[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.

                          ____________________