[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.

                          ____________________