[Congressional Record Volume 154, Number 37 (Wednesday, March 5, 2008)]
[House]
[Pages H1259-H1272]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




PROVIDING FOR CONSIDERATION OF H.R. 1424, PAUL WELLSTONE MENTAL HEALTH 
                    AND ADDICTION EQUITY ACT OF 2007

  Ms. CASTOR. Mr. Speaker, by direction of the Committee on Rules, I 
call up House Resolution 1014 and ask for its immediate consideration.
  The Clerk read the resolution, as follows:

                              H. Res. 1014

       Resolved, That upon the adoption of this resolution it 
     shall be in order to consider in the House the bill (H.R. 
     1424) to amend section 712 of the Employee Retirement Income 
     Security Act of 1974, section 2705 of the Public Health 
     Service Act, and section 9812 of the Internal Revenue Code of 
     1986 to require equity in the provision of mental health and 
     substance-related disorder benefits under group health plans. 
     The bill shall be considered as read. All points of order 
     against consideration of the bill are waived except those 
     arising under clause 9 or 10 of rule XXI. In lieu of the 
     amendments recommended by the Committees on Energy and 
     Commerce, Ways and Means, and Education and Labor, the 
     amendment in the nature of a substitute printed in the report 
     of the Committee on Rules accompanying this resolution shall 
     be considered as adopted. All points of order against 
     provisions of the bill, as amended, are waived. The previous 
     question shall be considered as ordered on the bill, as 
     amended, to final passage without intervening motion except: 
     (1) two hours of debate equally divided among and controlled 
     by the chairman and ranking minority member of the Committee 
     on Energy and Commerce, the chairman and ranking minority 
     member of the Committee on Ways and Means, and the chairman 
     and ranking minority member of the Committee on Education and 
     Labor; and (2) one motion to recommit with or without 
     instructions.
       Sec. 2.  In the engrossment of H.R. 1424, the Clerk shall--
        (a) add the text of H.R. 493, as passed by the House, as 
     new matter at the end of H.R. 1424;
       (b) conform the title of H.R. 1424 to reflect the addition 
     to the engrossment of H.R. 493;
       (c) assign appropriate designations to provisions within 
     the engrossment; and
       (d) conform provisions for short titles within the 
     engrossment.
       Sec. 3.  During consideration of H.R. 1424 pursuant to this 
     resolution, notwithstanding the operation of the previous 
     question, the Chair may postpone further consideration of the 
     bill to such time as may be designated by the Speaker.

                              {time}  1400


                             Point of Order

  Mr. BROUN of Georgia. Mr. Speaker, I make a point of order against 
the consideration of the resolution because it is in violation of 
section 426(a) of the Congressional Budget Act.
  The resolution provides that ``all points of order against 
consideration of the bill are waived except those arising under clause 
9 and 10 of rule XXI.'' This waiver of all points of order includes a 
waiver of section 425 of the Congressional Budget Act which causes the 
resolution to be in violation of section 426(a).
  The SPEAKER pro tempore. The gentleman from Georgia makes a point of 
order that the resolution violates section 426(a) of the Congressional 
Budget Act of 1974.

[[Page H1260]]

  The gentleman has met the threshold burden to identify the specific 
language in the resolution on which the point of order is predicated. 
Such a point of order shall be disposed of by the question of 
consideration.
  The gentleman from Georgia and a Member opposed, the gentlewoman from 
Florida, each will control 10 minutes of debate on the question of 
consideration.
  After that debate, the Chair will put the question of consideration, 
to wit: Will the House now consider the resolution?
  The Chair recognizes the gentleman from Georgia.
  Mr. BROUN of Georgia. Mr. Speaker, I have both professional and 
personal interest in this bill. I'm a medical doctor, and for years 
I've treated depression, anxiety, a lot of panic disorders. I'm also an 
addictionologist. I've treated drug and alcohol addiction and eating 
disorders. And so I've had many patients over the years that have had 
these kinds of problems.
  My mom has been involved in dealing with her own depression all the 
way up until she died of metastatic breast cancer, and she worked with 
the mental health society in our home community.
  I also have personal interest in this bill because my wife has 
suffered from depression. She has an eating disorder and has dealt with 
this in her history. She has suffered from depression to the point that 
several years ago she even tried to take her own life, and except for 
the grace of God she should have died. And so I do have a very personal 
interest in this bill. Mr. Speaker, this is why I have a vested 
interest in how Congress addresses health care, and especially mental 
health coverage.
  CBO estimates that the cost of the mandates to the private sector in 
this bill would be at least $1.3 billion in 2008; and this would rise 
to $3 billion in 2012. The Unfunded Mandates Reform Act, or UMRA, 
establishes an annual threshold that cannot be exceeded, at least 
without Congress waiving this rule. For 2007, that threshold amount is 
$131 million, a great deal of money. This bill exceeds the $131 million 
threshold by over $1 billion, and it will place a crushing burden on 
private health insurers and millions of Americans seeking affordable 
health insurance. These mandates will directly harm businesses and 
Americans' ability to obtain affordable health insurance.
  This legislation is very well intended. It is also rash and very 
poorly drafted and I assure you that if this mental health parity bill 
is signed into law in its current form, it will result in at least 
three things:
  H.R. 1424 will increase health insurance and mental health costs;
  H.R. 1424 will result in Americans losing their mental health 
coverage due to the mandates and the increased costs of those mandates;
  H.R. 1424 will result in a myriad of lawsuits.
  I testified before the Rules Committee last night and offered two 
amendments that would have drastically improved this legislation. Well, 
the Democratic majority, instead of choosing to allow an honest 
dialogue and an open debate on an extremely important issue of mental 
health, they chose to deny all amendments to this legislation. Not only 
that, the majority changed the underlying bill's language late last 
night and inserted the text of the Genetic Information Non-
Discrimination Act. This legislation will further erode mental health 
parity and jeopardize affordable group health insurance in America.
  Mr. Speaker, I reserve the balance of my time.
  Ms. CASTOR. Mr. Speaker, I yield myself such time as I may consume.
  I strongly oppose the gentleman's point of order.
  This point of order is being raised today for one purpose and one 
purpose only, that is, to block this rule and ultimately the underlying 
bill, an underlying bill that prohibits discrimination against 
Americans with mental illness.
  I'm heartened by the fact that I do not believe the gentleman's point 
of order comes from a unanimous opinion of the other side of the aisle 
because the underlying bill is a bipartisan effort cosponsored by 274 
Members of the House of Representatives. Yet there are opponents of 
this bill, and they will raise these dilatory tactics. The opponents 
don't even want to allow a debate or a final vote on this critical 
measure. They simply want to stop the process and kill the bill through 
this procedural maneuver.
  So despite whatever dilatory procedural devices the other side tries 
to use to stop this bill, we will stand up for the millions of 
Americans who need parity in mental health coverage, and we will vote 
to consider this important legislation today.
  We must consider this rule, and we will pass the Paul Wellstone 
Mental Health and Addiction Equity Act today.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BROUN of Georgia. Mr. Speaker, I yield 1 minute to the gentleman 
from Washington (Mr. Hastings).
  Mr. HASTINGS of Washington. I thank the gentleman for yielding.
  I could hardly believe my ears when I heard my friend from Florida 
say that this is a dilatory tactic, and the idea was to, what was it, 
to deny a vote on this bill? For goodness sakes. Last night there were 
several attempts, several attempts to try to improve this bill in a way 
that would make it more palatable to more people in this House, and 
they were turned down every time by the majority, Democrat majority, in 
the Rules Committee. And so for my friend from Florida to stand up and 
say that that is an attempt to kill this bill, when last night she 
participated in an exercise to do exactly that, is just beyond me.
  Mr. BROUN of Georgia. Mr. Speaker, I want to say that I resent my 
sincerity on this being questioned by the gentlelady from Florida. I am 
very sincere about this.
  Ms. CASTOR. Will the gentleman yield?
  Mr. BROUN of Georgia. No, ma'am.
  I am very sincere about this. I talked to the Rules Committee last 
night. I have talked on this floor here tonight. And for you to make 
these charges that I'm not sincere about this bill is absolutely 
incorrect. Maybe the gentlelady didn't hear me, but I have very 
personal interests in mental health. It is an extremely important issue 
to me, to my wife, to my family. And for you to say I'm not sincere 
about this, I am just very shocked about that. But I am sincere.
  This bill, the way it's written, is going to actually deny people 
mental health coverage. We tried to fix it last night, make it better. 
And those attempts were denied over and over and over again.
  Mr. Speaker, I reserve the balance of my time.
  Ms. CASTOR. Mr. Speaker, I am pleased at this time to yield 2 minutes 
to my colleague from Tennessee (Mr. Cohen).
  Mr. COHEN. I thank the gentlelady from Florida for making this time 
available.
  My father was a physician. After being a pediatrician for many years, 
he chose to change his specialty and go into psychiatry, and then child 
adolescent psychiatry. As a result of that, I was exposed to mental 
health issues and mental health treatment and the need for mental 
health professionals throughout this country.
  There has been a misconception in this country about people needing 
mental health treatment and their being adequately covered by 
insurance. In the same way that a physical illness affects people, 
mental illnesses do. And mental health treatment has been woefully 
undercovered and underserved, people who suffer from that in our 
country.
  I am proud to be a cosponsor of this bill and to join with the 
gentleman from Minnesota and the gentleman from Rhode Island who 
brought the bill and other cosponsors, because I think it shows that 
this Congress understands that mental health treatment needs to be 
covered, that diseases of the mind are similar to diseases of the body, 
the effect they can have on a person's overall well-being, but that 
their mental health and their physical health are also intertwined, and 
if mental health is not treated, physical health is affected.
  We need to be concerned about all of our fellow citizens, our 
brothers and sisters who might suffer from any illness. And it's time 
that we came out from the cloak of an ancient time when we looked upon 
mental health treatment as something to be shunned, to be embarrassed 
about if it was somebody

[[Page H1261]]

in our families, our friends, or even ourselves. And so I 
wholeheartedly endorse this bill and feel that the passage of this bill 
will be a great day for Americans and for science.
  Mr. BROUN of Georgia. Mr. Speaker, in addition to the concerns that I 
raised earlier regarding the provisions of the mental health parity 
bill, that it will actually decrease mental health coverage and 
increase health insurance costs, let me share several additional 
concerns I have with the Genetic Information Non-Discrimination Act 
that was inserted late last night.
  Title I of the GINA legislation imposes Federal mandates on health 
plans regarding insurance coverage, while title II imposes mandates on 
employers regarding employment and related hiring decisions. However, 
there is no explicit language in this legislation clarifying that group 
health insurance plan sponsors may not be subjected to the more 
expansive remedies provided by title II.
  Why is that a problem? Because title II provides for rulemaking by 
the EEOC, the Equal Employment Opportunity Commission, and remedies 
before the EEOC and, ultimately, Federal courts.
  During floor debate on H.R. 493, Congressman Rob Andrews suggested 
that ``employers, including to the extent employers control or direct 
benefit plans, are subject to the requirements of title II of this 
bill,'' including the much broader definition of genetic testing and 
tougher penalties associated with that title.
  I believe that this lack of clarity could and will lead to additional 
lawsuits through the use of broader remedies available in title II that 
are intended to be reserved for employers who violate their employees' 
civil rights, not for employees seeking to litigate group health plan 
disputes.
  Further, section 502 of ERISA says that all lawsuits must go through 
Federal court, which is not addressed in the mental health parity 
legislation. Nothing in this bill states that section 502 is preserved, 
so lawsuits can and will be brought in State court.
  Mr. Speaker, I reserve the balance of my time.
  Ms. CASTOR. At this time I will reserve the balance of my time.
  Mr. BROUN of Georgia. Mr. Speaker, I want to go through just a list 
of some things that this bill will do.
  It's going to increase health care costs. CBO estimates that H.R. 
1424 would impose mandates on private insurance companies, a total of 
$3 billion annually by 2012. These costs will ultimately be borne by 
employers offering health insurance and employees seeking to obtain 
coverage.
  Number two, it will increase the cost of business due to private 
sector mandates. The bill contains multiple new Federal mandates on the 
private sector, affecting the design and structure of health insurance 
plans.
  The bill also increases the threshold level at which employees 
suffering increased claim costs as a result of implementing the new 
Federal mandates can claim an exemption from the provisions of H.R. 
1424.
  Number three, I think this will decrease the mental health coverage. 
While the bill imposes several new Federal mandates on those employers 
who choose to offer mental health coverage, there is nothing in H.R. 
1424 that would require plans to cover these conditions. Thus H.R. 1424 
could have the perverse effect of actually decreasing mental health 
coverage by encouraging an employee who is frustrated with the bill's 
onerous burdens to drop mental health insurance altogether.
  Four, I think it will increase the number of uninsured. It will erode 
the Federal preemption for employers. This codification of treatment 
mandate for health plans, they are going to use DSM-IV to codify that. 
And this book, DSM-IV, was generated for physicians to use just to be 
able to classify mental health. It has a whole lot of things in here 
that most employers would not want to cover.

                              {time}  1415

  It will increase an intergovernmental mandate. It is a violation of 
UMRA. It has a lack of conscience clause, and it has a lack of medical 
management tools.
  The SPEAKER pro tempore. The gentleman from Georgia's time has 
expired.
  Ms. CASTOR. Mr. Speaker, I urge a ``yes'' vote on the consideration 
of the resolution so we can move forward on the rule and to consider 
the bill.
  Those that oppose our efforts to end discrimination when it comes to 
mental health services will get their opportunity to debate the bill 
and to vote against these measures.
  So with that, Mr. Speaker, I urge a ``yes'' vote to consider the 
rule.
  The SPEAKER pro tempore. All time for debate has expired.
  The question is: Will the House now consider the resolution?
  The question was taken; and the Speaker pro tempore announced that 
the noes appeared to have it.
  Ms. CASTOR. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The vote was taken by electronic device, and there were--yeas 215, 
nays 192, answered ``present'' 1, not voting 20, as follows:

                             [Roll No. 94]

                               YEAS--215

     Ackerman
     Allen
     Altmire
     Andrews
     Arcuri
     Baca
     Baird
     Baldwin
     Barrow
     Bean
     Becerra
     Berkley
     Berman
     Berry
     Bishop (GA)
     Bishop (NY)
     Blumenauer
     Boren
     Boswell
     Boucher
     Boyd (FL)
     Boyda (KS)
     Brady (PA)
     Braley (IA)
     Brown, Corrine
     Butterfield
     Capps
     Capuano
     Cardoza
     Carnahan
     Carney
     Castor
     Chandler
     Clarke
     Clay
     Cleaver
     Clyburn
     Cohen
     Cooper
     Costa
     Costello
     Courtney
     Cramer
     Crowley
     Cuellar
     Cummings
     Davis (AL)
     Davis (CA)
     Davis (IL)
     Davis, Lincoln
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Dicks
     Dingell
     Doggett
     Donnelly
     Doyle
     Edwards
     Ellison
     Ellsworth
     Emanuel
     Engel
     Eshoo
     Etheridge
     Farr
     Fattah
     Filner
     Frank (MA)
     Giffords
     Gillibrand
     Gordon
     Green, Al
     Green, Gene
     Grijalva
     Gutierrez
     Hall (NY)
     Hare
     Harman
     Hastings (FL)
     Herseth Sandlin
     Higgins
     Hill
     Hinchey
     Hirono
     Hodes
     Holden
     Holt
     Honda
     Hooley
     Hoyer
     Inslee
     Israel
     Jackson (IL)
     Jefferson
     Johnson (GA)
     Jones (OH)
     Kanjorski
     Kaptur
     Kennedy
     Kildee
     Kilpatrick
     Kind
     Kirk
     Klein (FL)
     LaHood
     Langevin
     Larsen (WA)
     Larson (CT)
     Lee
     Levin
     Lewis (GA)
     Lipinski
     Loebsack
     Lofgren, Zoe
     Lowey
     Lynch
     Mahoney (FL)
     Maloney (NY)
     Markey
     Marshall
     Matheson
     Matsui
     McCarthy (NY)
     McCollum (MN)
     McDermott
     McGovern
     McIntyre
     McNerney
     McNulty
     Meeks (NY)
     Melancon
     Michaud
     Miller (NC)
     Miller, George
     Mitchell
     Mollohan
     Moore (KS)
     Moore (WI)
     Moran (VA)
     Murphy (CT)
     Murphy, Patrick
     Murtha
     Nadler
     Napolitano
     Neal (MA)
     Oberstar
     Obey
     Olver
     Pallone
     Pascrell
     Pastor
     Payne
     Perlmutter
     Peterson (MN)
     Pomeroy
     Price (NC)
     Rahall
     Ramstad
     Richardson
     Rothman
     Roybal-Allard
     Ruppersberger
     Ryan (OH)
     Sanchez, Linda T.
     Sanchez, Loretta
     Sarbanes
     Schakowsky
     Schiff
     Schwartz
     Scott (GA)
     Scott (VA)
     Serrano
     Sestak
     Shays
     Shea-Porter
     Sherman
     Shuler
     Sires
     Skelton
     Slaughter
     Smith (WA)
     Snyder
     Solis
     Space
     Spratt
     Stark
     Stupak
     Sutton
     Tanner
     Tauscher
     Taylor
     Thompson (CA)
     Thompson (MS)
     Tierney
     Towns
     Tsongas
     Udall (NM)
     Van Hollen
     Velazquez
     Visclosky
     Walz (MN)
     Wasserman Schultz
     Waters
     Watson
     Watt
     Waxman
     Weiner
     Welch (VT)
     Wexler
     Wilson (OH)
     Wu
     Wynn
     Yarmuth

                               NAYS--192

     Abercrombie
     Aderholt
     Akin
     Alexander
     Bachus
     Barrett (SC)
     Bartlett (MD)
     Barton (TX)
     Biggert
     Bilbray
     Bilirakis
     Bishop (UT)
     Blackburn
     Bonner
     Bono Mack
     Boozman
     Boustany
     Brady (TX)
     Broun (GA)
     Brown (SC)
     Buchanan
     Burgess
     Burton (IN)
     Buyer
     Calvert
     Camp (MI)
     Campbell (CA)
     Cannon
     Cantor
     Capito
     Carter
     Castle
     Chabot
     Coble
     Conaway
     Crenshaw
     Cubin
     Culberson
     Davis (KY)
     Davis, David
     Davis, Tom
     Deal (GA)
     Dent
     Diaz-Balart, L.
     Diaz-Balart, M.
     Doolittle
     Drake
     Dreier
     Duncan
     Ehlers
     Emerson
     English (PA)
     Everett
     Fallin
     Feeney
     Ferguson
     Flake
     Forbes
     Fortenberry
     Fossella
     Foxx
     Franks (AZ)
     Frelinghuysen
     Gallegly
     Garrett (NJ)
     Gerlach
     Gilchrest
     Gingrey
     Gohmert
     Goode
     Goodlatte
     Granger
     Graves
     Hall (TX)
     Hastings (WA)
     Hayes
     Heller
     Hensarling
     Herger
     Hinojosa
     Hobson
     Hoekstra
     Hulshof
     Hunter
     Inglis (SC)
     Issa
     Jackson-Lee (TX)
     Johnson (IL)
     Johnson, Sam
     Jones (NC)
     Jordan
     Kagen
     King (IA)
     King (NY)
     Kingston
     Kline (MN)
     Knollenberg
     Kuhl (NY)
     Lamborn
     Lampson
     Latham
     LaTourette
     Latta
     Lewis (CA)
     Lewis (KY)
     Linder
     LoBiondo
     Lucas
     Lungren, Daniel E.
     Mack
     Manzullo
     Marchant
     McCarthy (CA)
     McCaul (TX)
     McCotter

[[Page H1262]]


     McCrery
     McHenry
     McHugh
     McKeon
     McMorris Rodgers
     Mica
     Miller (FL)
     Miller (MI)
     Miller, Gary
     Moran (KS)
     Musgrave
     Myrick
     Neugebauer
     Nunes
     Paul
     Pearce
     Pence
     Peterson (PA)
     Petri
     Pickering
     Pitts
     Platts
     Porter
     Price (GA)
     Pryce (OH)
     Putnam
     Radanovich
     Regula
     Rehberg
     Reichert
     Reynolds
     Rodriguez
     Rogers (AL)
     Rogers (KY)
     Rogers (MI)
     Rohrabacher
     Ros-Lehtinen
     Roskam
     Ross
     Royce
     Ryan (WI)
     Salazar
     Sali
     Saxton
     Schmidt
     Sensenbrenner
     Sessions
     Shadegg
     Shimkus
     Shuster
     Simpson
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Souder
     Stearns
     Tancredo
     Terry
     Thornberry
     Tiahrt
     Tiberi
     Turner
     Upton
     Walberg
     Walden (OR)
     Walsh (NY)
     Wamp
     Weldon (FL)
     Weller
     Westmoreland
     Whitfield (KY)
     Wilson (NM)
     Wilson (SC)
     Wittman (VA)
     Wolf
     Young (AK)
     Young (FL)

                        ANSWERED ``PRESENT''--1

       
     Bachmann
       

                             NOT VOTING--20

     Blunt
     Boehner
     Brown-Waite, Ginny
     Cole (OK)
     Conyers
     Gonzalez
     Johnson, E. B.
     Keller
     Kucinich
     Meek (FL)
     Murphy, Tim
     Ortiz
     Poe
     Rangel
     Renzi
     Reyes
     Rush
     Sullivan
     Udall (CO)
     Woolsey

                              {time}  1440

  Messrs. KING of New York, DUNCAN, WITTMAN of Virginia, HOBSON, WOLF 
and RODRIGUEZ changed their vote from ``yea'' to ``nay.''
  Messrs. RUPPERSBERGER, LYNCH and KIRK changed their vote from ``nay'' 
to ``yea.''
  Mrs. BACHMANN changed her vote from ``nay'' to ``present.''
  So the question of consideration was decided in the affirmative.
  The result of the vote was announced as above recorded.
  Stated against:
  Mr. COLE of Oklahoma. Mr. Speaker, on Wednesday, March 5, 2008, I was 
unavoidably detained and missed rollcall vote No. 94.
  Had I been present and voting, I would have voted as follows: 
Rollcall vote No. 94: ``nay'' (On Question of consideration on the Rule 
to provide for consideration of H.R. 1424--Paul Wellstone Mental Health 
and Addiction Equity Act of 2007).
  The SPEAKER pro tempore. The gentlewoman from Florida is recognized 
for 1 hour.
  Ms. CASTOR. Mr. Speaker, for the purpose of debate only, I yield the 
customary 30 minutes to my colleague from the Rules Committee, the 
gentleman from Washington (Mr. Hastings). All time yielded during 
consideration of the rule is for debate only.


                             General Leave

  Ms. CASTOR. Mr. Speaker, I ask unanimous consent that all Members be 
given 5 legislative days in which to revise and extend their remarks on 
House Resolution 1014.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Florida?
  There was no objection.
  Ms. CASTOR. I yield myself such time as I may consume.
  Mr. Speaker, House Resolution 1014 provides for the consideration of 
H.R. 1424, the Paul Wellstone Mental Health and Addiction Equity Act of 
2007, which expands the Mental Health Parity Act of 1996 to provide for 
equity in the terms of employer-sponsored health benefits for mental 
health and substance-related disorders compared to medical and surgical 
disorders.
  Mr. Speaker, this is an anti-discrimination bill, this is a health 
care bill, this is a pro-business economic development bill, this is 
also a pro-family bill, and this is a bill that supports our veterans. 
This is a bipartisan effort, with 274 cosponsors in the House, of which 
I am proud to be one.
  Unfortunately, Federal action is necessary because Americans who 
suffer from illnesses like depression, postpartum depression, severe 
anxiety, bipolar disorder, and many other diseases are being 
discriminated against. You see, HMOs and many health insurance 
companies have been more focused on their bottom lines than on the 
health of our families. Mental health is just as critical to our lives 
and well-being as any physical ailments or disease. And yet health 
insurers continue to treat mental illness differently from physical 
illness.
  In America, more than 50 million adults, at least 22 percent of the 
U.S. population, suffer from mental health issues or substance abuse 
disorders. In addition, one out of every 10 children or adolescents has 
a serious mental health problem and another 10 percent have mild to 
moderate problems. Untreated mental illness harms our families and 
children, emotionally and financially. Untreated mental illness results 
in higher costs for businesses in lost productivity. Untreated mental 
illness often leads to criminal activity, which is very costly. Mental 
disorders are the leading cause of disability for individuals aged 15 
to 44 in the United States.
  A study sponsored by the National Institute of Mental Health revealed 
that mental and addictive disorders cost our country more than $300 
billion annually. This includes productivity losses of $150 billion, 
health care costs of over $70 billion, and $80 billion for costs such 
as criminal justice.
  Unfortunately, less than one-third of the people with a mental 
disorder who seek care receive adequate treatment. Despite the losses 
suffered in our society as a result of mental illness and all of the 
studies that demonstrate this, national employer survey data indicates 
that mental health coverage still is not offered at comparable coverage 
to other medical conditions.

                              {time}  1445

  Even after passage of the 1996 Mental Health Parity Act and all of 
the efforts of the States, the Government Accountability Office found 
that 87 percent of plans had more restrictive design features for 
mental health benefits than for medical and surgical benefits. In 
addition, many employers have adopted restrictive measures, such as 
limiting the number of covered outpatient visits for mental illness. 
This is so shortsighted. It is so costly.
  Former Surgeon General Dr. David Satcher found that when health 
insurance plans unevenly impose higher costs for mental health 
services, the result, of course, is a reduction in treatment for those 
who need it, lost productivity and higher costs in the long run. Dr. 
Satcher stated that this is a true issue of fairness in coverage.
  Similarly, another recent study found that deductibles and outpatient 
cost sharing were much higher for substance abuse than for general 
medical care. Well, this legislation addresses those inequities and 
provides a cost-effective way of providing increased access to mental 
health care. The bill prohibits discrimination by diagnosis by 
requiring coverage of all mental illnesses and substance-related 
disorders, just as we provide for Members of Congress and others 
covered by the Federal Employees Health Benefits Program. Treatment for 
mental illness is a proven money-saver. In fact, for every $1 spent on 
treatment, we save over $12.
  Mr. Speaker, we all owe a debt of gratitude to Mr. Kennedy of Rhode 
Island and Mr. Ramstad of Minnesota for their bipartisan leadership on 
this legislation and their work to provide for the mental health needs 
of our families, our neighbors, our veterans and our children. We also 
owe great thanks to the Wellstone family. But, most of all, we can't 
forget the families throughout America who have a modest request of 
their Congress, and that is that they be treated fairly.
  Mr. Speaker, I reserve the balance of my time.
  Mr. HASTINGS of Washington. Mr. Speaker, I want to thank the 
gentlewoman from Florida (Ms. Castor) for yielding me the customary 30 
minutes, and I yield myself such time as I may consume.
  (Mr. HASTINGS of Washington asked and was given permission to revise 
and extend his remarks.)
  Mr. HASTINGS of Washington. Mr. Speaker, history is being made today 
in the U.S. House of Representatives. Yesterday, Democrat leaders and 
the Democrat-controlled Rules Committee chose for a record-setting, a 
record-setting 50th time to consider legislation under a completely 
closed process that allows no amendments, no alternatives, no 
substitute proposals, and permits not a single Member of this House the 
opportunity to change or improve the underlying bill.
  Last January, the new Democrat majority promised the American people 
a new era of openness in the U.S. House, but they have delivered the 
most restrictive and unfair process in the history of the House. It is 
only March in the first part of the second session of this Congress, 
but the Democrats have already exceeded the 49 closed rules of the 
entire 109th Congress.

[[Page H1263]]

  Mr. Speaker, that is a historic low. We were promised change, and we 
have gotten it. Only it has been change, Mr. Speaker, for the worse.
  Mr. Speaker, time after time, Democrat leaders have shut down any and 
all opportunity for Members of the House to amend, alter or debate 
legislation. This is a sad and disrespectful way to approach the 
business of the American people and the people's House. It doesn't have 
to be this way, and it certainly isn't what the Democrat leaders 
promised a little more than a year ago. That promise has been tossed 
out the window, along with any pretense to seek out bipartisan 
compromise in passing legislation.
  Mr. Speaker, the Senate has passed a bipartisan bill on mental health 
parity, and, Mr. Speaker, it passed unanimously. Yet House Democrat 
leaders refuse to even allow the bipartisan Senate compromise to be 
voted on in the House. An amendment to allow a House vote on the Senate 
compromise was blocked by the Democrat Rules Committee, just as it 
blocked every other amendment offered by Members of this House, and 
that only happened last night.
  Yet the reach of this bill goes far beyond mental health parity. The 
$1.3 billion cost it would impose on businesses providing health care 
to employees is an issue that, frankly, is not addressed, or any loss 
of care that may result from new government mandates that are contained 
in the bill is also not addressed.
  The reach of this bill stretches deep into the ability of doctors to 
provide care to patients across this country through a $3 billion cut 
in health care to Americans served by doctor-owned hospitals. This is 
the second time in 7 months that the House will vote on legislation 
that seeks to ban doctor-owned hospitals by cutting funding from 
Medicare and Medicaid to these facilities, and, as such, Mr. Speaker, 
it imposes a very real and serious threat to some Americans' ability to 
access health care.
  One of the hospitals threatened by this proposal is Wenatchee Valley 
Medical Center in my district in central Washington. The Wenatchee 
Valley Medical Center, Mr. Speaker, was founded in 1940 by three 
physicians. In the last 68 years it has grown, and now employs 1,500 
people. It serves a population of 250,000 people in an area the size of 
the State of Maryland and it treats 150,000 patients a year. It has 
been designated by the State of Washington as a ``critical need 
hospital'' that is serving a rural underserved area.
  Today, Mr. Speaker, it is 100 percent owned by 150 doctors. 
Apparently, that is a crime, because this bill would outlaw this 
facility as it has existed for 68 years, because this bill would 
prohibit any hospital from being more than 40 percent owned by doctors 
if they are to continue receiving Medicare patients for the care that 
they provide to their seniors.
  Mr. Speaker, the Wenatchee Valley Medical Center has been treating 
and caring for patients longer than there has been even 50 States in 
our Union, and yet this bill could end that care.
  When I discussed this threat to Wenatchee with the proposal sponsors 
last night in the Rules Committee, they said the simple answer was to 
sell the 60 percent stake in a government-ordered fire sale so it meets 
the 40 percent limit on doctor ownership. Not only is a fair price, Mr. 
Speaker, unlikely to be paid when selling under a threat of government 
action, but it is unfair and disruptive to any institution with a long 
record of excellent care.
  Mr. Speaker, what is so nefarious about 100 percent doctor ownership, 
or 75 percent, or 50 percent, or even, Mr. Speaker, 41 percent? What is 
magically solved with the ownership of 40 percent? The answer is 
nothing, nothing when it comes to Wenatchee.
  The irony is not lost on me that this bill only bans doctor-owned 
hospitals in an effort to supposedly target bad behavior. Consider 
this, Mr. Speaker: If a corporation engages in the exact, in the exact 
same practices that this bill tries to stop doctor-owned hospitals from 
doing, the corporation would pay no penalty. It wouldn't even be 
touched. So apparently patients are safer if corporations are in 
charge, but patients are in danger and taxpayers are being ripped off 
if doctors prosper from owning a hospital and are providing excellent 
care.
  What is really happening in this bill is a push to move our country 
ever closer to a Canadian-style government-run health care system, as 
under this bill such a Canadian-style system will replace good, high 
quality care from down-home doctors with the extensive medical 
expertise of Congress. The Federal Government will decide where 
Americans will get care and what hospitals will be banned or shutdown. 
The Federal Government will also decide when Americans are allowed to 
get care, if they are allowed to get care at all.
  If the Federal Government can ban doctors from owning a hospital, 
then the health care access of every American, Mr. Speaker, in my view, 
is at risk. I fundamentally disagree with those who believe that an 
all-knowing Congress and thousands of Federal bureaucrats can deliver 
Americans the best health care possible.
  Keep in mind, this ban on doctor-owned hospitals, quote-unquote, 
saves $3 billion. Ironically, Mr. Speaker, this is accomplished by 
denying or reducing access to care for seniors and poor Americans on 
Medicaid and Medicare. Instead of growing the size and power of the 
Federal Government by taking decisions away from local doctors and 
removing freedoms from individual Americans, we should be allowing 
American patients to make more choices and free doctors to focus on 
their profession of healing.
  Mr. Speaker, when it comes to Wenatchee Valley Medical Center, the 
accusations of negligent care and fiscal rip-offs that are leveled at 
doctor-owned hospitals simply don't apply to this facility. Wenatchee 
is not guilty of the sins of others simply because it is a doctor-owned 
hospital since 1940. It should not be targeted or threatened for the 
real or anecdotal failures of recently created doctor-owned hospitals.
  The language in this bill is simply not ready for passage as it is 
currently written. It is too broad and imprecise. It would punish 
honest, well-performing hospitals and doctors and their patients for 
the actions of others. If there is bad behavior, Mr. Speaker, to be 
banned, then target that behavior. Don't impose an overreaching ban 
that harms innocent patients and doctors.
  My constituents are not alone in facing this threat. Both Mr. 
Hinojosa of Texas and Mr. Kagen of Wisconsin have similar concerns 
about health care institutions in their districts.
  Efforts to improve this legislation so that it doesn't threaten and 
harm our home-grown hospitals have not been met with openness. In fact, 
we have been denied on a bipartisan basis. Last night in the Rules 
Committee I made three separate attempts to try to offer an amendment 
to protect innocent hospitals. However, Democrats on the Rules 
Committee chose to deny each and every attempt to preserve the 
stricture of my hospital and the hospitals of Mr. Hinojosa and Mr. 
Kagen.
  Mr. Speaker, there are legitimate bipartisan concerns about the toll 
this language would have on local hospitals that have done no harm and 
who provide important health care access to thousands of Americans.
  This bill needs to be corrected, not forced through the House with 
zero opportunity for improvement or amendment. This record-setting 
closed rule denies any chance for help to be provided to Wenatchee 
Valley Medical Center or to patients in hospitals in Texas and 
Wisconsin. The rule deserves to be defeated and this House allowed to 
vote on correcting this flawed bill.
  Mr. Speaker, I reserve the balance of my time.
  Ms. CASTOR. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, this is truly a good-news story for American families 
today, because not only are we going to outlaw discrimination against 
those who suffer from mental illness, but we adhere to the pay-as-you-
go rules that were adopted by this Congress, led by Democrats, at the 
beginning of this Congress. Pay-as-you-go means that this bill is paid 
for.
  And while I certainly respect the gentleman from Washington for 
speaking up for a medical center which operates in his district, there 
is a bigger picture here. And to explain that bigger picture, I yield 
2\1/2\ minutes to the gentleman from New Jersey (Mr. Pallone), who 
chairs the Subcommittee on Health for the Energy and Commerce 
Committee.

[[Page H1264]]

  Mr. PALLONE. Mr. Speaker, I want to thank the gentlewoman from 
Florida. She makes the point that this physician self-referral 
provision in the bill actually serves two purposes. On the one hand, it 
is about half of the pay-for for the cost of the legislation. The 
physicians self-referral basically generates about $2.4 billion over 10 
years, which is about half of the pay-for in this bill.

                              {time}  1500

  But beyond that, in addressing the gentleman from Washington's 
concerns, it is actually a good thing. It is a good government 
proposal. And what it does, it ends the ability of physicians to self-
refer to a hospital in which they have ownership. This change is 
consistent with the original intent of the physicians self-referral 
laws. The loophole for whole hospital ownership was only there because 
of tiny rural hospitals that were then owned by one doctor who 
practiced there.
  Now that structure is no longer commonplace and that is why the 
hospital associations all endorse our bill. The bill does provide a 
grandfather for hospitals that currently have physician ownership and 
had a provider agreement with Medicare as of July 2007, the date of 
introduction of the bill. Within 18 months of enactment, they need to 
meet a standard that no physician owned more than 2 percent of the 
facility individually and that aggregate physician ownership was 40 
percent or less.
  So it is possible for the hospital in the State of Washington to 
reconfigure and meet this provision. But I just want to understand why 
we are doing this. These physician-owned hospitals essentially are a 
problem because they are being overutilized. There is overutilization. 
In other words, physicians are referring patients to these hospitals in 
many cases for unnecessary procedures. The reason why CBO scores this 
and uses it as a pay-for is because we know that these unnecessary 
procedures or overutilization takes place and is not basically a good 
thing. So we are trying to end this practice of self-referral. We are 
not completely precluding a hospital from reconfiguring itself and 
staying open, but, generally speaking, we need to end the practice.
  Mr. HASTINGS of Washington. Mr. Speaker, I yield myself 15 seconds.
  If the issue is to go after doctor-owned hospitals that are not doing 
the ethical thing, then why not go after them instead of writing a bill 
that covers everything carte blanche including this facility in my 
district? The gentleman has not answered that. He didn't answer it last 
night, and he probably won't answer it today.
  I yield to my friend from Texas, a member of the Rules Committee, Mr. 
Sessions, 2\1/2\ minutes.
  Mr. SESSIONS. I thank the gentleman for giving me this time.
  I am shocked and stunned that we financed overutilization and that is 
why we are doing this. Yet we understand that utilizing these physician 
hospitals, these new hospitals, saved the government money and are all 
about patient choice and are all about making sure that people who 
utilize these new hospitals don't get infections, don't get sick, don't 
check into a hospital to have surgery where other sick people are. It 
is a concept that keeps America not only the leading health care 
provider in the world; it is done in an efficient and cost-effective 
way. I am surprised that we find out it is overutilization.
  Mr. Speaker, rather than taking this opportunity to bring parity to 
our health care delivery system, the Democrat leadership today is using 
this legislation as a vehicle to restrict future health care choices 
for Medicare patients. That is what this is about. It is to further own 
the opportunity for Medicare patients to be able to get the choices 
that they want, and the Democrat leadership is taking that away. 
Instead of using this opportunity to focus on mental health parity, the 
Democrats have decided to pay for this bill by pushing patients and 
limiting their options that they can receive for their own care.
  Mr. Speaker, we will be real honest about this. According to 
HealthGrades, which is a nationwide study to look at hospitals and how 
efficient they are and how safe they are, three of the Nation's top 10 
cardiac programs and three of the Nation's top 10 programs for joint 
replacement are at physician-owned hospitals. And despite the fact that 
these physician-owned hospitals make up only 3 percent of the Nation's 
hospitals, they are among the most efficient and the safest hospitals 
for people, our seniors, to go in and receive care. What will happen 
here today is an absolute mistake.
  Mr. Speaker, I submit for the Record the Statement of Administrative 
Policy on this issue and I will quote from that:
  ``First, the bill would place new restrictions on physician-owned 
hospitals. This administration opposes this provision, which is 
unnecessary and could restrict patient choice without decreasing 
Medicare costs.''
  That is right, it is going to be more expensive to argue about 
overutilization. Incredibly silly.

 Statement of Administration Policy--H.R. 1424--Paul Wellstone Mental 
                Health and Addiction Equity Act of 2007

       The Administration supports passage of mental health parity 
     legislation that does not significantly increase health 
     coverage costs. However, the Administration has concerns with 
     H.R. 1424, which would effectively mandate coverage of a 
     broad range of diseases and conditions and would have a 
     negative effect on the accessibility and affordability of 
     employer-provided health benefits and would undermine the 
     uniform administration of employee benefit plans. For 
     example, the bill's confusing preemption provisions could be 
     read to add a patchwork of remedies that vary from State to 
     State. Therefore the Administration strongly opposes House 
     passage of H.R. 1424 or any legislation that expands benefits 
     and remedies beyond what is included in the Senate-passed S. 
     558.
       H.R. 1424 also includes two provisions to offset the 
     approximately $3 billion in on-budget costs associated with 
     the bill. First, the bill would place new restrictions on 
     physician-owned hospitals. The Administration opposes this 
     provision, which is unnecessary and could restrict patient 
     choice without decreasing Medicare costs. HHS already has 
     administrative policies in place to address concerns about 
     physician-owned hospitals, including disclosure of physician 
     ownership, patient safety measures, and revisions to 
     Medicare's payment systems to better reflect patients' 
     severity of illness and the resources needed to treat 
     patients.
       Second, the bill also would increase the Medicaid drug 
     rebate. The Administration objects to any offset that would 
     legislatively mandate an increase to the rebate percentage. 
     As CBO has noted in its 2007 analysis of budget options, it 
     is unknown how this change would impact non-Medicaid 
     beneficiaries and other payers. The Administration is 
     concerned that the proposal would have an adverse impact on 
     private purchasers, including the uninsured, further distort 
     the market for prescription drugs, and discourage innovation 
     in the drug development process.
       The Administration urges Congress to offer meaningful 
     protections to American workers and their families by 
     eliminating the disparities between mental health benefits 
     and medical and surgical benefits, without broadly mandating 
     new benefits. The Administration believes the Senate bill 
     strikes the necessary balance of treating mental illness with 
     the same urgency as physical illnesses without significantly 
     increasing health care costs. The Administration would also 
     urge the House to preserve uniformity in health plan 
     administration as has been done in S. 558.


               Genetic Information Non-discrimination Act

       The rule requires that the provisions of H.R. 493 as passed 
     by the House be added to the Mental Health Parity bill after 
     the House passes H.R. 1424. While the Administration strongly 
     supports passage of legislation to prevent the misuse of an 
     individual's personal genetic information and believes such 
     legislation is critical to realizing the full potential of 
     genomic medicine, the Administration has both substantive and 
     process objections to the rule. The Administration is 
     strongly opposed to the lack of a clear ``firewall'' between 
     title I of the Genetic Information Nondiscrimination Act 
     (GINA), which addresses genetic discrimination in health 
     benefits provided by health insurers and plans, and title 11 
     of GINA, which addresses genetic discrimination in 
     employment. The Administration is concerned that the bill 
     fails to ensure that health benefits disputes are properly 
     brought under the appropriate remedies in ERISA, the Public 
     Health Service Act, or the Internal Revenue Code and that it 
     could unintentionally permit ``forum shopping.'' The 
     Administration also is concerned that unless the legislation 
     is clarified, the bill could be construed to have the 
     unintended effect of prohibiting health plans and issuers 
     from using information about the manifested disease of a 
     dependent covered under an individual's plan for appropriate 
     and routine insurance purposes. The Administration also 
     believes it is important that the legislation's relationship 
     with other provisions of law, such as Health Insurance 
     Portability and Accountability Act, be clearly defined. 
     Finally, the Administration looks forward to working with 
     Congress to address these concerns and pass Mental Health 
     Parity and Genetic Nondiscrimination legislation this year.


[[Page H1265]]


  Ms. CASTOR. Mr. Speaker, I am proud to yield 2 minutes to the 
gentlewoman from the powerful Rules Committee and the State of 
California (Ms. Matsui).
  Ms. MATSUI. I thank the gentlewoman from Florida for yielding me 
time.
  Mr. Speaker, I would like to begin today by thanking my colleagues, 
Mr. Kennedy and Mr. Ramstad. Their advocacy on this issue has been 
truly remarkable.
  We held a field hearing in my district last year on mental health. It 
provided my constituents with a forum for important dialogue about an 
issue that affects millions of Americans.
  Mr. Speaker, anyone who has had a family member with a mental illness 
knows how difficult living with the disease can be for everyone 
involved. They also know one thing above all else: physical illness and 
mental illness are equally painful and equally challenging. In many 
ways, mental health patients suffer more because our insurance system 
discriminates against them. That is why this legislation is so 
important, because it is about people, people who struggle with mental 
illness every day and every night, people who suffer in silence without 
a doctor's help because their insurance will not cover mental health or 
addiction treatments.
  This House has the chance to demonstrate its compassion and 
commitment to these people, Mr. Speaker. With one vote, we can put 
behind us the false conception that mental illness is not as serious as 
cancer or diabetes or many other diseases covered by health insurance 
plans.
  On the contrary, mental illnesses are some of the most serious health 
conditions we face. The battle against them has been enormously 
difficult for millions of families across our Nation.
  It has been tough, but this is a battle that we must win, Mr. 
Speaker. With mental health parity, it is a battle we can and will win.
  Again, I thank Mr. Kennedy and Mr. Ramstad for their courageous 
commitment to this legislation.
  Mr. HASTINGS of Washington. Mr. Speaker, I am pleased to yield 4 
minutes to the gentlelady from New Mexico (Mrs. Wilson), a member of 
the Energy and Commerce Committee.
  Mrs. WILSON of New Mexico. Mr. Speaker, I will be asking for a 
recorded vote on the previous question today, and the reason is that 
the House majority leader, Mr. Hoyer, has just announced that the House 
will not take up the electronic surveillance bill this week, further 
delaying any decisions in the closing of an important intelligence gap. 
We have now gone 18 days since the expiration of the Protect America 
Act. If the previous question is defeated, we will immediately bring up 
the Senate legislation to close that gap.
  I also rise today to oppose this rule. I commend Mr. Ramstad and Mr. 
Kennedy for their work on mental health parity. In the past, I have 
been a cosponsor of their legislation. But I offered a substitute 
amendment in the Rules Committee last night which was not ruled in 
order. The alternative is supported by 285 organizations that support 
the Senate version of the mental health parity bill which passed the 
United States Senate unanimously in September. The differences are on 
policy, and my amendment was not made in order. Instead, we have the 
50th closed rule of this Congress. No amendments. This floor can't 
stomach debate on policy issues, and I think that is a sad commentary 
on the way this House is being run.
  This is a major bill, one of the most important, I think, we will 
consider this year. I believe very strongly that mental illness and a 
disease of the brain is a medical condition that should be treated as 
seriously as a disease of the heart or the liver or the lungs.
  The amendment that I offered, the substitute, is a bipartisan 
compromise that was worked out in negotiations lasting over 2 years. It 
is supported by mental health providers, the mental health community, 
business and the insurance industry.
  Mr. Speaker, I submit for the Record a list of 285 organizations 
supporting the alternative I offered.

 285 Organizations Supporting the Mental Health Parity Act of 2007, S. 
         558, or the Domenici/Kennedy/Enzi Manager's Amendment

       Abilities in Motion.
       ACCESS--DSPA Alliance.
       Addictions Care Center of Albany (NY).
       AFL-CIO.
       Albany County Consumer Advocacy Board for Mental Health, 
     Inc. (NY).
       Alexander Graham Bell Association for the Deaf and Hard of 
     Hearing.
       Alliance for Children and Families.
       Alliance for the Betterment of Citizens with Disabilities 
     (ABCD) (Hamilton, NJ).
       Alliance for Eating Disorders Awareness.
       American Academy of Child and Adolescent Psychiatry.
       American Academy of Cosmetic Surgery.
       American Academy of Family Physicians.
       American Academy of Neurology.
       American Academy of Pediatrics.
       American Academy of Physician Assistants.
       American Association for Geriatric Psychiatry.
       American Association for Marriage and Family Therapy.
       American Association for Psychosocial Rehabilitation.
       American Association of Children's Residential Centers.
       American Association of Pastoral Counselors.
       American Association of People with Disabilities.
       American Association of Practicing Psychiatrists.
       American Association of School Administrators.
       American Association of Suicidology.
       American Association on Health and Disability.
       American Association on Intellectual and Developmental 
     Disabilities.
       American Board of Examiners in Clinical Social Work.
       American College of Occupational and Environmental 
     Medicine.
       American Council of the Blind.
       American Counseling Association.
       American Dance Therapy Association.
       American Federation of Teachers.
       American Foundation for Suicide Prevention.
       American Foundation for the Blind.
       American Gastroenterological Association.
       American Geriatrics Society.
       American Group Psychotherapy Association.
       American Hospital Association.
       American Jail Association.
       American Medical Association.
       American Medical Rehabilitation Providers Association.
       American Mental Health Counselors Association.
       American Music Therapy Association.
       American Network of Community Options and Resources.
       American Nurses Association.
       American Occupational Therapy Association.
       American Orthopsychiatric Association.
       American Psychiatric Association.
       American Psychiatric Nurses Association.
       American Psychoanalytic Association.
       American Psychological Association.
       American Psychotherapy Association.
       American Public Health Association.
       American School Health Association.
       American Society of Plastic Surgeons.
       American Therapeutic Recreation Association.
       American Thoracic Society.
       America's HealthTogether.
       Anorexia Nervosa and Related Eating Disorders, Inc..
       Anxiety Disorders Association of America.
       Arizona Council of Human Service Providers.
       Aspire of Western New York. Inc.
       Association for Ambulatory Behavioral Healthcare.
       Association for Behavioral Health and Wellness.
       Association for the Advancement of Psychology.
       Association for Psychological Science.
       Association of American Medical Colleges.
       Association of Asian Pacific Community Health 
     Organizations.
       Association of Assistive Technology Act Programs.
       Association of Jewish Family & Children's Agencies.
       Association of University Centers on Disabilities.
       Association to Benefit Children.
       Autism Society of America.
       Barbara Schneider Foundation.
       Bazelon Center for Mental Health Law.
       Behavioral Health/Consumers In Action, Inc. (Phoenix, AZ).
       The Bridge, Inc. (Caldwell, NJ).
       The Carter Center Mental Health Program.
       Center for Disability Issues and the Health Professions.
       C.H.E.E.E.R.S. Center 4 Health Enlightenment Enrichment 
     Empowerment Renewal Services (AZ).
       Chicago Children's Advocacy Center.
       Child and Family Service (Ewa Beach, HI).
       Child and Family Services of Yuma, Inc. (Yuma, AZ).
       Child and Family Resources, Inc (Tucson. AZ).
       Child Neurology Society.
       Child Welfare League of America.
       Children and Adults with Attention-Deficit/Hyperactivity 
     Disorder.
       Children's Aid and Family Services, Inc. (Paramus, NJ).
       Children's Defense Fund.
       The Children's Guild (Baltimore, MD).

[[Page H1266]]

       Children's Home of Reading (Reading, PA).
       Children's Hospital Boston.
       Christian Family Care Agency (Phoenix, AZ).
       Clinical Social Work Association.
       Clinical Social Work Guild 49, OPEIU.
       College of Psychiatric and Neurologic Pharmacists.
       Connecticut Council of Family Service Agencies.
       Cornerstones of Care (Kansas City, MO).
       Corporation for Supportive Housing.
       Council for Children with Behavior Disorders.
       Council for Exceptional Children.
       Council of Family & Child Caring Agencies (New York, NY).
       Council of Parent Attorneys and Advocates.
       Council of State Administrators of Vocational 
     Rehabilitation.
       County of Santa Clara, CA.
       Dads and Daughters.
       DePelchin Children's Center (Houston, TX).
       Depression and Bipolar Support Alliance.
       Disability Center for Independent Living.
       Disability Rights Education and Defense Fund. Inc..
       Disability Service Providers of America.
       Division for Learning Disabilities (DLD) of the Council for 
     Exceptional Children.
       Easter Seals.
       Eating Disorders Coalition for Research, Policy & Action.
       Eating Disorder Referral and Information Center/
     EDReferral.com.
       The Elisa Project.
       Ensuring Solutions to Alcohol Problems.
       Epilepsy Foundation.
       Families For Depression Awareness.
       Families USA.
       Family & Children First, Inc. (Louisville, KY).
       Family and Children's Association (Mineola, NY).
       Family and Children's Center (Mishawaka, IN).
       Family & Children First, Inc. (Louisville, KY).
       Family & Children's Service of Niagara, Inc. (Niagara 
     Falls, NY).
       Family and Community Service of Delaware County (PA).
       Family Means (Stillwater, MN).
       Family Service Agency (North Little Rock, AR).
       Family Service Association of New Jersey.
       Family Service League (Huntington, NY).
       Family Service of Chester County, PA.
       Family Service of Lackawanna County, PA.
       Family Service of the Piedmont (Jamestown, NC).
       Family Services Centers, Inc. (Clearwater, FL).
       Family Services of Greater Houston.
       Family Services of Greater Waterbury, Inc. (CT).
       Family Services of Northeast Wisconsin (Green Bay, WI).
       Family Voices.
       Federation of American Hospitals.
       Federation of Behavioral, Psychological, & Cognitive 
     Sciences.
       Federation of Families for Children's Mental Health.
       Feeling Blue Suicide Prevention Center.
       First Focus.
       Friends Committee on National Legislation (Quaker).
       Gail R. Schoenbach/FREED Foundation.
       Germantown Settlement (Philadelphia, PA).
       Glove House, Inc (Elmira, NY).
       Goodwill Industries International, Inc.
       Gurze Books.
       Hale Kipa, Inc. (Honolulu, HI).
       Hamilton-Madison House, Inc. (New York, NY).
       Hartley House (New York, NY).
       Helen Keller National Center.
       The Hillside Family of Agencies (Rochester, NY).
       Hope House Inc. (Albany, NY).
       Hudson Guild (New York, NY).
       Human Rights Campaign.
       Huntington Family Centers, Inc. (Syracuse, NY).
       Institute for the Advancement of Social Work Research.
       International Association of Jewish Vocational Services.
       Jewish Board of Family and Children's Services (New York, 
     NY).
       Jewish Family Services of Greater Hartford.
       Jewish Federation of Metropolitan Chicago.
       Jewish Vocational Service of Metropolitan Chicago.
       Kentucky Center for Mental Health Studies.
       Khmer Health Advocates.
       Kids Project.
       Kristin Brooks Hope Center.
       LDA, the Learning Disabilities Association of America.
       Little Colorado Behavioral Health Centers (St. Johns, AZ).
       Lutheran Services in America.
       McHenry County Mental Health Board.
       Mental Health America.
       Methodist Home for Children (Philadelphia, PA).
       Minnesota Council of Child Caring Agencies.
       National Advocacy Center of the Sisters of the Good 
     Shepherd.
       National Alliance for Hispanic Health.
       National Alliance for Research on Schizophrenia and 
     Affective Disorders.
       National Alliance on Mental Illness.
       National Alliance on Mental Illness--New York City Metro.
       National Alliance on Mental Illness--Clarion County of PA.
       National Alliance to End Homelessness.
       National Asian American Pacific Islander Mental Health 
     Association.
       National Association for the Advancement of Orthotics & 
     Prosthetics.
       National Association for Children's Behavioral Health.
       National Association for Rural Mental Health.
       National Association for the Dually Diagnosed.
       National Association of Anorexia Nervosa and Associated 
     Disorders--ANAD.
       National Association of Councils on Developmental 
     Disabilities.
       National Association of Counties.
       National Association of County and City Health Officials.
       National Association of County Behavioral Health and 
     Developmental Disability Directors.
       National Association of Disability Representatives.
       National Association of Mental Health Planning & Advisory 
     Councils.
       National Association of Pediatric Nurse Practitioners.
       National Association of Psychiatric Health Systems.
       National Association of School Psychologists.
       National Association of Social Workers.
       National Association of Social Workers--Louisiana Chapter.
       National Association of State Directors of Special 
     Education.
       National Association of State Head Injury Administrators.
       National Association of State Mental Health Program 
     Directors.
       National Center for Learning Disabilities, Inc.
       National Center for Policy Research for Women & Families.
       National Coalition for the Homeless.
       National Coalition on Deaf-Blindness.
       National Committee to Preserve Social Security and 
     Medicare.
       National Council for Community Behavioral Healthcare.
       National Council of Jewish Women.
       National Council on Aging.
       National Council on Alcoholism and Drug Dependence 
     (Phoenix, AZ).
       National Council on Family Relations.
       National Council on Independent Living.
       National Council on Problem Gambling.
       National Disability Rights Network.
       National Down Syndrome Congress.
       National Down Syndrome Society.
       National Education Association.
       National Hispanic Medical Association.
       National Hopeline Network.
       National Law Center on Homelessness & Poverty.
       National Mental Health Awareness Campaign.
       National Mental Health Consumers' Self-Help Clearinghouse.
       National Multiple Sclerosis Society.
       National Network for Youth.
       National Organization of People of Color Against Suicide.
       National Partnership for Women and Families.
       National Recreation and Park Association.
       National Rehabilitation Association.
       National Research Center for Women & Families.
       National Respite Coalition.
       National Rural Health Association.
       National TASC.
       New Jersey Alliance for Children, Youth and Families.
       New Jersey Association of Mental Health Agencies, Inc.
       Newtown Youth and Family Services (Newtown, CT).
       NISH.
       Northamerican Association of Masters in Psychology.
       Obsessive Compulsive Foundation.
       Ophelia's Place.
       PACER Center.
       Paralyzed Veterans of America.
       Pendleton Academies (Pendleton, OR).
       People With Disabilities Foundation.
       Personal & Family Counseling Services (New Philadelphia, 
     OH).
       PREHAB of Arizona (Mesa, AZ).
       Presbyterian Church (U.S.A.) Washington Office.
       Pressley Ridge (Pittsburgh, PA).
       Puente de Vida Recovery Center--The Council on Alcoholism 
     and Drug Abuse of Sullivan County (NY).
       School Social Work Association of America.
       Screening for Mental Health, Inc.
       The Shaken Baby Alliance.
       Sjogren's Syndrome Foundation.
       Society for Research on Child Development.
       Society of Professors of Child and Adolescent Psychiatry.
       Somerset Home for Temporarily Displaced Children 
     (Bridgewater, NJ).
       Suicide Awareness Voices of Education.
       Suicide Prevention Action Network USA.
       TASH.
       The Advocacy Institute.
       The Arc of Salem County, NJ.
       The Arc of the United States.
       Title II Community AIDS National Network.
       Toby House, Inc. (Phoenix, AZ).
       Tourette Syndrome Association, Inc.
       Union for Reform Judaism.

[[Page H1267]]

       Unitarian Universalist Association of Congregations.
       United Cerebral Palsy Association.
       United Community & Family Services. Inc. (Norwich, CT).
       United Jewish Communities.
       United Methodist Church--General Board of Church and 
     Society.
       United Neighborhood Centers of America.
       United Spinal Association.
       U.S. Psychiatric Rehabilitation Association.
       Wisconsin Association of Family & Children's Agencies.
       Witness Justice.
       Working Assets.
       World Institute on Disability.
       Yellow Ribbon International Suicide Prevention Program.


                   Business and Insurance Supporting

       Aetna, Inc.
       American Benefits Council.
       America's Health Insurance Plans.
       AstraZeneca Pharmaceuticals--US.
       BlueCross BlueShicld Association.
       CIGNA.
       Eli Lilly and Company.
       National Association of Health Underwriters.
       National Association of Manufacturers.
       National Association of Wholesaler-Distributors.
       National Business Group on Health.
       National Federation of Independent Business.
       National Retail Federation.
       Retail Industry Leaders Association.
       Society for Human Resource Management.
       U.S. Chamber of Commerce.

  There is one big difference between the House bill and the Senate 
bill that is important. The House bill requires that if a company 
insures any mental illness, they must provide coverage for all of the 
conditions listed in a diagnostic manual called the DSM-IV. That is 
highly unusual. Even the Federal employees' health plan that we have 
here in the Congress just says that you have to offer categories, like 
substance abuse. It doesn't say you have to cover every diagnosis, like 
caffeine addiction, which is a subcategory under substance abuse. This 
is unprecedented and, I think, would cause a lot of businesses to not 
offer mental health coverage at all.
  So the risk here of unintended consequences, since no business is 
required to offer mental health insurance, is that 18 million Americans 
who suffer from serious mental illness may actually lose their 
coverage. That is the important policy choice that we are not having 
the opportunity to debate here today because an alternative has not 
been allowed.
  Finally, I would say this. The alternative that I put forward was 
also paid for, but it wasn't paid for by closing physician-owned 
hospitals. It is paid for by extending an asset verification electronic 
system from a pilot project that exists in three States now to all 50 
States. It is a fairly straightforward approach to getting fraud out of 
the Medicaid system and would pay for this mental health parity bill 
that has passed unanimously in the Senate.
  The alternative that I offered is better for the mentally ill. It is 
widely supported by business, by insurance, and the mental health 
community. It does not close our physician-owned hospitals and is the 
kind of debate we should be having on this floor. For that reason, I 
would urge my colleagues to vote against the rule in front of us today.
  Ms. CASTOR. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Texas (Ms. Jackson-Lee).
  (Ms. JACKSON-LEE of Texas asked and was given permission to revise 
and extend her remarks.)
  Ms. JACKSON-LEE of Texas. Let me thank the gentlelady from Florida 
and the gentleman from Minnesota for yielding and their indulgence.
  Mr. Speaker, I am rising to first of all take my hat off to 
Congressman Patrick Kennedy. This is a day in waiting, for he has 
worked without tiring in the tradition of my good friend, Senator Paul 
Wellstone, now deceased, who worked and committed themselves to 
changing the inequity, really, I would think, constitutionally wrong, 
to disallow mental health parity and those who suffered from mental 
health issues.
  All of our family members, or all of our families, have faced these 
crises. We ask the question, what do we do? That is why I am so 
disappointed that we have taken the work of Patrick Kennedy and 
imploded it. We have dissolved the bipartisan allegiance to this bill, 
the commitment to mental health parity, by destroying hospitals in our 
districts, hospitals that are serving the poor of our districts. Why 
they would think that this was an important element of this bill, I 
don't know. And that is, of course, to end the growth of physician-
owned hospitals in urban and rural areas for poor and those who are 
without access to hospitals.
  This would restrict the ability and capacity of physician-owned 
hospitals. It doesn't matter if the hospital is rural or in the inner 
city, big or small. It punishes these hospitals. In Houston, in the 
18th Congressional District, it punishes St. Joseph's, it punishes the 
Heights Hospital, and it does so without any reason.
  We could pay for this by the tax cuts that we are taking away from 
those making over $250,000, or the tax cuts on the energy company. But 
why are you breaking the backs of those who clearly need an 
opportunity?
  This bill should include a robust State license emergency care with 
doctors on call at all times to care for patients. That is what these 
hospitals need to have. Maintain a minimum number of physicians 
available at all times to provide service and provide charity care 
equal to at least 4 percent of its operating budget. We can put 
criteria on these hospitals. We don't have to destroy them. I am 
saddened by what we have done to this bill.


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore (Mr. Snyder). Members are reminded to heed 
the gavel.
  Mr. HASTINGS of Washington. Mr. Speaker, I am pleased to yield 3 
minutes to the gentleman from Georgia (Mr. Gingrey), a former member of 
the Rules Committee.
  Mr. GINGREY. Mr. Speaker, I thank the gentleman for yielding.
  We have heard, particularly from our side of the aisle, the objection 
to this bill, H.R. 1424, in regard to procedure and in regard to pay-
fors, which basically I agree with. The fact is that this is the 50th 
time that the Democratic majority has brought forth a bill, an 
important bill, with a closed rule and no opportunity for our side. In 
the case of myself as a physician member, I think I had some good 
thoughts about this bill. In fact, I was proud to support the extension 
of the original Paul Wellstone Mental Health and Addiction Equity Act. 
I thought that was a good thing. But now my objection to the rule and 
the underlying bill, Mr. Speaker, is mainly about policy. I think they 
have taken this bill and adulterated it to an extent that it is 
unbelievable that the gentlelady from Florida in her opening remarks 
said that this is a business-friendly piece of legislation.
  Now if we were talking about covering things like bipolar disorder, 
depressive disorders, anxiety disorders, post-traumatic stress 
syndrome, certainly this is very important that we have mental health 
parity. But as one of the previous speakers on our side of the aisle 
said, what you have done in expanding this to cover things on a 
mandated basis to our employees, diseases in the Diagnostic Statistical 
Manual of Mental Illnesses, jet lag fatigue, caffeine intoxication, 
sibling rivalry, substance induced sexual dysfunction, transvestite 
fetishism, can you imagine any employer being willing to cover things 
like that?

                              {time}  1515

  You are throwing the baby out with the bath water. You had a good 
bill. I was proud to support it, and I would proudly support it today, 
but to expand it to the point where no employer will offer mental 
health coverage, that means so many of these people, families with 
adult children, adult dependent children, who are suffering from some 
of these conditions that we know of that I mentioned, bipolar disorder, 
schizophrenia, they desperately need help, and they need health parity. 
I am in favor of that and I would support it. That is why I am 
supportive of the Senate version.
  But I stand here, and I ask all of my colleagues to look at this and 
read it and understand why hardly any employer would accept this and 
provide health coverage when it provides all of these things that are 
totally unnecessary.
  With that, I ask my colleagues to defeat this rule and this 
underlying legislation. Let's take it back to the drawing board and do 
probably what Paul Wellstone intended originally, and my friend Patrick 
Kennedy as well. We have ruined an otherwise good bill.

[[Page H1268]]

  Ms. CASTOR. Mr. Speaker, I yield 2 minutes to the gentleman from 
Minnesota (Mr. Ellison).
  Mr. ELLISON. Mr. Speaker, it has been an honor for me to speak in 
support of the Paul Wellstone Mental Health and Addiction Equity Act of 
2007. I want to thank both Congressman Kennedy and Congressman Ramstad 
for their dedication to ending the insurance discrimination and 
ensuring that all Americans have access to mental health and addiction 
services.
  As a Minnesotan, I'm struck by the emotion of this day because the 
late Paul Wellstone's tireless efforts to ensure mental health parity 
might finally be realized. Paul Wellstone knew it was wrong for health 
insurers to place discriminatory restrictions on treatments, and I am 
honored to be part of this effort to finally guarantee that millions of 
Americans who need mental health and addiction services can obtain the 
services they deserve.
  The urgent need for the Paul Wellstone Mental Health and Addiction 
Equity Act is surely best expressed by those who have seen a loved one 
in need denied coverage. I think immediately of Kitty Westin, a 
Minnesotan whose daughter Anna suffered from anorexia, a deadly disease 
that affects approximately 8 million Americans and ultimately claimed 
Anna's life. During her daughter's battle with anorexia, Kitty took 
Anna to the hospital. Anna was refused care by the insurance company 
because it did not consider access to mental health treatment important 
enough to cover.
  Kitty knows this is completely unacceptable and has been fighting 
selflessly to make sure that no other family experiences the same 
frustration and pain. I commend her for carrying on Anna's legacy so 
impressively through her advocacy efforts and community work. For Kitty 
and all of those who have encountered insurance discrimination, I carry 
Paul Wellstone's message that access to mental health and addiction 
services is imperative and must take place now.
  Mr. HASTINGS of Washington. Mr. Speaker, I am pleased to yield 2 
minutes to the gentleman from Washington (Mr. Reichert).
  Mr. REICHERT. Mr. Speaker, I thank my colleague from the State of 
Washington, and I rise in strong opposition to this closed rule. This 
rule gives the House no opportunity to engage in meaningful debate 
about this important issue.
  I am disappointed that the majority did not make in order a 
substitute amendment I cosponsored to consider the bipartisan 
legislation that was unanimously approved by the Senate last year.
  Let me be clear: I strongly support mental health parity. That is 
precisely why I am so concerned that the bill before us today could 
derail our efforts to pass mental health parity legislation altogether.
  While the House bill could reduce access to care for the mentally 
ill, decrease the affordability for health care coverage, and even 
close a hospital in my State, the Senate measure represents some of the 
very best that can come from bipartisan collaboration and compromise. 
It reflects the interests of mental health advocates and providers 
while also respecting the rights of States like Washington to enact 
mental health laws that go beyond the Federal standard.
  Mr. Speaker, I came to this House, this body, a little over 3 years 
ago. My previous profession was in law enforcement for 33 years, so I 
came here in a little bit different way than most Members of the House 
of Representatives. So today I make the statement not as a Republican 
but as a citizen of the United States of America. I am standing here 
today as an American saying that we need to stop the partisan bickering 
and we need to come together as Democrats and Republicans and we need 
to address this issue of not having opportunity, not having a voice, to 
share in the decisions that are being made in this House. It is time 
that we come together.
  The Senate bill that passed unanimously needs to be considered on the 
House floor.
  Ms. CASTOR. Mr. Speaker, I yield 1 minute to the gentlewoman from 
California, a champion for America's families, children, and veterans, 
and the Speaker of the House, Ms. Pelosi.
  Ms. PELOSI. Mr. Speaker, I thank the gentlewoman for yielding and for 
her leadership in bringing the rule to the floor, which will enable us 
to debate legislation that is very important to many people in America. 
I thank Mr. Pallone for his leadership on the committee of 
jurisdiction, a House subcommittee of Energy and Commerce, and I thank 
Mr. Hastings as well for the opportunity to debate this important 
issue.
  This is a very special day in the Congress of the United States. We 
are all very proud of our work, but there are some days that really 
stand out as historic, days that represent breakthroughs for America's 
families.
  Today we are debating an issue that is relevant to the lives of so 
many people in our country. And we owe a great debt of gratitude to two 
of our colleagues, Congressman Patrick Kennedy of Rhode Island and 
Congressman Ramstad of Minnesota, for their great knowledge of the 
issue of mental illness and addiction, for their political astuteness 
of the political process here, and for their generosity of spirit to 
share their personal experience with us, to use their knowledge of 
issues relating to mental illness and addiction to benefit so many 
people in our country. It is painful, I know, and therefore very 
courageous of them to do so. And simply said, without their leadership, 
we would not have this opportunity today. So I am pleased to salute the 
leadership of Congressman Kennedy and Congressman Ramstad. With this 
legislation, they have given hope to millions of Americans.
  Mr. Speaker, I rise in support of the legislation also because 
illness of the brain must be treated just like illness anywhere else in 
the body. The Paul Wellstone Mental Health and Addiction Equity Act is 
a comprehensive bill to help end discrimination against those who seek 
treatment for mental illness.
  There is no shame in mental illness. The great shame would be if 
Congress did not take action to ensure that individuals with mental 
health illnesses and addictions are given the attention, treatment, and 
resources they need to lead a healthy life.
  This is an issue of national significance. Did you know, and I found 
the figure startling, every year mental illness results in 1.3 billion 
lost days of work or school; 1.3 billion days. That adds up to more 
lost productivity for mental illness than arthritis, stroke, heart 
attack, and cancer combined. Combined. Yet bipartisan and independent 
research shows that there is no significant cost to insuring mental 
illness like any other medical disease.
  This legislation will be especially relevant for our returning 
veterans from Iraq and Afghanistan who later become employed in the 
private sector. This will be potentially life-saving for those brave 
men and women who served in the National Guard and Reserves but who 
don't receive VA care for their entire lifetime.
  Mr. Speaker, to help remove the stigma against mental illness, for 
the millions suffering from mental illness and addiction, and because 
it is the right thing for our Nation, I urge my colleagues to support 
the Paul Wellstone Mental Health and Addiction Equity Act. It is 
legislation that is long overdue. It gives hope to millions of people 
in our country and their families.
  I urge my colleagues to support the legislation and honor the 
leadership, the courage, the generosity of spirit of Mr. Kennedy and 
Mr. Ramstad in making this day possible for us.
  Mr. HASTINGS of Washington. Mr. Speaker, I reserve the balance of my 
time.
  Ms. CASTOR. Mr. Speaker, I yield 2 minutes to the gentleman from 
Illinois (Mr. Davis).
  (Mr. DAVIS of Illinois asked and was given permission to revise and 
extend his remarks.)
  Mr. DAVIS of Illinois. Mr. Speaker, I want to thank the gentlewoman 
from Florida for yielding. I rise in strong support of this rule and 
the underlying bill. Like all of my colleagues, I want to commend 
Representatives Kennedy and Ramstad for their unrelenting advocacy for 
mental health. As a matter of fact, we have watched them travel all 
across the country, holding hearing after hearing, engaging people, 
trying to help them understand that mental illness, that mental health 
is just as important as any other aspect.
  I have heard us debate cost. All of us know that insanity is doing 
the same

[[Page H1269]]

thing over and over again and expecting a different result. We know 
that education, early diagnosis and prevention can save us billions of 
dollars in mental health. And so I would urge passage of this rule and 
passage of the underlying bill.
  Mr. HASTINGS of Washington. Mr. Speaker, I yield myself 4 minutes.
  Mr. Speaker, there are several parts to this bill. And obviously by 
the remarks that I made previously, I am worried about what we call the 
pay-for part of that because it would have a detrimental effect, as I 
mentioned, on doctor-owned facilities, particularly in my district, but 
also in other parts of the country.
  Since this issue came up some 7 months ago, we discovered that there 
are very few doctor-owned facilities that are unique in the sense of 
what I was talking about today, and I think my colleagues from 
Wisconsin and Texas talked about last night in the Rules Committee, and 
so I want to ask my friend from New Jersey who is the sponsor of this 
legislation, and I will be happy to yield to him.
  He talked about the issue of overutilization. Now, I simply have to 
bring this up because I doubt that the 150,000 patients of the 
Wenatchee Valley Clinic would say that they are overutilizing that 
clinic. I think they go there because they want to have their health 
needs taken care of. So I don't think that is applicable to that 
facility, and I mentioned that in my previous remarks.
  I want to ask my friend from New Jersey a question.
  As I mentioned, apparently there are just a few hospitals that fall 
in the category that I was describing.

                              {time}  1530

  But there are bipartisan concerns about the effects of this bill on 
good hospitals providing quality care. I made that point.
  Will you work with me and other Members from both sides of the aisle 
to protect these hospitals and to exempt them totally from this ban on 
doctor ownership?
  I yield to my friend from New Jersey.
  Mr. PALLONE. The answer to that is that we believe that the 
legislation, as it is before you today, accomplishes that goal. In 
other words, as I said, these hospitals within 18 months of enactment, 
they can essentially reconfigure, so if no physician owned more than 2 
percent--
  Mr. HASTINGS of Washington. Reclaiming my time, I asked if the 
gentleman would work with me, and apparently the gentleman is saying 
that he won't work with me, even though this apparently is a very, very 
small universe, a universe of hospitals that deserve, I think, to have 
some sort of special consideration because if you have, for example, a 
government-mandated fire sale, what is the value of the enterprise that 
you're trying to sell? Yet that is precisely the language that you have 
in place.
  So I'm asking you again. Since there are very few of these 
facilities, in three different States, would you work with us to exempt 
them totally from the ban that's imposed by this bill?
  Mr. PALLONE. The answer is, no, if I could explain why just very 
briefly.
  Mr. HASTINGS of Washington. The gentleman answered me yes. Now go 
ahead with your no. Please explain your no.
  I yield to the gentleman.
  Mr. PALLONE. I've been trying to explain that the reason that the 
money is saved pursuant to this provision is because physician self-
referrals inherently are not a good thing. We are trying to discourage 
it as much as possible and not having it be the case in the future. Now 
there are some hospitals that, as you said, historically had this 
configuration. But we don't want to encourage it. We want to discourage 
it. That's why we're saying that we'll have a standard with the 40 
percent and the 2 percent and we'll even allow some of them to grow if 
they meet certain standards. But we're not looking to have this 
continue because it inherently is not a good thing.
  Mr. HASTINGS of Washington. Reclaiming my time, I appreciate the 
gentleman's explanation.
  To me, Mr. Speaker, this sounds precisely as a look into the future, 
as we move towards what I would consider, I know that some would want, 
a government-style health care in this country, where conditions are 
going to be set forth on what kind of care, when that care is, what's 
the condition of ownership. All of these things apparently are on the 
horizon, and we are seeing an inkling into the future of how that would 
be effected.
  Mr. Speaker, I reserve my time.
  Ms. CASTOR. Mr. Speaker, I yield 2 minutes to the gentleman from 
Maryland (Mr. Cummings).
  Mr. CUMMINGS. Mr. Speaker, I rise today in support of the rule for 
the Paul Wellstone Mental Health and Addiction Equity Act of 2007.
  The time is long past due for Congress to, once and for all, act to 
end discrimination against patients seeking treatment for mental 
illness and addiction. More than 57 million Americans suffer from 
mental illness and more than 26 million suffer from addiction. 
Unfortunately, our Nation's investment in services for individuals with 
mental illness and addiction has not kept pace with the trend. Last 
year, untreated mental illness cost the U.S. economy over $150 billion, 
and untreated addiction cost over $400 billion.
  H.R. 1424 reverses this trend by guaranteeing that plans cover the 
same range of mental illnesses and addiction disorders offered by the 
Federal employee health plan that Members of Congress use; prohibiting 
insurers and group health plans from imposing treatment of financial 
limitations when they offer mental health benefits that are more 
restrictive from those applied to medical and surgical services; and 
creating medical management tools that are based on valid medical 
evidence and pertinent to the patient's medical condition so that 
specific coverage is not arbitrary and is more transparent to the 
patient.
  This is a piece of legislation that is critically important to our 
Nation and to my constituents.
  Just the other day I received a letter from a Mr. Smith in my 
district, whose son, a 16-year-old, was diagnosed with attention 
deficit hyperactivity disorder.
  Last spring Mr. Smith's son started using marijuana and used it 
increasingly as the months progressed in what was described as self-
medication. His grades dropped and he withdrew from his friends and 
showed other signs of substance abuse.
  When his parents placed him in an outpatient counseling facility, Mr. 
Smith learned, to his surprise, that the necessary treatment was not 
covered under his employer-based health insurance. After that 
counseling proved ineffective, he sent his son to a facility for in-
patient treatment which cost approximately $25,000.
  This legislation is very important, and I would urge my colleagues to 
vote in favor of the rule and the legislation.
  Mr. HASTINGS of Washington. Mr. Speaker, I reserve my time.
  Ms. CASTOR. Mr. Speaker, I have the right to close, and we do not 
have any additional speakers, so I will reserve the balance of my time 
until my colleague has made his closing remarks.
  Mr. HASTINGS of Washington. Mr. Speaker, I yield myself the balance 
of my time.
  Mr. Speaker, there's been a lot of discussion here today on the 
underlying bill, the subject of which has broad support. The issues are 
the PAYGO and the issues are the denial, denial of the Democrat 
leadership in this House to allow a vote on a bill that passed in the 
other body unanimously. So much for openness that was promised a little 
over a year ago.
  Mr. Speaker, I want to focus my closing remarks on another issue, 
another issue that has not been taken up and needs to be addressed, and 
that's the FISA issue that we have talked about so many times.
  It has come to my attention today, and it will be in a publication 
presumably tomorrow, that the distinguished majority leader said that 
the electronic surveillance bill, or the FISA bill, will not be taken 
up this week.
  We are becoming unprotected in this country because we don't have all 
the capabilities that we need in our intelligence community.
  With that, Mr. Speaker, in this rule, Democrat leaders have blocked 
the House from voting on a bipartisan compromise on mental health 
parity, as I had mentioned.
  I want to talk now about modernizing the Foreign Intelligence 
Surveillance Act into the 21st century. The Senate has passed 
legislation that will

[[Page H1270]]

bring this 1970s Jimmy Carter-era law up to date to reflect today's age 
of disposable cell phones and the Internet. Yet for weeks now, House 
Democrat leaders have refused to allow Representatives to vote on this 
Senate bill. They've done this despite the public support given the 
bipartisan Senate compromise by 21 members of the Democrat Blue Dog 
Coalition.
  House Democrat leaders are tying the hands of our intelligence 
professionals to make them jump through unnecessary red tape and 
paperwork to protect our country. If foreign persons in foreign places 
are conspiring and plotting to harm Americans and our country, then our 
intelligence personnel should be listening to them. They shouldn't have 
to waste precious time and energy on bureaucratic hurdles.
  We can protect and are protecting the constitutional rights of 
Americans, but we also must protect their lives by recognizing the 
terrorist threat to our country and modernizing FISA.
  I ask all my colleagues to join with me in defeating the previous 
question so that we can immediately move to vote on the bipartisan 
Senate FISA bill.
  Mr. Speaker, I ask unanimous consent to have the text of the 
amendment and extraneous material inserted into the Record prior to the 
vote on the previous question.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Washington?
  There was no objection.
  Mr. HASTINGS of Washington. Mr. Speaker, I urge my colleagues to 
oppose this 50th closed rule, record-setting 50th closed rule that 
denies every Member from offering an amendment on the House floor, and 
to vote ``no'' on the previous question and in favor of a bipartisan 
permanent solution that closes the terrorist loophole.
  With that, Mr. Speaker, I yield back the balance of my time.
  Ms. CASTOR. Mr. Speaker, back on the Paul Wellstone Mental Health 
Equity Act, I submit for the Record a letter of support from the 
Federation of American Hospitals along with a related letter from the 
American Hospital Association, Coalition of Full Service Community 
Hospitals and Federation of American Hospitals.


                             Federation of American Hospitals,

                                                    March 3, 2008.
     Speaker Nancy Pelosi,
     U.S. Congress,
     Washington, DC.
     Minority Leader John Boehner,
     U.S. Congress,
     Washington, DC.
       Dear Speaker Pelosi and Leader Boehner: The Federation of 
     American Hospital (FAH), representing America's investor-
     owned and managed hospitals and health systems, supports 
     swift passage of the Paul Wellstone Mental Health and 
     Addiction Equity Act of 2007 (H.R. 1424). This 1egislation 
     will provide greatly needed access to mental health treatment 
     for Americans who need it most.
       This bipartisan legislation would end prevalent forms of 
     health insurance discrimination against patients with 
     debilitating chronic mental illnesses. Additionally, H.R. 
     1424 will assist millions of Americans in obtaining the 
     necessary hospital care they need and were previously denied 
     because of inadequate mental health coverage.
       H.R. 1424 is paid for, in part, by prohibiting physician 
     self-referral to a hospital in which a physician has an 
     ownership interest. Physician self-referral presents an 
     inherent conflict of interest, creates an unlevel, anti-
     competitive playing field; threatens patient safety; fails 
     low-income and uninsured patients; and, has resulted in the 
     overutilization of limited Medicare resources. We strongly 
     support this provision.
       We deeply appreciate Congress's ongoing commitment to 
     mental health parity and strengthening the Medicare program.
           Sincerely,
                                 ------
                                 
                                                    March 4, 2008.
     Hon. Louise McIntosh Slaughter,
     Chair, House Committee on Rules, House of Representatives, 
         Washington, DC.
       Dear Chairwoman Slaughter: On behalf of our nearly 5,000 
     member hospitals, health systems, and other health care 
     organizations, and our 37,000 individual members, the 
     American Hospital Association (AHA), along with the 
     Federation of American Hospitals and the Coalition of Full 
     Service Community Hospitals, strongly opposes the amendment 
     expected to be offered by Rep. Hinojosa (D-TX) during Rules 
     Committee consideration of H.R. 1424.
       The amendment would seriously erode the investment 
     provisions currently included in H.R. 1424 designed to ensure 
     that physician ownership interests and their potential to 
     cause conflicts of interest are limited and to ensure that 
     physician investments are bona fide and not simply a means to 
     buy physician referrals. Specifically, it would allow 
     grandfathered facilities of 300 beds or more to maintain 
     their current level of physician ownership without regard to 
     the aggregate and individual physician limits. Currently, 
     under H.R. 1424, physicians would be granted 18 months to 
     adjust their current physician ownership level.
       Furthermore, it would allow existing physician-owned 
     facilities that had already provided loans or financing for 
     physicians to purchase their ownership interest to continue 
     to do so. Finally, it weakens the language in H.R. 1424 as it 
     pertains to the needed limitations on growth.
       Physician self-referral to hospitals in which they have an 
     ownership stake presents an inherent conflict of interest. 
     These arrangements create an uneven, anti-competitive playing 
     field, threaten patient safety and have, according to 
     independent research, resulted in over-utilization, siphoning 
     precious resources away from the Medicare program.
       The only way to protect the Medicare program and the 
     seniors it serves, as well as ensure fair competition, is to 
     place needed restrictions on self-referral. We urge the 
     Committee to reject this amendment.
           Sincerely.

                                                 Rick Pollack,

                                         Executive Vice President,
                                    American Hospital Association.

  Mr. Speaker, if anyone had followed the debate today, they might 
think that hospitals throughout the country are opposed to this. To the 
contrary. Please let me read a portion of the Federation of American 
Hospitals letter to the speaker and the minority leader.
  ``The Federation of American Hospitals, representing America's 
investor-owned and managed hospitals and health systems, supports swift 
passage of the Paul Wellstone Mental Health and Addiction Equity Act. 
This legislation will provide greatly needed access to mental health 
treatment for Americans who need it most.
  ``This bipartisan legislation would end prevalent forms of health 
insurance discrimination against patients with debilitating chronic 
mental illnesses. Additionally, it will assist millions of Americans in 
obtaining the necessary hospital care they need and were previously 
denied because of inadequate mental health coverage.
  ``H.R. 1424 is paid for, in part, by prohibiting physician self-
referral to a hospital in which a physician has an ownership interest. 
Physician self-referral presents an inherent conflict of interest, 
creates an unlevel, anti-competitive playing field, threatens patient 
safety, fails low-income and uninsured patients, and has resulted in 
the overutilization of limited Medicare resources. We strongly support 
this provision.
  ``We deeply appreciate Congress' ongoing commitment to mental health 
parity and strengthening the Medicare program.''
  Mr. Speaker, what a tremendous lifeline we provide to families of 
veterans today by ending the discrimination that exists under many 
group health plans for mental health treatment. Unfortunately, people 
struggling with mental illness and addiction are often denied coverage 
for mental health treatment. Insurers often increase patient costs for 
mental health treatment by limiting in-patient days, capping outpatient 
visits, and requiring higher copayments than for physical illnesses.
  It is estimated that over 90 percent of workers with employer-
sponsored health insurance are enrolled in plans that impose higher 
costs in at least one of these ways. This is unfair. The treatment is 
unfair, and it's a major barrier to receiving adequate health care. 
Consequently, many mental health and substance-related disorders go 
untreated.
  Clearly, diseases of the mind should be afforded the same treatment 
as diseases of the body. That benefits us all. Today's bill will end 
this discrimination by prohibiting health insurers from placing 
discriminatory restrictions on treatment and cost sharing.
  Mr. Speaker, again this is an anti-discrimination bill. This is a 
health care bill. This is a pro-business and economic development bill. 
This is a pro-family bill. And this is a bill that supports our 
veterans. So today we strike a blow for fairness and equity and 
improved access to mental health treatment which will fundamentally 
improve the lives of millions of American families.
  Mr. Speaker, I urge a ``yes'' vote on the previous question and on 
the rule.
  The material previously referred to by Mr. Hastings of Washington is 
as follows:

[[Page H1271]]

    Amendment to H. Res. 1014 Offered by Mr. Hastings of Washington

  At the end of the resolution, add the following:
  Sec. 4. ``That upon adoption of this resolution, before consideration 
of any order of business other than one motion that the House adjourn, 
the bill (H.R. 3773) to amend the Foreign Intelligence Surveillance Act 
of 1978 to establish a procedure for authorizing certain acquisitions 
of foreign intelligence, and for other purposes, with Senate amendment 
thereto, shall be considered to have been taken from the Speaker's 
table. A motion that the House concur in the Senate amendment shall be 
considered as pending in the House without intervention of any point of 
order. The Senate amendment and the motion shall be considered as read. 
The motion shall be debatable for one hour equally divided and 
controlled by the Majority Leader and the Minority Leader or their 
designees. The previous question shall be considered as ordered on the 
motion to final adoption without intervening motion.''
  (The information contained herein was provided by Democratic Minority 
on multiple occasions throughout the 109th Congress.)

        The Vote on the Previous Question: What It Really Means

       This vote, the vote on whether to order the previous 
     question on a special rule, is not merely a procedural vote. 
     A vote against ordering the previous question is a vote 
     against the Democratic majority agenda and a vote to allow 
     the opposition, at least for the moment, to offer an 
     alternative plan. It is a vote about what the House should be 
     debating.
       Mr. Clarence Cannon's Precedents of the House of 
     Representatives, (VI, 308-311) describes the vote on the 
     previous question on the rule as ``a motion to direct or 
     control the consideration of the subject before the House 
     being made by the Member in charge.'' To defeat the previous 
     question is to give the opposition a chance to decide the 
     subject before the House. Cannon cites the Speaker's ruling 
     of January 13, 1920, to the effect that ``the refusal of the 
     House to sustain the demand for the previous question passes 
     the control of the resolution to the opposition'' in order to 
     offer an amendment. On March 15, 1909, a member of the 
     majority party offered a rule resolution. The House defeated 
     the previous question and a member of the opposition rose to 
     a parliamentary inquiry, asking who was entitled to 
     recognition. Speaker Joseph G. Cannon (R-Illinois) said: 
     ``The previous question having been refused, the gentleman 
     from New York, Mr. Fitzgerald, who had asked the gentleman to 
     yield to him for an amendment, is entitled to the first 
     recognition.''
       Because the vote today may look bad for the Democratic 
     majority they will say ``the vote on the previous question is 
     simply a vote on whether to proceed to an immediate vote on 
     adopting the resolution .... [and] has no substantive 
     legislative or policy implications whatsoever.'' But that is 
     not what they have always said. Listen to the definition of 
     the previous question used in the Floor Procedures Manual 
     published by the Rules Committee in the 109th Congress, (page 
     56). Here's how the Rules Committee described the rule using 
     information from Congressional Quarterly's ``American 
     Congressional Dictionary'': ``If the previous question is 
     defeated, control of debate shifts to the leading opposition 
     member (usually the minority Floor Manager) who then manages 
     an hour of debate and may offer a germane amendment to the 
     pending business.''
       Deschler's Procedure in the U.S. House of Representatives, 
     the subchapter titled ``Amending Special Rules'' states: ``a 
     refusal to order the previous question on such a rule [a 
     special rule reported from the Committee on Rules] opens the 
     resolution to amendment and further debate.'' (Chapter 21, 
     section 21.2) Section 21.3 continues: Upon rejection of the 
     motion for the previous question on a resolution reported 
     from the Committee on Rules, control shifts to the Member 
     leading the opposition to the previous question, who may 
     offer a proper amendment or motion and who controls the time 
     for debate thereon.''
        Clearly, the vote on the previous question on a rule does 
     have substantive policy implications. It is one of the only 
     available tools for those who oppose the Democratic 
     majority's agenda and allows those with alternative views the 
     opportunity to offer an alternative plan.

  Ms. CASTOR. Mr. Speaker, I yield back the balance of my time, and I 
move the previous question on the resolution.
  The SPEAKER pro tempore. 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.
  Mr. HASTINGS of Florida. Mr. Speaker, on that I demand the yeas and 
nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 and clause 9 of rule 
XX, this 15-minute vote on ordering the previous question will be 
followed by 5-minute votes on adopting House Resolution 1014, if 
ordered, and suspending the rules with regard to H.R. 4774 and H. Con. 
Res. 286.
  The vote was taken by electronic device, and there were--yeas 215, 
nays 195, not voting 18, as follows:

                             [Roll No. 95]

                               YEAS--215

     Ackerman
     Allen
     Altmire
     Andrews
     Arcuri
     Baca
     Baird
     Baldwin
     Becerra
     Berkley
     Berman
     Berry
     Bishop (GA)
     Bishop (NY)
     Blumenauer
     Boren
     Boswell
     Boucher
     Boyd (FL)
     Boyda (KS)
     Brady (PA)
     Braley (IA)
     Brown, Corrine
     Butterfield
     Capps
     Capuano
     Cardoza
     Carnahan
     Carney
     Castor
     Chandler
     Clarke
     Clay
     Cleaver
     Clyburn
     Cohen
     Cooper
     Costello
     Courtney
     Crowley
     Cuellar
     Davis (AL)
     Davis (CA)
     Davis (IL)
     Davis, Lincoln
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Dicks
     Dingell
     Doggett
     Doyle
     Edwards
     Ellison
     Ellsworth
     Emanuel
     Engel
     Eshoo
     Etheridge
     Farr
     Fattah
     Filner
     Frank (MA)
     Giffords
     Gilchrest
     Gillibrand
     Gordon
     Green, Al
     Green, Gene
     Grijalva
     Gutierrez
     Hall (NY)
     Hare
     Harman
     Hastings (FL)
     Herseth Sandlin
     Higgins
     Hill
     Hinchey
     Hinojosa
     Hirono
     Hodes
     Holden
     Holt
     Honda
     Hooley
     Hoyer
     Inslee
     Israel
     Jackson (IL)
     Jefferson
     Johnson (GA)
     Jones (OH)
     Kanjorski
     Kaptur
     Kennedy
     Kildee
     Kilpatrick
     Kind
     Kirk
     Klein (FL)
     Kucinich
     LaHood
     Langevin
     Larsen (WA)
     Larson (CT)
     Lee
     Levin
     Lewis (GA)
     Lipinski
     Loebsack
     Lofgren, Zoe
     Lowey
     Lynch
     Mahoney (FL)
     Maloney (NY)
     Markey
     Marshall
     Matheson
     Matsui
     McCarthy (NY)
     McCollum (MN)
     McDermott
     McGovern
     McIntyre
     McNerney
     McNulty
     Meeks (NY)
     Melancon
     Michaud
     Miller (NC)
     Miller, George
     Mitchell
     Mollohan
     Moore (KS)
     Moore (WI)
     Moran (VA)
     Murphy (CT)
     Murphy, Patrick
     Murtha
     Nadler
     Napolitano
     Neal (MA)
     Oberstar
     Obey
     Olver
     Pallone
     Pascrell
     Pastor
     Payne
     Perlmutter
     Peterson (MN)
     Platts
     Pomeroy
     Price (NC)
     Rahall
     Ramstad
     Richardson
     Ross
     Rothman
     Roybal-Allard
     Ruppersberger
     Ryan (OH)
     Salazar
     Sanchez, Linda T.
     Sanchez, Loretta
     Sarbanes
     Schakowsky
     Schiff
     Schwartz
     Scott (GA)
     Scott (VA)
     Serrano
     Sestak
     Shea-Porter
     Sherman
     Shuler
     Sires
     Skelton
     Slaughter
     Smith (WA)
     Snyder
     Solis
     Space
     Spratt
     Stark
     Stupak
     Sutton
     Tanner
     Tauscher
     Taylor
     Thompson (CA)
     Thompson (MS)
     Tierney
     Towns
     Tsongas
     Udall (CO)
     Udall (NM)
     Van Hollen
     Velazquez
     Visclosky
     Walz (MN)
     Wasserman Schultz
     Waters
     Watson
     Watt
     Waxman
     Weiner
     Welch (VT)
     Wexler
     Wilson (OH)
     Wu
     Wynn
     Yarmuth

                               NAYS--195

     Abercrombie
     Aderholt
     Akin
     Alexander
     Bachmann
     Bachus
     Barrett (SC)
     Barrow
     Bartlett (MD)
     Barton (TX)
     Bean
     Biggert
     Bilbray
     Bilirakis
     Bishop (UT)
     Blackburn
     Blunt
     Boehner
     Bonner
     Bono Mack
     Boozman
     Boustany
     Brady (TX)
     Broun (GA)
     Brown (SC)
     Buchanan
     Burgess
     Burton (IN)
     Buyer
     Calvert
     Camp (MI)
     Campbell (CA)
     Cannon
     Cantor
     Capito
     Carter
     Castle
     Chabot
     Coble
     Conaway
     Cramer
     Crenshaw
     Cubin
     Culberson
     Davis (KY)
     Davis, David
     Davis, Tom
     Deal (GA)
     Dent
     Diaz-Balart, L.
     Diaz-Balart, M.
     Donnelly
     Doolittle
     Drake
     Dreier
     Duncan
     Ehlers
     Emerson
     English (PA)
     Everett
     Fallin
     Feeney
     Ferguson
     Flake
     Forbes
     Fortenberry
     Fossella
     Foxx
     Franks (AZ)
     Frelinghuysen
     Gallegly
     Garrett (NJ)
     Gerlach
     Gingrey
     Gohmert
     Goode
     Goodlatte
     Granger
     Graves
     Hall (TX)
     Hastings (WA)
     Hayes
     Heller
     Hensarling
     Herger
     Hobson
     Hoekstra
     Hulshof
     Hunter
     Inglis (SC)
     Issa
     Jackson-Lee (TX)
     Johnson (IL)
     Johnson, Sam
     Jones (NC)
     Jordan
     Kagen
     King (IA)
     King (NY)
     Kingston
     Kline (MN)
     Knollenberg
     Kuhl (NY)
     Lamborn
     Lampson
     Latham
     LaTourette
     Latta
     Lewis (CA)
     Lewis (KY)
     Linder
     LoBiondo
     Lucas
     Lungren, Daniel E.
     Mack
     Manzullo
     Marchant
     McCarthy (CA)
     McCaul (TX)
     McCotter
     McCrery
     McHenry
     McHugh
     McKeon
     McMorris Rodgers
     Mica
     Miller (FL)
     Miller (MI)
     Miller, Gary
     Moran (KS)
     Murphy, Tim
     Musgrave
     Myrick
     Neugebauer
     Nunes
     Paul
     Pearce
     Pence
     Petri
     Pickering
     Pitts
     Porter
     Price (GA)
     Pryce (OH)
     Putnam
     Regula
     Rehberg
     Reichert
     Reynolds
     Rodriguez
     Rogers (AL)
     Rogers (KY)
     Rogers (MI)
     Rohrabacher
     Ros-Lehtinen
     Roskam
     Royce
     Ryan (WI)
     Sali
     Saxton
     Schmidt
     Sensenbrenner
     Sessions
     Shadegg
     Shays
     Shimkus
     Shuster
     Simpson

[[Page H1272]]


     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Souder
     Stearns
     Sullivan
     Tancredo
     Terry
     Thornberry
     Tiahrt
     Tiberi
     Turner
     Upton
     Walberg
     Walden (OR)
     Walsh (NY)
     Wamp
     Weldon (FL)
     Weller
     Westmoreland
     Whitfield (KY)
     Wilson (NM)
     Wilson (SC)
     Wittman (VA)
     Wolf
     Young (AK)
     Young (FL)

                             NOT VOTING--18

     Brown-Waite, Ginny
     Cole (OK)
     Conyers
     Costa
     Cummings
     Gonzalez
     Johnson, E. B.
     Keller
     Meek (FL)
     Ortiz
     Peterson (PA)
     Poe
     Radanovich
     Rangel
     Renzi
     Reyes
     Rush
     Woolsey


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore (during the vote). Members are advised there 
are 2 minutes remaining on this vote.

                              {time}  1606

  Ms. PRYCE of Ohio and Mr. GARY G. MILLER of California changed their 
vote from ``yea'' to ``nay.''
  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.
  Mr. HASTINGS of Washington. Mr. Speaker, on that I demand the yeas 
and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. This will be a 5-minute vote.
  The vote was taken by electronic device, and there were--yeas 209, 
nays 198, not voting 21, as follows:

                             [Roll No. 96]

                               YEAS--209

     Abercrombie
     Ackerman
     Allen
     Altmire
     Andrews
     Arcuri
     Baca
     Baird
     Baldwin
     Bean
     Becerra
     Berkley
     Berman
     Berry
     Bishop (GA)
     Bishop (NY)
     Blumenauer
     Boswell
     Boucher
     Boyd (FL)
     Boyda (KS)
     Brady (PA)
     Braley (IA)
     Brown, Corrine
     Butterfield
     Cannon
     Capps
     Capuano
     Cardoza
     Carnahan
     Carney
     Castor
     Chandler
     Clarke
     Clay
     Cleaver
     Clyburn
     Cohen
     Cooper
     Costa
     Costello
     Courtney
     Cramer
     Crowley
     Cummings
     Davis (AL)
     Davis (CA)
     Davis (IL)
     Davis, Lincoln
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Dicks
     Dingell
     Doggett
     Donnelly
     Doyle
     Edwards
     Ellison
     Ellsworth
     Emanuel
     Engel
     Eshoo
     Etheridge
     Farr
     Fattah
     Filner
     Frank (MA)
     Giffords
     Gillibrand
     Gordon
     Grijalva
     Gutierrez
     Hall (NY)
     Hare
     Harman
     Hastings (FL)
     Herseth Sandlin
     Higgins
     Hill
     Hinchey
     Hirono
     Hodes
     Holden
     Holt
     Honda
     Hooley
     Hoyer
     Inslee
     Israel
     Jackson (IL)
     Jefferson
     Johnson (GA)
     Jones (OH)
     Kanjorski
     Kaptur
     Kennedy
     Kildee
     Kilpatrick
     Kind
     Kirk
     Klein (FL)
     Kucinich
     LaHood
     Langevin
     Larsen (WA)
     Larson (CT)
     Lee
     Levin
     Lewis (GA)
     Lipinski
     Loebsack
     Lofgren, Zoe
     Lowey
     Lynch
     Mahoney (FL)
     Maloney (NY)
     Markey
     Marshall
     Matheson
     Matsui
     McCarthy (NY)
     McCollum (MN)
     McDermott
     McGovern
     McIntyre
     McNerney
     McNulty
     Meeks (NY)
     Melancon
     Michaud
     Miller (NC)
     Miller, George
     Mitchell
     Mollohan
     Moore (KS)
     Moore (WI)
     Moran (VA)
     Murphy (CT)
     Murphy, Patrick
     Murtha
     Nadler
     Napolitano
     Neal (MA)
     Oberstar
     Obey
     Olver
     Pallone
     Pascrell
     Payne
     Perlmutter
     Peterson (MN)
     Pomeroy
     Price (NC)
     Rahall
     Ramstad
     Richardson
     Rodriguez
     Rothman
     Roybal-Allard
     Ruppersberger
     Ryan (OH)
     Sanchez, Linda T.
     Sanchez, Loretta
     Sarbanes
     Schakowsky
     Schiff
     Schwartz
     Scott (GA)
     Scott (VA)
     Serrano
     Sestak
     Sherman
     Sires
     Skelton
     Slaughter
     Smith (WA)
     Solis
     Space
     Spratt
     Stupak
     Sutton
     Tanner
     Tauscher
     Taylor
     Thompson (CA)
     Thompson (MS)
     Tierney
     Towns
     Tsongas
     Udall (CO)
     Udall (NM)
     Van Hollen
     Velazquez
     Visclosky
     Walsh (NY)
     Walz (MN)
     Wasserman Schultz
     Waters
     Watson
     Watt
     Waxman
     Weiner
     Welch (VT)
     Wexler
     Wilson (OH)
     Wu
     Yarmuth

                               NAYS--198

     Aderholt
     Akin
     Alexander
     Bachmann
     Bachus
     Barrett (SC)
     Barrow
     Bartlett (MD)
     Barton (TX)
     Biggert
     Bilbray
     Bilirakis
     Bishop (UT)
     Blackburn
     Blunt
     Boehner
     Bonner
     Bono Mack
     Boozman
     Boren
     Boustany
     Brady (TX)
     Broun (GA)
     Brown (SC)
     Buchanan
     Burgess
     Burton (IN)
     Buyer
     Calvert
     Camp (MI)
     Campbell (CA)
     Cantor
     Capito
     Carter
     Castle
     Chabot
     Coble
     Conaway
     Crenshaw
     Cubin
     Cuellar
     Culberson
     Davis (KY)
     Davis, David
     Davis, Tom
     Deal (GA)
     Dent
     Diaz-Balart, L.
     Diaz-Balart, M.
     Doolittle
     Drake
     Dreier
     Duncan
     Ehlers
     Emerson
     English (PA)
     Everett
     Feeney
     Ferguson
     Flake
     Forbes
     Fortenberry
     Fossella
     Foxx
     Franks (AZ)
     Frelinghuysen
     Gallegly
     Garrett (NJ)
     Gerlach
     Gilchrest
     Gingrey
     Gohmert
     Goode
     Goodlatte
     Granger
     Graves
     Green, Al
     Green, Gene
     Hall (TX)
     Hastings (WA)
     Hayes
     Heller
     Hensarling
     Herger
     Hinojosa
     Hobson
     Hoekstra
     Hulshof
     Inglis (SC)
     Issa
     Jackson-Lee (TX)
     Johnson (IL)
     Johnson, Sam
     Jones (NC)
     Jordan
     Kagen
     King (IA)
     King (NY)
     Kingston
     Kline (MN)
     Knollenberg
     Kuhl (NY)
     Lamborn
     Lampson
     Latham
     LaTourette
     Latta
     Lewis (CA)
     Lewis (KY)
     Linder
     LoBiondo
     Lucas
     Lungren, Daniel E.
     Mack
     Manzullo
     Marchant
     McCarthy (CA)
     McCaul (TX)
     McCotter
     McCrery
     McHenry
     McHugh
     McKeon
     McMorris Rodgers
     Mica
     Miller (FL)
     Miller (MI)
     Miller, Gary
     Moran (KS)
     Murphy, Tim
     Musgrave
     Myrick
     Neugebauer
     Nunes
     Pastor
     Paul
     Pearce
     Pence
     Petri
     Pickering
     Pitts
     Platts
     Porter
     Price (GA)
     Pryce (OH)
     Putnam
     Regula
     Rehberg
     Reichert
     Reynolds
     Rogers (AL)
     Rogers (KY)
     Rogers (MI)
     Rohrabacher
     Ros-Lehtinen
     Roskam
     Ross
     Royce
     Ryan (WI)
     Salazar
     Sali
     Saxton
     Schmidt
     Sensenbrenner
     Sessions
     Shadegg
     Shays
     Shimkus
     Shuler
     Shuster
     Simpson
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Snyder
     Souder
     Stearns
     Sullivan
     Tancredo
     Terry
     Thornberry
     Tiahrt
     Tiberi
     Turner
     Upton
     Walberg
     Walden (OR)
     Wamp
     Weldon (FL)
     Weller
     Westmoreland
     Whitfield (KY)
     Wilson (NM)
     Wilson (SC)
     Wittman (VA)
     Wolf
     Young (AK)
     Young (FL)

                             NOT VOTING--21

     Brown-Waite, Ginny
     Cole (OK)
     Conyers
     Fallin
     Gonzalez
     Hunter
     Johnson, E. B.
     Keller
     Meek (FL)
     Ortiz
     Peterson (PA)
     Poe
     Radanovich
     Rangel
     Renzi
     Reyes
     Rush
     Shea-Porter
     Stark
     Woolsey
     Wynn


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore (during the vote). Members are advised there 
are 2 minutes remaining on the vote.

                              {time}  1613

  Mr. AL GREEN of Texas changed his vote from ``yea'' to ``nay.''
  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.

                          ____________________