[Congressional Record Volume 143, Number 22 (Wednesday, February 26, 1997)]
[House]
[Pages H636-H639]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




    REPEALING FEDERAL CHARTER OF GROUP HOSPITALIZATION AND MEDICAL 
                             SERVICES, INC.

  Mr. DAVIS of Virginia. Mr. Speaker, I move to suspend the rules and 
pass the bill (H.R. 497) to repeal the Federal charter of Group 
Hospitalization and Medical Services, Inc., and for other purposes.
  The Clerk read as follows:

                                H.R. 497

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. REPEAL OF FEDERAL CHARTER OF GROUP HOSPITALIZATION 
                   AND MEDICAL SERVICES, INC.

       (a) Repeal of Federal Charter.--
       (1) In general.--The Act entitled ``An Act providing for 
     the incorporation of certain persons as Group 
     Hospitalization, Inc.'', approved August 11, 1939 (53 Stat. 
     1412), is repealed.
       (2) Authorization to file articles of incorporation.--Group 
     Hospitalization and Medical Services, Inc. is hereby 
     authorized to file articles of incorporation under the 
     District of Columbia Nonprofit Corporation Act.
       (3) Effective Date.--The amendment made by paragraph (1) 
     shall take effect upon the filing and effectiveness of 
     articles of incorporation of Group Hospitalization and 
     Medical Services, Inc. under the District of Columbia 
     Nonprofit Corporation Act.
       (b) Effects of Becoming a District of Columbia Nonprofit 
     Corporation.--Effective

[[Page H637]]

     upon the filing and effectiveness of articles of 
     incorporation of Group Hospitalization and Medical Services, 
     Inc. as authorized in paragraph (2) of subsection (a), Group 
     Hospitalization and Medical Services, Inc.--
       (1) Shall be District of Columbia nonprofit corporation 
     subject to he articles of incorporation;
       (2) shall be deemed organized and existing under the 
     District of Columbia Nonprofit Corporation Act, 
     notwithstanding any of the provisions of section 4 of the 
     District of Columbia Nonprofit Corporation Act regarding 
     organizations subject to any of the provisions of the 
     insurance laws of the District of Columbia;
       (3) shall be legally domiciled in the District of Columbia;
       (4) shall be regulated by the Superintendent of Insurance 
     of the District of Columbia in accordance with the laws and 
     regulations of the District of Columbia;
       (5) shall continue to exist; and
       (6) shall continue to be authorized to transact business--
       (A) under existing certificates of authority and licenses 
     issued to Group Hospitalization and Medical Services, Inc. 
     before such filing and effectiveness,
       (B) under the name ``Group Hospitalization and Medical 
     Services, Inc.'', and
       (C) under applicable laws and regulations.

     SEC. 2. WAIVER OF CONGRESSIONAL REVIEW PERIOD.

       Notwithstanding section 602(c)(1) of the District of 
     Columbia Self-Government and Governmental Reorganization Act 
     (sec. 1-233(c)(1), D.C. Code), the Hospital and Medical 
     Services Corporation Regulatory Act of 1996 (D.C. Act 11-505) 
     shall take effect on the date of the enactment of such Act or 
     the date of the enactment of this Act, whichever is later.
  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Virginia [Mr. Davis] and the gentlewoman from the District of Columbia 
[Ms. Norton] each will control 20 minutes.
  The Chair recognizes the gentleman from Virginia [Mr. Davis].
  (Mr. DAVIS of Virginia asked and was given permission to revise and 
extend his remarks.)
  Mr. DAVIS of Virginia. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, H.R. 497 repeals the Federal charter of the Group 
Hospitalization and Medical Services, Inc., the Blue Cross/Blue Shield 
Plan of the National Capital Area.
  GHMSI, as it is known, is the only insurance company to have a 
Federal charter. It was granted in 1939. Under the charter, provision 
is made for its repeal by Congress.
  The GHMSI Federal charter has become an anachronism and an impediment 
to competition. This bill seeks to level the playing field. When 
granted in 1939, the District of Columbia Code did not have provisions 
to regulate such an entity. It has had such regulatory provisions now 
for a number of years. As recently as 1992 and 1993, Congress amended 
the charter to specify that GHMSI be domiciled in the District and 
governed by local laws and regulations. At the present time, GHMSI is 
subject to the District's Nonprofit Corporation Act and is under the 
jurisdiction of the Superintendent of Insurance.
  By waiving the congressional review period for D.C. Act 11-505, as 
provided for in this bill, the new entity, upon acceptance of its 
articles of incorporation, will continue to be governed by local laws 
without a gap or a delay in enforcement. The bill authorizes GHMSI to 
file articles of incorporation under the District's Nonprofit 
Corporation Act. The new entity would continue to be governed under its 
existing certificate of authority and licenses and will continue to be 
bound by applicable laws and regulations. Local regulation would 
continue to be the responsibility of the Superintendent of Insurance of 
the District of Columbia.
  H.R. 497 is necessary because of the significant changes which have 
occurred in health care delivery systems nationwide and in the 
Washington metropolitan area. These changes are the result of market-
based reforms stimulated by the growth of managed care. Health care 
plans must now compete to survive. Successful plans must be keyed to 
consumers, markets, and products. All other Blue Cross plans in the 
country are State-chartered corporations operated under State 
regulatory oversight. GHMSI alone needs congressional approval to 
change its corporate structure.
  These arguments are not theoretical. On January 14, 1997, Blue Cross/
Blue Shield of the National Capital Area and Blue Cross/Blue Shield of 
Maryland signed a letter of intent to combine by forming a nonprofit 
holding company, with both plans as subsidiaries. This is subject to 
review by the insurance commissioners for Maryland, Virginia, and the 
District of Columbia, but without this bill Congress would also have to 
vote its approval. To require congressional approval of such an action 
puts GHMSI at a competitive disadvantage.
  This bill is essential in order for GHMSI to fully compete in the 
marketplace and for the ability of subscribers in the region to obtain 
and maintain quality and affordable health care benefits.
  Mr. Speaker, I want to make very clear that GHMSI will be the very 
same corporation after the repeal of the Federal charter as it was 
before the repeal of the Federal charter. This is merely a change in 
identity, form, or place of organization for the group health of GHMSI 
of the type recognized as a reorganization under section 368(a)(1)(F) 
of the Internal Revenue Code of 1986.
  Mr. Speaker, I urge passage of this bill.

Questions and Answers Regarding H.R. 497, To Repeal the Federal Charter 
          of Group Hospitalization and Medical Services, Inc.

       Q. What does this bill do?
       A: It repeals the Federal Charter of Group Hospitalization 
     and Medical Services, Inc. This is the entity that holds a 
     license from the Blue Cross and Blue Shield Association to do 
     business as Blue Cross and Blue Shield of the National 
     Capital Area.
       Q: Why repeal the federal charter?
       A: To help regional consumers by giving the District Blues 
     the same flexibility that all other health insurance 
     companies in the country have. The charter has become an 
     anachronism and an impediment to competition. GHMSI is the 
     only health insurance company to hold a federal charter. This 
     bill creates a more level playing field.
       Q: When was the federal charter granted?
       A: It dates back to 1939, when there was no local home rule 
     in the District of Columbia and no local laws governing 
     nonprofit health insurance companies. There is now a 
     Superintendent of Insurance in the District and a local 
     Nonprofit Corporation Act.
       Q: How are other Blue Cross plans in the country treated?
       A: All others are state chartered corporations operating 
     under state regulatory oversight. GHMSI alone needs 
     congressional approval to change its corporate structure.
       Q: Does Blue Cross support this bill?
       A: Yes. In fact, they requested it.
       Q: Does the bill effect any other health insurance company 
     in the country?
       A: No. The bill, if enacted, would become part of the 
     District of Columbia Code.
       Q: Does the bill have any impact on federal employees?
       A: No.
       Q: Is the bill supported by District local officials?
       A: Yes. It is supported by locally elected officials and by 
     the control board.
       Q: Does the bill change anything for Blue Cross 
     subscribers?
       A: Not at all.
       Q: Does the bill have any direct effect on the federal 
     budget?
       A: No. The Congressional Budget Office and the Joint 
     Committee on Taxation have so stated in writing.
       Q: Has this bill been introduced before?
       A: No. But it was included in the Omnibus Continuing 
     Resolution passed by the House last year.
       Q: Is there any known opposition to this bill at the 
     present time?
       A: No. Co-sponsors include members of the regional 
     delegation from both sides of the aisle.
       Q: Does the bill have any impact on for-profit health 
     insurance companies?
       A: No.
       Q: How does this bill compare to the laws governing 
     nonprofit health insurance companies in the bordering states 
     of Maryland and Virginia?
       A: It establishes comparability. The bill authorizes GHMSI 
     to file articles of incorporation under the District's 
     Nonprofit Corporation Act. The new entity would continue to 
     be governed under its existing certificates of authority and 
     licenses. It would continue to be bound by applicable laws 
     and regulations. Local regulation would continue to be by the 
     Superintendent of Insurance of the District of Columbia upon 
     certification of the articles of incorporation.
       Q: Is this bill strictly theoretical?
       A: No. On January 14, 1997 Blue Cross/Blue Shield of the 
     National Capital Area and Blue Cross/Blue Shield of Maryland 
     signed a Letter of Intent to combine by forming a holding 
     company, with both plans as subsidiaries. This is subject to 
     review by the insurance commissioners for Maryland, Virginia, 
     and the District of Columbia. Without this bill Congress 
     would also have to vote its approval. To require 
     congressional approval of such an action puts the Blues at a 
     competitive disadvantage. Successful plans, reflecting 
     market-based reforms, must compete to survive by being keyed 
     to consumers.
       Q: What about the waiver provision in the bill for D.C. Act 
     11-505?
       A: This is necessary in order to insure that there will be 
     no delay and no gap in enforcement of local laws to the new 
     nonprofit Blue

[[Page H638]]

     Cross company authorized by this bill. D.C. Act 11-505 is the 
     new Hospital and Medical Services Corporation Act enacted by 
     the District government. It passed unanimously and was 
     approved by the control board.
       Q: Is there any known opposition to D.C. Act 11-505?
       A: No. It was transmitted to Congress by the District 
     Government on February 4, 1997.
       Q: What happens if the congressional review period for D.C. 
     Act 11-505 is not waived?
       A: Then the enactment could not pass into the District Code 
     until after H.R. 479 passes, hence creating a likely delay in 
     enforcement. Thus, this section of the bill was included out 
     of an abundance of caution.
       Q: Why was D.C. Act 11-505 deemed necessary?
       A: Because otherwise there would be no local laws governing 
     GHMSI or its successor corporation in the District of 
     Columbia. GHMSI is now operating under a consent order with 
     the District of Columbia Insurance Administration. The 
     original federal charter expressly exempts GHMSI from 
     District Government regulation, though this was amended by 
     Congress in 1992 to permit such regulation.

  Mr. Speaker, I reserve the balance of my time.
  Ms. NORTON. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I want to begin by thanking the gentleman from Indiana 
[Mr. Burton] for allowing us to expedite consideration of this bill, 
and I want to express my appreciation to the subcommittee chair, the 
gentleman from Virginia [Tom Davis], for his work in making certain 
that this bill came to the floor this morning.
  Mr. Speaker, in August 1939 Congress granted a Federal charter to 
Group Hospitalization, Inc., which authorized it to arrange for the 
provision of hospital services on a nonprofit basis to individuals 
residing in the District of Columbia. This was necessary because, at 
the time, the District had no laws in place to regulate nonprofit 
health insurance companies and, of course, there was no self-government 
at the time, but this body was the legislating body for the District of 
Columbia. The District only had the means to regulate mutual insurance 
companies, which group hospitalization did not wish to become. As a 
consequence, Group Hospitalization, Inc. began its operations exempt 
from local regulation.
  In October 1984, the charter was amended to expand Group 
Hospitalization's purpose beyond arranging for hospital services to 
include arranging for the provision of medical services on a nonprofit 
basis. This amendment also provided for a change of the company's name 
to Group Hospitalization and Medical Services, Inc., otherwise known as 
GHMSI. GHMSI is currently licensed by the Blue Cross and Blue Shield 
Association to do business as Blue Cross and Blue Shield of the 
National Capital area.

                              {time}  1145

  In the early 1990's, GHMSI's management engaged in a wide range of 
questionable business practices which threatened the corporation's 
financial stability. The Senate Government Affairs Committee's 
Subcommittee on Investigations held hearings on the situation. The 
subcommittee determined that the situation might have been avoided had 
GHMSI been fully regulated by the District government.
  To remedy this situation and protect the interests of the citizens 
served by GHMSI, the Congress amended its charter in both 1992 and 1993 
to provide that it be licensed and regulated by the District 
government.
  Last December, the District government enacted the Hospital and 
Medical Services Corporation Regulatory Act. This legislation 
establishes an improved statutory framework for the District's 
insurance administration to regulate GHMSI and any other similar 
nonprofit insurance corporations.
  Last month GHMSI and Blue Cross and Blue Shield of Maryland announced 
that they had signed a letter of intent to combine their business 
operations through the formation of a nonprofit holding company. Both 
health plans will continue to operate as subsidiaries of the holding 
company. This arrangement is expected to enhance their financial 
stability and provide their members with access to a wider array of 
service providers.
  The completion of this transaction would be made possible by the 
repeal of GHMSI's Federal charter. However, it would still be subject 
to regulatory reviews and approvals by the insurance commissioners of 
the District of Columbia, Maryland, and Virginia.
  Today, GHMSI is the only federally chartered health insurance 
corporation. All other Blue Cross and Blue Shield plans and all other 
commercial insurance companies are State chartered and subject to State 
regulatory oversight.
  In order for GHMSI to make a change in its corporate structure, the 
Congress would have to amend its charter. This is a burdensome process 
that encumbers GHMSI's efficient operation.
  In order to enable GHMSI to compete within the insurance industry on 
a level playing field, it is appropriate that Congress grant its 
request to repeal the charter and allow the local government to 
exclusively regulate GHMSI's affairs.
  This bill is fully in keeping with self-government and home rule. We 
therefore have before us, Mr. Speaker, a bill that facilitates the 
operations of a very important company located in the District of 
Columbia at the same time that it removes a remnant from the prehome 
rule period of the District of Columbia. So it serves the interests of 
all involved. I am pleased that it also serves the interests of the 
local governments in the neighboring regions as well.
  Mr. CUMMINGS. Mr. Speaker, the proposal that we are considering today 
will help bring improved services and benefits to the many Blue Cross/
Blue Shield subscribers in my district in Baltimore and to many of the 
constituents of representatives from suburban Maryland, Northern 
Virginia, and Washington, DC.
  I commend the gentleman from Virginia for introducing this necessary 
legislation.
  This bill extinguishes the Federal charter of Blue Cross/Blue Shield 
of the National Capital Area, which will permit it to organize and come 
under the jurisdiction of D.C. insurance laws--as it should have long 
ago. A merger between the National Capital area Blue Cross/Blue Shield 
and Maryland Blue Cross/Blue Shield will create a $3 billion-dollar-a-
year nonprofit company--providing health care coverage to 25 percent of 
the 8 million residents of Maryland, the District, and the Northern 
Virginia suburbs.
  Just as important, my constituents in Baltimore that are enrolled in 
the Blue Cross/Blue Shield plan will receive tangible results from the 
merger. It will increase competition, which will result in better 
service, more options, and access to a larger number of doctors, 
hospitals, and pharmacies at a lower cost for its customers.
  The passage of H.R. 497 is essential to giving my constituents in 
Baltimore, and the constituents of the members of Maryland, Virginia, 
and Washington, DC the type of comprehensive, quality health care they 
deserve.
  I am glad to know that we in Congress are doing all that we can to 
give health care providers greater flexibility to meet our constituents 
health care needs.
  Again, I congratulate the gentleman from Virginia, Mr. Davis for 
introducing this meaningful legislation and for working with the 
minority in such a bipartisan fashion.
  I urge my colleagues to suspend the rules and pass H.R. 497.
  Mr. HOYER. Mr. Speaker, I rise today to express my support for H.R. 
497, a bill to repeal the Federal Charter for Group Hospitalization and 
Medical Services, Inc., better known as Blue Cross and Blue Shield of 
the National Capital Area.
  H.R. 497 eliminates an outdated arrangement under which GHMSI, alone 
among health insurance providers, has had to operate. H.R. 497 
authorizes GHMSI to file articles of incorporation with the District of 
Columbia Nonprofit Corporation Act. The bill thus paves the way for 
GHMSI to become a District of Columbia nonprofit corporation--legally 
domiciled in the District of Columbia and subject to regulation by the 
superintendent of insurance for the District of Columbia.
  GHMSI will continue to exist under the same name and will be 
authorized to transact business as it has--under all existing licenses 
and certificates of authority.
  With the exception of GHMSI, Blue Cross Blue Shield plans and all 
other commercial insurance companies around the country are State 
chartered corporations operating under State regulatory oversight.
  H.R. 497 will place GHMSI on an equal footing with other plans and 
health insurers--enabling it to continue to provide comprehensive and 
affordable coverage to residents of the District of Columbia and the 
Washington Metropolitan area, while meeting the challenges of a 
changing health care marketplace.
  Of particular importance to my Maryland constituents, H.R. 497 will 
facilitate the proposed merger of GHMSI with Blue Cross and Blue Shield 
of Maryland. A recent letter of intent announced the plan to combine 
the business operations of the two entities under a single holding 
company.
  This combination of business operations will provide a larger 
provider network--offering

[[Page H639]]

greater portability and choice, broader product options, and improved 
customer service to residents of the District of Columbia, northern 
Virginia, and Maryland who work in one area and reside in another.
  I urge all of my colleagues to support this bill which will enable 
GHMSI to face the abundant challenges of the fast-changing health care 
marketplace and to compete and serve its customers on a fair and equal 
footing.
  Ms. NORTON. Mr. Speaker, I yield back the balance of my time.
  Mr. DAVIS of Virginia. Mr. Speaker, I urge the passage of the bill, 
and I yield back the balance of my time.
  The SPEAKER pro tempore [Mr. Shays]. The question is on the motion 
offered by the gentleman from Virginia [Mr. Davis] that the House 
suspend the rules and pass the bill, H.R. 479.
  The question was taken.
  Mr. DAVIS of Virginia. Mr. Speaker, on that I demand the yeas and 
nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 5 of rule I and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

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