coverdell and 
Senator Thurmond be added as cosponsors.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Indiana.
  Mr. COATS. Mr. President, I find it somewhat ironic that, just a 
couple of days after the majority leader and others of our colleagues 
criticized the Republicans for trying to take some time to find out 
what is in the bill, now we are told that we ought to find out what the 
surprises are in the Mitchell bill and eliminate those surprises. I 
think that is what we were trying to do. We were trying to work through 
this 1,443 page bill.
  We have learned that graduate medical education is a potential 
serious problem. We have learned now that there is a $10,000 fine that 
no one even knew about.
  It is hard for me to understand how our colleagues, on the one hand, 
can say you have had plenty of time to understand all of this, and now 
they are standing up, saying, ``Well, we did not know about this, 
either, so we will join with you in taking it out.'' I just do not 
think you can have it both ways.
  The bottom line is, this is a massive bill, full of surprises. The 
more we read it, the more surprises we find.
  And so, our request for some time to understand what is in this bill 
before we impose it on the American people, I think, is a legitimate 
request. I am glad we are now working through the process. I just 
wonder how many more surprises we are going to find.
  But I am pleased that our colleagues are joining us in exposing the 
problems in the Mitchell bill and beginning, piece by piece, to 
eliminate those surprises so that we understand what it is we are 
voting on when we finally have this vote.
  If there is any time remaining, I am happy to yield it back.
  The PRESIDING OFFICER. Who yields time?
  Mr. PACKWOOD. Mr. President, I yield back the remainder of the time I 
have.
  The PRESIDING OFFICER. All time is yielded back.
  Mr. PACKWOOD. Mr. President, I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second? There appears to 
be.
  The yeas and nays were ordered.


                       vote on amendment no. 2563

  The PRESIDING OFFICER. The vote now occurs on amendment No. 2563, 
offered by the Senator from Oklahoma [Mr. Nickles].
  The yeas and nays have been ordered. The clerk will call the roll.
  The legislative clerk called the roll.
  The result was announced--yeas 100, nays 0, as follows:

                      [Rollcall Vote No. 289 Leg.]

                               YEAS--100

     Akaka
     Baucus
     Bennett
     Biden
     Bingaman
     Bond
     Boren
     Boxer
     Bradley
     Breaux
     Brown
     Bryan
     Bumpers
     Burns
     Byrd
     Campbell
     Chafee
     Coats
     Cochran
     Cohen
     Conrad
     Coverdell
     Craig
     D'Amato
     Danforth
     Daschle
     DeConcini
     Dodd
     Dole
     Domenici
     Dorgan
     Durenberger
     Exon
     Faircloth
     Feingold
     Feinstein
     Ford
     Glenn
     Gorton
     Graham
     Gramm
     Grassley
     Gregg
     Harkin
     Hatch
     Hatfield
     Heflin
     Helms
     Hollings
     Hutchison
     Inouye
     Jeffords
     Johnston
     Kassebaum
     Kempthorne
     Kennedy
     Kerrey
     Kerry
     Kohl
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lott
     Lugar
     Mack
     Mathews
     McCain
     McConnell
     Metzenbaum
     Mikulski
     Mitchell
     Moseley-Braun
     Moynihan
     Murkowski
     Murray
     Nickles
     Nunn
     Packwood
     Pell
     Pressler
     Pryor
     Reid
     Riegle
     Robb
     Rockefeller
     Roth
     Sarbanes
     Sasser
     Shelby
     Simon
     Simpson
     Smith
     Specter
     Stevens
     Thurmond
     Wallop
     Warner
     Wellstone
     Wofford
  So the amendment (No. 2563) was agreed to.
  Mr. MOYNIHAN. Mr. President, I move to reconsider the vote by which 
the amendment was agreed to.
  Mr. PACKWOOD. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  Mr. MOYNIHAN. Mr. President, I would just like to observe that on 
this, the second vote on the Mitchell amendment, we have had a 
bipartisan vote of 100-0. A bipartisan measure has been adopted. It is 
a good sign.
  I yield the floor.
  Mr. PACKWOOD. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Feingold). The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. FORD. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________