[Congressional Record Volume 142, Number 116 (Thursday, August 1, 1996)]
[House]
[Pages H9785-H9796]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
{time} 1830
CONFERENCE REPORT ON H.R. 3103, HEALTH INSURANCE PORTABILITY AND
ACCOUNTABILITY ACT OF 1996
Mr. ARCHER. Pursuant to House Resolution 502, I call up the
conference report on the bill (H.R. 3103) to amend the Internal Revenue
Code of 1986 to improve portability and continuity of health insurance
coverage in the group and individual markets, to combat waste, fraud,
and abuse in health insurance and health care delivery, to promote the
use of medical savings accounts, to improve access to long-term care
services and coverage, to simplify the administration of health
insurance, and for other purposes, and ask for its immediate
consideration.
The Clerk read the title of the bill.
The SPEAKER pro tempore (Mr. Ney). Pursuant to House Resolution 502,
the conference report is considered as having been read.
(For conference report and statement, see proceedings of the House of
July 31, 1996, at page H9473).
The SPEAKER pro tempore. The gentleman from Texas [Mr. Archer] and
the gentleman from California [Mr. Stark] will each control 30 minutes.
The Chair recognizes the gentleman from Texas [Mr. Archer].
general leave
Mr. ARCHER. Mr. Speaker, I ask unanimous consent that all Member may
have 5 legislative days within which to revise and extend their remarks
and include extraneous matter on the conference report on H.R. 3103.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Texas?
There was no objection.
Mr. ARCHER. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, this is truly a great day and a great week. As
significant as all our actions may be for this historic new Congress,
the action we take today is even greater for someone else. That someone
else may be the victim of breast cancer, locked in a job that she
cannot change because she fears losing her health insurance. It may be
a victim of diabetes. It may be someone who has had a heart attack, a
stroke, or anyone who has ever been seriously ill.
It also, Mr. Speaker, may be my new little baby grandchild, who, born
prematurely this year, came into the world weighing just 2 pounds. To
me, this little boy is a beautiful child who, thanks to the wonder of
modern medicine, can now have a full life. But to others, my grandchild
is still a preexisting condition. When he gets older, he too may not be
able to change jobs or even get insurance in the first place.
But I am happy to say that this bill changes all that. This bill lets
people change jobs without losing their health insurance, even if they
have a preexisting condition.
What a major breakthrough for my grandson, Archer Samuel Hadley, and
for millions of Americans who now know this Congress has heard their
pleas and answered their prayers. This is the bill that does that, and
much, much more. It powerfully fights fraud and abuse by creating new
criminal penalties and by increasing funding for prosecution and
investigation.
It creates strong and workable medical savings accounts so people can
choose their own doctors and control their own health care destiny,
seeking the best value in the marketplace, without relying on third
parties to pay the bill. It creates new tax deductions that help make
health care more available and affordable for millions of Americans.
Mr. Speaker, this is the health bill that the American people have
wanted for years, and Mr. Speaker, we did it without a government
takeover of the health care delivery system of this country.
We promised to make these changes, and I am proud that we have done
it, working together in a bipartisan way, doing the job the American
people expect of this Congress.
It has been a great week for this Republican Congress, and a great
week for all of us. It has been a great 2 years of accomplishment for
our efforts to reform Congress and change America. This Congress will
go down in history as the did-something Congress. More importantly, it
has been a great week for the American people.
[[Page H9786]]
Mr. Speaker, I reserve the balance of my time.
Mr. STARK. Mr. Speaker, I yield myself 4 minutes.
Mr. Speaker, the bill that passed the Senate unanimously was a great
bill. The conference product that we discuss today is an okay bill. The
House Republicans have turned the Senate silk purse into a sow's ear,
and there are many reasons for disappointment.
For example, why, my Republican friends, is there no mental health
parity amendment? We should have done it. It was part of the bill
passed by the Senate. It does not cost much. Sixteen cents per thousand
is all it costs. We could raise the deductibility $5 for every policy
and pay for it. So I would say to the gentleman from Texas, Bill
Archer, if his grandson had been born with mental illness, he could not
have afforded to be treated because this bill would deny him that
coverage.
We did not have a real conference where we could have worked this
out. We could have phased in the cost of eliminating these caps, but
the Republicans would refuse to meet on this issue.
The bill's antifraud provisions are bad. The advisory opinions on
intent-based fraud cases are unprecedented, and the Justice Department-
HHS's Inspector General strongly oppose them. It will cost Medicare
$388 million in foregone revenues over 6 years. Advisory opinion fees
are not dedicated to the inspector general, and it devastates the
agency's ability to fight fraud that they talk about.
The MSA's are bad. The earlier version could cost $1 billion over 5
years. Who knows what this modest plan will do? But it is a payoff to
J. Patrick Rooney and the Golden Rule Insurance Co., who have given the
Republicans over $1.2 million, that we can determine.
The conference agreement tries to limit the harm by limiting MSA's,
but we doubt if it will. Last night someone inserted a 2-year monopoly
patent extension for the American Home Products Co., which has really
nothing to do with this bill.
There is a guaranteed issue only to small groups. The Senate bill
guaranteed that any group, any company, could buy any group health plan
sold in a State. The House Republicans limited the guaranteed issue to
small businesses of 50, so a firm of 51 people does not have guaranteed
access while a firm of 50 does. It makes no sense at all. It is silly.
It discriminates against mid-size companies in dangerous lines of work:
logging companies, for example.
The MediGap duplication. This allows the sale of unnecessary and
duplicative health insurance policies, a special interest gift to
American Family Life Insurance Co. The consumer groups are outraged.
This will let unscrupulous salesmen once again sell policies which
seldom or never pay out any benefits.
As for phasing in the deduction for self-insured, the Senate did a
far better job. The GOP bill goes to 80 percent by 2006. The House
Democrats would have had 80 percent by 2002. It is backloaded. They
could and should have used the MSA money to increase the deduction for
all self-employed.
Mr. Speaker, this bill channels people into a limited number of plans
and could drive up rates. There is a proposal for cross-subsidization,
but there is no guarantee. The Senate bill had an easy and obvious
solution: Every individual plan offered by an insurer had to be
available to an eligible individual. We do not need this complicated
proposal. We should have kept it simple.
What the bill does not do is the price of policies are unaffected.
They could remain too high. This is only going to help 400,000 people,
the CBO tells us. The number of uninsured is rising at 1 million a
year. Medicaid cuts passed yesterday will hurt millions of people.
We took one step forward with this bill, and yesterday we took 10
steps backward, so I hope that this bill could be expanded and returned
to conference to do the job and the proper job that was done by the
Senate under the leadership of Senator Kennedy.
Mr. Speaker, I reserve the balance of my time.
Mr. ARCHER. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I would simply say that at this moment, when we are
going to do so much good for so many Americans, I am saddened that my
friend, the gentleman from California, has taken a confrontational
attitude to attempt to try to pick apart this bill. Instead of looking
at the good, he is looking at things that he does not think are
perfect. It is very much like the individual who goes into the Sistine
Chapel and looks up at that gorgeous ceiling and says, oh, look at the
cracks.
Mr. Speaker, I yield 3 minutes to the gentleman from Virginia [Mr.
Bliley], the respected chairman of the Committee on Commerce.
(Mr. BLILEY asked and was given permission to revise and extend his
remarks.)
Mr. BLILEY. Mr. Speaker, I thank the gentleman from Texas, chairman
of the Committee on Ways and Means, for yielding me the time.
Mr. Speaker, as we say down in Richmond, this day has been a long
time coming.
This measure gives American workers something they've been promised
for 20 years or more--the right not to be denied health insurance
coverage because of a pre-existing condition.
They'll have that right, whether they change jobs or, God forbid,
lose their jobs.
But that's not all. This bill also assures the job-creators--those
men and women in small businesses all across America--that they, too,
will be guaranteed that they can now purchase coverage from insurers.
It's long overdue. And it's being brought to you by the first
Republican Congress in 40 years.
Not the big labor bosses who promised it all these years.
Not the Clinton White House that demagogued this issue from coast to
coast.
No, I repeat: it's being brought to American workers by the first
Republican Congress in 40 years.
That's because those folks sacrificed the good on the altar of the
perfect.
Common-sense health care reform isn't enough, they said.
Providing Americans the right to keep their private health insurance
isn't adequate, they said.
They didn't care about those things.
What they cared about was universal coverage--Canadian-style health
care.
They failed in that goal, and their failure brought this Republican
Majority to Washington.
Today, that Republican Majority delivers what the others just
promised.
Our Committee, I'm proud to say, played a key role in this
legislation--with what I believe to be the heart and soul of this
measure.
Because of the Commerce Committee's portability provisions, Americans
who lose their health insurance because they lose or change their jobs,
once they exhaust their COBRA coverage, will have a guaranteed right to
purchase health insurance.
From now on, the Insurance Companies will have to offer these
individuals a comprehensive policy.
Every day in this country, men, women and children are diagnosed with
leukemia, with cancer, with cystic fibrosis, with diabetes. With any
number of illnesses that the insurance companies call ``pre-existing
conditions.''
Those poor people and their families have enough on their minds,
without having to worry that if they change jobs, or move, or get laid
off, they'll lose coverage for those conditions because of a
``preexisting condition'' clause.
Because of the Commerce Committee's provisions in this bill, they
won't ever have to worry about that, ever again.
Mr. Speaker, this year our committee has improved the safety of the
food we eat, the purity of the water we drink.
We've improved the phones we communicate with, the computers we use,
the television we watch.
With the Securities bill, we've made it easier for American
businesses to raise the money they need to create new jobs.
And with Securities Litigation Reform, we've scored the first victory
in my memory against the powerful Trial Lawyers' Lobby.
Mr. Speaker, that ain't bad.
But none of these, in my mind, is as important to Americans as what
we've achieved today.
This is an historic accomplishment, one that has been too long in
coming.
It's a pity it didn't happen three years ago. It could have, but some
wanted to over-reach.
I want to thank my friend, Mr. Dingell, who has worked so hard for so
many years in fulfillment of this goal.
[[Page H9787]]
I want to thank the chairman of our Health Subcommittee, Michael
Bilirakis, and his ranking Democrat, Henry Waxman.
But most of all, I want to thank our colleague from Illinois, Dennis
Hastert, without whose singular efforts this day would never have
happened.
In this Olympic week we've gone from the ``gridlock Congress'' to the
``gold medal Congress.''
This is a great day, Mr. Speaker. A great day for this 104th
Congress, a great day for millions of American workers and their
families.
Mrs. KENNELLY. Mr. Speaker, I yield 2 minutes to the gentleman from
Maryland [Mr. Cardin].
Mr. CARDIN. Mr. Speaker, I thank my friend, the gentlewoman from
Connecticut, for yielding me this time.
Mr. Speaker, let me first start by thanking my colleagues on both
sides of the aisle, particularly my two friends on the Committee on
Ways and Means, the gentlemen from California, Mr. Stark and Mr.
Thomas, for bringing forward a bill on health care reform.
Mr. Speaker, I support the Kennedy-Kassebaum bill, the bill from
conference that is before us. This bill is not a panacea of health care
reform, but it is a good bill, on balance, that expands access to
health coverage for working Americans. When this bill is signed into
law, it will ensure that if you have insurance, you can keep it. This
is an important change from today's system. It will provide a new
measure of health security for working Americans.
The conference report before us ensures that working Americans with
preexisting conditions cannot be denied health insurance as long as
they maintain coverage. In addition, it would prevent insurance
companies from using genetic information to deny health coverage. It is
absurd that today's genetic testing advances are being used by
insurance companies to deny coverage. This bill will end that practice.
Mr. Speaker, let me just give one example of how a typical working
family can benefit from the legislation before us. The bill will
provide someone the freedom to leave IBM to start their own computer
company, even if a member of that person's family is suffering from
diabetes. Today that person would be unable to find an insurance
company who would cover the family if they went out on their own. After
passage of this legislation, that person would be able to pursue that
career without the fear of putting their family's health in danger.
In addition to the health insurance reforms, the bill would equalize
the tax treatment of health insurance premiums between the self-
employed and major corporations. This change, based on legislation I
authored, will benefit thousands of small business owners around our
country.
Today's consideration of this bill is long overdue. It is an
important step. However, it is by no means the final step or even a
comprehensive solution to health reform. The bill fails to address
affordability of health insurance. This is a vital issue which we must
not overlook. We still have a long way to go. I urge my colleagues to
continue to work together for comprehensive health care reform to
extend health coverage to all Americans.
{time} 1845
Mr. ARCHER. Mr. Speaker, I yield such time as he may consume to the
gentleman from Kansas [Mr. Roberts], the distinguished chairman of the
Committee on Agriculture.
(Mr. ROBERTS asked and was given permission to revise and extend his
remarks.)
Mr. ROBERTS. Mr. Speaker, as a cofounder and former chairman of the
Rural Health Care Coalition, I rise in support of this bill. I thank
Mr. Archer, Mr. Bliley, Mr. Thomas, Mr. Goodling, and Mr. Hastert for
their leadership and perseverance.
Mr. Speaker, I rise in strong support of the conference report to
H.R. 3103, the Health Insurance Portability and Accountability Act.
This bill includes sensible, workable provisions to expand access to
affordable health care insurance for America's families.
This legislation is especially important to my constituents in
Kansas. Ten percent of Kansans lack any form of health insurance. These
folks are generally small business owners or self-employed farmers and
ranchers. This bill takes several steps to bring relief to these
individuals and their families by expanding their insurance options.
first, this legislation will make health insurance portable. Under
H.R. 3103, the 4 million Americans who are staying in their jobs just
to maintain their health insurance benefits will finally be free to
pursue other opportunities. This ``job lock'' is a real problem for not
only the employer and the employee, but also for the economy. Today,
too many working parents are afraid to pursue new opportunities, start
a new career or become an entrepreneur because they don't want to lose
the health insurance they now have.
Second, this legislation will limit the preexisting condition
requirements that currently prevent 21 million Americans from getting
health insurance coverage. I have heard horror story after horror story
about families that have lost everything just because their insurance
company won't cover Dad with his heart condition or the new baby who
was born with diabetes.
Third, this legislation will make health insurance affordable.
Individuals who lose coverage through their employer will now be able
to purchase affordable health insurance on their own. This legislation
will also bring some well-deserved relief by increasing the tax
deduction for health insurance for self-employed individuals, including
the small business owners, farmers, and ranchers in Kansas, from the
current 30 percent to 80 percent. This increase in deductibility is
something that my colleagues and I on the Rural Health Care Coalition
have been working toward for years.
Finally, this legislation takes the first step to make health
insurance accountable through a limited medical savings accounts
demonstration project. It's time that we all took an active role in the
health care decisions that affect our daily lives and pocketbooks.
Medical savings accounts will put families in control of their health
care. In Kansas, which is home to over 65,000 small businesses, these
MSA accounts provide the opportunity for individuals to choose where to
spend hard-earned health care insurance dollars.
My colleagues, the time has finally come. We have agreed on real
reform that will get at the root of one of the most serious flaws in
our health care system. I applaud Chairman Archer and all those who
have worked tirelessly on this effort and I urge my colleagues to join
me in support of the conference agreement.
Mr. ARCHER. Mr. Speaker, I yield 3 minutes to the distinguished
gentleman from Pennsylvania [Mr. Goodling], the chairman of the
Committee on Economic and Educational Opportunities.
(Mr. GOODLING asked and was given permission to revise and extend his
remarks.)
Mr. GOODLING. Mr. Speaker, I rise in support of the conference report
on H.R. 3103, The Health Insurance Portability and Accountability Act
of 1996. This is truly an historic occasion which rivals the passage of
ERISA (the Employee Retirement Income Security Act of 1974) upon which
the foundation of this health insurance reform legislation is based.
The provisions in the conference report relating to portability and
health insurance accessibility are structured similarly to those in the
House passed bill and the ERISA Targeted Health Insurance Reform
legislation originally reported by the Committee on Economic and
Educational Opportunities. Under the new portability protections,
employees can no longer be told that their plan will not cover them
because of a preexisting medical condition when they are continuously
insured. Small employers can no longer be told by insurers that health
insurance is not available to their employees because of the risks of
their jobs or their previous claims experience. In sum, employees will
no longer have to fear, when they leave their job or take a new job,
that they or their loved ones will lose access to health insurance.
This legislation will actually increase the choice of health
insurance coverage offered to American workers, but without taking away
the coverage they currently enjoy. These choices includes high
deductible health plans and medical savings accounts for which the
employees of small employers and the self-employed will be newly
eligible.
Former employees who have exhausted their access to employer coverage
will also be given important new rights to acquire health insurance in
the individual market even though they or a dependent may have a
preexisting medical condition.
Health coverage will also be made more available and affordable by
granting millions of self-employed businessmen and businesswomen the
right to deduct their health insurance costs on a basis similar to
corporations. When fully phased in, these Americans will be able to
deduct 80% of their premium costs.
[[Page H9788]]
Both public and private health plans will be better protected from
unnecessary costs under the provisions of Title II, which are designed
to prevent health care fraud and abuse and to recover any losses in
connection with such plans.
The conference agreement is a solid step forward in securing
increased health insurance accessibility, affordability and
accountability for American workers and their families.
I would be remiss, however, if I did not mention my disappointment
that the conference report does not include two important reforms
designed to expand coverage and reduce health insurance costs.
Malpractice reform was dropped as a concession to the White House in
order to move the legislation along. I reject the idea that reforms of
malpractice awards are unnecessary and will continue to insist we
address this issue in the future.
Also, by omitting the small business pooling provisions under
Subtitle C of the House bill, I believe this Congress has missed an
important opportunity to extend more affordable coverage to the
millions of uninsured employees working for our country's small
businesses who today do not have health insurance coverage. These
provisions would have built upon the ERISA cornerstone of this Nation's
employee benefits law to allow employers, particularly small employers,
to achieve economies of scale by joining together to form either self-
insured or fully-insured health plans. The number of uninsured workers
will be a continual reminder that this mechanism for expanded health
coverage is needed and should be included at the earliest possible
time.
Nonetheless, the legislation does preserve without change the ERISA
preemption cornerstone which has fueled the marketplace dynamics that
have recently reduced health insurance cost inflation, at least in the
large group market. Also reflected in the new preemption section of
this Act (adding section 704 to ERISA) is the need for national
uniformity regarding the procedures and reporting required to make the
portability mechanism work for all the employee health benefit plans
covered under the legislation.
The participants and beneficiaries of ERISA covered health plans can
also look to the uniform remedies under that Act to enforce their
rights to the portability, preexisting condition, enrollment,
renewability and nondiscrimination requirements applicable to both
ERISA plans and insurers under ERISA Part 7. Identical provisions apply
to church plans (but only under the Internal Revenue Code) and to
governmental plans and insurers (under the Public Health Service Act).
Section 104 makes it clear that these identical provisions are to be
interpreted, administered and enforced so as to have the same effect at
all times, regardless of the agency having primary authority with
respect to a particular entity or plan.
Finally, I consider this legislation particularly forward-looking in
its response to several issues of importance to all Americans. First is
the growing long-term care needs of the elderly and disabled. In
this connection, the legislation gives individuals and employers a
strong new incentive to plan ahead for long-term care expenditures.
Also, lest it be overlooked, the legislation addresses another issue
that all may one day face, and that is the extent to which the genetics
of each one of us may determine our future health status and, thus, our
ability to obtain health insurance coverage. In this regard, the
legislation prohibits a group health plan or insurer from excluding an
individual from enrolling (or continuing to be enrolled) under a group
health plan based on genetic information. In addition, genetic
information is not to be treated as a preexisting medical condition in
the absence of a diagnosis of the condition related to such genetic
information.
In conclusion, the Health Insurance Portability and Accountability
Act includes vital health insurance protections for American workers
and their families. These health insurance portability and
accessibility consumer protections are the common sense reforms that
Americans have said they need and that Republicans have attempted to
enact over the past several congresses. They could have been enacted
earlier but were sacrificed on the altar of big government.
In contrast, these common sense reforms were fashioned to avoid the
pitfalls of the Clinton plan--that is, the elimination of ERISA health
plans, one-size-fits-all mandated benefits and price controls that lead
to health care rationing. Rather than trying to create a new health
care system, the Health Insurance Portability and Accountability Act
seeks to build on those elements of the Nation's employment-based
system that work well--namely the fully-insured and self-insured group
health plans under ERISA--while at the same time making the important
changes to the current system on which there is a consensus. After
nearly three decades of debate on health insurance reform the time has
come to pass this landmark legislation and seek the President's
signature.
Mrs. KENNELLY. Mr. Speaker, I yield myself 2 minutes.
Mr. Speaker, I rise today in strong support of a simple premise--when
Americans leave or lose their job, they should not lose access to
health insurance. The legislation before us will now make that simple
guarantee the national standard.
However, I urge Members to resist the temptation to oversell this
legislation as a panacea. Many Americans who cannot afford health
insurance will still face financial barriers even after this
legislation is enacted.
I would also like to express my strong support for two other
provisions in the bill--favorable tax treatment for--long-term care
health insurance--and accelerated death benefits. I have worked on both
of these issues for many years.
Providing incentives for people to protect themselves against the
costs of long-term care will not only safeguard the family savings for
millions of Americans, but it may also reduce future Medicaid costs.
And allowing the terminally ill to receive the proceeds of their life
insurance tax free will assure access to health care for those
individuals. I only wish the committee had also included vital consumer
protections to prevent the terminally ill from being taken advantage of
during a very vulnerable time.
I urge Members to support this effort to make health coverage more
available--and to help the chronically ill and terminally ill pay their
medical bills.
Mr. Speaker, I yield 3 minutes to the gentleman from Missouri [Mr.
Clay].
(Mr. CLAY asked and was given permission to revise and extend his
remarks.)
Mr. CLAY. Mr. Speaker, I will vote for the conference report on H.R.
3103 because it will make a significant improvement in the lives of
many and a modest improvement in the lives of millions more.
The conference report will provide important protection to
individuals who have been laid off or have retired and are trying to
purchase health insurance for themselves.
It will allow workers to maintain their health coverage when they
change jobs, even if they or a family member have a chronic health
condition.
The report will require insurance companies and HMO's to sell
policies to small businesses. They will no longer be able to pick and
choose the companies they want to sell insurance to.
Insurance companies and employers will not be able to deny coverage,
drop coverage or change more just because an individual has a medical
condition.
While I will vote for the conference report, it has serious
shortcomings that, quite frankly, were completely avoidable.
The shame of it all is that the Republicans took the Senate bill--a
perfectly good bill that passed the Senate by a vote of 100 to 0--and
made it weaker. They added an unnecessary, unproven and ill-conceived
tax break that will only benefit special interest insurance companies
and affluent taxpayers. The Republicans have sugarcoated this tax break
by calling it health reform. But, it is nothing more than another tax
break.
Republicans, by dropping important protections for mentally ill
individuals, have missed a great opportunity to break new ground in the
protection of one of the Nation's most vulnerable groups. Given the
Domenici-Wellstone amendment in the Senate, the Conferees, if given the
chance, could have developed a sensible compromise that would have
provided significant protection for mentally ill persons. But the
conferees were never given the chance. A Bipartisan compromise on
mental health parity was never in the cards. It was largely for this
reason that I refused to sign the conference report.
Accordingly, I urge my colleagues to support the motion to recommit.
It will restore important protections for the mentally ill.
[[Page H9789]]
Mr. Speaker, I support this bill, but not the process that got us to
this point. It is wrong that the House Republicans made health reform a
partisan issue. The 40 million individuals who are uninsured and the
million of others who are locked into their jobs because of chronic
health conditions deserve better.
Mr. ARCHER. Mr. Speaker, I yield 4 minutes to the distinguished
gentleman from California [Mr. Thomas], chairman of the Subcommittee of
Health of the Committee on Ways and Means.
Mr. THOMAS. Mr. Speaker, I yield to the gentleman from Hawaii [Mr.
Abercrombie] for the purpose of engaging in a colloquy.
Mr. ABERCROMBIE. I thank the gentleman from California [Mr. Thomas]
for yielding and for engaging in this colloquy which is very important
to the people of Hawaii.
Mr. Speaker, the question I have for this colloquy is, does H.R. 3103
adversely affect the integrity and purpose of the existing Hawaii
Prepaid Health Care Act of 1974?
Mr. THOMAS. I tell the gentleman that H.R. 3103 does not adversely
affect Hawaii's current exception, which is in fact the Health Care Act
of 1974. In addition to that, the whole question of MSA's that has been
discussed is a tax question, and that also does not affect Hawaii's
system. The new MSA pilot program is an opportunity and not a mandate
affecting employer or individual health insurance plans. I am pleased
to say that Hawaii can go its own way.
Mr. ABERCROMBIE. I thank the gentleman from California.
Mr. THOMAS. Mr. Speaker, I would take my own time to mention briefly
that I have listened to several Democrats, and I assume we will hear
from several more. Their basic message is: You woulda, coulda, shoulda.
I just find it totally ironic. All you have to do is just come with
me 3 short years ago. I was not the chairman of the Subcommittee on
Health and Environment then. I was the ranking member. The gentleman
from California [Mr. Stark] was the chairman. What the Democrats did
when they had a majority in the House and the Senate and had a member
of their own party in White House is put absolutely nothing on the
floor of this House; absolutely nothing on portability; absolutely
nothing increasing penalties on waste, fraud, and abuse.
The Democrats talk woulda, coulda, shoulda, about a product.
I want to address myself to my Republican colleagues here. I do not
want us to vote against the conference report because minority leader
Daschle joined us in a press conference praising the work product
working positively between the House and the Senate. And I do not want
my Republican colleagues to vote against this conference report because
the senior Senator from Massachusetts [Mr. Kennedy] signed the
conference report and said some very nice words about all of us working
very hard to produce a good product.
I do want my colleagues to vote for this conference report because a
name has not been mentioned on this floor who not only deserves to be
mentioned but deserves to be praised. That is the senior Senator from
Kansas, the chairwoman. Nancy Kassebaum is who this legislation belongs
to. I think it is a very appropriate capping of an illustrious career
to take this positive document and place it before us.
So despite all of the rather petulant-sounding woulda, coulda,
shoulda from those people who owned the House, the Senate and the
presidency and put nothing on this floor, I would just like to say it
was a real pleasure working with chairman of the Committee on Ways and
Means, the gentleman from Texas [Mr. Archer], and the staff members on
that committee who worked extremely hard: Chip Kahn, Kathy Means and
Elise Gemeinhardt.
It was a real pleasure working with the Committee on Commerce,
Chairman Bliley, Subcommittee Chairman Bilirakis, with Howard Cohen and
Melody Harned.
It was a real pleasure working with Chairman Goodling, Subcommittee
Chairman Harris Fawell, and Russ Mueller as a hardworking staff; with
Chairman Hyde of the Committee on the Judiciary, and Diane Schacht
working very hard.
All of those people should be proud. They delivered. We delivered. We
have on this floor a conference report that makes a real change in the
lives of millions of Americans. We make health care more affordable,
more available, and we did it without a government takeover of health
care, which was what they were trying to get on the floor. Thank
goodness enough Democrats, who made up the majority at that time, said
no. And thank goodness enough Democrats today will support this
excellent conference report, we will send it to the President, and the
president will sign it.
Mr. STARK. Mr. Speaker, I yield such time as he may consume to the
gentleman from Illinois [Mr. Yates].
(Mr. YATES asked and was given permission to revise and extend his
remarks.)
Mr. YATES. Mr. Speaker, I rise in support of the conference report.
It carries at long last--it should have been passed years ago.
Unfortunately, its time had not yet come because of the strong
opposition of special interests.
I'm pleased that it provides mobility in coverage and requires
overlooking ill-health problems. It is a first step--there is much more
that has to be done--in the field of mental health, for example.
I commend those who brought this bill before the Congress. I look
forward to working with them to enforce the opportunity of providing
much better access to health care to the people of America.
I intend to support the motion to recommit because that can be one
way to make the bill better. If that fails I intend to support the
bill.
Mr. STARK. Mr. Speaker, I yield 5 minutes to the gentleman from
Michigan [Mr. Dingell].
(Mr. DINGELL asked and was given permission to revise and extend his
remarks.)
{time} 1900
Mr. DINGELL. Mr. Speaker, I enjoyed the remarks of my good friend
from California. I was so delighted to hear him. It ranks with the
conversion of St. Paul. I have not seen any lightning bolts, and I have
not observed him riding a jackass, but I do want to say that my
Republican colleagues have finally come around and supported Kennedy-
Kassebaum. Wonderful. Great news.
Having said that, I commend the gentleman for having had the scales
removed from his eyes, and I urge him to support the same kind of
glorious advances in other issues. It would be helpful.
I also would say to him that he was talking about the days when the
Democrats ran the Congress and now the days when the Republican run the
Congress. This is the way things go, but I would say that the gentleman
from California has an urgent and an important responsibility in this
place and that is to pay the bills.
I was just thinking the other day how nice it would be if my office
rent were paid on time, if my suppliers were paid on time, if my
telephone bills were paid on time, and if the bills of the other
Members on both sides of the aisle were paid on time. And perhaps if
the gentleman would just diminish to a small degree these wonderful
partisan speeches which he makes and concentrate on paying the bills of
the House, how much better this whole operation would be. Then we could
address the way the content of legislation is being considered, rather
than engaged in these kinds of small pickety pickety polemics in which
we have just engaged.
Mr. Speaker, I will be delighted to yield to the gentleman, but I do
have a few other words which will be helpful to him and I know he
wishes to hear, so I would yield later.
Mr. Speaker, this has been a very curious process, and it will be
noted my name does not appear on the conference report, even though I
do urge my colleagues to vote for the bill. My colleagues on the other
side of the aisle have chosen to move this legislation at this late
time, after long waits, with such speed that we were not able to
confirm that the bill's language accurately reflected the agreements
reached.
Nevertheless, I will take faith that the language truly reflects the
bipartisan agreement which Senator Kennedy so admirably defended. I
trust that at least some of the advocates of this legislation have
carried out their responsibilities, as they have said, and I do intend
to support the conference report.
[[Page H9790]]
The bill makes some small, but important steps forward. The
portability provisions and the provisions against preexisting
conditions will benefit about 25 million Americans. That leaves,
however, I would tell my good friend from California, and I am
delighted to see him standing because I want him to hear this, some 40
million Americans who do not have health care. I know that he will want
to do something other than to just turn them over at some future time
to a system which is not providing them health care.
This bill will ensure that people who change jobs can get health
coverage from a new employer without preexisting condition
restrictions. This will provide peace of mind for workers who lose
their jobs by assuring them they can purchase health coverage without
devastating penalties and restrictions.
While this legislation does good things, at least one of the things
that it does needs to be examined. My good Republican friends have
tucked away a couple of nice little provisions here which will hinder
the fight against health care fraud and abuse. They will allow
repeatedly negligent providers to escape civil monetary penalties, and
they will require an unprecedented and indeed most curious advisory
opinion process for an intent-based criminal statute, something which I
have never seen before.
American taxpayers will now also be asked to pay for inflated claims
submitted by doctors and hospitals who are grossly negligent in the
billing process. The Congressional Budget Office says that these
provisions will cost American taxpayers tens of millions of dollars.
What a blow for economy struck by this particular provision!
The advisory opinion requirement is opposed by the Attorney General,
the Inspector General of HHS and by the National Association of
Attorneys General.
We may now reflect on whether this is good or not and, indeed, we may
realize that at some time soon we will regret having included these
provisions, and we may again need to address the problems of fraud and
abuse which we are creating with this particular language.
Mr. Speaker, I am pleased we are passing this legislation today. I
only hope that we can come back soon and continue the process to
provide health care for the 40 million Americans who have no health
care at all, and who live in raw terror of cancer or emphysema or
stroke or heart attack or other illnesses for which they know there is
no medical care available.
Mr. THOMAS. Mr. Chairman, will the gentleman yield?
Mr. DINGELL. I yield to the gentleman from California.
Mr. THOMAS. Mr. Speaker, we know to err is human, to forgive divine.
I am going to try to elevate the gentleman. I thank him for his vote on
the conference report, and in the 105th Congress this new majority will
work with him to remove and eliminate those errors that we know he will
point out to us, and we appreciate his presence.
Mr. DINGELL. Mr. Speaker, reclaiming my time, I want to thank my good
friend for that. It is always a pleasure to deal with him.
Mr. ARCHER. Mr. Speaker, I yield 1 minute to the gentleman from the
State of Nebraska [Mr. Christensen], a member of the Committee on Ways
and Means.
Mr. CHRISTENSEN. Mr. Speaker, I thank the chairman for yielding me
this time.
Listening to the last Speaker talk, I am reminded about, and looking
at the Clinton care, the Government takeover of our health care system,
almost 2 years ago, when they thought they had the answers to the
health care problems in America.
What was their solution? Well, their solution was taking one-seventh
of our GDP, taking control of it and putting together a national health
care board, regional health alliances, corporate health alliances,
putting an ombudsman in here, and having employer mandates involved.
What is our solution? Our solution is private health care, putting
together a medical savings account, free market solutions so that we
would not have a Government takeover of the health care system as the
Democrats have done.
Mr. Speaker, I salute the chairman for his leadership in this area.
Mr. STARK. Mr. Speaker, may I inquire as to the time remaining on
both sides?
The SPEAKER pro tempore (Mr. Ney). The gentleman from California [Mr.
Stark] has 14\3/4\ minutes remaining, and the gentleman from Texas [Mr.
Archer], has 15 minutes remaining.
Mr. STARK. Mr. Speaker, I yield 2 minutes to the gentlewoman from
Texas [Ms. Jackson-Lee].
(Ms. JACKSON-LEE of Texas asked and was given permission to revise
and extend her remarks.)
Ms. JACKSON-LEE of Texas. Mr. Speaker, I thank the gentleman from
California for yielding me this time, and I rise enthusiastically to
support a bipartisan piece of legislation, Kennedy-Kassebaum, might I
emphasize, that brings to the American public a real health reform that
deals with portability and preexisting conditions.
Yesterday I received a call from a local businessperson in my
district who was saddened and disturbed, wondering whether this
legislation had yet passed because his wife was moving to another
position and had a preexisting disease. I am gratified to be able to
make that call now and to indicate that we are doing the right thing.
I am glad to say that we are dealing with long-term care insurance
and accelerated death benefits that demonstrate the understanding of
the Senate and House on some of these issues facing a segment of our
citizens often ignored or forgotten. Now AIDS patients can receive
their life insurance benefits tax free and actually receive the aid
they have paid for to ease their suffering before they depart this
world.
Equally so, let me say that I am gratified we now end the health
benefit tax discrimination against the self-employed, allowing the same
deduction that America's corporations get. Although it is not 100
percent, it is only 80 percent by the year 2006, it is in the right
way.
Let me tell my colleagues why I am a little disturbed. I am saddened
this bill is silent on the needs of millions of mentally ill Americans,
and I hope that we will be able to return to this bill and provide
relief for them.
I am also saddened, or at least disturbed, that we would burden
physicians with overly burdensome fraud provisions, and I believe we
should reconsider. We should get rid of fraud, waste, and abuse, but it
certainly should not be at the expense of making criminals of
physicians that provide us good health care across the Nation.
I am saddened that the last minute special interests found that they
could extend a patent for the drug Lodine, which hurts millions of
Americans who now cannot get low-cost generic drugs because of this
extension.
I do, however, want to thank the bipartisan effort of my colleague
from Texas, Chairman Archer, and the gentleman from California, Mr.
Stark, and all those who have worked so hard on this legislation, to be
able to say that now we can tell America and they have the potential of
good health care, and certainly we will remember those who are attacked
with preexisting conditions.
Mr. Speaker, I rise to offer my full support for this conference
report. Regardless of whatever else this Congress has failed to do,
passage of this conference report is of the utmost importance and
necessity. Every portion of this legislation will have a positive
impact on the lives of millions of Americans and I applaud the
sometimes strained but ultimately successful bipartisan efforts to see
this bill through during this session.
The immediate effect of this bill will be tremendous. Yesterday, I
received a call from a businessman who lives in my district. He was
worried because his wife will soon be changing jobs and they were
concerned that a recent potential medical condition would not be
covered by the new policy unless this bill was soon enacted. He is a
prime example of the good that this legislation will bring about,
making sure that individuals and families do not fall through the
health insurance cracks and suffer physical, mental, or financial
distress.
I believe that the provisions dealing with long-term care insurance
and accelerated death benefits demonstrate the understanding of the
Senate and House of some of the issues facing a
[[Page H9791]]
segment of the citizenry often ignored or forgotten. Now, AIDS patients
can receive their life insurance benefits tax free and actually receive
the aid they have paid for to ease their suffering before they depart
this world.
And I am glad to see that this body is moving toward ending the
health benefit tax discrimination against the self-employed. Why should
these individuals not get the same deduction as America's corporations?
Although the deduction is not 100 percent and although the 80 percent
is not reached until the far-away year of 2006, it is a first step in
the right direction. Maybe another day will allow us to increase this
rate and implementation of this idea, but for now, I will celebrate
along with thousands of self-employed individuals in my district and
across the country.
While I am saddened that this bill is silent on the needs of millions
of mentally ill Americans, some relief must be given. Further, the
overly burdensome fraud provisions against physicians should be
reconsidered and we must fix that in a later review of the bill. Also a
last-minute special interest extension of a patent for the drug Lodine
hurts millions of Americans who now cannot get low-cost generic drugs
that would do the same thing--this must be remedied.
This legislation has been a long time in coming and is something that
should have been done many years ago. No longer will people be trapped
in undesirable jobs because they or a member of their family suffer
from a medical condition. And no longer will spirited entrepreneurs be
wrongly penalized for their courage and chutzpah in striking out on
their own. Mr. Speaker, this is a landmark day for the millions we
represent and for this Congress as well. Support this report and in
doing so, support the needs of the American people.
Mr. ARCHER. Mr. Speaker, I yield 2 minutes to the gentleman from
Pennsylvania [Mr. Gekas].
(Mr. GEKAS asked and was given permission to revise and extend his
remarks.)
Mr. GEKAS. Mr. Speaker, I thank the gentleman from Texas for yielding
me this time.
A few months ago I was going store to store visiting constituents in
the lovely town of Effron, PA, in Lancaster County, the target of many,
many thousands of tourists during the course of a year, where the
cloisters and the people who man them and woman them daily do their
routines.
One lady stopped me and we started talking about health care. I will
not name her, I will call here Mrs. Calabash. Mrs. Calabash asked me
what would happen if her husband, who was presently employed, would
lose his job; were there any prospects for making sure that health care
coverage would follow him into the search for a new job.
I told her we are working on it, Mrs. Calabash, and before this year
is out, I told here we were going to be voting on portability, the
transferability of insurance coverage, access to insurance coverage,
for someone like her husband.
Mrs. Calabash thanked me, and now here at last on this particular
evening I will be able to fulfill my promise to her. Portability, which
never was accomplished by a previous congress, which was not even
contemplated until the Republican Congress undertook the leadership of
this House, now is at hand.
All I can say is I am happy to report that to Mrs. Calabash. This one
is for you, Mrs. Calabash, and now, good night, Mrs. Calabash.
Mr. STARK. Mr. Speaker, I yield 2 minutes to the gentleman from New
Mexico [Mr. Richardson].
(Mr. RICHARDSON asked and was given permission to revise and extend
his remarks.)
Mr. RICHARDSON. Mr. Speaker, I thank the chairman and the ranking
member.
Mr. Speaker, this bill tears down one of the biggest barriers that
stand between Americans and health insurance coverage. I am glad to be
part of legislation and of passing legislation that guarantees millions
of Americans insurance coverage as they move from job to job. This bill
also prevents discrimination against those individuals with preexisting
conditions. This is a bipartisan effort that deserves enormous
commendation.
Unfortunately, Mr. Chairman, this bill has left 5 million Americans
with mental illness behind. I had offered the House amendment in the
Committee on Commerce to this bill to guarantee those with mental
illness the same coverage as a person with any other illness.
Unfortunately, it was ruled out of order.
Those mental health provisions, however, were included in the health
insurance reform bill in the other body. This conference report fails
to include mental health parity language and, therefore, to provide
important protections for mental illness.
Mental illness is just as serious as hearth disease or cancer, yet
insurers have for years not offered complete coverage for the treatment
of mental illness. Nearly one out of four adults suffer from some kind
of severe mental illness in the United States each year, yet 95 percent
of the major insurance companies in our country have limited coverage
for psychiatric care.
Left untreated, mental illness can lead to some of our Nation's most
pressing social problems. For example, 32 percent of the Nation's
homeless suffer from some type of mental disorder, 12 million children
suffer from some type of mental disorder also.
Mr. Speaker, let us pass this bill, but in the future we must address
the issue of mental health parity. I am disappointed we did not do so
when we had this opportunity, but perhaps in the next session of the
Congress this should be a top priority and we should all do it in a
bipartisan way. One out of five Americans is affected by this problem.
{time} 1915
Mr. ARCHER. Mr. Speaker, I yield 2 minutes to the gentleman from Iowa
[Mr. Ganske].
Mr. GANSKE. Mr. Speaker, I spoke earlier this evening on the
provisions against fraud in the bill. And to go back over these, they
establish a national health care fraud control program and extend
antifraud rules for Medicare and Medicaid.
There are a number of good things in this. If there is fraud and
abuse in the system and a senior citizen would identify this, the
Secretary can provide a reward to those seniors who have identified the
problem.
I have practiced in the system. Unfortunately, there is some fraud
and abuse in the system among all practitioners, and so I would enter
into a colloquy with the gentlewoman from Texas [Ms. Jackson-Lee] if
she would care to enter into a colloquy, because I think that this bill
is a reasoned approach to something that is very important to help
reduce health care costs, and that is the fact that the Inspector
General has identified fraud and abuse in the system.
One of the things that we have found is that in the bill when we are
talking about criminal penalties, we are talking about knowing and
willful, and so there is a high standard for practitioners to receive
whatever type for criminal procedures. And then for civil procedures,
there must be a negligent behavior and it must be an action that is in
reckless disregard of the rules or of health.
So I would yield to the gentlewoman from Texas if she would care to
tell me exactly what is in the bill in these areas that concerns her.
Ms. JACKSON-LEE. Mr. Speaker, if the gentleman would yield, I thank
the gentleman for his kindness and I noted the distinction and
certainly do appreciate at least one point that the gentleman from Iowa
[Mr. Ganske] made. I think we all can agree that we should attempt to
eliminate fraud and abuse and certainly weed out from our practitioners
any suggestion that they might manipulate the system.
Might I say that I look upon the medical profession as one over all
whose chief responsibility is to service the needy public with respect
to its health needs. I do believe that even though we have civil and
criminal penalties distinguished, that we still have a criteria that
raises much of what physicians may do to a criminal level, even though
we have a standard of reckless abandonment or a higher standard of
negligence. I think we can revisit it and still get a fraud and abuse
and not have the high penalties that we have that would discourage many
of our physicians who practice in the inner city and rural communities.
[[Page H9792]]
Mr. ARCHER. Mr. Speaker, I yield myself 1 minute.
Mr. Speaker, I simply ask a question of the gentleman from Iowa [Mr.
Ganske]. I understood the gentlewoman from Texas to say that this bill
would make criminals out of good doctors, and I would like for the
gentleman to respond to that since he is a physician himself.
Mr. GANSKE. Mr. Speaker, if the gentleman would yield, the bill I
think is fair. It addresses the issue of reducing fraud and abuse in
the system, and yet it establishes fairness for practitioners.
In some of the original legislation, there were some concerns but
they have been worked out among various groups, so that provider
groups, I think they feel in general that as long as there are knowing
and willful provisions in there, in the criminal sections of the fraud
and abuse sections, that this is an acceptable standard and a fair
standard.
Mr. ARCHER. Mr. Speaker, reclaiming my time, so the gentleman would
say, then, that this would not make criminals out of good doctors?
Mr. GANSKE. Mr. Speaker, That is exactly my understanding of this
bill.
Mr. STARK. Mr. Speaker, I yield 3 minutes to the gentleman from
Washington [Mr. McDermott].
Mr. McDERMOTT. Mr. Speaker, it is a rather unique bill where all the
Democratic conferees come out here, did not sign the bill, hold their
nose, and they are going to support it. I know why that is. There are
24 provisions that really are troublesome in this bill and the
committee never met and dealt with them.
One is the whole question of mental health parity. What that issue
means is that if the patient has a mental illness and their insurance
plan pays 80 percent for surgery for cancer or a brain tumor or
something else, they have to pay 80 percent on a mental health claim.
Right now most plans pay 80 percent on some kinds of things and 50
percent for mental illness. People with mental illness in this country
are discriminated against by the insurance industry and the Senate
voted it and the House refused to consider it and it has been left out
of this bill. There will be a motion to recommit. I urge all of my
colleagues to vote for that motion to recommit because that will
reinsert parity for the mentally ill.
The gentleman from New Mexico [Mr. Richardson] says one out of five
people in this country are affected by mental illness and that is an
issue that ought to be dealt with. There is no excuse for us letting
the insurance companies discriminate against people simply because they
have mental illness.
No worse, or equally bad, in this bill is the section on
administrative simplification, which aroused the insurance companies to
have an insurance data that can use your Social Security number. This
is the day that we voted to give the insurance companies the right to
use your Social Security number and gather all the information in a
clearinghouse for which there is no privacy protection in this bill.
Now people want to think that it is called ``administrative
simplification,'' but simply what it does is give the insurance
companies the ability to shift information back and forth, use it
against applicants for life insurance, auto insurance, homeowners
insurance. Anything they want to do, they can do in this bill because
there is not one single shred of protection of your privacy.
I raised this issue in the Committee on Ways and Means. The chairman
of the subcommittee who stands up here and says, ``It is such a
wonderful bill,'' said he would deal with it. It did not get dealt
with. In fact, it went in the conference committee and came out worse.
He is less protected.
Doctors could be required to give a patient data of encounters. That
means if a patient goes to see the doctor and tells the doctor anything
that has gone on in their life, the doctor could be compelled by the
insurance company data system to release that information because there
is nothing, nothing in here that protects the doctor-patient
relationship.
I think people had real qualms on that conference committee about
signing it because in many ways, although we help a few people with the
whole issue of portability, if we read the bill we find that is not
very good, that we are taking away people's privacy and we are
discriminating against the mentally ill.
Mr. Speaker, I urge Members to vote for the motion to recommit.
Mr. ARCHER. Mr. Speaker, I yield myself 1 minute.
Mr. Speaker, it is ironic to me as I listen to the arguments on the
other side of the aisle from people who will vote for this bill in the
end, make no mistake about it, most of them will vote for this bill
because they know that it moves in the right direction. But when we
first debated this bill on the floor of the House, what we heard from
the other side of the aisle was, ``Do not add anything to Kassebaum-
Kennedy. We want a clean bill. Do not expand it.'' And now they are
saying we have not expanded it enough.
This seems to me as very, very strange, and what it appears is that
it is the moment that counts, not the policies, not what we are doing.
it is the moment. And if they cannot be satisfied at that moment about
everything, they are going to complain.
We have a good bill here. It is a bill that, unfortunately, we had to
drop malpractice out, but the trial lawyers' influence in the Senate
caused that to have to be dropped out. That is too bad because that,
unfortunately, drives up the cost of health care.
We had other provisions for small businesses that could unite
nationally to have competitive insurance, and they forced that to be
dropped out, but this is a good bill, Mr. Speaker.
Mr. STARK. Mr. Speaker, I yield 4 minutes to the gentleman from
Michigan [Mr. Bonior], the minority whip.
Mr. BONIOR. Mr. Speaker, it was more than a year ago when a
bipartisan group first offered a bill to expand access to health care
for millions of Americans, and over the past 18 months we have worked
to build a bipartisan coalition to make modest changes so that if
someone changed jobs, lost their job, has a preexisting condition, they
will never lose their health insurance.
For 9 months, Bob Dole and Newt Gingrich and the Republican
leadership would not let the Kennedy-Kassebaum bill to come to a vote
on the House floor. It is not found in the Contract on America. It was
not part of their priority. They refused to take any action until the
President of the United States stood there in his State of the Union
Address and called on them to make health care portable for this
country.
When public pressure finally built to the point where Bob Dole had to
act, last April, the Kennedy-Kassebaum bill passed, as my friend from
Washington State said, 100 to nothing. It could have been sent to the
President the next day and millions of working families would have been
spared the pain and the misery of losing their health insurance. But
instead, we had to deal with MSAs, medical savings accounts, even
though every credible publication has said they are designed for the
health and the wealthy.
What we have to understand is that this is about the lives of real
people. Somewhere in America today, Mr. Speaker, there is a father who
has been offered a better job to take care of his family, but he cannot
take it because his son has diabetes and his health insurance will not
go with him. Somewhere in America today there is a single mom who goes
to bed every night praying that her kids will not get sick because she
has a preexisting condition and she cannot get health insurance. No
company will cover her.
These people are not strangers. Every one of us knows these people.
We work with them. We worship with them. We see them in our grocery
stores and in our school yards.
All over America today parents are working hard, sometimes working
two jobs, three jobs to give their kids a better life. They deserve to
have the peace of mind to know that if they change their job or they
lose their job or if they have a preexisting condition they will never
lose their health insurance.
This bill takes an important step in that direction, but it needs to
go further. We should have accepted and it is a shame that we are not
accepting the Wellstone-Domenici compromise. It is a provision that
provides parity between lifetime limits for mental illness and lifetime
limits for physical illnesses.
People with mental illness suffer enough. They should not be made to
[[Page H9793]]
feel ashamed when they ask for help. Many of them are struggling to
understand what is happening to their minds and to their bodies. They
struggle every day with a pain that is every bit as real and every bit
as punishing as a physical ailment.
Many times it is not just the individual who is affected, it is the
whole family. Just think of the pain of a young boy or a young girl or
a parent, the pain they must feel as they watch their mother or their
child or their father struggle with an illness that throws them into a
darkness that is so deep there does not seem to be a way out.
Mental illness is hard enough to live with. They should not be forced
to face the additional burden of discrimination under the law. They
should be treated with the dignity and with the respect that they
deserve. The Wellstone-Domenici compromise moves us in that direction.
Overall, this is a good bill, but we can make it better if we vote
for the motion to recommit. I urge Members to stand with Senators
Wellstone and Domenici. Say ``shame'' on the insurance companies that
play games with people's lives. Support the motion to recommit and give
all of our families the security that they deserve.
Mr. ARCHER. Mr. Speaker, I yield myself 2 minutes.
Mr. Speaker, the gentleman has made the statement that every
publication says that medical savings accounts are just for the healthy
and the wealthy. The facts are that I do not know a one. The only
comprehensive study that has been done was by the RAND Corporation and
they said just the reverse. There was no adverse selection.
There is not one shred of evidence that I know of that MSAs are only
for the healthy and the wealthy, but we can say anything we want to on
this floor. Clearly, it does not have to be supported by evidence.
Let me also say that it is ironic to me that on the one hand the
statement is made, all we want was Kassebaum-Kennedy, do not add
anything to it. That is what the President said right in this room in
his State of the Union Address. Do not add anything. Now they are
complaining because something has not been added to it.
They had the opportunity then. They take a position today totally
contrary to what they took in the debate when this bill was before the
House.
They had the opportunity to offer a motion to recommit with mental
health parity in it. What was their motion to recommit? Kassebaum-
Kennedy of the do not expand it, do not change it. Do not give anything
else to any additional people.
{time} 1930
Do not do anything on fraud and abuse. Do not do anything on
malpractice. Do not do anything to help small business get lower
premium costs for their employees. Do not give MSAs where the
individual can control their options. Now they want to add more.
I guess consistency, I remember many years ago when the chairman of
the Committee on the Judiciary stood in the well and said, consistency
is the hobgoblin of small minds. Perhaps he was right, but I believe
consistency is important.
Mr. Speaker, I reserve the balance of my time.
Mr. STARK. Mr. Speaker, I yield such time as he may consume to the
gentleman from Oregon [Mr. DeFazio].
(Mr. DeFAZIO asked and was given permission to revise and extend his
remarks.)
Mr. DeFAZIO. Mr. Speaker, I thank the gentleman for yielding.
Mr. Speaker, I plan to vote for the conference report to H.R. 3103
because it provides needed relief for Americans by guaranteeing
portability of health insurance and limiting pre-existing condition
exclusions. This is an important step in improving access to health
care for individuals who were previously denied coverage. I am pleased
to see the Congress come together to ensure these minimal protections.
However, I remain disturbed by important provisions left out of the
conference report and by harmful provisions in the bill which need to
be corrected.
Mr. Speaker, for the past 3 months I have been trying to persuade my
colleagues to include the Senate provisions on parity of mental health
coverage in the final version of H.R. 3103. These provisions were
inserted in the Senate version of the health insurance reform bill by
an overwhelming vote of 68 to 32. While the Senate conceded to a
compromise on the controversial House-passed medical savings accounts
provisions, there was no comparable compromise on the mental health
parity provisions. These is absolutely no relief in this bill for the
millions of Americans who suffer from mental illnesses. It is with
great sadness that I am voting for health care legislation which
completely ignores this vulnerable segment of our population.
I want my colleagues and the American people to know that I'm not
going to give up on this issue. We have a majority of Senators who have
gone on record supporting parity coverage for mental illness. I was
joined by over 100 Members of Congress, from both political parties, in
a letter to conferees supporting the Senate provisions. We will
continue the fight against discrimination by insurance companies of
people with mental illness and I believe we will ultimately achieve a
victory.
In addition, I am very concerned about a provision in the conference
report that threaten the continued privacy of our medical records. As
Americans we cherish our fundamental right to privacy. Over the past
few decades we have seen this right chipped away by technological
advances we could never foreseen. We have all seen how legislation
ensuring the continued right to privacy has not kept up with these
advances. This conference report strikes another blow at our privacy by
requiring administrative simplification of medical records without
providing adequate protections. The bill imposes national standards for
the collection and distribution of data for billing purposes and
requires the use of a ``unique identifier'' for medical records.
Shockingly, it does not prohibit the use of Social Security numbers for
this identifier. If Social Security numbers are used for medical
records' access virtually anyone will be able to screen our most
private medical history. This must be addressed either through
corrective legislation or Administrative action.
Mr. Speaker, I'm not going to vote against this bill and deny relief
to so many Americans just because of these concerns. But, I'm
distressed that we are being forced to swallow these anti-privacy
provisions and I think its shameful that the leadership has left out so
many of our needy citizens who need adequate insurance coverage. I urge
my colleagues to take my concerns to heart and work with me in the
future to correct these serious flaws.
Mr. STARK. Mr. Speaker, I yield myself the balance of my time.
Under the rules, my motion to recommit is not debatable. I would urge
that my colleagues on both sides of the aisle support the motion to
recommit the Kennedy-Kassebaum agreement to conference, a conference
which has never existed, and to work out an acceptable mental health
amendment along the lines of the Domenici-Wellstone mental health
parity compromise.
The gentleman from Texas is right. We asked them not to load up the
original Kennedy-Kassebaum bill with Christmas tree giveaways to the
drug companies, giveaways to Golden Rule Life, all of whom are big
contributors to the Republican Party. But as long as that has been done
and Members on this side are going to vote for the bill, I pose the
question on the motion to recommit as to why the Republicans would deny
mental health benefits at no cost. You have to explain that to every
family who has a mental health illness in the family.
For relatively no or little cost at all, you are denying mental
health coverage to millions of Americans. I do not know why you do
that. There is no good reason. There is no good reason at all except if
you are trying to bail out the insurance companies because most of your
staff used to be lobbyists for them.
But what I am suggesting to you is that for less than 16 cents a
thousand dollars of premium you can add mental health benefits to every
employee in this country. Why you would deny that escapes me. Why you
would not take away the fear that somebody with a mental health illness
would get the same treatment that somebody with a physical illness is,
to me, obscene just to deny that for whatever reason.
There has been no good reason offered to deny these benefits. Private
insurance premiums would rise less than sixteen one-hundredths of a
percent; $5 a year in deductibility. Yes, you will have different
opinions from the health insurance industry for whom your staff have
been captives, but the truth is that if you were willing to provide
fair coverage and willing to go against the interests of the big
contributors to your campaigns, you would do the right thing for the
American people.
[[Page H9794]]
You will have to face every mental health group in this country, who
will say it is the Republicans who have denied mental health coverage
to millions of American workers for the sake of big campaign
contributions. That, to me, is an obscenity that I would not want to
face in the political arena.
The small businesses that you have helped have been limited. The
bailing out of one drug company, which is also in the motion to
recommit, is another example of payoffs from big drug companies. Is
there no humanity?
Your health bill was yesterday, when you denied access to any help to
a million children. That was your health reform. Now you are going to
deny mental health coverage to the Americans who need it. All I can say
is it is a shame, it is a travesty. Yes, people will vote for the
limited expansions you give to less than 400,000 people a year, but no,
why would you deny mental health coverage to these people?
Vote for the motion to recommit. You can do the right thing back in
conference quickly and then your bill might have some credibility.
Mr. ARCHER. Mr. Speaker, I yield myself 30 seconds in order to engage
in a colloquy with the gentleman from California. I understand the
gentleman from California wishes to ask a question about what possible
impact this bill might have on Medicare beneficiaries.
Mr. STARK. Mr. Speaker, will the gentleman yield?
Mr. ARCHER. I yield to the gentleman from California.
Mr. STARK. Mr. Speaker, if the distinguished gentleman is referring
to the MSA section of the bill, title III, subtitle (a), it is my
understanding that Medicare beneficiaries are not permitted to open an
MSA account. Is that the gentleman's intention?
Mr. ARCHER. Yes, Mr. Speaker, no Medicare beneficiaries are permitted
to enroll in MSA accounts.
Mr. STARK. Mr. Speaker, I thank the gentleman.
Mr. ARCHER. Mr. Speaker, I yield 2 minutes to the gentleman from
California [Mr. Thomas].
Mr. THOMAS. Mr. Speaker, I am using this time during debate because,
as the gentleman from California [Mr. Stark] said, there is no time to
debate the motion to recommit. I have just seen the motion to recommit,
and he was speaking about the mental health provision. I do think
Members need to understand just what has gone on here, notwithstanding
the absolutely outrageous statements that the gentleman from California
made, and perhaps he got carried away with his own ``eloquence.''
To review the bidding, there was no mental health provision in the
bill that passed the House. We tried to work it out. There was no
compromising. Folks were not willing to give on the Democratic side.
On the Senate side, there was an amendment that was accepted by a
voice vote and immediately following the passage of the bill, 100 to
nothing, the chairwoman and the ranking member, Senator Kassebaum and
Senator Kennedy and others, went to the mike and said, ``We are
probably going to take this out in conference.'' Because everyone knew
the amendment that was passed was simply an unworkable piece of
legislation.
We sat down in conference and read it and realized it was totally
unworkable. However, the House, not having any provision, said,
``Senate, work it out. We will accept whatever you can work out. It was
your provision; you folks come to an agreement. We will accept what you
can work out.''
One of the major discussions throughout the conference was the
Senators talking among themselves about what the mental health
provision was going to be. The chairwoman from Kansas offered Senator
Domenici the agreed-upon mental health provision and the Senator said,
``I choose nothing.''
It was the Senate's choice, notwithstanding the vitriolic statements
from the gentleman from California. What is in the bill is the Senate's
choice. It was a Senate provision. The conferences said, let the Senate
work its will.
What is before this House is a conference report containing the
Senate's will on mental health. That is what is in front of us. The
motion to recommit to change the Senate's will is opposed by this
gentleman and opposed by everybody on this side because that is not
everything that is in the motion to recommit. The gentleman has other
provisions he chose not to speak about. Vote ``no'' on the motion to
recommit.
Mr. ARCHER. Mr. Speaker, I yield the balance of my time to the
gentleman from Illinois [Mr. Hastert], who played such a big role in
working this conference report to where we could get it on the floor.
Mr. HASTERT. Mr. Speaker, I thank the gentleman very much for the
time.
It wonders me when I listen to some of the arguments on the other
side that insurance companies are holding down the mental health parity
issue. I will tell my colleagues, the insurance companies would love to
have mental health parity because they would like to have those
premiums coming in.
The gentleman from Washington, who says it is terrible that we do not
have mental health parity in the bill, I guess if I was a psychiatrist
I would think it was terrible also. But that is a provision that we do
not have in the bill.
I will tell Members why. There are two groups of people who lose when
we put mental health parity in this bill. I am talking about billions
of dollars of cost, not millions, not thousands, not hundreds, but
billions of dollars of cost.
First of all, to people who buy insurance policies, if mental health
parity is in that bill, it would cost the moms and dads, the middle-
class workers in this country an increased insurance cost which would
be astronomical, so there is a good reason that that is not in the
bill.
The second good reason is that the employers who provide health care
and mental health care to their employees all of a sudden would have a
choice. Your choice is, Mr. Employer, that you will start to increase
your health care costs astronomically because you are including a
provision in here that has never gone through a committee in this
House, did not go through a committee in the Senate, but somebody would
like to throw it in. What happens, the employer says, ``I always
provided mental health for my employees, but the cost is so high I am
not going to do it anymore.''
Who loses out? The people that lose out in that provision are the
people who for years were able to cover themselves with mental health
policies but now, because of a provision that was put in in the Senate
at the last minute, without debate or anything else, on a whim, was
knocked out in conference committee.
Who wins because of that? People who have to pay the bills, my
colleagues, not the gentleman from California, who advocated a big
Government health care takeover just 3\1/2\ years ago or 4 years ago,
or the gentleman from Washington, who advocated that we do the Canadian
health care plan where the Government does everything and we lose
control of what happens in health care in this country.
So, Mr. Speaker, there is a reason things happen around here, a good
reason. I think we have a bill before us today that has some provisions
in it.
I, again, was wondering why my good friend who is the minority whip
from Michigan, he said we are just denying moms and dads this ability
to cover themselves. I remember distinctly that my good friend from
Michigan denied the Rowland-Bilirakis bill from coming forward in this
House 3\1/2\ years ago, when we would have given portability to moms
and dads who wanted to move to better jobs, that wanted better
opportunity. But they were denied that because some Members in this
House wanted to present a big Government takeover of health care, and
they were afraid that the Rowland-Bilirakis bill would undercut that.
It is 3\1/2\ years later, Mr. Speaker. There is a bill here that will
give people portability in health care. It will give the doctor the
ability to tell his patient what the cost of a service is. That patient
can choose, with his medical savings account, whether he wants to go to
this doctor or that doctor or that doctor because he knows what
something costs. He knows what the problems are and he gets straight
answers because he makes that decision, not a third party payer
someplace.
To the gentleman from California, that is going to save health care
costs in this country billions and billions of dollars, something that
you wanted to
[[Page H9795]]
deny when you wanted big health care to take over in this country. The
barber in Illinois that told me awhile back that he wanted
deductibility for the cost of his health care from his income tax, we
do that in this bill. We do a lot of good things for people. It is a
good bill, and I think it deserves the support of this body.
I thank the chairman and the chairman of the Committee on Ways and
Means and the chairman of the Committee on Commerce and the Senate
staff and all our staff who worked to make this thing happen.
The SPEAKER pro tempore. Without objection, the previous question is
ordered on the conference report.
There was no objection.
motion to recommit offered by mr. stark
Mr. STARK. Mr. Speaker, I offer a motion to recommit.
The SPEAKER pro tempore (Mr. Ney). Is the gentleman opposed to the
conference report?
Mr. STARK. In its present form, yes.
The SPEAKER pro tempore. The Clerk will report the motion to
recommit.
The Clerk read as follows:
Mr. Stark moves to recommit the conference report on the
bill H.R. 3103 to the committee on conference with
instructions to the managers on the part of the House, to do
everything possible, within the scope of the conference, (1)
to modify Section 305 of the Senate amendment relating to
mental health insurance parity so as to improve mental health
care insurance while minimizing any impact on the cost or
availability of health insurance plans, and (2) to produce a
conference report which confines itself to the differences
between the bill as passed by the House and passed by the
Senate.
{time} 1945
The SPEAKER pro tempore (Mr. Ney). 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. STARK. 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.
Pursuant to the provisions of clause 5 of rule XV, the chair
announces that he will reduce to a minimum of 5 minutes the period of
time within which a vote by electronic device will be taken on the
question of agreeing to the conference report.
The vote was taken by electronic device, and there were--yeas 198,
nays 228, not voting 7, as follows:
[Roll No. 392]
YEAS--198
Abercrombie
Ackerman
Andrews
Baesler
Baldacci
Barrett (WI)
Becerra
Beilenson
Bentsen
Berman
Bevill
Bishop
Blumenauer
Blute
Bonior
Borski
Boucher
Browder
Brown (CA)
Brown (FL)
Brown (OH)
Bryant (TX)
Bunn
Cardin
Chapman
Clay
Clayton
Clement
Clyburn
Coleman
Collins (IL)
Collins (MI)
Condit
Conyers
Costello
Coyne
Cramer
Cummings
Cunningham
Danner
de la Garza
DeFazio
DeLauro
Dellums
Deutsch
Dicks
Dingell
Dixon
Doggett
Dooley
Doyle
Durbin
Edwards
Engel
Eshoo
Evans
Farr
Fattah
Fazio
Fields (LA)
Filner
Flake
Foglietta
Forbes
Fox
Frank (MA)
Frost
Furse
Gejdenson
Gephardt
Gibbons
Gillmor
Gilman
Gonzalez
Gordon
Green (TX)
Gutierrez
Hall (OH)
Hall (TX)
Hamilton
Harman
Hastings (FL)
Hefner
Hilliard
Hinchey
Holden
Hoyer
Jackson (IL)
Jackson-Lee (TX)
Jacobs
Jefferson
Johnson (SD)
Johnson, E. B.
Johnston
Kanjorski
Kaptur
Kennedy (MA)
Kennedy (RI)
Kennelly
Kildee
Kleczka
Klink
LaFalce
Lantos
Leach
Levin
Lewis (GA)
Lipinski
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)
Pelosi
Peterson (FL)
Pomeroy
Poshard
Rahall
Rangel
Reed
Richardson
Rivers
Roemer
Rose
Roukema
Roybal-Allard
Rush
Sabo
Sanders
Sawyer
Schiff
Schroeder
Schumer
Scott
Serrano
Skaggs
Slaughter
Spratt
Stark
Stockman
Stokes
Studds
Stupak
Tanner
Tejeda
Thompson
Thornton
Thurman
Torkildsen
Torres
Torricelli
Towns
Traficant
Velazquez
Vento
Visclosky
Ward
Waters
Watt (NC)
Waxman
Williams
Wise
Woolsey
Wynn
Yates
NAYS--228
Allard
Archer
Armey
Bachus
Baker (CA)
Baker (LA)
Ballenger
Barcia
Barr
Barrett (NE)
Bartlett
Barton
Bass
Bateman
Bereuter
Bilbray
Bilirakis
Bliley
Boehlert
Boehner
Bonilla
Bono
Brewster
Bryant (TN)
Bunning
Burr
Burton
Buyer
Callahan
Calvert
Camp
Campbell
Canady
Castle
Chabot
Chambliss
Chenoweth
Christensen
Chrysler
Clinger
Coble
Coburn
Collins (GA)
Combest
Cooley
Cox
Crane
Crapo
Cremeans
Cubin
Davis
Deal
DeLay
Diaz-Balart
Doolittle
Dornan
Dreier
Duncan
Dunn
Ehlers
Ehrlich
English
Ensign
Everett
Ewing
Fawell
Fields (TX)
Flanagan
Foley
Fowler
Franks (CT)
Franks (NJ)
Frelinghuysen
Frisa
Funderburk
Gallegly
Ganske
Gekas
Geren
Gilchrest
Goodlatte
Goodling
Goss
Graham
Greene (UT)
Greenwood
Gunderson
Gutknecht
Hancock
Hansen
Hastert
Hastings (WA)
Hayes
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
Lewis (CA)
Lewis (KY)
Lightfoot
Linder
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
Payne (VA)
Peterson (MN)
Petri
Pickett
Pombo
Porter
Portman
Pryce
Quillen
Quinn
Radanovich
Ramstad
Regula
Riggs
Roberts
Rogers
Rohrabacher
Ros-Lehtinen
Roth
Royce
Salmon
Sanford
Saxton
Scarborough
Schaefer
Seastrand
Sensenbrenner
Shadegg
Shaw
Shays
Shuster
Sisisky
Skeen
Skelton
Smith (MI)
Smith (NJ)
Smith (TX)
Smith (WA)
Solomon
Souder
Spence
Stearns
Stenholm
Stump
Talent
Tate
Tauzin
Taylor (MS)
Taylor (NC)
Thomas
Thornberry
Tiahrt
Upton
Volkmer
Vucanovich
Walker
Walsh
Wamp
Watts (OK)
Weldon (FL)
Weldon (PA)
Weller
White
Whitfield
Wicker
Wolf
Young (AK)
Zeliff
Zimmer
NOT VOTING--7
Brownback
Dickey
Ford
Lincoln
McDade
Wilson
Young (FL)
{time} 2003
Messrs. Saxton, Skelton, and Volkmer changed their vote from ``yea''
to ``nay.''
Mr. Jefferson and Mr. Hall of Texas changed their vote from ``nay''
to ``yea.''
So the motion to recommit was rejected.
The result of the vote was announced as above recorded.
The SPEAKER pro tempore. (Mr. Ney). The question is on the conference
report.
Pursuant to House Resolution 392, the yeas and nays are ordered.
This is a 5-minute vote.
The vote was taken by electronic device, and there were--yeas 421,
nays 2, not voting 10, as follows:
[Roll No. 393]
YEAS--421
Abercrombie
Ackerman
Allard
Andrews
Archer
Armey
Bachus
Baesler
Baker (CA)
Baker (LA)
Baldacci
Ballenger
Barcia
Barr
Barrett (NE)
Barrett (WI)
Bartlett
Barton
Bass
Becerra
Beilenson
Bentsen
Bereuter
Berman
Bevill
Bilbray
Bilirakis
Bishop
Bliley
Blumenauer
Blute
Boehlert
Boehner
Bonilla
Bonior
Bono
Borski
Boucher
Brewster
Browder
Brown (CA)
Brown (FL)
Brown (OH)
Bryant (TN)
Bryant (TX)
Bunn
Bunning
Burr
Burton
Buyer
Callahan
Calvert
Camp
Campbell
Canady
Cardin
Castle
Chabot
Chambliss
Chapman
[[Page H9796]]
Chenoweth
Christensen
Chrysler
Clay
Clayton
Clement
Clinger
Clyburn
Coble
Coburn
Coleman
Collins (GA)
Collins (IL)
Collins (MI)
Combest
Condit
Conyers
Cooley
Costello
Cox
Coyne
Cramer
Crane
Crapo
Cremeans
Cubin
Cummings
Cunningham
Danner
Davis
de la Garza
Deal
DeFazio
DeLauro
DeLay
Dellums
Deutsch
Dicks
Dingell
Dixon
Doggett
Dooley
Doolittle
Dornan
Doyle
Dreier
Duncan
Dunn
Durbin
Edwards
Ehlers
Ehrlich
Engel
English
Ensign
Eshoo
Evans
Everett
Ewing
Farr
Fattah
Fawell
Fazio
Fields (LA)
Fields (TX)
Filner
Flake
Flanagan
Foglietta
Foley
Forbes
Fowler
Fox
Frank (MA)
Franks (CT)
Franks (NJ)
Frelinghuysen
Frisa
Frost
Funderburk
Furse
Gallegly
Ganske
Gejdenson
Gekas
Gephardt
Geren
Gibbons
Gilchrest
Gillmor
Gilman
Gonzalez
Goodlatte
Goodling
Gordon
Goss
Green (TX)
Greene (UT)
Greenwood
Gunderson
Gutierrez
Gutknecht
Hall (OH)
Hall (TX)
Hamilton
Hancock
Hansen
Harman
Hastert
Hastings (FL)
Hastings (WA)
Hayes
Hayworth
Hefley
Hefner
Heineman
Herger
Hilleary
Hilliard
Hinchey
Hobson
Hoekstra
Hoke
Holden
Horn
Hostettler
Houghton
Hoyer
Hunter
Hutchinson
Hyde
Inglis
Istook
Jackson (IL)
Jackson-Lee (TX)
Jacobs
Jefferson
Johnson (CT)
Johnson (SD)
Johnson, E. B.
Johnson, Sam
Johnston
Jones
Kanjorski
Kaptur
Kasich
Kelly
Kennedy (MA)
Kennedy (RI)
Kennelly
Kildee
Kim
King
Kingston
Kleczka
Klink
Klug
Knollenberg
Kolbe
LaFalce
LaHood
Lantos
Largent
Latham
LaTourette
Laughlin
Lazio
Leach
Levin
Lewis (CA)
Lewis (GA)
Lewis (KY)
Lightfoot
Linder
Lipinski
Livingston
LoBiondo
Lofgren
Longley
Lowey
Lucas
Luther
Maloney
Manton
Manzullo
Markey
Martinez
Martini
Mascara
Matsui
McCarthy
McCollum
McCrery
McDermott
McHale
McHugh
McInnis
McIntosh
McKeon
McKinney
McNulty
Meehan
Meek
Menendez
Metcalf
Meyers
Mica
Millender-McDonald
Miller (CA)
Miller (FL)
Minge
Mink
Moakley
Molinari
Mollohan
Montgomery
Moorhead
Moran
Morella
Murtha
Myers
Myrick
Nadler
Neal
Nethercutt
Neumann
Ney
Norwood
Nussle
Oberstar
Obey
Olver
Ortiz
Orton
Owens
Oxley
Packard
Pallone
Parker
Pastor
Paxon
Payne (NJ)
Payne (VA)
Pelosi
Peterson (FL)
Peterson (MN)
Petri
Pickett
Pombo
Pomeroy
Porter
Portman
Poshard
Pryce
Quillen
Quinn
Radanovich
Rahall
Ramstad
Rangel
Reed
Regula
Richardson
Riggs
Rivers
Roberts
Roemer
Rogers
Rohrabacher
Ros-Lehtinen
Rose
Roth
Roukema
Roybal-Allard
Royce
Rush
Sabo
Salmon
Sanders
Sanford
Sawyer
Saxton
Scarborough
Schaefer
Schiff
Schroeder
Schumer
Scott
Seastrand
Sensenbrenner
Serrano
Shadegg
Shaw
Shays
Shuster
Sisisky
Skaggs
Skeen
Skelton
Slaughter
Smith (MI)
Smith (NJ)
Smith (TX)
Smith (WA)
Solomon
Souder
Spence
Spratt
Stearns
Stenholm
Stockman
Stokes
Studds
Stump
Stupak
Talent
Tanner
Tate
Tauzin
Taylor (MS)
Taylor (NC)
Tejeda
Thomas
Thompson
Thornberry
Thornton
Thurman
Tiahrt
Torkildsen
Torres
Torricelli
Towns
Traficant
Upton
Velazquez
Vento
Visclosky
Volkmer
Vucanovich
Walker
Walsh
Wamp
Ward
Waters
Watt (NC)
Watts (OK)
Waxman
Weldon (FL)
Weldon (PA)
Weller
White
Whitfield
Wicker
Wise
Wolf
Woolsey
Wynn
Yates
Young (AK)
Zeliff
Zimmer
NAYS--2
Stark
Williams
NOT VOTING--10
Bateman
Brownback
Diaz-Balart
Dickey
Ford
Graham
Lincoln
McDade
Wilson
Young (FL)
{time} 2015
So the conference report was agreed to.
The result of the vote was announced as above recorded.
A motion to reconsider was laid on the table.
____________________