[Congressional Record Volume 142, Number 29 (Wednesday, March 6, 1996)]
[House]
[Pages H1756-H1759]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           HEALTH CARE REFORM

  The SPEAKER pro tempore. Under the Speaker's announced policy of May 
12, 1995, the gentleman from New Jersey [Mr. Pallone] is recognized for 
60 minutes as the designee of the minority leader.
  Mr. PALLONE. Mr. Speaker, the reason I am here today is because 
Democrats as a party in the House of Representatives, basically over 
170 democratic Members of the House of Representatives, are uniting 
behind a proposal that would make modest but important improvements in 
America's health insurance. Basically it would provide access to more 
Americans so that they can have health insurance, and guaranteeing also 
that if they lose their job or change jobs, that they can carry their 
insurance with them.
  The bill that we are all uniting behind and cosponsoring is sponsored 
in the House of Representatives by the gentlewoman from New Jersey, 
Mrs. Marge Roukema, a Republican and a colleague of mine, and her bill 
is basically the same as the one that is sponsored in the Senate by 
Senators Kassebaum and Ted Kennedy. So this is a bipartisan effort.
  Basically, it is a bipartisan effort to try to bring very modest 
health insurance reform to the American people. I should also point out 
that in his State of the Union Address, President Clinton said that he 
would sign this bill if it was passed by the Senate and the House and 
brought to his desk.
  The problem that we face right now is that there are strong 
indications that the House Republican leadership, Speaker Newt Gingrich 
and the Republican leadership in the House, are not willing to bring 
the bill to the floor in its existing form, and, in fact, are talking 
about loading up the legislation with many other provisions which we 
think we make it more difficult for this bill to pass.
  I want to introduce to talk a little bit about the bill, the 
gentlewoman from California [Ms. Eshoo]. Before I do that though, I 
just wanted to say very briefly, that, as I said, there are 170 
Democrat Members of the House that have signed on as cosponsors to this 
bill, and there are numerous organizations, most notably the American 
Medical Association and a list of probably about 100 different health 
care specialty groups, as well as some insurers, who are not saying 
that they also support the bill.
  in addition to that, there has been a commitment by the Republican 
leadership in the Senate to bring the bill to the floor the second or 
third week in April. So, again, the only thing that is holding up 
action on this legislation at this point is the House Republican 
leadership, which so far has been unwilling to bring it to the floor.
  Mr. Speaker, I would like to introduce my colleague, the gentlewoman 
from California [Ms. Eshoo], who has been a strong leader on this 
issue.
  Ms. ESHOO. I thank the gentleman from New Jersey [Mr. Pallone].
  Mr. Speaker, I would like to return the compliment with a multiplier, 
because the gentleman has been at the forefront in support of the 
changes that need to be made for the American people on health care. He 
has been an eloquent voice in the committee that we both serve on, the 
Committee on Commerce, when it has come to Medicare and the protection 
of the elderly in our Nation. He has spoken not only eloquently but 
very sensibly. Sometimes I think the most uncommon of the senses is 
common sense. He does not lack that.
  I am delighted to join with my colleague today during this special 
order to talk about this bill on health insurance. I ran for Congress 
in 1992, and one of the issues that motivated me the most, because it 
was something that I concentrated on and gave 10 years of

[[Page H1757]]

legislative time and sweat and sometimes some tears, but it was all 
worth it, when I served in local government, was on the issue of health 
care.
  I recognized back in 1982 that, if there was an issue that was 
driving our economy that needed to be reshaped and reformed, it was 
health care. I guess I was not only right then, I was dead right. That 
was back in 1982, and we went on to make some wonderful reforms and 
changes in the county where I served on the board of supervisors.
  Then running for Congress, of course, it was what we talked about and 
promised. I think it is about time that we keep, at least, some of our 
promises to the American people. Even though there was not sweeping 
health care reform legislation in the 103d Congress, some cheered that. 
But the American people have been left without solutions that they need 
to bring to their day-to-day lives.
  So this legislation, which is bipartisan, which was shaped in the 
Senate by both the Republican and Democratic Senator, has now attracted 
support, important support from both sides of the aisle. It is not all 
things to all people. It is not a Christmas tree with many decorations 
on it. But quite simply it strikes at the heart of two issues that we 
can address in the 104th Congress.

  First is portability. Portability, what does that mean? It means that 
where you work and you are insured with a policy, that if you move to 
another job or if you lose your job, you can continue that health care 
coverage. How? By individuals being willing to pay for it. So this is 
not a government program, as important as some of them are to those in 
other circumstances in our society, this is a piece of legislation that 
acknowledges and will give to people what they want, and that is 
portability.
  Some say that they experience job lock. They will not leave their 
jobs for another because they do not want to leave this benefit behind. 
Certainly on the threshold of the 21st century, the Congress of the 
United States would be forward looking and say, We are more than 
willing to catch up with what is going on in society and allow our 
citizens to take with them the benefit that they already enjoy and that 
they themselves are willing to pay for.
  So I think that is not only a very important principle to set down, 
but it really is responding to what people want. If the Congress itself 
wants to distinguish itself to the American people, I think we better 
be about their business and to respond to what they talk to us about 
every day.
  I am a Californian, and I do not stay in Washington on the weekend. 
As soon as the bells go off, I race off to Dulles Airport to fly home 
to be with my constituents. This issue of portability has been spoken 
to and about tens of thousands of times just in my congressional 
district alone.
  This is not a Democratic issue, it is not a Republican issue. This is 
the people's issue. So this legislation which we are so proud to 
support contains this provisions.
  The other provision is something that people have spoken, I think, to 
every single Member of Congress about in our respective congressional 
districts. That is those that have a preexisting condition are redlined 
by the insurance companies.
  Now, let us back up for a minute and understand why we all buy 
insurance to begin with. I know that I buy and pay for my automobile 
insurance in the eventuality that something happens and I am involved 
in an automobile accident, that I am covered. I do not do that so that, 
when the accident happens, the insurance company drops me. We buy it to 
be covered at the time that we need the coverage.
  So there are tens of millions of Americans today that on the basis of 
a preexisting condition, which is part of health care, everyone's body 
is not perfect. Every human body does not remain perfect from birth 
until God calls us. So we need to make these provisions for the people 
in our country.
  I think that it is one of the real unfairnesses of the insurance 
industry. So we need to make these provisions. There is a great deal 
that is written today, everything that we pick up, from the New York 
Times to all of the weekly magazine publications, about the anxiety 
that is underlying the American public today.
  Mr. Speaker, I think that we can take a quantum leap on their behalf 
if in fact we speak to those things that help to make a family secure. 
I do not think any one of us in cosponsoring this bill is making the 
promise that it cures everything, that it takes care of everything. It 
does not. But, again, it does strike to the heart of two very major, 
important provisions that need to be made by law by this Congress. I 
think that there will be a grateful Nation that will acknowledge the 
work of the people in the 104th Congress if in fact we produce this for 
them.
  Now, for those that are listening in, they are probably thinking, 
This sounds so simple. It sounds so sensible. What could ever stand in 
the way of this? There are always interests that weigh in, certainly 
the health insurers in the country.
  I think it is time that the Congress look at the interests of the 
American people. Certainly we can listen to what people's concerns are, 
about what they like or dislike about a bill. But then we must move on. 
We are here for the people of America. The Speaker sits in the chair 
with the American flag behind him. Over that it says, ``In God we 
trust.''
  I would like to think that the American people will say at the end of 
this process and this bill that we know the President will sign, not as 
a Christmas tree, not diluted to be less than what it is now, but that 
the American people will say, ``in the Congress we trust,'' because 
they responded to what we need, to what the families need, to what 
individuals need, to add to the security that they really deserve.

                              {time}  1630

  So I would like to again salute my colleague, Mr. Pallone, for the 
leadership that he has provided with the health care task force that 
has certainly been in operation on the Democratic side of the aisle to 
help bring forward the sensible reforms, not a Rube Goldberg plan that 
no one can understand.
  No one can charge that this is Big Government on any individual's 
back. This is for the people. They are willing to pay for these 
provisions, but the law must change in order for them to enjoy them.
  So ``thank you'' to you, Mr. Pallone, for your leadership. It is 
ongoing. You are tenacious. I think that you were absolutely terrific. 
I look forward to gathering round the desk of the President on a 
bipartisan basis when he signs this bill into law, hopefully this year, 
and that we can conclude the 104th Congress in keeping the promise that 
we made to the American people that we would indeed try to lift them up 
and that there will be sensible health care reform, and I think that 
this bill, H.R. 2893, is it.
  Thank you for sharing some of this special order time. I think that 
this is special, and I think that it is in order.
  Mr. PALLONE. I want to thank my colleague from California, Ms. Eshoo, 
for explaining the bill and basically why those two principles of 
portability and limitations on preexisting conditions as the basis for 
getting health insurance are so important.
  As you indicated, it seems like this is apple pie. In other words, 
why would anybody oppose it? But as we know, that is not the case. In 
fact, without getting into all the bureaucracy of it, what we are 
trying to press and challenge the Republican leadership to do is to 
simply bring up this bill in what we call a clean form, exactly the way 
you described it and the way it was introduced, and not load onto it 
all kinds of other things that may create controversy and make it 
difficult to pass.
  One of the things that we have heard is that in the Senate, Senators 
Kassebaum and Kennedy seem to have a commitment from the Republican and 
the Democratic leadership to do exactly that. When the bill comes up, 
as I said, in mid-April or possibly late April, they already have a 
commitment that there will not be any amendments. Somebody might offer 
an amendment, but there is not going to be any effort to allow those 
amendments to succeed, not because you and I or others do not think 
that we should go further and do more for health insurance reform, 
because we do, but because we just know that these things are basic and 
we do not want them cluttered up.
  Now, on the other hand, if I could just come back to the House for a

[[Page H1758]]

minute, what we are hearing in the House from the Republican leadership 
is very different. Just to give you some information, this was from 
yesterday's New York Times, and just to read a little bit, it says that 
the House Republican leaders said today they would soon take up this 
bill, but they intend to add provisions that are likely to generate 
bitter, prolonged disputes in Congress.
  For example, they are talking about adding provisions dealing with 
medical malpractice, antitrust law, special savings accounts for 
medical expenses, and tax deductions for the health insurance costs of 
people who are self-employed. Again, we may or may not agree with those 
points, but they are, as you know being in the Commerce Committee, 
tremendously controversial.
  It says, in fact, in the article that the decision to add these 
provisions essentially is made to placate conservative House 
Republicans or to satisfy committee chairmen keenly interested in one 
provision or another. I honestly believe, though, that the real 
motivation is to sabotage the bill because they know, the House 
Republican leadership knows, as you and I know, that these provisions 
are very controversial. Many of them were hotly contested during the 
Medicaid, Medicare budget battle that we had for a year that was never 
resolved, and I think it is important for us to keep pointing out we 
want a clean bill.

  We do not want, for the sake of those who are more conservative or 
those who are more liberal, to sort of muck up this bill, because it is 
so important that it move forward.
  Ms. ESHOO. Would the gentleman yield for just a moment?
  Mr. PALLONE. Sure.
  Ms. ESHOO. I think as people are tuned in and hopefully listening and 
finding this, our conversation, enlightening, the reason why we point 
out, excuse the expression, the ying and yang of this, is that what has 
taken place in the Senate around this bipartisan bill and the promise 
to keep it clean is to keep it uncomplicated.
  With the ingredients that are already there, they are winning 
ingredients. We know that a souffle only rises once, and so we want to 
capture that opportunity. For that set of ingredients that has been 
agreed to and I think will breed the success that we are looking for, 
these two major, important health care reforms for the people of 
America, that we duplicate that recipe and those ingredients in the 
House.
  If in fact other ingredients are thrown into this so that the souffle 
does not rise, then I do not think it is difficult to predict. We will 
lumber toward the end of the 104th Congress, I think, with egg on the 
face, most frankly, because the American people are exhausted with the 
partisanship that comes around these life issues and what secures their 
family.
  They do not want to hear these kind of debates. They want us to stand 
next to them, pay attention to what they are saying, and at least 
incrementally come out with the two things that this very sensible 
bipartisan bill represents.
  So thanks again to my colleague. I think you are exactly what people 
sent you here to do, that you are sensible, that you are caring, and 
that we want to be effective and produce for the American people. After 
all, this is the House of the people, this Chamber that we are standing 
in.
  Some of the greatest Americans have come and gone from this floor, 
have addressed the Nation from that podium, and I think that we are 
their political descendents and we would do well to remind ourselves of 
the greatness of individuals of the past.
  The reason that they were great was because they were good. Why were 
they good? Because they were effective. Why were they effective? It is 
because they produced things for the American people, and they are long 
in the American people's memory for what they accomplished on their 
behalf.
  I think that we can do the same thing, and I would call on the 
Speaker and anyone else that is thinking of, excuse the expression, 
mucking up the bill or placing on it those things that will make it 
cave in, instead of shepherding it across the finish line and producing 
a great touchdown for America.
  Thank you.
  Mr. PALLONE. Thank you. I just wanted to continue, if I could, to 
talk about some of the efforts, if you will, that are taking place even 
today to try to avoid Mrs. Roukema's bill from coming to the floor in 
the clean form that we just talked about.
  First of all, in the Committee on Economic and Educational 
Opportunities today a bill was reported out by Mr. Fawell of Illinois 
instead of the Roukema bill that we just discussed. In fact, there was 
an effort by the Democrats on the committee to simply pose an amendment 
that would move the Roukema bill or take up the Roukema bill, and that 
was defeated along partisan lines, the Democrats voting for it, the 
Republicans against it.
  The Fawell bill, if you will, that was actually reported out of the 
Committee on Economic and Educational Opportunities does not include 
the Roukema bill's protections for individuals who have been laid off 
or retired and are trying to purchase health insurance for themselves. 
It also contains weaker provisions with respect to protecting 
individuals against being denied health care due to preexisting 
conditions.
  Another shortcoming, if you will, of the Fawell bill includes 
provisions that would threaten State reform initiatives designed to 
increase access and affordability in the health insurance market. 
Basically this deals with the whole issue of ERISA, where the Federal 
Government essentially preempts any State efforts to improve access or 
to do more, if you will, in terms of health insurance reform than the 
Federal Government might do.
  So already, getting back to the point that myself and the gentlewoman 
from California made before, already there are efforts on the part of 
the Republican leadership in the House to sort of muck up this bill and 
not bring the clean bill to the floor that would simply address the 
issues of portability and limitations on preexisting conditions.
  We also understand that in another House committee, the House Ways 
and Means Committee, there may be an effort to bring up a bill, H.R. 
1610, by Mr. Thomas. That again is a much weaker reform measure than 
the Roukema bill. What we are seeing here essentially is the leadership 
in the House moving to try to enact provisions that are much less 
reform-minded, if you will, than the legislation that we have talked 
about today.
  I wanted to go back briefly to just explain in a little more detail 
what this legislation that was sponsored by Mrs. Roukema would do and 
how important it is to the average American. Essentially what it is is 
a minimum guarantee for all citizens with employment-based health 
coverage, in other words, these are people that are buying insurance on 
the job or essentially getting insurance through their employer, that 
as long as they pay their premiums, their health insurance can never be 
taken away from them, whether they change jobs, lose their jobs, or get 
sick.

  That is essentially what we are trying to do. Exclusions for 
preexisting conditions would be limited. They cannot be reimposed on 
those with current coverage who change jobs or whose employers change 
insurance companies.
  No employers who want to buy a policy for their employees can be 
turned down because of the health of their employees. No employees can 
be excluded from an employer's policy because they have higher than 
average health care costs, and cancellation of policies will be 
prohibited for those who continue to pay their premiums. Any employee 
losing group coverage because they leave their job or for any other 
reason would be guaranteed the right to buy an individual policy.
  Now, again, the Roukema bill, H.R. 2893, to get a little more 
specific, would prohibit insurers and employers from limiting or 
denying coverage under group plans for more than 12 months for a 
medical condition that was diagnosed or treated during the previous 6 
months. So, in other words, if you have coverage now, I will use the 
example of a cancer patient.
  If you are working, for example, for General Motors and when you are 
there working you discover that you have cancer and you have to have 
treatment, be treated for cancer, and 6 months later you were to change 
jobs and while you are still undergoing treatment and move to, for 
example, to Ford Motor Co. and start working there, well, essentially 
the new company would only be allowed to exclude

[[Page H1759]]

you from coverage at most over a lifetime of 12 months. So that maybe 
for the first 6 months, there would not be the guarantee of health 
coverage once you change jobs, but there would be after those 6 months.
  Now, again, those of us who believe that there should be universal 
coverage and that you should not be able to exclude anybody at any time 
would say that even that is not enough. But at least to guarantee that, 
that a person for the most can be excluded for only 12 months, is a 
significant change in the law from what you are guaranteed right now.
  Also, denial of individual coverage to workers losing group coverage 
that have had it for at least 18 months would also be prohibited. I do 
not want to get into all the specific details, but essentially it is a 
significant improvement from the way the law now reads.
  The other thing that I wanted to point out today is that our 
Democratic caucus health care task force, which is supportive of the 
Roukema bill and which has sort of spearheaded the effort to try to get 
the many Democratic cosponsors that we now have for the bill, about 
171, we developed about 6 months ago a set of principles on health care 
reform which is essentially guiding what we do in this Congress. The 
two goals that we set forth in our Democratic principles of health care 
reform that are really most important are, first, that Democrats remain 
committed to universal coverage for all Americans and, second, that 
Democrats remain committed to assure that high quality health care is 
affordable for all.
  So essentially what our task force principles say is that we will 
support any proposals which move the Nation closer to these goals of 
universal coverage and high quality health care that is affordable for 
all, and we will oppose proposals which move the Nation further away 
from those goals. For that reason we have been very much opposed to the 
cuts and changes in Medicare and Medicaid that the Republican 
leadership has proposed as part of its budget recommendations in 1995 
and that continue into 1996.

  At the same time, though, the principles that are incorporated in the 
Roukema bill which we talked about on the floor today, the principles 
that basically limit exclusion for preexisting conditions and the 
principles that allow you to carry your health insurance with you from 
one job to the other, so to speak, these are principles that move us in 
the direction, if you will, of universal coverage and more high quality 
coverage that is affordable.

                              {time}  1645

  That is not to say that these are the answers and that these are 
going to necessarily achieve universal coverage or affordable health 
care, but at least they move us in that direction, and that is why our 
health care task force is very much supportive of the Roukema bill.
  What we are saying essentially, and I cannot reiterate it enough, is 
that in this Congress so far nothing really has been accomplished to 
move us toward health care reform, and even with the battle over 
Medicare and Medicaid and the budget battles that continue, it is not 
likely that there is going to be much resolution of those issues and 
those programs. But at least, if we can achieve modest health insurance 
reform on the issues of portability and on the issue of preexisting 
conditions, then we will have accomplished something, and there is a 
need for bipartisan cooperation to at least achieve those modest goals 
as we continue to work toward the ultimate goal of universal coverage 
and affordable quality health care for all.
  So with that, I would just like to conclude this special order today, 
but point out that we are going to continue to press that the Roukema 
bill be brought to the floor as a clean bill and oppose any efforts to 
try to prevent its adoption in this Congress and its ultimately being 
signed into law by President Clinton who has repeatedly stated that he 
will sign the bill and that he supports this very modest health care 
insurance reform.

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