[Congressional Record Volume 141, Number 64 (Thursday, April 6, 1995)]
[House]
[Pages H4366-H4374]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




   PROVIDING FOR CONSIDERATION OF H.R. 483, MEDICARE SELECT EXPANSION

  Ms. PRYCE. Mr. Speaker, by direction of the Committee on Rules, I 
call up House Resolution 130 and ask for its immediate consideration.
  The Clerk read the resolution, as follows:

                              H. Res. 130

       Resolved, That at any time after the adoption of this 
     resolution the Speaker may, pursuant to clause 1(b) of rule 
     XXIII, declare the House resolved into the Committee of the 
     Whole House on the state of the Union for consideration of 
     the bill (H.R. 483) to amend title XVIII of the Social 
     Security Act to permit medicare select policies to
      be offered in all States, and for other purposes. The first 
     reading of the bill shall be dispensed with. All points of 
     order against consideration of the bill are waived. 
     General debate shall be confined to the bill and shall not 
     exceed one hour equally divided and controlled by the 
     chairman and ranking minority member of the Committee on 
     Commerce. After general debate the bill shall be 
     considered for amendment under the five-minute rule. In 
     lieu of any committee amendment it shall be in order to 
     consider as an original bill for the purpose of amendment 
     under the five-minute rule an amendment in the nature of a 
     substitute consisting of the text of H.R. 1391. That 
     amendment in the nature of a substitute shall be 
     considered as read. No amendment to that amendment in the 
     nature of a substitute shall be in order except one 
     further amendment in the nature of a substitute which may 
     be offered only by Representative Dingell of Michigan or 
     his designee, shall be considered as read, shall be 
     debatable for one hour equally divided and controlled by 
     the proponent and an opponent, and shall not be subject to 
     amendment. At the conclusion of consideration of the bill 
     for amendment the Committee shall rise and report the bill 
     to the House with such amendment as may have been adopted. 
     Any Member may demand a separate vote in the House on any 
     amendment adopted in the Committee of the Whole to the 
     bill or to the amendment in the nature of a substitute 
     made in order as original text. The previous question 
     shall be considered as ordered on the bill and any 
     amendment thereto to final passage without intervening 
     motion except one motion to recommit with or without 
     instructions.
       Sec. 2. Subject to clause 2(l)(5) of rule XI, the Committee 
     on Commerce may file a report to the House on H.R. 483 at any 
     time.

  The SPEAKER pro tempore. The gentlewoman from Ohio [Ms. Pryce] is 
recognized for 1 hour.


                     amendment offered by Ms. Pryce

  Ms. PRYCE. Mr. Speaker, I ask unanimous consent that House Resolution 
130 be amended on page 2, line 3, by inserting after ``bill'' the words 
``for failure to comply with clause (2)(1)(6) of rule XI.''
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Ohio?
  Mr. MOAKLEY. Mr. Speaker, reserving the right to object, I would like 
to know exactly what the gentlewoman from Ohio [Ms. Pryce] is doing at 
the present time.
  Ms. PRYCE. Mr. Speaker, will the gentleman yield?
  Mr. MOAKLEY. Further reserving the right to object, I yield to the 
gentlewoman from Ohio.
  Ms. PRYCE. Mr. Speaker, the words proposed to be inserted were 
inadvertently deleted from the text of the rule, even though it is 
clear from the motion made in committee that those included words were 
to be reported.
  Mr. MOAKLEY. Mr. Speaker, the gentlewoman has a very lucid 
explanation, and I withdraw my reservation of objection.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Ohio?
  There was no objection.
  The SPEAKER pro tempore. The resolution is amended.
  Ms. PRYCE. Mr. Speaker, for purposes of debate only, I yield the 
customary 30 minutes to the gentleman from Massachusetts [Mr. Moakley], 
pending which I yield myself such time as I may consume.
  During consideration of this resolution, all time yielded is for the 
purposes of debate only.
  Mr. Speaker, time is of the essence. That is the basic principle 
underlying our consideration of this legislation today.
  In 1990, Congress created the Medicare Select Program to allow 
Medicare recipients the option of purchasing a MediGap managed care 
option. This 15-State demonstration project is set to expire on June 
30, a date that is not so far away when you consider that we are about 
to begin a 3-week district work period. Unless Congress takes prompt 
action to renew this program, the insurance benefits of nearly half a 
million senior citizens covered by the Medicare Select Program would be 
in jeopardy.
  Failure to extend the program's authority would most likely lead to 
higher premiums for current enrollees, presenting a new burden for 
senior citizens who live on fixed incomes.
  The legislation before us, crafted by the distinguished gentlewoman 
from Connecticut [Mrs. Johnson], expands this option now being tried 
successfully in 15 States to seniors in all 50 States, extends the 
program for a minimum of 5 additional years, and puts it on track to 
becoming permanent if the Secretary of Health and Human Services 
certifies that certain conditions have been met.
  In order to expedite consideration of this bill in the House, and to 
ensure that the Senate, will have ample time to debate this issue, the 
Committee on Rules has reported a fair and balanced rule for this very 
necessary legislation. Only the rule will be considered by the House 
today.
  Mr. Speaker, the rule provides for 1 hour of general debate, equally 
divided and controlled by the chairman and ranking minority member of 
the Committee on Commerce, after which time the bill shall be 
considered for amendment under the 5-minute rule.
  The rule makes in order as an original bill for the purpose of 
amendment under the 5-minute rule an amendment in the nature of a 
substitute consisting of the text of H.R. 1391. This bill reflects a 
consensus position reached by the two committees of jurisdiction in 
this matter: The Committee on Commerce, and the Committee on Ways and 
Means.
  No amendment to that amendment in the nature of a substitute shall be 
in order, except one further amendment in the nature of a substitute 
which may be offered only by Representative Dingell or his designee. 
The amendment shall not be subject to further amendment, and is 
debatable for an hour, which shall be equally divided and controlled by 
the proponent and an opponent.
  Finally, the minority is provided with one motion to recommit, with 
or without instructions.
  Mr. Speaker, health care reform dominated much of the time and 
attention of the 103d Congress. This year, work has already begun to 
explore new and innovative ways to make health care more available and 
affordable for our citizens, especially for older Americans.
  As Chairman Bliley stated before the Committee on Rules last evening, 
this legislation provides a reasonable balance to permit a very 
valuable, and arguably successful, program for our senior citizens to 
continue, while allowing us time to evaluate the program more closely 
before making it permanent.
  [[Page H4367]] Our colleagues should keep in mind that the Medicare 
Select Program provides senior citizens with another viable option to 
receive affordable medical care. Premiums under the select option have 
resulted in savings as high as 37 percent over traditional MediGap 
products. By giving older Americans more choices within MediGap, we 
give them the flexibility to choose plans which meet their special, 
individual needs.
  Mr. Speaker, the sponsors of this legislation have made it very clear 
that the House needs to act on this bill before leaving for the 
upcoming district work period. More than 450,000 Medicare beneficiaries 
will be impacted if the Medicare Select Demonstration Program is not 
expanded.
  Mr. Speaker, this is a fair, balanced, and responsible rule. It 
provides the minority with two distinct opportunities to offer 
alternative proposals. These proposals may contain whatever germane 
amendments the minority leadership considers most important, as long as 
they are consistent with the standing rules of the House.
  In the Rules Committee hearing, we discussed a number of substantive 
amendments which were offered during the separate committee markup 
process, all of which were defeated at the committee level. While these 
proposals do have merit, Mr. Speaker, the Rules Committee majority 
strongly believes that they should be brought up when the House 
considers legislation specifically addressing reform of Medicare and 
MediGap programs. It would seem unfair to single out one program for 
reform at this time when all MediGap policies together should be 
examined at the proper time.
  Once again, Mr. Speaker, let me emphasize that it is imperative that 
the House complete its consideration of this legislation and forward it 
to the Senate, which we all know operates at a much different pace than 
the House.
  I urge my colleagues on both sides of the aisle to support this fair, 
balanced, and very reasonable rule.
  Mr. Speaker, I reserve the balance of my time.
  Mr. MOAKLEY. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, it gives me great pleasure to stand on the House floor 
today to publicly thank my good friend, the gentleman from New York, 
Mr. Jerry Solomon.
  Democrats were upset to learn yesterday that the Republican 
leadership was going to deny the Democrats on the Commerce Committee 
their right to have 3 days to file their views.
  But Jerry Solomon came to our rescue. He talked to his leadership and 
convinced them to change the schedule so that Democrats on the Commerce 
Committee will be given time to file their views.
  That's right. Thanks to Jerry Solomon we are taking up the rule 
today, but we will take up the bill tomorrow and Democrats will have 
the right to voice their opinion just as Republicans did when they were 
in the minority.
  Unfortunately, I cannot say Democrats are as happy with this rule as 
we were with Jerry Solomon yesterday.
  Today, we are discussing a closed rule on a simple, noncontroversial 
bill that anyone and everyone should be allowed to amend if they see 
fit.
  But for some reason Republicans seem to have gotten in the habit of 
breaking promises and socking it to American families. They are 
shutting down this rule just as they restricted 66 percent of the 
contract rules.
  At least three amendments that were offered in the Commerce Committee 
had significant bipartisan support. I would ask my colleagues, what is 
going on here?
  What reason on Earth could you have to forbid Democrats and 
Republicans from offering amendments to this Medicare bill?
  I urge my colleagues to defeat this rule.
         Department of Health and Human Services, Health Care 
           Financing Administration,
                                    Washington, DC, April 5, 1995.
     Hon. John D. Dingell,
     House of Representatives,
     Washington, DC.
       Dear Mr. Dingell: I am responding to your request as to 
     whether there is any federal requirement that Medicare SELECT 
     insurers notify their enrollees about the status of their 
     policies prior to the expiration of the current authorization 
     for the demonstration.
       There are no provisions in Federal law, regulations or the 
     NAIC Model that require plans to notify enrollees in April or 
     for that matter any time prior to the expiration of the 
     demonstration authority. Even after the demonstration 
     authority expires, plans are required to maintain coverage to 
     all enrollees who continue to hold policies.
       Confusion may have arisen on this issue of notification 
     because of a provision in Section 10-N of the NAIC Model. 
     This section outlines the requirements for plans to provide 
     continuation of coverage in the event that the Secretary 
     notifies the states of her determination that SELECT policies 
     should be discontinued because of the failure of the 
     demonstration to be reauthorized or its substantial 
     amendment. This notification to states is at the Secretary's 
     discretion. Given the bipartisan interest in both the House 
     and Senate, we don't anticipate making such a determination 
     in the foreseeable future even in the unlikely event that 
     there is a temporary lapse in the authority for the 
     demonstration.
       We are committed to working with Congress to improve the 
     options available to our beneficiaries. As you are aware, the 
     Administration supports a temporary extension of the 15-state 
     demonstration. Such an extension would provide sufficient 
     time to examine what we have learned from the demonstration 
     and to make needed changes to SELECT based on our findings. I 
     look forward to working with you on these issues.
           Sincerely,
                                                 Bruce C. Vladeck,
                                                    Administrator.

                Floor Procedure in the 104th Congress; Compiled by the Rules Committee Democrats                
----------------------------------------------------------------------------------------------------------------
                                                                       Process used for floor      Amendments in
        Bill No.                  Title            Resolution No.           consideration              order    
H.R. 1*................  Compliance.............  H. Res. 6         Closed......................           None.
H. Res. 6..............  Opening Day Rules        H. Res. 5         Closed; contained a closed             None.
                          Package.                                   rule on H.R. 1 within the                  
                                                                     closed rule.                               
H.R. 5*................  Unfunded Mandates......  H. Res. 38        Restrictive; Motion adopted             N/A.
                                                                     over Democratic objection                  
                                                                     in the Committee of the                    
                                                                     Whole to limit debate on                   
                                                                     section 4; Pre-printing                    
                                                                     gets preference.                           
H.J. Res. 2*...........  Balanced Budget........  H. Res. 44        Restrictive; only certain            2R; 4D.
                                                                     substitutes.                               
H. Res. 43.............  Committee Hearings       H. Res. 43 (OJ)   Restrictive; considered in              N/A.
                          Scheduling.                                House no amendments.                       
H.R. 2*................  Line Item Veto.........  H. Res. 55        Open; Pre-printing gets                 N/A.
                                                                     preference.                                
H.R. 665*..............  Victim Restitution Act   H. Res. 61        Open; Pre-printing gets                 N/A.
                          of 1995.                                   preference.                                
H.R. 666...............  Exclusionary Rule        H. Res. 60        Open; Pre-printing gets                 N/A.
                          Reform Act of 1995.                        preference.                                
H.R. 667...............  Violent Criminal         H. Res. 63        Restrictive; 10 hr. Time Cap            N/A.
                          Incarceration Act of                       on amendments.                             
                          1995.                                                                                 
H.R. 668...............  The Criminal Alien       H. Res. 69        Open; Pre-printing gets                 N/A.
                          Deportation                                preference; Contains self-                 
                          Improvement Act.                           executing provision.                       
H.R. 728...............  Local Government Law     H. Res. 79        Restrictive; 10 hr. Time Cap            N/A.
                          Enforcement Block                          on amendments; Pre-printing                
                          Grants.                                    gets preference.                           
H.R. 7.................  National Security        H. Res. 83        Restrictive; 10 hr. Time Cap            N/A.
                          Revitalization Act.                        on amendments; Pre-printing                
                                                                     gets preference.                           
H.R. 729...............  Death Penalty/Habeas...  N/A               Restrictive; Brought up                 N/A.
                                                                     under UC with a 6 hr. time                 
                                                                     cap on amendments.                         
S. 2...................  Senate Compliance......  N/A               Closed; Put on suspension              None.
                                                                     calendar over Democratic                   
                                                                     objection.                                 
H.R. 831...............  To Permanently Extend    H. Res. 88        Restrictive; Makes in order              1D.
                          the Health Insurance                       only the Gibbons amendment;                
                          Deduction for the Self-                    waives all points of order;                
                          Employed.                                  Contains self-executing                    
                                                                     provision.                                 
H.R. 830...............  The Paperwork Reduction  H. Res. 91        Open........................            N/A.
                          Act.                                                                                  
H.R. 889...............  Emergency Supplemental/  H. Res. 92        Restrictive; makes in order              1D.
                          Rescinding Certain                         only the Obey substitute.                  
                          Budget Authority.                                                                     
H.R. 450...............  Regulatory Moratorium..  H. Res. 93        Restrictive; 10 hr. Time Cap            N/A.
                                                                     on amendments; Pre-printing                
                                                                     gets preference.                           
H.R. 1022..............  Risk Assessment........  H. Res. 96        Restrictive; 10 hr. Time Cap            N/A.
                                                                     on amendments.                             
H.R. 926...............  Regulatory Flexibility.  H. Res. 100       Open........................            N/A.
H.R. 925...............  Private Property         H. Res. 101       Restrictive; 12 hr. time cap             1D.
                          Protection Act.                            on amendments; Requires                    
                                                                     Members to pre-print their                 
                                                                     amendments in the Record                   
                                                                     prior to the bill's                        
                                                                     consideration for                          
                                                                     amendment. Waives                          
                                                                     germaneness and budget act                 
                                                                     points of order as well as                 
                                                                     points of order concerning                 
                                                                     appropriating on a                         
                                                                     legislative bill against                   
                                                                     the committee substitute                   
                                                                     used as base text.                         
H.R. 1058..............  Securities Litigation    H. Res. 105       Restrictive; 8 hr. time cap              1D.
                          Reform Act.                                on amendments; Pre-printing                
                                                                     gets preference; Makes in                  
                                                                     order the Wyden amendment                  
                                                                     and waives germaness                       
                                                                     against it.                                
H.R. 988...............  The Attorney             H. Res. 104       Restrictive; 7 hr. time cap             N/A.
                          Accountability Act of                      on amendments; Pre-printing                
                          1995.                                      gets preference.                           
H.R. 956...............  Product Liability and    H. Res. 109       Restrictive; Makes in order          8D; 7R.
                          Legal Reform Act.                          only 15 germane amendments                 
                                                                     and denies 64 germane                      
                                                                     amendments from being                      
                                                                     considered.                                


                                                                                                                
[[Page H4368]]
           Floor Procedure in the 104th Congress; Compiled by the Rules Committee Democrats--Continued          
----------------------------------------------------------------------------------------------------------------
                                                                       Process used for floor      Amendments in
        Bill No.                  Title            Resolution No.           consideration              order    
----------------------------------------------------------------------------------------------------------------
H.R. 1158..............  Making Emergency         H. Res. 115       Restrictive; Combines                   N/A.
                          Supplemental                               emergency H.R. 1158 &                      
                          Appropriations and                         nonemergency 1159 and                      
                          Rescissions.                               strikes the abortion                       
                                                                     provision; makes in order                  
                                                                     only pre-printed amendments                
                                                                     that include offsets within                
                                                                     the same chapter (deeper                   
                                                                     cuts in programs already                   
                                                                     cut); waives points of                     
                                                                     order against three                        
                                                                     amendments; waives cl 2 of                 
                                                                     rule XXI against the bill,                 
                                                                     cl 2, XXI and cl 7 of rule                 
                                                                     XVI against the substitute;                
                                                                     waives cl 2(e) of rule XXI                 
                                                                     against the amendments in                  
                                                                     the Record; 10 hr time cap                 
                                                                     on amendments. 30 minutes                  
                                                                     debate on each amendment.                  
H.J. Res. 73...........  Term Limits............  H. Res. 116       Restrictive; Makes in order           1D; 3R
                                                                     only 4 amendments                          
                                                                     considered under a ``Queen                 
                                                                     of the Hill'' procedure and                
                                                                     denies 21 germane                          
                                                                     amendments from being                      
                                                                     considered.                                
H.R. 4.................  Welfare Reform.........  H. Res. 119       Restrictive; Makes in order          5D; 26R
                                                                     only 31 perfecting                         
                                                                     amendments and two                         
                                                                     substitutes; Denies 130                    
                                                                     germane amendments from                    
                                                                     being considered; The                      
                                                                     substitutes are to be                      
                                                                     considered under a ``Queen                 
                                                                     of the Hill'' procedure;                   
                                                                     All points of order are                    
                                                                     waived against the                         
                                                                     amendments.                                
H.R. 1271..............  Family Privacy Act.....  H. Res. 125       Open........................             N/A
H.R. 660...............  Housing for Older        H. Res. 126       Open........................             N/A
                          Persons Act.                                                                          
H.R. 1215..............  The Contract With        H. Res. 129       Restrictive; Self Executes                1D
                          America Tax Relief Act                     language that makes tax                    
                          of 1995.                                   cuts contingent on the                     
                                                                     adoption of a balanced                     
                                                                     budget plan and strikes                    
                                                                     section 3006. Makes in                     
                                                                     order only one substitute.                 
                                                                     Waives all points of order                 
                                                                     against the bill,                          
                                                                     substitute made in order as                
                                                                     original text and Gephardt                 
                                                                     substitute.                                
H.R. 483...............  Medicare Select          H. Res. 130       Restrictive; Waives cl                    1D
                          Extension.                                 2(1)(6) of rule XI against                 
                                                                     the bill; makes H.R. 1391                  
                                                                     in order as original text;                 
                                                                     makes in order only the                    
                                                                     Dingell substitute; allows                 
                                                                     Commerce Committee to file                 
                                                                     a report on the bill at any                
                                                                     time.                                      
----------------------------------------------------------------------------------------------------------------
*Contract Bills, 67% restrictive; 33% open. **All legislation, 74% restrictive; 26% open. ****Restrictive rules 
  are those which limit the number of amendments which can be offered, and include so called modified open and  
  modified closed rules as well as completely closed rules and rules providing for consideration in the House as
  opposed to the Committee of the Whole. This definition of restrictive rule is taken from the Republican chart 
  of resolutions reported from the Rules Committee in the 103rd Congress. ****Not included in this chart are    
  three bills which should have been placed on the Suspension Calendar. H.R. 101, H.R. 400, H.R. 440.           

Mr. Speaker, I reserve the balance of my time.
  Ms. PRYCE. Mr. Speaker, I yield 3 minutes to the gentleman from 
Florida [Mr. Goss], a very distinguished member of the Committee on 
Rules.
  (Mr. GOSS asked and was given permission to revise and extend his 
remarks.)
  Mr. GOSS. Mr. Speaker, I rise in support of this very fair, 
structured rule for the consideration of H.R. 1391. This rule balances 
the rights of the minority, with the pressing need to extend the 
extraordinarily popular, and highly effective Medicare Select Program. 
Seniors in my home State of Florida have benefited greatly from this 
pilot program. Currently, more than 50,000 Medicare enrollees in 
Florida have voluntarily chosen to purchase one of these unique 
MediGap-PPO products--a product that helps fill the gap between what 
health care actually costs and what Medicare will pay. Often this is a 
substantial gap that has placed seniors in tough financial straits. On 
the whole, Medicare select enrollees in Florida enjoy supplemental 
premium costs that are about 25 percent lower than traditional 
indemnity products. To seniors living on fixed incomes, this type of 
insurance savings can make the crucial difference between barely 
surviving and maintaining a certain level of quality of life. In some 
cases, it can mean the difference between having supplemental coverage 
for such costly things as prescription drugs or not. Seniors I have 
talked to appreciate the simplified billing process that a Medicare 
select policy offers--they do not have to front the cost of care and 
then file two separate claims to seek reimbursement. In most cases, 
under this program, all out-of-pocket costs are determined
 and paid at the time of service. While some have expressed concerns 
about the quality of care provided through these plans, seniors in 
Florida have consistently expressed very high rates of satisfaction 
with the care they have received. This has been demonstrated most 
convincingly by the fact that more than 90 percent of enrollees retain 
their policies--even though they could choose another Medigap option at 
any time. Mr. Speaker, in order to ensure that the hundreds of 
thousands of current Medicare select enrollees maintain the benefits of 
this program, the Congress must act expeditiously. The program is set 
to expire on June 30. And without assurances that the law will be 
extended, insurers will have to begin to notify enrollees of their 
plan's pending termination. By passing this rule, and H.R. 1391 today, 
we will not only ensure that current beneficiaries maintain coverage, 
but we will make it possible for seniors in an additional 35 States to 
enjoy the benefits of this program. By extending the Medicare Select 
Program to the rest of the country, we will reaffirm our commitment to 
giving seniors more choices in Medicare--and provide them with more 
opportunities to reduce their health care costs. I urge adoption of 
this rule and the bill.

  Mr. MOAKLEY. Mr. Speaker, I yield 7 minutes to the gentleman from 
Michigan [Mr. Dingell], the ranking member of the committee.
                              {time}  1400

  Mr. DINGELL. Mr. Speaker, let me thank the distinguished gentleman 
from Massachusetts for yielding this time to me.
  Mr. Speaker, this is a gag rule pure and simple. It is not needed at 
this particular time. There is plenty of time to deal with this 
legislation. If we pass this legislation tomorrow or today, the other 
body will not be able to move on it until after they come back. If we 
pass it the day after we come back from the recess, the other body can 
still consider the legislation within sufficient time to meet the June 
30 deadline.
  Mr. Speaker, I rise in opposition, and I say this with great respect 
for my good friend, the chairman of the Committee on Rules, the 
gentleman from New York, who has given us another gag rule.
  I also object to the extraordinary way in which this bill was brought 
to the floor and the way in which the minority's rights have been 
trampled. There are two rules that have been dealt with unfavorably: 
One is the 3-day requirement with regard to the minority having 
opportunity to file minority views, and the other is a provision which 
requires a 3-day layover. Neither of these needs to be waived at this 
time.
  This is a closed rule. It is an unfair rule. It is a restrictive 
rule. It prevents Members from offering amendments other than one 
substitute that requires any and all amendments to be packaged into 
one, regardless of whether they are consistent with each other. It 
simply imposes on the Congress a requirement that we legislate poorly 
without adequate opportunity for debate or proper discussion on a piece 
of legislation which is relatively unimportant and on which there is no 
great need for haste.
  There is absolutely no justification for this closed rule. Even the 
justification suggested by my colleagues in the majority collapse on 
close scrutiny.
  My friend, the gentlewoman from Connecticut [Mrs. Johnson], has 
suggested at the Rules Committee that a closed rule shutting off 
individual amendments is appropriate because she disagrees with the 
substance of the amendments. It is my view those kind of amendments 
should be a matter of decision by the House and not by the Committee on 
Rules, and certainly not by one Member alone.
  An open rule would have afforded my colleagues the opportunity to 
argue why amendments should be passed or defeated. The gentlewoman from 
Connecticut has suggested that matters on which the Members disagree 
should not be put before the Members for their consideration. That 
seems to indicate we should make this body more like the Russian Duma 
or perhaps the Reichstag and that disagreement over facts and policy 
are not appropriate for Members on the House floor.
  The gentlewoman has also suggested that a closed rule was justified 
because the amendments the minority was contemplating were too narrow 
in scope and should apply to a broader series of insurance policies. 
Ironically, her bill was narrowed by the Republicans in the Committee 
on Ways and Means precisely for the purpose of preventing the 
[[Page H4369]] offering of germane amendments that were broader.
  The bill brought before the Committee on Commerce was similarly 
narrowed to just this one class of policy. We heard in the Rules 
Committee that a closed rule might be justified by the fact that the 
Commerce Committee markup involved a discrete number of amendments and 
took only 2 hours to complete. That sounds like a bill uniquely suited 
and qualified for a completely open rule. It would not burden Members 
with too many votes or too much debate time.
  Given the relatively small number of issues and the limited time they 
might occupy, we are here witnessing a rule that has been closed 
gratuitously.
  Finally, it was suggested in the Rules Committee that a closed rule 
was in order because this bill was reported out by the Ways and Means 
Committee by a large margin.
  Leaving aside the fact that amendments in the Commerce Committee lost 
by narrow margins, has the measure for whether minority rights should 
be protected become the number of people in the minority?
  We have heard a lot about how a closed rule was necessary because 
this legislation is urgent. Nothing could be further from the truth. 
Indeed the minority has not been in any way uncooperative in bringing 
this legislation to floor. Nor did we in any way delay the 
consideration of the legislation in either of the two committees.
  Even if this legislation were urgent, and it is not, does it mean 
that debate must be stifled? We managed to debate quite fully the 
resolution on the Gulf war, and that matter had real urgency and was 
not so limited, in fact, by time.
  But the fact is this bill is not urgently needed. Arguments about the 
legal need for notification of insurers and policyholders are wrong and 
are being used to alarm senior citizens unnecessarily so that some 
insurers who might cut a fat hog off this program might scare off any 
opposition to it. The 15-State demonstration project does not expire 
until the end of June, and I have not heard of a single Member who 
objects to the extension of that particular program.
  But what is really curious here is how the proponents of this rule 
are using the expiration of a program in 15 States, 3 months from now, 
3 months from now, to justify urgent expansion of this experiment to 
the other 35 States.
  This is like rushing through a bill that gives flood relief not only 
to California but the other 49 States and arguing that it is urgent.
  A further sign that these arguments are phony is the lack of urgency 
felt in the other body. There is no indication that body will act 
before the recess. There has not even been a committee markup there.
  In addition to being unduly restrictive, this rule comes to the floor 
under an exceptional and highly objectionable procedure. The committee 
report has not been filed. Indeed the Rules Committee met last night 
without having a committee report before it. The minority has not had 
its full 3 days to prepare its views. In fact, the rule contains a most 
extraordinary provision permitting the committee to file its report at 
any time. Are we beginning a process whereby the committees will not 
have to file their reports until after bills are passed?
  The rule also waives the 3-day layover. These are rights which have 
always been considered sacrosanct, and whenever any attempt was made to 
control them on the part of the Democrats when we controlled this body, 
there was enormous outrage expressed by our colleagues on the 
Republican side.
  Finally, the rule is objectionable because it makes in order a bill 
that no committee has reported out. It purports to be a compromise 
between Commerce and the Ways and Means Committees, but there was no 
consultation whatsoever that took place between the majority and 
minority. Therefore, it is not a compromise.
  Furthermore, the Ways and Means Committee would not even be 
represented on the floor under this closed rule.
  I urge my colleagues to reject this rule, I urge my colleagues to let 
us consider the matter in a more deliberate and appropriate fashion. 
There is no need for haste. We have not been delaying the matter. I 
believe that in protecting the rights of the minority, the rights of 
all Americans are protected as opposed to just some select few in the 
insurance industry.
  Ms. PRYCE. Mr. Speaker, I yield 5 minutes to the gentlewoman from the 
State of Connecticut [Mrs. Johnson], who has done so much hard work on 
this issue.
  Mrs. JOHNSON of Connecticut. Mr. Chairman, I rise in support of this 
rule permitting us to vote an extension and expansion of Medicare 
Select. I urge my colleagues to support making these health insurance 
plans, which Consumer Reports has rated so highly, available to seniors 
in all 50 States.
  I support this rule because it allows us to get to the central issue, 
preserving a low-cost, high-quality insurance option for seniors while 
not allowing requirements to be imposed on a single Medigap policy that 
cannot under this bill be imposed on all MediGap policies in the 
market.
  Mr. Speaker, it is important that we not add requirements to Medicare 
Select that would treat these plans differently from other MediGap 
prices. During each committee's markup, amendments were defeated 
because they would have required select plans to offer benefits, plan 
options and rates that would not apply to other Medigap policies.
  The time to address these issues is when we make changes to all 
Medigap plans. Otherwise, Medicare Select plans would operate on an 
unlevel playing field and at a competitive disadvantage, eroding the 
savings seniors now enjoy by choosing these plans.
  The Ways and Means Committee approved extension and expansion of the 
select program with a very bipartisan vote of 31 to 2. The Commerce 
Committee reported its legislation by voice vote.
  My esteemed colleague, the gentleman from Michigan [Mr. Dingell], 
agrees that this bill has broad bipartisan support.
  If Congress does not act to extend this program this week, nearly a 
half-million seniors risk losing low-cost MediGap coverage. Companies 
offering these policies need to begin making plans now to prepare 
providers and beneficiaries about the future of their program.
  Medicare Select is a MediGap policy--covering costs and services that 
Medicare does not. The difference is that select enrollees get their 
care from a preferred provider organization. Enrollees are still 
Medicare beneficiaries: Medicare will cover their health care costs 
even if they go outside the health network. By staying within the 
network, beneficiaries make the best use of their coverage because the 
health plan picks up most or all of their out-of-pocket costs.
  Medicare Select is not a Medicare HMO/risk-contracting plan. Such 
plans require Medicare beneficiaries to obtain their care entirely 
within the network, or Medicare won't pay. With select, beneficiaries 
can still get Medicare to cover their charges even if they go outside 
the network, and in cases of emergency, the plan will reimburse charges 
in full.
  Medicare Select saves beneficiaries money. Seniors on fixed incomes 
can save from 9 to 38 percent on the cost of their MediGap premium--up 
to $300 a year.
  Mr. Speaker, Medicare Select is not a Government program. Medicare 
Select is a MediGap insurance policy and regulated at the Federal and 
State levels just as all such policies are.
  Mr. Speaker, it operates around Medicare requirements. But it has 
indirect benefits to Medicare, however, because enrollees are using 
health providers within an integrated delivery system. Thus, 
inappropriate utilization of medical services is avoided. A California 
select plan found that the cost of medical services per admission for 
network providers was 20 percent lower than for non-network providers. 
In addition, the average length of stay for network providers was 50 
percent lower than for non-network providers.
  I urge my colleagues to support this rule and support the extension 
of Medicare Select to all States before we adjourn.
  Mr. MOAKLEY. Mr. Speaker, I yield 7 minutes to the gentleman from 
California [Mr. Stark], the ranking minority member of the 
subcommittee.
  [[Page H4370]] Mr. STARK. I thank the gentleman for yielding this 
time to me.
  Mr. Speaker, I just wanted to remind my colleagues that Medicare is 
the finest health insurance program in the country. It is the only 
functional health insurance system in the country, and universal 
coverage is guaranteed. More than 99 percent of the Americans over 65 
are covered. No private insurance company will even offer insurance to 
people in that age group.
  There is no insurance plan in the country that offers beneficiaries a 
higher, more broader choice of high-quality, affordable health 
insurance than does Medicare.
  The success of this program, although it may rankle those who cannot 
stand to see the Federal Government do anything well, is, in large 
part, due to the willingness of prior Congresses to provide choice to 
beneficiaries or at the same time putting in the extra effort to 
guarantee to those beneficiaries that this range of choices will not be 
hazardous to their health.
  Strong beneficiary protections are vital to the well-being of the 
seniors of our country.
  I might remind the gentlewoman from Connecticut that she misspoke. 
There are no Federal regulations on Medicare select, none whatsoever. 
Therein might be the modest suggestion that many of us would have for 
improving this experiment and guaranteeing that it does not become 
subject to the same avaricious group, like Prudential Insurance, who 
have been fined $300 million for stealing billions from senior 
citizens.
  I am not sure those are the people I want to run my mother's health 
care plan under Medicare select, and there would be nothing to stop 
them from stealing under this plan if Prudential chose to run one.
  There are many other questions about the program, questions about the 
use of attained-age premiums, the bait-and-switch policy that some 
insurance companies use, selling a lowball premium to somebody when 
they turn 65 only to see that premium double and triple when they get 
to the delicate age of 67 or 68 or 80, where they can no longer afford 
it and see their premiums doubled and tripled.
  There is no protection against that. Questions about the 
comparability of Medicare select products with other MediGap products, 
so that unscrupulous insurance salesmen do not unnecessarily confuse 
and cancel insurance for senior citizens.
  The seniors deserve some protection there against those few 
unscrupulous sales people.
  Last but not least, questions about the effect of these products on 
the Medicare expenditures, the trust fund which my Republican 
colleagues are so concerned about as they continue to break the trust 
fund with their capricious tax cuts, it is a fact that this has not 
saved Medicare any money at all and may indeed cost extra money. Those 
things should be looked at.
  It seems to me that some modest protections--even the gentlewoman 
from Connecticut, in her original bill, had a few protections in her 
bill which were stripped out when the bill was presented to the 
Committee on Ways and Means.
                              {time}  1415

  These questions deserve answers, and I would ask the gentlewoman who 
is managing the bill for the majority what is the hurry. I do not know. 
If we pass this today or tomorrow, is there a reason that this bill 
must pass tomorrow or today?
  Ms. PRYCE. Mr. Speaker, will the gentleman yield?
  Mr. STARK. I yield to the gentlewoman from Ohio.
  Ms. PRYCE. We would like to get this to the Senate as soon as 
possible. Their pace is much different than ours. They are coming back 
a week before we are, so they can get a jump on it and get moving on 
it. This does expire in June, and we would like to see this extended.
  Mr. STARK. I am reliably informed they do not intend to take it up, 
but, other than that, it can lay over there as well as lay here. That 
could well be. We still have until the end of June, and, as I say, why 
are we bringing it up today? I mean, if it is such urgency, I do not 
know because it seems to me we are bringing it up without the 
responsible procedure of seeing whether the bill is indeed any good. A 
closed rule does not permit any changes, and, except in some of the tax 
bills, I do not know what this urge, this rush, to judgment. If it is 
so good, why would it not stand the scrutiny of some discussion? I 
really do not--have no understanding of that, and I have heard precious 
little response from the majority side as to what they are scared of. 
What is it they are afraid of that will be offered?
  I am puzzled. I begin to--I would not say smell a rat--but why we 
would rush to jam this down the throats of unsuspecting seniors? My 
mother is perfectly happy right now with Blue Cross, and she has got 
Aetna--or she has got AARP's MediGap. Why? She is happy.
  Mr. BILBRAY. Mr. Speaker, will the gentleman yield?
  Mr. STARK. I yield to the gentleman from California.
  Mr. BILBRAY. Let me say, as somebody who has had to work with this 
population from a county service point of view, the inconsistency of 
not letting them know as soon as humanly possible what their options 
are and if this program will be available, and, as somebody who 
administered Federal programs, as my colleague knows, his side of the 
aisle again and again--
  Mr. STARK. If I could reclaim my time to just explain to the 
gentleman that those people who are in the plan cannot be canceled even 
if we do not pass this. They are guaranteed to stay in. The only thing 
it would prevent is those insurance salesmen from selling new plans for 
perhaps a day or a week, it we miss the goal.
  Mr. BILBRAY. Mr. Speaker, will the gentleman yield?
  Mr. STARK. I yield to the gentleman from California.
  Mr. BILBRAY. I say to the gentleman, ``But their premiums can be 
raised, and you tell a senior that it's no problem. You just pay more, 
and you won't know what that is in the future. We try to lay a defined 
course for these people. They have enough insecurity. They don't need 
us playing games back and forth, and you, more than anybody else, knows 
that you try to send messages that we pre-warn citizens of a changing 
situation as much as humanly possible.''
  Mr. STARK. If I can reclaim and explain to the gentleman. The 
premiums under the current law cannot be raised during the middle of 
the year so that there, first, is no danger that existing beneficiaries 
under these plans would have their premiums raised until the end of 
their policy year; and, second, there would be no restrictions on their 
being able to maintain their policies. It is just that the salesmen, 
admittedly, and it may hurt the insurance salesmen because they earn 
their living doing this. I would just suggest that it is risky business 
dealing with the fragile elderly who are easily confused, and I say 
that Democrat elderly are as confused as Republican elderly. We ought 
to be able to protect them through the process.
  Ms. PRYCE. Mr. Speaker, I yield 5 minutes to the gentleman from 
California [Mr. Thomas], who has done a lot of work in this area and 
can speak to many of the concerns just raised.
  (Mr. THOMAS asked and was given permission to revise and extend his 
remarks.)
  Mr. THOMAS. Mr. Speaker, I would tell the gentleman from California, 
my friend and colleague who is a freshman, that at the beginning of the 
104th Congress it was my privilege to follow the gentleman from 
California [Mr. Stark] as the chairman of the Health Subcommittee of 
the Committee on Ways and Means. What he probably does not realize is 
that this program was supposed to be a permanent program back in 1990. 
It moved through the Congress as a permanent program. At the 11th hour, 
behind closed doors, with pulled curtains, they made it a demonstration 
program. This whining about, gee, what is the delay--I will not yield--
the delay is in the gentleman's lap completely.
  It took us until 11:30 at night the last day of the 103d Congress to 
extend this program.
  I loved the gentleman from Michigan asking what is the problem. We 
have plenty of time to move legislation. At 1:30 a.m. the Senate acted 
to extend this program. Why do they not want to move forward? They want 
to see the 
[[Page H4371]] program dead; that is why. All of these crocodile tears 
about seniors. What they are scared to death about is that this one 
little choice program among 10 other MediGap policies will show, by 
people choosing it, that managed care is a better way to go in the 
Medicare Program. They cannot stand one chink in the armor of the old-
fashioned fee-for-service system to be tested at all.
  Now we moved this bill through the Committee on Ways and Means on 
March 8. The first week in March we moved this bill.
  How many members of the Committee on Ways and Means opposed this? 
Two. There is one of them. He convinced one other member to oppose 
making this permanent. The gentleman from Florida [Mr. Gibbons], a 
senior himself representing a number of seniors, he is for it. The 
gentleman from California [Mr. Matsui], outspoken in terms of the 
protection of seniors' rights, he voted for it. Thirty-one members of 
the Committee on Ways and Means said, ``You're right. This program 
should be made permanent.''
  What is the rush? There are only about 18 legislative days between 
now and when this program expires. They want to take all the time in 
the world.
  This objection about rights under this rule? ``How many times, when 
you were the majority, did you not even give us the right to 
recommit?''
  I say to my colleagues, ``You've got two bites at the apple. You can 
offer your own substitute, and then you can have the motion to 
recommit. You can change it twice. You've got an opportunity to 
convince folks that making it permanent is wrong. You couldn't convince 
the Commerce Committee. You could only convince two members of the Ways 
and Means Committee.''
  The idea that we did not give them 3 days to examine this rule? 
Notice carefully he said we are violating the 3-day rule, not on the 
bill, but on the rule itself. Those folks need 3 days to study a two-
paragraph rule? I say to my colleagues, ``You've got your full 3 days 
guaranteed to the minority on the bill.''
  Now, finally, what I consider absolutely egregious and outrageous, 
for the gentleman from California to stand up and say that the 
gentlewoman from Connecticut is wrong about Federal protections on this 
program. She said there were some; he said there were none.
  I would invite the gentleman's attention to the Federal Register, 
August 21, 1992, beginning on page 37993, which is section 10, Medicare 
Select Policies
 and Certificates. This section shall apply to Medicare select policies 
and certificates, and on, and on, and on, page, after page, after page 
of a Federal structuring that is to be followed by the States to make 
sure that the seniors are protected in this program area.

  This rule is a good rule, it is a fair rule, it is an appropriate 
rule, it is a timely rule. We will pass this rule, and then, more 
importantly, we will finally being to move permanently, Medicare 
select.
  The seniors deserve a choice. These detractors continue to try to 
stand in the way, and we will not let them.
  Mr. MOAKLEY. Mr. Speaker, I yield 5 minutes to the gentleman from 
California [Mr. Waxman] who is the ranking member of the committee.
  (Mr. WAXMAN asked and was given permission to revise and extend his 
remarks.)
  Mr. STARK. Mr. Speaker, will the gentleman yield?
  Mr. WAXMAN. I yield to the gentleman from California.
  Mr. STARK. I just wanted to correct the misstatements of the previous 
speaker.
  On March 8 the committee report indicates that the gentleman from 
Florida [Mr. Gibbons] did not vote. As a practical matter, he was out 
sick on that day and did not vote on this bill either way.
  Second, the House of Representatives has never considered Medicare 
select in its deliberations. It was added about the Senators in a 
conference and never considered in the House of Representatives, and I 
stand by the statement that there are no Federal regulations covering 
it.
  Mr. WAXMAN. Mr. Speaker, I thank the gentleman from California [Mr. 
Stark] for that clarification.
  I must say I am absolutely astounded by the comments of the gentleman 
from California [Mr. Thomas] a minute or two ago on the House floor. He 
seems to ignore the whole history of this proposal and then 
mischaracterizes what is at issue today.
  The Medicare Program pays for the beneficiaries to go to the doctors 
and the hospitals of their choice and pays most of those costs, but 
there are costs that have to be incurred by the elderly. For that 
people go out and buy MediGap supplemental insurance policies.
  There are a lot of anticonsumer practices in the sale of these 
policies, so in 1990 the Congress said the insurance commissioner 
should set up a uniform benefit package for MediGap so people can 
compare one policy to another. People were being sold MediGap policies 
to cover things that were already covered under Medicare. They were 
paying for coverage that they already had. The consumers were being 
ripped off.
  So these policies were established, 10 different packages.
  At the same time the Congress moved to allow people to go into HMO's 
and have their coverage through a health maintenance organization. 
Medicare select came out as a sort of different kind of policy, not an 
HMO, but not a complete choice of doctors and hospitals for the 
Medicare beneficiary. The Medicare select said that, if a senior would 
sign up, they could go to the doctors on the panel. If they went 
outside the panel, they had to pay for it. Their MediGap policy would 
only cover the doctors on the panel, to supplement the Medicare 
payments to them. It is like a preferred provider organization, and it 
was established as an experiment because it was the only MediGap policy 
being sold that did not give the consumer the free choice of doctors 
and other health providers.
  Many consumers have found this very appealing. It has been an 
experiment in a number of States, and that experiment is up. But before 
the experiment is up, we have not had the analysis yet of how well it 
has done, but from those of us who have followed it, like in my own 
State of California, I think it has been a choice for consumers that 
has been well worth while.
  The bill before us would make it available in all 50 States. In my 
opinion that may be premature, but I have no serious problem with 
allowing Medicare select policies in 50 States. But there are two 
problems that we should address. One is if someone goes into a Medicare 
select panel, and they do not like the doctors, and they do not feel 
they are being treated well in this kind of hybrid MediGap policy. They 
should be permitted to leave and go to another MediGap coverage policy 
that would give them the choice of doctors.
  One of the amendments that was offered in the Committee on Commerce 
by a Republican Member, a doctor, the gentleman from Iowa [Mr. 
Ganske]--he offered, and I supported, many of our Members supported, 
the ability of people, if they did not like their Medicare select 
policy, to be able to have a choice of another MediGap policy. They 
might not have this choice, they might not have it because they passed 
up the opportunity for another policy if they signed up on Medicare 
select. So we wanted to say, if Medicare select were going to be made 
available in all 50 States, they ought to make sure the consumers have 
a choice to opt out. That is a very important consumer protection.
  One would think from what the gentleman from California [Mr. Thomas] 
had to say it was not even an issue, but that is what we are talking 
about in this rule because that amendment would not even be permitted 
to be offered as a separate amendment on the House floor when this bill 
is presented.
  A second issue:
  If people are in a MediGap policy, they could have a fairly low rate 
when they start, but there is nothing to restrict the insurance 
companies as they get older and sicker from moving up the rate of that 
MediGap policy cost.
                              {time}  1430

  That seems to be a real troublesome area, where consumers can be 
taken advantage of. And if they are priced out of their ability to buy 
that Medigap policy, because they have attained a higher age and 
therefore can have a higher premium imposed upon them, the consumers 
may be priced out 
[[Page H4372]] of the ability to get any Medigap coverage. So we wanted 
to have an amendment on that issue.
  The Committee on Rules offered a rule that we are now considering 
that will not even give us that opportunity to offer those amendments. 
We have to tie them all together in a substitute amendment, but not be 
able to offer these two distinct amendments. That is what our objection 
to this rule is all about. It is not that we do not want to have 
Medicare Select policies. It is that we do not want them marked in a 
way where the consumers can be disadvantaged.
  Now, the rule is an unfair rule and it has been hastily put together. 
The bill was marked up in our committee, the Committee on Energy and 
Commerce, Monday evening, and we offered those two separate amendments 
that we are not going to be permitted to offer. The rule now before us 
not only would not allow these two amendments to be offered, it waives 
the usual 3-day layover period and it would permit the bill to be 
brought up even though a committee report with dissenting views has not 
been filed, as far as I know, by the Committee on Energy and Commerce.
  I think that we ought to have an opportunity to debate these issues 
when the bill comes up. Some of us will support the bill, to allow 
Medicare Select as an option. But they should not have Medicare Select 
as an option that freezes people into a panel of doctors which may not 
be satisfactory to them and not allow them then to get another Medigap 
policy.
  So I would urge opposition to this resolution, to allow us the 
opportunity to argue these separate issues, to protect the elderly 
consumers in this country from unscrupulous insurance practices when 
they go out to get their Medigap policy.
  Mr. Speaker, I urge a ``no'' vote on the rule.
  Ms. PRYCE. Mr. Speaker, it is my pleasure to yield 4 minutes to the 
distinguished Chair of the Subcommittee on Health and Environment of 
the Committee on Commerce, the gentleman from Florida [Mr. Bilirakis].
  Mr. BILIRAKIS. Mr. Speaker, I thank the gentlewoman for yielding time 
to me.
  Mr. Speaker, I rise in support of the rule providing for the 
consideration of legislation to extend the current Medicare Select 
Program which is scheduled to expire in June.
  On January 11, 1995, our colleague, the gentlewoman from Connecticut, 
introduced H.R. 483, a bill to amend title 18 of the Social Security 
Act to permit Medicare Select policies to be offered in all States, and 
for other purposes. That bill was referred to the Committee on Commerce 
as the committee of primary jurisdiction and in addition, to the 
Committee on Ways and Means.
  On February 15, 1995, our Health and Environment Subcommittee held an 
oversight hearing on Medicare Select and issues related to Medicare 
managed care. On March 22, 1995, the subcommittee met and marked up 
H.R. 483 and approved the bill for full committee consideration, as 
amended, by a voice vote. On Monday, April 3, 1995, the full Commerce 
Committee met and ordered H.R. 483 reported to the House, as amended, 
by a voice vote, a quorum being present.
  As ordered reported by the Commerce Committee, H.R. 483 would extend 
the Medicare Select Program for an additional 5 years and expand the 
coverage to include all 50 States in order to continue in an improved 
way the demonstration project, which is really what we are trying to 
do.
  The Committee on Ways and Means also completed action on H.R. 483, 
and reported a different version of the legislation to the House. The 
Ways and Means Committee version of the bill extends the Medicare 
Select Program to all 50 States on a permanent basis.
  Since the time that both committees completed action on H.R. 483, the 
committees have met and have developed a consensus bill, H.R. 1391, 
which was introduced in the House on April 4. This rule makes in order 
the text of H.R. 1391.
  The bill to be considered would extend the Medicare Select Program 
for a 5-year period and expands the coverage to all 50 States.
  The bill would also require the Secretary of the Department of Health 
and Human Services to conduct a study comparing the health care costs, 
quality of care, and access to services under Medicare select policies 
with other Medigap policies. This study must be completed by the end of 
1998. Based on the results of this study, the Secretary must make a 
determination that the Medicare Select Program is permanent unless the 
study finds that, first, Medicare select has not resulted in savings to 
Medicare select enrollees, second, it has led to significant 
expenditures in the Medicare Program, or third, it has significantly 
diminished access to and quality of care.
  I think this bill provides for a reasonable balance that will permit 
a valuable and innovative program for our senior citizens to be 
continued while permitting a more informed evaluation of the program. 
We must remember that Medicare select is a Medigap insurance policy 
which provides seniors with another option to receive medical care. By 
giving the elderly more choices within Medigap, we give them the option 
to pick plans which meet their individual needs.
  Mr. Speaker, I urge adoption of this rule that will provide for 
consideration of this important legislation.
  Mr. MOAKLEY. Mr. Speaker, I yield 4 minutes to the gentleman from 
Oregon [Mr. Wyden].
  (Mr. WYDEN asked and was given permission to revise and extend his 
remarks.)
  Mr. WYDEN. Mr. Speaker, I rise in opposition to the rule, and 
specifically would like to address the comment that the gentleman from 
California [Mr. Thomas] made earlier about the views that somehow 
Democrats are a little bit frightened of managed care or skeptical of 
its benefits.
  I come from an area with one of the highest concentrations of 
Medicare and managed care in our country, and we know that there can be 
good managed Medicare. But in our programs, there is real choice. There 
are real options. And that is why we are concerned about this rule, 
because we think it takes away needed options from senior citizens.
  Frankly, because I believe that when we come back the other side will 
be proposing major cuts in Medicare that are going to take additional 
choices and options away from seniors, I think it is very important 
that in Medicare select we build in some more choices and some more 
consumer protections.
  For example, my friends on the other side are not worried about 
attained age pricing in their bill. What that means is that the prices 
the senior citizens pay go up with the age of the older person. A lot 
of these older people have no idea about the rate hikes
 that are going to hit them with Medicare select.

  We hear that seniors are happy at this point about Medicare select. 
Of course they are, because the product is new. A lot of these older 
people may have only had it for 18 months. They got a statement, maybe 
a disclosure form, that said there was going to be attained age 
pricing. It did not prepare them for the rate shock that is coming.
  Let us vote against this rule, let us fashion an alternative, that 
provides real choice to older people. Let us offer an alternative that 
protects senior citizens against draconian rate hikes.
  Mr. Speaker, I urge my colleagues to vote against this rule, and then 
fashion a bipartisan program that will protect the rights of older 
people in our country.
  Ms. PRYCE. Mr. Speaker, I yield 2 minutes to the gentleman from 
California [Mr. Bilbray], a distinguished new Member who has much 
experience.
  Mr. BILBRAY. Mr. Speaker, let me just say as somebody who is new on 
the block, but has been involved in many programs that have been 
mandated, allowed, and pursued by the Federal Government, one of the 
greatest frustrations a constituency in America has is when Washington 
starts sending mixed signals and then waits for the last minute to give 
a go-ahead. The inconsistency of the political process in Congress is 
always frustrating for the constituents out in real world America. They 
watch us in the House and they watch the Senate with their faster than 
light process of coming to a conclusion to let America know what the 
rules are that they are going to be able to live by.
  Well, I strongly support this proposal, because I think we need to 
send a clear message to our seniors, not only in California where we 
have over 100,000 seniors that have made this 
[[Page H4373]] choice, Mr. Speaker, but also many other States where 
this opportunity is needed.
  Mr. Speaker, I know there are those who fear the MediGap concept. I 
know there are those who want to defend to their dying day the fee for 
service, even if it means denying an alternative to fee for service to 
our seniors.
  Mr. Speaker, I strongly urge my colleagues, not as just a Member of 
Congress, but as somebody who has not so long ago been a consumer of 
the products that come out of Congress, let us send that clear message 
as quick as possible, let us make sure the consumer knows what the 
rules are, and let Congress get its job done in time so the seniors 
know the rules that they are going to be expected to play by.
  Mr. MOAKLEY. Mr. Speaker, I yield 1 minute to the gentleman from 
California [Mr. Stark].
  Mr. STARK. Mr. Speaker, may I engage the gentlewoman from Ohio [Ms. 
Pryce] in a colloquy for a moment.
  Mr. Speaker, I gather that the majority feels that we should move 
ahead rapidly with this bill, and I begin to sense that we are not 
going to have any opportunity to amend it.
  Ms. PRYCE. Mr. Chairman, will the gentleman yield?
  Mr. STARK. I yield to the gentlewoman from Ohio.
  Ms. PRYCE. Mr. Speaker, I disagree with the gentleman. There are two 
opportunities.
  Mr. STARK. Mr. Speaker, the gentlewoman from Ohio is correct. I am 
sure we are not making many friends with all this, but this is one of 
the things we might do to accommodate many of our colleagues who might 
like to end the 100 days sooner: Is there any reason in the rule that 
the bill could not be considered this afternoon?
  Ms. PRYCE. Mr. Speaker, if the gentleman will yield further, It is my 
understanding we are protecting the rights of the minority.
  Mr. STARK. Mr. Speaker, I am about to suggest, if the minority would 
be willing to accept unanimous consent, that the bill be considered 
today, so in a matter of comity we are prepared and would be happy to 
proceed, and I am sure we would make a lot of friends.
  Mr. Speaker, I do not believe unanimous consent is necessary, but I 
ask unanimous consent that the bill be considered today.
  Mr. SOLOMON. Mr. Speaker, I reserve the right to object.
  The SPEAKER pro tempore (Mr. Hobson). The gentleman from California 
[Mr. Stark] was not recognized for the purpose of making a unanimous-
consent request. The unanimous consent request is not entertained.
  Mr. SOLOMON. Mr. Speaker, If the gentleman would yield, let me just 
say to the gentleman, as the gentleman from Massachusetts [Mr. Moakley] 
has said, we did defend the minority's rights. We wanted to give 3 days 
for the minority's views. I always insisted on it when I was in the 
minority. You have just filed your minority views, and we have Members 
on this side of the aisle that would like to have time to look at your 
minority views. We value your views, seriously.
  Mr. MOAKLEY. Mr. Speaker, I yield 1 minute to the gentleman from 
Michigan [Mr. Dingell].
  Mr. DINGELL. Mr. Speaker, I understand that my views on this matter 
have created vast distress on the part of my Republican colleagues. 
They are very easily distressed, and this pains me. For the help of my 
colleagues on that side, I would say I do not mind bringing the bill up 
today or tomorrow. If the leadership on that side wants to do it, they 
can do it. They have been quite wanton in disregard of the rights of 
the minority and in disregard of the rules, and I see no reason why I 
would object to further practices of that sort at this time.
  So if the leadership on the other side wants to bring this bill up, 
they control this place. I would suggest that they should commence 
doing so forthwith, and then we will hear less complaining on the 
Republican side about how this side, in insisting on the orderly 
conduct of the business of the House and the proper conduct of the 
business and protection of the rights of the minority, is delaying the 
conduct of the business of the House, which we in fact are not doing.
  The bill is going to be passed. It needs to be perfected. It will not 
be passed as perfected because the Republicans will not participate in 
the perfection of it by eliminating two very significant problems, 
which the amendments to be offered by this side would perfect.

                              {time}  1445

  Mr. MOAKLEY. Mr. Speaker, I have no further requests for time, and I 
yield back the balance of my time.
  Ms. PRYCE. Mr. Speaker, I yield 30 seconds to the gentleman from 
California [Mr. Thomas].
  Mr. THOMAS. Mr. Chairman, I thank the gentlewoman for yielding time 
to me.
  I do have to compliment the minority. I thought perhaps they were not 
learning to become the minority quite as quickly as we had hoped they 
would. But what we have just heard on the part of the minority is an 
absolute denouncement of the rule because it denies them the privileges 
of the minority on the 3-day rule. And then less then 20 minutes later, 
standing up and deciding, maybe they really did not want that 3-day 
period.
  They talked about the fact that this does not need to be rushed 
through at all. And then less than an hour later, gee, we might as well 
expedite the business of the House.
  I compliment them that both sides of the mouth is working well.
  Mrs. COLLINS of Illinois. Mr. Speaker, I rise in opposition to the 
closed rule on HR. 483, the Expanded Use of Medicare Select Policies 
Act that would extend the Medicare Select demonstration program that 
currently exists in my State of Illinois and 14 other States and would 
allow all 50 States to participate.
  Once again, despite the promises and pledges by the Republicans to 
allow open debate on the House floor, we are being forced to accept a 
closed rule that only permits one amendment to be considered. Several 
germane amendments that were submitted for consideration have been 
rejected outright with no explanation given. Yet again, free debate is 
stifled by this rule that permits only 1 hour of debate. Mr. Speaker, 
this is clearly not sufficient time for the two committees of 
jurisdiction to debate the bill and the substitute to be discussed.
  As we have seen since the 104th Congress first convened in January, 
the Republicans talk a good talk. They pledge their dedication to free 
and open debate, they declare how committed they are to the open rule 
process and yet, once again, we are being bound and gagged with a 
closed rule for no apparent reason. We are forced to race through the 
debate at top speed with no chance to truly discuss or debate the 
important bill before us.
  I intend to oppose this rule and I urge my colleagues to do the same.
  Ms. PRYCE. Mr. Speaker, I yield back the balance of my time, and I 
move the previous question on the resolution.
  The previous question was ordered.
  The SPEAKER pro tempore (Mr. Hobson). The question is on the 
resolution.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. MOAKLEY. Mr. Speaker, I object to the vote on the ground that a 
quorum is not present and make the point of order that a quorum is not 
present.
  The SPEAKER pro tempore. Evidently a quorum is not present.
  The Sergeant at Arms will notify absent Members.
  The vote was taken by electronic device, and there were--yeas 253, 
nays 172, not voting 9, as follows:

                             [Roll No. 298]

                               YEAS--253

     Allard
     Armey
     Bachus
     Baker (CA)
     Baker (LA)
     Ballenger
     Barr
     Barrett (NE)
     Bartlett
     Barton
     Bass
     Bateman
     Bereuter
     Bevill
     Bilbray
     Bilirakis
     Bliley
     Blute
     Boehlert
     Boehner
     Bonilla
     Bono
     Borski
     Brewster
     Brownback
     Bryant (TN)
     Bunn
     Bunning
     Burr
     Burton
     Buyer
     Callahan
     Calvert
     Camp
     Canady
     Castle
     Chabot
     Chambliss
     Chenoweth
     Christensen
     Chrysler
     Clinger
     Coble
     Coburn
     Collins (GA)
     Combest
     Condit
     Cooley
     Cox
     Crane
     Crapo
     Cremeans
     Cubin
     Cunningham
     Davis
     de la Garza
     DeLay
     Diaz-Balart
     Doolittle
     Dornan
     Dreier
     Duncan
     Dunn
     Ehlers
     Ehrlich
     Emerson
     English
     Ensign
     Everett
     Ewing
     Fawell
     Fields (TX)
     Flanagan
     Foley
     Forbes
     Fowler
     Fox
     Franks (CT)
     Franks (NJ)
     Frelinghuysen
     Frisa
     Funderburk
     Gallegly
     Ganske
     Gekas
     Geren
     Gilchrest
     [[Page H4374]] Gillmor
     Gilman
     Goodlatte
     Goodling
     Gordon
     Goss
     Graham
     Greenwood
     Gunderson
     Gutknecht
     Hancock
     Hansen
     Hastert
     Hastings (WA)
     Hayes
     Hayworth
     Hefley
     Heineman
     Herger
     Hilleary
     Hobson
     Hoke
     Horn
     Hostettler
     Houghton
     Hunter
     Hutchinson
     Hyde
     Inglis
     Istook
     Jacobs
     Johnson (CT)
     Johnson, Sam
     Jones
     Kasich
     Kelly
     Kennelly
     Kim
     King
     Kingston
     Kleczka
     Klug
     Knollenberg
     Kolbe
     LaHood
     Latham
     LaTourette
     Laughlin
     Lazio
     Leach
     Lewis (CA)
     Lewis (KY)
     Lightfoot
     Linder
     Livingston
     LoBiondo
     Longley
     Lucas
     Manzullo
     Martini
     McCollum
     McCrery
     McDade
     McHugh
     McInnis
     McIntosh
     McKeon
     Metcalf
     Meyers
     Mica
     Miller (FL)
     Molinari
     Montgomery
     Moorhead
     Moran
     Morella
     Myers
     Myrick
     Nethercutt
     Neumann
     Ney
     Norwood
     Nussle
     Oxley
     Packard
     Parker
     Paxon
     Pelosi
     Peterson (MN)
     Petri
     Pombo
     Pomeroy
     Porter
     Portman
     Pryce
     Quillen
     Quinn
     Radanovich
     Ramstad
     Regula
     Riggs
     Roberts
     Roemer
     Rogers
     Rohrabacher
     Ros-Lehtinen
     Rose
     Roth
     Roukema
     Royce
     Salmon
     Sanford
     Saxton
     Scarborough
     Schaefer
     Schiff
     Seastrand
     Sensenbrenner
     Shadegg
     Shaw
     Shays
     Shuster
     Skeen
     Skelton
     Smith (MI)
     Smith (NJ)
     Smith (TX)
     Smith (WA)
     Solomon
     Souder
     Spence
     Spratt
     Stearns
     Stenholm
     Stockman
     Stump
     Talent
     Tate
     Tauzin
     Taylor (NC)
     Thomas
     Thornberry
     Tiahrt
     Torkildsen
     Torricelli
     Traficant
     Upton
     Vucanovich
     Waldholtz
     Walker
     Walsh
     Wamp
     Ward
     Watts (OK)
     Weldon (FL)
     Weldon (PA)
     Weller
     White
     Whitfield
     Wicker
     Wilson
     Wolf
     Young (AK)
     Young (FL)
     Zeliff
     Zimmer

                               NAYS--172

     Abercrombie
     Andrews
     Baesler
     Baldacci
     Barcia
     Barrett (WI)
     Becerra
     Beilenson
     Bentsen
     Berman
     Bishop
     Bonior
     Boucher
     Browder
     Brown (CA)
     Brown (FL)
     Brown (OH)
     Bryant (TX)
     Cardin
     Clay
     Clayton
     Clement
     Clyburn
     Coleman
     Collins (IL)
     Collins (MI)
     Conyers
     Costello
     Coyne
     Cramer
     Danner
     Deal
     DeFazio
     DeLauro
     Dellums
     Deutsch
     Dicks
     Dingell
     Dixon
     Doggett
     Dooley
     Doyle
     Durbin
     Edwards
     Engel
     Eshoo
     Evans
     Farr
     Fattah
     Fazio
     Fields (LA)
     Filner
     Flake
     Foglietta
     Ford
     Frank (MA)
     Furse
     Gejdenson
     Gephardt
     Gibbons
     Gonzalez
     Green
     Gutierrez
     Hall (OH)
     Hall (TX)
     Hamilton
     Harman
     Hastings (FL)
     Hefner
     Hinchey
     Hoekstra
     Holden
     Hoyer
     Jackson-Lee
     Jefferson
     Johnson (SD)
     Johnson, E. B.
     Johnston
     Kanjorski
     Kaptur
     Kennedy (MA)
     Kennedy (RI)
     Kildee
     Klink
     LaFalce
     Lantos
     Levin
     Lewis (GA)
     Lincoln
     Lipinski
     Lofgren
     Lowey
     Luther
     Maloney
     Manton
     Markey
     Martinez
     Mascara
     Matsui
     McCarthy
     McDermott
     McHale
     McKinney
     McNulty
     Meehan
     Meek
     Menendez
     Mfume
     Mineta
     Minge
     Mink
     Moakley
     Mollohan
     Murtha
     Nadler
     Neal
     Oberstar
     Obey
     Olver
     Ortiz
     Orton
     Owens
     Pallone
     Pastor
     Payne (NJ)
     Payne (VA)
     Peterson (FL)
     Pickett
     Poshard
     Rahall
     Rangel
     Reed
     Richardson
     Rivers
     Roybal-Allard
     Rush
     Sabo
     Sanders
     Sawyer
     Schroeder
     Schumer
     Scott
     Serrano
     Sisisky
     Skaggs
     Slaughter
     Stark
     Stokes
     Studds
     Stupak
     Tanner
     Taylor (MS)
     Tejeda
     Thompson
     Thornton
     Thurman
     Torres
     Towns
     Tucker
     Velazquez
     Vento
     Visclosky
     Volkmer
     Waters
     Watt (NC)
     Waxman
     Williams
     Wise
     Woolsey
     Wyden
     Wynn
     Yates

                             NOT VOTING--9

     Ackerman
     Archer
     Chapman
     Dickey
     Frost
     Hilliard
     Largent
     Miller (CA)
     Reynolds

                              {time}  1505

  Mr. HOLDEN and Mr. GEJDENSON changed their vote from ``yea'' to 
``nay.''.
  Mr. LAZIO of New York changed his vote from ``nay'' to ``yea''
  So the resolution was agreed to.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.
  

                          ____________________