[Congressional Record Volume 149, Number 170 (Friday, November 21, 2003)]
[House]
[Pages H12230-H12246]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 WAIVING POINTS OF ORDER AGAINST CONFERENCE REPORT ON H.R. 1, MEDICARE 
     PRESCRIPTION DRUG, IMPROVEMENT, AND MODERNIZATION ACT OF 2003

  Ms. PRYCE of Ohio. Mr. Speaker, by direction of the Committee on 
Rules, I call up House Resolution 463 and ask for its immediate 
consideration.
  The Clerk read the resolution, as follows:

                              H. Res. 463

       Resolved, That upon adoption of this resolution it shall be 
     in order to consider the conference report to accompany the 
     bill (H.R. 1) to amend title XVIII of the Social Security Act 
     to provide for a voluntary program for prescription drug 
     coverage under the Medicare Program, to modernize the 
     Medicare Program, to amend the Internal Revenue Code of 1986 
     to allow a deduction to individuals for amounts contributed 
     to health savings security accounts and health savings 
     accounts, to provide for the disposition of unused health 
     benefits in cafeteria plans and flexible spending 
     arrangements, and for other purposes. All points of order 
     against the conference report and against its consideration 
     are waived. The conference report shall be considered as 
     read.

  The SPEAKER pro tempore. The gentlewoman from Ohio (Ms. Pryce) is 
recognized for 1 hour.
  Ms. PRYCE of Ohio. Mr. Speaker, for the purpose of debate only, I 
yield the customary 30 minutes to my colleague and friend, the 
gentlewoman from New York (Ms. Slaughter), pending which I yield myself 
such time as I may consume. During consideration of this resolution, 
all time yielded is for the purpose of debate only.
  Mr. Speaker, H. Res. 463 is a standard rule waiving all points of 
order against the conference report to accompany H.R. 1, the 
Prescription Drug and Medicare Modernization Act of 2003. The rule also 
waives all points of order against its consideration.
  Mr. Speaker, I rise today in full support of the rule and of the 
underlying bill. I would like to thank Chairman Thomas and Chairman 
Tauzin for their outstanding coordination, their remarkable leadership, 
and the inspiring vision that they have provided on this critical 
legislation. The conferees have all worked extraordinarily hard to

[[Page H12231]]

produce the most sweeping Medicare bill in generations.
  Since 1965, Medicare has provided a guarantee of health care coverage 
for most all Americans. Stability, longevity, and integrity have been 
the hallmarks of this program, offering the promise of a secure 
retirement. But a lot has changed since 1965. Our investment in 
research and medicine has yielded us advanced medications, therapies, 
and technology that have paved the way for our seniors to live longer, 
healthier lives. Unfortunately, Medicare has not changed with these 
medical advancements. The most obvious shortcoming is the lack of 
prescription drug coverage, the best tool medicine has to offer.
  Before us today is an opportunity to pass landmark legislation that 
addresses these shortcomings and finally propels the program of 
Medicare into the 21st century, most notably by covering these 
prescription drugs. If we do not act and pass this plan before us 
today, the future of our seniors will be in doubt, with their happy and 
healthy lives uncertain. And if we do not act today, the fate of 
Medicare will be certain: bankruptcy.
  So today we will accomplish two long overdue goals. First, we will 
strengthen Medicare to save it for future seniors; and, second, we will 
enhance the program by providing much-needed prescription drug 
coverage, bringing this 1965 health care program into the 21st century. 
And to those who are telling us to slow down, I say seniors have waited 
too long. This House has passed a Medicare prescription drug plan three 
times since Republicans have controlled Congress, each time only to be 
scuttled. Today we will finally end the denial of benefits to our 
seniors and end the delay.
  Folks in my district tell me that they cannot go another year without 
the help of Medicare prescription drug coverage. They want us to speed 
up the process. They tell me that when you are sick and you are 
elderly, Medicare is not just health care; it is peace of mind. Well, 
we listened and we acted, producing this historic package.
  Our seniors are not the only ones who have spoken out in support of 
this plan. Let me tell you, some very knowledgeable folks on the front 
lines of health care delivery, people who understand the needs of our 
seniors and the problems with Medicare, have made their support for 
this bill very clear. Allow me to name just a few: the American 
Association of Retired Persons, the AARP, the largest senior group in 
the Nation representing 35 million seniors, card-carrying, dues-paying, 
voting seniors; the American Medical Association; the American 
Hospitals Association; employers Coalition on Medicare; the Alzheimer's 
Association; American Society of Radiology and Oncology; Rural Hospital 
Coalition; National Hospice and Palliative Care Organization; the 
College of Obstetrics and Gynecology; American Society of 
Anesthesiologists; American Physical Therapy Association; pathologists; 
nurse practitioners. The list goes on and on. It includes hundreds and 
hundreds of supporters. They back this plan because they know how 
important and long overdue it is, plain and simple.
  There are many reasons to vote for this package, but I want to call 
attention to a few that are significant. First of all, this 
prescription drug plan is voluntary, universal, and guaranteed. Period. 
If you are over 65 and you qualify for Medicare, you qualify for this 
benefit. If you want it, you can have it. If you do not, you do not 
have to take it. With this benefit, 40 million seniors will begin 
receiving significant savings on their medications.

                              {time}  2145

  To begin with, we offer immediate savings with the prescription drug 
discount card that will offer up to 25 percent in savings early next 
year. This drug discount card is a tremendous first step while the 
larger benefit is implemented.
  After the drug is fully phased in in 2006 it will work like this: 
After a $250 deductible, Medicare will pay 75 percent of seniors' drug 
cost up to $2,250 a year. Medicare will then provide catastrophic 
protection, giving seniors 95 percent coverage for out-of-pocket drug 
costs. That is beyond $3,600. On average this reduces seniors' cost of 
medication by 50 percent.
  This package also switches the focus of health care from reactive 
disease treatment to proactive disease prevention. The old saying ``an 
ounce of prevention is worth a pound of cure'' could not be more 
appropriate in this instance. Gone are the days of waiting until the 
symptoms are so obvious and the disease is so advanced that the only 
options are expensive hospital stays and surgeries.
  Twenty-first century medicine can prevent, preempt, and predict 
illnesses through advanced screenings and innovative tests. In many 
cases taking a pill is all that it takes to prevent a chronic disease 
from becoming a life-threatening illness. Medicare will cover the 
preventative medications that keep our seniors out of the hospitals and 
off of the operating tables. And with this revolutionary shift in 
focus, Medicare will cover the $20 prescription before the $6,000 
surgery even becomes necessary. That is not only real savings for the 
American taxpayer, but it is a real life savings for our seniors.
  This landmark bill improves health care for our seniors, especially 
those who need it most, through significantly increased assistance for 
so-called ``disproportionate share hospitals.'' Such hospitals, as the 
term implies, care for a disproportionate share of low-income patients, 
and the last thing they need is funding cuts. Under this plan the 
hospitals will see a significant increase and allow them to care for 
these low-income families and seniors.
  In addition to its strong commitment to our lower-income seniors in 
general, the plan is particularly good news for women. Since women make 
up a majority of Medicare beneficiaries and tend to suffer more from 
chronic illnesses, this landmark improvement in the Medicare system 
will radically change their lives for better. Half of the senior women 
who are under Medicare will receive complete drug coverage, an 
extraordinary step forward for these women who are suffering 
unnecessarily high drug cost burdens even as we speak. The disease 
management aspect of this bill will help prevent the progression of the 
chronic illnesses from which a majority of senior women suffer.
  Clearly, this plan means a better life for women and for all of our 
seniors, but it also will lessen the burden upon the Medicare program 
by creating a health savings account. Health savings accounts allow 
forward-thinking and penny-wise workers to start saving for their 
future medical costs tax free. These accounts are allowed to grow 
without burdensome taxation, providing all Americans with the 
opportunity to save for their own future medical expenses. Who can 
argue with the promotion of these strong values, values like personal 
responsibility, savings, financial discipline? These things have been 
gone from our health care delivery system for decades now. It is time 
we bring them back. And who can argue against a voluntary program that 
relieves the financial burden of Medicare and the taxpayers who fund 
it?
  Finally, this package includes a provision that I have championed for 
many years. Under the current system, anticancer drugs are only covered 
if they are injected or intravenously delivered. But today with the new 
advances in cancer therapy, many anticancer drugs can be taken orally, 
and, therefore, are not covered by Medicare. This plan begins to change 
that finally.
  The plan will deliver the comforting pain-relieving and cancer-curing 
drugs that these patients so desperately need to deal with their 
illnesses. They need these medications now, and they are going to start 
to get them now.
  Mr. Speaker, there is a value attached to this legislation that 
resonates not only among our seniors but to all Americans. The value is 
the freedom to choose the plan that works best for someone in their own 
situation. Each senior is different with different needs and different 
family situations. With this plan these differences can, for the first 
time, be honored. Seniors who are happy with traditional Medicare in 
their current coverage are free to stay where they are, but if they 
choose, seniors will have many options available to them and they will 
be able to pick the coverage that best meets their health care needs. 
If they are not

[[Page H12232]]

content with the current coverage, they can choose from other plans to 
save on their medications and preventative care. This is a win-win 
solution, a commonsense approach. So today the vote is simple. It is 
either ``yes'' in favor of millions of seniors who plead for us to pass 
this bill, or it is another ``no,'' another ``no'' in favor of 
politics, another ``no'' in favor of partisanship, another ``no'' with 
an eye toward the upcoming election. In short, another ``no'' against 
American senior citizens and against the future viability of the 
Medicare system upon which they rely. Members can choose to listen to 
the seniors who are asking them to put partisanship, politics and 
election strategy aside, or they can oppose this bill.
  But to those of my colleagues who plan to vote ``no,'' I would ask: 
How is this package not an improvement for our seniors who have no 
coverage and are struggling to pay for their medications? Why would 
they rather give our seniors nothing at all than give them this plan 
that will help them? How will they explain that to future generations, 
their children, their grandchildren why they did not support bringing 
Medicare up to speed with their generation and their needs?
  I remember the opponents of the tremendously successful welfare 
reform of 1996. They predicted doomsday scenarios, millions of women 
and children out on the streets starving. The reality is that 7 years 
later, the welfare rolls have dropped from 14 million to 5 million. The 
reality is that welfare reform made the American Dream possible for 
millions of Americans who were previously trapped in generational 
cycles of poverty and helplessness.
  These same naysayers are making the same claims about this Medicare 
plan today. I say to my friends, their shouts, their cries, their 
failed predictions were myths in 1996 and they are myths today. To 
those who plan to vote against strengthening America, I urge them to be 
bold, to exercise leadership and show courage by propelling America's 
health care system into the 21st Century. Vote for this bill. If the 
Members think this bill does good but does not go far enough to help 
our seniors, then I ask them to support it and let us work together to 
improve it in the future. Do not let the perfect become enemy of the 
very good. Our seniors deserve our support, all of our support.
  I urge this Congress to pass the underlying bill, but first of all, 
let us pass this rule.
  Mr. Speaker, I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I yield myself such time as I may 
consume.
  (Ms. SLAUGHTER asked and was given permission to revise and extend 
her remarks.)
  Ms. SLAUGHTER. Mr. Speaker, I thank the gentlewoman from Ohio for 
yielding me the customary 30 minutes.
  Mr. Speaker, I want to repeat something I said earlier today when I 
heard the long list of people who support this bill. We have to ask 
ourselves do they know what in the world is in it? Because we certainly 
do not.
  Seniors, we do know, are drowning from the high cost of prescription 
drugs and the Republicans are telling them to swim towards an HMO. To 
paraphrase the old saying, ``Congress giveth and Congress taketh 
away,'' but in this case it mostly takes away. Congress takes away any 
hope for meaningful prescription drug coverage. It takes away the 
existing employer-provided benefits and low-income protections from 
retirees, and it takes away Medicare as we know it. It lures seniors 
with the promise of generosity and then gives them a pittance. But when 
this bill does give, it is wonderfully generous.
  The Medicare Prescription Drug and Modernization Act is a boon for 
the pharmaceutical industry and for the insurance companies but does 
absolutely nothing to control the skyrocketing prices of prescription 
drugs. In fact, the bill forbids the government from doing anything 
about it.
  Drug prices have risen dramatically in the last 20 years, increasing 
256 percent since 1980. For years seniors have called our Congress to 
do something about these crushing drug prices, but this plan does 
nothing to freeze or reduce the out-of-control prices of medications. 
What it does do, as I said, is prevent the government from using its 
market power to bring the prices down. The Veterans Administration has 
had great success in reducing drug prices by bargaining with the drug 
companies. Why would we purposely tie our own hands? Our health system 
is crumbling under the burden of the prescription drug costs. Tossing 
billions of dollars at insurance companies to get them to do what they 
do not want to do and 70 billion to corporations to get them to do what 
they should do and a boon to pharmaceutical companies by not allowing 
reimportation to please them is not going to buttress this health care 
system. That money would have been far better spent on the prescription 
drug program. But saddling the elderly with even greater drug costs and 
our children with even greater deficits is no way to solve a public 
health crisis.
  A few years ago, I organized a busload of seniors to travel to Canada 
to purchase medicine at a fraction of the prices charged in the 
American market. We had dozens more people interested in the trip than 
we could accommodate, but the savings were anywhere from $100 to $650 
on a 3-month supply of medication.
  Would it not be wonderful if the seniors could save that much at 
their local drug store? Unfortunately, this bill will not let them go 
to Canada anymore. Despite having passed the House twice, money-saving 
drug reimportation would be banned. The out-of-pocket costs for 
prescription drugs would continue to consume more and more of the 
seniors' fixed income.
  Almost 40 years ago, Mr. Speaker, Congress created the Medicare 
program and promised to help seniors with the burden of their health 
care costs. Private insurers did not want to offer the health insurance 
to older people any more than they do now. The premiums were raised to 
unaffordable levels, and seniors were dropped from health coverage 
altogether. Companies saw older people as a threat to the bottom line. 
So the Federal Government stepped in and filled the void in the 
marketplace.
  And now we face a similar situation. If insurers thought they could 
make a dollar or two by offering prescription drug coverage to seniors, 
the plans would have already been in the marketplace. The bill creates 
a new benefits program unwisely relying on insurance products that do 
not exist. The Republicans are hoping that a $12 billion slush fund 
will entice the private insurers to develop prescription drug 
insurance. But the lucrative pharmaceutical industry with about a 30 
percent profit yearly is the big winner in this game. A blank check is 
being written to the big drug companies, and in the first 8 years of 
this program, the companies stand to make a windfall of $139 billion 
over and above their current profits of 30 percent annually. The market 
recognizes this plan as a boon for drug companies because the stock 
prices of the major companies went up just over the news that this bill 
is nearing completion.
  The proponents of privatizing Medicare also win. The scheme takes the 
first giant step to privatize Medicare. In six metropolitan areas, 
Medicare's guaranteed coverage would be replaced with what is 
essentially a voucher program to purchase private insurance with public 
money if they can find it. This ``demonstration'' could force up to 10 
million seniors who want traditional fee-for-service Medicare to pay 
the higher premiums or turn to HMOs. Once Medicare is gone, there will 
never be another program ever like it in the United States paid for by 
payroll taxes. I am worried about the seniors that I represent, and it 
would be devastating for the seniors in western New York to lose those 
guaranteed benefits.
  Mr. Speaker, the pharmaceutical companies, the HMOs, and the 
insurance industry had far more access to the negotiations than the 
Democrats did, as the Members have heard that story before, and I will 
not belabor it. But I do want to say something about the AARP. 
President William Novelli's endorsement of this plan is no surprise. 
The support is waved around as if it is the seal of approval of every 
American senior. But 210 national, State, and local organizations 
oppose the plan, and seniors from coast to coast are ripping up their 
AARP cards. Interestingly, Mr. Novelli is the founder of the firm 
Porter Novelli, the group behind the television ads that brought down

[[Page H12233]]

the efforts to reform health care in the 1990's. Do any of the Members 
remember ``Harry and Louise''? Is Mr. Novelli hostile to meaningful 
health care reform, or can he just be paid to do anything, because $20 
million in this bill goes to AARP?

                              {time}  2200

  This is not the first time that Congress has messed with Medicare. 
Congress passed the Medicare Catastrophic Coverage Act of 1988 without 
even providing the Members sufficient opportunity to read its pages, 
much like tonight, and the fine print. The result was a momentous 
backlash. American seniors were outraged with the legislation, so 
outraged that Congress was forced to repeal the law the very next year.
  Congress later created a Medicare+Choice program, which was also a 
failure. Within a few short years after its conception, private 
insurers dropped Medicare+Choice beneficiaries by the thousands, 
leaving them with no health benefits at all. My constituents are 
asking, does this face them again? I hope we remember our history and 
not repeat these mistakes and vote against this bill.
  But the prescription drug proposal before us is a placebo, not a 
cure. It fails seniors, the out-of-control cost of prescription drugs 
will remain unchecked, and some will argue that this scheme is better 
than nothing. But believe me, a bad bill is worse than no bill. 
Medicare must be preserved. To dismantle this historic program is to 
break the sacred promise that Congress made to seniors.
  Mr. Speaker, I yield for a unanimous consent request to the 
gentlewoman from California (Ms. Woolsey).
  (Ms. WOOLSEY asked and was given permission to revise and extend her 
remarks.)
  Ms. WOOLSEY. Mr. Speaker, I rise against this sham Republican 
prescription drug bill that will harm, not help, elderly women.
  Mr. Speaker, I rise today to express my profound disappointment at 
the Medicare Conference Report and this squandered opportunity to help 
seniors afford the increasing cost of prescription drugs.
  I want to make one thing abundantly clear to everyone here today: 
This debate is not about prescription drugs. Instead, the majority has 
taken this opportunity to advance a plan that will undermine the future 
of Medicare.
  Seniors may think this final bill will help them with some of their 
prescription drug costs. While it will save some seniors a small amount 
of money after they pay an unspecified premium, this bill will give 
them little more than a false sense of security.
  Seniors will read the newspaper headlines and believe that we have 
passed a drug benefit that will alleviate all of their financial 
hardships. They'll mistakenly think that they no longer have to choose 
between paying for groceries and paying for their prescriptions.
  But imagine their surprise when they read the fine print. Our seniors 
need immediate help. Many will be shocked to learn that this bill won't 
give them a prescription drug benefit until 2006. If this is such a 
great plan, why must seniors wait 3 more years to reap its supposed 
benefits?
  They'll find that their out of pocket costs are still enormous. 
Imagine their outrage, as they dutifully write a check to pay their 
monthly premium, even though they aren't receiving any drug coverage, 
because they have fallen into the ``donut hole'' coverage gap.
  Seniors who currently enjoy quality prescription drug coverage many 
think this doesn't impact them, but they too are in for a rude shock. 
As many as 2 million will watch their prescription drug benefit 
provided by their former employer vanish into thin air.
  Others will find their previously generous benefit slashed to the 
bare bones level of Medicare, complete with high deductibles, premiums, 
and a ``donut hole'' coverage gap. That's because employers will be 
eligible for subsidies if they provide any type of coverage--even if 
it's less than what they promised their employees.
  But this bill is about far more than prescription drugs. This is the 
biggest bait and switch operation I've seen in quite some time. The 
majority is saving one thing and doing quite another. They'll talk all 
they want about providing prescription drugs. But their actions will 
ruin the Medicare program that for decades has so effectively provided 
seniors with access to health care.
  You won't hear them talking about their large subsidies to private 
health plans. They won't talk about the voucher scheme that will begin 
in 2010. They'll employ the euphemism ``demonstration project'', 
instead of speaking honestly to seniors about their real goal: 
privatization.
  They won't talk about the catastrophic impact this legislation will 
have on the poorest of the poor. By imposing an assets test on poor 
seniors who need additional help, this legislation could force a widow 
living only on her social security benefit to choose between selling 
her wedding ring and qualifying for an additional subsidy. She could be 
disqualified from receiving the help she needs because she has 
purchased a burial plot next to her husband's. This is tragic--and you 
won't hear about it from the majority.
  They also won't talk about the ways in which they are helping their 
friends in the pharmaceutical industry. By continuing a long standing 
restriction on the reimportation of prescription drugs, and by 
prohibiting Medicare from negotiating lower prescription drug prices, 
the majority is assuring that seniors will continue to pay 
astronomically high prices for the medicines they need.
  Our seniors deserve an honest and complete explanation of what this 
bill will do to Medicare. Seniors deserve a prescription drug bill that 
is actually about prescription drugs. Our seniors need a comprehensive 
benefit, not a false sense of security. I urge my colleagues to join me 
in opposing this bait and switch proposal.
  Ms. SLAUGHTER. Mr. Speaker, I yield for a unanimous consent request 
to the gentlewoman from New York (Ms. Velazquez).
  (Ms. VELAZQUEZ asked and was given permission to revise and extend 
her remarks.)
  Ms. VELAZQUEZ. Mr. Speaker, I rise against this sham Republican drug 
bill that will increase costs, reduce coverage, and dismantle Medicare 
as we know it.
  Ms. SLAUGHTER. Mr. Speaker, I yield for a unanimous consent to the 
gentlewoman from Wisconsin (Ms. Baldwin).
  (Ms. BALDWIN asked and was given permission to revise and extend her 
remarks.)
  Ms. BALDWIN. Mr. Speaker, I rise in opposition to this conference 
report which will dismantle Medicare as we know it, harming millions of 
women who depend on that program.
  Mr. Speaker, I urge my colleagues to vote against this sham of a 
bill. It does not provide the real, guaranteed, affordable drug benefit 
that our seniors desperately need. Worse yet, this bill sets the stage 
for dismantling the entire Medicare program.
  I think that all of my colleagues would agree with me when I say that 
one of the issues we hear most about is the need for affordable 
prescription drugs. Whether I am at the grocery store, at the airport 
baggage claim, or in meetings all across my district in Wisconsin, the 
one thing that I hear over and over is that seniors cannot afford to 
pay for their prescription drugs.
  The bill on the floor today does not contain the prescription drug 
benefit that seniors deserve. Instead of providing an affordable 
prescription drug benefit, this bill creates an incomplete and 
expensive benefit--a benefit with a hole, where seniors will be paying 
premiums and receiving no benefit.
  Aside from the meager benefit, there is nothing in this bill that 
addresses the ever-rising cost of prescription drugs. Instead of 
including measures to ensure that prescription drugs are affordable, 
this bill actually prohibits the federal government from negotiating 
lower drug prices for Medicare beneficiaries. Instead of helping 
seniors obtain affordable prescription drugs, this bill provides 
partial coverage of drug spending until total costs reach $2,250 and 
then leaves seniors high and dry. There is a huge gap in coverage where 
seniors must pay 100 percent out of pocket and continue paying 
premiums, until they reach a high out-of-pocket cap. Millions of 
seniors will fall into this gaping hole. I believe seniors deserve 
affordable drug coverage, and this bill fails to achieve that goal.
  Further, this bill takes us down the dangerous road of privatizing 
Medicare. It is my strong belief that privatization of Medicare is 
unwarranted. Our Nation's seniors and persons with disabilities have 
counted on Medicare since it was first enacted in 1965. It has provided 
health care insurance to the oldest, sickest, and frailest in our 
society and done so in a cost-efficient manner. Why then, would we seek 
to dismantle such a successful program? This bill relies on private 
insurers to provide a prescription drug benefit. Seniors would have to 
join HMOs and private insurance plans to get the benefit, meaning that 
premiums and benefits would vary across the country and seniors would 
not be able to choose their own doctor or pharmacy.
  In addition, this bill includes a provision that authorizes a massive 
``demonstration'' project that could affect up to 6 million seniors. 
Starting in the year 2010, this ``demonstration'' project forces 
Medicare to compete with private plans. This competition is wholly 
unfair

[[Page H12234]]

and on an unlevel playing field. Seniors will be given a voucher to 
purchase health care insurance, either from Medicare or from private 
insurers. We know from past experience what will happen: the youngest 
and healthiest seniors will go to private insurers, leaving the sickest 
and frailest seniors in Medicare. This will automatically drive up 
Medicare's costs and will give Republican legislators ammunition for 
dismantling this program. Make no mistake about it; this massive 
``demonstration'' project will be the beginning of the end of Medicare.
  Today, we will vote on the most dramatic changes in the Medicare 
program since its inception. This bill does include unprecedented 
benefits--unfortunately the benefits will go predominantly to the 
politically-connected pharmaceutical and insurance industries, rather 
than to America's seniors who need relief. It saddens me that the 
legislation we vote on today will not provide seniors with what they 
need most: comprehensive prescription drug coverage and affordable 
prices. Seniors need a comprehensive prescription drug benefit that is 
affordable and dependable for all--with no gaps or gimmicks in 
coverage. The conference agreement before us fails on all these counts, 
and I urge my colleagues to vote against it.
  Ms. SLAUGHTER. Mr. Speaker, I yield for a unanimous consent 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 rise against this 
misdirected Medicare proposal that will increase out-of-pocket expenses 
for the poorest and sickest women.
  Mr. Speaker, this is about as ugly as it gets. Just when I thought 
the Republican Leadership could not work any harder to undermine the 
Democratic process, to abuse their power, and to play politics with 
critical issues at the expense of the American people--they have just 
taken it to a higher, or should I say ``lower'' level. This bill is a 
sham and the rule is a sham.
  When this process first began, and the President and the House and 
Senate Leaders proclaimed that they intended to produce a Prescription 
Drug Plan, my Democratic Colleagues and I tried to give them the 
benefit of the doubt. We tried to work in a bipartisan fashion. At one 
point, I wrote a letter to the Members of the House-Senate Conference 
Committee and encouraged them to include fair provisions for our 
physicians and hospitals, so that they would be able to afford to 
continue providing excellent care for our seniors. I am pleased to say 
that they did respond to that request, and have put in some funds for 
those deserving groups. But that is where the collaborations ended.
  The Democrats on the Conference Committee, among them, had decades of 
experience in the field of health policy. No one could question their 
commitment to helping Seniors, but in a deeply cynical move by 
Republican Leadership, Democrats were barred from even entering 
conference meetings. That is against everything our Founding Fathers 
intended this ``People's House'' to be. We got our first glimpse of 
this bill just over 24 hours ago. Even in our haste to get it read, we 
have found numerous flaws and pitfalls in it. In 2006, if it is allowed 
to come into effect, I am sure our Seniors will find many more.
  No one in this House has had a chance to really think through this 
monstrous conference report. We should all join together and raise a 
massive point of order against it, so that we will have the time to 
give it the consideration it deserves. The Rule does not let us make 
that happen.
  The Rules Committee Chairman seems to be saying, ``well money is 
tight, so let's just take what we can get, and be happy with this bill. 
Let's just shove it through.'' But the conference report that we are 
now finally getting a glimpse of is so bad, it would actually leave 
millions of Senior Citizens worse off than they were without it. And as 
Doctors say in the Hippocratic Oath, the most important rule in 
healthcare is Do No Harm.
  Furthermore, there is no rush to pass this bill. The Republican 
authors conveniently made their plan kick in in 2006, well after the 
presidential elections of 2004. Obviously, they don't want Seniors to 
go to the poll furious when they realize how bad this plan is. The 
point is, we can wait till Spring and do this job right--and still make 
their 2006 timeline.
  This rule and this bill really are the epitome of just how bad 
partisanship and political demagoguery can get. Let's defeat this rule. 
Let's take a step back, get some fellowship back over Thanksgiving, and 
start fresh later. We can do this right. Our Seniors deserve it.
  Ms. SLAUGHTER. Mr. Speaker, I yield for a unanimous consent request 
to the gentlewoman from Michigan (Ms. Kilpatrick).
  (Ms. KILPATRICK asked and was given permission to revise and extend 
her remarks.)
  Ms. KILPATRICK. Mr. Speaker, I ask unanimous consent to revise and 
extend my remarks on this Medicare proposal that takes Medicare from 
patient care.
  Mr. Speaker, I rise today to urge all my colleagues to vote against 
the Medicare Conference Report offered by the Republican leadership. 
Seniors want a prescription drug benefit that is affordable and 
guaranteed under the Medicare system.
  Passage of this bill would weaken prescription drug benefits, fail to 
lower drug costs, and weaken the Medicare program.
  Congress needs to pass a good Medicare bill that actually helps 
seniors and not just any bill that benefits pharmaceutical companies, 
HMOs, and special interest. Our colleagues on the other side of the 
aisle have a take it or leave it attitude. They want the American 
public to believe that if this conference report is not passed then all 
opportunities for a real prescription drug benefit under Medicare is 
lost. However, I submit to you that if a true bipartisan effort was 
made at the conference table, then much could be accomplished.
  Mr. Speaker, there are dozens of reasons why this conference report 
should be defeated and never become law. Many of these reasons have 
already been mentioned but I want to take this time to highlight a few.
  The three Democratic House conferees were shut out of the process and 
were not allowed in the conferee meeting. The treatment of these House 
Members is reasons enough for every member of this body to reject this 
conference report.
  The legislation would not create a prescription drug benefit until in 
2006. However, HMOs, insurance companies, and pharmaceutical companies 
receive billions of dollars upon enactment of the conference report.
  The bill also explicitly prohibits the Secretary of Health and Human 
Services from negotiating lower drug prices on behalf of America's 40 
million Medicare beneficiaries.
  The bill does not allow Americans to import drugs from Canada and 
other countries where prices are lower. International comparisons of 
pharmaceutical prices have shown that elderly and uninsured consumers 
in the United States often pay more for prescription drugs than 
consumers in other countries. As a result, more and more elderly 
consumers are traveling outside the country to find cheaper, more 
affordable prescription drugs. My district borders Windsor, Ontario, 
Canada, where I have known many of my seniors travel to get their 
prescriptions filled.
  The GOP plan includes provisions that will privatize Medicare and 
force senior citizens into HMOs and other private insurance plans.
  Millions of senior and Americans with disabilities currently covered 
by Medicare would actually find themselves worse off if the conference 
report becomes law. Low-income seniors who get additional assistance 
form Medicaid will pay more for their prescriptions because they will 
lose their Medicaid benefit.
  Currently, Medicare beneficiaries who receive medicine through 
Medicaid either pay no co-payments or are charged nominal amounts per 
month per prescription. Under the new plan, people will pay three-to-
five dollars per month, per brand-name prescription and one or two 
dollars for generic drugs. Depending on their income. These co-payments 
will increase each year.
  The GOP plan creates an unlimited program of Health Savings Accounts 
(HSAs). This tax break benefits the healthy and wealthy and could 
dramatically raise health insurance premiums for other Americans--
particularly families with moderate incomes and those with high health 
expenses.
  Seniors will lose their retiree health benefits. More than two 
million seniors in employer-based retiree plans are in jeopardy of 
being dropped from coverage because the bill creates incentives for 
employers to drop prescription drug coverage.
  Mr. Speaker, the Medicare Conference Report before this body will 
have a detrimental effect on senior and disabled citizens in my home 
state of Michigan.
  143,000 Medicare beneficiaries in Michigan will lose their retiree 
health benefits.
  183,200 Medicaid beneficiaries in Michigan will pay more for the 
prescription drugs they need.
  90,000 fewer seniors in Michigan will qualify for low-income 
protections than under the Senate bill because of the assets test and 
lower qualifying income levels.
  44,980 Medicare beneficiaries in Michigan will pay more for Part B 
premiums because of income relating.
  Providing affordable prescription drugs to our seniors and the 
uninsured should have been the goal. The Republican lead Congress 
squandered this opportunity to include a real prescription drug benefit 
within the Medicare plan.
  Mr. Speaker, there are hundreds of national, state, and regional 
organizations that have

[[Page H12235]]

come out against the Medicare conference report. I stand today with the 
seniors in my district and across the nation in opposition to this 
bill.
  I ask my colleagues to stand with me and vote against this Medicare 
Conference Report that fails to provide an affordable and reliable 
Medicare prescription drug coverage, gives billions to HMOs, insurance 
companies, and pharmaceutical companies, prohibits drug reimportation, 
and privatizes Medicare.
  Ms. SLAUGHTER. Mr. Speaker, I yield for a unanimous consent request 
to the gentlewoman from New York (Mrs. Lowey).
  (Mrs. Lowey asked and was given permission to revise and extend her 
remarks.)
  Mrs. LOWEY. Mr. Speaker, I rise against this prescription drug bill, 
because it will prohibit Medicare from negotiating price with the 
pharmaceuticals to lower prices for our sickest and most elderly 
population.
  Mr. Speaker, we are on the cusp of passing a Medicare prescription 
drug benefit that should have put seniors first, but, instead, will 
become the death knell for Medicare.
  Some are saying this is a matter of now or never, that we must pass 
this legislation tonight. That's just not true--where there's a will, 
there's a way. So, I urge my colleagues to refrain from rushing to 
judgment, vote against this bill, and work together, Republicans and 
Democrats alike, through December to craft a plan that will stay true 
to Medicare's tried and trusted roots.
  Mr. Speaker, the bill before us will allow insurance bureacrafts--not 
doctors--decide which drugs to prescribe and how much to charge 
seniors; and leaves major gaps in coverage that will affect almost half 
of Medicare recipients. I will end Medicare as we know it, and will 
have questionable impacts on some of the most well regarded state-
sponsored drug coverage programs, including New York's.
  But, my colleagues, the straw that breaks the camel's back is the 
lack of any attempt to bring down the skyrocketing costs of drugs. H.R. 
1 will prohibit the federal government from using the muscle of the 40 
million seniors in Medicare to negotiate lower drug prices. And it puts 
the brakes on the reimportation of pharmaceuticals from Canada and 
overseas--where drugs are sold for two, three, and four times less than 
in the U.S.
  This one-two punch will not only hurt seniors. It will block hard-
working Americans, including the 43.6 million uninsured, from obtaining 
cheaper drugs--leaving taxpayers to foot the bill for a plan that 
rewards private industry at the expense of consumers.
  The drug companies, with profit margins over 18 percent, have spend 
hundreds of millions of dollars trying to influence American opinion on 
prescription drugs. Yet, they will be rewarded with 40 percent profit 
increases. The same HMOs that left seniors in the cold under 
Medicare+Choice will be given a $12 billion slush fund to entice their 
participation in this plan.
  I have fought for years to give seniors an affordable, guaranteed, 
comprehensive, and voluntary prescription drug benefit under Medicare. 
I am deeply saddened and disappointed that the House leadership in 
forcing a vote on a bill, which many of us have not even been able to 
read in completion, that is not worthy of our seniors.
  I urge my colleagues to vote ``no'' on the bill.
  Ms. SLAUGHTER. Mr. Speaker, I yield for a unanimous consent request 
to the gentlewoman from Texas (Ms. Eddie Bernice Johnson).
  (Ms. EDDIE BERNICE JOHNSON of Texas asked and was given permission to 
revise and extend her remarks.)
  Ms. EDDIE BERNICE JOHNSON of Texas. Mr. Speaker, I rise against this 
so-called Medicare proposal devised by former Speaker Gingrich and the 
pharmaceutical industry that will increase out-of-pocket expenses for 
the poorest and sickest women.
  Mr. Speaker, the sham Republican prescription drug bill will harm, 
not help, elderly women.
  I oppose the Republican Medicare bill because it does not ensure that 
our seniors, especially our most venerably elderly women, get the long 
overdue Medicare prescription drug benefit that is available and 
affordable to all.
  How will this Medicare Reform proposal hurt women? First you must 
realize that women account for the majority of people who are on both 
Medicare and Medicaid. To make matters worst, the proposal is harmful 
to the poorest and sickest women because their out of pocket cost would 
increase above what Medicaid currently allows.
  I believe we must carefully draft legislation to protect the health 
and well-being of our citizens. It is shameful that many American 
seniors must regularly make the heartbreaking choice between paying for 
food and paying for prescription medicine. As a former nurse, I have 
spend much of my career working to ensure that our nation's health care 
system provides a wide range of affordable services.
  But unfortunately, drug prices are going up over 3 times the rate of 
inflation giving the drug industry more profits than all others--the 
result: seniors can't afford the medicine they need.
  Yet this proposal would actually prohibit Medicare from getting the 
best price for seniors. This bill states, and I quote, ``[Medicare] may 
not . . . interfere in any way with negotiations between . . . Medicare 
Advantage organizations . . . and drug manufacturers . . .'' In 
laymen's term that means Medicare must pay whatever the drug companies 
want to charge. This makes the new law a multi-billion dollar subsidy 
to the drug industry and a rip-off for America's senior citizens.
  This is especially hurtful to women because nearly eight in ten women 
on Medicare use prescription drugs regularly. Because the bill doesn't 
allow for the government to negotiate price controls on drugs, our 
women will have to face higher drug cost, as well as the American 
Treasury.
  Democrats have led the fight to add a drug benefit to Medicare. But 
what started as a fight to add a drug benefit has become a fight to 
save Medicare as we know it. Over and over again we have demonstrated 
our willingness to compromise and accept a less-than-perfect drug 
benefit when they approved a bipartisan Senate bill this summer. But 
instead of seeking bipartisanship, Republicans have insisted on 
including provisions that would turn Medicare into a voucher program 
and could cap government spending on Medicare. These provisions have 
nothing to do with providing beneficiaries affordable prescription 
drugs. They are intended to undermine Medicare.
  Medicare was created because the private health care system would not 
provide affordable health insurance coverage for seniors. We shouldn't 
be turning back the clock to those times. But that's exactly what the 
Republican bill--as written--will do.
  The American public should be outraged that the Republican leadership 
is playing politics with the health and well-being of millions of our 
citizens, and I hope the voters will remember this shameful abuse of 
power when they go the polls at election time.
  Ms. SLAUGHTER. Mr. Speaker, I yield for a unanimous consent request 
to the gentlewoman from New York (Mrs. McCarthy).
  (Mrs. McCARTHY of New York asked and was given permission to revise 
and extend her remarks.)
  Mrs. McCARTHY of New York. Mr. Speaker, I rise against the Medicare 
bill that is going to be giving billions of dollars of giveaway money 
that should be going for prescription drugs and not to the insurance 
companies and not to the pharmaceutical companies.
  Mr. Speaker, I rise, once again, in opposition to this flawed 
prescription drug bill. It is nothing more than a sheep in wolf's 
clothing.
  I'm frustrated because this Medicare bill contains some provisions I 
feel are necessary. Indeed, hospitals and doctors may see higher 
reimbursement rates. It would provide a meager prescription drug 
benefit, and includes some protections for low-income seniors.
  All of these provisions are a step in the right direction. 
Unfortunately, they are overshadowed by the bill's overall 
shortcomings.
  I had hoped that the effort to add a prescription drug benefit to 
Medicare would be a discussion about freeing seniors from the 
skyrocketing costs of medicine.
  But instead, it's become a struggle for the future of Medicare.
  The bill starts us down the path to privatizing Medicare. It damages 
the safety net we've stitched for our vulnerable seniors. And worst of 
all, it does nothing to make drug companies keep the cost of their 
medicines down, which is what I thought this effort was all about in 
the first place.
  Most of Long Island's seniors would be forced to go to private 
insurers for their drug coverage. In fact, this bill takes us down the 
same road Long Island has already traveled with Medicare+Choice HMOs. 
At first, we throw money at them, the private plans provide coverage, 
and everyone's happy. But over time, costs mount, federal 
reimbursements don't keep up, and the private insurers cut and run. 
This Medicare plan would throw billions more at HMOs and other private 
insurers with no guarantee that they'd continue to cover seniors. What 
happens when the HMO gravy train stops? Once again, our seniors will be 
left holding the bag. That goes against the very reason we created 
Medicare in the first place: to provide seniors with a safety net that 
the private insurance market could not and did not provide them with.
  In addition, the bill would actually prohibit the government from 
negotiating lower drug prices. Veterans on Long Island benefit from

[[Page H12236]]

lower drug prices because the Veterans Administration negotiates prices 
on their behalf. If it works for veterans, why deny it to our seniors?
  Finally, many seniors would find themselves in the ``doughnut hole,'' 
a gap in the very prescription drug coverage we are supposedly trying 
to provide them.
  Simply put, the bill is not good enough, and I refuse to compromise 
the needs of our seniors in hopes of advancing a political agenda.
  We must go back to the drawing board and create a real prescription 
drug benefit for seniors. We must do it without damaging their safety 
net or turning Medicare over to HMOs and insurance companies. Finally, 
we must do no harm, I learned years ago as a young nurse.
  Mr. Speaker, this bill will do harm. I must vote against it.
  Ms. SLAUGHTER. Mr. Speaker, I yield for a unanimous consent request 
to the gentlewoman from California (Ms. Watson).
  Ms. WATSON. Mr. Speaker, I rise against this sham Medicare proposal 
that the AARP supports. Bill Novelli is smiling because AARP gets 
millions of dollars, he gets $420,000 annual salary, and all grandma 
gets is a doughnut hole.


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore (Mr. LaHood). As recorded in section 957 of 
the House Rules and Manual, although a unanimous-consent request to 
insert remarks in debate may comprise a simple, declarative statement 
of the Member's attitude toward the pending measure, it is improper for 
a Member to embellish such a request with other oratory; and it can 
become an imposition on the time of the Member who has yielded for that 
purpose. The Chair will entertain as many requests to insert as may be 
necessary to accommodate Members, but the Chair also must ask that 
Members cooperate by confining such requests to the proper form.
  Ms. SLAUGHTER. We would be happy to cooperate. Mr. Speaker, is it 
correct that we can rise for the unanimous consent request to say that 
we oppose the bill?
  The SPEAKER pro tempore. The gentlewoman is correct.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield for a unanimous 
consent request to the gentlewoman from California (Ms. Linda T. 
Sanchez).
  (Ms. LINDA T. SANCHEZ asked and was given permission to revise and 
extend her remarks.)
  Ms. LINDA T. SANCHEZ of California. Mr. Speaker, I ask unanimous 
consent to revise and extend my remarks about this sham Medicare 
proposal that I oppose.
  Ms. SLAUGHTER. Mr. Speaker, I yield for a unanimous consent request 
to the gentlewoman from Ohio (Mrs. Jones).
  (Mrs. JONES of Ohio asked and was given permission to revise and 
extend her remarks.)
  Mrs. JONES of Ohio. Mr. Speaker, without embellishing my statement, I 
adamantly oppose the legislation that is before us on behalf of the 
millions of low-income workers who will not receive adequate funding 
under this bill.
  Ms. SLAUGHTER. Mr. Speaker, I yield for a unanimous consent request 
to the gentlewoman from California (Ms. Lofgren).
  (Ms. LOFGREN asked and was given permission to revise and extend her 
remarks.)
  Ms. LOFGREN. Mr. Speaker, I ask unanimous consent to revise and 
extend my remarks in opposition to the bill because it increases costs 
for the poorest who are mainly women.
  Mr. Speaker, the current Medicare Prescription Drug bill we are 
debating this evening, if passed, will force many low-income seniors to 
pay more for their Medicare coverage. Despite its $400 billion price 
tag, this legislation will leave some 6.4 million of the poorest and 
sickest Medicare beneficiaries who currently receive prescription drug 
coverage through Medicaid, worse off, as they will no longer be able to 
depend on assistance with their co-payments and will no longer depend 
on getting help paying for prescription drugs that are prescribed by 
their doctors but are not on the list of drugs and therefore not 
covered by the private insurers who will administer the new Medicare 
bill.
  Mr. Speaker, this piece of legislation is not ``paid for.'' I expect 
that it will worsen the nation's long-term fiscal problems 
substantially adding to the deficit. Is the proposal good enough to 
justify this?
  After weeks of secret hearings, in which not one Democratic Member of 
the House of Representatives was allowed to participate, we were 
presented with a Medicare prescription drug plan that is more geared 
towards benefiting industry, the HMOs, and insurance companies than in 
serving the healthcare needs of our elderly and disabled.
  In the forty years since Medicare was created, it has been hailed as 
an affordable, defined, guaranteed, and comprehensive healthcare plan 
for all senior citizens. I agree that Medicare should evolve. I also 
understand that prescription drug costs are rising at an alarming rate 
of 17 percent per year. But the current proposal facing Congress does 
too little to help control drug costs, requires seniors to spend too 
much out-of-pocket, and compromises many of the basic principles that 
have made Medicare so valued and effective. This proposal prohibits the 
federal government from using its vast buying power to negotiate 
significant discounts for the millions of seniors and disabled who have 
come to rely on Medicare.
  Mr. Speaker, my constituents and seniors across this nation believe 
that an affordable, guaranteed prescription drug benefit is urgently 
needed. Sadly, the prescription drug benefit in this bill would not go 
into effect until 2006.
  Mr. Speaker, my constituents and seniors across this nation asked 
this Congress for a strong prescription drug benefit through Medicare, 
it did not ask this Congress to begin the process of privatizing 
Medicare. They believe that reforming Medicare does not mean 
privatizing Medicare. Under this bill, millions of Medicare 
beneficiaries are forced to pay more just to stay with their own 
doctors. Premium support, a provision included in this bill will allow 
private insurance plans to lure healthy seniors out of Medicare, 
leaving older and disabled seniors behind to pay higher premiums for 
the same coverage they're receiving today. Mr. Speaker, my district 
lies within Santa Clara County in California. Santa Clara County is in 
one of 41 metropolitan areas that could be selected to participate in 
this demonstration that would lead to the privatization of Medicare. 
Under this plan, seniors must be prepared to deal with changing 
benefits, premiums and access to care from year to year.
  Mr. Speaker, these new benefits are not guaranteed. This Republican-
drafted Medicare reform bill creates a major gap in coverage that will 
leave millions of seniors and disabled persons without any drug 
coverage during parts of the year. Once a senior's drug costs reaches a 
moderate level of $2,250, all coverage would be cut off. It isn't until 
the out-of-pocket prescription drugs costs rise to a much higher 
level--roughly $3600--that coverage kicks back in. It will also erode 
retiree coverage for up to 2.7 million seniors who, after years of hard 
work earned a prescription drug benefit through their retirement plans. 
Those lucky enough to have such coverage must now worry about whether 
or not they will lose that hard-earned benefit under this proposal.
  Mr. Speaker, this bill is not comprehensive. The bill eliminates 
Medicare's promise to retirees by arbitrarily limiting the ability of 
Congress to fund the program. As baby boomers retire and require more 
physician visits, hospital services, and pharmaceutical coverage, 
Republicans want to limit the amount of money that would be spent on 
Medicare. This means the services seniors expect and deserve will be 
cut, premiums will increase, or reimbursements to physicians and 
hospitals will be severely restricted.
  Mr. Speaker, I remind my colleagues and those trying to follow all 
the possible implications of this bill that the coverage offered under 
this plan is not, repeat not, like that offered to members of Congress 
and other federal workers. No Federal employee or member of Congress 
has a drug benefit that has a deductible, or a $2,850 coverage gap or 
donut hole in the benefit. In fact, during the debate on the drug 
benefit, Republican members of Congress voted to ensure that Federal 
employees' benefits would not be lowered to the level in the new drug 
plan.
  There are many parts of this bill that I applaud. I am happy that the 
bill includes increased payments to doctors and to hospitals that will 
allow them to continue to offer services to Medicare patients. I am 
very happy that the bill includes critically needed funding for safety-
net hospitals that serve our needy so well. Indeed in California, this 
provision alone will restore several hundred million dollars in 
reimbursements over the next ten years. Mr. Speaker, these provisions 
are the kind of reforms to Medicare that would pass this house nearly 
unanimously if they were presented separate from this bad bill.
  Mr. Speaker, these good provisions do not override the potential 
devastating effects of this bill. I cannot support a bill that I feel 
will destroy the fundamental promise of Medicare, a program that 
seniors and the disabled have known and trusted for nearly 40 years. 
With the future of Medicare at stake, I believe that Congress can--and 
must--do better. Rather than pass a bad bill, we should defeat this bad

[[Page H12237]]

bill and stand firm as we fight for a prescription drug benefit that 
our seniors demand and deserve.
  Ms. SLAUGHTER. Mr. Speaker, I yield for a unanimous consent request 
to the gentlewoman from Nevada (Ms. Berkley).
  (Ms. BERKLEY asked and was given permission to revise and extend her 
remarks.)
  Ms. BERKLEY. Mr. Speaker, I ask unanimous consent to revise and 
extend my remarks about premium support provisions in this conference 
report that will undermine the Medicare system on which older women 
depend.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from 
California (Ms. Lee) for a unanimous consent request.
  (Ms. LEE asked and was given permission to revise and extend her 
remarks.)
  Ms. LEE. Mr. Speaker, I ask unanimous consent to revise and extend my 
remarks on this sham Republican prescription drug bill because it will 
harm, not help, elderly women. I did not come to Congress to dismantle 
and privatize Medicare.
  Ms. SLAUGHTER. Mr. Speaker, I yield for a unanimous consent request 
to the gentlewoman from California (Ms. Loretta Sanchez).
  (Ms. LORETTA SANCHEZ of California asked and was given permission to 
revise and extend her remarks.)
  Ms. LORETTA SANCHEZ of California. Mr. Speaker, I ask unanimous 
consent to revise and extend my remarks about the premium support 
provisions in this conference report that I believe will undermine the 
Medicare system on which elderly women rely.
  Mr. Speaker, I wish to express my concerns today over the Medicare 
bill and how it will leave millions of seniors without the adequate 
care they deserve.
  Under this bill nearly 3 million seniors will loose their 
prescription drug coverage, while 6 million will likely see an increase 
in the price of their medications and nearly 10 million would see an 
increase their Medicare premiums if they refuse to join an HMO.
  This bill is not a plan for our seniors, rather it is a plan that 
benefits drug companies and the insurance industry. This legislation 
would even prohibit Medicare from negotiating better prices for 
prescription drugs. It would spend $7 billion, desperately needed for 
covering all retired Americans, on creating individual health security 
accounts for only those who could afford them.
  I urge my colleagues to vote against this legislation. We need to 
work for our seniors and provide them with a Medicare bill that helps 
them and not the big pharmaceutical and insurance companies.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from 
California (Mrs. Davis) for a unanimous consent request.
  (Mrs. DAVIS of California asked and was given permission to revise 
and extend her remarks.)
  Mrs. DAVIS of California. Mr. Speaker, I ask unanimous consent to 
revise and extend my remarks expressing my opposition to this bill, 
which fails to provide women with the affordable and reliable Medicare 
prescription drug coverage that they desperately need.
  Mr. Speaker, I rise to talk about older women and their need for a 
real prescription drug benefit. The legislation we have before us 
represents a hollow substitute for a bona fide Medicare prescription 
drug benefit.
  Every week, I hear from seniors overwhelmed with the cost of 
prescription drugs. Many find themselves juggling their expenses--often 
putting off paying some bills--in order to buy their medication. These 
seniors, our parents and grandparents, who have worked their whole 
lives and contributed to making our nation great never imagined they 
would spend their retirement struggling to make ends meet. Congress 
must act and provide seniors with a prescription drug benefit.
  Our seniors--especially older women who, literally, are the face of 
Medicare--are counting on Congress to provide a real solution to the 
rising cost of prescription drugs. However, this debate has moved 
beyond providing prescription drugs to seriously undermine Medicare.
  The Medicare conference report before us disportionately harms older 
women in the following ways: Women account for the majority of people 
who are on both Medicare and Medicaid. However, this proposal prohibits 
Medicaid from continuing to provide the poorest and sickest women with 
drugs that certain Medicare drug plans may not cover.
  Older and sicker beneficiaries, often women, have not joined HMOs and 
tend to rely on the traditional Medicare program. This conference 
report is harmful to older and sicker women because its ``premium 
support'' provisions would undermine the traditional Medicare program 
and cause costs in that program to rise.
  Nearly eight in ten women on Medicare use prescription drugs 
regularly. This legislation is harmful to women because it prohibits 
the government from negotiating price controls on drugs, leading to 
higher drug costs for both seniors.
  Where is the benefit for women who are living on a fixed income and 
cannot afford to pay out-of-pocket during the coverage gap?
  Where is the benefit for the women who, because they were stay-at-
home mothers and did not earn a pension, cannot afford the prescription 
drugs they desperately need?
  For my constituents, this legislation is not good enough. I cannot 
support this legislation when I know we can do better. We are doing 
more than providing prescription drugs, we are legislating the future 
of Medicare.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from the 
Virgin Islands (Mrs. Christensen) for a unanimous consent request.
  (Mrs. CHRISTENSEN asked and was given permission to revise and extend 
her remarks.)
  Mrs. CHRISTENSEN. Mr. Speaker, I ask unanimous consent to revise and 
extend my remarks in strong opposition to the rule and the conference 
report, which helps HMOs and hurts poor women, minorities, and the 
disabled.
  Mr. Speaker, I rise in opposition to the rule and the Medicare 
conference report.
  The process by which we come to this place has been ugly. The 
conference committee locked out the democratic leadership from the 
process, and is sending this bill down without the 3 days to review it 
that we were promised.
  But we should not be surprised. The bill itself is a more important 
broken promise--this one to the Senior citizens and disabled persons 
who have relied on Medicare to be there for them, and who have waited 
long for a comprehensive prescription drug benefit. They would be the 
real losers if we pass this bill and that is why I am asking my 
colleagues to vote ``no.''
  Let us not take away the Medicare wrap around provision for those who 
need it, let us not jeopardize the good prescription drug benefit so 
many of our seniors and disabled now have, let us not put any more 
money in the already rich HMO's, let us take the means test and the 
mean out of this bill, and above all let us not destroy Medicare.
  Mr. Speaker, this bill stinks, and no amount of promises to fund 
rural hospitals or increase physician's reimbursement can make it smell 
any better. Besides, this is coming from the same Party leadership that 
has been cutting physician and hospital fees, and refusing to remedy 
them for years. If they are known for anything, it is for broken 
promises.
  We have no reason to rush and accept this defective piece of 
legislation that takes away more than it gives, and puts the first nail 
in the coffin the Republicans have been building for a long time for 
Medicare.
  Any prescription drug benefit won't take effect until more than two 
years from now, so if we really care about our seniors and disabled we 
should take the time to get it right.
  And if all of the tears I see shedding on the other side of the aisle 
for our suffering doctors, the struggling hospitals are any more than 
of the crocodile variety, we should do the right thing before we go 
home and pass those provisions now.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from Georgia 
(Ms. Majette) for a unanimous consent request.
  (Ms. MAJETTE asked and was given permission to revise and extend her 
remarks.)
  Ms. MAJETTE. Mr. Speaker, I rise to oppose the Republican 
prescription drug bill because it is bad for women, especially poor, 
elderly women; and they deserve better than this.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from 
California (Ms. Millender-McDonald) for a unanimous consent request.
  (Ms. MILLENDER-McDONALD asked and was given permission to revise and 
extend her remarks.)
  Ms. MILLENDER-McDONALD. Mr. Speaker, I ask unanimous consent to 
revise and extend my remarks about the premium support provisions in 
this conference report that will undermine the Medicare system on which 
elderly women in my district depend.
  Mr. Speaker, today I rise in opposition to H.R. 1. This conference 
report represents the beginning stages of this Administration's 
withdrawal from its promise to seniors. This report being considered on 
the House floor today, sets the stage for a gradual pullout of the 
federal government providing benefits to seniors and shifting the 
responsibility to private insurers.
  As our nation's population ages and the baby boomer generation places 
additional burden on our healthcare infrastructure, we can

[[Page H12238]]

no longer provide a ``one-size fits all'' level of healthcare. I am a 
strong and passionate advocate of a Medicare program that would cover 
all of our nation's seniors and provide a comprehensive prescription 
drug benefit. This is not that benefit. Mr. Speaker, this is not a 
better solution than ``no benefits''--it's worse. It gives our seniors 
false hope. It makes seniors think that this government is expanding 
Medicare services, while it takes a backdoor approach to privatization 
of the Medicare program.
  Mr. Speaker, in my home state of California, hundred of thousands of 
Medicare beneficiaries will lose their retiree health benefits. 
Medicaid beneficiaries will pay more for the prescription drugs they 
need. Hundreds of thousands of Medicare beneficiaries will pay more for 
Part B premiums because of so-called income relating provisions.
  Last night, Mr. Speaker, I spoke with my Congressional Seniors 
Council which represents leaders from senior associations in the 37th 
congressional district. This council has expressed its deepest concerns 
with H.R. 1. On behalf of the more than 51,000 seniors in the 37th 
Congressional district, this council fears Seniors, who should 
otherwise qualify for a drug benefit, may no longer qualify because of 
the asset provision in this report. Seniors, who have saved their hard-
earned money for use during retirement, who relied on the promises of 
this Administration, become disqualified from receiving the 
prescription drug benefit. Very poor and very sick dual eligible 
beneficiaries will lose wrap around coverage for prescription drugs 
making out-of-pocket costs more than they can afford.
  I urge my fellow colleagues for the sake of Medicare beneficiaries in 
their districts, to vote against H.R. 1. Our seniors deserve better.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from 
California (Mrs. Capps), who is also a nurse, for a unanimous consent 
request.
  (Mrs. CAPPS asked and was given permission to revise and extend her 
remarks.)
  Mrs. CAPPS. Mr. Speaker, I rise in opposition to the harmful cuts in 
care amounting to $1 billion a year for all those who are being treated 
for cancer.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from Ohio (Ms. 
Kaptur) for a unanimous consent request.
  (Ms. KAPTUR asked and was given permission to revise and extend her 
remarks.)
  Ms. KAPTUR. Mr. Speaker, I rise to oppose this GOP drug company 
bonanza that is going to make affordable drug prices impossible for the 
majority of this Nation's seniors. What a shame.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from 
California (Ms. Solis) for a unanimous consent request.
  (Ms. SOLIS asked and was given permission to revise and extend her 
remarks.)
  Ms. SOLIS. Pido permiso para revisar y decir estas palabras.
  Sr. Orador, estoy en contra del proyecto de ley Medicare que no 
ayudara a las mujeres que son el 70 por ciento de los mayores de edad.
  (English translation of the above statement is as follows:)
  Mr. Speaker, I rise in opposition to this Medicare bill which does 
nothing to help women, who make up more than 70 percent of the elderly 
poor.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from 
California (Ms. Waters) for a unanimous consent request.
  (Ms. WATERS asked and was given permission to revise and extend her 
remarks.)
  Ms. WATERS. Mr. Speaker, I rise in opposition to this sham Medicare 
proposal that will end Medicare as we know it and simply fatten the 
pockets of the pharmaceutical industry and the HMOs.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from Missouri 
(Ms. McCarthy) for a unanimous consent request.
  (Ms. McCARTHY of Missouri asked and was given permission to revise 
and extend her remarks.)
  Ms. McCARTHY of Missouri. Mr. Speaker, I ask unanimous consent to 
revise and extend my remarks about the premium support provisions in 
this conference report that will undermine the Medicare system on which 
the elderly in my district and around this Nation depend.
  Mr. Speaker, I rise today in opposition to H.R. 1, the Medicare 
Prescription Drug and Modernization Act of 2003. I strongly support the 
inclusion of a prescription drug benefit as part of the Medicare 
program. Unfortunately, instead of providing a prescription benefit, 
this legislation includes dramatic changes in the entire Medicare 
program. As Washington Post columnist E.J. Dionne recently wrote, 
``They went in to design a prescription drug benefit for seniors and 
came out with an aardvark.''
  Mr. Speaker, in 1965, President Johnson and the Congress had the 
wisdom to create the Medicare program. The program accomplished its 
mission--it has ensured every single American's health coverage upon 
reaching 65 years of age. Since the bill's passage, Congress has made 
changes to the program to keep it current and to ensure that seniors 
received the highest quality care.
  Now seniors are asking us to include a prescription drug benefit 
within the Medicare program. They want a benefit that offers 
comprehensive, affordable coverage to all seniors. I agree with them 
wholeheartedly. Instead of designing a prescription drug benefit, the 
majority created H.R. 1, which will end Medicare as we know it.
  Mr. Speaker, this proposal is confusing and inadequate. For the first 
$2,000 of coverage, the consumer will pay over $1,100; for the first 
$5,000 of coverage, the consumer will pay approximately $4,000. If a 
consumer buys $5,000 of drugs a year, the consumer will pay 80 percent 
of that cost. Elderly women will be hardest hit.
  Under this misguided plan, seniors will be forced to choose private 
prescription plans each year. A move between states, or even between 
towns, could force them to select another plan. In my district, seniors 
who chose to relocate from Kansas to Missouri could face the loss of 
their chosen prescription drug plan.
  I am also concerned that this legislation will encourage companies 
that offer employer-provided drug coverage to drop or reduce their 
benefits. While the bill includes billions in subsidies for companies 
to maintain their benefits, more than 2.7 million retirees are likely 
to lose their employer provided coverage under this bill.
  Seniors have been asking for a prescription drug benefit. They have 
not been asking for HMOs to take over Medicare. Yet that is what we are 
being asked to vote on today. This legislation includes ``cost 
containment'' provisions that will prompt significant cuts in the 
Medicare program if more than 45 percent of the costs of Medicare are 
borne from general tax revenues. Let's be clear--this cost cap would 
effectively end Medicare as a basic right for our seniors.
  In a machiavellian effort to pass this misguided legislation, the 
authors have included billions in additional payments for doctors, 
hospitals, rural health facilities, and ambulance services among 
others. Sadly, these quality health care providers are forced to 
support this legislation even though many fear it will be bad for 
seniors and could unravel the Medicare program. Those funds should not 
be held hostage by this Medicare privatization scheme. I urge my 
colleagues to consider supporting stand alone legislation that would 
help our providers and save the Medicare program.
  As E.J. Dionne wisely recommended, we should reject this flawed bill 
and ``let's then have a national debate on the future of Medicare, out 
in the open, and not in some congressional back room.'' Mr. Speaker, I 
urge all of my colleagues to reject this measure and go back to the 
basics. Give seniors what they deserve--a comprehensive Medicare 
prescription drug benefit.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from 
Connecticut (Ms. DeLauro) for a unanimous consent request.
  (Ms. DeLAURO asked and was given permission to revise and extend her 
remarks.)
  Ms. DeLAURO. Mr. Speaker, I rise against a prescription drug bill 
that prohibits the government from using its market power to negotiate 
the best price for prescription drugs, the central issue of this debate 
and concern of the people of this country.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from 
California (Ms. Eshoo) for a unanimous consent request.
  (Ms. ESHOO asked and was given permission to revise and extend her 
remarks.)
  Ms. ESHOO. Mr. Speaker, I rise against this bill which, in my view, I 
used the yardstick to measure it by my mother; and in doing the 
calculations, my mother, at 89\1/2\ years old, will be hurt by this, as 
will women her age across the country. She and they deserve so much 
better.
  It's with great disappointment that I rise today to express my 
opposition to this Medicare Prescription Drug legislation. As the 
daughter of a Medicare beneficiary, I know first hand how important 
prescription drug coverage is for America's seniors, and I held out 
great hope that this would be the year we finally succeeded in 
providing seniors with an affordable, stable benefit.

[[Page H12239]]

  Unfortunately, now that we have the long-awaited legislation before 
us, it is clear that it doesn't embody any of these important 
principles.
  This bill does nothing to lower drug costs for America's senior 
citizens. It provides an unstable insurance benefit, undercuts the 
viability of the employer-provided retirement health insurance, and 
fundamentally undermines the Medicare program that has served seniors 
so well for nearly 40 years.
  Specifically, the bill: Brings privatization to the Medicare program 
in 2010. Although this is being described as a ``demonstration 
project,'' this ``demonstration'' will affect as many as 7 million 
beneficiaries who will be forced to pay higher premiums and more money 
to keep the same benefits they have today if they don't join an HMO; 
has a $2800 gap in drug coverage that will leave millions of seniors 
without any help in paying for their drugs for part of the year, even 
though they will have to continue to pay their monthly premiums; 
Creates disincentives to employers to retain retiree drug coverage. An 
estimated 2 to 3 million seniors who have good drug coverage now 
through retiree health plans could lose it under the proposed plan.
  In California, this means more than a quarter of a million seniors 
may lose their employer-sponsored health care. Real reform would 
encourage employers to expand retiree coverage, not take it away; 
Purposefully creates, for the first time, disparities between seniors 
across the country. Seniors living in different areas of the country 
will pay different premiums for the exact same benefits. In another 
first, this bill links how much a senior earns to how much they will 
pay in premiums. If a senior makes more than $80,000 they will pay 
higher premiums than the rest of the Medicare population.

  Does not address the rising cost of prescription drugs for 
individuals, nor does it harness overall Medicare spending in future 
years. In fact, the bill specifically prohibits the Secretary of Health 
and Human Services from negotiating with drug companies for lower 
prices.
  Jeopardizes coverage for cancer patients by drastically cutting 
funding for chemotherapy drugs.
  Finally, this bill dramatically changes Medicare by limiting the 
total amount of money that can be spent on the program--meaning 
services will be cut and premiums will increase.
  I do want to take a moment to highlight the few bright spots in this 
bill.
  The bill reverses a recent decision by the Centers for Medicare and 
Medicaid Services (CMS) that threatened seniors' access to innovative 
treatments. For years biotechnology products, which often represent the 
most advanced treatments for diseases, were critically under-
reimbursed. This bill ensures that these life-saving treatments will be 
available for all seniors by raising payment levels to an appropriate 
level. This bill also provides more speedy coverage of new medical 
device technologies and more streamlined processes by new technologies 
in the Medicare program.
  Second, the bill includes critical funding for relief from the 
devastating payment reductions to Medicaid disproportionate share 
hospitals. This is very important for California which has a severe 
budget shortfall. The funding in the Conference Report restores several 
hundred million dollars to safety-net providers in California over the 
next 10 years. With more than six million MediCal recipients and 6.3 
million uninsured residents in California, Medicaid DSH funds are 
invaluable to the safety net hospitals that serve low-income 
populations.
  Unfortunately, these issues aren't enough to overcome the faulty 
foundation that this bill rests on. It's with a heavy heart that I say 
``This Medicare Prescription Drug bill should be rejected.'' We have 
not honored the seniors who have done so much to make our country 
great, and I cannot justify a ``yes'' vote on a bad bill just for the 
opportunity to say we've succeeded in providing a drug benefit.
  Mr. Speaker, I urge my colleagues to vote against the bill.
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from Florida 
(Ms. Corrine Brown) for a unanimous consent request.
  (Ms. CORRINE BROWN of Florida asked and was given permission to 
revise and extend her remarks.)
  Ms. CORRINE BROWN of Florida. Mr. Speaker, I rise against this sham 
Medicare proposal on behalf of Claude and Mildred Pepper, my 
grandmother, and all of the other seniors who will be increased out-of-
pocket expenses for this sham Medicare bill.
  Ms. SLAUGHTER. Mr. Speaker, I am proud to yield to the gentlewoman 
from California (Ms. Pelosi), our leader, for a unanimous consent 
request.
  (Ms. PELOSI asked and was given permission to revise and extend her 
remarks.)
  Ms. PELOSI. Mr. Speaker, I rise in opposition to this hoax of a plan. 
How can a plan be for the benefit of seniors when the first $4,000 of 
$5,000 of benefits have to be paid for by a senior who makes $13,500 a 
year?
  Ms. SLAUGHTER. Mr. Speaker, I yield to the gentlewoman from New York 
(Mrs. Maloney) for a unanimous consent request.
  (Mrs. MALONEY asked and was given permission to revise and extend her 
remarks.)
  Mrs. MALONEY of New York. Mr. Speaker, I rise in opposition to this 
ill-conceived bill which promises to be a magic potion for seniors, but 
is a poison pill for Medicare.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield to the gentleman 
from Florida (Mr. Hastings), my colleague on the Committee on Rules.
  (Mr. HASTINGS of Florida asked and was given permission to revise and 
extend his remarks.)
  Mr. HASTINGS of Florida. Mr. Speaker, after that array, you have to 
be a very strong man to oppose this bill, and I ask unanimous consent 
that my remarks be included in the Record.
  Mr. Speaker it gives me no greater disappointment to rise today in 
opposition to the co-called Prescription Drug and Medicare 
Modernization Act Conference Report. I might call it something else but 
that wouldn't be appropriate.
  Since 1965 Medicare has been a vital instrument in ensuring quality 
healthcare to America's elderly and disabled. Medicare's 40 million 
beneficiaries use thousands of different health care products and 
services furnished by over 1 million providers in hundreds of markets 
nationwide. However, today a great number of you seek to dismantle 
Medicare with a fool's gold of a bill tilted the Prescription Drug and 
Medicare Modernization Act.
  Despite my Democratic colleagues' best efforts to make this an 
inclusive and comprehensive process; one that addresses the real 
concerns of America's seniors and disabled, we were shut out from 
negotiations. We were shut out in June and we are shut out now. Today 
we have before us what the Republicans think is a Medicare and 
Prescription Drug reform. This is not a reform. This is a gutting of 
Medicare. It eviscerates one of the most successful great society 
programs in order to line the pockets of pharmaceutical companies.
  Mr. Speaker, I am disturbed to my core that any person in their right 
mind would find this bill fit to deliver to America's seniors. HR 1 is 
seriously flawed and inept for several reasons. First, the prescription 
drug benefits is only available through private insurance companies and 
HMOs.
  Second, the bill does not ensure affordable prescription drugs. 
Because of the arbitrary budget cap pushed by the administration, HR 1 
has high deductibles and does not guarantee an affordable premium.
  In addition, this scam of a sham bill creates large coverage gaps--
with many seniors being required to pay high premiums even when they 
don't receive benefits.
  Lastly, the bill does not promise prescription drug benefits to all 
beneficiaries. By relying on private insurance companies to offer 
coverage, this approach does not guarantee the same benefits for 
seniors, like Larry Colado of Myakka City, Florida, who lives in a 
rural community. Larry Colado is a Vietnam Veteran turned farmer who 
cannot afford health coverage and now faces losing the little that he 
has because, unlike Darwin, this administration believes in the 
survival of the richest.
  Approving this bill may not guarantee a destitute future for members 
of Congress, but it will guarantee a destitute future for those seniors 
who do not and have not served in this body.
  Mr. Speaker, simply put, this bill should be wrapped around a toilet 
paper holder and stuck in one of the Capitol's bathroom stalls.
  I adamantly oppose the so-called Prescription Drug and Medicare 
Modernization Act. It is a snake oil and it stinks.
  Ms. PRYCE of Ohio. Mr. Speaker, I yield such time as he may consume 
to the gentleman from California, the chairman of the Committee on 
Rules (Mr. Dreier).
  Mr. DREIER. Mr. Speaker, continuing this spirit of comity, I ask 
unanimous consent that the conference report on H.R. 1 be debatable for 
2 hours, doubling the amount of time that is made in order for 
consideration for a conference report.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Ms. PRYCE of Ohio. Mr. Speaker, I am very pleased to yield 2 minutes 
to the gentleman from Florida (Mr. Lincoln Diaz-Balart), my friend and 
colleague from our Committee on Rules.
  Mr. LINCOLN DIAZ-BALART of Florida. Mr. Speaker, I thank the 
gentlewoman from Ohio for yielding me this time.

[[Page H12240]]

  This legislation is very important legislation. It will help seniors, 
all seniors throughout the land; but especially low-income seniors will 
benefit, will benefit the most from this law. America's neediest 
seniors, individuals with up to $12,900 a year of income, $17,000 per 
couple, will immediately receive a cash credit of $600 to purchase 
their medications. And, again, in the year 2006, seniors with incomes 
of up to $10,300, or $13,250 per couple, will pay only $1 for generic 
prescriptions and $3 for brand-name medicines. Mr. Speaker, 13,235 
reside in the district that I am honored to represent. I would urge all 
of my colleagues here this evening to check.
  The gentleman from Florida (Mr. Shaw) has the information and he was 
so kind to provide it to me, district-by-district, how many low-income 
seniors will get extraordinary relief by this legislation.

                              {time}  2215

  Those with incomes of up to $13,900 a year, $17,900 per couple will 
pay only $2 for generic medications and $5 for brand name medications.
  Mr. Speaker, 20,715 reside in the district that I am honored to 
represent. Seniors with incomes up to $15,500 a year, $20,000 per year 
per couple, will pay only a minimum monthly premium and initial 
deductible of $50 and then only 15 percent of their prescription drug 
costs up to $3,600 after which they will pay only $2 for generic drugs, 
$5 for brand names.
  Now, all other seniors receive extraordinary help by this 
legislation, Mr. Speaker, but low-income seniors more than anyone else.
  So I urge everyone in this hall, I think we all have an obligation to 
check the facts with regard to what we are voting on this evening: 
Concrete important specific help for seniors throughout the country on 
an issue that, I think, is the most important domestic issue facing 
this country. And I am proud to have supported this legislation in the 
Committee on Rules and to urge all of my colleagues to make it law, 
send it to the President tonight.
  Ms. SLAUGHTER. Mr. Speaker, I yield 3 minutes to the gentleman from 
Massachusetts (Mr. McGovern).
  (Mr. McGOVERN asked and was given permission to revise and extend his 
remarks.)
  Mr. McGOVERN. Mr. Speaker, Medicare is one of the most important 
successful social programs in the history of this country. For nearly 
40 years, Medicare has been a lifeline for our senior citizens. I 
certainly do not argue that Medicare is perfect. Thanks to 
extraordinary advances in medical science, it is clear that Medicare 
needs a real prescription drug benefit.
  The program should be strengthened so that future generations have 
access to high quality, affordable health care, but I believe that 
Medicare is a sacred trust between the United States government and the 
seniors of this country. The Republican majority in this House clearly 
does not believe what I believe, because if they did, this bill would 
not be before us.
  This is a bill that fails to give seniors the drug benefit they need 
and deserve and expect. This bill forces millions of seniors to pay 
more for their prescription drugs. This bill is a huge give-away to the 
HMOs and the drug companies. This bill does nothing to control the 
exploding costs of medicine. And worst of all, this bill shoves 
Medicare down the path to privatization. It ends Medicare as we know 
it. This is a defining issue. You can put all the bells and whistles 
and spin on it that you want. You can add a little money here or a 
tweak there to buy off a few interest groups or to make the bill more 
appealing to certain geographic areas. You can try to claw your way to 
a majority vote, and you might succeed. But your success will not mask 
the fact that this bill is bad for senior citizens.
  So much of what people think is good about the Federal Government the 
supporters of this bill are ripping apart.
  And let me say just a word, actually two words, about the processing 
used here. It is lousy. No one has had the time to properly review 
this. There are rules of this House, and we should follow them, 
especially with regard to giving Members of both parties the chance to 
actually see what they are voting on. But the Committee on Rules, once 
again, decided that the rules of this House do not matter. Maybe we 
should rename it the ``Break the Rules Committee.''
  I guarantee you that for weeks to come we will be discovering lots of 
goods for special interests tucked into the dark corners of this 
legislation. The leadership of this House is more concerned with doing 
this bill fast than doing it right. If we take our time and do this 
right, it would give every Member the chance to read the fine print. 
Unless, of course, that is exactly what scares the leadership most.
  Now, I have heard the argument out there that, well, this bill is not 
perfect. It is not even very good, but we have to pass something. Mr. 
Speaker, not if that something is a windfall for HMOs and drug 
companies. Not if that something is the privatization and dismantling 
of Medicare. Not if that something is a sound bite rather than a 
meaningful drug benefit.
  There is a fundamental disagreement here because, to me, protecting 
Medicare is non-negotiable. If I voted for this bill I could not look 
at the people who sent me here and claim that I was representing their 
interests.
  I believe our seniors deserve a defined, guaranteed, affordable 
prescription drug benefit under Medicare and that is what I am for. 
This bill does not even come close.
  Vote no on the rule. Vote no on the bill.
  Ms. PRYCE of Ohio. Mr. Speaker, I yield 3 minutes to gentleman from 
California (Mr. Dreier), the very distinguished Chairman of the Rules 
Committee.
  (Mr. Dreier asked and was given permission to revise and extend his 
remarks.)
  Mr. DREIER. Mr. Speaker, I rise in strong support of this rule and 
the underlying conference report. My friend from Massachusetts (Mr. 
McGovern) is absolutely right, Medicare is a sacred trust. He is also 
right when he says that this conference report, when we pass it, will 
end Medicare as we know it. Medicare as we know it does not have 
provisions for prescription drug coverage. And guess what? If we pass 
this, we will, in fact, end Medicare as we know it by making 
prescription drugs available to seniors.
  It will also end Medicare as we know it because right now under 
Medicare there is a provision that allows for $148,000 to be expended 
on heart transplant surgery, but at the same time it does not provide 
the $1,000 a year that would be necessary for people to prevent heart 
disease by giving them access to Lipitor. And so it is true, we are 
going to finally bring about the very important reforms necessary so 
that we can maintain that sacred trust to which my friend refers.
  So I believe, Mr. Speaker, that we have an opportunity to go a long 
way towards addressing this concern that exists on both sides of the 
aisle. I know that my democratic colleagues, Mr. Speaker, want to make 
sure that we do provide access for senior citizens to affordable 
prescription drugs. And I believe that on both sides of the aisle, Mr. 
Speaker, there is a clear understanding that if we are going to do 
that, we have to bring about major reforms so that we maintain the 
solvency of Medicare for the future. I also believe that as we look at 
the changes that will come about in the area of potentially creating 
another new entitlement program, Republicans and Democrats, Democrats 
who raise concern regularly about deficit spending, should feel good 
about the unprecedented measures that we put in this bill that allow 
for our Members to insist on a vote if, in fact, Medicare outlays 
exceed 45 percent of general revenues.
  So I believe we are going a long way towards addressing these 
concerns. And then that wonderful incentive that also is there for 
people to plan for retirement with health savings accounts. Planning 
for their health care needs of the future is exactly what this measure 
will do by taking those very successful HSAs that have been out there 
and expanding that program.
  Mr. Speaker, this may not be, this may not be the perfect solution, 
but this is our opportunity to bring about these much needed reforms.
  And I urge my colleagues to support this rule, and, in a bipartisan 
way, do as I know the other body will do, and that is vote in support 
of this conference report so that we can help our seniors.

[[Page H12241]]

  Ms. SLAUGHTER. Mr. Speaker, I yield 3 minutes to the gentleman from 
Maryland (Mr. Hoyer), the minority whip.
  (Mr. HOYER asked and was given permission to revise and extend his 
remarks.)
  Mr. HOYER. Mr. Speaker, I rise in opposition to this rule. And I 
invite the 41 Members of this side of the aisle who wrote a letter just 
a few days ago, those 41 Members, all Republicans, said to the 
gentleman from Illinois (Speaker Hastert) and the gentleman from Texas 
(Majority Leader DeLay) that this is one of the most important issues 
that this Congress, or any Congress, will consider, and give us at 
least, they said, 3 days to consider this bill.
  This bill is over 1,100 pages in length. It will affect not only the 
40 million Americans who are eligible for Medicare, but it will also 
affect their families, their children, their sons and daughters who are 
confident that this country will provide for health care security for 
seniors.
  I invite those 41 Members, this is about the process, this has been a 
terrible process, a shameful process. Speaker Hastert, an honorable 
man, appointed the gentleman from Michigan (Mr. Dingell), the Dean of 
this House, serving here since 1955, one of the most knowledgeable 
people, not Democrats or Republican, most knowledgeable Americans with 
respect to health care and Medicare and Social Security. And then he 
appointed one of the most senior Members of this House, the gentleman 
from New York (Mr. Rangel) to this conference, and the gentleman from 
Arkansas (Mr. Berry), the only pharmacist that serves in this House.
  Shamefully, shamefully, they were neither invited, nor allowed, to 
come to the table to discuss this bill. I invite the 41 signers of this 
letter, if they meant what they said in this letter, to vote no on this 
rule. To vote no on this rule so that we can, in fact, look at it 
closely. Just 2 more days this bill, 1,100 pages in length, which was 
put on the Web just last afternoon, just approximately 24 hours ago.
  I say to the signatories on this letter, if you meant what you said, 
if you believe the processes of this House ought to be followed, if you 
believe this issue is important enough to know what you are doing, to 
read the bill, to digest its consequences, to understand the adverse 
consequences that it will have on the poor, on those who were left 
behind in Medicare when the HSAs take the healthiest and wealthiest out 
of the system and force premiums higher for those who can least afford 
it, read this bill, understand this bill. You have not done so.
  Some of our most respected colleagues signed this letter, Republicans 
all. I ask every Democrat to vote against this rule, to give ourselves 
and our constituents further time to consider this bill. I ask the 
Republicans honor their letter, honor their rules. Vote no on this one.
  Ms. PRYCE of Ohio. Mr. Speaker, I yield 3 minutes to the gentleman 
from Washington (Mr. Hastings), my friend from our Committee on Rules.
  Mr. HASTINGS of Washington. Mr. Speaker, I thank the gentlewoman from 
Ohio (Ms. Pryce) for yielding, and I congratulate her on the way she 
excellently laid out the main provisions of this bill in her opening 
remarks.
  I support this bill, Mr. Speaker, and this bill includes several 
important improvements to Medicare in addition to making prescription 
drugs available and affordable for seniors. But I am particularly 
pleased that this bill contains the largest, most comprehensive rural 
health care package ever considered by Congress to ensure that seniors 
in rural America are able to get the care they need.
  I often hear from seniors they are having a hard time finding a 
doctor will accept Medicare patients. Now, doctors and hospitals in 
rural areas provide the same quality care as in urban areas, all too 
often Medicare fails to pay rural health care providers enough to cover 
their costs. This often forces doctors to consider whether they can 
continue accepting Medicare patients and, therefore, causes hospitals 
to cut back on their services.
  As a member of two rural health care caucuses, I have met repeatedly 
with committee leaders and Secretary Thompson to stress the importance 
of ensuring that rural areas receive the Medicare payments that they 
deserve.
  Mr. Speaker, until the disparity between rural and urban 
reimbursement is fixed, seniors in small town America have fewer and 
fewer health care options. I commend the conferees for recognizing this 
need. I am pleased that the National Rural Health Care Association has 
endorsed this bill saying, quote, ``This is a strong step forward this 
strengthening the health care system for nearly 60 million rural 
Americans,'' end quote.
  By passing this bill, we will permanently end the disparity in 
Medicare payments between urban and rural hospitals. We will provide 
more money to rural hospitals for the care of uninsured patients, we 
will increase funds for critical access hospitals and home health care 
agencies and raise payments to doctors to encourage them to provide 
services in physician-short areas.
  Simply put, Mr. Speaker, after years of effort H.R. 1 will finally 
give doctors, hospitals, home health nurses, and other care providers 
the resources they need to provide seniors who live in rural areas like 
my district in central Washington the medical care they deserve.
  Accordingly, I urge my colleague to support both the rule and the 
underlying bill.

                              {time}  2230

  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
New Jersey (Mr. Menendez), the minority caucus chairman.
  Mr. MENENDEZ. Mr. Speaker, the Republican plan that we consider here 
tonight is not a Medicare prescription drug plan, but rather a poison 
bill for our Nation's seniors and for Medicare itself. The more you 
know about this bill, the less you like it.
  The Republican plan would encourage employers to drop retiree 
coverage for their employees. And this means that approximately 94,000 
New Jerseyans in my State will be left with no coverage. I thought this 
debate is supposed to be about expanding coverage for our seniors, not 
taking it away.
  Under their demonstration plan, 7 million beneficiaries would be 
forced to pay more for Medicare if they do not give up their doctor and 
join an HMO. The Republican plan would cut payments to oncologists 
nationwide and would result in New Jersey cancer care providers losing 
$552 million, this in a State that has the third highest instance of 
cancer in the United States, and in which cancer is the second leading 
cause of death.
  Republicans would include a $14 billion bribe to get private 
insurance company plans to compete against Medicare. Why give away 
billions of taxpayers money to private insurance interests when that 
money could be used to enhance a true prescription drug benefit under 
Medicare? Obviously, Republicans are more concerned about their special 
interests than senior interests.
  Republicans would make millions of seniors pay more for their drugs. 
Seniors would pay $4,020 out of the first $5,100 in prescription drug 
costs. And low-income seniors, like my 83-year-old mother who worked 
her entire life in the factory of New Jersey and who suffers from 
Alzheimer's, would pay higher premiums and would lose additional 
assistance under Medicaid. And only in Washington would Republicans 
prohibit the Federal Government from using the collective purchasing 
power of 40 million citizens to obtain lower prescription drug prices.
  Let us stand up for our parents and our grandparents and our seniors. 
Vote against the rule. Vote against this poison pill that is this plan.
  Ms. PRYCE of Ohio. Mr. Speaker, I yield 2\1/2\ minutes to the 
gentleman from the State of New York (Mr. Reynolds), my very good 
friend from the Committee on Rules.
  (Mr. REYNOLDS asked and was given permission to revise and extend his 
remarks.)
  Mr. REYNOLDS. Mr. Speaker, I thank the gentlewoman for yielding me 
time.
  Mr. Speaker, I rise in strong support of this rule and the underlying 
legislation.
  For the first time in the nearly 40-year history of the Medicare 
program, Congress tonight has the opportunity to provide more than 40 
million seniors

[[Page H12242]]

and disabled Americans a guaranteed prescription drug benefit.
  In my home State of New York, this means nearly 3 million Medicare 
beneficiaries will have greater access to life-saving prescriptions. 
For many of these beneficiaries, this amounts to drug coverage that 
they would not otherwise have; and for countless others, it means 
vastly improved benefits.
  In providing a prescription drug discount card, greater access to 
less-expensive generic drugs, enhanced ability to create individualized 
health savings accounts and strong protections for retirees with 
current coverage, this bill helps bring Medicare into the 21st century.
  What the bill also accomplishes is improved access to care in a 
variety of other areas that will help Americans all across the country 
get the care they need and deserve. For example, by updating the 
critical hospital formulas for marketbasket and indirect medical 
education, New York State will be infused with over $1.2 billion over 
the next 10 years.
  Of that, hospitals in my congressional district will receive close to 
$40 million. In cash-strapped regions of western New York that I 
represent, this payment relief is great news for patients of all ages 
and income levels.
  New York will also be bolstered by many other funding streams that 
will bring critical Federal funds into the State and help mitigate 
local fiscal burdens. And the Federal Government assuming costs of New 
York beneficiaries eligible for both Medicare and Medicaid, the State 
will save over $3 billion over 8 years on prescription drug coverage 
for its Medicaid population.
  Because New York already provides a popular, generous prescription 
drug program, well over 300,000 seniors, the State will have access to 
$125 million over 2 years in transitional assistance to help the new 
Federal drug program coordinate with the existing State program.
  These funds will ensure a seamless transition and coordination of 
benefits for many seniors who want to remain in the State program, yet 
still receive enhanced benefits through the Federal plan.
  Mr. Speaker, this body is poised to make history. Today begins the 
final step in a journey that began not 3 days ago, not 3 years ago, but 
nearly a decade ago. Congress promised a prescription drug benefit. 
Congress promised to make Medicare stronger, and it took this majority 
to deliver on that promise.
  I urge my colleagues to support the rule and the underlying 
legislation.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Ohio (Mr. Brown).
  Mr. BROWN of Ohio. Mr. Speaker, I thank the gentlewoman from New York 
(Ms. Slaughter) for yielding me time.
  We have been here before, Mr. Speaker. We will debate late into the 
night and consider one of the most important votes we have ever cast. 
At 2:54 a.m. on a Friday last March, the House cut veterans benefits by 
3 votes.
  At 2:39 a.m. on a Friday in April, House Republicans slashed 
education by five votes.
  At 1:56 a.m. on a Friday in May, the House passed the Leave No 
Millionaire Behind Tax Cut Bill by a handful of votes.
  At 2:33 a.m. on a Friday in June, the House GOP passed Medicare 
privatization by one vote.
  At 12:57 a.m. on a Friday in July, the House eviscerated Head Start 
by one vote. And then after returning from summer recess, at 12:12 a.m. 
on a Friday in October, the House voted $87 billion for Iraq.
  Always in the middle of the night. Always after the press had passed 
their deadlines. Always after the American people had turned off the 
news and gone to bed. And here we go again, Mr. Speaker.
  Republican leadership delivered this bill to us last night at 1:46 
a.m.
  Mr. Speaker, I do not really blame my Republican colleagues because 
when Republican leaders sit down with the insurance industry and the 
drug industry behind closed doors and write a bill to privatize 
Medicare, of course they do not want the public to know.
  When Republican leaders sit down with the drug industry to write a 
bill to deliver $139 billion in additional pharmaceutical profits to 
their biggest contributors, of course they do not want the public to 
know.
  When Republican leaders sit down with the insurance industry to write 
a bill to set up a $20 billion slush fund for HMOs, some of their 
biggest contributors, of course they do not want the public to know.
  This bill proposes the most radical changes to Medicare since its 
creation a generation ago. We should not do it under the cover of 
darkness. Americans deserve better.
  Ms. PRYCE of Ohio. Mr. Speaker, I yield 1 minute to the gentleman 
from Indiana (Mr. Burton).
  Mr. BURTON of Indiana. Mr. Speaker, I admire our President and my 
leaders in the House, but I want to tell you why I oppose this bill.
  The average senior is going to pay $4,000 in order to receive the 
first $1,500 in benefits. Now, we should take care of the 24 percent of 
seniors across this country that have no drug coverage; but this covers 
all of them, including the 76 percent that do have coverage.
  Employers will, in my opinion, in spite of a $70 billion payoff, drop 
their seniors and put them on the government program, and they are 
going to get less coverage than they have right now, and it will cost a 
lot more.
  This program is going to cost much more, in my opinion, than the $400 
billion that we estimate. I think it will go as high as maybe a 
trillion dollars over the next 10 years. And, finally, there is no 
negotiation with the pharmaceutical companies on drug prices even 
though Americans are paying as much as five to 10 times more than they 
are paying in Germany and Canada and other places in the world; and 
that is just not right.
  Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentlewoman from 
Illinois (Ms. Schakowsky).
  Ms. SCHAKOWSKY. Mr. Speaker, a little history lesson. August 17, 
1989, front page of the Chicago Tribune, outside the Copernicus Senior 
Center in Chicago. These are the constituents of Congressman Dan 
Rostenkowski who is in this car.
  They are not happy with their Congressman, and they are not happy 
with the catastrophic health care bill.
  When the Congressman escaped from his car, a reporter asked him if he 
sympathized with the seniors who were mad about this bill, and he said, 
``No, they do not understand.'' But, unfortunately, it was not the 
seniors who did not get it. It was the Congressman. Three months later 
that bill was repealed.
  A big mistake was made. This Congress overwhelmingly passed the 
catastrophic. Everyone on Capitol Hill liked it including the AARP. 
They did not check with the seniors, and we are about to make the same 
mistake tonight. A thousand pages and more, 40 years of Medicare, but 
40 hours to read this bill.
  I tell you, if you vote for this, you better get your running shoes. 
The senior citizens will be after you.
  Ms. PRYCE of Ohio. Mr. Speaker, I yield 2 minutes to the gentleman 
from the State of Florida (Mr. Shaw), from the Committee on Ways and 
Means, who worked so hard on this bill.
  (Mr. SHAW asked and was given permission to revise and extend his 
remarks.)
  Mr. SHAW. Mr. Speaker, I thank the gentlewoman for yielding me time.
  Medicare passed this Congress on July 27 of 1965 and was signed into 
law in Independence, Missouri, on July 30 of 1965. It is interesting, 
and I was watching C-SPAN today and watching the goings on within the 
Committee on Rules. And I heard several of the Democrat witnesses come 
in and say, your party did not support Medicare in the first place and 
you want it to wither on the vine.
  After hearing this over and over, I thought, well, it is about time 
somebody goes into the archives and finds out the truth. The truth is 
the majority of the Republicans in this House of Representatives in 
1965 did support Medicare. So the big lie now can go down and be 
deflated.
  Also, I have heard many witnesses on the other side say what a 
bonanza this is for big drug companies. Nobody is mentioning the fact 
that we are shortening the time that generics can get on the market. 
You think the big drug companies like that? Of course not.
  Also, the discount card where prices will be negotiated and seniors 
will get

[[Page H12243]]

their drugs for less money. Nobody on that side is talking about that.
  What this is actually is a cost-containment bill and probably the 
largest one that will ever be signed into law providing for the cost 
containment in drugs.
  I sent out a survey as many of us do to some of our constituents and 
was just simply asking them did they want this drug bill. I received 
back the biggest number that I have ever received. They are still 
coming in and they are just now hitting and we already have 12,000 
replies. And guess what? Only 100 said no. And most of them were 
misinformed by this bill thinking they might have lost the coverage 
that they had. This is a good bill. Let us do it for our seniors. Let 
us do it for the people at the lower economic levels who desperately 
need this.
  Why would you deny this to them? Somebody can buy drugs for so little 
and be able to get a better quality of life. Life is meant to be 
enjoyed, not endured. Let us vote ``yes'' on the rule. Let us vote 
``yes'' on the bill.
  The SPEAKER pro tempore (Mr. LaHood). The gentlewoman from Ohio (Ms. 
Pryce) has 3 minutes remaining. The gentlewoman from New York (Ms. 
Slaughter) has 9\1/2\ minutes remaining.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
North Carolina (Mr. Price).
  (Mr. PRICE asked and was given permission to revise and extend his 
remarks.)
  Mr. PRICE of North Carolina. Mr. Speaker, we began this effort years 
ago with a relatively simple concept: let us add a prescription drug 
benefit to Medicare, giving help to the countless older Americans who 
so desperately need it. But this bill has ended up doing the very thing 
seniors do not want us to do--to privatize their coverage.
  Little do they know that the so-called prescription drug benefit will 
operate nothing like their other Medicare benefits. An enormous sticker 
shock awaits them. If a senior needs $5,000 worth of medication, he or 
she will have to pay $4,000 in order to get it. If drug costs are 
$3,500, he or she will pay $2,500.
  This bill has a gaping so-called doughnut hole where any drug costs 
that fall between $2,250 and $5,100 are not covered at all. Do you 
think that is what our constituents have in mind when they think of 
prescription drug coverage?
  But this spotty coverage is not the worst of it. An even more 
unpleasant surprise awaits. This bill forces Medicare beneficiaries to 
get drug coverage through private companies or an HMO.
  Our Republican friends would apparently rather do anything than 
strengthen basic Medicare, so they have devised a convoluted scheme to 
throw enough money at private companies to induce them to offer drug-
only policies, policies which these same companies say make no sense in 
terms of insurance principles.

                              {time}  2245

  The Senate bill offered a fallback plan to provide Medicare coverage 
if these private plans did not materialize, but that fallback has been 
fatally weakened in the bill before us.
  We have heard a lot about choice tonight, but the only real choice 
most seniors will have under this bill is whether they obtain their 
prescription drug coverage through a private drug plan or an HMO, and 
whether they would rather have medications they can afford or a doctor 
of their own choosing. Under this plan they cannot have both.
  Mr. Speaker, this bill is a betrayal of our seniors. This is not an 
improvement, an expansion of Medicare. It is just the opposite. We 
should defeat this bill and go back to the drawing board immediately.
  Ms. PRYCE of Ohio. Mr. Speaker, I yield for a unanimous consent 
request to the gentleman from Florida (Mr. Shaw), a member of the 
Committee on Ways and Means.
  (Mr. SHAW asked and was given permission to revise and extend his 
remarks, and include extraneous material.)
  Mr. SHAW. Mr. Speaker, I submit to the Record a letter of endorsement 
from the Republican Governors Association and a letter from my own 
Governor, Governor Jeb Bush, endorsing this bill.

                                                 State of Florida,


                                       Office of the Governor,

                               Tallahassee, FL, November 21, 2003.
     Hon. E. Clay Shaw, Jr.,
     Rayburn House Office Building,
     Washington, DC.
       Dear Congressman Shaw: Today, there is very good news for 
     Florida's three million Medicare beneficiaries. The recent 
     bipartisan conference agreement for Medicare will provide 
     first-time access to prescription drug coverage. As the 
     second largest home to seniors, this drug benefit--along with 
     many other improvements and modernizations--will have the 
     most significant impact for residents in our State since the 
     enactment of Medicare in 1965.
       Medicare will increase in value as our beneficiaries will 
     have available to them a prescription drug benefit, and 
     critical protections against high out-of-pocket drug costs. 
     New preventive benefits will keep our residents healthier, 
     and provide a higher quality of life. The new opportunities 
     to be screened for many illnesses and conditions will result 
     in far fewer serious health consequences.
       Designed to provide enhanced coverage for the lowest income 
     beneficiaries, over 650,000 of Florida's low-income Medicare 
     beneficiaries--who are not eligible for Medicaid drug 
     coverage--will receive $10 billion in critical prescription 
     drug benefits from 2006 through 2015. The prescription drug 
     discount card will provide our seniors and disabled Medicare 
     beneficiaries with much-needed discounts, and a $600 per year 
     subsidy in transitioning to the new drug benefit.
       Another 490,000 low-income individuals dually eligible for 
     Medicare and Medicaid will receive more than $6.7 billion 
     annually in prescription drug benefits, with no gap in 
     coverage. This new federal benefit will save the taxpayers of 
     Florida over $3 billion--in just the first 10 years. These 
     are state Medicaid costs that can be reinvested in other 
     health care needs.
       This reform package will strengthen the Medicare program, 
     while providing beneficiaries a prescription drug benefit, 
     more choices and improved care options. All Floridians will 
     benefit from the option to accumulate tax-free health dollars 
     through Health Savings Accounts to pay for medical expenses. 
     Other reforms include a transition to electronic prescribing, 
     creating incentives for our hospitals and doctors to reduce 
     errors by using this new e-technology.
       Seniors cannot afford to indulge the political appetites of 
     Washington, where the issue of prescription drugs has turned 
     into a search for the perfect. Our representatives must look 
     to those who are being denied the opportunity for life-saving 
     prescription drugs. Today's bill may not be ideal, but it is 
     just right for those who have been waiting too long.
       AARP has led the long fight for a Medicare drug benefit, 
     and I commend their leadership in ensuring passage of this 
     bill. I join with them in urging you to support this historic 
     legislation. There has never been a greater opportunity to do 
     more for the seniors in Florida.
           Sincerely,
                                                         Jeb Bush,
     Governor.
                                  ____

                                              Republican Governors


                                                  Association,

                                Washington, DC, November 21, 2003.
     Hon. J. Dennis Hastert,
     Speaker, House of Representatives, The Capitol, Washington, 
         DC.
     Hon. Bill Frist,
     Majority Leader, U.S. Senate, The Capitol, Washington, DC.
     Hon. Nancy Pelosi,
     Minority Leader, House of Representatives, The Capitol, 
         Washington, DC.
     Hon. Tom Daschle,
     Minority Leader, U.S. Senate, Washington, DC.
       Dear Speaker Hastert, Representative Pelosi, Senator Frist, 
     and Senator Daschle: As Governors, we urge the U.S. Congress 
     to pass the bipartisan Medicare Conference Agreement. Passage 
     of this legislation will provide more choices and better 
     benefits to Americans. Under the bipartisan agreement, 
     Medicare beneficiaries would be provided significant savings 
     and access to broader coverage.
       Medicare will provide first-time access to prescription 
     drug coverage to many of our seniors. The agreement also 
     assists states with the costs related to the dual eligible 
     population. Assistance to low income persons as well as 
     critical protection against high out-of-pocket drug costs are 
     essential components of this legislation. Most importantly, 
     the preventive benefits found in this measure will keep our 
     constituents healthier.
       Passage of this historic legislation will modernize the 
     delivery of quality healthcare in America. Therefore, we 
     commend you and the conferees for providing leadership in 
     developing this legislation and offer our support of its 
     passage.
           Sincerely,
       Bill Owens, Governor of Colorado, RGA Chairman.
       Bob Taft, Governor of Ohio, RGA Vice Chairman.
       Robert R. Riley, Governor of Alabama.
       Robert Ehrlich, Jr., Governor of Maryland.
       Jeb Bush, Governor of Florida.
       Felix Camacho, Governor of Guam.
       Mitt Romney, Governor of Massachusetts.
       Haley Barbour, Governor-elect of Mississippi.
       Mike Johanns, Governor of Nebraska.
       John Hoeven, Governor of North Dakota.

[[Page H12244]]

       Olene S. Walker, Governor of Utah.
       Ernie Fletcher, Governor-elect of Kentucky.
       Frank H. Murkowski, Governor of Alaska.
       John G. Rowland, Governor of Connecticut.
       Sonny Perdue, Governor of Georgia.
       Dirk Kempthorne, Governor of Idaho.
       Tim Pawlenty, Governor of Minnesota.
       Kenny Guinn, Governor of Nevada.
       James H. Douglas, Governor of Vermont.
       Don Carcieri, Governor of Rhode Island.
       Mike Rounds, Governor of South Dakota.
       Rick Perry, Governor of Texas.

  Ms. PRYCE of Ohio. Mr. Speaker, I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Connecticut (Ms. DeLauro).
  Ms. DeLAURO. Mr. Speaker, this is a defining moment for the senior 
citizens of this country. For years we have tried to provide a 
prescription drug benefit to help them with the rising cost of 
medicine, but this bill does nothing about the central issue, price. It 
prohibits the government from using its market power to negotiate the 
best price for drugs and does nothing to allow Americans to import 
drugs from countries like Canada where prices are lower. As a result, 
prices will continue to rise and over time wipe out any gains that 
seniors realize from the new benefit which does not even begin until 
2006.
  Rather, the bill is the first step toward eliminating the universal 
guaranteed benefit that defines Medicare. For the first time, it caps 
the amount of money that can be spent on the program, meaning services 
that are guaranteed today will not be guaranteed tomorrow. It creates a 
two-tiered health care system, one for the affluent, one for everyone 
else. For as many as 10 million seniors, premium support will force 
them to give up the doctors that they have been with for years, force 
them into HMOs that will cut services and cost more.
  So today we consider more than a prescription drug benefit. We 
consider the future of our contract with the families in this country, 
a contract that says that after a lifetime of hard work, paying taxes, 
that we have a moral obligation to ensure our parents and our 
grandparents have a dignified retirement. By ending the guarantee of 
equal health care provided to every senior in this country for nearly 
four decades, we are breaking that contract.
  I was not elected to preside over the dismantling of Medicare, the 
embodiment of our country's shared values, in exchange for a feeble 
prescription drug benefit that does nothing to bring down the prices of 
prescription drugs. We should send this bill back to the drawing board, 
do whatever it takes to deliver a real drug benefit that maintains 
Medicare's promise to senior citizens. We owe them nothing less.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield 2 minutes to the 
gentleman from Arkansas (Mr. Berry), actually a pharmacist.
  Mr. BERRY. Mr. Speaker, this is the most shameful attempt to deceive 
the Greatest Generation. The question that continues to go through my 
mind is why would you want to do this to these good people. They 
survived the Depression, they fought World War II, and they built this 
great Nation into what it is today.
  Being an Anglo-Saxon, male Protestant, I have not known the hurt of 
being excluded or denied my rights like my dear friend the gentleman 
from Georgia (Mr. Lewis). After having served on this conference 
committee, I have an idea of what that must feel like. At every attempt 
to be a part of this conference, the House Democrats were ridiculed, 
humiliated, used every trick that they could imagine to try to make us 
feel like we just simply should not be a part of this act, and we are 
not. This is the Republicans' deal. Let them have credit for this sorry 
piece of work.
  I can tell my colleagues, I do not also understand why they would 
want to continue to give billions of dollars to the drug companies and 
to pass an act that would make it possible for the drug companies of 
this country to have the exclusive right to continue to rob the senior 
citizens. The burden of this dishonorable act rests on those that have 
written it and those that will vote to pass it.
  I suspect that our Founding Fathers must be very sad this evening, 
but let it be known henceforth and hereafter, the Republicans did this 
to our seniors, and the Democrats fought every last step of the way to 
try to keep it from happening.
  Ms. SLAUGHTER. Mr. Speaker, may I inquire from my colleague, does she 
have anymore speakers?
  Ms. PRYCE of Ohio. I have one remaining speaker.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Washington (Mr. Baird).
  Mr. BAIRD. Mr. Speaker, I thank the gentlewoman for yielding me the 
time.
  I cannot get up and say this bill is awful entirely. I think there 
are some very good parts, and I think some good efforts have been put 
into it, but I have two concerns.
  First of all, side effects. I think the side effects of this bill may 
well be fatal to some, and more importantly, I believe that most 
Members on both sides of the aisle have not really read this bill and 
do not fully understand it.
  Earlier tonight, I invited the gentlewoman from Ohio to explain a 
simple passage.
  Ms. PRYCE of Ohio. Mr. Speaker, will the gentleman yield?
  Mr. BAIRD. I yield to the gentlewoman from Ohio.
  Ms. PRYCE of Ohio. Mr. Speaker, I appreciate that. Earlier today, and 
once again now, a statement was placed in front of me, a statement 
which was a long, drawn out document, and he was asking me to explain 
it, and it is very unfortunate that we were not provided with that in 
advance.
  Mr. BAIRD. Reclaiming my time, the point I am making is I do not 
think the gentlewoman has actually read the bill sufficiently to 
explain it.
  I spent 23 years of my life in health care. I hold a doctorate in 
clinical psychology. I have spent hours on this bill. My eyes are 
exhausted. I must say I do not know fully well enough what is in it.
  My colleagues have said to us, and I agree, this is one of the most 
important bills that we will face in our career, and yet my colleagues 
have given us less than 24 hours to look at it.
  The great philosopher Socrates said this when the politicians of 
Athens imprisoned him, he said to his the young people he taught, he 
said, These people have imprisoned me for pointing out to them how 
little they know. Instead of being angry at me for pointing that out, 
they should be angry at themselves for knowing so little.
  His advantage was he admitted that he did not know. What I would ask 
the gentlewoman is a simple request that we almost never do here. Let 
us break with precedent. Let us say, you know what, this is important, 
we are moving too fast. I look around this room and I will say to my 
distinguished colleagues I bet you, you have not read the bill 
carefully, and you really, fully cannot explain it to your 
constituents, and if you have not and if this bill spends $400 billion 
of the taxpayers' money and is going to blow a hole in the lid of this 
deficit and is going to deprive people who desperately need 
pharmaceutical care, then why do we not just take a little bit of time 
and read it? Who knows, I might actually like it well enough to vote 
for it, but I cannot vote for something you have not given us enough 
time to read.
  That is what the people of expect of us when they send us here. That 
is what a republic is all about it, but we do it a great disservice in 
this institution of late.
  Ms. PRYCE of Ohio. Mr. Speaker, may I inquire as to the time 
remaining and how many speakers the gentlewoman from New York has?
  The SPEAKER pro tempore (Mr. LaHood). The gentlewoman from Ohio (Ms. 
Pryce) has 3 minutes remaining. The gentlewoman from New York (Ms. 
Slaughter) has 1\1/2\ minutes remaining.
  Ms. PRYCE of Ohio. I have one speaker.
  Ms. SLAUGHTER. I have one more speaker.
  Mr. Speaker, I yield 1 minute to the gentleman from Ohio (Mr. 
Kucinich).
  Mr. KUCINICH. Mr. Speaker, this legislation was written at the behest 
of insurance companies and pharmaceutical companies. This is the 
beginning of the end of universal health care for seniors.
  Since Medicare was enacted in 1965, seniors went from a group least 
likely to have health insurance to most likely to have health insurance 
because of Medicare. Medicare has achieved goals that Congress has not 
been able to accomplish for the rest of our population

[[Page H12245]]

by keeping millions out of poverty, increasing access to health care, 
improving quality of life and even extending life expectancy by 20 
percent.
  This conference report will eliminate universal health care for the 
only part of our population that has it. It will lead to benefit cuts 
by the creation of an artificial cap on Medicare spending. It will 
increase costs for millions of seniors. It will privatize Medicare in 
order to dismantle it.
  We should be expanding Medicare so that all Americans can have 
quality health care under a single-payer system with fully-paid 
prescription drug benefits.
  This legislation is a choice between health care in the public 
interest which we still have with Medicare or health care in the 
private interest. Choose wisely. Reject the rule, reject the 
legislation.
  Ms. SLAUGHTER. Mr. Speaker, I reserve the balance of my time.
  Ms. PRYCE of Ohio. Mr. Speaker, I am very pleased to yield 2 minutes 
to the gentlewoman from West Virginia (Mrs. Capito), my friend and 
colleague.
  Mrs. CAPITO. Mr. Speaker, I would like to thank my distinguished 
colleague from Ohio for yielding me the time. I rise in support of the 
rule and the underlying bill.
  We have all listened to and viewed the rhetoric surrounding the 
Medicare prescription drug legislation this week. We have all faced the 
questions regarding what is in the bill and what is not. There has been 
a multitude of fallacies about who is covered and who is not. Mr. 
Speaker, the truth of the matter is this Medicare prescription drug 
package will grant 40 million Medicare seniors a drug benefit they do 
not have.
  I am especially proud of the low-income provisions in this bill. In 
my home State of West Virginia where our seniors are clamoring for this 
coverage, fully one-third of the Medicare beneficiaries will only pay 
up to $5 for prescriptions. This is real savings for those who need it 
most.
  The truth is that seniors fortunate enough to have coverage through a 
previous employer will maintain that benefit. Corporations, small 
businesses, unions, State and local governments will receive serious 
help to allow them to continue to offer that benefit.
  The truth is that in this legislation senior women will now have 
greater access to more affordable health care. Women live longer than 
men, with less income and suffer from more chronic illnesses. Disease 
management and access to a prescription drug benefit will allow women 
to enhance the quality of life in their senior years.
  Mr. Speaker, I can handle this truth. West Virginia's seniors can 
handle this truth. America's seniors can handle this truth. It is time 
to get past the rhetoric and deliver on a promise we have all made to 
America's seniors.
  Ms. SLAUGHTER. Mr. Speaker, I yield myself the remaining time.
  I am going to ask for a no vote on the previous question so we can 
amend the rule and restore the right of all Members under the House 
rules to consider the report for 3 days before they vote on it. Voting 
no on the previous question will not block consideration of the report. 
It will simply give all the Members who were not in the secret, closed 
meetings a chance to read it and a chance to look before we leap.
  Mr. Speaker, I ask unanimous consent that the text of the amendment 
be printed in the Record immediately prior to the vote on the previous 
question.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from New York?
  There was no objection.

                              {time}  2300

  Ms. PRYCE of Ohio. Mr. Speaker, I yield myself such time as I may 
consume.
  We have heard a lot of rhetoric tonight, as the gentlewoman from West 
Virginia (Mrs. Capito) mentioned. You would think we were talking about 
different bills. But the truth is the 35 million seniors that the AARP 
represents cannot be wrong. This bill is what America's seniors need. 
They know it and we know it. We have heard them.
  And let me remind my colleagues that we have before us today a 
historic opportunity, an opportunity to make the most sweeping changes 
to the outdated Medicare program since it began in 1965. Bring our 
seniors the financial relief and the lifesaving medications that they 
so desperately need and deserve. Support this rule and the bipartisan 
legislation that it supports.
  The text of the amendment referred to previously by Ms. Slaughter is 
as follows:

       Strike all after the resolving clause and insert in lieu 
     thereof the following:
       ``That upon adoption of this resolution it shall be in 
     order to consider the conference report to accompany the bill 
     (H.R. 1) to amend title XVIII of the Social Security Act to 
     provide for a voluntary program for prescription drug 
     coverage under the Medicare Program, to modernize the 
     Medicare Program, to amend the Internal Revenue Code of 1986 
     to allow a deduction to individuals for amounts contributed 
     to health savings security accounts and health savings 
     accounts, to provide for the disposition of unused health 
     benefits in cafeteria plans and flexible spending 
     arrangements, and for other purposes. All points of order 
     against the conference report and against its consideration 
     (except those arising under clause 8(a)(1)(A) of rule XXII) 
     are waived.''

  Ms. PRYCE of Ohio. Mr. Speaker, I yield back the balance of my time, 
and I move the previous question on the resolution.
  The SPEAKER pro tempore (Mr. LaHood). The question is on ordering the 
previous question.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Ms. SLAUGHTER. 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 clause 9 of rule XX, the Chair will reduce to 5 minutes 
the minimum time for electronic voting, if ordered, on the question of 
agreeing to the resolution.
  The vote was taken by electronic device, and there were--yeas 228, 
nays 204, not voting 2, as follows:

                             [Roll No. 665]

                               YEAS--228

     Aderholt
     Akin
     Bachus
     Baker
     Ballenger
     Barrett (SC)
     Bartlett (MD)
     Barton (TX)
     Bass
     Beauprez
     Bereuter
     Biggert
     Bilirakis
     Bishop (UT)
     Blackburn
     Blunt
     Boehlert
     Boehner
     Bonilla
     Bonner
     Bono
     Boozman
     Bradley (NH)
     Brady (TX)
     Brown (SC)
     Brown-Waite, Ginny
     Burgess
     Burns
     Burr
     Burton (IN)
     Buyer
     Calvert
     Camp
     Cannon
     Cantor
     Capito
     Carter
     Castle
     Chabot
     Chocola
     Coble
     Cole
     Collins
     Cox
     Crane
     Crenshaw
     Cubin
     Culberson
     Cunningham
     Davis, Jo Ann
     Davis, Tom
     Deal (GA)
     DeLay
     DeMint
     Diaz-Balart, L.
     Diaz-Balart, M.
     Doolittle
     Dreier
     Duncan
     Dunn
     Ehlers
     Emerson
     English
     Everett
     Feeney
     Ferguson
     Flake
     Fletcher
     Foley
     Forbes
     Fossella
     Franks (AZ)
     Frelinghuysen
     Gallegly
     Garrett (NJ)
     Gerlach
     Gibbons
     Gilchrest
     Gillmor
     Gingrey
     Goode
     Goodlatte
     Goss
     Granger
     Graves
     Green (WI)
     Greenwood
     Gutknecht
     Harris
     Hart
     Hastings (WA)
     Hayes
     Hayworth
     Hefley
     Hensarling
     Herger
     Hobson
     Hoekstra
     Hostettler
     Houghton
     Hulshof
     Hunter
     Hyde
     Isakson
     Issa
     Istook
     Janklow
     Jenkins
     Johnson (CT)
     Johnson (IL)
     Johnson, Sam
     Jones (NC)
     Keller
     Kelly
     Kennedy (MN)
     King (IA)
     King (NY)
     Kingston
     Kirk
     Kline
     Knollenberg
     Kolbe
     LaHood
     Latham
     LaTourette
     Leach
     Lewis (CA)
     Lewis (KY)
     Linder
     LoBiondo
     Lucas (OK)
     Manzullo
     McCotter
     McCrery
     McHugh
     McInnis
     McKeon
     Mica
     Miller (FL)
     Miller (MI)
     Miller, Gary
     Moran (KS)
     Murphy
     Musgrave
     Myrick
     Nethercutt
     Neugebauer
     Ney
     Northup
     Norwood
     Nunes
     Nussle
     Osborne
     Ose
     Otter
     Oxley
     Paul
     Pearce
     Pence
     Peterson (PA)
     Petri
     Pickering
     Pitts
     Platts
     Pombo
     Porter
     Portman
     Pryce (OH)
     Putnam
     Quinn
     Radanovich
     Ramstad
     Regula
     Rehberg
     Renzi
     Reynolds
     Rogers (AL)
     Rogers (KY)
     Rogers (MI)
     Rohrabacher
     Ros-Lehtinen
     Royce
     Ryan (WI)
     Ryun (KS)
     Saxton
     Schrock
     Sensenbrenner
     Sessions
     Shadegg
     Shaw
     Shays
     Sherwood
     Shimkus
     Shuster
     Simmons
     Simpson
     Smith (MI)
     Smith (NJ)
     Smith (TX)
     Souder
     Stearns
     Sullivan
     Sweeney
     Tancredo
     Tauzin
     Taylor (NC)
     Terry
     Thomas
     Thornberry
     Tiahrt
     Tiberi
     Toomey
     Turner (OH)
     Upton
     Vitter
     Walden (OR)
     Walsh
     Wamp
     Weldon (FL)
     Weldon (PA)
     Weller
     Whitfield
     Wicker
     Wilson (NM)
     Wilson (SC)
     Wolf
     Young (AK)
     Young (FL)

[[Page H12246]]



                               NAYS--204

     Abercrombie
     Ackerman
     Alexander
     Allen
     Andrews
     Baca
     Baird
     Baldwin
     Ballance
     Becerra
     Bell
     Berkley
     Berman
     Berry
     Bishop (GA)
     Bishop (NY)
     Blumenauer
     Boswell
     Boucher
     Boyd
     Brady (PA)
     Brown (OH)
     Brown, Corrine
     Capps
     Capuano
     Cardin
     Cardoza
     Carson (IN)
     Carson (OK)
     Case
     Clay
     Clyburn
     Conyers
     Cooper
     Costello
     Cramer
     Crowley
     Cummings
     Davis (AL)
     Davis (CA)
     Davis (FL)
     Davis (IL)
     Davis (TN)
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Deutsch
     Dicks
     Dingell
     Doggett
     Dooley (CA)
     Doyle
     Edwards
     Emanuel
     Engel
     Eshoo
     Etheridge
     Evans
     Farr
     Fattah
     Filner
     Ford
     Frank (MA)
     Frost
     Gonzalez
     Green (TX)
     Grijalva
     Gutierrez
     Hall
     Harman
     Hastings (FL)
     Hill
     Hinchey
     Hinojosa
     Hoeffel
     Holden
     Holt
     Honda
     Hooley (OR)
     Hoyer
     Inslee
     Israel
     Jackson (IL)
     Jackson-Lee (TX)
     Jefferson
     John
     Johnson, E. B.
     Jones (OH)
     Kanjorski
     Kaptur
     Kennedy (RI)
     Kildee
     Kilpatrick
     Kind
     Kleczka
     Kucinich
     Lampson
     Langevin
     Lantos
     Larsen (WA)
     Larson (CT)
     Lee
     Levin
     Lewis (GA)
     Lipinski
     Lofgren
     Lowey
     Lucas (KY)
     Lynch
     Majette
     Maloney
     Markey
     Marshall
     Matheson
     Matsui
     McCarthy (MO)
     McCarthy (NY)
     McCollum
     McDermott
     McGovern
     McIntyre
     McNulty
     Meehan
     Meek (FL)
     Meeks (NY)
     Menendez
     Michaud
     Millender-McDonald
     Miller (NC)
     Miller, George
     Mollohan
     Moore
     Moran (VA)
     Murtha
     Nadler
     Napolitano
     Neal (MA)
     Oberstar
     Obey
     Olver
     Ortiz
     Owens
     Pallone
     Pascrell
     Pastor
     Payne
     Pelosi
     Peterson (MN)
     Pomeroy
     Price (NC)
     Rahall
     Rangel
     Reyes
     Rodriguez
     Ross
     Rothman
     Roybal-Allard
     Ruppersberger
     Rush
     Ryan (OH)
     Sabo
     Sanchez, Linda T.
     Sanchez, Loretta
     Sanders
     Sandlin
     Schakowsky
     Schiff
     Scott (GA)
     Scott (VA)
     Serrano
     Sherman
     Skelton
     Slaughter
     Smith (WA)
     Snyder
     Solis
     Spratt
     Stark
     Stenholm
     Strickland
     Stupak
     Tanner
     Tauscher
     Taylor (MS)
     Thompson (CA)
     Thompson (MS)
     Tierney
     Towns
     Turner (TX)
     Udall (CO)
     Udall (NM)
     Van Hollen
     Velazquez
     Visclosky
     Waters
     Watson
     Watt
     Waxman
     Weiner
     Wexler
     Woolsey
     Wu
     Wynn

                             NOT VOTING--2

     Gephardt
     Gordon
       


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore (Mr. LaHood) (during the vote). Members are 
advised 2 minutes remain in this vote.

                              {time}  2319

  So the previous question was ordered.
  The result of the vote was announced as above recorded.
  The SPEAKER pro tempore. The question is on the resolution.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.


                             Recorded Vote

  Ms. SLAUGHTER. Mr. Speaker, I demand a recorded vote.
  A recorded vote was ordered.
  The SPEAKER pro tempore. This will be a 5-minute vote.
  The vote was taken by electronic device, and there were--ayes 225, 
noes 205, not voting 4, as follows:

                             [Roll No. 666]

                               AYES--225

     Aderholt
     Akin
     Bachus
     Baker
     Ballenger
     Barrett (SC)
     Bartlett (MD)
     Barton (TX)
     Bass
     Beauprez
     Bereuter
     Biggert
     Bilirakis
     Bishop (UT)
     Blackburn
     Blunt
     Boehlert
     Boehner
     Bonilla
     Bonner
     Bono
     Boozman
     Bradley (NH)
     Brady (TX)
     Brown (SC)
     Brown-Waite, Ginny
     Burgess
     Burns
     Burr
     Burton (IN)
     Buyer
     Calvert
     Camp
     Cantor
     Capito
     Carter
     Castle
     Chabot
     Chocola
     Coble
     Cole
     Collins
     Cox
     Crane
     Crenshaw
     Cubin
     Culberson
     Cunningham
     Davis, Jo Ann
     Davis, Tom
     Deal (GA)
     DeLay
     DeMint
     Diaz-Balart, L.
     Diaz-Balart, M.
     Doolittle
     Dreier
     Duncan
     Dunn
     Ehlers
     Emerson
     English
     Everett
     Feeney
     Ferguson
     Flake
     Fletcher
     Foley
     Forbes
     Fossella
     Franks (AZ)
     Frelinghuysen
     Gallegly
     Garrett (NJ)
     Gerlach
     Gibbons
     Gilchrest
     Gillmor
     Gingrey
     Goode
     Goodlatte
     Goss
     Granger
     Graves
     Green (WI)
     Greenwood
     Gutknecht
     Harris
     Hart
     Hastings (WA)
     Hayes
     Hayworth
     Hefley
     Hensarling
     Herger
     Hobson
     Hoekstra
     Hostettler
     Houghton
     Hulshof
     Hunter
     Hyde
     Isakson
     Issa
     Istook
     Janklow
     Jenkins
     Johnson (CT)
     Johnson (IL)
     Johnson, Sam
     Jones (NC)
     Keller
     Kelly
     Kennedy (MN)
     King (IA)
     King (NY)
     Kingston
     Kirk
     Kline
     Knollenberg
     Kolbe
     LaHood
     Latham
     LaTourette
     Leach
     Lewis (CA)
     Lewis (KY)
     Linder
     LoBiondo
     Lucas (OK)
     Manzullo
     McCotter
     McCrery
     McHugh
     McInnis
     McKeon
     Mica
     Miller (FL)
     Miller (MI)
     Miller, Gary
     Moran (KS)
     Murphy
     Musgrave
     Myrick
     Nethercutt
     Neugebauer
     Ney
     Northup
     Norwood
     Nunes
     Nussle
     Osborne
     Ose
     Otter
     Oxley
     Paul
     Pearce
     Pence
     Peterson (PA)
     Pickering
     Pitts
     Platts
     Pombo
     Porter
     Portman
     Pryce (OH)
     Putnam
     Quinn
     Radanovich
     Ramstad
     Regula
     Rehberg
     Renzi
     Reynolds
     Rogers (AL)
     Rogers (KY)
     Rogers (MI)
     Rohrabacher
     Ros-Lehtinen
     Royce
     Ryan (WI)
     Ryun (KS)
     Saxton
     Schrock
     Sensenbrenner
     Sessions
     Shadegg
     Shaw
     Shays
     Sherwood
     Shimkus
     Shuster
     Simmons
     Simpson
     Smith (MI)
     Smith (NJ)
     Smith (TX)
     Souder
     Stearns
     Sullivan
     Sweeney
     Tauzin
     Taylor (NC)
     Terry
     Thomas
     Thornberry
     Tiahrt
     Tiberi
     Toomey
     Turner (OH)
     Upton
     Vitter
     Walden (OR)
     Walsh
     Wamp
     Weldon (FL)
     Weldon (PA)
     Weller
     Whitfield
     Wicker
     Wilson (NM)
     Wilson (SC)
     Wolf
     Young (AK)
     Young (FL)

                               NOES--205

     Abercrombie
     Ackerman
     Alexander
     Allen
     Andrews
     Baca
     Baird
     Baldwin
     Ballance
     Becerra
     Bell
     Berkley
     Berman
     Berry
     Bishop (GA)
     Bishop (NY)
     Blumenauer
     Boswell
     Boucher
     Boyd
     Brady (PA)
     Brown (OH)
     Brown, Corrine
     Capps
     Capuano
     Cardin
     Cardoza
     Carson (IN)
     Carson (OK)
     Case
     Clay
     Clyburn
     Conyers
     Cooper
     Costello
     Cramer
     Crowley
     Cummings
     Davis (AL)
     Davis (CA)
     Davis (FL)
     Davis (IL)
     Davis (TN)
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Deutsch
     Dicks
     Dingell
     Doggett
     Dooley (CA)
     Doyle
     Edwards
     Emanuel
     Engel
     Eshoo
     Etheridge
     Evans
     Farr
     Fattah
     Filner
     Ford
     Frank (MA)
     Frost
     Gonzalez
     Green (TX)
     Grijalva
     Gutierrez
     Hall
     Harman
     Hastings (FL)
     Hill
     Hinchey
     Hinojosa
     Hoeffel
     Holden
     Holt
     Honda
     Hooley (OR)
     Hoyer
     Inslee
     Israel
     Jackson (IL)
     Jackson-Lee (TX)
     Jefferson
     John
     Johnson, E. B.
     Jones (OH)
     Kanjorski
     Kaptur
     Kennedy (RI)
     Kildee
     Kilpatrick
     Kind
     Kleczka
     Kucinich
     Lampson
     Langevin
     Lantos
     Larsen (WA)
     Larson (CT)
     Lee
     Levin
     Lewis (GA)
     Lipinski
     Lofgren
     Lowey
     Lucas (KY)
     Lynch
     Majette
     Maloney
     Markey
     Marshall
     Matheson
     Matsui
     McCarthy (MO)
     McCarthy (NY)
     McCollum
     McDermott
     McGovern
     McIntyre
     McNulty
     Meehan
     Meek (FL)
     Meeks (NY)
     Menendez
     Michaud
     Millender-McDonald
     Miller (NC)
     Miller, George
     Mollohan
     Moore
     Moran (VA)
     Murtha
     Nadler
     Napolitano
     Neal (MA)
     Oberstar
     Obey
     Olver
     Ortiz
     Owens
     Pallone
     Pascrell
     Pastor
     Payne
     Pelosi
     Peterson (MN)
     Pomeroy
     Price (NC)
     Rahall
     Rangel
     Reyes
     Rodriguez
     Ross
     Rothman
     Roybal-Allard
     Ruppersberger
     Rush
     Ryan (OH)
     Sabo
     Sanchez, Linda T.
     Sanchez, Loretta
     Sanders
     Sandlin
     Schakowsky
     Schiff
     Scott (GA)
     Scott (VA)
     Serrano
     Sherman
     Skelton
     Slaughter
     Smith (WA)
     Snyder
     Solis
     Spratt
     Stark
     Stenholm
     Strickland
     Stupak
     Tancredo
     Tanner
     Tauscher
     Taylor (MS)
     Thompson (CA)
     Thompson (MS)
     Tierney
     Towns
     Turner (TX)
     Udall (CO)
     Udall (NM)
     Van Hollen
     Velazquez
     Visclosky
     Waters
     Watson
     Watt
     Waxman
     Weiner
     Wexler
     Woolsey
     Wu
     Wynn

                             NOT VOTING--4

     Cannon
     Gephardt
     Gordon
     Petri


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore (during the vote). Members are advised 2 
minutes remain in this vote.

                              {time}  2328

  So the resolution was agreed to.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.

                          ____________________