[Congressional Record Volume 142, Number 85 (Tuesday, June 11, 1996)]
[House]
[Pages H6133-H6141]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
MOTION TO INSTRUCT OFFERED BY MR. DINGELL
Mr. DINGELL. Mr. Speaker, I offer a motion to instruct conferees.
The Clerk read as follows:
Mr. Dingell moves that the managers on the part of the
House at the conference on the disagreeing votes of the two
Houses on the Senate amendment to the House bill H.R. 3103 be
instructed--
(1) to recede to the Senate amendment except with respect
to section 305 of the Senate amendment; and
(2) with respect to such section (A) to consider whether
the enactment of such section would result in an increase in
premiums for private health plans and (B) if so, to provide
for concurring with such section with an amendment that
adjusts such section to provide for the maximum coverage of
mental health services under health plans without increasing
such premiums.
The SPEAKER pro tempore. The gentleman from Michigan [Mr. Dingell]
will be recognized for 30 minutes in favor of his motion. Does the
gentleman from Texas [Mr. Archer] wish to be recognized in opposition
to the motion?
Mr. ARCHER. I do, Mr. Speaker.
The SPEAKER pro tempore. The gentleman from Texas [Mr. Archer] will
be recognized for 30 minutes in opposition to the motion.
The Chair recognizes the gentleman from Michigan [Mr. Dingell].
Mr. DINGELL. Mr. Speaker, I yield myself 5 minutes.
(Mr. DINGELL asked and was given permission to revise and extend his
remarks.)
Mr. DINGELL. Mr. Speaker, here we go again. Once again our friends
and colleagues on the Republican side have spent days and weeks behind
closed doors. Our colleagues have been negotiating with themselves.
They have been excluding Members on this side of the aisle. They have
been excluding the President. They have been using their usual highly
partisan style, strategy and technique.
They have stuck a controversial and objectionable medical savings
account provision in their bill to serve the Dole for President
campaign and to assist special interest friends in the health insurance
industry.
Mr. Speaker, our motion to instruct is simple: It tells the House
conferees, ``Do not reinvent the wheel.'' We have before us a good bill
which came from the Senate. It was totally noncontroversial. It
properly rejected a broad medical savings account provision as unwise
and fiscally irresponsible. The instruction tells House conferees that
with the exception of one provision on which further analysis may be
needed, simply recede to the Senate.
On that one provision, an important bipartisan amendment to provide
mental health parity offered by our friends and colleagues, Mr.
Domenici and Mr. Wellstone, it instructs the conferees to study the
issue and to consider whether the provision would raise health
insurance premiums. If the provision is found to raise premiums, the
motion tells the conferees to do their best to adjust it to provide for
the maximum possible mental health coverage without raising premiums
and within the scope of the conference.
Make no mistake, my colleagues: The conference committee is about to
be appointed, but it is one which already has its decisions made. All
the important decisions are in place. Once more, the extremist
Republican majority has told the American people and the President of
the United States, ``It's our way or the highway.''
The Congress has an opportunity this year to enact a
noncontroversial, a bipartisan, a consenus health insurance reform
bill, a small one but an important one, a bill that would make health
insurance more widely available to the American people. Some 28 million
people will benefit from the enactment of this legislation. It is a
bill which would assure portability, guaranteed access and renewal. It
would limit preexisting condition exclusions, and set up purchasing
pools for small business.
This is a bill which was so broadly supported that it passed the
Senate of the United States 100 to nothing. The Republican majority is
not content, however, to stop here with a good bill. They could not
resist playing politics with the health and security of the American
people. And in spite of the President's good faith offer to negotiate a
carefully constructed pilot program on MSA's, they just could not
resist sending a bill that will have to be vetoed.
The beneficiaries of this will be the health insurance industry, and
then only a part of it. The people who will suffer from this choice are
the American people. Some 28 million Americans will not get the
benefits of this legislation.
My Republican colleagues locked the doors. They locked out the
American people. They ignored the will of the other body, which voted
against MSA's, and they crowbarred this curious provision into the
bill.
As they have done over and over again in this Congress, they bent the
rules and, quite frankly, they are in the process of making a mockery
of the conference structure of the two bodies.
Mr. Speaker, who is going to pay in the end for this partisanship? It
is going to be the American people, 28 million of whom will be denied
the benefits of significant improvements in health insurance and major
reform.
Let us have a real conference with genuine bipartisan dialog and
negotiation. Bring the President into the process in good faith, not by
distorting the process by making the agreement beforehand and then
telling the President to fly off.
A Presidential signature is going to be difficult. Let us get the
Presidential signature. Let us enact the legislation. Let us support
the motion to instruct.
{time} 1130
Mr. ARCHER. Mr. Speaker, I yield 3 minutes to the gentleman from
California [Mr. Thomas], the respected chairman of the subcommittee of
the Committee on Ways and Means.
(Mr. THOMAS asked and was given permission to revise and extend his
remarks.)
Mr. THOMAS. Mr. Speaker, it is with great pleasure and a certain
amount of pride that I take the floor this morning, finally, as we
appoint the conferees to meet with the Senate on our health insurance
package.
I find it somewhat ironic that this package passed the House some
time ago, passed the Senate on April 16, but it is not until June 11
that we are naming conferees. That is simply because the Senate
stalled. The Senate would not go forward. The Senate Democrats wanted
to play politics with health care once more.
We discovered, Mr. Speaker, that the President's mediscare tactics
over the last year cost the American people more than $100 billion when
we compare the 1995 Medicare trustees report with the 1996 Medicare
trustees report. If we follow the wishes of the former chairman of the
Committee on Commerce and pass this motion to instruct, we are once
again going to be part of an operation that delays and obfuscates.
Mr. Speaker, the gentleman said that the negotiations that we have
been carrying on with the Senate tried to crowbar provisions into the
package. One man's crowbar is another's compromise and accommodation,
and I just find it totally ironic that the gentleman from Michigan,
given his history of rather cavalier and arrogant management of
conference reports, would, in fact, make such a comment.
He alluded to the fact that the Senate package passed the floor 100
to 0. If that is the case, why is the motion to instruct not to go with
the Senate program? Oh no, he knows there were
[[Page H6134]]
flaws in the Senate bill. So on the one hand he says we have to go with
the Senate, they are wise, they were bipartisan, they passed it 100 to
0, but, oh, by the way, in the motion to instruct, we do want to make
changes in the Senate provision.
Well, let me tell my colleagues, the House and the Senate coming
together has created historic legislation. We believe the President
will be compelled to sign this package. We changed the language in the
fraud and abuse area so that someone committing a bookkeeping error
would not be liable to the penalties. Rather it is deliberate ignorance
or reckless disregard of the law, rather than a simple bookkeeping
error.
Mr. Speaker, we have cleared away a lot of the paperwork logjam that
has been there way too long. We cleaned up the long-term care insurance
area, changing the Tax Code to allow seniors to deduct this off of
their medical expenses. That has been left to languish far too long.
And on MSA's, the agreement between the House and the Senate is to
begin on January 1 with employers of less than 50 employees. Currently,
out of the 29 million in that category, only 3 million have health
insurance. The MSA's will afford health insurance for millions of
Americans if we disregard the motion to instruct.
Mr. DINGELL. Mr. Speaker, I yield myself 30 seconds.
The distinguished gentleman from California has referred to me in a
most kindly fashion. He has also alluded to the fact that the deal has
already been cut. I would note that this is interesting from the
standpoint of the business at hand.
He has also said some other things. He has tried to blame the
Democrats in the Senate for the action of the Republican Presidential
nominee, the gentleman from Kansas, Mr. Dole, who is the majority
leader over there until this afternoon, I am told, at which time he
will be leaving. But it will be noted that this good majority leader
has not, during the time that the gentleman from California complains,
appointed the conferees.
Mr. Speaker, I yield 3 minutes to the distinguished gentleman from
California [Mr. Stark].
Mr. STARK. Mr. Speaker, I thank the gentleman for yielding me this
time.
Mr. Speaker, the press reports indicate that Republicans have reached
a deal among themselves and at long last, after 2 months, they want to
appoint conferees, which I presume is for taking pictures and
presenting us with a done deal. Not exactly what I would consider an
open and fair legislative process.
My colleagues across the aisle have purposely turned their backs on
the best opportunity of the year for a bipartisan bill that would have
been developed openly and fairly. It is completely backward from the
normal process and is designed to end run the will of a majority of the
Senate in opposition to medical savings accounts.
Mr. Speaker, we do not know many, many of the important deals of the
back room deal. If it is like previous ones that handed billions of
dollars to the American Medical Association in exchange for support of
an ill constructed and conceived Medicare bill, or if it is similar to
a payoff of the supporters of GOPAC and the Republican Party to pay off
the Golden Rule Insurance Co., we can be pretty sure that those deals
are in there.
The Senate passed a good bill. It did a better job on mental health
amendments, which provided parity, which I assume the Republicans do
not care about mental health. It did not deal roughshod with
malpractice, and recognizes that 80,000 people are killed in hospitals
each year. It weakened antifraud, or the Republican bill weakens
antifraud and the Senate did not. The Senate did away with the MEWA's
and is a better bill all around.
The Senate bill provides 80 percent deductibility for the self-
employed. It covers all companies, not just those with less than 50
workers, and it is a better protection for the purchase of an
individual insurance policy.
Mr. Speaker, for individuals, for U.S. citizens, the Senate is a
better bill. The House bill is better for large contributors to the
Republican Party. The House bill is a better bill for rich doctors. The
House bill is a better bill for insurance companies. It is not as good
a bill for individuals in this country.
It would be in the best interest of our constituents, of all people
in this country, to go back, accept the Senate bill and recognize that
we have thereby done a good job.
Mr. ARCHER. Mr. Speaker, I yield myself such time as I may consume. I
rise in opposition to the motion to instruct.
Mr. Speaker, it seems ironic to me that the minority wants us to
abandon all of the bipartisan work that occurred in the House of
Representatives and simply accept the Senate bill. It is also
interesting that the only part of the Senate bill that they do not want
us to accept at face value is the provision on mental health.
Amazing. They want us to dump malpractice reform, which is driving up
the cost of health care for all Americans. But, of course, that is what
the trial lawyers want. So they want that to be totally dumped.
They want us to dump the ability of small businesses to be able to
pool together to get their insurance prices down so that they can
compete with large companies. They want that thrown overboard.
They want all of the revisions that will help to cut the cost of
paperwork and administrative redtape dumped.
They want us to dump the provisions that will help those who are in
terminal illness from being able to have accelerated death benefits out
of their insurance policies, like those on AIDS, so that they can
expend that money for their health care in the last 2 years of their
lives.
They want the elderly to be dumped and the ability that we provide in
the House bill for them to be able to have long-term care deductibility
on their insurance premiums.
They want all that to be thrown over and accept at face value
everything in the Senate bill except the provision that the Senate put
it to help those who have mental illness.
Mr. Speaker, this is a weird motion to instruct, and I think the
House should clearly turn it down because it exposes the minority for
what they really are. They do not want real health care reform, they
just want issues.
We have a very good bill in the House, passed overwhelmingly by a
bipartisan vote, and we will work from that to negotiate with the
Senate so that we can end up with a better bill than what the Senate
has created.
Mr. Speaker, I reserve the balance of my time.
Mr. DINGELL. Mr. Speaker, I yield 2 minutes to the distinguished
gentleman from New Jersey [Mr. Pallone].
Mr. PALLONE. Mr. Speaker, it is a sad day today in the House of
Representatives on health care reform. We know that this process began
in the President's State of the Union address where he called upon this
House, on a bipartisan basis, to pass the Kennedy-Kassebaum bill, with
the goal essentially of expanding insurance coverage basically for
people who have preexisting conditions, who have not been able to get
health insurance, or for those who have trouble because they lose their
health insurance when they lose their job or transfer from job to job.
We had a bipartisan consensus to move on these two issues,
portability and preexisting conditions, to expand insurance coverage.
But, instead, from the very beginning, the Republican leadership
insisted on these medical savings accounts, which is nothing more than
a special interest way of providing catastrophic health care coverage
that most Americans, except for the healthy and the wealthiest among
us, will not be able to take advantage of.
It was all done because essentially it was a payback. The Golden Rule
Insurance Co. has made big contributions to the GOP, and they would
reap big profits if the MSA proposal becomes law. They have given about
$1.2 million basically to various GOP causes. So from the very
beginning there were not conferees appointed because we know that the
other side, the Republicans, wanted to include the MSA's, and they
still have.
Mr. Speaker, with this proposal today, our understanding is that when
the conference is done they will simply ratify a proposal that still
allows these MSA's to be included. It is a shame, because the Kennedy-
Kassebaum bill was
[[Page H6135]]
crafted to keep premiums affordable because it would not impact the
insurance risk pool by encouraging healthy individuals to drop
coverage.
The MSA provision does the opposite. It is the poison pill. It
basically makes it so that only the healthy and the wealthy can take
advantage of this catastrophic coverage, and Americans who do not
choose to join the MSA's, because of the high risks involved, will see
their health insurance premiums increase.
The end result then, Mr. Speaker, is health insurance premiums
increase for the average American. And instead of having more people
insured, which was the very purpose for the President's call back in
his State of the Union address, we will have less Americans insured.
Mr. ARCHER. Mr. Speaker, I yield myself such time as I may consume.
The gentleman's comments are just not founded on facts. The Rand
Corp. has done a study about medical savings accounts, the Journal of
American Medicine has come out with a study, and both of them say there
will not be adverse selection. Both of them do not support in any way
the gentleman's comments that this would help the rich or this would
help only those who are healthy. Not so at all. All of the empirical
data puts that down.
Mr. Speaker, I yield 2 minutes to the gentlewoman from Connecticut
[Mrs. Johnson], the respected chairman of the Subcommittee on Oversight
of the Ways and Means Committee.
Mrs. JOHNSON of Connecticut. Mr. Speaker, I thank the gentleman for
yielding me this time.
Mr. Speaker, this is an extraordinary opportunity for this House and
this Congress. We have the opportunity in the conference process to
come to agreement on a bill, and we can already see the agreement out
before us that will guarantee to the working people of America the
right to move from job to job without losing their health insurance due
to preexisting conditions.
Why would we want to limit conferees' ability to merge the fraud and
abuse provisions of the House and Senate bill and choose those
provisions that are really strongest but also most protective against
small minor mistakes and making those as criminal?
Why would we want to tie the conferees' hands and not let them
include administrative simplification provisions worth billions and
billions of dollars in savings to our health care system?
Why would we not want them to consider a compromise in the medical
savings account that does not open up the right to medical savings
account to the big givers of the Republican Party, as my colleague, the
gentleman from California [Mr. Stark], claims, but rather only opens it
up to the employees of small businesses, 50 or under?
Frankly, Mr. Speaker, those folks are not big givers to either party.
They are just folks who do not have health insurance and need an
opportunity to have this choice.
{time} 1145
It is a small, modest compromise. It requires a study, and it
requires a congressional vote after 3 years before an expansion. It is
just the right kind of compromise that the House and Senate are capable
of coming to to move forward with the public business so that we can
guarantee portability to America's workers, so that we can guarantee
long-term deductibility of long-term insurance premiums; truly the
right answer to controlling Medicaid spiraling costs, absolutely the
right answer to make long-term health care premiums deductible.
That is in this. As important a reform as this Congress has ever
considered in the health care area. We have the opportunity to serve
the public well.
Mr. Speaker, I oppose the special instructions of the gentleman from
Michigan [Mr. Dingell].
Mr. DINGELL. Mr. Speaker, I yield 2 minutes to the distinguished
gentleman from Maryland [Mr. Cardin].
Mr. CARDIN. Mr. Speaker, I congratulate the gentleman from Michigan
[Mr. Dingell] for the work he has done on health care reform. I am
pleased that we are finally going to conference on this health reform
bill.
Since the President's State of the Union Address, there has been
bipartisan support in passing legislation that would eliminate
preexisting conditions for people who lose their jobs and need to
change from one group plan to another, or from a group plan to an
individual plan.
We have wanted portability, both Democrats and Republicans have asked
for us to move this legislation, and I am pleased that at last we are
going to conference in order to get this done.
Mr. Speaker, I support the motion of the gentleman from Michigan to
instruct the conferees, and let me give two reasons that I hope that
the final bill that we will vote on will contain.
First, mental health parity. Mental health parity is important to
help start to remove the historical discrimination against mental
illness in this Nation. There has been a lot of talk that that may
increase the premium cost. Let me give the experience of the State of
Maryland.
Mr. Speaker, we have enacted mental health parity in our State that
is effective against State-regulated health insurance plans. We have
found no appreciable increase in premium costs as a result of
establishing parity.
Mr. Speaker, when consumers have reasonable access to health care, we
find that we have more cost-effective health care; we do not force
people into more costly circumstances. We have found in-patient care
actually decline as a result of providing mental health parity. We
would hope that the final bill that comes to the floor from conference
will include mental health parity.
The second reason I support the gentleman's proposal is the MEWA
provision that allows employers to join together but preempts the
abilities of our States to regulate. We talk about we want the States
to do more, but the MEWA provisions in the House bill would prevent our
States from regulating. The State of Maryland has enacted small market
reforms. The MEWA provisions would prevent that.
Mr. Speaker, I urge my colleagues to support the motion.
Mr. ARCHER. Mr. Speaker, I yield 6 minutes to the gentleman from
Illinois [Mr. Hastert], a gentleman who has contributed so much to the
development of health care policy in the House.
Mr. HASTERT. Mr. Speaker, it is interesting to hear the debate,
especially from the other side of the aisle. It is also interesting to
hear the rhetoric from the other side of the aisle that tries to create
a class warfare on a piece of legislation that is really for what the
American people want.
If my colleagues would look at this bill, this does not treat any
special interests, it does not take any upper-income group and give
them a special deal. What it does is allow working Americans, people
who work for small businesses, people who are self-employed to, have a
choice.
Is that so wrong to do, to give people choices on what they want with
their health care future; what they want to do to choose a health care
policy that best suits them and their family? A health care choice that
they have the opportunity to begin to take care of their long-term
health care future if they wish to do that? That is exactly what is in
this bill.
Mr. Speaker, we give portability and affordability. That was our
goal: To let people have the ability to get health care insurance, even
when they change jobs, group to group or group to individual. That they
are not denied health care because they or their family have a
preexisting condition. That is out of this bill. We are there. They
have the ability to have that portability. They have the ability to
move from job to job.
Also, one of the things that we do here is long-term care so seniors
who worry about their golden years and beyond those times when maybe
they are able to take care of themselves, that they are not thrown out
into the issue that they have to give up all of their resources that
they are able to take their life insurance, in fact if they had a
catastrophic health care problem that they could convert that life
insurance tax free into long-term care insurance, and also treats long-
term care insurance in a tax issue that is just like any other health
care insurance. It is tax deductible. Does that not make sense? I think
it makes a lot of sense.
Deductibility, for those people who have never had the break in small
business, where big businesses can go and
[[Page H6136]]
deduct their health care insurance as an expense against their
business, small business has never had that. Sometimes we have given
them 25 percent; sometimes it has been zero, because the Congress has
not acted, and then now it is 30 percent.
Mr. Speaker, we try to move that to parity. We try to give those
people, and we do in this bill, 80-percent deductibility, so small-
business people have the ability to go out and buy insurance and get
the same break that big businesses get.
Fraud and abuse: The American people know that fraud and abuse is one
of the biggest issues out there, that one out every 10 health care
dollars gets wasted. Wasted. And any senior citizen will tell you that
waste, fraud, and abuse is rampant in our system.
Mr. Speaker, we address waste, fraud, and abuse in this issue. We
take that issue down and say that we are going to draw the line of
those few people in the health care providers that take advantage of
the poor, that take advantage of the old, that take advantage of people
who need health care and get slicked into something that they cannot
afford.
Mr. Speaker, I have to say that the gentleman from New Jersey [Mr.
Pallone], who spoke a few minutes ago, made this big issue and talked
about class warfare and something for the rich. I just have to say that
that is just not so.
Now, I would never accuse that gentleman of not telling everything
that he knows, but let me say this: He offered the same motion on the
floor when we discussed health care reform, this same piece of
legislation, and it was defeated overwhelmingly in this House. And now
he is coming back from a second bite of the apple, I think that is a
little bit much.
Mr. Speaker, let us talk about medical savings accounts. Medical
savings accounts in this bill give the people who are small-business
people the ability to give their employees a choice. Now, I thought in
a democracy such as the United States of America, that choice is really
what democracy is all about, small ``D'' democracy.
Choice is what people can choose. Choice puts the market in. Choice
gives the ability to go out and buy the best program for the best
amount of money.
Now, if we think government is smarter than the people, if we insist
on big government programs, then we would want to deny people choice.
We want to deny them the ability to do the right thing. This piece of
legislation gives people choice. It allows them to do the right thing
for themselves and their family.
Mr. Speaker, I salute the gentleman from Texas [Mr. Archer], chairman
of the Committee on Ways and Means, and the gentleman from Virginia
[Mr. Bliley], chairman of the Committee on Commerce, for doing the
right thing in this bill, coming out with a piece of legislation that
really gives us true health care reform, something that we have not
seen in this Chamber for 20 years. It is time we pass it and it is time
we pass it in the House version.
The SPEAKER pro tempore. Without objection, the gentleman from New
Jersey [Mr. Pallone] will be recognized to yield the time previously
allocated to the gentleman from Michigan [Mr. Dingell].
There was no objection.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from
Washington [Mr. McDermott].
(Mr. McDERMOTT asked and was given permission to revise and extend
his remarks.)
Mr. McDERMOTT. Mr. Speaker, what we are engaged in here today is
basically a sham. The Republicans have met by themselves and decided
what this bill is going to contain. And much of what the gentleman from
Illinois [Mr. Hastert] says is correct. There are a lot of good things
in this bill.
But, Mr. Speaker, this proposal is designed to be vetoed by the
President. Now, if we answer 10 issues and all of them are good, we
have portability, and we make it so that preexisting conditions cannot
prohibit consumers from getting insurance and so forth, if we had 10
issues that were good and we knew we could get them, but we had one
other issue that the President said, ``If you put that in, I am going
to veto it,'' why would we put it in except unless we wanted the
President to veto it?
The Republicans have no intention of passing this bill. They stuck
that poison pill of medical savings accounts in simply because they
know the President has given his word. He has told them in advance,
``If you put that in, gentleman and ladies, I am going to veto this
bill.'' So, they do it anyway.
Now, the question then is why, after 2 years of fighting, do they
have a secret conference committee make the decisions and put a bill
out here on the floor that they know the President is going to veto?
Mr. Speaker, my answer is that they have no intention of doing
anything to fix the American's problem with health care in this
country. There are now 44 million people in this county, and the number
is growing every single day, and yet they refuse to make the very small
changes of portability and getting rid of preexisting conditions.
In fact, Mr. Speaker, they are going to kill the mental health
provisions. As a psychiatrist, I know that people who have mental
health problems in their family have a very difficult time getting
coverage. And this bill that the Senate put together was a good
proposal. It ought to be accepted, but, in fact, they have put in a
poison pill.
Mr. ARCHER. Mr. Speaker, I yield myself 1 minute.
Mr. Speaker, I would ask the gentleman from Washington why is it that
in this motion to recommit the only thing in the Senate bill that is
not protected is the mental health provisions? The only thing that this
motion to recommit says to the conferees that they can take out of the
Senate bill is the mental health provision, the very thing that the
gentleman says is so important? Why is that in this motion to instruct?
Mr. McDERMOTT. Mr. Speaker, will the gentleman yield?
Mr. ARCHER. I yield to the gentleman from Washington.
Mr. McDERMOTT. Mr. Speaker, I thank the gentleman for giving me an
opportunity to respond to that. On our side, we figured out that we
have to make compromises to get things through.
Mr. ARCHER. Mr. Speaker, to say that the gentleman wants to
compromise that, and not take the Senate language, but not compromise
anything else, why is that the only part that the Democrats are willing
to compromise? That seems very strange.
The gentleman, particularly because of his background, I would think
would want that to be taken out of this motion to instruct.
Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from California
[Mr. Thomas].
Mr. THOMAS. Mr. Speaker, I would ask the gentleman from Washington if
he would like to come to the mike. I will give him time on my time to
respond to a question I would like to ask him, because in his statement
he was quite emphatic that if the medical savings accounts as we are
beginning to work them out with the chairwoman on the Senate side from
Kansas, that if, in fact, we work out something that is acceptable to
the gentlewoman from Kansas, that the President is going to veto it.
Mr. Speaker, the gentleman from Washington spoke with such certainty
that this was a poison pill. I guess I would ask the gentleman if it is
included and the President signs it, what does it tell the gentleman
about the President? Why is he so certain the President is going to
veto the package if it has the compromised MSA language in it?
Mr. McDERMOTT. Mr. Speaker, will the gentleman yield?
Mr. THOMAS. I yield to the gentleman from Washington.
Mr. McDERMOTT. Mr. Speaker, I think the President has made it pretty
clear that if my colleagues on the other side of the aisle put the
medical savings accounts in, and this proposal is not some kind of
pilot program. The gentleman knows that. It goes for 3 years, then it
becomes open to the whole world. My view is that the gentleman is going
to continue and----
Mr. THOMAS. Mr. Speaker, reclaiming my time, I was amazed as to how
certain the gentleman from Washington was that the President would veto
it. I think that certainty does not come from knowledge; it comes from
fear that the President will, in fact, sign the legislation because it
is a reasonable compromise and is going to
[[Page H6137]]
leave a lot of people who have been very unwilling to be reasonable out
on the limb.
Mr. Speaker, we are going to test that hypothesis very soon because I
believe the President will sign this very responsible health insurance
reform package.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from
Connecticut [Ms. DeLauro].
{time} 1200
Ms. DeLAURO. Mr. Speaker, today will be remembered as a sad day in
this Congress, a day when we missed an opportunity to help millions of
working families. Once again congressional Republicans serve up
legislation to help wealthy special interests. This bill, which started
off as a good bipartisan bill that would have helped working families,
people who move from job to job, to maintain their health insurance,
prohibit preexisting condition, add parity for mental illness, this
bill has been hijacked by Speaker Gingrich and by Majority Leader Dole.
Under the banner of reform, the House passed a bill that raises
health care costs, hurts consumers and increases the number of
uninsured. By including medical savings accounts, skimming the healthy
and the wealthy out of the traditional insurance pool, we will see in
fact insurance costs go up. Do not take my word for it. Take the
American Academy of Actuaries, not a liberal group by any stretch of
the imagination. They estimated that this skimming process would result
in a 61 percent increase in health care premiums for those who remain
in traditional plans.
Let me tell my colleagues why do we have such bad policy here in the
House. We will find out in a second here when we know that the company
that provides most of these medical savings accounts, the Golden Rule
Insurance Co., has been the third largest donor to Republican political
campaigns, more than a million dollars to the Republican Party over the
last 4 years. That is why we see this addition to this bill.
Sadly, this is a bad piece of legislation. Let me repeat, under the
banner of reform this bill as passed will raise health care costs. It
hurts consumers and it will increase the number of uninsured. We had a
wonderful opportunity to pass help for working families in this
country. Because of special interests, the Republican majority has
denied that opportunity to working families today.
Mr. ARCHER. Mr. Speaker, I reserve the balance of my time.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from
Texas [Mr. Bentsen].
(Mr. BENTSEN asked and was given permission to revise and extend his
remarks.)
Mr. BENTSEN. Mr. Speaker, I rise in support of the motion to instruct
because it puts us on a fast track to real bipartisan market-based
health care reform by adopting the Senate bill.
Mr. Speaker, my Republican colleagues have been negotiating amongst
themselves and would now have us buy what we might call a pig in a
poke, sight unseen, take it or leave it. We do not know but we think
they have made some beneficial corrections to the original Republican
bill, including the dropping of MEWA's or an unregulated small business
insurance product and allowing for full deduction of health insurance
costs for the self-employed which was actually in the Democratic
substitute which I offered along with the gentleman from Michigan [Mr.
Dingell] and the gentleman from South Carolina [Mr. Spratt]. We think
that is good, but we do not know if it is real in there.
Unfortunately, we have fiddled away several months in order for the
Republicans to force an iffy and untested, unsure tax incentive on the
entire Nation. While there may be merit in the medical savings
accounts, we really do not know and we should not hold up portability
and preexisting condition discrimination for a pilot project. That is
why the Republican Senate rejected the Dole MSA amendment when this
bill was considered in the other body.
It is unclear and we do not know whether MSA's will result in a
dilution of the insurance pool. We do not know whether or not employers
will choose to substitute lesser benefits for their employees. We do
not know what the real fiscal impact will be. So it comes down to a
basic fact of why not pass what we all agree upon and get it done and
come back and look at that. But our colleagues do not want to do it.
I would also add, Mr. Speaker, that we do not know whether or not
this bill would still contain duplicative medigap insurance premiums
which would cause senior citizens who pay twice for what they are
getting only once. Quite frankly, what we ought to do is to go back and
pass a guarantee of issue of medigap insurance for senior citizens
since the Republican Medicare plan seeks to force seniors to managed
care anyway. But we do not know what that bill is going to do with
that. Mr. Speaker, the fact of the matter is they have been dealing
amongst themselves. Let us pass a bill that we all agree upon and let
the American people have a victory for once.
Mr. ARCHER. Mr. Speaker, I yield myself such time as I may consume.
As I listen to the comments from the other side of the aisle, I can
only conclude that the Democrats really want to have it both ways. They
want to talk about special interests, but they do not want to talk
about the special interests and the trial lawyers who will not let us
have medical malpractice reform. They do not want to talk about that.
They want to talk about secret agreements. Yet the reason that we have
not gone to conference after all these weeks is because in the other
body one Senator has prohibited, prevented the appointment of
conferees. In the other body, we are told, well, you have to reach an
informal agreement amongst yourselves before we can consider the
appointment of conferees.
We should not be able to have this argument both ways.
Then their argument is that, oh, well, of course, this is going to be
vetoed because there is a poison pill in here, and that poison pill is
medical savings accounts. God forbid that we let people choose their
own health care and spend their own money in order to determine what
the best value of health care is for each individual, the ultimate in
portability. When you have a medical savings account, if you do change
jobs, you clearly carry it with you. It is yours. It is the ultimate in
portability.
If it is a poison pill, how can it be that 80 percent of the American
people by polls, survey after survey, support medical savings accounts?
Why is it poison when 80 percent of the people say, give me that choice
in my individual life?
Mr. Speaker, I reserve the balance of my time.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes and 30 seconds to the
gentleman from Michigan [Mr. Levin].
(Mr. LEVIN asked and was given permission to revise and extend his
remarks.)
Mr. LEVIN. Mr. Speaker, there is a lot of smoke screening going on
here. The issue is not malpractice insurance. I think the Republicans
are ready to drop that. The issue is MSA's and whether they will be
included. There is a good reason. The reason it was held up, the whole
conference on the other side, was because the majority leader, as I
understand it, wanted to stack the conference with Members who are in
favor of MSA's.
Let me just indicate the problems with MSA's, as they came through
the House. First of all, there is a health policy issue. That is, if
you allow people to go into these, the healthier people, they are
likely to raise the premiums for everybody else. That is the problem.
There is a second problem and that relates to tax policy.
As they passed the House, here is what people could do, and I
understand the gist of this remains in the agreement that none of us
have seen. That is, people, especially wealthier people who would
benefit, could put moneys into MSA's, they could accumulate income from
those investments; they would not be taxed. At a certain age they could
withdraw that without penalty. I think it was 59 here. Maybe it has
been raised. If they kept the moneys until death, it would not be
subject to taxation upon death.
So essentially what we have is an incentive for wealthier people. It
is kind of an IRA for wealthy people.
By the way, they could take the money, they could keep it in there
and spend other income on health care. That is why we say, just as my
colleague tied Medicare to tax breaks for very wealthy people, we are
tying what
[[Page H6138]]
is needed here, and that is portability and protection against
preexisting conditions to a proposal that is mainly going to be a tax
benefit for wealthier people. It is not a choice issue. It is that
issue. And my colleague has never faced up to it.
That is why we are questioning MSA's in addition to the health
policy. We need to respond to this. Otherwise we are going to have our
opposition and a veto from the President.
Mr. ARCHER. Mr. Speaker, I yield 1 minute and 30 seconds to the
gentleman from Illinois [Mr. Hastert].
Mr. HASTERT. Mr. Speaker, I have a great deal of respect for the
gentleman from Michigan, but he is just uninformed or he does not know
what he is talking about. When he talks about smoke screen, it is the
incredible smoke screen that is coming up on the other side of the
aisle.
Medical savings accounts can accrue, true. But when you withdraw, if
you withdraw that medical savings account for anything except health
care, you pay a 15-percent penalty. Nobody is going to try to accrue
this money and then try to pull it out with a 15-percent penalty. That
is far above what advantage they get in the tax benefit. Also it is not
for rich people. This is for small business people and self-employed
people. That is the way the bill was written. Those people who work day
in and day out with the sweat of their brow so that they can afford
health care for their family and they can have a choice of health care
for their family.
Finally let me say, when a person is 65 years of age, yes, he can
withdraw that money and pay his taxes on it or he could withdraw that
money and put it into long-term care. Boy, is that not a problem in
this country? Or he can withdraw that money and pay for a catastrophic
health care problem in his family. That is certainly a problem,
especially if you are over 56 years of age. What the Members on the
other side of the aisle are doing is trying to deny senior citizens the
ability to have health care security and long-term health care
security. That is where the smoke screen is, Mr. Speaker.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes and 30 seconds to the
gentleman from Massachusetts [Mr. Markey].
Mr. MARKEY. Mr. Speaker, these are very simple instructions. It says,
say yes to Kennedy-Kassebaum. Say yes to portability. Say yes to a ban
on preexisting conditions. That is what our instructions here today are
to the negotiators. Let us get this done.
It says no to medical savings accounts and no to medical malpractice
caps. It says no to all of the special interest feeding frenzy which is
now building up around this bill.
American families are concerned about job lock; they cannot move with
their medical insurance. They are afraid that they have preexisting
conditions that will make it impossible for them to ever get new
insurance, so we are trying to protect them. But now what happens is
all the special interests ride in with this very important bill and
they try to turn it into a goodie grab bag for all of their special
interest concerns.
Kennedy-Kassebaum is not perfect, but it is a very good bill; and it
is what the American people want: portability, preexisting conditions
protected against.
My mother always said that half a loaf is better than none. I support
Kennedy-Kassebaum, even though it is really a couple of slices and I
know that the American people want a whole loaf so that they have not
only health insurance which is accessible but also affordable. But we
cannot get that done this year. There will be no bill.
Unfortunately, the leadership, the House and Senate leadership has
taken a couple of good, wholesome slices of health insurance reform and
slapped a whole lot of extraneous junk food on top, creating a health
care hoagie of medical savings accounts, caps on medical malpractice
awards and other unhealthy additives. These anchovies and olives and
onions are certain to tickle the taste buds of a very few special
interests but cause heartburn for millions of consumers.
Mr. Speaker, the House and Senate Republican leadership has taken a
noncontroversial health care bill and turned it into a special interest
feeding frenzy. That is wrong, just plain wrong.
We should put the needs of American families above the demands of the
gluttons of Gucci Gulch outside the Committee on Ways and Means.
Mr. ARCHER. Mr. Speaker, I yield myself such time as I may consume.
Again, it would be very good if we could stick to the facts. What
this motion to instruct does is it takes a whole Senate bill, dumps
everything in the House bill, takes the whole Senate bill, except for
one thing, help for the mentally ill. It says, no, the mentally ill can
be thrown overboard, but everything else that is in the Senate bill,
you have to accept.
{time} 1215
It says no to small-business pooling that will let them compete with
major corporations. That is what it says no to. That is in the House
bill, not in the Senate bill. It says no to paperwork simplification.
It says no to fraud and abuse. We cannot attack fraud and abuse. We got
a very touch good provision in the House bill; the Senate does not.
Says no to long-term care facilitation so people can protect themselves
in that way.
It says yes to the trial lawyers; no malpractice reform.
This will likely be the only health care bill that passes the
Congress this year.
Why should the American people be kept waiting for things that they
want, that are so popular with them?
The American people need this bill. For the first time, working
Americans will be able to leave their jobs without having to worry
about losing their health insurance due to a preexisting condition.
We should move quickly to enact a conference report that powerfully
fights fraud and abuse in the health care system. It has often been
said that could be as much as 10 percent of health care costs. The
Senate bill does not have that; the House bill rightfully does in this
one health care train that will leave the station this year.
This bill can create new criminal penalties against those who engage
in health care fraud and a national health care fraud and abuse control
program to coordinate Federal, State, and local law enforcement
actions.
We can end the discrimination in the Tax Code against more than 3
million small self-employed business people, increasing the
deductibility of health insurance to 80 percent for the self-employed
and giving them the opportunity to select, if they wish, medical
savings accounts.
We can make health care more affordable to senior citizens by passing
into law two of the Contract With America items that allow tax
deductions for long-term health care needs, like nursing home and
health care coverage in long-term care. Also, terminally ill patients
receive benefits by allowing them to receive tax-free, accelerated
death benefits on their insurance policies while they are terminally
ill.
And, finally, we can pass a bill that includes the ultimate and best
in portability, which is medical savings accounts. MSA's are a valuable
option in the health care market because they put people in control of
their own health care decisions. They are popular with 80 percent of
the American people. The only reason I can believe that they have been
made so controversial by the other side, because they are not
controversial with the American people, is because they are the single
biggest bulwark to the Federal Government taking over our entire health
care system, and so many on the other side would like nothing more than
what President Clinton proposed in the last Congress, which is a
complete Federal takeover of the health care system. The American
people do not want that.
MSA's have a bipartisan history in the House. Over 40 Democrats voted
for them here in the House. They were originated in the first bill by
myself and the gentleman from Indiana [Mr. Jacobs], a Democrat. And
Democrats over and over again have supported them.
Under a compromise that has been informally agreed to at the demands
at the Senate prior to going to conference, which it should not have
been that way, and had the Democrat Senators not held up the
appointment of conferees in the Senate we would have this done some
time ago, but under that informal agreement MSA's would be available to
people to work in small
[[Page H6139]]
businesses with employment of under 50 employees and to the self-
employed, and employers with bigger numbers of employees and
individuals would have to wait for 3 additional years. But 29 million
Americans work in companies with 50 or fewer employees, and just 3
million, only 3 million, have health insurance.
Mr. Speaker, we should open the door to then, and we will with this
bill. Our MSA option will for the first time give the uninsured access
to health care. For too many working Americans, health insurance is not
even an option; it simply is not offered at all, especially for those
who work in small business.
So I am bewildered to hear the critics of MSA's who would rather keep
people without health care than allow this important option to be
enacted into law, and it is only an option, not a mandate.
MSA's stand for medical savings accounts, but MSA's really stand for
Medical Security Act. With MSA's people can be secure in the health
care needs knowing that they can take their health insurance with them,
and for those without insurance, MSA's represent a wonderful way to be
safe and secure for illness.
We should delay no further. We have appointed conferees or authorized
the appointment of conferees. Let us reject this motion to instruct.
Let us work this out. Let us add good features that are in the House
bill in this one-time-only health care reform package that can move
into law this year.
Mr. Speaker, I reserve the balance of my time.
Mr. PALLONE. Mr. Speaker, I yield 1 minute to the gentleman from Ohio
[Mr. Brown].
Mr. BROWN of Ohio. Mr. Speaker, I thank the gentleman for yielding
this time to me.
What has happened on this very simple bill? Kassebaum-Kennedy was a
simple bill that dealt with two problems. It dealt with the problem of
preexisting condition and the problem with portability. Then Speaker
Gingrich and Republican leaders have chosen to attach to this bill all
kinds of special-interest provisions for the largest insurance
companies in America. All we are asking simply is that the House pass,
that we instruct conferees to do what the Senate did when the Senate
passed this bill unanimously a hundred to nothing and when the Senate
defeated medical savings accounts. All we are asking is that Kassebaum-
Kennedy be dealt with cleanly and simply, that we have a ban on
preexisting condition and that we deal with the problems of portability
so people can move their insurance from one employer to another
employer.
All Speaker Gingrich wants to do, what he wants to do is load up this
bill with special-interest provisions to pay back big insurance
companies that have helped Republican campaigns in the last couple of
years.
The choice is clear. Vote ``yes'' on health reform. Vote ``yes'' on
the motion to instruct.
Mr. HASTERT. Mr. Speaker, I move to take the words of the gentleman
down.
The SPEAKER pro tempore (Mr. Walker). The gentleman from Ohio [Mr.
Brown] will suspend, and the gentleman from Illinois [Mr. Hastert] has
demanded the words be taken down.
The gentleman from Ohio will be seated while the clerk transcribes
the words.
{time} 1240
Mr. HASTERT. Mr. Speaker, I withdraw my demand.
The SPEAKER pro tempore (Mr. Walker). The gentleman from Illinois
withdraws his demand. The time of the gentleman from Ohio [Mr. Brown]
has expired.
Without objection, the gentleman from Illinois [Mr. Hastert] will
control time.
There was no objection.
Mr. HASTERT. Mr. Speaker, I yield myself 1 minute.
Mr. Speaker, we heard a lot of rhetoric back and forth in this
Chamber today. I think there has been some good discussion of issues. I
think that we should talk about medical savings accounts and get the
facts out about medical savings accounts and other issues in this bill.
But I think this House does not do itself any honor when in my opinion
we try to impugn a Members' motives of why an issue is included or an
issue is not included. I guess we could go back and forth in this
Chamber and point fingers at each other for this issue or that issue or
this support or that support, but I think we really need to focus on
what those issues are and the positives and negatives, and I will just
say that I will continue to watch and in my opinion when we impugn
other Member's motives, of either side of this aisle, I do not think
that should be tolerated in this Congress, and I will try to make sure
that it does not occur.
Mr. PALLONE. Mr. Speaker, I would inquire about the time that
remains.
The SPEAKER pro tempore. The gentleman from New Jersey [Mr. Pallone]
has 7 minutes remaining and the gentleman from Illinois [Mr. Hastert]
has 3 minutes remaining.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from
California [Mr. Fazio].
Mr. FAZIO of California. Mr. Speaker, I rise in support of the motion
to instruct conferees offered by the gentleman from Michigan [Mr.
Dingell] and in opposition to the partisan agreement reached last
night.
I oppose this agreement because a small band of Republicans have
insisted on including a provision sure to provoke a Presidential veto.
The medical savings account provision favors their wealthy patrons
over those citizens in dire need of health insurance reform.
This legislation began as true bipartisan effort in both houses of
Congress.
The bill's twin goals of affordability and portability were also
supported by the President. On the night of the State of the Union
address, almost 5 months ago, he promised to sign this bill in its
original form.
Indeed, the other body passed their version of this bill by a 100-to-
0 margin. But this extremely rare example of bipartisanship was
hijacked by Republicans in the House who do not seem to want reform.
The MSA provision allows the healthy wealthy to opt out of the
insurance pool and build up their own medical savings accounts.
The result of this is that conventional insurance pools are broken up
and those who are both sick and unable to afford MSA's are potentially
left to fend for themselves.
The long-term effect of this double affliction is to increase the
number of Americans who must go without health insurance. This
provision completely defeats the purpose of health insurance reform.
There is a saying in the other body, ``99 is never enough.''
Unanimity is required. If 100 U.S. Senators can agree on health
insurance reform legislation, why can we not?
I urge my colleagues to oppose this reported conference agreement and
pass a bill that we can all agree on and that the President will sign.
The American people need health insurance reform. Let us not snatch it
away from them for partisan political gain.
Mr. HASTERT. Mr. Speaker, I yield such time as he may consume to the
gentleman from Texas [Mr. Archer], the chairman of the Committee on
Ways and Means.
Mr. ARCHER. I thank the gentleman for yielding time.
Mr. Speaker, this is like a broken record. There is no empirical data
to support what the gentleman from California just said.
Apparently the other side of the aisle has decided that they want to
kill the opportunity for freedom of choice on the part of individuals
and small employers to be able to select their own doctor and to pay
their own medical bills. I do not know why they want to do that, but
they have made that decision.
Now they have come up with this phrase that it benefits only the
healthy and the wealthy. There is no data to support that. In fact,
just the reverse. Both the Journal of American Medicine and the Rand
Study showed just the opposite. The empirical data that we do have
shows that there will be no adverse election.
We cannot continue to listen to this patented rhetoric of it only
helps the healthy and the wealthy with no empirical data to support it.
The SPEAKER pro tempore. The gentleman from Illinois [Mr. Hastert]
has 1\3/4\ minutes remaining, the gentleman from New Jersey [Mr.
Pallone] has 5
[[Page H6140]]
minutes remaining, and the gentleman from New Jersey has the right to
close.
Mr. PALLONE. Mr. Speaker, may I inquire as to how many speakers they
have on the other side that remain?
Mr. HASTERT. We only have one.
Mr. PALLONE. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman
from Rhode Island [Mr. Kennedy].
{time} 1245
Mr. KENNEDY of Rhode Island. Mr. Speaker, you do not really need a
lot of empirical information to understand that insurance companies
only make money off of healthy people, and that if they had a choice in
this world of profit making, sick people cost them money. It is a
given. It is common sense.
So what we were able to do in this Kennedy-Kassebaum bill is get two
things that kept insurance companies from blocking health insurance to
all kinds of people, even people who needed health insurance:
Preexisting condition and portability.
There is agreement on it, and it is wonderful that even Republicans
on the other side of the aisle agreed with this concept, that we needed
to rein in the insurance companies on this issue.
We have agreed to come this far. Why do we need to jeopardize
something that has already been agreed on because we want to put in
this medical savings account? We have agreed on all this. Now what do
they want? The Republicans in the House want to add this medical
savings account.
Guess who supports this? Insurance companies. Guess why? Because,
again, it allows them to only insure healthy people and block out
health insurance for sick people that is going to cost them money.
Just think about who is behind this, and I think you will be able to
understand why you do not need any empirical evidence to know why
medical savings accounts are going to be the killer of health care
reform.
Mr. HASTERT. Mr. Speaker, I yield myself the balance of my time.
Mr. Speaker, I just want to review this and say we have had a lot of
rhetoric, as I said before, back and forth. The gentleman from Rhode
Island talks about class warfare, how only the rich. That is completely
false. There is no empirical data. That is why we have a study in this
bill to look at what medical savings accounts actually do.
For the party on the other side of the aisle that supports big
government decisions, that blocked out medical savings accounts because
they do not want people to make choices, that they do not want people
to test the market for themselves and to see what price and what
services are best suited to themselves and their families, I think this
is a crazy argument. But so be it.
What we need to do is to pass this legislation. We need to appoint
the conference committee. We need to go ahead and meet as a conference,
and then work out what differences there are. It is surprising to me
that the same party that blocked in the other body the ability for us
to name conference committee members so that we can sit down and
discuss this issue is now saying, ``Well, this is an inside,
clandestine, bipartisan agreement.''
We had to sit down and go through the conduits to talk to the White
House, to talk with the other side in the other body, in order for us
to be able to name conferees. It that is not a stalling of the process,
when one Member in the Senate can stall and hold up the process for the
American people, having portability, having health care choice, having
long-term care for senior citizens, when that happens, that is not
democracy. We need to pass this bill today.
Mr. PALLONE. Mr. Speaker, I yield the balance of my time to the
gentleman from Michigan [Mr. Bonior] the distinguished minority whip.
The SPEAKER pro tempore (Mr. Walker). The gentleman from Michigan
[Mr. Bonior] is recognized for 3\1/2\ minutes.
Mr. BONIOR. Mr. Speaker, I rise today to urge my colleagues to
support this motion to instruct, to restore the simple straightforward
bill to protect people's health care which passed by the Senate by a
vote of 100 to 0.
Mr. Speaker, I am not arguing for some partisan position only by my
party. If this motion passes, we will have a bill that all Republicans,
all Democrats, all Americans can support. It is not that we are
supposed to come here and try to figure out this health care bill in an
hour's debate. We are supposed to work across party lines.
Are my colleagues on this side of the aisle so ideologically driven,
so completely out of touch with the real lives of the American people,
that they would destroy any chance for health care reform with this
partisan, divisive amendment?
The clock is ticking, and if we do not act soon, this will go down in
history as one of the least productive Congresses in the history of
this country. So far, not a single thing has been done to improve the
lives of ordinary Americans. Is that something my colleagues want to
live with on this side of the aisle? The minimum wage, we passed it
here, it is going to die. Pension reform, nothing happening. Education
reforms, nothing is happening.
Now we are at the goal line and have a chance to put across a bill
that will guarantee coverage for people, so if they lose their jobs or
change their jobs they will have health insurance, and we have this
medical savings account, which the Washington Post, the New York Times,
Consumers Report, even the Wall Street Journal, has indicated is for
the healthy and the wealthy. Yes, Mr. Archer, the healthy and the
wealthy, driving everybody else's rates up in regular insurance pools.
Mr. Speaker, I urge my colleagues, on behalf of the 637,000
Michiganders who will benefit by this bill, minus this medical savings
account, to vote for the motion to instruct and to send a message to
the country. This is the least we can do in this do-nothing Congress,
is pass a small, scaled-down health care bill that will protect them
and this country.
Ms. JACKSON-LEE of Texas. Mr. Speaker, this motion to instruct will
almost certainly insure the signing into law, of this badly needed
health insurance reform legislation which will help millions of working
American men and women. The House Republicans have the hubris to
include in their version, elements which they know will provoke a veto
by the President. In particular, the special interest medical savings
accounts and malpractice liability provisions have corrupted this
legislation and condemned it and the millions it would help. It seems
to be obvious that my Republican colleagues are much more interested in
scoring political points with their special interest friends than
actually passing legislation which will greatly help the actual people
they were elected to represent.
By adopting the slightly modified Senate bill as our own, we can send
to conference a clean and trouble-free bill that the President has
stated he will indeed sign. It will be free of the untested and
unproven medical savings accounts. While we can all speculate as to
what will happen if we let loose upon the Nation, this new health
insurance creature, we do not really know. And before we radically
change how the men, women, and children receive their fundamental
health care, I believe that more time and study should be applied to
the issue and possibly a pilot experiment done. I say this because
MSA's have the potential to drive up premiums for those who can least
afford it and drive others into the ranks of the uninsured. The devil
is in the details and the details I have seen are very devilish to be
sure. This issue is so controversial, the Senate cannot even appoint
its conference committee members. That fact alone should cause my
colleagues to stop and reassess their priorities and their intentions--
whether it is to pass real legislation which will help all Americans or
to repay their political debts.
The citizens of this country want this reform, clean and unspoiled.
If this Congress does nothing else, this reform bill is one of the most
important things we can do during this session. This legislation will
remove from the nightmares of millions of Americans the fear they are
now plagued with--loss of health insurance benefit and costly medical
bills they cannot pay. I urge all Members to vote for this motion and
secure the health rights of all Americans. Passing the Senate version
cleanly will help Texans and Americans to obtain health insurance in
spite of preexisting condition and be able to carry their health
insurance with them when they leave their job.
Mrs. LINCOLN. Mr. Speaker, I rise today to share my views regarding
the motion to instruct conferees on H.R. 3103, the Health Coverage
Availability Act, offered by my friend from Michigan, Mr. Dingell.
I support coverage of mental health benefits by insurance companies,
as long as the coverage does not cause a large increase in premiums for
everyone else in the insurance pool. Mental health illnesses are a
significant problem in this Nation, and if left untreated, can cause
serious harm to the patients as well
[[Page H6141]]
as their loved ones. In addition, it is fiscally responsible to provide
mental health treatment because proper preventive measures allow many
patients to lead productive lives without having to be admitted into
expensive long-term-care facilities. Mr. Dingell's motion asks for the
maximum level of mental health coverage that does not drive up the
premium costs for others, and I am supportive of this motion.
In addition, the motion deletes medical savings accounts [MSAs] from
H.R. 3103. Although I supported final passage of H.R. 3103 in late
March because of the importance of providing workers health insurance
portability, I did not support the MSA provisions as written in the
bill. If we are going to include MSAs in this legislation, I believe
that we should implement them on a demonstration basis so we can test
the cost effectiveness of MSAs as well as the impact they would have on
the insurance pool as a whole. We must ensure that the health and well-
being of all Americans is the most important consideration regarding
the establishment of MSAs, not just the health of those who can afford
a special account.
Mr. Speaker, H.R. 3103 has many important provisions. It prohibits
insurance companies from denying health care coverage to workers who
move to another company, or who lose their jobs or become self-
employed. The legislation also bars insurers from excluding coverage of
preexisting illnesses for more than a year. In addition, this bill
increases the tax deduction for health insurance costs paid by the
self-employed, and it expands the opportunity for small businesses to
form coalitions to provide them with health insurance.
Enactment of these measures is too important to be held up by
disagreements on mental health benefits and MSAs. Therefore, I hope
that we will move swiftly toward compromise on these issues so that we
can provide our constituents with quality health insurance reform
legislation.
The SPEAKER pro tempore. Without objection, the previous question is
ordered on the motion to recommit.
There was no objection.
The SPEAKER pro tempore. The question is on the motion to recommit.
The question was taken; and the Speaker pro tempore announced that
the noes appeared to have it.
Mr. PALLONE. 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 182,
nays 235, answered ``present'' 2, not voting 15, as follows:
[Roll No. 226]
YEAS--182
Abercrombie
Ackerman
Andrews
Baesler
Baldacci
Barcia
Barrett (WI)
Becerra
Beilenson
Bentsen
Berman
Bevill
Bishop
Blumenauer
Bonior
Borski
Boucher
Browder
Brown (CA)
Brown (OH)
Bryant (TX)
Bunn
Cardin
Chapman
Clay
Clayton
Clement
Clyburn
Coleman
Collins (IL)
Collins (MI)
Conyers
Costello
Coyne
Cramer
Cummings
Danner
de la Garza
DeFazio
DeLauro
Dellums
Dicks
Dingell
Dixon
Doggett
Dooley
Doyle
Durbin
Edwards
Engel
Eshoo
Evans
Farr
Fattah
Fazio
Fields (LA)
Filner
Flake
Foglietta
Ford
Frank (MA)
Frost
Furse
Gephardt
Gilman
Gonzalez
Gordon
Green (TX)
Gutierrez
Hall (OH)
Hefner
Hilliard
Hinchey
Holden
Hoyer
Jackson (IL)
Jackson-Lee (TX)
Jefferson
Johnson (SD)
Johnson, E. B.
Johnston
Kanjorski
Kaptur
Kennedy (MA)
Kennedy (RI)
Kennelly
Kildee
Kleczka
Klink
LaFalce
Lantos
Levin
Lewis (GA)
Lofgren
Lowey
Luther
Maloney
Manton
Markey
Martinez
Martini
Mascara
Matsui
McCarthy
McDermott
McHale
McKinney
McNulty
Meehan
Meek
Menendez
Millender-McDonald
Miller (CA)
Minge
Mink
Moakley
Mollohan
Moran
Morella
Murtha
Nadler
Neal
Oberstar
Obey
Olver
Ortiz
Orton
Owens
Pallone
Pastor
Payne (NJ)
Payne (VA)
Pelosi
Peterson (FL)
Pomeroy
Rahall
Rangel
Reed
Richardson
Rivers
Rose
Roukema
Roybal-Allard
Rush
Sabo
Sanders
Sawyer
Schroeder
Schumer
Scott
Serrano
Skaggs
Skelton
Slaughter
Spratt
Stark
Stokes
Studds
Stupak
Tanner
Tejeda
Thompson
Thornton
Thurman
Torkildsen
Torres
Towns
Traficant
Velazquez
Vento
Visclosky
Volkmer
Ward
Waters
Watt (NC)
Waxman
Williams
Wilson
Wise
Woolsey
Wynn
Yates
NAYS--235
Allard
Archer
Armey
Bachus
Baker (CA)
Baker (LA)
Ballenger
Barr
Barrett (NE)
Bartlett
Barton
Bass
Bereuter
Bilbray
Bilirakis
Bliley
Blute
Boehlert
Boehner
Bonilla
Bono
Brewster
Brownback
Bryant (TN)
Bunning
Burr
Burton
Buyer
Callahan
Camp
Campbell
Canady
Castle
Chabot
Chambliss
Chenoweth
Christensen
Chrysler
Clinger
Coble
Coburn
Collins (GA)
Combest
Condit
Cooley
Cox
Crane
Crapo
Cremeans
Cubin
Cunningham
Davis
Deal
DeLay
Diaz-Balart
Dickey
Doolittle
Dornan
Dreier
Duncan
Dunn
Ehlers
Ehrlich
Emerson
Ensign
Everett
Ewing
Fawell
Fields (TX)
Flanagan
Foley
Forbes
Fowler
Fox
Franks (CT)
Franks (NJ)
Frelinghuysen
Frisa
Funderburk
Gallegly
Ganske
Gekas
Geren
Gilchrest
Gillmor
Goodlatte
Goss
Graham
Greene (UT)
Greenwood
Gunderson
Gutknecht
Hall (TX)
Hamilton
Hancock
Hansen
Hastert
Hastings (WA)
Hayworth
Hefley
Heineman
Herger
Hilleary
Hobson
Hoekstra
Hoke
Horn
Hostettler
Houghton
Hunter
Hutchinson
Hyde
Inglis
Istook
Johnson (CT)
Johnson, Sam
Jones
Kasich
Kelly
Kim
King
Kingston
Klug
Knollenberg
Kolbe
LaHood
Largent
Latham
LaTourette
Laughlin
Lazio
Leach
Lewis (CA)
Lewis (KY)
Lightfoot
Linder
Lipinski
Livingston
LoBiondo
Longley
Lucas
Manzullo
McCollum
McCrery
McHugh
McInnis
McIntosh
McKeon
Metcalf
Meyers
Mica
Miller (FL)
Molinari
Montgomery
Moorhead
Myers
Myrick
Nethercutt
Neumann
Ney
Norwood
Nussle
Oxley
Packard
Parker
Paxon
Peterson (MN)
Petri
Pickett
Pombo
Porter
Portman
Poshard
Pryce
Quillen
Quinn
Radanovich
Ramstad
Regula
Riggs
Roberts
Roemer
Rogers
Rohrabacher
Ros-Lehtinen
Roth
Royce
Salmon
Sanford
Saxton
Scarborough
Schaefer
Seastrand
Sensenbrenner
Shadegg
Shaw
Shays
Shuster
Sisisky
Skeen
Smith (MI)
Smith (NJ)
Smith (TX)
Smith (WA)
Solomon
Souder
Spence
Stearns
Stockman
Stump
Talent
Tate
Tauzin
Taylor (MS)
Taylor (NC)
Thomas
Thornberry
Tiahrt
Upton
Vucanovich
Walker
Walsh
Wamp
Watts (OK)
Weldon (FL)
Weldon (PA)
Weller
White
Whitfield
Wicker
Wolf
Young (AK)
Young (FL)
Zeliff
Zimmer
ANSWERED ``PRESENT''--2
Goodling
Jacobs
NOT VOTING--15
Bateman
Brown (FL)
Calvert
Deutsch
English
Gejdenson
Gibbons
Harman
Hastings (FL)
Hayes
Lincoln
McDade
Schiff
Stenholm
Torricelli
{time} 1315
Messrs. SAXTON, ROEMER, HORN, and HOSTETTLER changed their vote from
``yea'' to ``nay.''
Mr. GILMAN changed his vote from ``nay'' to ``yea.''
So the motion to instruct was rejected.
The result of the vote was announced as above recorded.
A motion to reconsider was laid on the table.
{time} 1315
The Speaker pro tempore (Mr. Walker).
Without objection, the Chair appoints the following conferees:
Messrs. Archer, Thomas, Bliley, Bilirakis, Goodling, Fawell, Hyde,
McCollum, Hastert, Gibbons, Stark, Dingell, Waxman, Clay, Conyers, and
Bonior.
There was not objection.
____________________