[Congressional Record Volume 156, Number 133 (Wednesday, September 29, 2010)]
[House]
[Pages H7230-H7257]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         JAMES ZADROGA 9/11 HEALTH AND COMPENSATION ACT OF 2010

  Mr. NADLER. Mr. Speaker, pursuant to House Resolution 1674, I call up 
the bill (H.R. 847) to amend the Public Health Service Act to extend 
and improve protections and services to individuals directly impacted 
by the terrorist attack in New York City on September 11, 2001, and for 
other purposes, and ask for its immediate consideration.
  The Clerk read the title of the bill.
  The SPEAKER pro tempore. Pursuant to House Resolution 1674, in lieu 
of the amendments recommended by the Committee on Energy and Commerce 
and the Committee on the Judiciary now printed in the bill, the 
amendment in the nature of a substitute printed in House Report 111-648 
is adopted and the bill, as amended, is considered read.
  The text of the bill, as amended, is as follows:

                                H.R. 847

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

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``James 
     Zadroga 9/11 Health and Compensation Act of 2010''.
       (b) Table of Contents.--The table of contents of this Act 
     is as follows:

Sec. 1. Short title; table of contents.

               TITLE I--WORLD TRADE CENTER HEALTH PROGRAM

Sec. 101. World Trade Center Health Program.

           ``TITLE XXXIII--WORLD TRADE CENTER HEALTH PROGRAM

       ``Subtitle A--Establishment of Program; Advisory Committee

``Sec. 3301. Establishment of World Trade Center Health Program.
``Sec. 3302. WTC Health Program Scientific/Technical Advisory 
              Committee; WTC Health Program Steering Committees.
``Sec. 3303. Education and outreach.
``Sec. 3304. Uniform data collection and analysis.
``Sec. 3305. Clinical Centers of Excellence and Data Centers.
``Sec. 3306. Definitions.

 ``Subtitle B--Program of Monitoring, Initial Health Evaluations, and 
                               Treatment

                        ``Part 1--WTC Responders

``Sec. 3311. Identification of WTC responders and provision of WTC-
              related monitoring services.
``Sec. 3312. Treatment of enrolled WTC responders for WTC-related 
              health conditions.
``Sec. 3313. National arrangement for benefits for eligible individuals 
              outside New York.

                        ``Part 2--WTC Survivors

``Sec. 3321. Identification and initial health evaluation of screening-
              eligible and certified-eligible WTC survivors.
``Sec. 3322. Followup monitoring and treatment of certified-eligible 
              WTC survivors for WTC-related health conditions.
``Sec. 3323. Followup monitoring and treatment of other individuals 
              with WTC-related health conditions.

                       ``Part 3--Payor Provisions

``Sec. 3331. Payment of claims.
``Sec. 3332. Administrative arrangement authority.

                 ``Subtitle C--Research Into Conditions

``Sec. 3341. Research regarding certain health conditions related to 
              September 11 terrorist attacks.
``Sec. 3342. World Trade Center Health Registry.

                         ``Subtitle D--Funding

``Sec. 3351. World Trade Center Health Program Fund.

       TITLE II--SEPTEMBER 11TH VICTIM COMPENSATION FUND OF 2001

Sec. 201. Definitions.
Sec. 202. Extended and expanded eligibility for compensation.
Sec. 203. Requirement to update regulations.
Sec. 204. Limited liability for certain claims.
Sec. 205. Funding; attorney fees.

    TITLE III--LIMITATION ON TREATY BENEFITS FOR CERTAIN DEDUCTIBLE 
        PAYMENTS; TIME FOR PAYMENT OF CORPORATE ESTIMATED TAXES

Sec. 301. Limitation on treaty benefits for certain deductible 
              payments.
Sec. 302. Time for payment of corporate estimated taxes.

                      TITLE IV--BUDGETARY EFFECTS

Sec. 401. Compliance with Statutory Pay-As-You-Go Act of 2010.

               TITLE I--WORLD TRADE CENTER HEALTH PROGRAM

     SEC. 101. WORLD TRADE CENTER HEALTH PROGRAM.

       The Public Health Service Act is amended by adding at the 
     end the following new title:

           ``TITLE XXXIII--WORLD TRADE CENTER HEALTH PROGRAM

       ``Subtitle A--Establishment of Program; Advisory Committee

     ``SEC. 3301. ESTABLISHMENT OF WORLD TRADE CENTER HEALTH 
                   PROGRAM.

       ``(a) In General.--There is hereby established within the 
     Department of Health and Human Services a program to be known 
     as the World Trade Center Health Program, which shall be 
     administered by the WTC Program Administrator, to provide 
     beginning on July 1, 2011--
       ``(1) medical monitoring and treatment benefits to eligible 
     emergency responders and recovery and cleanup workers 
     (including those who are Federal employees) who responded to 
     the September 11, 2001, terrorist attacks; and
       ``(2) initial health evaluation, monitoring, and treatment 
     benefits to residents and other building occupants and area 
     workers in New York City who were directly impacted and 
     adversely affected by such attacks.
       ``(b) Components of Program.--The WTC Program includes the 
     following components:
       ``(1) Medical monitoring for responders.--Medical 
     monitoring under section 3311, including clinical 
     examinations and long-term health monitoring and analysis for 
     enrolled WTC responders who were likely to have been exposed 
     to airborne toxins that were released, or to other hazards, 
     as a result of the September 11, 2001, terrorist attacks.
       ``(2) Initial health evaluation for survivors.--An initial 
     health evaluation under section 3321, including an evaluation 
     to determine eligibility for followup monitoring and 
     treatment.
       ``(3) Followup monitoring and treatment for wtc-related 
     health conditions for responders and survivors.--Provision 
     under sections 3312, 3322, and 3323 of followup monitoring 
     and treatment and payment, subject to the provisions of 
     subsection (d), for all medically necessary health and mental 
     health care expenses of an individual with respect to a WTC-
     related health condition (including necessary prescription 
     drugs).
       ``(4) Outreach.--Establishment under section 3303 of an 
     education and outreach program to potentially eligible 
     individuals concerning the benefits under this title.
       ``(5) Clinical data collection and analysis.--Collection 
     and analysis under section 3304 of health and mental health 
     data relating to individuals receiving monitoring or 
     treatment benefits in a uniform manner in collaboration with 
     the collection of epidemiological data under section 3342.
       ``(6) Research on health conditions.--Establishment under 
     subtitle C of a research program on health conditions 
     resulting from the September 11, 2001, terrorist attacks.
       ``(c) No Cost Sharing.--Monitoring and treatment benefits 
     and initial health evaluation benefits are provided under 
     subtitle B without any deductibles, copayments, or other cost 
     sharing to an enrolled WTC responder or certified-eligible 
     WTC survivor.

[[Page H7231]]

     Initial health evaluation benefits are provided under 
     subtitle B without any deductibles, copayments, or other cost 
     sharing to a screening-eligible WTC survivor.
       ``(d) Preventing Fraud and Unreasonable Administrative 
     Costs.--
       ``(1) Fraud.--The Inspector General of the Department of 
     Health and Human Services shall develop and implement a 
     program to review the WTC Program's health care expenditures 
     to detect fraudulent or duplicate billing and payment for 
     inappropriate services. This title is a Federal health care 
     program (as defined in section 1128B(f) of the Social 
     Security Act) and is a health plan (as defined in section 
     1128C(c) of such Act) for purposes of applying sections 1128 
     through 1128E of such Act.
       ``(2) Unreasonable administrative costs.--The Inspector 
     General of the Department of Health and Human Services shall 
     develop and implement a program to review the WTC Program for 
     unreasonable administrative costs, including with respect to 
     infrastructure, administration, and claims processing.
       ``(e) Quality Assurance.--The WTC Program Administrator 
     working with the Clinical Centers of Excellence shall develop 
     and implement a quality assurance program for the monitoring 
     and treatment delivered by such Centers of Excellence and any 
     other participating health care providers. Such program shall 
     include--
       ``(1) adherence to monitoring and treatment protocols;
       ``(2) appropriate diagnostic and treatment referrals for 
     participants;
       ``(3) prompt communication of test results to participants; 
     and
       ``(4) such other elements as the Administrator specifies in 
     consultation with the Clinical Centers of Excellence.
       ``(f) Annual Program Report.--
       ``(1) In general.--Not later than 6 months after the end of 
     each fiscal year in which the WTC Program is in operation, 
     the WTC Program Administrator shall submit an annual report 
     to the Congress on the operations of this title for such 
     fiscal year and for the entire period of operation of the 
     program.
       ``(2) Contents included in report.--Each annual report 
     under paragraph (1) shall include at least the following:
       ``(A) Eligible individuals.--Information for each clinical 
     program described in paragraph (3)--
       ``(i) on the number of individuals who applied for 
     certification under subtitle B and the number of such 
     individuals who were so certified;
       ``(ii) of the individuals who were certified, on the number 
     who received monitoring under the program and the number of 
     such individuals who received medical treatment under the 
     program;
       ``(iii) with respect to individuals so certified who 
     received such treatment, on the WTC-related health conditions 
     for which they were treated; and
       ``(iv) on the projected number of individuals who will be 
     certified under subtitle B in the succeeding fiscal year and 
     the succeeding 10-year period.
       ``(B) Monitoring, initial health evaluation, and treatment 
     costs.--For each clinical program so described--
       ``(i) information on the costs of monitoring and initial 
     health evaluation and the costs of treatment and on the 
     estimated costs of such monitoring, evaluation, and treatment 
     in the succeeding fiscal year; and
       ``(ii) an estimate of the cost of medical treatment for 
     WTC-related health conditions that have been paid for or 
     reimbursed by workers' compensation, by public or private 
     health plans, or by New York City under section 3331.
       ``(C) Administrative costs.--Information on the cost of 
     administering the program, including costs of program 
     support, data collection and analysis, and research conducted 
     under the program.
       ``(D) Administrative experience.--Information on the 
     administrative performance of the program, including--
       ``(i) the performance of the program in providing timely 
     evaluation of and treatment to eligible individuals; and
       ``(ii) a list of the Clinical Centers of Excellence and 
     other providers that are participating in the program.
       ``(E) Scientific reports.--A summary of the findings of any 
     new scientific reports or studies on the health effects 
     associated with exposure described in section 3306(1), 
     including the findings of research conducted under section 
     3341(a).
       ``(F) Advisory committee recommendations.--A list of 
     recommendations by the WTC Scientific/Technical Advisory 
     Committee on additional WTC Program eligibility criteria and 
     on additional WTC-related health conditions and the action of 
     the WTC Program Administrator concerning each such 
     recommendation.
       ``(3) Separate clinical programs described.--In paragraph 
     (2), each of the following shall be treated as a separate 
     clinical program of the WTC Program:
       ``(A) Firefighters and related personnel.--The benefits 
     provided for enrolled WTC responders described in section 
     3311(a)(2)(A).
       ``(B) Other wtc responders.--The benefits provided for 
     enrolled WTC responders not described in subparagraph (A).
       ``(C) WTC survivors.--The benefits provided for screening-
     eligible WTC survivors and certified-eligible WTC survivors 
     in section 3321(a).
       ``(g) Notification to Congress Upon Reaching 80 Percent of 
     Eligibility Numerical Limits.--The Secretary shall promptly 
     notify the Congress of each of the following:
       ``(1) When the number of enrollments of WTC responders 
     subject to the limit established under section 3311(a)(4) has 
     reached 80 percent of such limit.
       ``(2) When the number of certifications for certified-
     eligible WTC survivors subject to the limit established under 
     section 3321(a)(3) has reached 80 percent of such limit.
       ``(h) Consultation.--The WTC Program Administrator shall 
     engage in ongoing outreach and consultation with relevant 
     stakeholders, including the WTC Health Program Steering 
     Committees and the Advisory Committee under section 3302, 
     regarding the implementation and improvement of programs 
     under this title.

     ``SEC. 3302. WTC HEALTH PROGRAM SCIENTIFIC/TECHNICAL ADVISORY 
                   COMMITTEE; WTC HEALTH PROGRAM STEERING 
                   COMMITTEES.

       ``(a) Advisory Committee.--
       ``(1) Establishment.--The WTC Program Administrator shall 
     establish an advisory committee to be known as the WTC Health 
     Program Scientific/Technical Advisory Committee (in this 
     subsection referred to as the `Advisory Committee') to review 
     scientific and medical evidence and to make recommendations 
     to the Administrator on additional WTC Program eligibility 
     criteria and on additional WTC-related health conditions.
       ``(2) Composition.--The WTC Program Administrator shall 
     appoint the members of the Advisory Committee and shall 
     include at least--
       ``(A) 4 occupational physicians, at least 2 of whom have 
     experience treating WTC rescue and recovery workers;
       ``(B) 1 physician with expertise in pulmonary medicine;
       ``(C) 2 environmental medicine or environmental health 
     specialists;
       ``(D) 2 representatives of WTC responders;
       ``(E) 2 representatives of certified-eligible WTC 
     survivors;
       ``(F) an industrial hygienist;
       ``(G) a toxicologist;
       ``(H) an epidemiologist; and
       ``(I) a mental health professional.
       ``(3) Meetings.--The Advisory Committee shall meet at such 
     frequency as may be required to carry out its duties.
       ``(4) Reports.--The WTC Program Administrator shall provide 
     for publication of recommendations of the Advisory Committee 
     on the public Web site established for the WTC Program.
       ``(5) Duration.--Notwithstanding any other provision of 
     law, the Advisory Committee shall continue in operation 
     during the period in which the WTC Program is in operation.
       ``(6) Application of faca.--Except as otherwise 
     specifically provided, the Advisory Committee shall be 
     subject to the Federal Advisory Committee Act.
       ``(b) WTC Health Program Steering Committees.--
       ``(1) Consultation.--The WTC Program Administrator shall 
     consult with 2 steering committees (each in this section 
     referred to as a `Steering Committee') that are established 
     as follows:
       ``(A) WTC responders steering committee.--One Steering 
     Committee, to be known as the WTC Responders Steering 
     Committee, for the purpose of receiving input from affected 
     stakeholders and facilitating the coordination of monitoring 
     and treatment programs for the enrolled WTC responders under 
     part 1 of subtitle B.
       ``(B) WTC survivors steering committee.--One Steering 
     Committee, to be known as the WTC Survivors Steering 
     Committee, for the purpose of receiving input from affected 
     stakeholders and facilitating the coordination of initial 
     health evaluations, monitoring, and treatment programs for 
     screening-eligible and certified-eligible WTC survivors under 
     part 2 of subtitle B.
       ``(2) Membership.--
       ``(A) WTC responders steering committee.--
       ``(i) Representation.--The WTC Responders Steering 
     Committee shall include--

       ``(I) representatives of the Centers of Excellence 
     providing services to WTC responders;
       ``(II) representatives of labor organizations representing 
     firefighters, police, other New York City employees, and 
     recovery and cleanup workers who responded to the September 
     11, 2001, terrorist attacks; and
       ``(III) 3 representatives of New York City, 1 of whom will 
     be selected by the police commissioner of New York City, 1 by 
     the health commissioner of New York City, and 1 by the mayor 
     of New York City.

       ``(ii) Initial membership.--The WTC Responders Steering 
     Committee shall initially be composed of members of the WTC 
     Monitoring and Treatment Program Steering Committee (as in 
     existence on the day before the date of the enactment of this 
     title).
       ``(B) WTC survivors steering committee.--
       ``(i) Representation.--The WTC Survivors Steering Committee 
     shall include representatives of--

       ``(I) the Centers of Excellence providing services to 
     screening-eligible and certified-eligible WTC survivors;
       ``(II) the population of residents, students, and area and 
     other workers affected by the September 11, 2001, terrorist 
     attacks;
       ``(III) screening-eligible and certified-eligible survivors 
     receiving initial health evaluations, monitoring, or 
     treatment under part 2

[[Page H7232]]

     of subtitle B and organizations advocating on their behalf; 
     and
       ``(IV) New York City.

       ``(ii) Initial membership.--The WTC Survivors Steering 
     Committee shall initially be composed of members of the WTC 
     Environmental Health Center Survivor Advisory Committee (as 
     in existence on the day before the date of the enactment of 
     this title).
       ``(C) Additional appointments.--Each Steering Committee may 
     recommend, if approved by a majority of voting members of the 
     Committee, additional members to the Committee.
       ``(D) Vacancies.--A vacancy in a Steering Committee shall 
     be filled by an individual recommended by the Steering 
     Committee.

     ``SEC. 3303. EDUCATION AND OUTREACH.

       ``The WTC Program Administrator shall institute a program 
     that provides education and outreach on the existence and 
     availability of services under the WTC Program. The outreach 
     and education program--
       ``(1) shall include--
       ``(A) the establishment of a public Web site with 
     information about the WTC Program;
       ``(B) meetings with potentially eligible populations;
       ``(C) development and dissemination of outreach materials 
     informing people about the program; and
       ``(D) the establishment of phone information services; and
       ``(2) shall be conducted in a manner intended--
       ``(A) to reach all affected populations; and
       ``(B) to include materials for culturally and 
     linguistically diverse populations.

     ``SEC. 3304. UNIFORM DATA COLLECTION AND ANALYSIS.

       ``(a) In General.--The WTC Program Administrator shall 
     provide for the uniform collection of data (and analysis of 
     data and regular reports to the Administrator) on the 
     prevalence of WTC-related health conditions and the 
     identification of new WTC-related health conditions. Such 
     data shall be collected for all individuals provided 
     monitoring or treatment benefits under subtitle B and 
     regardless of their place of residence or Clinical Center of 
     Excellence through which the benefits are provided. The WTC 
     Program Administrator shall provide, through the Data Centers 
     or otherwise, for the integration of such data into the 
     monitoring and treatment program activities under this title.
       ``(b) Coordinating Through Centers of Excellence.--Each 
     Clinical Center of Excellence shall collect data described in 
     subsection (a) and report such data to the corresponding Data 
     Center for analysis by such Data Center.
       ``(c) Collaboration With WTC Health Registry.--The WTC 
     Program Administrator shall provide for collaboration between 
     the Data Centers and the World Trade Center Health Registry 
     described in section 3342.
       ``(d) Privacy.--The data collection and analysis under this 
     section shall be conducted and maintained in a manner that 
     protects the confidentiality of individually identifiable 
     health information consistent with applicable statutes and 
     regulations, including, as applicable, HIPAA privacy and 
     security law (as defined in section 3009(a)(2)) and section 
     552a of title 5, United States Code.

     ``SEC. 3305. CLINICAL CENTERS OF EXCELLENCE AND DATA CENTERS.

       ``(a) In General.--
       ``(1) Contracts with clinical centers of excellence.--The 
     WTC Program Administrator shall, subject to subsection 
     (b)(1)(B), enter into contracts with Clinical Centers of 
     Excellence (as defined in subsection (b)(1)(A))--
       ``(A) for the provision of monitoring and treatment 
     benefits and initial health evaluation benefits under 
     subtitle B;
       ``(B) for the provision of outreach activities to 
     individuals eligible for such monitoring and treatment 
     benefits, for initial health evaluation benefits, and for 
     followup to individuals who are enrolled in the monitoring 
     program;
       ``(C) for the provision of counseling for benefits under 
     subtitle B, with respect to WTC-related health conditions, 
     for individuals eligible for such benefits;
       ``(D) for the provision of counseling for benefits for WTC-
     related health conditions that may be available under 
     workers' compensation or other benefit programs for work-
     related injuries or illnesses, health insurance, disability 
     insurance, or other insurance plans or through public or 
     private social service agencies and assisting eligible 
     individuals in applying for such benefits;
       ``(E) for the provision of translational and interpretive 
     services for program participants who are not English 
     language proficient; and
       ``(F) for the collection and reporting of data in 
     accordance with section 3304.
       ``(2) Contracts with data centers.--
       ``(A) In general.--The WTC Program Administrator shall 
     enter into contracts with Data Centers (as defined in 
     subsection (b)(2))--
       ``(i) for receiving, analyzing, and reporting to the WTC 
     Program Administrator on data, in accordance with section 
     3304, that have been collected and reported to such Data 
     Centers by the corresponding Clinical Centers of Excellence 
     under subsection (b)(1)(B)(iii);
       ``(ii) for the development of monitoring, initial health 
     evaluation, and treatment protocols, with respect to WTC-
     related health conditions;
       ``(iii) for coordinating the outreach activities conducted 
     under paragraph (1)(B) by each corresponding Clinical Center 
     of Excellence;
       ``(iv) for establishing criteria for the credentialing of 
     medical providers participating in the nationwide network 
     under section 3313;
       ``(v) for coordinating and administering the activities of 
     the WTC Health Program Steering Committees established under 
     section 3002(b); and
       ``(vi) for meeting periodically with the corresponding 
     Clinical Centers of Excellence to obtain input on the 
     analysis and reporting of data collected under clause (i) and 
     on the development of monitoring, initial health evaluation, 
     and treatment protocols under clause (ii).
       ``(B) Medical provider selection.--The medical providers 
     under subparagraph (A)(iv) shall be selected by the WTC 
     Program Administrator on the basis of their experience 
     treating or diagnosing the health conditions included in the 
     list of WTC-related health conditions.
       ``(C) Clinical discussions.--In carrying out subparagraph 
     (A)(ii), a Data Center shall engage in clinical discussions 
     across the WTC Program to guide treatment approaches for 
     individuals with a WTC-related health condition.
       ``(D) Transparency of data.--A contract entered into under 
     this subsection with a Data Center shall require the Data 
     Center to make any data collected and reported to such Center 
     under subsection (b)(1)(B)(iii) available to health 
     researchers and others as provided in the CDC/ATSDR Policy on 
     Releasing and Sharing Data.
       ``(3) Authority for contracts to be class specific.--A 
     contract entered into under this subsection with a Clinical 
     Center of Excellence or a Data Center may be with respect to 
     one or more class of enrolled WTC responders, screening-
     eligible WTC survivors, or certified-eligible WTC survivors.
       ``(4) Use of cooperative agreements.--Any contract under 
     this title between the WTC Program Administrator and a Data 
     Center or a Clinical Center of Excellence may be in the form 
     of a cooperative agreement.
       ``(b) Centers of Excellence.--
       ``(1) Clinical centers of excellence.--
       ``(A) Definition.--For purposes of this title, the term 
     `Clinical Center of Excellence' means a Center that 
     demonstrates to the satisfaction of the Administrator that 
     the Center--
       ``(i) uses an integrated, centralized health care provider 
     approach to create a comprehensive suite of health services 
     under this title that are accessible to enrolled WTC 
     responders, screening-eligible WTC survivors, or certified-
     eligible WTC survivors;
       ``(ii) has experience in caring for WTC responders and 
     screening-eligible WTC survivors or includes health care 
     providers who have been trained pursuant to section 3313(c);
       ``(iii) employs health care provider staff with expertise 
     that includes, at a minimum, occupational medicine, 
     environmental medicine, trauma-related psychiatry and 
     psychology, and social services counseling; and
       ``(iv) meets such other requirements as specified by the 
     Administrator.
       ``(B) Contract requirements.--The WTC Program Administrator 
     shall not enter into a contract with a Clinical Center of 
     Excellence under subsection (a)(1) unless the Center agrees 
     to do each of the following:
       ``(i) Establish a formal mechanism for consulting with and 
     receiving input from representatives of eligible populations 
     receiving monitoring and treatment benefits under subtitle B 
     from such Center.
       ``(ii) Coordinate monitoring and treatment benefits under 
     subtitle B with routine medical care provided for the 
     treatment of conditions other than WTC-related health 
     conditions.
       ``(iii) Collect and report to the corresponding Data Center 
     data in accordance with section 3304(b).
       ``(iv) Have in place safeguards against fraud that are 
     satisfactory to the Administrator, in consultation with the 
     Inspector General of the Department of Health and Human 
     Services.
       ``(v) Treat or refer for treatment all individuals who are 
     enrolled WTC responders or certified-eligible WTC survivors 
     with respect to such Center who present themselves for 
     treatment of a WTC-related health condition.
       ``(vi) Have in place safeguards, consistent with section 
     3304(c), to ensure the confidentiality of an individual's 
     individually identifiable health information, including 
     requiring that such information not be disclosed to the 
     individual's employer without the authorization of the 
     individual.
       ``(vii) Use amounts paid under subsection (c)(1) only for 
     costs incurred in carrying out the activities described in 
     subsection (a), other than those described in subsection 
     (a)(1)(A).
       ``(viii) Utilize health care providers with occupational 
     and environmental medicine expertise to conduct physical and 
     mental health assessments, in accordance with protocols 
     developed under subsection (a)(2)(A)(ii).
       ``(ix) Communicate with WTC responders and screening-
     eligible and certified-eligible WTC survivors in appropriate 
     languages and conduct outreach activities with relevant 
     stakeholder worker or community associations.

[[Page H7233]]

       ``(x) Meet all the other applicable requirements of this 
     title, including regulations implementing such requirements.
       ``(C) Transition rule to ensure continuity of care.--The 
     WTC Program Administrator shall to the maximum extent 
     feasible ensure continuity of care in any period of 
     transition from monitoring and treatment of an enrolled WTC 
     responder or certified-eligible WTC survivor by a provider to 
     a Clinical Center of Excellence or a health care provider 
     participating in the nationwide network under section 3313.
       ``(2) Data centers.--For purposes of this title, the term 
     `Data Center' means a Center that the WTC Program 
     Administrator determines has the capacity to carry out the 
     responsibilities for a Data Center under subsection (a)(2).
       ``(3) Corresponding centers.--For purposes of this title, a 
     Clinical Center of Excellence and a Data Center shall be 
     treated as `corresponding' to the extent that such Clinical 
     Center and Data Center serve the same population group.
       ``(c) Payment for Infrastructure Costs.--
       ``(1) In general.--The WTC Program Administrator shall 
     reimburse a Clinical Center of Excellence for the fixed 
     infrastructure costs of such Center in carrying out the 
     activities described in subtitle B at a rate negotiated by 
     the Administrator and such Centers. Such negotiated rate 
     shall be fair and appropriate and take into account the 
     number of enrolled WTC responders receiving services from 
     such Center under this title.
       ``(2) Fixed infrastructure costs.--For purposes of 
     paragraph (1), the term `fixed infrastructure costs' means, 
     with respect to a Clinical Center of Excellence, the costs 
     incurred by such Center that are not reimbursable by the WTC 
     Program Administrator under section 3312(c).

     ``SEC. 3306. DEFINITIONS.

       ``In this title:
       ``(1) The term `aggravating' means, with respect to a 
     health condition, a health condition that existed on 
     September 11, 2001, and that, as a result of exposure to 
     airborne toxins, any other hazard, or any other adverse 
     condition resulting from the September 11, 2001, terrorist 
     attacks, requires medical treatment that is (or will be) in 
     addition to, more frequent than, or of longer duration than 
     the medical treatment that would have been required for such 
     condition in the absence of such exposure.
       ``(2) The term `certified-eligible WTC survivor' has the 
     meaning given such term in section 3321(a)(2).
       ``(3) The terms `Clinical Center of Excellence' and `Data 
     Center' have the meanings given such terms in section 3305.
       ``(4) The term `enrolled WTC responder' means a WTC 
     responder enrolled under section 3311(a)(3).
       ``(5) The term `initial health evaluation' includes, with 
     respect to an individual, a medical and exposure history, a 
     physical examination, and additional medical testing as 
     needed to evaluate whether the individual has a WTC-related 
     health condition and is eligible for treatment under the WTC 
     Program.
       ``(6) The term `list of WTC-related health conditions' 
     means--
       ``(A) for WTC responders, the health conditions listed in 
     section 3312(a)(3); and
       ``(B) for screening-eligible and certified-eligible WTC 
     survivors, the health conditions listed in section 3322(b).
       ``(7) The term `New York City disaster area' means the area 
     within New York City that is--
       ``(A) the area of Manhattan that is south of Houston 
     Street; and
       ``(B) any block in Brooklyn that is wholly or partially 
     contained within a 1.5-mile radius of the former World Trade 
     Center site.
       ``(8) The term `New York metropolitan area' means an area, 
     specified by the WTC Program Administrator, within which WTC 
     responders and eligible WTC screening-eligible survivors who 
     reside in such area are reasonably able to access monitoring 
     and treatment benefits and initial health evaluation benefits 
     under this title through a Clinical Center of Excellence 
     described in subparagraphs (A), (B), or (C) of section 
     3305(b)(1).
       ``(9) The term `screening-eligible WTC survivor' has the 
     meaning given such term in section 3321(a)(1).
       ``(10) Any reference to `September 11, 2001' shall be 
     deemed a reference to the period on such date subsequent to 
     the terrorist attacks at the World Trade Center, Shanksville, 
     Pennsylvania, or the Pentagon, as applicable, on such date.
       ``(11) The term `September 11, 2001, terrorist attacks' 
     means the terrorist attacks that occurred on September 11, 
     2001, in New York City, in Shanksville, Pennsylvania, and at 
     the Pentagon, and includes the aftermath of such attacks.
       ``(12) The term `WTC Health Program Steering Committee' 
     means such a Steering Committee established under section 
     3302(b).
       ``(13) The term `WTC Program' means the Word Trade Center 
     Health Program established under section 3301(a).
       ``(14) The term `WTC Program Administrator' means--
       ``(A) with respect to paragraphs (3) and (4) of section 
     3311(a) (relating to enrollment of WTC responders), section 
     3312(c) and the corresponding provisions of section 3322 
     (relating to payment for initial health evaluation, 
     monitoring, and treatment), paragraphs (1)(C), (2)(B), and 
     (3) of section 3321(a) (relating to determination or 
     certification of screening-eligible or certified-eligible WTC 
     responders), and part 3 of subtitle B (relating to payor 
     provisions), an official in the Department of Health and 
     Human Services, to be designated by the Secretary; and
       ``(B) with respect to any other provision of this title, 
     the Director of the National Institute for Occupational 
     Safety and Health, or a designee of such Director.
       ``(15) The term `WTC-related health condition' is defined 
     in section 3312(a).
       ``(16) The term `WTC responder' is defined in section 
     3311(a).
       ``(17) The term `WTC Scientific/Technical Advisory 
     Committee' means such Committee established under section 
     3302(a).

 ``Subtitle B--Program of Monitoring, Initial Health Evaluations, and 
                               Treatment

                        ``PART 1--WTC RESPONDERS

     ``SEC. 3311. IDENTIFICATION OF WTC RESPONDERS AND PROVISION 
                   OF WTC-RELATED MONITORING SERVICES.

       ``(a) WTC Responder Defined.--
       ``(1) In general.--For purposes of this title, the term 
     `WTC responder' means any of the following individuals, 
     subject to paragraph (4):
       ``(A) Currently identified responder.--An individual who 
     has been identified as eligible for monitoring under the 
     arrangements as in effect on the date of the enactment of 
     this title between the National Institute for Occupational 
     Safety and Health and--
       ``(i) the consortium coordinated by Mt. Sinai Hospital in 
     New York City that coordinates the monitoring and treatment 
     for enrolled WTC responders other than with respect to those 
     covered under the arrangement with the Fire Department of New 
     York City; or
       ``(ii) the Fire Department of New York City.
       ``(B) Responder who meets current eligibility criteria.--An 
     individual who meets the current eligibility criteria 
     described in paragraph (2).
       ``(C) Responder who meets modified eligibility criteria.--
     An individual who--
       ``(i) performed rescue, recovery, demolition, debris 
     cleanup, or other related services in the New York City 
     disaster area in response to the September 11, 2001, 
     terrorist attacks, regardless of whether such services were 
     performed by a State or Federal employee or member of the 
     National Guard or otherwise; and
       ``(ii) meets such eligibility criteria relating to exposure 
     to airborne toxins, other hazards, or adverse conditions 
     resulting from the September 11, 2001, terrorist attacks as 
     the WTC Program Administrator, after consultation with the 
     WTC Scientific/Technical Advisory Committee, determines 
     appropriate.
     The WTC Program Administrator shall not modify such 
     eligibility criteria on or after the date that the number of 
     enrollments of WTC responders has reached 80 percent of the 
     limit described in paragraph (4) or on or after the date that 
     the number of certifications for certified-eligible WTC 
     survivors under section 3321(a)(2)(B) has reached 80 percent 
     of the limit described in section 3321(a)(3).
       ``(2) Current eligibility criteria.--The eligibility 
     criteria described in this paragraph for an individual is 
     that the individual is described in any of the following 
     categories:
       ``(A) Firefighters and related personnel.--The individual--
       ``(i) was a member of the Fire Department of New York City 
     (whether fire or emergency personnel, active or retired) who 
     participated at least one day in the rescue and recovery 
     effort at any of the former World Trade Center sites 
     (including Ground Zero, Staten Island Landfill, and the New 
     York City Chief Medical Examiner's Office) for any time 
     during the period beginning on September 11, 2001, and ending 
     on July 31, 2002; or
       ``(ii)(I) is a surviving immediate family member of an 
     individual who was a member of the Fire Department of New 
     York City (whether fire or emergency personnel, active or 
     retired) and was killed at the World Trade site on September 
     11, 2001; and
       ``(II) received any treatment for a WTC-related health 
     condition described in section 3312(a)(1)(A)(ii) (relating to 
     mental health conditions) on or before September 1, 2008.
       ``(B) Law enforcement officers and wtc rescue, recovery, 
     and cleanup workers.--The individual--
       ``(i) worked or volunteered onsite in rescue, recovery, 
     debris cleanup, or related support services in lower 
     Manhattan (south of Canal St.), the Staten Island Landfill, 
     or the barge loading piers, for at least 4 hours during the 
     period beginning on September 11, 2001, and ending on 
     September 14, 2001, for at least 24 hours during the period 
     beginning on September 11, 2001, and ending on September 30, 
     2001, or for at least 80 hours during the period beginning on 
     September 11, 2001, and ending on July 31, 2002;
       ``(ii)(I) was a member of the Police Department of New York 
     City (whether active or retired) or a member of the Port 
     Authority Police of the Port Authority of New York and New 
     Jersey (whether active or retired) who participated onsite in 
     rescue, recovery, debris cleanup, or related services in 
     lower Manhattan (south of Canal St.), including Ground Zero, 
     the Staten Island Landfill, or the barge loading piers, for 
     at least 4 hours during the period beginning September 11, 
     2001, and ending on September 14, 2001;
       ``(II) participated onsite in rescue, recovery, debris 
     cleanup, or related services in at Ground Zero, the Staten 
     Island Landfill, or

[[Page H7234]]

     the barge loading piers, for at least one day during the 
     period beginning on September 11, 2001, and ending on July 
     31, 2002;
       ``(III) participated onsite in rescue, recovery, debris 
     cleanup, or related services in lower Manhattan (south of 
     Canal St.) for at least 24 hours during the period beginning 
     on September 11, 2001, and ending on September 30, 2001; or
       ``(IV) participated onsite in rescue, recovery, debris 
     cleanup, or related services in lower Manhattan (south of 
     Canal St.) for at least 80 hours during the period beginning 
     on September 11, 2001, and ending on July 31, 2002;
       ``(iii) was an employee of the Office of the Chief Medical 
     Examiner of New York City involved in the examination and 
     handling of human remains from the World Trade Center 
     attacks, or other morgue worker who performed similar post-
     September 11 functions for such Office staff, during the 
     period beginning on September 11, 2001, and ending on July 
     31, 2002;
       ``(iv) was a worker in the Port Authority Trans-Hudson 
     Corporation Tunnel for at least 24 hours during the period 
     beginning on February 1, 2002, and ending on July 1, 2002; or
       ``(v) was a vehicle-maintenance worker who was exposed to 
     debris from the former World Trade Center while retrieving, 
     driving, cleaning, repairing, and maintaining vehicles 
     contaminated by airborne toxins from the September 11, 2001, 
     terrorist attacks during a duration and period described in 
     subparagraph (A).
       ``(C) Responders to the september 11 attacks at the 
     pentagon and shanksville, pennsylvania.--The individual--
       ``(i)(I) was a member of a fire or police department 
     (whether fire or emergency personnel, active or retired), 
     worked for a recovery or cleanup contractor, or was a 
     volunteer; and performed rescue, recovery, demolition, debris 
     cleanup, or other related services at the Pentagon site of 
     the terrorist-related aircraft crash of September 11, 2001, 
     during the period beginning on September 11, 2001, and ending 
     on the date on which the cleanup of the site was concluded, 
     as determined by the WTC Program Administrator; or
       ``(II) was a member of a fire or police department (whether 
     fire or emergency personnel, active or retired), worked for a 
     recovery or cleanup contractor, or was a volunteer; and 
     performed rescue, recovery, demolition, debris cleanup, or 
     other related services at the Shanksville, Pennsylvania, site 
     of the terrorist-related aircraft crash of September 11, 
     2001, during the period beginning on September 11, 2001, and 
     ending on the date on which the cleanup of the site was 
     concluded, as determined by the WTC Program Administrator; 
     and
       ``(ii) is determined by the WTC Program Administrator to be 
     at an increased risk of developing a WTC-related health 
     condition as a result of exposure to airborne toxins, other 
     hazards, or adverse conditions resulting from the September 
     11, 2001, terrorist attacks, and meets such eligibility 
     criteria related to such exposures, as the WTC Program 
     Administrator determines are appropriate, after consultation 
     with the WTC Scientific/Technical Advisory Committee.
       ``(3) Enrollment process.--
       ``(A) In general.--The WTC Program Administrator shall 
     establish a process for enrolling WTC responders in the WTC 
     Program. Under such process--
       ``(i) WTC responders described in paragraph (1)(A) shall be 
     deemed to be enrolled in such Program;
       ``(ii) subject to clause (iii), the Administrator shall 
     enroll in such program individuals who are determined to be 
     WTC responders;
       ``(iii) the Administrator shall deny such enrollment to an 
     individual if the Administrator determines that the numerical 
     limitation in paragraph (4) on enrollment of WTC responders 
     has been met;
       ``(iv) there shall be no fee charged to the applicant for 
     making an application for such enrollment;
       ``(v) the Administrator shall make a determination on such 
     an application not later than 60 days after the date of 
     filing the application; and
       ``(vi) an individual who is denied enrollment in such 
     Program shall have an opportunity to appeal such 
     determination in a manner established under such process.
       ``(B) Timing.--
       ``(i) Currently identified responders.--In accordance with 
     subparagraph (A)(i), the WTC Program Administrator shall 
     enroll an individual described in paragraph (1)(A) in the WTC 
     Program not later than July 1, 2011.
       ``(ii) Other responders.--In accordance with subparagraph 
     (A)(ii) and consistent with paragraph (4), the WTC Program 
     Administrator shall enroll any other individual who is 
     determined to be a WTC responder in the WTC Program at the 
     time of such determination.
       ``(4) Numerical limitation on eligible wtc responders.--
       ``(A) In general.--The total number of individuals not 
     described in paragraph (1)(A) or (2)(A)(ii) who may be 
     enrolled under paragraph (3)(A)(ii) shall not exceed 25,000 
     at any time, of which no more than 2,500 may be individuals 
     enrolled based on modified eligibility criteria established 
     under paragraph (1)(C).
       ``(B) Process.--In implementing subparagraph (A), the WTC 
     Program Administrator shall--
       ``(i) limit the number of enrollments made under paragraph 
     (3)--

       ``(I) in accordance with such subparagraph; and
       ``(II) to such number, as determined by the Administrator 
     based on the best available information and subject to 
     amounts available under section 3351, that will ensure 
     sufficient funds will be available to provide treatment and 
     monitoring benefits under this title, with respect to all 
     individuals who are enrolled through the end of fiscal year 
     2020; and

       ``(ii) provide priority (subject to paragraph (3)(A)(i)) in 
     such enrollments in the order in which individuals apply for 
     enrollment under paragraph (3).
       ``(5) Disqualification of individuals on terrorist watch 
     list.--No individual who is on the terrorist watch list 
     maintained by the Department of Homeland Security shall 
     qualify as an eligible WTC responder. Before enrolling any 
     individual as a WTC responder in the WTC Program under 
     paragraph (3), the Administrator, in consultation with the 
     Secretary of Homeland Security, shall determine whether the 
     individual is on such list.
       ``(b) Monitoring Benefits.--
       ``(1) In general.--In the case of an enrolled WTC responder 
     (other than one described in subsection (a)(2)(A)(ii)), the 
     WTC Program shall provide for monitoring benefits that 
     include monitoring consistent with protocols approved by the 
     WTC Program Administrator and including clinical examinations 
     and long-term health monitoring and analysis. In the case of 
     an enrolled WTC responder who is an active member of the Fire 
     Department of New York City, the responder shall receive such 
     benefits as part of the individual's periodic company medical 
     exams.
       ``(2) Provision of monitoring benefits.--The monitoring 
     benefits under paragraph (1) shall be provided through the 
     Clinical Center of Excellence for the type of individual 
     involved or, in the case of an individual residing outside 
     the New York metropolitan area, under an arrangement under 
     section 3313.

     ``SEC. 3312. TREATMENT OF ENROLLED WTC RESPONDERS FOR WTC-
                   RELATED HEALTH CONDITIONS.

       ``(a) WTC-Related Health Condition Defined.--
       ``(1) In general.--For purposes of this title, the term 
     `WTC-related health condition' means a condition that--
       ``(A)(i) is an illness or health condition for which 
     exposure to airborne toxins, any other hazard, or any other 
     adverse condition resulting from the September 11, 2001, 
     terrorist attacks, based on an examination by a medical 
     professional with experience in treating or diagnosing the 
     health conditions included in the applicable list of WTC-
     related health conditions, is substantially likely to be a 
     significant factor in aggravating, contributing to, or 
     causing the illness or health condition, as determined under 
     paragraph (2); or
       ``(ii) is a mental health condition for which such attacks, 
     based on an examination by a medical professional with 
     experience in treating or diagnosing the health conditions 
     included in the applicable list of WTC-related health 
     conditions, is substantially likely to be a significant 
     factor in aggravating, contributing to, or causing the 
     condition, as determined under paragraph (2); and
       ``(B) is included in the applicable list of WTC-related 
     health conditions or--
       ``(i) with respect to a WTC responder, is provided 
     certification of coverage under subsection (b)(2)(B)(iii); or
       ``(ii) with respect to a screening-eligible WTC survivor or 
     certified-eligible WTC survivor, is provided certification of 
     coverage under subsection (b)(2)(B)(iii), as applied under 
     section 3322(a).

     In the case of a WTC responder described in section 
     3311(a)(2)(A)(ii) (relating to a surviving immediate family 
     member of a firefighter), such term does not include an 
     illness or health condition described in subparagraph (A)(i).
       ``(2) Determination.--The determination under paragraph (1) 
     or subsection (b) of whether the September 11, 2001, 
     terrorist attacks were substantially likely to be a 
     significant factor in aggravating, contributing to, or 
     causing an individual's illness or health condition shall be 
     made based on an assessment of the following:
       ``(A) The individual's exposure to airborne toxins, any 
     other hazard, or any other adverse condition resulting from 
     the terrorist attacks. Such exposure shall be--
       ``(i) evaluated and characterized through the use of a 
     standardized, population-appropriate questionnaire approved 
     by the Director of the National Institute for Occupational 
     Safety and Health; and
       ``(ii) assessed and documented by a medical professional 
     with experience in treating or diagnosing health conditions 
     included on the list of WTC-related health conditions.
       ``(B) The type of symptoms and temporal sequence of 
     symptoms. Such symptoms shall be--
       ``(i) assessed through the use of a standardized, 
     population-appropriate medical questionnaire approved by the 
     Director of the National Institute for Occupational Safety 
     and Health and a medical examination; and
       ``(ii) diagnosed and documented by a medical professional 
     described in subparagraph (A)(ii).
       ``(3) List of health conditions for wtc responders.--The 
     list of health conditions for WTC responders consists of the 
     following:
       ``(A) Aerodigestive disorders.--
       ``(i) Interstitial lung diseases.
       ``(ii) Chronic respiratory disorder--fumes/vapors.
       ``(iii) Asthma.

[[Page H7235]]

       ``(iv) Reactive airways dysfunction syndrome (RADS).
       ``(v) WTC-exacerbated chronic obstructive pulmonary disease 
     (COPD).
       ``(vi) Chronic cough syndrome.
       ``(vii) Upper airway hyperreactivity.
       ``(viii) Chronic rhinosinusitis.
       ``(ix) Chronic nasopharyngitis.
       ``(x) Chronic laryngitis.
       ``(xi) Gastroesophageal reflux disorder (GERD).
       ``(xii) Sleep apnea exacerbated by or related to a 
     condition described in a previous clause.
       ``(B) Mental health conditions.--
       ``(i) Posttraumatic stress disorder (PTSD).
       ``(ii) Major depressive disorder.
       ``(iii) Panic disorder.
       ``(iv) Generalized anxiety disorder.
       ``(v) Anxiety disorder (not otherwise specified).
       ``(vi) Depression (not otherwise specified).
       ``(vii) Acute stress disorder.
       ``(viii) Dysthymic disorder.
       ``(ix) Adjustment disorder.
       ``(x) Substance abuse.
       ``(C) Musculoskeletal disorders for certain wtc 
     responders.--In the case of a WTC responder described in 
     paragraph (4), a condition described in such paragraph.
       ``(D) Additional conditions.--Any cancer (or type of 
     cancer) or other condition added, pursuant to paragraph (5) 
     or (6), to the list under this paragraph.
       ``(4) Musculoskeletal disorders.--
       ``(A) In general.--For purposes of this title, in the case 
     of a WTC responder who received any treatment for a WTC-
     related musculoskeletal disorder on or before September 11, 
     2003, the list of health conditions in paragraph (3) shall 
     include:
       ``(i) Low back pain.
       ``(ii) Carpal tunnel syndrome (CTS).
       ``(iii) Other musculoskeletal disorders.
       ``(B) Definition.--The term `WTC-related musculoskeletal 
     disorder' means a chronic or recurrent disorder of the 
     musculoskeletal system caused by heavy lifting or repetitive 
     strain on the joints or musculoskeletal system occurring 
     during rescue or recovery efforts in the New York City 
     disaster area in the aftermath of the September 11, 2001, 
     terrorist attacks.
       ``(5) Cancer.--
       ``(A) In general.--The WTC Program Administrator shall 
     periodically conduct a review of all available scientific and 
     medical evidence, including findings and recommendations of 
     Clinical Centers of Excellence, published in peer-reviewed 
     journals to determine if, based on such evidence, cancer or a 
     certain type of cancer should be added to the applicable list 
     of WTC-related health conditions. The WTC Program 
     Administrator shall conduct the first review under this 
     subparagraph not later than 180 days after the date of the 
     enactment of this title.
       ``(B) Proposed regulations and rulemaking.--Based on the 
     periodic reviews under subparagraph (A), if the WTC Program 
     Administrator determines that cancer or a certain type of 
     cancer should be added to such list of WTC-related health 
     conditions, the WTC Program Administrator shall propose 
     regulations, through rulemaking, to add cancer or the certain 
     type of cancer to such list.
       ``(C) Final regulations.--Based on all the available 
     evidence in the rulemaking record, the WTC Program 
     Administrator shall make a final determination of whether 
     cancer or a certain type of cancer should be added to such 
     list of WTC-related health conditions. If such a 
     determination is made to make such an addition, the WTC 
     Program Administrator shall by regulation add cancer or the 
     certain type of cancer to such list.
       ``(D) Determinations not to add cancer or certain types of 
     cancer.--In the case that the WTC Program Administrator 
     determines under subparagraph (B) or (C) that cancer or a 
     certain type of cancer should not be added to such list of 
     WTC-related health conditions, the WTC Program Administrator 
     shall publish an explanation for such determination in the 
     Federal Register. Any such determination to not make such an 
     addition shall not preclude the addition of cancer or the 
     certain type of cancer to such list at a later date.
       ``(6) Addition of health conditions to list for wtc 
     responders.--
       ``(A) In general.--Whenever the WTC Program Administrator 
     determines that a proposed rule should be promulgated to add 
     a health condition to the list of health conditions in 
     paragraph (3), the Administrator may request a recommendation 
     of the Advisory Committee or may publish such a proposed rule 
     in the Federal Register in accordance with subparagraph (D).
       ``(B) Administrator's options after receipt of petition.--
     In the case that the WTC Program Administrator receives a 
     written petition by an interested party to add a health 
     condition to the list of health conditions in paragraph (3), 
     not later than 60 days after the date of receipt of such 
     petition the Administrator shall--
       ``(i) request a recommendation of the Advisory Committee;
       ``(ii) publish a proposed rule in the Federal Register to 
     add such health condition, in accordance with subparagraph 
     (D);
       ``(iii) publish in the Federal Register the Administrator's 
     determination not to publish such a proposed rule and the 
     basis for such determination; or
       ``(iv) publish in the Federal Register a determination that 
     insufficient evidence exists to take action under clauses (i) 
     through (iii).
       ``(C) Action by advisory committee.--In the case that the 
     Administrator requests a recommendation of the Advisory 
     Committee under this paragraph, with respect to adding a 
     health condition to the list in paragraph (3), the Advisory 
     Committee shall submit to the Administrator such 
     recommendation not later than 60 days after the date of such 
     request or by such date (not to exceed 180 days after such 
     date of request) as specified by the Administrator. Not later 
     than 60 days after the date of receipt of such 
     recommendation, the Administrator shall, in accordance with 
     subparagraph (D), publish in the Federal Register a proposed 
     rule with respect to such recommendation or a determination 
     not to propose such a proposed rule and the basis for such 
     determination.
       ``(D) Publication.--The WTC Program Administrator shall, 
     with respect to any proposed rule under this paragraph--
       ``(i) publish such proposed rule in accordance with section 
     553 of title 5, United States Code; and
       ``(ii) provide interested parties a period of 30 days after 
     such publication to submit written comments on the proposed 
     rule.
     The WTC Program Administrator may extend the period described 
     in clause (ii) upon a finding of good cause. In the case of 
     such an extension, the Administrator shall publish such 
     extension in the Federal Register.
       ``(E) Interested party defined.--For purposes of this 
     paragraph, the term `interested party' includes a 
     representative of any organization representing WTC 
     responders, a nationally recognized medical association, a 
     Clinical or Data Center, a State or political subdivision, or 
     any other interested person.
       ``(b) Coverage of Treatment for WTC-Related Health 
     Conditions.--
       ``(1) Determination for enrolled wtc responders based on a 
     wtc-related health condition.--
       ``(A) In general.--If a physician at a Clinical Center of 
     Excellence that is providing monitoring benefits under 
     section 3311 for an enrolled WTC responder makes a 
     determination that the responder has a WTC-related health 
     condition that is in the list in subsection (a)(3) and that 
     exposure to airborne toxins, other hazards, or adverse 
     conditions resulting from the September 1, 2001, terrorist 
     attacks is substantially likely to be a significant factor in 
     aggravating, contributing to, or causing the condition--
       ``(i) the physician shall promptly transmit such 
     determination to the WTC Program Administrator and provide 
     the Administrator with the medical facts supporting such 
     determination; and
       ``(ii) on and after the date of such transmittal and 
     subject to subparagraph (B), the WTC Program shall provide 
     for payment under subsection (c) for medically necessary 
     treatment for such condition.
       ``(B) Review; certification; appeals.--
       ``(i) Review.--A Federal employee designated by the WTC 
     Program Administrator shall review determinations made under 
     subparagraph (A).
       ``(ii) Certification.--The Administrator shall provide a 
     certification of such condition based upon reviews conducted 
     under clause (i). Such a certification shall be provided 
     unless the Administrator determines that the responder's 
     condition is not a WTC-related health condition in the list 
     in subsection (a)(3) or that exposure to airborne toxins, 
     other hazards, or adverse conditions resulting from the 
     September 1, 2001, terrorist attacks is not substantially 
     likely to be a significant factor in aggravating, 
     contributing to, or causing the condition.
       ``(iii) Appeal process.--The Administrator shall establish, 
     by rule, a process for the appeal of determinations under 
     clause (ii).
       ``(2) Determination based on medically associated wtc-
     related health conditions.--
       ``(A) In general.--If a physician at a Clinical Center of 
     Excellence determines pursuant to subsection (a) that the 
     enrolled WTC responder has a health condition described in 
     subsection (a)(1)(A) that is not in the list in subsection 
     (a)(3) but which is medically associated with a WTC-related 
     health condition--
       ``(i) the physician shall promptly transmit such 
     determination to the WTC Program Administrator and provide 
     the Administrator with the facts supporting such 
     determination; and
       ``(ii) the Administrator shall make a determination under 
     subparagraph (B) with respect to such physician's 
     determination.
       ``(B) Procedures for review, certification, and appeal.--
     The WTC Program Administrator shall, by rule, establish 
     procedures for the review and certification of physician 
     determinations under subparagraph (A). Such rule shall 
     provide for--
       ``(i) the timely review of such a determination by a 
     physician panel with appropriate expertise for the condition 
     and recommendations to the WTC Program Administrator;
       ``(ii) not later than 60 days after the date of the 
     transmittal under subparagraph (A)(i), a determination by the 
     WTC Program Administrator on whether or not the condition 
     involved is described in subsection (a)(1)(A) and is 
     medically associated with a WTC-related health condition;
       ``(iii) certification in accordance with paragraph 
     (1)(B)(ii) of coverage of such condition if determined to be 
     described in subsection (a)(1)(A) and medically associated 
     with a WTC-related health condition; and
       ``(iv) a process for appeals of determinations relating to 
     such conditions.
       ``(C) Inclusion in list of health conditions.--If the WTC 
     Program Administrator

[[Page H7236]]

     provides certification under subparagraph (B)(iii) for 
     coverage of a condition, the Administrator may, pursuant to 
     subsection (a)(6), add the condition to the list in 
     subsection (a)(3).
       ``(D) Conditions already declined for inclusion in list.--
     If the WTC Program Administrator publishes a determination 
     under subsection (a)(6)(B) not to include a condition in the 
     list in subsection (a)(3), the WTC Program Administrator 
     shall not provide certification under subparagraph (B)(iii) 
     for coverage of the condition. In the case of an individual 
     who is certified under subparagraph (B)(iii) with respect to 
     such condition before the date of the publication of such 
     determination the previous sentence shall not apply.
       ``(3) Requirement of medical necessity.--
       ``(A) In general.--In providing treatment for a WTC-related 
     health condition, a physician or other provider shall provide 
     treatment that is medically necessary and in accordance with 
     medical treatment protocols established under subsection (d).
       ``(B) Regulations relating to medical necessity.--For the 
     purpose of this title, the WTC Program Administrator shall 
     issue regulations specifying a standard for determining 
     medical necessity with respect to health care services and 
     prescription pharmaceuticals, a process for determining 
     whether treatment furnished and pharmaceuticals prescribed 
     under this title meet such standard (including any prior 
     authorization requirement), and a process for appeal of a 
     determination under subsection (c)(3).
       ``(4) Scope of treatment covered.--
       ``(A) In general.--The scope of treatment covered under 
     this subsection includes services of physicians and other 
     health care providers, diagnostic and laboratory tests, 
     prescription drugs, inpatient and outpatient hospital 
     services, and other medically necessary treatment.
       ``(B) Pharmaceutical coverage.--With respect to ensuring 
     coverage of medically necessary outpatient prescription 
     drugs, such drugs shall be provided, under arrangements made 
     by the WTC Program Administrator, directly through 
     participating Clinical Centers of Excellence or through one 
     or more outside vendors.
       ``(C) Transportation expenses for nationwide network.--The 
     WTC Program Administrator may provide for necessary and 
     reasonable transportation and expenses incident to the 
     securing of medically necessary treatment through the 
     nationwide network under section 3313 involving travel of 
     more than 250 miles and for which payment is made under this 
     section in the same manner in which individuals may be 
     furnished necessary and reasonable transportation and 
     expenses incident to services involving travel of more than 
     250 miles under regulations implementing section 3629(c) of 
     the Energy Employees Occupational Illness Compensation 
     Program Act of 2000 (title XXXVI of Public Law 106-398; 42 
     U.S.C. 7384t(c)).
       ``(5) Provision of treatment pending certification.--With 
     respect to an enrolled WTC responder for whom a determination 
     is made by an examining physician under paragraph (1) or (2), 
     but for whom the WTC Program Administrator has not yet 
     determined whether to certify the determination, the WTC 
     Program Administrator may establish by rule a process through 
     which the Administrator may approve the provision of medical 
     treatment under this subsection (and payment under subsection 
     (c)) with respect to such responder and such responder's WTC-
     related health condition (under such terms and conditions as 
     the Administrator may provide) until the Administrator makes 
     a decision on whether to certify the determination.
       ``(c) Payment for Initial Health Evaluation, Monitoring, 
     and Treatment of WTC-Related Health Conditions.--
       ``(1) Medical treatment.--
       ``(A) Use of feca payment rates.--Subject to subparagraphs 
     (B) and (C), the WTC Program Administrator shall reimburse 
     costs for medically necessary treatment under this title for 
     WTC-related health conditions according to the payment rates 
     that would apply to the provision of such treatment and 
     services by the facility under the Federal Employees 
     Compensation Act. For treatment not covered under the 
     previous sentence or subparagraph (B), the WTC Program 
     Administrator shall establish by regulation a reimbursement 
     rate for such treatment.
       ``(B) Pharmaceuticals.--
       ``(i) In general.--The WTC Program Administrator shall 
     establish a program for paying for the medically necessary 
     outpatient prescription pharmaceuticals prescribed under this 
     title for WTC-related health conditions through one or more 
     contracts with outside vendors.
       ``(ii) Competitive bidding.--Under such program the 
     Administrator shall--

       ``(I) select one or more appropriate vendors through a 
     Federal competitive bid process; and
       ``(II) select the lowest bidder (or bidders) meeting the 
     requirements for providing pharmaceutical benefits for 
     participants in the WTC Program.

       ``(iii) Treatment of fdny participants.--Under such program 
     the Administrator may enter into an agreement with a separate 
     vendor to provide pharmaceutical benefits to enrolled WTC 
     responders for whom the Clinical Center of Excellence is 
     described in section 3305 if such an arrangement is deemed 
     necessary and beneficial to the program by the WTC Program 
     Administrator.
       ``(C) Improving quality and efficiency through modification 
     of payment amounts and methodologies.--The WTC Program 
     Administrator may modify the amounts and methodologies for 
     making payments for initial health evaluations, monitoring, 
     or treatment, if, taking into account utilization and quality 
     data furnished by the Clinical Centers of Excellence under 
     section 3305(b)(1)(B)(iii), the Administrator determines that 
     a bundling, capitation, pay for performance, or other payment 
     methodology would better ensure high quality and efficient 
     delivery of initial health evaluations, monitoring, or 
     treatment to an enrolled WTC responder, screening-eligible 
     WTC survivor, or certified-eligible WTC survivor.
       ``(2) Monitoring and initial health evaluation.--The WTC 
     Program Administrator shall reimburse the costs of monitoring 
     and the costs of an initial health evaluation provided under 
     this title at a rate set by the Administrator by regulation.
       ``(3) Determination of medical necessity.--
       ``(A) Review of medical necessity and protocols.--As part 
     of the process for reimbursement or payment under this 
     subsection, the WTC Program Administrator shall provide for 
     the review of claims for reimbursement or payment for the 
     provision of medical treatment to determine if such treatment 
     is medically necessary and in accordance with medical 
     treatment protocols established under subsection (d).
       ``(B) Withholding of payment for medically unnecessary 
     treatment.--The Administrator shall withhold such 
     reimbursement or payment for treatment that the Administrator 
     determines is not medically necessary or is not in accordance 
     with such medical treatment protocols.
       ``(d) Medical Treatment Protocols.--
       ``(1) Development.--The Data Centers shall develop medical 
     treatment protocols for the treatment of enrolled WTC 
     responders and certified-eligible WTC survivors for health 
     conditions included in the applicable list of WTC-related 
     health conditions.
       ``(2) Approval.--The medical treatment protocols developed 
     under paragraph (1) shall be subject to approval by the WTC 
     Program Administrator.

     ``SEC. 3313. NATIONAL ARRANGEMENT FOR BENEFITS FOR ELIGIBLE 
                   INDIVIDUALS OUTSIDE NEW YORK.

       ``(a) In General.--In order to ensure reasonable access to 
     benefits under this subtitle for individuals who are enrolled 
     WTC responders, screening-eligible WTC survivors, or 
     certified-eligible WTC survivors and who reside in any State, 
     as defined in section 2(f), outside the New York metropolitan 
     area, the WTC Program Administrator shall establish a 
     nationwide network of health care providers to provide 
     monitoring and treatment benefits and initial health 
     evaluations near such individuals' areas of residence in such 
     States. Nothing in this subsection shall be construed as 
     preventing such individuals from being provided such 
     monitoring and treatment benefits or initial health 
     evaluation through any Clinical Center of Excellence.
       ``(b) Network Requirements.--Any health care provider 
     participating in the network under subsection (a) shall--
       ``(1) meet criteria for credentialing established by the 
     Data Centers;
       ``(2) follow the monitoring, initial health evaluation, and 
     treatment protocols developed under section 
     3305(a)(2)(A)(ii);
       ``(3) collect and report data in accordance with section 
     3304; and
       ``(4) meet such fraud, quality assurance, and other 
     requirements as the WTC Program Administrator establishes, 
     including sections 1128 through 1128E of the Social Security 
     Act, as applied by section 3301(d).
       ``(c) Training and Technical Assistance.--The WTC Program 
     Administer may provide, including through contract, for the 
     provision of training and technical assistance to health care 
     providers participating in the network under subsection (a).

                        ``PART 2--WTC SURVIVORS

     ``SEC. 3321. IDENTIFICATION AND INITIAL HEALTH EVALUATION OF 
                   SCREENING-ELIGIBLE AND CERTIFIED-ELIGIBLE WTC 
                   SURVIVORS.

       ``(a) Identification of Screening-Eligible WTC Survivors 
     and Certified-Eligible WTC Survivors.--
       ``(1) Screening-eligible wtc survivors.--
       ``(A) Definition.--In this title, the term `screening-
     eligible WTC survivor' means, subject to subparagraph (C) and 
     paragraph (3), an individual who is described in any of the 
     following clauses:
       ``(i) Currently identified survivor.--An individual, 
     including a WTC responder, who has been identified as 
     eligible for medical treatment and monitoring by the WTC 
     Environmental Health Center as of the date of enactment of 
     this title.
       ``(ii) Survivor who meets current eligibility criteria.--An 
     individual who is not a WTC responder, for purposes of the 
     initial health evaluation under subsection (b), claims 
     symptoms of a WTC-related health condition and meets any of 
     the current eligibility criteria described in subparagraph 
     (B).
       ``(iii) Survivor who meets modified eligibility criteria.--
     An individual who is not a WTC responder, for purposes of the 
     initial health evaluation under subsection (b), claims 
     symptoms of a WTC-related health condition and meets such 
     eligibility criteria relating to exposure to airborne toxins, 
     other hazards, or adverse conditions resulting from the 
     September 11, 2001, terrorist attacks as the WTC 
     Administrator determines,

[[Page H7237]]

     after consultation with the Data Centers described in section 
     3305 and the WTC Scientific/Technical Advisory Committee and 
     WTC Health Program Steering Committees under section 3302.

     The Administrator shall not modify such criteria under clause 
     (iii) on or after the date that the number of certifications 
     for certified-eligible WTC survivors under paragraph (2)(B) 
     has reached 80 percent of the limit described in paragraph 
     (3) or on or after the date that the number of enrollments of 
     WTC responders has reached 80 percent of the limit described 
     in section 3311(a)(4).
       ``(B) Current eligibility criteria.--The eligibility 
     criteria described in this subparagraph for an individual are 
     that the individual is described in any of the following 
     clauses:
       ``(i) A person who was present in the New York City 
     disaster area in the dust or dust cloud on September 11, 
     2001.
       ``(ii) A person who worked, resided, or attended school, 
     childcare, or adult daycare in the New York City disaster 
     area for--

       ``(I) at least 4 days during the 4-month period beginning 
     on September 11, 2001, and ending on January 10, 2002; or
       ``(II) at least 30 days during the period beginning on 
     September 11, 2001, and ending on July 31, 2002.

       ``(iii) Any person who worked as a cleanup worker or 
     performed maintenance work in the New York City disaster area 
     during the 4-month period described in subparagraph (B)(i) 
     and had extensive exposure to WTC dust as a result of such 
     work.
       ``(iv) A person who was deemed eligible to receive a grant 
     from the Lower Manhattan Development Corporation Residential 
     Grant Program, who possessed a lease for a residence or 
     purchased a residence in the New York City disaster area, and 
     who resided in such residence during the period beginning on 
     September 11, 2001, and ending on May 31, 2003.
       ``(v) A person whose place of employment--

       ``(I) at any time during the period beginning on September 
     11, 2001, and ending on May 31, 2003, was in the New York 
     City disaster area; and
       ``(II) was deemed eligible to receive a grant from the 
     Lower Manhattan Development Corporation WTC Small Firms 
     Attraction and Retention Act program or other government 
     incentive program designed to revitalize the lower Manhattan 
     economy after the September 11, 2001, terrorist attacks.

       ``(C) Application and determination process for screening 
     eligibility.--
       ``(i) In general.--The WTC Program Administrator in 
     consultation with the Data Centers shall establish a process 
     for individuals, other than individuals described in 
     subparagraph (A)(i), to be determined to be screening-
     eligible WTC survivors. Under such process--

       ``(I) there shall be no fee charged to the applicant for 
     making an application for such determination;
       ``(II) the Administrator shall make a determination on such 
     an application not later than 60 days after the date of 
     filing the application;
       ``(III) the Administrator shall make such a determination 
     relating to an applicant's compliance with this title and 
     shall not determine that an individual is not so eligible or 
     deny written documentation under clause (ii) to such 
     individual unless the Administrator determines that--

       ``(aa) based on the application submitted, the individual 
     does not meet the eligibility criteria; or
       ``(bb) the numerical limitation on certifications of 
     certified-eligible WTC survivors set forth in paragraph (3) 
     has been met; and

       ``(IV) an individual who is determined not to be a 
     screening-eligible WTC survivor shall have an opportunity to 
     appeal such determination in a manner established under such 
     process.

       ``(ii) Written documentation of screening-eligibility.--

       ``(I) In general.--In the case of an individual who is 
     described in subparagraph (A)(i) or who is determined under 
     clause (i) (consistent with paragraph (3)) to be a screening-
     eligible WTC survivor, the WTC Program Administrator shall 
     provide an appropriate written documentation of such fact.
       ``(II) Timing.--

       ``(aa) Currently identified survivors.--In the case of an 
     individual who is described in subparagraph (A)(i), the WTC 
     Program Administrator shall provide the written documentation 
     under subclause (I) not later than July 1, 2011.
       ``(bb) Other members.--In the case of another individual 
     who is determined under clause (i) and consistent with 
     paragraph (3) to be a screening-eligible WTC survivor, the 
     WTC Program Administrator shall provide the written 
     documentation under subclause (I) at the time of such 
     determination.
       ``(2) Certified-eligible wtc survivors.--
       ``(A) Definition.--The term `certified-eligible WTC 
     survivor' means, subject to paragraph (3), a screening-
     eligible WTC survivor who the WTC Program Administrator 
     certifies under subparagraph (B) to be eligible for followup 
     monitoring and treatment under this part.
       ``(B) Certification of eligibility for monitoring and 
     treatment.--
       ``(i) In general.--The WTC Program Administrator shall 
     establish a certification process under which the 
     Administrator shall provide appropriate certification to 
     screening-eligible WTC survivors who, pursuant to the initial 
     health evaluation under subsection (b), are determined to be 
     eligible for followup monitoring and treatment under this 
     part.
       ``(ii) Timing.--

       ``(I) Currently identified survivors.--In the case of an 
     individual who is described in paragraph (1)(A)(i), the WTC 
     Program Administrator shall provide the certification under 
     clause (i) not later than July 1, 2011.
       ``(II) Other members.--In the case of another individual 
     who is determined under clause (i) to be eligible for 
     followup monitoring and treatment, the WTC Program 
     Administrator shall provide the certification under such 
     clause at the time of such determination.

       ``(3) Numerical limitation on certified-eligible wtc 
     survivors.--
       ``(A) In general.--The total number of individuals not 
     described in paragraph (1)(A)(i) who may be certified as 
     certified-eligible WTC survivors under paragraph (2)(B) shall 
     not exceed 25,000 at any time.
       ``(B) Process.--In implementing subparagraph (A), the WTC 
     Program Administrator shall--
       ``(i) limit the number of certifications provided under 
     paragraph (2)(B)--

       ``(I) in accordance with such subparagraph; and
       ``(II) to such number, as determined by the Administrator 
     based on the best available information and subject to 
     amounts made available under section 3351, that will ensure 
     sufficient funds will be available to provide treatment and 
     monitoring benefits under this title, with respect to all 
     individuals receiving such certifications through the end of 
     fiscal year 2020; and

       ``(ii) provide priority in such certifications in the order 
     in which individuals apply for a determination under 
     paragraph (2)(B).
       ``(4) Disqualification of individuals on terrorist watch 
     list.--No individual who is on the terrorist watch list 
     maintained by the Department of Homeland Security shall 
     qualify as a screening-eligible WTC survivor or a certified-
     eligible WTC survivor. Before determining any individual to 
     be a screening-eligible WTC survivor under paragraph (1) or 
     certifying any individual as a certified eligible WTC 
     survivor under paragraph (2), the Administrator, in 
     consultation with the Secretary of Homeland Security, shall 
     determine whether the individual is on such list.
       ``(b) Initial Health Evaluation To Determine Eligibility 
     for Followup Monitoring or Treatment.--
       ``(1) In general.--In the case of a screening-eligible WTC 
     survivor, the WTC Program shall provide for an initial health 
     evaluation to determine if the survivor has a WTC-related 
     health condition and is eligible for followup monitoring and 
     treatment benefits under the WTC Program. Initial health 
     evaluation protocols under section 3305(a)(2)(A)(ii) shall be 
     subject to approval by the WTC Program Administrator.
       ``(2) Initial health evaluation providers.--The initial 
     health evaluation described in paragraph (1) shall be 
     provided through a Clinical Center of Excellence with respect 
     to the individual involved.
       ``(3) Limitation on initial health evaluation benefits.--
     Benefits for an initial health evaluation under this part for 
     a screening-eligible WTC survivor shall consist only of a 
     single medical initial health evaluation consistent with 
     initial health evaluation protocols described in paragraph 
     (1). Nothing in this paragraph shall be construed as 
     preventing such an individual from seeking additional medical 
     initial health evaluations at the expense of the individual.

     ``SEC. 3322. FOLLOWUP MONITORING AND TREATMENT OF CERTIFIED-
                   ELIGIBLE WTC SURVIVORS FOR WTC-RELATED HEALTH 
                   CONDITIONS.

       ``(a) In General.--Subject to subsection (b), the 
     provisions of sections 3311 and 3312 shall apply to followup 
     monitoring and treatment of WTC-related health conditions for 
     certified-eligible WTC survivors in the same manner as such 
     provisions apply to the monitoring and treatment of WTC-
     related health conditions for enrolled WTC responders.
       ``(b) List of WTC-Related Health Conditions for 
     Survivors.--The list of health conditions for screening-
     eligible WTC survivors and certified-eligible WTC survivors 
     consists of the following:
       ``(1) Aerodigestive disorders.--
       ``(A) Interstitial lung diseases.
       ``(B) Chronic respiratory disorder--fumes/vapors.
       ``(C) Asthma.
       ``(D) Reactive airways dysfunction syndrome (RADS).
       ``(E) WTC-exacerbated chronic obstructive pulmonary disease 
     (COPD).
       ``(F) Chronic cough syndrome.
       ``(G) Upper airway hyperreactivity.
       ``(H) Chronic rhinosinusitis.
       ``(I) Chronic nasopharyngitis.
       ``(J) Chronic laryngitis.
       ``(K) Gastroesophageal reflux disorder (GERD).
       ``(L) Sleep apnea exacerbated by or related to a condition 
     described in a previous clause.
       ``(2) Mental health conditions.--
       ``(A) Posttraumatic stress disorder (PTSD).
       ``(B) Major depressive disorder.
       ``(C) Panic disorder.
       ``(D) Generalized anxiety disorder.
       ``(E) Anxiety disorder (not otherwise specified).
       ``(F) Depression (not otherwise specified).
       ``(G) Acute stress disorder.
       ``(H) Dysthymic disorder.

[[Page H7238]]

       ``(I) Adjustment disorder.
       ``(J) Substance abuse.
       ``(3) Additional conditions.--Any cancer (or type of 
     cancer) or other condition added to the list in section 
     3312(a)(3) pursuant to paragraph (5) or (6) of section 
     3312(a), as such provisions are applied under subsection (a) 
     with respect to certified-eligible WTC survivors.

     ``SEC. 3323. FOLLOWUP MONITORING AND TREATMENT OF OTHER 
                   INDIVIDUALS WITH WTC-RELATED HEALTH CONDITIONS.

       ``(a) In General.--Subject to subsection (c), the 
     provisions of section 3322 shall apply to the followup 
     monitoring and treatment of WTC-related health conditions in 
     the case of individuals described in subsection (b) in the 
     same manner as such provisions apply to the followup 
     monitoring and treatment of WTC-related health conditions for 
     certified-eligible WTC survivors.
       ``(b) Individuals Described.--An individual described in 
     this subsection is an individual who, regardless of location 
     of residence--
       ``(1) is not an enrolled WTC responder or a certified-
     eligible WTC survivor; and
       ``(2) is diagnosed at a Clinical Center of Excellence with 
     a WTC-related health condition for certified-eligible WTC 
     survivors.
       ``(c) Limitation.--
       ``(1) In general.--The WTC Program Administrator shall 
     limit benefits for any fiscal year under subsection (a) in a 
     manner so that payments under this section for such fiscal 
     year do not exceed the amount specified in paragraph (2) for 
     such fiscal year.
       ``(2) Limitation.--The amount specified in this paragraph 
     for--
       ``(A) the last calendar quarter of fiscal year 2011 is 
     $5,000,000;
       ``(B) fiscal year 2012 is $20,000,000; or
       ``(C) a succeeding fiscal year is the amount specified in 
     this paragraph for the previous fiscal year increased by the 
     annual percentage increase in the medical care component of 
     the consumer price index for all urban consumers.

                       ``PART 3--PAYOR PROVISIONS

     ``SEC. 3331. PAYMENT OF CLAIMS.

       ``(a) In General.--Except as provided in subsections (b) 
     and (c), the cost of monitoring and treatment benefits and 
     initial health evaluation benefits provided under parts 1 and 
     2 of this subtitle shall be paid for by the WTC Program from 
     the World Trade Center Health Program Fund.
       ``(b) Workers' Compensation Payment.--
       ``(1) In general.--Subject to paragraph (2), payment for 
     treatment under parts 1 and 2 of this subtitle of a WTC-
     related health condition of an individual that is work-
     related shall be reduced or recouped to the extent that the 
     WTC Program Administrator determines that payment has been 
     made, or can reasonably be expected to be made, under a 
     workers' compensation law or plan of the United States, a 
     State, or a locality, or other work-related injury or illness 
     benefit plan of the employer of such individual, for such 
     treatment. The provisions of clauses (iii), (iv), (v), and 
     (vi) of paragraph (2)(B) of section 1862(b) of the Social 
     Security Act and paragraphs (3) and (4) of such section shall 
     apply to the recoupment under this subsection of a payment to 
     the WTC Program (with respect to a workers' compensation law 
     or plan, or other work-related injury or illness plan of the 
     employer involved, and such individual) in the same manner as 
     such provisions apply to the reimbursement of a payment under 
     section 1862(b)(2) of such Act to the Secretary (with respect 
     to such a law or plan and an individual entitled to benefits 
     under title XVIII of such Act) except that any reference in 
     such paragraph (4) to payment rates under title XVIII of the 
     Social Security Act shall be deemed a reference to payment 
     rates under this title.
       ``(2) Exception.--Paragraph (1) shall not apply for any 
     quarter, with respect to any workers' compensation law or 
     plan, including line of duty compensation, to which New York 
     City is obligated to make payments, if, in accordance with 
     terms specified under the contract under subsection 
     (d)(1)(A), New York City has made the full payment required 
     under such contract for such quarter.
       ``(3) Rules of construction.--Nothing in this title shall 
     be construed to affect, modify, or relieve any obligations 
     under a worker's compensation law or plan, other work-related 
     injury or illness benefit plan of an employer, or any health 
     insurance plan.
       ``(c) Health Insurance Coverage.--
       ``(1) In general.--In the case of an individual who has a 
     WTC-related health condition that is not work-related and has 
     health coverage for such condition through any public or 
     private health plan (including health benefits under title 
     XVIII, XIX, or XXI of the Social Security Act) the provisions 
     of section 1862(b) of the Social Security Act shall apply to 
     such a health plan and such individual in the same manner as 
     they apply to group health plan and an individual entitled to 
     benefits under title XVIII of such Act pursuant to section 
     226(a) of such Act. Any costs for items and services covered 
     under such plan that are not reimbursed by such health plan, 
     due to the application of deductibles, copayments, 
     coinsurance, other cost sharing, or otherwise, are 
     reimbursable under this title to the extent that they are 
     covered under the WTC Program. The program under this title 
     shall not be treated as a legally liable party for purposes 
     of applying section 1902(a)(25) of the Social Security Act.
       ``(2) Recovery by individual providers.--Nothing in 
     paragraph (1) shall be construed as requiring an entity 
     providing monitoring and treatment under this title to seek 
     reimbursement under a health plan with which the entity has 
     no contract for reimbursement.
       ``(3) Maintenance of required minimum essential coverage.--
     No payment may be made for monitoring and treatment under 
     this title for an individual for a month (beginning with July 
     2014) if with respect to such month the individual--
       ``(A) is an applicable individual (as defined in subsection 
     (d) of section 5000A of Internal Revenue Code of 1986) for 
     whom the exemption under subsection (e) of such section does 
     not apply; and
       ``(B) is not covered under minimum essential coverage, as 
     required under subsection (a) of such section.
       ``(d) Required Contribution by New York City in Program 
     Costs.--
       ``(1) Contract requirement.--
       ``(A) In general.--No funds may be disbursed from the World 
     Trade Center Health Program Fund under section 3351 unless 
     New York City has entered into a contract with the WTC 
     Program Administrator under which New York City agrees, in a 
     form and manner specified by the Administrator, to pay the 
     full contribution described in subparagraph (B) in accordance 
     with this subsection on a timely basis, plus any interest 
     owed pursuant to subparagraph (E)(i). Such contract shall 
     specify the terms under which New York City shall be 
     considered to have made the full payment required for a 
     quarter for purposes of subsection (b)(2).
       ``(B) Full contribution amount.--Under such contract, with 
     respect to the last calendar quarter of fiscal year 2011 and 
     each calendar quarter in fiscal years 2012 through 2018 the 
     full contribution amount under this subparagraph shall be 
     equal to 10 percent of the expenditures in carrying out this 
     title for the respective quarter and with respect to calendar 
     quarters in fiscal years 2019 and 2020, such full 
     contribution amount shall be equal to \1/9\ of the Federal 
     expenditures in carrying out this title for the respective 
     quarter.
       ``(C) Satisfaction of payment obligation.--The payment 
     obligation under such contract may not be satisfied through 
     any of the following:
       ``(i) An amount derived from Federal sources.
       ``(ii) An amount paid before the date of the enactment of 
     this title.
       ``(iii) An amount paid to satisfy a judgment or as part of 
     a settlement related to injuries or illnesses arising out of 
     the September 11, 2001, terrorist attacks.
       ``(D) Timing of contribution.--The payment obligation under 
     such contract for a calendar quarter in a fiscal year shall 
     be paid not later than the last day of the second succeeding 
     calendar quarter.
       ``(E) Compliance.--
       ``(i) Interest for late payment.--If New York City fails to 
     pay to the WTC Program Administrator pursuant to such 
     contract the amount required for any calendar quarter by the 
     day specified in subparagraph (D), interest shall accrue on 
     the amount not so paid at the rate (determined by the 
     Administrator) based on the average yield to maturity, plus 1 
     percentage point, on outstanding municipal bonds issued by 
     New York City with a remaining maturity of at least 1 year.
       ``(ii) Recovery of amounts owed.--The amounts owed to the 
     WTC Program Administrator under such contract shall be 
     recoverable by the United States in an action in the same 
     manner as payments made under title XVIII of the Social 
     Security Act may be recoverable in an action brought under 
     section 1862(b)(2)(B)(iii) of such Act.
       ``(F) Deposit in fund.--The WTC Program Administer shall 
     deposit amounts paid under such contract into the World Trade 
     Center Health Program Fund under section 3351.
       ``(2) Payment of new york city share of monitoring and 
     treatment costs.--With respect to each calendar quarter for 
     which a contribution is required by New York City under the 
     contract under paragraph (1), the WTC Program Administrator 
     shall--
       ``(A) provide New York City with an estimate of such amount 
     of the required contribution at the beginning of such quarter 
     and with an updated estimate of such amount at the beginning 
     of each of the subsequent 2 quarters;
       ``(B) bill such amount directly to New York City; and
       ``(C) certify periodically, for purposes of this 
     subsection, whether or not New York City has paid the amount 
     so billed.

     Such amount shall initially be estimated by the WTC Program 
     Administrator and shall be subject to adjustment and 
     reconciliation based upon actual expenditures in carrying out 
     this title.
       ``(3) Rule of construction.--Nothing in this subsection 
     shall be construed as authorizing the WTC Administrator, with 
     respect to a fiscal year, to reduce the numerical limitation 
     under section 3311(a)(4) or 3321(a)(3) for such fiscal year 
     if New York City fails to comply with paragraph (1) for a 
     calendar quarter in such fiscal year.
       ``(e) Work-Related Described.--For the purposes of this 
     section, a WTC-related health condition shall be treated as a 
     condition that is work-related if--
       ``(1) the condition is diagnosed in an enrolled WTC 
     responder, or in an individual who qualifies as a certified-
     eligible WTC survivor on the basis of being a rescue, 
     recovery, or cleanup worker; or

[[Page H7239]]

       ``(2) with respect to the condition the individual has 
     filed and had established a claim under a workers' 
     compensation law or plan of the United States or a State, or 
     other work-related injury or illness benefit plan of the 
     employer of such individual.

     ``SEC. 3332. ADMINISTRATIVE ARRANGEMENT AUTHORITY.

       ``The WTC Program Administrator may enter into arrangements 
     with other government agencies, insurance companies, or other 
     third-party administrators to provide for timely and accurate 
     processing of claims under sections 3312, 3313, 3322, and 
     3323.

                 ``Subtitle C--Research Into Conditions

     ``SEC. 3341. RESEARCH REGARDING CERTAIN HEALTH CONDITIONS 
                   RELATED TO SEPTEMBER 11 TERRORIST ATTACKS.

       ``(a) In General.--With respect to individuals, including 
     enrolled WTC responders and certified-eligible WTC survivors, 
     receiving monitoring or treatment under subtitle B, the WTC 
     Program Administrator shall conduct or support--
       ``(1) research on physical and mental health conditions 
     that may be related to the September 11, 2001, terrorist 
     attacks;
       ``(2) research on diagnosing WTC-related health conditions 
     of such individuals, in the case of conditions for which 
     there has been diagnostic uncertainty; and
       ``(3) research on treating WTC-related health conditions of 
     such individuals, in the case of conditions for which there 
     has been treatment uncertainty.

     The Administrator may provide such support through 
     continuation and expansion of research that was initiated 
     before the date of the enactment of this title and through 
     the World Trade Center Health Registry (referred to in 
     section 3342), through a Clinical Center of Excellence, or 
     through a Data Center.
       ``(b) Types of Research.--The research under subsection 
     (a)(1) shall include epidemiologic and other research studies 
     on WTC-related health conditions or emerging conditions--
       ``(1) among enrolled WTC responders and certified-eligible 
     WTC survivors under treatment; and
       ``(2) in sampled populations outside the New York City 
     disaster area in Manhattan as far north as 14th Street and in 
     Brooklyn, along with control populations, to identify 
     potential for long-term adverse health effects in less 
     exposed populations.
       ``(c) Consultation.--The WTC Program Administrator shall 
     carry out this section in consultation with the WTC 
     Scientific/Technical Advisory Committee.
       ``(d) Application of Privacy and Human Subject 
     Protections.--The privacy and human subject protections 
     applicable to research conducted under this section shall not 
     be less than such protections applicable to research 
     conducted or funded by the Department of Health and Human 
     Services.

     ``SEC. 3342. WORLD TRADE CENTER HEALTH REGISTRY.

       ``For the purpose of ensuring ongoing data collection 
     relating to victims of the September 11, 2001, terrorist 
     attacks, the WTC Program Administrator shall ensure that a 
     registry of such victims is maintained that is at least as 
     comprehensive as the World Trade Center Health Registry 
     maintained under the arrangements in effect as of April 20, 
     2009, with the New York City Department of Health and Mental 
     Hygiene.

                         ``Subtitle D--Funding

     ``SEC. 3351. WORLD TRADE CENTER HEALTH PROGRAM FUND.

       ``(a) Establishment of Fund.--
       ``(1) In general.--There is established a fund to be known 
     as the World Trade Center Health Program Fund (referred to in 
     this section as the `Fund').
       ``(2) Funding.--Out of any money in the Treasury not 
     otherwise appropriated, there shall be deposited into the 
     Fund for each of fiscal years 2012 through 2020 (and the last 
     calendar quarter of fiscal year 2011)--
       ``(A) the Federal share, consisting of an amount equal to 
     the lesser of--
       ``(i) 90 percent of the expenditures in carrying out this 
     title for the respective fiscal year (initially based on 
     estimates, subject to subsequent reconciliation based on 
     actual expenditures); or
       ``(ii)(I) $71,000,000 for the last calendar quarter of 
     fiscal year 2011, $318,000,000 for fiscal year 2012, 
     $354,000,000 for fiscal year 2013, $382,000,000 for fiscal 
     year 2014, $431,000,000 for fiscal year 2015, $481,000,000 
     for fiscal year 2016, $537,000,000 for fiscal year 2017, 
     $601,000,000 for fiscal year 2018, and $173,000,000 for 
     fiscal year 2019; and
       ``(II) subject to paragraph (4), an additional $499,000,000 
     for fiscal year 2019 and $743,000,000 for fiscal year 2020; 
     plus
       ``(B) the New York City share, consisting of the amount 
     contributed under the contract under section 3331(d).
       ``(3) Contract requirement.--
       ``(A) In general.--No funds may be disbursed from the Fund 
     unless New York City has entered into a contract with the WTC 
     Program Administrator under section 3331(d)(1).
       ``(B) Breach of contract.--In the case of a failure to pay 
     the amount so required under the contract--
       ``(i) the amount is recoverable under subparagraph (E)(ii) 
     of such section;
       ``(ii) such failure shall not affect the disbursement of 
     amounts from the Fund; and
       ``(iii) the Federal share described in paragraph (2)(A) 
     shall not be increased by the amount so unpaid.
       ``(4) Aggregate limitation on funding beginning with fiscal 
     year 2019.--Beginning with fiscal year 2019, in no case shall 
     the share of Federal funds deposited into the Fund under 
     paragraph (2) for such fiscal year and previous fiscal years 
     and quarters exceed the sum of the amounts specified in 
     paragraph (2)(A)(ii)(I).
       ``(b) Mandatory Funds for Monitoring, Initial Health 
     Evaluations, Treatment, and Claims Processing.--
       ``(1) In general.--The amounts deposited into the Fund 
     under subsection (a)(2) shall be available, without further 
     appropriation, consistent with paragraph (2) and subsection 
     (c), to carry out subtitle B and sections 3302(a), 3303, 
     3304, 3305(a)(2), 3305(c), 3341, and 3342.
       ``(2) Limitation on mandatory funding.--This title does not 
     establish any Federal obligation for payment of amounts in 
     excess of the amounts available from the Fund for such 
     purpose.
       ``(3) Limitation on authorization for further 
     appropriations.--This title does not establish any 
     authorization for appropriation of amounts in excess of the 
     amounts available from the Fund under paragraph (1).
       ``(c) Limits on Spending for Certain Purposes.--Of the 
     amounts made available under subsection (b)(1), not more than 
     each of the following amounts may be available for each of 
     the following purposes:
       ``(1) Surviving immediate family members of firefighters.--
     For the purposes of carrying out subtitle B with respect to 
     WTC responders described in section 3311(a)(2)(A)(ii)--
       ``(A) for the last calendar quarter of fiscal year 2011, 
     $100,000;
       ``(B) for fiscal year 2012, $400,000; and
       ``(C) for each subsequent fiscal year, the amount specified 
     under this paragraph for the previous fiscal year increased 
     by the percentage increase in the consumer price index for 
     all urban consumers (all items; United States city average) 
     as estimated by the Secretary for the 12-month period ending 
     with March of the previous year.
       ``(2) WTC health program scientific/technical advisory 
     committee.--For the purpose of carrying out section 3302(a)--
       ``(A) for the last calendar quarter of fiscal year 2011, 
     $25,000;
       ``(B) for fiscal year 2012, $100,000; and
       ``(C) for each subsequent fiscal year, the amount specified 
     under this paragraph for the previous fiscal year increased 
     by the percentage increase in the consumer price index for 
     all urban consumers (all items; United States city average) 
     as estimated by the Secretary for the 12-month period ending 
     with March of the previous year.
       ``(3) Education and outreach.--For the purpose of carrying 
     out section 3303--
       ``(A) for the last calendar quarter of fiscal year 2011, 
     $500,000;
       ``(B) for fiscal year 2012, $2,000,000; and
       ``(C) for each subsequent fiscal year, the amount specified 
     under this paragraph for the previous fiscal year increased 
     by the percentage increase in the consumer price index for 
     all urban consumers (all items; United States city average) 
     as estimated by the Secretary for the 12-month period ending 
     with March of the previous year.
       ``(4) Uniform data collection.--For the purpose of carrying 
     out section 3304 and for reimbursing Data Centers (as defined 
     in section 3305(b)(2)) for the costs incurred by such Centers 
     in carrying out activities under contracts entered into under 
     section 3305(a)(2)--
       ``(A) for the last calendar quarter of fiscal year 2011, 
     $2,500,000;
       ``(B) for fiscal year 2012, $10,000,000; and
       ``(C) for each subsequent fiscal year, the amount specified 
     under this paragraph for the previous fiscal year increased 
     by the percentage increase in the consumer price index for 
     all urban consumers (all items; United States city average) 
     as estimated by the Secretary for the 12-month period ending 
     with March of the previous year.
       ``(5) Research regarding certain health conditions.--For 
     the purpose of carrying out section 3341--
       ``(A) for the last calendar quarter of fiscal year 2011, 
     $3,750,000;
       ``(B) for fiscal year 2012, $15,000,000; and
       ``(C) for each subsequent fiscal year, the amount specified 
     under this paragraph for the previous fiscal year increased 
     by the percentage increase in the consumer price index for 
     all urban consumers (all items; United States city average) 
     as estimated by the Secretary for the 12-month period ending 
     with March of the previous year.
       ``(6) World trade center health registry.--For the purpose 
     of carrying out section 3342--
       ``(A) for the last calendar quarter of fiscal year 2011, 
     $1,750,000;
       ``(B) for fiscal year 2012, $7,000,000; and
       ``(C) for each subsequent fiscal year, the amount specified 
     under this paragraph for the previous fiscal year increased 
     by the percentage increase in the consumer price index for 
     all urban consumers (all items; United States city average) 
     as estimated by the Secretary for the 12-month period ending 
     with March of the previous year.''.

       TITLE II--SEPTEMBER 11TH VICTIM COMPENSATION FUND OF 2001

     SEC. 201. DEFINITIONS.

       Section 402 of the Air Transportation Safety and System 
     Stabilization Act (49 U.S.C. 40101 note) is amended--
       (1) in paragraph (6) by inserting ``, or debris removal, 
     including under the World Trade Center Health Program 
     established under section 3001 of the Public Health Service 
     Act, and payments made pursuant to the

[[Page H7240]]

     settlement of a civil action described in section 
     405(c)(3)(C)(iii)'' after ``September 11, 2001'';
       (2) by inserting after paragraph (6) the following new 
     paragraphs and redesignating subsequent paragraphs 
     accordingly:
       ``(7) Contractor and subcontractor.--The term `contractor 
     and subcontractor' means any contractor or subcontractor (at 
     any tier of a subcontracting relationship), including any 
     general contractor, construction manager, prime contractor, 
     consultant, or any parent, subsidiary, associated or allied 
     company, affiliated company, corporation, firm, organization, 
     or joint venture thereof that participated in debris removal 
     at any 9/11 crash site. Such term shall not include any 
     entity, including the Port Authority of New York and New 
     Jersey, with a property interest in the World Trade Center, 
     on September 11, 2001, whether fee simple, leasehold or 
     easement, direct or indirect.
       ``(8) Debris removal.--The term `debris removal' means 
     rescue and recovery efforts, removal of debris, cleanup, 
     remediation, and response during the immediate aftermath of 
     the terrorist-related aircraft crashes of September 11, 2001, 
     with respect to a 9/11 crash site.'';
       (3) by inserting after paragraph (10), as so redesignated, 
     the following new paragraph and redesignating the subsequent 
     paragraphs accordingly:
       ``(11) Immediate aftermath.--The term `immediate aftermath' 
     means any period beginning with the terrorist-related 
     aircraft crashes of September 11, 2001, and ending on August 
     30, 2002.''; and
       (4) by adding at the end the following new paragraph:
       ``(14) 9/11 crash site.--The term `9/11 crash site' means--
       ``(A) the World Trade Center site, Pentagon site, and 
     Shanksville, Pennsylvania site;
       ``(B) the buildings or portions of buildings that were 
     destroyed as a result of the terrorist-related aircraft 
     crashes of September 11, 2001;
       ``(C) any area contiguous to a site of such crashes that 
     the Special Master determines was sufficiently close to the 
     site that there was a demonstrable risk of physical harm 
     resulting from the impact of the aircraft or any subsequent 
     fire, explosions, or building collapses (including the 
     immediate area in which the impact occurred, fire occurred, 
     portions of buildings fell, or debris fell upon and injured 
     individuals); and
       ``(D) any area related to, or along, routes of debris 
     removal, such as barges and Fresh Kills.''.

     SEC. 202. EXTENDED AND EXPANDED ELIGIBILITY FOR COMPENSATION.

       (a) Information on Losses Resulting From Debris Removal 
     Included in Contents of Claim Form.--Section 405(a)(2)(B) of 
     the Air Transportation Safety and System Stabilization Act 
     (49 U.S.C. 40101 note) is amended--
       (1) in clause (i), by inserting ``, or debris removal 
     during the immediate aftermath'' after ``September 11, 
     2001'';
       (2) in clause (ii), by inserting ``or debris removal during 
     the immediate aftermath'' after ``crashes''; and
       (3) in clause (iii), by inserting ``or debris removal 
     during the immediate aftermath'' after ``crashes''.
       (b) Extension of Deadline for Claims Under September 11th 
     Victim Compensation Fund of 2001.--Section 405(a)(3) of such 
     Act is amended to read as follows:
       ``(3) Limitation.--
       ``(A) In general.--Except as provided by subparagraph (B), 
     no claim may be filed under paragraph (1) after the date that 
     is 2 years after the date on which regulations are 
     promulgated under section 407(a).
       ``(B) Exception.--A claim may be filed under paragraph (1), 
     in accordance with subsection (c)(3)(A)(i), by an individual 
     (or by a personal representative on behalf of a deceased 
     individual) during the period beginning on the date on which 
     the regulations are updated under section 407(b) and ending 
     on December 22, 2031.''.
       (c) Requirements for Filing Claims During Extended Filing 
     Period.--Section 405(c)(3) of such Act is amended--
       (1) by redesignating subparagraphs (A) and (B) as 
     subparagraphs (B) and (C), respectively; and
       (2) by inserting before subparagraph (B), as so 
     redesignated, the following new subparagraph:
       ``(A) Requirements for filing claims during extended filing 
     period.--
       ``(i) Timing requirements for filing claims.--An individual 
     (or a personal representative on behalf of a deceased 
     individual) may file a claim during the period described in 
     subsection (a)(3)(B) as follows:

       ``(I) In the case that the Special Master determines the 
     individual knew (or reasonably should have known) before the 
     date specified in clause (iii) that the individual suffered a 
     physical harm at a 9/11 crash site as a result of the 
     terrorist-related aircraft crashes of September 11, 2001, or 
     as a result of debris removal, and that the individual knew 
     (or should have known) before such specified date that the 
     individual was eligible to file a claim under this title, the 
     individual may file a claim not later than the date that is 2 
     years after such specified date.
       ``(II) In the case that the Special Master determines the 
     individual first knew (or reasonably should have known) on or 
     after the date specified in clause (iii) that the individual 
     suffered such a physical harm or that the individual first 
     knew (or should have known) on or after such specified date 
     that the individual was eligible to file a claim under this 
     title, the individual may file a claim not later than the 
     last day of the 2-year period beginning on the date the 
     Special Master determines the individual first knew (or 
     should have known) that the individual both suffered from 
     such harm and was eligible to file a claim under this title.

       ``(ii) Other eligibility requirements for filing claims.--
     An individual may file a claim during the period described in 
     subsection (a)(3)(B) only if--

       ``(I) the individual was treated by a medical professional 
     for suffering from a physical harm described in clause (i)(I) 
     within a reasonable time from the date of discovering such 
     harm; and
       ``(II) the individual's physical harm is verified by 
     contemporaneous medical records created by or at the 
     direction of the medical professional who provided the 
     medical care.

       ``(iii) Date specified.--The date specified in this clause 
     is the date on which the regulations are updated under 
     section 407(a).''.
       (d) Clarifying Applicability to All 9/11 Crash Sites.--
     Section 405(c)(2)(A)(i) of such Act is amended by striking 
     ``or the site of the aircraft crash at Shanksville, 
     Pennsylvania'' and inserting ``the site of the aircraft crash 
     at Shanksville, Pennsylvania, or any other 9/11 crash site''.
       (e) Inclusion of Physical Harm Resulting From Debris 
     Removal.--Section 405(c) of such Act is amended in paragraph 
     (2)(A)(ii), by inserting ``or debris removal'' after ``air 
     crash''.
       (f) Limitations on Civil Actions.--
       (1) Application to damages related to debris removal.--
     Clause (i) of section 405(c)(3)(C) of such Act, as 
     redesignated by subsection (c), is amended by inserting ``, 
     or for damages arising from or related to debris removal'' 
     after ``September 11, 2001''.
       (2) Pending actions.--Clause (ii) of such section, as so 
     redesignated, is amended to read as follows:
       ``(ii) Pending actions.--In the case of an individual who 
     is a party to a civil action described in clause (i), such 
     individual may not submit a claim under this title--

       ``(I) during the period described in subsection (a)(3)(A) 
     unless such individual withdraws from such action by the date 
     that is 90 days after the date on which regulations are 
     promulgated under section 407(a); and
       ``(II) during the period described in subsection (a)(3)(B) 
     unless such individual withdraws from such action by the date 
     that is 90 days after the date on which the regulations are 
     updated under section 407(b).''.

       (3) Settled actions; authority to reinstitute certain 
     lawsuits.--Such section, as so redesignated, is further 
     amended by adding at the end the following new clauses:
       ``(iii) Settled actions.--In the case of an individual who 
     settled a civil action described in clause (i), such 
     individual may not submit a claim under this title unless 
     such action was commenced after December 22, 2003, and a 
     release of all claims in such action was tendered prior to 
     the date on which the James Zadroga 9/11 Health and 
     Compensation Act of 2010 was enacted.
       ``(iv) Authority to reinstitute certain lawsuits.--In the 
     case of a claimant who was a party to a civil action 
     described in clause (i), who withdrew from such action 
     pursuant to clause (ii), and who is subsequently determined 
     to not be an eligible individual for purposes of this 
     subsection, such claimant may reinstitute such action without 
     prejudice during the 90-day period beginning after the date 
     of such ineligibility determination.''.

     SEC. 203. REQUIREMENT TO UPDATE REGULATIONS.

       Section 407 of the Air Transportation Safety and System 
     Stabilization Act (49 U.S.C. 40101 note) is amended--
       (1) by striking ``Not later than'' and inserting ``(a) In 
     General.--Not later than''; and
       (2) by adding at the end the following new subsection:
       ``(b) Updated Regulations.--Not later than 90 days after 
     the date of the enactment of the James Zadroga 9/11 Health 
     and Compensation Act of 2010, the Special Master shall update 
     the regulations promulgated under subsection (a) to the 
     extent necessary to comply with the provisions of title II of 
     such Act.''.

     SEC. 204. LIMITED LIABILITY FOR CERTAIN CLAIMS.

       Section 408(a) of the Air Transportation Safety and System 
     Stabilization Act (49 U.S.C. 40101 note) is amended by adding 
     at the end the following new paragraphs:
       ``(4) Liability for certain claims.--Notwithstanding any 
     other provision of law, liability for all claims and actions 
     (including claims or actions that have been previously 
     resolved, that are currently pending, and that may be filed 
     through December 22, 2031) for compensatory damages, 
     contribution or indemnity, or any other form or type of 
     relief, arising from or related to debris removal, against 
     the City of New York, any entity (including the Port 
     Authority of New York and New Jersey) with a property 
     interest in the World Trade Center on September 11, 2001 
     (whether fee simple, leasehold or easement, or direct or 
     indirect) and any contractors and subcontractors, shall not 
     be in an amount that exceeds the sum of the following, as may 
     be applicable:
       ``(A) The amount of funds of the WTC Captive Insurance 
     Company, including the cumulative interest.

[[Page H7241]]

       ``(B) The amount of all available insurance identified in 
     schedule 2 of the WTC Captive Insurance Company insurance 
     policy.
       ``(C) As it relates to the limitation of liability of the 
     City of New York, the amount that is the greater of the City 
     of New York's insurance coverage or $350,000,000. In 
     determining the amount of the City's insurance coverage for 
     purposes of the previous sentence, any amount described in 
     clauses (i) and (ii) shall not be included.
       ``(D) As it relates to the limitation of liability of any 
     entity, including the Port Authority of New York and New 
     Jersey, with a property interest in the World Trade Center on 
     September 11, 2001 (whether fee simple, leasehold or 
     easement, or direct or indirect), the amount of all available 
     liability insurance coverage maintained by any such entity.
       ``(E) As it relates to the limitation of liability of any 
     individual contractor or subcontractor, the amount of all 
     available liability insurance coverage maintained by such 
     contractor or subcontractor on September 11, 2001.
       ``(5) Priority of claims payments.--Payments to plaintiffs 
     who obtain a settlement or judgment with respect to a claim 
     or action to which paragraph (4)(A) applies, shall be paid 
     solely from the following funds in the following order, as 
     may be applicable:
       ``(A) The funds described in clause (i) or (ii) of 
     paragraph (4)(A).
       ``(B) If there are no funds available as described in 
     clause (i) or (ii) of paragraph (4)(A), the funds described 
     in clause (iii) of such paragraph.
       ``(C) If there are no funds available as described in 
     clause (i), (ii), or (iii) of paragraph (4)(A), the funds 
     described in clause (iv) of such paragraph.
       ``(D) If there are no funds available as described in 
     clause (i), (ii), (iii), or (iv) of paragraph (4)(A), the 
     funds described in clause (v) of such paragraph.
       ``(6) Declaratory judgment actions and direct action.--Any 
     party to a claim or action to which paragraph (4)(A) applies 
     may, with respect to such claim or action, either file an 
     action for a declaratory judgment for insurance coverage or 
     bring a direct action against the insurance company 
     involved.''.

     SEC. 205. FUNDING; ATTORNEY FEES.

       Section 406 of the Air Transportation Safety and System 
     Stabilization Act (49 U.S.C. 40101 note) is amended--
       (1) in subsection (a), by striking ``Not later than'' and 
     inserting ``Subject to the limitations under subsection (d), 
     not later than'';
       (2) in subsection (b)--
       (A) by inserting ``in the amounts provided under subsection 
     (d)(1)'' after ``appropriations Acts''; and
       (B) by inserting ``subject to the limitations under 
     subsection (d)'' before the period; and
       (3) by adding at the end the following new subsections:
       ``(d) Limitation.--
       ``(1) In general.--The total amount of Federal funds paid 
     for compensation under this title, with respect to claims 
     filed on or after the date on which the regulations are 
     updated under section 407(b), shall not exceed 
     $8,400,000,000. Of such amounts, $4,200,000,000 shall be 
     available to pay such claims during the 10-year period 
     beginning on such date and $4,200,000,000 shall be available 
     to pay such claims after such period.
       ``(2) Pro-ration and payment of remaining claims.--
       ``(A) In general.--With respect to the one-year period 
     beginning on the date on which the first payment is made 
     under this title for claims filed pursuant to the regulations 
     updated under section 407(b), the Special Master shall 
     examine the total number of such claims paid during such 
     period and the amounts of the payments made for such claims 
     to project the total number and amount of claims expected to 
     be paid under this title during the 10-year period described 
     in paragraph (1). If, based on such projection, the Special 
     Master determines that there will be insufficient funds 
     available under paragraph (1) to pay such claims during such 
     10-year period, beginning on the first day following such 
     one-year period, the Special Master shall ratably reduce the 
     amount of compensation due claimants under this title in a 
     manner to ensure, to the extent possible, that--
       ``(i) all claimants who, before application of the 
     limitation under the second sentence of paragraph (1), would 
     have been determined to be entitled to a payment under this 
     title during such 10-year period, receive a payment during 
     such period; and
       ``(ii) the total amount of all such payments made during 
     such 10-year period do not exceed the amount available under 
     the second sentence of paragraph (1) to pay claims during 
     such period.
       ``(B) Payment of remainder of claim amounts.--In any case 
     in which the amount of a claim is ratably reduced pursuant to 
     subparagraph (A), on or after the first day after the 10-year 
     period described in paragraph (1), the Special Master shall 
     pay to the claimant the amount that is equal to the 
     difference between--
       ``(i) the amount that the claimant would have been paid 
     under this title during such period without regard to the 
     limitation under the second sentence of paragraph (1) 
     applicable to such period; and
       ``(ii) the amount the claimant was paid under this title 
     during such period.
       ``(e) Attorney Fees.--
       ``(1) In general.--Notwithstanding any contract, and except 
     as provided in paragraphs (2) and (3), the representative of 
     an individual may not charge, for services rendered in 
     connection with the claim of an individual under this title, 
     more than 10 percent of an award made under this title on 
     such claim.
       ``(2) Limitation.--
       ``(A) In general.--Except as provided in subparagraph (B), 
     in the case of an individual who was charged a legal fee in 
     connection with the settlement of a civil action described in 
     section 405(c)(3)(C)(iii),  the representative of the 
     individual may not charge any amount for compensation for 
     services rendered in connection with a claim filed under this 
     title.
       ``(B) Exception.--If the legal fee charged in connection 
     with the settlement of a civil action described in section 
     405(c)(3)(C)(iii) of an individual is less than 10 percent of 
     the aggregate amount of compensation awarded to such 
     individual through such settlement and the claim of the 
     individual under this title, the representative of such 
     individual may charge an amount for compensation for services 
     rendered in connection with such claim under this title to 
     the extent that such amount charged is not more than--
       ``(i) 10 percent of such aggregate amount, minus
       ``(ii) the total amount of all legal fees charged for 
     services rendered in connection with such settlement.
       ``(3) Exception.--With respect to a claim made on behalf of 
     an individual for whom a lawsuit was filed in the Southern 
     District of New York prior to January 1, 2009, in the event 
     that the representative believes in good faith that the fee 
     limit set by paragraph (1) or (2) will not provide adequate 
     compensation for services rendered in connection with such 
     claim because of the substantial amount of legal work 
     provided on behalf of the claimant (including work performed 
     before the enactment of this legislation), application for 
     greater compensation may be made to the Special Master. Upon 
     such application, the Special Master may, in his or her 
     discretion, award as reasonable compensation for services 
     rendered an amount greater than that allowed for in paragraph 
     (1). Such fee award will be final, binding, and non-
     appealable.''.

    TITLE III--LIMITATION ON TREATY BENEFITS FOR CERTAIN DEDUCTIBLE 
        PAYMENTS; TIME FOR PAYMENT OF CORPORATE ESTIMATED TAXES

     SEC. 301. LIMITATION ON TREATY BENEFITS FOR CERTAIN 
                   DEDUCTIBLE PAYMENTS.

       (a) In General.--Section 894 of the Internal Revenue Code 
     of 1986 (relating to income affected by treaty) is amended by 
     adding at the end the following new subsection:
       ``(d) Limitation on Treaty Benefits for Certain Deductible 
     Payments.--
       ``(1) In general.--In the case of any deductible related-
     party payment, any withholding tax imposed under chapter 3 
     (and any tax imposed under subpart A or B of this part) with 
     respect to such payment may not be reduced under any treaty 
     of the United States unless any such withholding tax would be 
     reduced under a treaty of the United States if such payment 
     were made directly to the foreign parent corporation.
       ``(2) Deductible related-party payment.--For purposes of 
     this subsection, the term `deductible related-party payment' 
     means any payment made, directly or indirectly, by any person 
     to any other person if the payment is allowable as a 
     deduction under this chapter and both persons are members of 
     the same foreign controlled group of entities.
       ``(3) Foreign controlled group of entities.--For purposes 
     of this subsection--
       ``(A) In general.--The term `foreign controlled group of 
     entities' means a controlled group of entities the common 
     parent of which is a foreign corporation.
       ``(B) Controlled group of entities.--The term `controlled 
     group of entities' means a controlled group of corporations 
     as defined in section 1563(a)(1), except that--
       ``(i) `more than 50 percent' shall be substituted for `at 
     least 80 percent' each place it appears therein, and
       ``(ii) the determination shall be made without regard to 
     subsections (a)(4) and (b)(2) of section 1563.

     A partnership or any other entity (other than a corporation) 
     shall be treated as a member of a controlled group of 
     entities if such entity is controlled (within the meaning of 
     section 954(d)(3)) by members of such group (including any 
     entity treated as a member of such group by reason of this 
     sentence).
       ``(4) Foreign parent corporation.--For purposes of this 
     subsection, the term `foreign parent corporation' means, with 
     respect to any deductible related-party payment, the common 
     parent of the foreign controlled group of entities referred 
     to in paragraph (3)(A).
       ``(5) Regulations.--The Secretary may prescribe such 
     regulations or other guidance as are necessary or appropriate 
     to carry out the purposes of this subsection, including 
     regulations or other guidance which provide for--
       ``(A) the treatment of two or more persons as members of a 
     foreign controlled group of entities if such persons would be 
     the common parent of such group if treated as one 
     corporation, and
       ``(B) the treatment of any member of a foreign controlled 
     group of entities as the common parent of such group if such 
     treatment is appropriate taking into account the economic 
     relationships among such entities.''.

[[Page H7242]]

       (b) Effective Date.--The amendment made by this section 
     shall apply to payments made after the date of the enactment 
     of this Act.

     SEC. 302. TIME FOR PAYMENT OF CORPORATE ESTIMATED TAXES.

       The percentage under paragraph (2) of section 561 of the 
     Hiring Incentives to Restore Employment Act in effect on the 
     date of the enactment of this Act is increased by 3 
     percentage points.

                      TITLE IV--BUDGETARY EFFECTS

     SEC. 401. COMPLIANCE WITH STATUTORY PAY-AS-YOU-GO ACT OF 
                   2010.

       The budgetary effects of this Act, for the purpose of 
     complying with the Statutory Pay-As-You-Go-Act of 2010, shall 
     be determined by reference to the latest statement titled 
     ``Budgetary Effects of PAYGO Legislation'' for this Act, 
     submitted for printing in the Congressional Record by the 
     Chairman of the House Budget Committee, provided that such 
     statement has been submitted prior to the vote on passage.

  The SPEAKER pro tempore. The bill shall be debatable for 1 hour, with 
30 minutes equally divided and controlled by the chair and ranking 
minority member of the Committee on Energy and Commerce, 20 minutes 
equally divided and controlled by the chair and ranking minority member 
of the Committee on the Judiciary, and 10 minutes equally divided and 
controlled by the chair and ranking minority member of the Committee on 
Ways and Means.
  The gentleman from California (Mr. Waxman) and the gentleman from 
Texas (Mr. Barton) each will control 15 minutes. The gentleman from New 
York (Mr. Nadler) and the gentleman from Texas (Mr. Smith) each will 
control 10 minutes. The gentleman from Michigan (Mr. Levin) and the 
gentleman from Michigan (Mr. Camp) each will control 5 minutes.
  The Chair recognizes the gentleman from New York.
  Mr. NADLER of New York. Mr. Speaker, I yield myself such time as I 
may consume.
  Mr. Speaker, I rise today in support of the James Zadroga 9/11 Health 
and Compensation Act.
  On September 11, 2001, al Qaeda orchestrated the deadliest terrorist 
attack in American history, killing almost 3,000 people and wounding 
thousands more. The attacks created an environmental nightmare as 
hundreds of tons of every contaminant known to man and woman came into 
the streets and the canyons of Manhattan and Brooklyn.

                              {time}  1310

  You can see pictures of this in front of us. Into this toxic crowd 
ran firefighters and police and other first responders. First 
responders came from all 50 States to aid in the rescue and cleanup of 
the subsequent days. The Environmental Protection Agency, the EPA, 
despite ample evidence to the contrary, kept falsely proclaiming that 
the air was safe to breathe. It wasn't. The terrorists caused the 
environmental catastrophe, but the Federal Government compounded the 
damage by telling people that the environment was safe when it wasn't, 
and now thousands of people are sick and in need of special care.
  We have a moral obligation to treat those who became ill, and that is 
what this bill is all about. For 8 years, Representative Maloney and I, 
supported in a bipartisan basis by the New York delegation and others, 
have worked to bring this bill to the floor. Now it is finally time to 
pass it.
  Time and again as we moved this bill through the legislative process, 
we have adjusted it, reduced its size and scope, limited its cost, and 
made concessions to broaden the coalition and lower the cost to the 
taxpayers. We worked with our colleagues on the other side of the aisle 
to reopen the Victim Compensation Fund in a responsible way in order to 
protect contractors from liability so they would not find they 
sacrificed their businesses to serve their country. We even agreed to 
cap attorney's fees.
  On the Victim Compensation Fund, this House, indeed this Congress, 
passed the Victim Compensation Fund almost unanimously a week or two 
after 9/11. Unfortunately, people who should have been compensated by 
that fund could not be because their sicknesses did not become evident 
until after the fund closed.
  Had we known that they would become ill, we certainly would have 
included them unanimously. That is why Ken Feinberg, testifying before 
the Judiciary Committee, urged us to reopen the fund, which is one-half 
of this bill.
  Feinberg said in March of last year, ``It is truly ironic that many 
of these very individuals who have filed lawsuits seeking compensation 
are the same type of individuals who received payments from the 9/11 
fund. Had these individuals manifested a physical injury before the 9/
11 fund expired, they too would have received compensation without 
litigating.''
  He went on to say, ``Reenacting the law establishing the Federal 
September 11th Victim Compensation Fund for an additional period of 
years in order to provide the same public compensation to eligible 
physical claimants could be justified on grounds of basic fairness.'' 
Now is our chance to right that wrong and provide that basic fairness 
of which he speaks.
  I know that some Members are concerned about the cost of providing 
the Victim Compensation Fund assistance and the health care for the 
survivors and first responders. Let me emphasize: This bill is fiscally 
responsible and balances the needs of our 9/11 heroes with fiscal 
restraints.
  It is completely paid for. We have achieved this by closing a tax 
loophole which allows foreign companies to evade U.S. taxes. Second, we 
have capped the funding level, capped the number of people who can 
participate, and capped the number of years the program can continue. 
We have consistently worked to reduce its cost, and in the month of 
July alone we brought the cost of this bill down an additional $3 
billion.
  Now let me appeal to my colleagues on the other side of the aisle. I 
understand that some may have a problem with the offset, even though it 
is not aimed at U.S. companies and is simply designed to improve 
withholding of taxes that are legally due. I understand.
  But I have to ask this: Just consider for a moment what we are 
talking about. Balance that tax rate against the needs of our 9/11 
heroes, needs that are so great, so raw, and so obvious, and let our 
moral obligation to the heroes of 9/11, our obligation, as Lincoln 
said, ``to care for him who shall have borne the battle,'' prevail. Let 
us do the honorable thing and vote for this bill.
  Mr. Speaker, the choice is simple. I will be voting today for the 
firefighters, for the police, for the first responders, for the 
survivors of the attacks. I urge every Member of the house to do the 
same.
  I want to thank Congresswoman Maloney, Congressman King, the New York 
delegation, the Speaker, the majority leader, the chairmen of the 
various committees, subcommittee chairs Pallone and Lofgren, and all 
the organizations like the State AFL-CIO from New York, the 
International Association of Firefighters, and the National Association 
of Police Organizations for their invaluable support for this bill.
  Mr. Speaker, my colleagues, do the right thing. Do the moral thing. 
Do the only moral thing. Vote for this bill.
  I reserve the balance of my time.


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore. The Chair will remind all persons in the 
gallery that they are guests of the House, and any manifestation of 
approval or disapproval of the proceedings is a violation of the rules 
of the House.
  Mr. SMITH of Texas. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, this bill presents a sensitive issue with regard to 
compensation for those who are suffering ailments as a result of the 
recovery and cleanup efforts at the World Trade Center site. No doubt 
there are many with legitimate claims as a result of their efforts at 
Ground Zero. However, this legislation as written creates a huge $8.4 
billion slush fund paid for by taxpayers that is open to abuse, fraud, 
and waste. That is because the legislation creates an inexplicable and 
unprecedented 21-year long fund.
  The case of the bill's namesake, James Zadroga, is indicative of the 
problems with this bill. Rather than finding that Detective Zadroga's 
death was the result of exposure to Ground Zero dust, the New York City 
medical examiner concluded that, ``It is our unequivocal opinion, with 
certainty beyond doubt, that the foreign material

[[Page H7243]]

in Detective Zadroga's lungs did not get there as a result of inhaling 
dust at the World Trade Center or elsewhere.'' So the bill is 
deceptive, starting with its title.
  The danger here is not simply the occasional unsupported claim, as in 
the case of Detective Zadroga, but the creation of a massive and 
expensive compensation system that will be subject to pervasive 
problems over the unprecedented 21 years it will be open to claimants.
  The legislation also vastly extends the geographic scope of the fund 
to cover ``routes of debris removal.'' This will result in the 
potential for a huge number of additional claimants with tenuous 
connections between their medical problems and the cleanup efforts at 
Ground Zero.
  The bill allows claims to be filed until the year 2031, an 
unjustifiable length of time. As Ken Feinberg, Special Master of the 
original 9/11 fund and the administrator of the BP oil spill claims 
process stated, ``no latent claims need such an extended date.''
  Additionally, the bill permits those who have settled their lawsuits 
to reopen their claims and seek additional taxpayer-funded compensation 
through the 9/11 fund. This is contrary to both the terms of the 
original 9/11 fund and to normal legal principles regarding final 
settlements.
  By greatly expanding the fund's eligibility criteria, these proposed 
changes not only will increase the cost of the fund, but will present 
more opportunities for fraud and abuse of taxpayer dollars.
  Also the bill does little, if anything, to limit the special master's 
unbounded authority. The amount of discretion given to the Special 
Master may have been acceptable under the original 9/11 fund because it 
was designed to compensate a limited number of claimants with 
relatively noncontroversial claims as soon as possible. However, this 
amount of discretion will not work for the 21-year-long fund created by 
this bill with its larger set of potential claimants who have injuries 
with more ambiguous causation. If nothing else, this structure will be 
an open invitation for spurious claims.
  The original 9/11 fund was an understandable expression of a nation's 
compassion and generosity following the deaths of thousands of innocent 
people. It was designed to settle the claims of those covered once and 
for all. Maybe that claim should be reopened to protect the 
construction contractors from the financially ruinous litigation they 
now face. But if we are going to reopen the funds, we should do so in a 
much more narrow way, with far less discretion for the Special Master 
than that provided for in H.R. 847.
  It is hard to explain spending billions of additional taxpayer 
dollars when Special Master Ken Feinberg has emphatically stated that 
the $1.5 billion in taxpayer money, charitable contributions, and 
insurance coverage currently available for distribution is ``more than 
sufficient to pay all eligible claims, as well as lawyers' fees and 
costs.''
  Why does Congress continue to overreach and consider taxpayers to be 
their personal slush fund? There is no excuse for this kind of 
legislation, and I hope thoughtful Members will want to oppose the 
bill.
  Mr. Speaker, I reserve the balance of my time.

                              {time}  1320

  Mr. NADLER of New York. Mr. Speaker, I yield 1 minute to the 
distinguished chairperson of the House Rules Committee, the gentlewoman 
from New York (Ms. Slaughter).
  Ms. SLAUGHTER. I thank the gentleman for yielding.
  I am proud to rise in support of the men and women who risked their 
lives for their fellow citizens following the attacks on September 11. 
On that day in 2001, tens of thousands of Americans raced to rescue 
those injured in the terrorist attacks. In the course of the work that 
day and the days following, they were exposed to dangerous toxins and 
physical hazards. After giving so much of themselves, many of the 
firefighters, police officers, and bystanders face serious respiratory, 
gastrointestinal, and mental health conditions. While Ground Zero is 7 
hours away from my own district in Rochester, the New Yorkers banded 
together as they joined the chorus of Americans asking how we could 
help. Just the other day, I talked to a captain of the Niagara Falls 
Fire Company who broke his leg at Ground Zero in an effort to rescue 
those trapped under rubble, many of western New Yorkers who answered 
the call to serve.
  We recently observed the anniversary of the 9/11 terrorist attacks, 
and we can't forget those who risked everything to help the victims at 
Ground Zero. For this reason, I support H.R. 847, the 9/11 Health and 
Compensation Fund.
  Mr. SMITH of Texas. Mr. Speaker, I continue to reserve the balance of 
my time.
  Mr. NADLER of New York. Mr. Speaker, I now yield 1 minute to the 
gentleman from New York (Mr. Maffei).
  Mr. MAFFEI. I thank my distinguished colleague from New York.
  September 11, 2001, it's a day we will never forget. Many people lost 
family members and neighbors, but alongside the sorrow and loss, we 
witnessed incredible acts of heroism and bravery. Thousands of 
emergency responders and volunteers risked their lives and came to our 
country's aid when we needed them most. Many of them were my 
constituents, even though I'm from upstate New York. Many came down in 
the months following and the weeks following.
  Thomas Kwasnaza from Marietta, New York, was one of the heroes that 
day. He was working as a police officer on 9/11, and he actually 
trained with James Zadroga, who was one of the first NYPD officers 
whose death is attributed to toxic chemicals.
  Mr. Speaker, on that day Members of Congress and all Americans alike, 
Republicans and Democrats, pledged to do anything we could--anything we 
could--for the victims, their families, and the rescuers who went in 
after them. We didn't say we would do anything as long as it doesn't 
cost too much. We didn't say we would do anything as long as there was 
no chance that an undocumented worker could possibly benefit. We didn't 
say we would do anything as long as it protects offshore companies that 
get away with sheltering their taxes. We said we would do anything. And 
that's what we have to do.


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore. Members shall heed the gavel.
  Mr. SMITH of Texas. Mr. Speaker, may I ask how much time remains on 
each side?
  The SPEAKER pro tempore. The gentleman from Texas has 5 minutes 
remaining. The gentleman from New York has 3 minutes remaining.
  Mr. SMITH of Texas. Mr. Speaker, I am prepared to close on this side; 
so at the appropriate time I will do so. Meanwhile, I reserve the 
balance of my time.
  Mr. NADLER of New York. Mr. Speaker, I now yield 1 minute to the 
gentleman from New York (Mr. McMahon).
  Mr. McMAHON. I just want to be very clear that we all owe a great 
debt of gratitude to Congress Members Maloney and Nadler from New York 
for their leadership on this issue.
  Mr. Speaker, my district of Staten Island was particularly hard hit 
from the 9/11 attacks. Nearly 300 of my constituents were murdered, 
including one-third of the firefighters killed on that day, and sick 
today are those uniformed and hard hat-wearing heroes--the operating 
engineers, the laborers, the steelworkers, ironworkers, and all the 
volunteers and residents.
  When I think about why we need this law, I think about Marty Fullam, 
a 30-year veteran FDNY lieutenant from Staten Island, who spent weeks 
going through toxic debris in the wake of 9/11, and years later his 
doctors confirmed his illness related thereto. He was told he would die 
without a new lung. And while he ultimately received a new lung earlier 
this year, his health continues to suffer. The last time he was here in 
July to fight for this bill, he actually made his condition worse. And 
he continues to recover from that. Our thoughts go out to him and his 
wife, Trish, and their daughters.
  Despite their deteriorating health, many first responders like Marty 
send this message. For that reason, Mr. Speaker, we must pass this 
bill. We must pass this bill.

[[Page H7244]]

                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore. The Chair requests that all Members respect 
the gavel.
  Mr. SMITH of Texas. Mr. Speaker, I yield myself the balance of my 
time.
  Mr. Speaker, this legislation represents an irresponsible overreach 
and does not contain the protections necessary to safeguard valuable 
taxpayer dollars from abuse, waste, and fraud. Ken Feinberg, Special 
Master of the original 9/11 Fund, testified twice before the Judiciary 
Committee on this legislation. Both times Mr. Feinberg advocated 
reenacting the 9/11 fund, but doing so on a much more limited basis 
than is done in this legislation. Why are we ignoring his advice?
  Mr. Feinberg stated that if the fund is reenacted, it should be for 
``a window of 5 years,'' not 21, and that it should be done with ``the 
understanding that there would be no changes in the rules and 
regulations governing the original fund and that the new law would 
simply be a `one line' reaffirmation of the original 9/11 fund.'' Mr. 
Feinberg warned that ``any attempt to modify the statutory provisions 
and accompanying regulations of the original fund will undercut 
political consensus.''
  Unfortunately, Mr. Feinberg's sound advice was ignored there, too. 
Instead, we are considering a bill that creates a fund with an 
unnecessary 21-year long duration and that contains special protections 
for trial lawyers; unnecessarily extends the original fund's 
eligibility criteria; and does not include the protections necessary to 
safeguard the fund from abuse, waste, and fraud. This is another 
example of Congress' insatiable appetite for the taxpayers' hard-earned 
dollars. I urge my colleagues to vote ``no'' on this bill.
  I yield back the balance of my time.
  Mr. NADLER of New York. Mr. Speaker, how much time do I have left?
  The SPEAKER pro tempore. The gentleman from New York has 2 minutes 
remaining.
  Mr. NADLER of New York. Mr. Speaker, I then yield the balance of my 
time to my partner for the last 6 years on this bill, the gentlewoman 
from New York (Mrs. Maloney).
  Mrs. MALONEY. I thank the gentleman for his leadership and for 
yielding and for his hard work for 6 years. It took us 4 years in 
college, and it has been 6 years on this bill. The time to pass the 
James Zadroga 9/11 Health and Compensation Act is now. It is 
bipartisan. It is patriotic. And it is overwhelmingly supported by 
Americans across this country.
  James Zadroga's father is with us today, as well as many hardworking 
men and women who worked on that pile, who selflessly risked their 
health and their lives to help others. And I thank the New York State 
AFL-CIO'S Dennis Hughes and Suzie Ballentine; the firefighters and fire 
officers who are here with us today, Al Hagen and Steve Cassidy; the 
police, Pat Lynch; the laborers, the construction workers; D.C. 37, Lee 
Clark, Mike McIntyre, John Feal. Many of you have received praise for 
your work, but many of you have said all you want is your health care.
  An estimated 36,000 Americans have received treatment for illnesses 
as a direct result of 9/11. Those who are suffering come from all of 
our 50 States and 428 of the 435 congressional districts nationwide 
were represented at 9/11. Here is a map of locations in Florida and in 
California where health care providers have provided medical services 
to 9/11 responders. Nearly every Member of this House of 
Representatives have people that worked there. And they are losing 
their health.
  Thousands of people lost their lives 9 years ago, but thousands and 
thousands more lost their health. This is not an entitlement. This is a 
responsibility to take care of those who took care of us when our 
country was attacked.
  Mr. Speaker, I would ask people to go to our Web site that outlines 
the participants from across this country and all of our congressional 
districts.
  It is now time for this Congress to do what we should have done long 
ago: provide proper care for those who lost their health because of 9/
11.
  We have a moral obligation to help those who were harmed by the 
attacks on America.
  In the spirit of patriotism and common purpose Congress showed the 
world in the aftermath of the 9/11 attacks, and for the sake of the 
thousands of 9/11 first responders and survivors who are suffering, I 
implore my colleagues to vote ``yes'' on this legislation.

                              {time}  1330

  The SPEAKER pro tempore. The gentleman from New Jersey (Mr. Pallone) 
and the gentleman from Texas (Mr. Barton) each will control 15 minutes.
  The Chair recognizes the gentleman from New Jersey.
  Mr. PALLONE. Mr. Speaker, I rise in strong support of H.R. 847, the 
James Zadroga 9/11 Health and Compensation Act of 2010. This important 
legislation was reported by the Energy and Commerce Committee with 
bipartisan support on May 25 by a vote of 33-12.
  I would like to take a moment to thank the bill's sponsors, 
Representative Carolyn Maloney and Jerry Nadler; as well as my 
colleagues from New York on the committee, Eliot Engel and Anthony 
Weiner, for their tireless work on behalf of this legislation.
  Now, beyond the immediate loss of life on September 11, today, 
thousands of people are suffering debilitating illnesses from its 
aftermath. H.R. 847 would establish the World Trade Center Health 
Program, a program to screen, monitor and treat eligible responders and 
survivors who are suffering from World Trade Center-related diseases, 
most commonly from the massive toxic dust cloud that enveloped lower 
Manhattan. The bill also funds research to improve our understanding of 
the health effects of the exposures over time.
  Federal spending for the WTC Health Program is capped at $3.2 billion 
and is fully paid for. The version before the House today is more than 
$1 billion less expensive than that reported with bipartisan support 
from the Energy and Commerce Committee.
  Mr. Speaker, Congress must ensure that the appropriate resources are 
available to take care of those who risked their own lives to save 
others on September 11, so I urge my colleagues to pass the bill.
  I reserve the balance of my time.
  Mr. BARTON of Texas. Mr. Speaker, I yield myself 5 minutes.
  (Mr. BARTON of Texas asked and was given permission to revise and 
extend his remarks.)
  Mr. BARTON of Texas. Mr. Speaker, I rise in respectful but sincere 
opposition to the pending bill. I have no disrespect for the victims or 
for the namesake's sponsor and his family, but I also have a sincere 
regard for the United States taxpayer, who is going to have to pay for 
this new entitlement program.
  The first myth that I want to relate is the implication that we don't 
have an existing victims' compensation fund. That is simply not true, 
Mr. Speaker. Twelve days after the attack back in September of 2001, we 
passed Public Law 107-42, the Victim Compensation Fund of 2001. We gave 
2 years, or a year and a half, for people to submit claims, and 97 
percent of the eligible victims or their families filed injury or death 
claims by December 22, 2003. Of the 2,973 victims, 2,880 families filed 
claims. The average award for the families of the victims actually 
killed in the attack averaged $2 million per victim while 70 people 
chose to file lawsuits and 23 eligible families took no action. In 
addition to death claims, 2,680 injury claims have been filed and 
processed. The average award for injured victims is nearly $400,000 per 
injury. Overall, this fund has paid out over $7 billion in the last 9 
years.
  We also passed the Victims of Terrorism Tax Relief Act back in 2001 
so that the families of the victims would not be subject to Federal 
income taxes for the year of the attack and also for the previous year 
to the attack.
  We currently have an existing 9/11 benefit program. President Obama 
requested $150 million for this budget year. In the years that this 
program has been in existence, in addition to the program I just 
explained, it has paid out $373 million.
  As of September 30 of last year, there have been 55,331 first 
responders in the monitoring and treatment programs that I have just 
discussed. Of those, 44,754 have received initial exams, and 13,000 
have been treated for World Trade Center-related health conditions in 
the past 12 months alone.
  So, in point of fact, we have an existing fund that has paid out over 
$7 billion. We have an ongoing fund. The President has asked for $150 
million per year, which the Republicans support.

[[Page H7245]]

On top of that, we are expected to vote for this new entitlement 
program, which is over $7 billion.
  My good friend from New Jersey said that it is going to save $1 
billion over the bill that was reported out of the Energy and Commerce 
Committee several months ago. What he doesn't tell you is the way they 
do that, which is by using a budget gimmick that simply doesn't fund 
the program in the year 2019. In fiscal year 2018, the amount provided 
in the bill would be $601 million. In 2019, that drops to $173 million. 
In fiscal year 2020, there is no funding at all. So they have simply 
decided that, at a date certain, they would start reducing the amount 
of money so they could get under their self-imposed budget window.
  Mr. Speaker, we want to help the victims of 9/11 in New York City. We 
certainly want to help the first responders. What we don't want to do 
is put on the average American taxpayers all around the country a $7 
billion to $8 billion brand new entitlement program that compensates at 
health care/Medicare rates of 140 percent above the baseline. As 
Congressman Smith just pointed out, it reopens some of these lawsuits 
and some of these cases that have already been solved.
  So, if you want help, we are willing to help, but let's use the 
existing program. Let's not create a new program, especially a new 
entitlement program, which we simply cannot afford at this point in 
time.
  Mr. Speaker, I ask unanimous consent that the gentleman from Illinois 
(Mr. Shimkus), the ranking member of the Health Subcommittee, be given 
the opportunity to control the balance of the time for the Energy and 
Commerce Committee's minority.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from New 
York (Mr. Engel), who has been a champion on this legislation and who 
also managed it through the Rules Committee yesterday.
  Mr. ENGEL. I thank my friend from New Jersey.
  Mr. Speaker, I rise in strong support of this bill.
  You know, I am going to try to speak from the heart. Those of us who 
represent districts in and around New York City all had constituents 
who died on 9/11. We all had friends who died on 9/11.
  Remember after 9/11 how we all banded together as Americans? Remember 
singing ``God Bless America'' on the steps of the Capitol? Remember how 
it didn't matter if you were Democrat or Republican--we were all 
Americans that day, and we should all still be Americans above and 
beyond anything else?
  I remember, on the Friday after the Tuesday attack, going with 
President Bush to Ground Zero, where he stood with a bullhorn and a 
fireman with him, where he pledged that there would be help forthcoming 
from the Federal Government. All we are asking now is to help these 
people who got sick--who were selfless, who didn't think of themselves, 
who responded, and who only wanted to try to help other people. They 
are now getting sick. They are now dying. They now need our help.
  You know, it's not true, my friends, to say, Well, I'm for helping 
these people, but I'm not for this bill.
  The bottom line is this: If you want to help the heroes of 9/11 and 
the first responders, you vote ``yes'' on the bill. If you don't want 
to help them and if you want to make excuses, you vote ``no'' on the 
bill. It's as simple as that. Yes or no. Yes or no.
  Do we help the people who need our help now, those who responded on 
9/11 when government officials told them that the air was clean and 
that it was okay to go down to Ground Zero, and they went there?

                              {time}  1340

  This is not a New York problem or a New Jersey problem or a 
Connecticut problem. This is an American problem. People are sick from 
431 districts of the 435 districts, and who are we to turn our backs on 
them now?
  So I beg my friends on both sides of the aisle, this is bipartisan. 
We're all American. Vote ``yes.''
  Mr. SHIMKUS. Mr. Speaker, I yield 5 minutes to my colleague and 
friend, the gentleman from New York (Mr. King).
  Mr. KING of New York. I thank the gentleman for yielding.
  Mr. Speaker, I rise in strong support of H.R. 847, and at the outset, 
let me commend my colleagues, Carolyn Maloney and Jerry Nadler, for the 
truly outstanding job they've done for all these years and for their 
directness and for their candor and for always being there when the 
tough decisions had to be made.
  Let me also thank former Congressman Vito Fossella for the work that 
he did for a number of years when he was here in the Congress on this 
bill as well.
  Let me commend the leadership in both parties. I commend the 
Democratic leadership for bringing this back up for a majority vote. I 
commend them for it. I know it's been tough. Some tough decisions had 
to be made, and they've made them. I thank them for that. I also thank 
the leadership for the Republican Party for working with a number of us 
to make sure that it would be a fair and open vote and debate here 
today. So I thank them for that.
  Let me also say that all of us know this has been a long and tortuous 
route to get this bill to the House floor today. During that time, 
there's been frustration, tempers have flared, but also, probably most 
importantly, people have died, and that's what we have to keep in mind. 
This is a real human issue. We have people sitting here in the gallery 
today. Many of them have breathing problems. Many of them have 
pulverized glass in their lungs. Many have poisonous toxins in their 
bloodstream. So this is real. This is a real human issue.
  And I share some of the concerns that Republicans have regarding, for 
instance, the funding stream, how this is going to be paid for. But the 
fact is, this is a good bill. We cannot allow the perfect to be the 
enemy of the good. It's more important to me, I believe, that we take 
care of those who are truly in need and we look at the bill in full 
perspective and in full view and keep that in mind. Keep in mind the 
victims, the men and women who went to Ground Zero on September 11 and 
stayed there for the days, weeks, and months afterward, and they were 
on that pile, and they're now suffering the most horrible diseases, 
diseases and illnesses which we see in our districts when we meet these 
people. We see them in the stores. We see them at ball games. We see 
them in church. So this, again, is for real.
  So let's, today, try to have the debate as we are, I think, in a very 
civil way. Let's realize there are honest differences of opinions on 
both sides, but the reality is, the people in galleries, those who 
couldn't make it to the gallery today, they don't have the luxury of 
waiting another 1 year or 2 years or 3 years or 4 years.
  I know that people on the Republican side have spoken about various 
programs that are available. The fact is this is such a unique type of 
disaster. The illnesses that have come from Ground Zero are very unique 
to Ground Zero, unfortunately. These are 9/11-type illnesses--the 
rarest types of cancer, the rarest types of blood disorders. It's 
essential we have a permanent registry so we will know exactly how 
these illnesses be treated, so that those in the other 430 districts 
around the country who could be suffering, for instance, from a cough, 
which a doctor may think is an innocent cough, will not realize it is a 
9/11 cough; those who have symptoms which may otherwise be undetected, 
they will not realize how significant they are and how they could be 
directly related to 9/11.
  And also, as far as whether or not this is an entitlement, or 
whatever term we want to use, the fact is, when it came to nuclear 
workers, Federal nuclear workers, we set up the exact same type of 
program. Call it entitlement, if you will. That program was set up to 
take care and compensate those who suffered serious illnesses resulting 
from their work in nuclear plants on nuclear projects.
  As far as the issue of the Victims Compensation Fund and all those 
who were compensated, the fact is the people we are talking about 
today, the victims we are talking about today, were people who didn't 
realize their illness until after the deadline had expired, people who 
are today just finding out

[[Page H7246]]

about their illness. It's latent. It's in their bloodstreams. It's in 
their lungs. And back in 2003 when this program closed, virtually no 
one knew the extent of the illnesses and diseases that would stem from 
September 11.
  The fact is they are there and they are getting worse and worse, and, 
as you know, Congressman Weiner just walked in, and he and I always 
haven't had the highest things to say about each other on the House 
floor. We're standing here together on this bill today. As he pointed 
out in the Energy and Commerce Committee hearing, the one thing we can 
be certain of is that the number of those who are entitled to take part 
in this program, that number is going to diminish. It is going to 
diminish because they're dying one by one. So let's keep that in mind.
  Again, it goes to the heart of what we should be as a Congress, what 
we should be as Republicans and Democrats, what we should be as 
Americans. And those of us, we all stood together on September 11, and 
9 years have gone by. And to many people it's something that happened a 
long time ago, but for those who are suffering today, it's something 
they live with every moment.
  So, with that, I urge everyone to make this as much of a bipartisan 
vote as possible. Send a message to the country, send a message to the 
world, and send a message to the victims that they are not forgotten. 
And not only that, we're not giving them any charity. We're not giving 
them anything. We're just rewarding them what they're entitled to 
receive for them putting their lives on the line for us.
  With that, I urge adoption of H.R. 847.


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore. The Chair would like to remind all Members 
that remarks in debate may not call attention to visitors in the 
gallery.
  Mr. PALLONE. Mr. Speaker, at this time, I would yield 1 minute to the 
gentleman from New York (Mr. Israel).
  Mr. ISRAEL. I thank the gentleman.
  Mr. Speaker, in the weeks after 9/11, I remember colleagues from 
throughout the Congress approaching those of us who suffered loss and 
who lost constituents saying, What can I do to help? What do you need? 
How can I assist? Today, we're taking you up on your offer.
  A few weeks ago, we commemorated the ninth anniversary of 9/11 and 
many people said the right prayers and they gave the right speeches, 
but now it's time to do the right thing.
  To the gentlemen and gentlewomen from Louisiana, when the hurricane 
swept through, New Yorkers paid to rebuild Louisiana.
  To the gentlemen and the gentlewomen from California, when the fires 
burned, New Yorkers ponied up to help California.
  To the gentleman from Texas who spoke earlier today, when Hurricane 
Alex ripped through Texas, New Yorkers helped pay the bill for 
recovery.
  And I want to be able to say to those gentlemen and gentlewomen that, 
when the terrorists came to New York, you were there for us, and not 
just New Yorkers who happened to be there that day, but the 11,000 
people who are suffering and ill today.
  They're not just New Yorkers. They're Americans living in your 
districts.
  Mr. SHIMKUS. Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. At this time, I yield 1 minute to the gentleman from New 
York (Mr. Hall).
  Mr. HALL of New York. Mr. Speaker, I thank the chairman for yielding.
  I rise in strong support of H.R. 847, the James Zadroga 9/11 Health 
and Compensation Act.
  We cannot talk about the 9/11 attacks without remembering the first 
responders who answered that call that day and safeguard us here every 
day. Police officers, firefighters, EMTs, and ordinary American 
citizens rushed into crumbling buildings and then worked countless 
hours in the days and weeks that followed; and now, more than 9 years 
later, many of those courageous first responders are suffering from 
serious illnesses caused by inhaling toxic fumes and particles in air 
that they were told was clear and safe to breathe.
  It is our patriotic duty to protect those who sacrificed for their 
fellow Americans. This is not a partisan issue. This is an issue of 
responsibility. Many of my constituents lost loved ones on that day, 
spent months combing through the rubble for remains, and are now 
suffering health problems as a result.
  Let's honor those who selflessly returned to Ground Zero to save 
those they did not know by standing together and passing this bill.
  Mr. SHIMKUS. I continue to reserve my time.
  Mr. PALLONE. Mr. Speaker, I yield 1 minute to the gentleman from New 
York (Mr. Meeks).
  Mr. MEEKS of New York. This is the United States House of 
Representatives, the United States of America. This is an institution 
that I am proud to be a Member of, and there comes a point in time in 
our lives when we just simply must do the right thing, keeping our 
priorities straight.
  This is a political body, but this is not a political issue. It 
should not be. It was not political when every man and woman went out 
to save and to sacrifice their own lives, in essence, on 9/11. They 
went out there not because they were Democrats or Republicans, they're 
black or white, they're from here or there. They went out there because 
this is the United States of America. This is the people's House. There 
comes a time for us not to be political but to take care of our own, 
and that's what this is all about.

                              {time}  1350

  Our own are sick. Our own are dying. And we, in the people's House, 
need to come to their aid and come to their aid now.
  Mr. SHIMKUS. I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, can I just ask the gentleman from Illinois 
if he has any additional speakers?
  I yield to the gentleman.
  Mr. SHIMKUS. I don't think we do. I mean, I'm not trying to game you 
here on this process. I just don't think there are any more, and I 
would like to close.
  Mr. PALLONE. Thank you.
  I yield 1\1/2\ minutes to the gentlewoman from New York (Ms. 
Velazquez).
  Ms. VELAZQUEZ. I want to thank the gentleman for yielding.
  Mr. Speaker, as is often the case with disasters, on 9/11 and in the 
weeks that followed, the best of America was on display. Neighborhoods 
came together to comfort and support one another. Communities in every 
corner of the country rallied together. In New York City, our brave 
first responders answered the call valiantly, putting their lives at 
risk to protect the rest of us.
  Over the last 9 years, the full scope of this tragedy's health 
effects has become increasingly clear. Firefighters, police officers, 
EMTs, and rescue workers are all suffering respiratory problems. Even 
schoolchildren and those who work in the area have exhibited health 
problems. It is estimated that 36,000 people have sought treatment 
after being exposed to the toxic dust at the World Trade Center site. 
It is not just New Yorkers who are affected. Ten thousand people 
traveled from every State of the Union, including Puerto Rico and the 
territories, to assist in the aftermath of these attacks. Like all of 
America, these heroes were a diverse group, representing every age, 
race, religion, and even status. No one asked them for their 
citizenship status when they stepped in to help. They were all there, 
and they were all heroes.
  This legislation will provide needed benefits for all those who are 
suffering from the toxins they were exposed to. This is the right thing 
to do. These brave individuals cast aside their own safety to assist 
their fellow human beings.
  Mr. SHIMKUS. I continue to reserve the balance of my time, Mr. 
Speaker.
  Mr. PALLONE. Mr. Speaker, I now yield 3 minutes to another champion 
of this bill from our committee, the gentleman from New York (Mr. 
Weiner).
  Mr. WEINER. I thank the gentleman from New Jersey.
  You know, I have heard some people describe this bill as an 
entitlement bill, as if people are lining up to get this benefit. Like 
someone would really want to be on the list of people eligible to get 
the money that's eligible under this bill to get the health care. The 
idea that someone would volunteer or be eager to get the benefits that, 
in order to get them, you have to have a stew of toxic dust in your 
lungs, so much that you can't breathe normally,

[[Page H7247]]

and you cough. And when you hear that 9/11 cough in New York, everyone 
knows it.
  The idea that it's open-ended--no, it's actually a pretty close-ended 
program in the most final sense of the word, in that many people who 
have the illnesses that we are trying to treat with this legislation 
are dying. There are people in this Chamber who are watching these 
proceedings and those that are home who once upon a time were the most 
vigorous, fit people imaginable. And it was because of that vigor and 
that fitness that they went down to Ground Zero on September 11. They 
didn't ask to be chosen. They didn't fill out a form. They didn't even 
wear protective gear. They went down because they felt it was their 
obligation. They didn't just come from Lower Manhattan. They didn't 
just come from New York.
  As I've said many times, if you were in New York the days after 
September 11, the streets were clogged with parked ambulances and 
firetrucks and cars, every license plate imaginable. Those people 
aren't asking for anything beyond just being able to cure the diseases 
that they got because they served. That's what this is about.
  To my colleagues who oppose this, yeah, I imagine there are 100 
different ways you can describe it and you can look at line 7 and page 
6 and come up with some reason to be against it. But I would ask my 
colleagues to take a step back. And every single one of us on September 
11 stood up in our districts and said, We are not going to forget the 
commitment that we made that day. Well, this is the moment. You can't 
stand up in your district on September 11 and say you won't forget, and 
have a red light next to your name today. It just doesn't wash. This is 
the day we repay our debts.
  You want to call it an entitlement bill? Okay, they are entitled. 
They are entitled to our care. They are entitled to our respect. They 
are entitled to the health care that they need, and they're entitled to 
a ``yes'' vote today. Let's give it to them.


                Announcement By the Speaker Pro Tempore

  The SPEAKER pro tempore. The Chair will remind all persons in the 
gallery that they are here as guests of the House and that any 
manifestation of approval or disapproval of the proceedings is in 
violation of the rules of the House.
  Mr. SHIMKUS. Mr. Speaker, may I ask for how much time is remaining 
and how many speakers my colleague from New Jersey has.
  The SPEAKER pro tempore. The gentleman from Illinois has 5 minutes, 
and the gentleman from New Jersey has 4\1/2\ minutes.
  Mr. PALLONE. At this point, I would just close myself, unless someone 
else comes down. So if you would like to close on our Energy and 
Commerce time, then I will follow you.
  Mr. SHIMKUS. Mr. Speaker, I yield myself the balance of the time.
  Our great friends from both sides of the aisle, our great friends 
from New York, it has been an interesting battle, one that is very 
tough to be engaged in. They are right. You know, the folks who 
responded need care. They need to be supported, and that's what we 
think we have been doing.
  When we started marking up this bill, there was $130 million in the 
fund. That was still there, cash on hand. The President, in his budget, 
said, We can do better than that. We need $150 million. So that started 
the process of us deciding what did we need to do and how did we need 
to do it, especially from the funding perspective.
  Now the entitlement debate is an interesting one to get involved in. 
I am a military veteran. I served actively for 5\1/2\ years. I served 
another 23 in the Reserves. The first line responders are heroes. But 
our men and women in uniform in Afghanistan, our men and women in Iraq, 
and our men and women around the world, they are heroes too. They don't 
have an entitlement program. They go through the regular authorization 
process. They go through the appropriation process. And you know what? 
When we go into the political battle, which we are coming upon, people 
attack folks about whether they are authorizing enough money or whether 
they are spending enough money. This is what happens here.
  We can spin it any way we want, but that's part of our debate. Do you 
use the same process to authorize funding to fight for the money and 
spend the money? And we would say, We should use the same categories we 
do with our military veterans, that we should use the same process we 
use for our active military forces. Again, the President wanted $150 
million. That's what we agreed upon. That's the amendment that we 
authorized in the marked-up bill. And some would argue and say, Gosh, 
there must be nothing being done. Nothing is being done. Well, we know 
that's not true. CDC has been before the committee twice, saying they 
have a list. They do have a registry. They are following up. In fact, 
as of September 30, the World Trade Center Program has enrolled 55,331 
responders. There are 55,331 responders in the program now. It's not 
like we're not doing anything.
  There are other issues with the bill. One of the concerns is, when 
the new health care law cuts money to hospitals under part A, about 
$150 billion in payments, the CMS actuary says, Guess what? Ten percent 
of all hospitals are going to close.

                              {time}  1400

  That is under the new health care bill. And it is rural hospitals 
that are the targets under the new health care law.
  Well, this provides more money under Medicare to New York City 
hospitals, at 140 percent of Medicare payments. We only pay 70 percent 
of Medicare payments in this country as a whole. But under this law, we 
are going to provide New York hospitals 140 percent of Medicare costs. 
So there are real issues of concern here, and it is unfortunate because 
it didn't have to be this way.
  All we asked for was the number that President Obama thought was 
good. He said $150 million. We said, fine, 20 million more than what 
the money was still in the fund at the time.
  And we are also saying they are all heroes. The 9/11 responders are 
heroes. Let's treat them like our veterans. Let's treat them like our 
active military. Why should we have a double standard? Can't we fight 
for their authorizations on an annual basis like we do for our active 
military and for our veterans? Of course we can.
  So, with that, Mr. Speaker, it is, again, unfortunate that we are in 
this position. We could have had a strong bipartisan bill. We don't 
have that. People will cast their votes, and they will be held 
accountable.
  I yield back the balance of my time.
  Mr. PALLONE. At this time I would like to yield 1 minute to the 
Speaker of the House and point out that if it wasn't for her efforts, 
we would not be here today moving this legislation.
  Ms. PELOSI. I thank the gentleman, but I, in turn, want to salute 
Congressman Peter King, Congresswoman Carolyn Maloney, Congressman 
Jerry Nadler, and the entire bipartisan New York delegation for giving 
us this opportunity today to do what is right and fair and just.
  Mr. Speaker, in observance of 9/11 earlier this month, we stood on 
the steps of the Capitol, Democrats and Republicans alike, to honor the 
memory that we lost that day. As we were standing there, I was thinking 
back to my first visit to Ground Zero. When you went there at that time 
following the tragedy, you knew that when you stepped there you were 
walking on sacred ground. There was an incredible silence as the 
workers feverishly, feverishly tried to retrieve the remains of those 
who were lost, and just repair the damage that was done to clear the 
wreckage.
  No pictures were allowed in recognition that we were on sacred 
ground. No photographs were allowed, and of course, silence was 
generally observed so that those who were working could hear each other 
as they quietly went about their very, very sad assignment.
  They, and those who rushed to the scene in real time when it 
happened, risked their lives and their health to do so. They didn't ask 
any questions: Is anybody going to take care of me? They were there to 
help.
  Again, back to the steps of the Capitol. When we were standing there 
earlier this month, I am sure Congresswoman Maloney, Congressman 
Nadler, Congressman King and others recall that many signs went up in 
the crowd that was gathered there. It said: ``Remember us next week.'' 
That was in anticipation that the bill might

[[Page H7248]]

come up the following week. Well, it is another week later. And we are 
here today to say that we do remember you this week. We remember what 
you did at the time. And it isn't only your sacrifice. It is the 
sacrifice of your families, of your health and the impact that that has 
on your family. You are community to New York, so there is the impact 
that it has on the community, and also the impact on our conscience to 
do what is right by those who we call heroes and we want to treat as 
such.
  Today we remember all the heroes of 9/11. We praise the strength of 
thousands of firefighters, rescue workers, first responders and medical 
personnel who turned tragedy into inspiration and gave of themselves to 
help a city and our Nation rebuild.
  We promised to help those who spent days, weeks and months doing the 
hard work our government and the American people expected them to do in 
the recovery effort. They went above and beyond the call of duty. We 
all know that. We all looked in frustration to think, if only we could 
help. But they were there. It was emotional, but it was professional. 
And we pledged to do everything in our power to ensure that their 
health and well-being would be taken care of. We did not want them to 
be unsung heroes. We wanted them to be recognized heroes.
  Today we are here to honor that pledge. It is long overdue, but 
nonetheless we are here to do right by these workers and vote for the 
James Zadroga 9/11 Health and Compensation Act.
  Words are, of course, inadequate to recognize and honor the bravery 
and courage of these brave Americans. But by this act of Congress, more 
than words, but by this act of Congress, we can truly express our 
gratitude to the ordinary men and women. Ordinary? No. Extraordinary 
men and women who took extraordinary action at that time.
  Named for Officer James Zadroga, a hero of the New York Police 
Department who died from respiratory disease contracted during the 
Ground Zero recovery effort, this legislation will help those who 
jeopardized their health to rescue others secure necessary medical 
treatment, especially for the unique exposures suffered at Ground Zero 
which are real; and ensure survivors and victims' families can obtain 
compensation for their losses through a reopened 9/11 victims 
compensation fund.
  It is fully paid for. This legislation does not increase the deficit. 
It is the least we can do for those who answered the call of duty and 
continue to suffer the ill health effects of their service. On 
September 11, 2001, all Americans were shocked by the horrifying images 
of terror and destruction. Yet, in the aftermath of that dark day, we 
responded in the best possible way, the best way Americans can: with 
resolve, with courage, with unity and with hope for a better future.
  So many of us couldn't be at the scene ourselves. We all were willing 
to help. People from all over were trying to send assistance. Those who 
did, though, did not do so for recognition or accolades or awards or 
medals. They did it because their fellow Americans were in need. In 
those acts they became heroes.
  The American people are looking to us to cast a vote that will allow 
these heroes to live out their lives with health and happiness.
  Again, I want to commend Congresswoman Carolyn Maloney, Congressman 
Jerry Nadler, Congressman Peter King--thank you, Peter--for their 
efforts to bring this bipartisan bill to the floor.
  We are all inspired by the firefighters and first responders who have 
advocated so hard and so long on behalf of their fellow heroes. And I 
am so pleased that so many of them are with us today to help us make 
this historic decision.
  We must now join together to provide this critical assistance. We 
must vote ``aye'' for the Health and Compensation Act. We must do so in 
a strong, bipartisan manner.
  I thank our colleagues for the personal involvement that they have 
taken in this. At times it has been emotional. There is a lot of 
passion in this issue, but this bill is a very dispassionate response 
to the needs of our heroes. Let's get a great big vote for it today.

                              {time}  1410

  Mr. PALLONE. Mr. Speaker, can I inquire how much time remains?
  The SPEAKER pro tempore. The gentleman from New Jersey has 3\1/2\ 
minutes.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  I have heard Members on the other side of the aisle talk about this 
as an entitlement program. I want to stress it is not an entitlement 
program. It is not a budget gimmick. The program sunsets in 10 years. 
The funding is capped. Enrollment is capped. The population can't grow 
beyond the enrollment cap in the bill.
  I hear from the opponents all about money, how much money is going to 
New York hospitals. I want to stress that this isn't really about who 
is going to pay for somebody's health insurance.
  One of the centers where people go for treatment is in my home State 
of New Jersey, in my district, at Rutgers, and my understanding is 
many, if not most of the people who go there, actually have health 
insurance. The problem is that we are creating these centers, and we 
want to make sure that they are there for a long time because they 
serve a very important purpose. People go there because they have 
particular diseases that come from the World Trade Center attack that 
can't be treated at other locations. And even if they go to their 
doctor, they end up coming here because they know how to treat and get 
the specialty care that they need.
  They also provide research. Many of these people don't contract the 
diseases until later in life; and I think, as time goes on, we are 
going to see, unfortunately, even more problems. At these centers they 
do the research to look and see what kind of treatment might be 
necessary as more and more people, unfortunately, come down with the 
diseases that resulted from the World Trade Center attack.
  So I know there is a lot of talk about money from the other side. And 
I don't mean to say that money isn't important, but I want people to 
understand, I want everyone to understand, this is not really about 
money. This is really about having a specialized program where people 
can be treated who sacrificed everything for America, and these centers 
need to be here. They need to be here a long time from now, even when 
there aren't people that are going to be down here and asking that this 
program continue. That is why this program has to be set up in this 
fashion today. It has to be properly funded. It has to be available for 
anyone who suffered any kind of disorder from this World Trade Center 
attack.
  Do I have any additional time, Mr. Speaker?
  The SPEAKER pro tempore. The gentleman has 1 minute remaining.
  Mr. PALLONE. I would yield that to the gentlewoman from Texas (Ms. 
Jackson Lee).
  Ms. JACKSON LEE of Texas. I traveled this journey with all of you. 
And Congresswoman Maloney, I wanted to come and thank you, along with 
the chairpersons of the Energy and Commerce and the Judiciary 
Committees, for never giving up.
  I think it is important to note that this bill will cover 
Pennsylvania, the Pentagon, and New York. And for those of us who 
listened to the families and the witnesses or the first responders 
themselves who saw the pain, and particularly those who already lost 
their lives, I think that this is a major step of balance, putting this 
in a system and a structure that has oversight, that provides ongoing 
care and provides for the coverage of those who, to this date, have 
suffered without coverage and comfort.
  So I rise to support this legislation, and I am very glad that the 
Judiciary Committee and Energy and Commerce continued to work, even 
when we were thwarted and rejected. We are now back with, I hope, the 
right approach, bipartisan approach. And I would ask all of my 
colleagues to ask the question what would they want to do for 
9/11 responders, and that is, vote ``yes.''
  Mr. Speaker, I stand in support of H.R. 847, the James Zadroga 9/11 
Health and Compensation Act. As this Nation remembers, September 11, 
2001, terrorists attacked the World Trade Center and the Pentagon. An 
airplane was also crashed by terrorists in

[[Page H7249]]

Shanksville, Pennsylvania. The first responders including firefighters 
and emergency personnel, who assisted to the heinous attacks on the 
World Trade Center, were exposed to extremely toxic dust resulting from 
the collapse of the Twin Towers.
  This exposure has resulted in serious respiratory, related illnesses 
and serious medical conditions. I concur with my colleagues, enacting 
this offset into law has far reaching ramifications nationwide. This 
critical health program would monitor and provide specialized treatment 
through Centers of Excellence for responders including emergency 
personnel, rescue, and clean-up workers who responded to the 9/11 
attacks on the World Trade Center, the Pentagon, and Shanksville, as 
well as residents, workers, and students who returned to the World 
Trade Center area shortly after the attacks.
  Seventy-one thousand individuals are enrolled in the World Trade 
Center Health Registry, indicating they were exposed to the toxins. 
36,000 Americans have received treatment for 9/11 related illnesses or 
injuries and over 53,000 responders are enrolled in medical monitoring. 
Additionally, over 10,000 people from across the country were on hand 
to assist in the aftermath of the 9/11 attacks. These responders came 
from nearly every congressional district and all 50 States. Funding for 
this health program to monitor and treat these responders and residents 
for resulting health conditions stemming from the terrorist attacks.
  Due diligence has been taken to assure that this offset will not 
adversely affect most foreign multinationals corporations by this 
offset. Most foreign multinationals will not be affected; given that 
these companies are organized in countries the U.S. has income tax 
treaties.

  It is imperative that we represent the tax payers of this Nation and 
close a loophole that has provided those multinational corporations, 
unfair competitive advantage over U.S. firms--allowing them to hide or 
shield their taxable income. This offset that must be enacted into law, 
would provide greater U.S. competition over rival foreign companies and 
illegal tax structures. Under the previous administration, the Under 
Secretary for Tax Policy clearly indicated some countries the U.S. has 
tax treaties negotiated decades ago, have adjusted their tax laws to 
become more like tax shelters.
  Must we allow this to continue and unfairly allow the shifting of 
income out of the U.S. tax jurisdiction and further erode our U.S. 
corporate tax base. This offset will aid U.S. based companies and 
eliminate their unfair competitive advantage afforded them through the 
U.S. tax code to these companies that have become tax shelters. Let us 
be clear, this offset seeks only those companies that have 
intentionally attempted to avoid U.S. taxes and disadvantage their U.S. 
competitors.
  As we enact fiscally sound and responsible legislation, it is 
important to note, this critical change is estimated to increase 
revenues by an estimated $7.4 billion over 2011 through 2020.
  We must live up to our obligation and not let the tragedy of 9/11 
persist and continue to deeply scar those who we should laud as this 
Nation's heroes. We must applaud our responders and show them that 
assistance is clearly at hand. I was pleased to work long years on the 
Judiciary Committee with Chairman Conyers to come to this day.
  I thank Representative Carolyn Maloney and my colleagues in advance 
who will rise in support of this important Act and reconfirm our 
commitment to this nation, and our first responders.
  Mr. Speaker, I strongly support H.R. 847 and ask for its immediate 
adoption.
  The SPEAKER pro tempore. The gentleman from New York (Mr. Rangel) and 
the gentleman from Louisiana (Mr. Boustany) each will control 5 
minutes.
  The Chair recognizes the gentleman from New York.
  Mr. RANGEL. Mr. Speaker, I yield 1 minute to the gentleman from the 
sovereign State of New Jersey (Mr. Pascrell).
  Mr. PASCRELL. Mr. Speaker, many folks from New Jersey, both first 
responders and workers, went to New York after this tragedy. There is 
no question that, when you look at the records, that there were people 
from all 50 States in Lower Manhattan on 9/11 and after 9/11. There are 
435 congressional districts, and 430 of them were represented by the 
names of constituents on the World Trade Center Health Registry.
  But you don't need that. You need to look at the two reports from 
Mount Sinai Hospital, a great hospital in New York City, to see the 
number of people that went to that hospital who worked on that pile 
even after they were given the all-clear signal by the government, not 
self-imposed.
  What in God's name are we doing to ourselves and arguing amongst 
ourselves when we know that this is the right thing to do? Get out of 
the bureaucracy nightmare. Let's do something together for a change. 
The only thing we have to show for it is bickering over the last 2 
years, and what did that bring us? These folks deserve our help, and 
they deserve it now.
  Mr. Speaker, I am so proud to standing here to support our heroes 
from 9/11.
  Today--more than four and a half years after the death of NYPD Det. 
James Zadroga--I am here to say that we need to pass the James Zadroga 
9/11 Health and Compensation Act right away because we are losing these 
brave souls as we speak.
  I'm sad to say its now been nine years since 9/11 and we still 
haven't passed the James Zadroga 9/11 Health and Compensation Act--nine 
years is too long to wait and watch as our first responders from that 
day continue to suffer physically and emotionally--nine years is late, 
BUT its not too late to do the right thing. We need to pass this bill 
and we need to pass it now.
  Nine years ago we gave those brave souls the ``all clear'' sign, but 
the government now knows that we were exposing those men and women to a 
poisonous dust that would stay with them for the rest of their lives.
  I have to admit it bothers me greatly that there were Members of this 
body who not only voted against the 9/11 Health Bill the last time, but 
spoke strongly against it as well.
  And yet I imagine earlier this month on the ninth anniversary of the 
attacks they spoke eloquently about the loss we all suffered as a 
nation--and they would be right on that point, but they would also be 
hypocrites if they vote against the 9/11 Health Bill today.
  I am proud to say that as a member of the Ways & Means Committee we 
found a way to pay for this bill so that we can do the right thing for 
our 9/11 workers AND for our children who will bear the debt of the 
decisions we make today.
  So the choice is clear do we support a responsible course to do right 
by our heroes--or do we support keeping open foreign tax loopholes?
  This isn't just a bill for New York and New Jersey--This is a bill 
for all Americans.
  We know that people from all 50 states were in lower Manhattan on or 
after 9/11 and now are facing serious health concerns--there are 435 
Congressional Districts and 431 of them are represented by the names of 
constituents on the World Trade Center Health Registry.
  After 9/11 we all said we would be there for these brave first 
responders--but today if we vote against this bill we are asking those 
same brave individuals to come to Washington, year after year to fight 
for their health benefits--do we expect them to come here ten years 
form now?
  By then it may be too late for many of these men and women who 
responded to their nation's call of duty.
  I urge all my colleagues to support the James Zadroga 9/11 Health and 
Compensation Act.
  Mr. BOUSTANY. I yield myself such time as I may consume.
  (Mr. BOUSTANY asked and was given permission to revise and extend his 
remarks.)
  Mr. BOUSTANY. Mr. Speaker, everyone in this Chamber salutes the 
heroic actions of those countless brave Americans, both first 
responders and ordinary citizens, who put sacrifice over self in 
responding to the tragic events of 9/11. In the wake of unspeakable 
tragedy in New York City, at the Pentagon, and in Shanksville, 
Pennsylvania, we also saw America at its best.
  Now, we have already heard considerable debate today, passionate 
debate, about the new health care entitlement this bill would create, 
and I think reasonable people can disagree about whether that program, 
that particular entitlement is appropriate. But I want to focus my 
remarks on the other part of this bill and on the unfortunate decision 
of our friends in the majority to pay for this legislation with a 
highly controversial tax increase on employers that our economy and our 
workforce simply cannot afford.
  Mr. Speaker, the bill would impose a $7.4 billion tax hike on U.S. 
businesses that happen to be headquartered overseas but that create 
good, high-paying American jobs right here at home in communities 
across this great country. These ``insourcing'' companies provide 
significant employment in the United States, with many of these jobs in 
the manufacturing sector.
  This tax increase will make it less attractive for many of these 
insourcing companies to initiate or expand operations here in the 
United States, potentially encouraging them to ship these jobs 
overseas. With the unemployment rate hovering near 10 percent

[[Page H7250]]

and businesses across the country continuing to struggle to meet 
payroll, now is the worst possible time for a tax hike on employers 
that will cost us more jobs.

                              {time}  1420

  This is not the first time House Democrats have tried to enact this 
particular tax hike, and it probably won't be the last. That is because 
even the Senate, Senate Democrats, continue to reject it, since it 
would not only cost jobs, but also violate our international treaty 
obligations. Even the Obama administration's own Treasury Department 
has testified before the House Ways and Means Committee that it ``has 
concerns about the specifics of this provision and whether it will 
override many of our income tax treaties.''
  Mr. Speaker, all of us, all of us in this Chamber recognize the 
hardships experienced by those brave Americans who responded to the 
events of 9/11. But a tax increase on employers that will cost other 
Americans their jobs is not the answer. We could have done this in a 
bipartisan way, but it is unfortunate we are not there today. I urge my 
colleagues to reject this harmful, misguided tax increase.
  I reserve the balance of my time.
  Mr. RANGEL. Mr. Speaker, I yield myself 1 minute.
  This is not a tax question. This is a moral question. This is one of 
the most serious abuses that we have in the Tax Code. It has come 
before this august body before and it has been supported for sound tax 
reasons.
  We are here today because we were given the opportunity by Mrs. 
Maloney and Mr. Nadler and the people of the State of New York to bring 
this before the House, with the support of the Speaker of the House. We 
had hoped so badly that this bipartisan issue would get a bipartisan 
vote.
  We have an opportunity to say thank you, not for those people who are 
jobless and helpless, but for those people who gave up their lives and 
their families that are surviving, and those heroes that came to the 
site, came to the pile, and exposed themselves to these death-
threatening diseases.
  We have a chance not to talk about loopholes that we have in our Tax 
Code, but loopholes we have in the hearts of people who want to say 
thank you to these brave men and women. From all over the country 
people came, and they didn't thank New Yorkers, they thanked the people 
who cared about what was happening to the United States of America.
  This flag is up, this flag is waving, and we really hope everyone 
gets a chance to salute it by saluting these people to be an example 
for Americans when anybody attacks us.
  I reserve the balance of my time.
  Mr. BOUSTANY. Mr. Speaker, I yield myself such time as I may consume
  I am from Louisiana and we are no stranger to tragedies, but this is 
being presented on the other side as an either/or proposition. The 
bottom line is we could have actually done better, we could have done 
better, and I am deeply concerned about those who will lose their jobs 
as a result of these tax provisions. It is important to recognize that.
  Don't just take my word for it. I have three letters here that I want 
to enter into the Record. These were addressed to the House Ways and 
Means Committee leadership. One is from the Organization For 
International Investment, a second from the U.S. Chamber of Commerce, 
and a third from the National Foreign Trade Council, all of which 
highlight the potential for significant job loss.
  As a physician I can say one of the first maxims I have always 
followed is first do no harm. We could have done better, Mr. Speaker.

                                                  Organization for


                                     International Investment,

                                               September 29, 2010.
     Hon. Sander Levin,
     Chairman, Committee on Ways and Means, House of 
         Representatives, Washington, DC.
     Hon. Dave Camp,
     Ranking Member, Committee on Ways and Means, House of 
         Representatives, Washington, DC.
       Dear Chairman Levin and Representative Camp: On behalf of 
     the Organization for International Investment (OFII), I am 
     writing to express continued concern with section 301 of the 
     James Zadroga 9/11 Health and Compensation Act (H.R. 847). 
     While we recognize the need for revenue, we must oppose this 
     provision as an offset because it represents a clear and 
     harmful override of our existing U.S. income tax treaties. 
     Although positive changes were made to this proposal since it 
     was originally introduced as an offset to the 2007 Farm Bill 
     (H.R. 2419), OFII remains opposed because it still uniquely 
     discriminates against U.S. subsidiaries of companies 
     headquartered abroad and clearly violates many of our 
     international agreements.
       OFII is the largest association of U.S. subsidiaries of 
     companies headquartered abroad. U.S. subsidiaries play an 
     important role in the growth and vitality of the U.S. 
     economy. They provide high-paying jobs for over five million 
     Americans and account for almost one-fifth of all U.S. 
     exports. A discriminatory tax increase sends a negative 
     signal to international investors and may dissuade these 
     companies from choosing the United States as a location for 
     job creating investment.
       As drafted, this proposal would unilaterally override many 
     of our bilateral income tax treaties and could lead to 
     retaliatory actions by other countries or withdrawal by our 
     treaty partners from existing treaties, negatively impacting 
     international business transactions. The Senate has opposed 
     this and similar provisions twice in the past two years for 
     these reasons.
       Congress has not held any hearings to examine this issue 
     and whether the proposal is the appropriate remedy to address 
     any perceived concerns. In this regard, there is no evidence 
     that existing safeguards, including the substantial and 
     restrictive anti-treaty shopping provisions (so-called 
     ``Limitation on Benefits'' (LOB) provisions) contained in 
     most of our current U.S. income tax treaties, are 
     ineffective. Further, if material tax abuses were evident, 
     the Treasury could implement changes to the U.S. Model Tax 
     Treaty that would avoid the negative consequences of 
     violating our international agreements.
       Since a similar proposal was introduced in 2007, the 
     Treasury has taken great strides to update the three 
     bilateral tax treaties without LOB provisions (Iceland, 
     Hungary, Poland).
       A protocol adding an LOB provision to the Iceland treaty 
     was negotiated by Treasury and ratified by the Senate in 
     2008. A similar protocol with Hungary has been negotiated and 
     initialed and could be ratified this year. Treasury is 
     expected to pursue a similar amendment to the treaty with 
     Poland during 2010-2011.
       Consistent with the conclusions in the Treasury Report that 
     was released in November 2007 that reviewed potential abuse 
     of income tax treaties, OFII believes re-negotiation of 
     existing income tax treaties without LOB provisions is a more 
     appropriate way to address the concerns underlying this 
     provision and we urge you to oppose including this provision 
     in the final version 9/11 Health and Compensation Act. We 
     would be glad to discuss our concerns with your staff in 
     greater detail.
           Sincerely,
                                                Nancy L. McLernon,
     President & CEO.
                                  ____

                                               Chamber of Commerce


                              of the United States of America,

                               Washington, DC, September 28, 2010.
       To the Members of the U.S. House of Representatives: The 
     U.S. Chamber of Commerce, the world's largest business 
     federation representing the interests of more than three 
     million businesses and organizations of every size, sector, 
     and region, urges that a provision related to taxation of 
     foreign owned companies be removed from H.R. 847, the ``James 
     Zadroga 9/11 Health and Compensation Act of 2010,'' because 
     H.R. 847 is an inappropriate vehicle for such esoteric and 
     unrelated concerns.
       The Chamber strongly opposes a tax on foreign-owned 
     companies doing business in the United States. The provision 
     included in H.R. 847 would raise taxes on foreign 
     corporations that invest and create jobs domestically, would 
     discourage foreign investment in the United States, override 
     long-standing tax treaties, damage U.S. relationships with 
     major trading partners, and could prompt retaliation by 
     foreign governments against U.S. companies operating abroad.
       Furthermore, the provision would further aggravate already 
     unsettled financial markets. At a time when governments 
     around the world are enhancing their companies' 
     competitiveness by cutting corporate taxes, this provision 
     would create an even more hostile tax environment in the 
     United States. Such a provision sends precisely the wrong 
     message to those firms wanting to invest in America.
       This taxation provision should not be shoehorned into H.R. 
     847, which is legislation targeted at the needs of some 
     responders to the 9/11 terrorist attack. Should Congress seek 
     to consider tax-related legislation during the few remaining 
     session days before the election, the Chamber believes 
     Congress should take up legislation that would help promote 
     economic growth, especially legislation to extend all of the 
     expiring 2001 and 2003 tax provisions and the tax provisions 
     that expired at the end of 2009.
           Sincerely,

                                              R. Bruce Josten,

                                         Executive Vice President,
                                               Government Affairs.

[[Page H7251]]

     
                                  ____
                                                  National Foreign


                                          Trade Council, Inc.,

                                                   Washington, DC.
     Hon. Sander Levin,
     Chairman, Committee on Ways and Means, House of 
         Representatives, Washington, DC.
     Hon. Dave Camp,
     Ranking Member, Committee on Ways and Means, House of 
         Representatives, Washington, DC.
       Dear Chairman Levin and Ranking Member Camp: The NFTC, 
     organized in 1914, is an association of some 300 U.S. 
     business enterprises engaged in all aspects of international 
     trade and investment. Our membership covers the full spectrum 
     of industrial, commercial, financial, and service activities, 
     and we seek to foster an environment in which U.S. companies 
     can be dynamic and effective competitors in the international 
     business arena. The NFTC opposes the provision included with 
     the ``James Zadroga 9/11 Health and Compensation Act of 
     2010'' that would undermine and override our existing U.S. 
     bilateral income tax treaties.
       The NFTC has long supported the expansion and strengthening 
     of the U.S. tax treaty network. Tax treaties reduce certain 
     taxes on cross-border investment and offer other provisions 
     that will greatly benefit U.S. trade and investment. The 
     abrupt changes to the U.S. tax treaties inherent in this 
     legislation could seriously impair the ability of the U.S. 
     Treasury to negotiate tax treaties and protocols with our 
     trading partners.
       The provision would raise taxes on foreign corporations 
     that invest and create jobs in the United States, would 
     further discourage foreign investment in the U.S., and damage 
     U.S. relationships with our major trading partners.
       The provision could also prompt retaliation by foreign 
     governments and would damage the credibility of our tax 
     treaty negotiators. The Treasury Department places a high 
     priority on preventing abuse or misuse of tax treaties. The 
     broad brush approach that overrides existing agreements could 
     impair on improving limitation on benefit provisions in 
     future treaties and protocols.
       Congress has not directly held any hearings to examine this 
     issue and whether the proposal is the appropriate remedy to 
     address any perceived concerns. Treasury has taken great 
     strides to update tax treaties to tighten the limitation on 
     benefit provisions. Any changes to the limitation on benefits 
     provisions should be negotiated by the U.S. Treasury, and 
     should not be dealt with through legislation.
       The NFTC urges Congress to remove this provision from the 
     legislation to avoid undermining our existing income tax 
     treaty system.
           Sincerely,
                                                Catherine Schultz,
                                    Vice President for Tax Policy.

  Mr. Speaker, I yield back the balance of my time.
  Mr. RANGEL. Mr. Speaker, before I recognize the next speaker, I would 
just like to say when voters get an opportunity to ask the question, 
``and what did you do to help these people who have given so much of 
their lives to this cause,'' that you just won't have to say that you 
tried to save jobs through an abusive tax provision.
  Our country wants to say thank you. Certainly our New York delegation 
in Congress does too.
  One of our Members felt this strongly. He felt it as an American, but 
he felt it also as a relative that had lost so much in this attack on 
the United States of America.
  For purposes of closing, Mr. Speaker, I recognize Joseph Crowley from 
the State of New York.
  Mr. CROWLEY. I thank my colleague and friend from New York (Mr. 
Rangel) for yielding me this time.
  Mr. Speaker, I rise in strong support of this bill. I would like to 
thank those who are here today for the debate who served our Nation so 
nobly on 9/11 and the days and months following. We thank you for your 
bravery and for your service.
  It has been 9 years since the terrorist attack that took the lives of 
close to 3,000 of our fellow Americans. Over those years, speeches have 
been offered and medals have been awarded and promises have been made--
promises have been made, and yet not fulfilled--all regarding our 9/11 
heroes. But 9 years later, the most important commitment and tribute 
remains to be fulfilled.
  The first responders, the first rebuilders, and the residents who 
risked their lives at Ground Zero are still waiting for much-needed 
health care services. These are the heroes who dug through the broken 
glass and the debris, and, yes, through human remains. These are the 
heroes who were urged by our Federal officials, return to life as usual 
in downtown New York because ``the air is safe.''
  Well, the government was wrong. The air was not safe, and now many, 
too many, are suffering as a result.
  Today we once again have the opportunity to honor our commitment that 
we made to those who answered the call to service. By passing the James 
Zadroga 9/11 Health and Compensation Act, we will provide critical 
health care service to those who stood up for America.
  As many of you know, my cousin, Battalion Chief John Moran, died on 
September 11. Many in the gallery above us knew my cousin John. As I 
mentioned back in July, his last known words to his driver that day 
were, ``Let me off here. I am going to try to make a difference.'' 
``Here'' was World Trade Center Tower Two.
  John died with honor and in service to his country, and I know that 
he would have wanted it no other way. But John, like the thousands of 
others who perished that day, would also want us to know that he would 
want the victims and the heroes of 9/11 who survived not to be 
forgotten.
  We don't need all of our colleagues' votes. What we need is your 
respect for the victims, for the families, for the survivors. And for 
one hour, and for one day, and with one vote, do not do what is 
politically correct, but do what is patriotically correct, and vote for 
this bill.
  Ms. ZOE LOFGREN of California. Mr. Speaker, I rise again today in 
support of H.R. 847, the James Zadroga 9/11 Health and Compensation Act 
of 2010.
  Voting for this bill is essential if we want to honor the true heroes 
of 9/11. These heroes are the firefighters, police officers, rescue 
workers, and volunteers who risked their lives to help the country 
during one of its darkest periods only to be misinformed by that 
country with respect to conditions at the World Trade Center crash 
site. They deserve our help. It is our duty to provide it to them.
  In the days after 9/11, Congress came together and--in a truly 
bipartisan effort--conceived of a system through which the victims of 
those terrible attacks could obtain medical treatment and just 
compensation. As we learned in various hearings and markups before the 
Judiciary Committee, that system was a stunning success.
  The 9/11 Victims Compensation Fund, for example, quickly compensated 
those who were injured or lost close family members in the attacks. 
Just over $7 billion was paid out in a 33-month period, with overhead 
costs of less than 3 percent, and with 97 percent of the families of 
deceased victims opting into the fund rather than pursuing tort relief 
in the courts. As Special Master Kenneth Feinberg stated in his written 
testimony before our committee earlier this year, ``this was one of the 
most efficient, streamlined and cost effective programs in American 
history.''
  Despite its incredible success, however, the job is not quite done. 
There remain thousands of people who require the protection of the VCF, 
but who--by no fault of their own--were unable to take advantage of it 
when it was available. This includes first responders, workers, and 
volunteers from around the country who rallied to help locate 
survivors, recover the dead, and clean up debris from the fallen 
towers. These are the people that the Nation and the world watched on 
television as they dropped everything in their own lives to rush to aid 
those who needed it the most.
  They were told by their government that the air was safe to breathe. 
But many are now sick and suffering because of their exposure to the 
toxic dust that covered much of lower Manhattan.
  People are sick and will continue to get sick because of their 
exposure to World Trade Center dust. We must resolve this problem, and 
that means passing H.R. 847.
  The bill would provide medical monitoring and treatment to the 
continuing victims of the 9/11 attacks. It would also reopen the 9/11 
Victims Compensation Fund to provide compensation to those victims.
  One thing is clear: the status quo is unacceptable. Worker's 
compensation has failed. Medical programs aren't covering enough 
people. And the World Trade Center Captive Insurance Fund, created by 
Congress to resolve claims such as those that remain outstanding, has 
instead used the money appropriated to contest each and every one of 
those claims. Six years and $300 million in administrative and legal 
costs later, the Captive Insurance Fund has settled less than 10 
claims.
  I believe this bill, while perhaps not perfect, goes a long way to 
establishing a fair and just program to care for and compensate those 
who continue to bear the deep scars from 
9/11. I urge my colleagues to support this bill, which is the result of 
a great deal of work on both sides of the aisle, and in the end is just 
the right thing to do.
  I congratulate Ms. Maloney, Mr. Nadler, Mr. King of New York and the 
other members of the New York delegation for their long struggle to 
bring this bill to the floor. I also

[[Page H7252]]

thank Speaker Pelosi for her strong commitment to helping the heroes 
and heroines of 
9/11.
  Mr. HOLT. Mr. Speaker, as a cosponsor of the James Zadroga 9/11 
Health and Compensation Act of 2010, I urge passage of this important 
bill.
  Today the House has the opportunity to honor the rescue and recovery 
workers who served our Nation after the devastating attacks at the 
World Trade Center on September 11, 2001 and, more important than empty 
honor, to provide for their care. My district suffered causalities that 
day and nine years later, the memory of that terrible day is still 
fresh in our minds.
  Along with the victims of 9/11, there were thousands of rescue and 
recovery workers who came to the aid of our Nation that day. These 
brave women and men rushed to Ground Zero to help the fallen and to 
participate in the clean-up effort without thinking about their health 
or safety. These workers were exposed to environmental hazards and have 
developed significant respiratory illnesses, chronic infections, and 
other medical conditions. Further, many first responders are only now 
being diagnosed with illnesses that are related to their exposure at 
Ground Zero.
  The Zadroga 9/11 Health and Compensation Act of 2010 would create the 
World Trade Center Health Program (WTCHP). The program would provide 
medical monitoring and treatment benefits to first responders and 
workers who were directly affected by the attacks. Additionally, the 
program would establish education and outreach programs and conduct 
research on physical and mental health conditions related to the 9/11 
attacks. The program would continue until 2020 and the total federal 
spending would be capped at $4.6 billion. The WTCHP program would serve 
more than 75,000 survivors, recovery workers, and members of the 
affected communities.
  This bill provides long-term health care and compensation for 
thousands of responders and survivors. By passing this bill, we will be 
paying tribute to the sacrifice and courage of these women and men and 
we will be paying a debt. This bill will be paid for with a partnership 
with New York City and by closing tax loopholes.
  When this bill was considered by the House before, some in the 
minority party put politics over these brave first responders. Today, 
we get a second chance to approve this important piece of legislation. 
We cannot let our first responders down.
  Ms. RICHARDSON. Mr. Speaker, I rise today in support of H.R. 847, the 
``James Zadroga 9/11 Health and Compensation Act,'' which will ensure 
that 9/11 emergency responders receive quality health care to address 
the lingering health effects resulting from their brave service on 
September 11, 2001.
  I thank Chairman Waxman for his leadership in bringing this bill to 
the floor. I also thank the sponsor of this legislation, Congresswoman 
Maloney, for her attention to this important issue.
  Mr. Speaker the courageous men and women who responded to the attacks 
of September 11, 2001 thrust themselves into a life-threatening 
situation, risking everything to respond to one of our Nation's most 
devastating tragedies. Many of these firefighters and emergency 
responders died in the aftermath of the attacks; I am forever grateful 
for these men and women who made the ultimate sacrifice. Many of those 
who survived continue to suffer from serious health issues, ranging 
from respiratory illness to post-traumatic stress syndrome. These 
individuals deserve our assurance that they will always receive first-
rate care.
  Unfortunately, since the closing of the 9/11 Compensation Fund on 
March 31, 2003, many first responders have had to fight just to get the 
medical treatment that they need. This bill will change that. H.R. 847 
will fund through 2019 the World Trade Center Health Program, ensuring 
that first responders suffering from 9/11-related health problems will 
be able to get care. The bill will also establish medical centers of 
excellence throughout the country to serve 9/11 responders. Currently 
many 9/11 emergency responders who no longer live in New York/New 
Jersey metro area are required to return there in order to receive 
care, a requirement that is often prohibitively inconvenient.
  Mr. Speaker, H.R. 847 is part of our ongoing obligation to the brave 
men and women who responded to 9/11. I urge my colleagues to join me in 
supporting this bill.
  Mr. ACKERMAN. Mr. Speaker, I rise today in the strongest possible 
support of the 9/11 Health and Compensation Act, H.R. 847.
  Mr. Speaker, we are here again on the floor of the House to consider 
doing the decent thing: helping the living victims of the 9/11 who 
continue to suffer the terrible effects of that day. For too long, the 
federal government has not stepped-up enough to help the responders, 
volunteers, workers and residents that went to Ground Zero during and 
after the horrific 9/11 attack. For too long, this Congress has not 
acted to help these victims on a permanent basis. Tragically, some of 
the very people that we want to help with this legislation have already 
died. Thousands of Americans who responded need medical treatment now. 
Thousands more will need treatment in the future. Nine years is too 
long: we must show the American people today that their representatives 
can put away their differences and work together to pass this bill. The 
sick and injured don't care about offsets and they don't care about 
election-year politics.
  The horrific attack of 9/11 wasn't just an attack on New York City; 
it was an attack upon the entire United States. The brave men and women 
in uniform who risk their lives every day in Afghanistan and elsewhere 
aren't defending just New York City, they're defending America. 
Responders came to Ground Zero in the thousands from all around the 
country, from almost every Congressional District. Over 13,000 
responders to Ground Zero are sick now and already are receiving 
medical treatment. Another 53,000 responders are currently being 
medically monitored and 71,000 individuals are enrolled in the World 
Trade Center Registry, meaning they were exposed to toxins at some 
point. In the coming years, these numbers will only increase as 
symptoms and conditions related to exposure to Ground Zero begin to 
manifest themselves in the victims. This measure would monitor and 
provide treatment to responders to Ground Zero and build on the 
existing monitoring and treatment programs. There's also an economic 
component to this bill. Victims would be able to be compensated for 
their economic losses and contractors would receive liability 
protection. We must pass this bill not only because it's the right 
thing to do for those people who are sick, but for the next generation 
of responders who will have to think twice about volunteering and 
working at a the site of a terrorist attack.
  So, Mr. Speaker, I urge all my colleagues to support the 9/11 Health 
and Compensation Act so that all the victims of 9/11 will receive the 
medical care and help they need and deserve.
  Mr. BISHOP of New York. Mr. Speaker, I rise in strong support of this 
bill and thank the leadership for giving it a second chance. The heroes 
who responded on September 11th certainly deserve a second chance.
  Those heroes didn't hesitate. Americans united immediately on 
September 11th. But 9 years later, this House remains divided.
  First responders, survivors, and their families have waited too long 
for Congress to act. On this congressional session's final day, we must 
fulfill our promise to care for them and treat them for their exposure 
to toxins at Ground Zero.
  Residents of Eastern Long Island, who I proudly represent, are 
getting sick, as are thousands who came from nearly every state. This 
isn't just a New York issue, it's an American issue.
  I urge my colleagues on both sides of the aisle to unite in support 
of our heroes by voting for the 9/11 Health and Compensation Act.
  The SPEAKER pro tempore. All time for debate has expired.
  Pursuant to House Resolution 1674, the previous question is ordered 
on the bill, as amended.
  The question is on the engrossment and third reading of the bill.
  The bill was ordered to be engrossed and read a third time, and was 
read the third time.


                           Motion to Recommit

  Mr. LEE of New York. Mr. Speaker, I have a motion to recommit at the 
desk.
  The SPEAKER pro tempore. Is the gentleman opposed to the bill?
  Mr. LEE of New York. In its present form.
  Mr. WAXMAN. Mr. Speaker, I reserve a point of order.
  The SPEAKER pro tempore. A point of order is reserved.
  The Clerk will report the motion to recommit.
  The Clerk read as follows:

       Mr. Lee of New York moves to recommit the bill H.R. 847 to 
     the Committee on Energy and Commerce with instructions to 
     report the same back to the House forthwith with the 
     following amendment:
       In subparagraph (A) of section 3312(c)(1) of the Public 
     Health Service Act, as added by section 101 of the bill, 
     strike ``the payment rates that would apply to the provision 
     of such treatment and services by the facility under the 
     Federal Employees Compensation Act'' and insert ``payment 
     rates equal to the payment rates for similar services under 
     parts A and B of title XVIII of the Social Security Act''.
       Strike title III and insert the following (and make such 
     changes to the table of contents in section 1(b) as may be 
     necessary):

TITLE III--REPEAL OF CERTAIN SPENDING PROVISIONS IN PATIENT PROTECTION 
                        AND AFFORDABLE CARE ACT

     SEC. 301. REPEALS.

       (a) In General.--The following provisions are hereby 
     repealed:

[[Page H7253]]

       (1) Subsections (a), (b), (c), (e), (g), (h), (i), (j), 
     (k), (l), and (m) of section 1899A of the Social Security Act 
     (relating to Independent Payment Advisory Board) and 
     subsections (b) and (c) of section 3403 of the Patient 
     Protection and Affordable Care Act (and the amendments made 
     by such subsections).
       (2) Section 4002 of such Act (relating to the Prevention 
     and Public Health Fund).
       (3) Subsections (a), (b), (c), and (d) of section 6301 of 
     such Act (and the amendments made by such subsections) 
     (relating to patient-centered outcomes research).
       (4) Section 10502 of such Act (relating to improving 
     infrastructure of a single health care facility).
       (b) Conforming Amendments.--In the table of contents in 
     section 101 of the Patient Protection and Affordable Care 
     Act, strike the items relating to sections 3403, 4002, and 
     10502.
       At the end of the bill, add the following new title (and 
     make such changes to the table of contents in section 1(b) as 
     may be necessary):

            TITLE V--ENACTING REAL MEDICAL LIABILITY REFORM

     SEC. 501. ENCOURAGING SPEEDY RESOLUTION OF CLAIMS.

       The time for the commencement of a health care lawsuit 
     shall be 3 years after the date of manifestation of injury or 
     1 year after the claimant discovers, or through the use of 
     reasonable diligence should have discovered, the injury, 
     whichever occurs first. In no event shall the time for 
     commencement of a health care lawsuit exceed 3 years after 
     the date of manifestation of injury unless tolled for any of 
     the following--
       (1) upon proof of fraud;
       (2) intentional concealment; or
       (3) the presence of a foreign body, which has no 
     therapeutic or diagnostic purpose or effect, in the person of 
     the injured person.
     Actions by a minor shall be commenced within 3 years from the 
     date of the alleged manifestation of injury except that 
     actions by a minor under the full age of 6 years shall be 
     commenced within 3 years of manifestation of injury or prior 
     to the minor's 8th birthday, whichever provides a longer 
     period. Such time limitation shall be tolled for minors for 
     any period during which a parent or guardian and a health 
     care provider or health care organization have committed 
     fraud or collusion in the failure to bring an action on 
     behalf of the injured minor.

     SEC. 502. COMPENSATING PATIENT INJURY.

       (a) Unlimited Amount of Damages for Actual Economic Losses 
     in Health Care Lawsuits.--In any health care lawsuit, nothing 
     in this title shall limit a claimant's recovery of the full 
     amount of the available economic damages, notwithstanding the 
     limitation in subsection (b).
       (b) Additional Noneconomic Damages.--In any health care 
     lawsuit, the amount of noneconomic damages, if available, may 
     be as much as $250,000, regardless of the number of parties 
     against whom the action is brought or the number of separate 
     claims or actions brought with respect to the same injury.
       (c) No Discount of Award for Noneconomic Damages.--For 
     purposes of applying the limitation in subsection (b), future 
     noneconomic damages shall not be discounted to present value. 
     The jury shall not be informed about the maximum award for 
     noneconomic damages. An award for noneconomic damages in 
     excess of $250,000 shall be reduced either before the entry 
     of judgment, or by amendment of the judgment after entry of 
     judgment, and such reduction shall be made before accounting 
     for any other reduction in damages required by law. If 
     separate awards are rendered for past and future noneconomic 
     damages and the combined awards exceed $250,000, the future 
     noneconomic damages shall be reduced first.
       (d) Fair Share Rule.--In any health care lawsuit, each 
     party shall be liable for that party's several share of any 
     damages only and not for the share of any other person. Each 
     party shall be liable only for the amount of damages 
     allocated to such party in direct proportion to such party's 
     percentage of responsibility. Whenever a judgment of 
     liability is rendered as to any party, a separate judgment 
     shall be rendered against each such party for the amount 
     allocated to such party. For purposes of this section, the 
     trier of fact shall determine the proportion of 
     responsibility of each party for the claimant's harm.

     SEC. 503. MAXIMIZING PATIENT RECOVERY.

       (a) Court Supervision of Share of Damages Actually Paid to 
     Claimants.--In any health care lawsuit, the court shall 
     supervise the arrangements for payment of damages to protect 
     against conflicts of interest that may have the effect of 
     reducing the amount of damages awarded that are actually paid 
     to claimants. In particular, in any health care lawsuit in 
     which the attorney for a party claims a financial stake in 
     the outcome by virtue of a contingent fee, the court shall 
     have the power to restrict the payment of a claimant's damage 
     recovery to such attorney, and to redirect such damages to 
     the claimant based upon the interests of justice and 
     principles of equity. In no event shall the total of all 
     contingent fees for representing all claimants in a health 
     care lawsuit exceed the following limits:
       (1) 40 percent of the first $50,000 recovered by the 
     claimant(s).
       (2) 33\1/3\ percent of the next $50,000 recovered by the 
     claimant(s).
       (3) 25 percent of the next $500,000 recovered by the 
     claimant(s).
       (4) 15 percent of any amount by which the recovery by the 
     claimant(s) is in excess of $600,000.
       (b) Applicability.--The limitations in this section shall 
     apply whether the recovery is by judgment, settlement, 
     mediation, arbitration, or any other form of alternative 
     dispute resolution. In a health care lawsuit involving a 
     minor or incompetent person, a court retains the authority to 
     authorize or approve a fee that is less than the maximum 
     permitted under this section. The requirement for court 
     supervision in the first two sentences of subsection (a) 
     applies only in civil actions.

     SEC. 504. ADDITIONAL HEALTH BENEFITS.

       In any health care lawsuit involving injury or wrongful 
     death, any party may introduce evidence of collateral source 
     benefits. If a party elects to introduce such evidence, any 
     opposing party may introduce evidence of any amount paid or 
     contributed or reasonably likely to be paid or contributed in 
     the future by or on behalf of the opposing party to secure 
     the right to such collateral source benefits. No provider of 
     collateral source benefits shall recover any amount against 
     the claimant or receive any lien or credit against the 
     claimant's recovery or be equitably or legally subrogated to 
     the right of the claimant in a health care lawsuit involving 
     injury or wrongful death. This section shall apply to any 
     health care lawsuit that is settled as well as a health care 
     lawsuit that is resolved by a fact finder. This section shall 
     not apply to section 1862(b) (42 U.S.C. 1395y(b)) or section 
     1902(a)(25) (42 U.S.C. 1396a(a)(25)) of the Social Security 
     Act.

     SEC. 505. PUNITIVE DAMAGES.

       (a) In General.--Punitive damages may, if otherwise 
     permitted by applicable State or Federal law, be awarded 
     against any person in a health care lawsuit only if it is 
     proven by clear and convincing evidence that such person 
     acted with malicious intent to injure the claimant, or that 
     such person deliberately failed to avoid unnecessary injury 
     that such person knew the claimant was substantially certain 
     to suffer. In any health care lawsuit where no judgment for 
     compensatory damages is rendered against such person, no 
     punitive damages may be awarded with respect to the claim in 
     such lawsuit. No demand for punitive damages shall be 
     included in a health care lawsuit as initially filed. A court 
     may allow a claimant to file an amended pleading for punitive 
     damages only upon a motion by the claimant and after a 
     finding by the court, upon review of supporting and opposing 
     affidavits or after a hearing, after weighing the evidence, 
     that the claimant has established by a substantial 
     probability that the claimant will prevail on the claim for 
     punitive damages. At the request of any party in a health 
     care lawsuit, the trier of fact shall consider in a separate 
     proceeding--
       (1) whether punitive damages are to be awarded and the 
     amount of such award; and
       (2) the amount of punitive damages following a 
     determination of punitive liability.
     If a separate proceeding is requested, evidence relevant only 
     to the claim for punitive damages, as determined by 
     applicable State law, shall be inadmissible in any proceeding 
     to determine whether compensatory damages are to be awarded.
       (b) Determining Amount of Punitive Damages.--
       (1) Factors considered.--In determining the amount of 
     punitive damages, if awarded, in a health care lawsuit, the 
     trier of fact shall consider only the following--
       (A) the severity of the harm caused by the conduct of such 
     party;
       (B) the duration of the conduct or any concealment of it by 
     such party;
       (C) the profitability of the conduct to such party;
       (D) the number of products sold or medical procedures 
     rendered for compensation, as the case may be, by such party, 
     of the kind causing the harm complained of by the claimant;
       (E) any criminal penalties imposed on such party, as a 
     result of the conduct complained of by the claimant; and
       (F) the amount of any civil fines assessed against such 
     party as a result of the conduct complained of by the 
     claimant.
       (2) Maximum award.--The amount of punitive damages, if 
     awarded, in a health care lawsuit may be as much as $250,000 
     or as much as two times the amount of economic damages 
     awarded, whichever is greater. The jury shall not be informed 
     of this limitation.

     SEC. 506. AUTHORIZATION OF PAYMENT OF FUTURE DAMAGES TO 
                   CLAIMANTS IN HEALTH CARE LAWSUITS.

       (a) In General.--In any health care lawsuit, if an award of 
     future damages, without reduction to present value, equaling 
     or exceeding $50,000 is made against a party with sufficient 
     insurance or other assets to fund a periodic payment of such 
     a judgment, the court shall, at the request of any party, 
     enter a judgment ordering that the future damages be paid by 
     periodic payments. In any health care lawsuit, the court may 
     be guided by the Uniform Periodic Payment of Judgments Act 
     promulgated by the National Conference of Commissioners on 
     Uniform State Laws.
       (b) Applicability.--This section applies to all actions 
     which have not been first set for trial or retrial before the 
     effective date of this title.

     SEC. 507. DEFINITIONS.

       In this title:
       (1) Alternative dispute resolution system; adr.--The term 
     ``alternative dispute resolution system'' or ``ADR'' means a 
     system that provides for the resolution of

[[Page H7254]]

     health care lawsuits in a manner other than through a civil 
     action brought in a State or Federal court.
       (2) Claimant.--The term ``claimant'' means any person who 
     brings a health care lawsuit, including a person who asserts 
     or claims a right to legal or equitable contribution, 
     indemnity, or subrogation, arising out of a health care 
     liability claim or action, and any person on whose behalf 
     such a claim is asserted or such an action is brought, 
     whether deceased, incompetent, or a minor.
       (3) Collateral source benefits.--The term ``collateral 
     source benefits'' means any amount paid or reasonably likely 
     to be paid in the future to or on behalf of the claimant, or 
     any service, product, or other benefit provided or reasonably 
     likely to be provided in the future to or on behalf of the 
     claimant, as a result of the injury or wrongful death, 
     pursuant to--
       (A) any State or Federal health, sickness, income-
     disability, accident, or workers' compensation law;
       (B) any health, sickness, income-disability, or accident 
     insurance that provides health benefits or income-disability 
     coverage;
       (C) any contract or agreement of any group, organization, 
     partnership, or corporation to provide, pay for, or reimburse 
     the cost of medical, hospital, dental, or income-disability 
     benefits; and
       (D) any other publicly or privately funded program.
       (4) Compensatory damages.--The term ``compensatory 
     damages'' means objectively verifiable monetary losses 
     incurred as a result of the provision of, use of, or payment 
     for (or failure to provide, use, or pay for) health care 
     services or medical products, such as past and future medical 
     expenses, loss of past and future earnings, cost of obtaining 
     domestic services, loss of employment, and loss of business 
     or employment opportunities, damages for physical and 
     emotional pain, suffering, inconvenience, physical 
     impairment, mental anguish, disfigurement, loss of enjoyment 
     of life, loss of society and companionship, loss of 
     consortium (other than loss of domestic service), hedonic 
     damages, injury to reputation, and all other nonpecuniary 
     losses of any kind or nature. The term ``compensatory 
     damages'' includes economic damages and noneconomic damages, 
     as such terms are defined in this section.
       (5) Contingent fee.--The term ``contingent fee'' includes 
     all compensation to any person or persons which is payable 
     only if a recovery is effected on behalf of one or more 
     claimants.
       (6) Economic damages.--The term ``economic damages'' means 
     objectively verifiable monetary losses incurred as a result 
     of the provision of, use of, or payment for (or failure to 
     provide, use, or pay for) health care services or medical 
     products, such as past and future medical expenses, loss of 
     past and future earnings, cost of obtaining domestic 
     services, loss of employment, and loss of business or 
     employment opportunities.
       (7) Health care lawsuit.--The term ``health care lawsuit'' 
     means any health care liability claim concerning the 
     provision of health care goods or services or any medical 
     product affecting interstate commerce, or any health care 
     liability action concerning the provision of health care 
     goods or services or any medical product affecting interstate 
     commerce, brought in a State or Federal court or pursuant to 
     an alternative dispute resolution system, against a health 
     care provider, a health care organization, or the 
     manufacturer, distributor, supplier, marketer, promoter, or 
     seller of a medical product, regardless of the theory of 
     liability on which the claim is based, or the number of 
     claimants, plaintiffs, defendants, or other parties, or the 
     number of claims or causes of action, in which the claimant 
     alleges a health care liability claim. Such term does not 
     include a claim or action which is based on criminal 
     liability; which seeks civil fines or penalties paid to 
     Federal, State, or local government; or which is grounded in 
     antitrust.
       (8) Health care liability action.--The term ``health care 
     liability action'' means a civil action brought in a State or 
     Federal court or pursuant to an alternative dispute 
     resolution system, against a health care provider, a health 
     care organization, or the manufacturer, distributor, 
     supplier, marketer, promoter, or seller of a medical product, 
     regardless of the theory of liability on which the claim is 
     based, or the number of plaintiffs, defendants, or other 
     parties, or the number of causes of action, in which the 
     claimant alleges a health care liability claim.
       (9) Health care liability claim.--The term ``health care 
     liability claim'' means a demand by any person, whether or 
     not pursuant to ADR, against a health care provider, health 
     care organization, or the manufacturer, distributor, 
     supplier, marketer, promoter, or seller of a medical product, 
     including, but not limited to, third-party claims, cross-
     claims, counter-claims, or contribution claims, which are 
     based upon the provision of, use of, or payment for (or the 
     failure to provide, use, or pay for) health care services or 
     medical products, regardless of the theory of liability on 
     which the claim is based, or the number of plaintiffs, 
     defendants, or other parties, or the number of causes of 
     action.
       (10) Health care organization.--The term ``health care 
     organization'' means any person or entity which is obligated 
     to provide or pay for health benefits under any health plan, 
     including any person or entity acting under a contract or 
     arrangement with a health care organization to provide or 
     administer any health benefit.
       (11) Health care provider.--The term ``health care 
     provider'' means any person or entity required by State or 
     Federal laws or regulations to be licensed, registered, or 
     certified to provide health care services, and being either 
     so licensed, registered, or certified, or exempted from such 
     requirement by other statute or regulation.
       (12) Health care goods or services.--The term ``health care 
     goods or services'' means any goods or services provided by a 
     health care organization, provider, or by any individual 
     working under the supervision of a health care provider, that 
     relates to the diagnosis, prevention, or treatment of any 
     human disease or impairment, or the assessment or care of the 
     health of human beings.
       (13) Malicious intent to injure.--The term ``malicious 
     intent to injure'' means intentionally causing or attempting 
     to cause physical injury other than providing health care 
     goods or services.
       (14) Medical product.--The term ``medical product'' means a 
     drug, device, or biological product intended for humans, and 
     the terms ``drug'', ``device'', and ``biological product'' 
     have the meanings given such terms in sections 201(g)(1) and 
     201(h) of the Federal Food, Drug and Cosmetic Act (21 U.S.C. 
     321(g)(1) and (h)) and section 351(a) of the Public Health 
     Service Act (42 U.S.C. 262(a)), respectively, including any 
     component or raw material used therein, but excluding health 
     care services.
       (15) Noneconomic damages.--The term ``noneconomic damages'' 
     means damages for physical and emotional pain, suffering, 
     inconvenience, physical impairment, mental anguish, 
     disfigurement, loss of enjoyment of life, loss of society and 
     companionship, loss of consortium (other than loss of 
     domestic service), hedonic damages, injury to reputation, and 
     all other nonpecuniary losses of any kind or nature.
       (16) Punitive damages.--The term ``punitive damages'' means 
     damages awarded, for the purpose of punishment or deterrence, 
     and not solely for compensatory purposes, against a health 
     care provider, health care organization, or a manufacturer, 
     distributor, or supplier of a medical product. Punitive 
     damages are neither economic nor noneconomic damages.
       (17) Recovery.--The term ``recovery'' means the net sum 
     recovered after deducting any disbursements or costs incurred 
     in connection with prosecution or settlement of the claim, 
     including all costs paid or advanced by any person. Costs of 
     health care incurred by the plaintiff and the attorneys' 
     office overhead costs or charges for legal services are not 
     deductible disbursements or costs for such purpose.
       (18) State.--The term ``State'' means each of the several 
     States, the District of Columbia, the Commonwealth of Puerto 
     Rico, the Virgin Islands, Guam, American Samoa, the Northern 
     Mariana Islands, the Trust Territory of the Pacific Islands, 
     and any other territory or possession of the United States, 
     or any political subdivision thereof.

     SEC. 508. EFFECT ON OTHER LAWS.

       (a) Vaccine Injury.--
       (1) To the extent that title XXI of the Public Health 
     Service Act establishes a Federal rule of law applicable to a 
     civil action brought for a vaccine-related injury or death--
       (A) this title does not affect the application of the rule 
     of law to such an action; and
       (B) any rule of law prescribed by this title in conflict 
     with a rule of law of such title XXI shall not apply to such 
     action.
       (2) If there is an aspect of a civil action brought for a 
     vaccine-related injury or death to which a Federal rule of 
     law under title XXI of the Public Health Service Act does not 
     apply, then this title or otherwise applicable law (as 
     determined under this title) will apply to such aspect of 
     such action.
       (b) Other Federal Law.--Except as provided in this section, 
     nothing in this title shall be deemed to affect any defense 
     available to a defendant in a health care lawsuit or action 
     under any other provision of Federal law.

     SEC. 509. STATE FLEXIBILITY AND PROTECTION OF STATES' RIGHTS.

       (a) Health Care Lawsuits.--The provisions governing health 
     care lawsuits set forth in this title preempt, subject to 
     subsections (b) and (c), State law to the extent that State 
     law prevents the application of any provisions of law 
     established by or under this title. The provisions governing 
     health care lawsuits set forth in this title supersede 
     chapter 171 of title 28, United States Code, to the extent 
     that such chapter--
       (1) provides for a greater amount of damages or contingent 
     fees, a longer period in which a health care lawsuit may be 
     commenced, or a reduced applicability or scope of periodic 
     payment of future damages, than provided in this title; or
       (2) prohibits the introduction of evidence regarding 
     collateral source benefits, or mandates or permits 
     subrogation or a lien on collateral source benefits.
       (b) Protection of States' Rights and Other Laws.--(1) Any 
     issue that is not governed by any provision of law 
     established by or under this title (including State standards 
     of negligence) shall be governed by otherwise applicable 
     State or Federal law.
       (2) This title shall not preempt or supersede any State or 
     Federal law that imposes greater procedural or substantive 
     protections for health care providers and health

[[Page H7255]]

     care organizations from liability, loss, or damages than 
     those provided by this title or create a cause of action.
       (c) State Flexibility.--No provision of this title shall be 
     construed to preempt--
       (1) any State law (whether effective before, on, or after 
     the date of the enactment of this Act) that specifies a 
     particular monetary amount of compensatory or punitive 
     damages (or the total amount of damages) that may be awarded 
     in a health care lawsuit, regardless of whether such monetary 
     amount is greater or lesser than is provided for under this 
     title, notwithstanding section 502(a); or
       (2) any defense available to a party in a health care 
     lawsuit under any other provision of State or Federal law.

     SEC. 510. APPLICABILITY; EFFECTIVE DATE.

       This title shall apply to any health care lawsuit brought 
     in a Federal or State court, or subject to an alternative 
     dispute resolution system, that is initiated on or after the 
     date of the enactment of this Act, except that any health 
     care lawsuit arising from an injury occurring prior to the 
     date of the enactment of this Act shall be governed by the 
     applicable statute of limitations provisions in effect at the 
     time the injury occurred.

  Mr. LEE of New York (during the reading). Mr. Speaker, I ask 
unanimous consent to dispense with the reading.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New York?
  Mr. WAXMAN. I object.
  The SPEAKER pro tempore. Objection is heard.
  The Clerk will continue to read.
  The Clerk continued to read.

                              {time}  1450

  Mr. WAXMAN (during the reading). Mr. Speaker, I ask unanimous consent 
that the remainder of the motion to recommit be considered as read.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  The SPEAKER pro tempore. Does the gentleman from California continue 
to reserve his point of order?
  Mr. WAXMAN. I withdraw my point of order.
  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
York is recognized for 5 minutes in support of his motion.
  Mr. LEE of New York. Mr. Speaker, I, like many of my colleagues, am a 
strong supporter of the underlying provisions in H.R. 847, the James 
Zadroga 9/11 health bill. In fact, I am a cosponsor of the bill and 
believe we should pass it for our 9/11 heroes. Unfortunately, H.R. 847 
is not on the floor today because the same harmful, job-killing tax 
hikes that were added to the bill in July are still here today.
  I'm a new Member of Congress. I'm from New York. I spent my entire 
career in the private sector before coming here, not in politics, 
focused on growing jobs in the manufacturing sector, and I can tell you 
firsthand these taxes will kill jobs in the United States. These are 
taxes on new jobs.
  I share the frustration of so many Americans when Congress talks a 
good game about creating jobs but does everything possible to send them 
offshore. These taxes, without a doubt, will send more jobs offshore. 
And with 15 million American workers out of work, it is unwise and 
unnecessary to pit America's jobless against the 9/11 heroes.
  Earlier today, I signed a letter, with the entire New York 
delegation, to the House leadership urging that this bill be considered 
without procedural games or poison pills meant to make the other party 
look bad. This motion to recommit lives up to that request.
  Specifically, this motion eliminates the job-killing tax hikes and, 
instead, finances the bill through spending cuts, just as the American 
people are urging us to do this in each and every one of our districts.
  It eliminates the duplicative Public Health Service Act slush fund. 
It repeals the poorly drafted comparative effectiveness research 
program and the Medicare Independent Payment Advisory Board. It also 
eliminates incentives to overutilize services by changing reimbursement 
rates. In addition, CBO says the motion reduces the deficit over the 
next 10 years. I want to repeat that. It reduces the deficit.
  It takes the additional step to save money and improve care for 
everyone by enacting something that was missing from the health care 
bill that was passed earlier this year. It enacts meaningful medical 
liability reform, reform supported by both sides of the aisle.
  By passing this motion to recommit, we can remove the harmful job-
killing tax hikes and do what's right for these 9/11 heroes and leave 
the politics aside.
  I urge adoption of this motion.
  I yield back the balance of my time.
  Mr. WAXMAN. Mr. Speaker, I rise in opposition to the motion to 
recommit.
  The SPEAKER pro tempore. The gentleman from California is recognized 
for 5 minutes.
  Mr. WAXMAN. This legislation is designed to provide health care 
services for the heroes of 9/11, the policemen and the firemen who 
didn't know what would be in store for them when they went into the 
World Trade Center. Many of them are suffering from the health 
consequences of their activities, and we have an obligation to provide 
the services that they need.
  What does this motion to recommit do? It would, first of all, reduce 
payments to health care providers, making it harder for those people to 
get access to hospitals to treat them. But the worst thing about this 
motion to recommit is that it strikes a pay-for that's been passed 
three times already in the House, and it eliminates areas of the health 
care reform law that are designed to save money and to prevent costly 
health problems.
  There are 248 organizations that have signed a letter opposing these 
kinds of cuts. This same kind of proposal was offered in the Senate and 
rejected very soundly. These are groups that are concerned that we have 
a health system that is there to protect the public health. Can you 
imagine the irony that the public health measures we're trying to put 
in place so that we can deal with chronic disease would be struck? They 
would wipe that out in order to pay for this bill.
  That is not the way to pay for this legislation. Groups such as the 
American Heart Association, the American Cancer Society, the American 
Diabetes Association, the American Lung Association, maternal and child 
health associations, and dozens of others all urge a ``no'' vote on 
this motion to recommit.
  Mr. Speaker, I yield the balance of my time to the gentleman from New 
York (Mr. Wiener), a very important member of our committee and a 
champion for this legislation.
  Mr. WEINER. You know, here in Washington, there are a couple of 
different ways you can kill a bill. One is the honest way--you vote 
``no.'' Put your card in, you press the ``no'' vote. It shows ``no'' up 
on the board. Another way you can kill legislation in this town is by 
offering up amendments or offering up procedures and offering up 
confusion about the bill, that it goes down for that reason and you 
don't quite have your fingerprints on it.
  Mr. Lee's an honorable man, he's a good man. But I have to tell you 
it as simply as I can. If you vote for his motion to recommit, the bill 
dies. If you vote for this motion that says, essentially, we're going 
to take out the money for the care, it doesn't matter how many 9/11 
events you go to, doesn't matter how many times you send out press 
releases that say you care, if you vote for this motion, you vote to 
kill the bill, period.
  And there's a lot of talk about what's in it. You want to relitigate 
the health care bill? Okay. We're going to get to do that the first 
Tuesday in November. People are going to be talking, oh, the health 
care bill is a good bill or bad bill. Let's do that later. Let's do the 
politics later. Let's do the right thing now. Let's try to take care of 
the people in this bill with money to do it.
  I understand this is a political town and we're in the midst of a 
political season, but can't we look around? Can't we, at this moment, 
look around and say this isn't the time for a parliamentary move or a 
clever motion to recommit?
  My colleagues, when you come down here, the only way you can go home 
and say that you care for the victims of September 11 is if you vote a 
``no'' on this motion and a ``yes'' on final passage. That's it.

                              {time}  1500

  The people in this room and back home are too smart to be fooled by 
anything else. ``I want it paid for this way.'' ``I want it paid for 
that way.''
  As Mr. Waxman just said, if you pass this amendment, it essentially 
says, We are going to go back and argue about the health care bill 
again. What is next? Are we going to go argue abortion or immigration? 
No, let's not do

[[Page H7256]]

that anymore. Well, if we are going to do it, let's do it in November 
on elections. We are going to have TV commercials and ads. Now let's 
just do the right thing. I want to see every Republican and every 
Democrat say, You know what, if there is one thing we agree upon, it's 
that the people who gave up their health on September 11 and the days 
after deserve our care and our respect. We need a ``no'' vote, my 
colleagues.
  I have to tell you something, I have worked with the people who were 
advocating for 9/11 health for 9 years, and some of them are here. They 
are too smart. They are going to know that if you vote in favor of this 
motion to recommit, plain and simple, you are voting to kill this bill. 
We are not going to let it happen. Nine years is too long.
  But I'll tell you something about time, it's also pretty darn close 
to election day. In 434 districts in this country are people who have a 
9/11 cough. I hope they are watching this debate, and I hope they watch 
not just final passage, which hopefully we get to, because if this Lee 
amendment passes, this bill is going down. We can't let that happen.
  I urge a ``no'' vote on the motion to recommit and a ``yes'' vote on 
passage.
  The SPEAKER pro tempore. Without objection, the previous question is 
ordered on the motion to recommit.
  There was no objection.
  The SPEAKER pro tempore. The question is on the motion to recommit.
  The question was taken; and the Speaker pro tempore announced that 
the noes appeared to have it.
  Mr. LEE of New York. 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 the motion to recommit will be followed by 
5-minute votes on passage of the bill, if ordered; and motions to 
suspend the rules with respect to H.R. 3685, H.R. 5993, and House 
Resolution 1326.
  The vote was taken by electronic device, and there were--yeas 185, 
nays 244, not voting 4, as follows:

                             [Roll No. 549]

                               YEAS--185

     Aderholt
     Adler (NJ)
     Akin
     Alexander
     Austria
     Bachmann
     Bachus
     Barrett (SC)
     Bartlett
     Barton (TX)
     Biggert
     Bilbray
     Bilirakis
     Bishop (UT)
     Blackburn
     Boehner
     Bonner
     Bono Mack
     Boozman
     Boucher
     Boustany
     Brady (TX)
     Bright
     Broun (GA)
     Brown (SC)
     Brown-Waite, Ginny
     Buchanan
     Burgess
     Burton (IN)
     Buyer
     Calvert
     Camp
     Campbell
     Cantor
     Capito
     Carter
     Cassidy
     Castle
     Chaffetz
     Coble
     Coffman (CO)
     Cole
     Conaway
     Crenshaw
     Culberson
     Davis (KY)
     Davis (TN)
     Dent
     Diaz-Balart, L.
     Diaz-Balart, M.
     Djou
     Dreier
     Duncan
     Ehlers
     Emerson
     Flake
     Fleming
     Forbes
     Fortenberry
     Foxx
     Franks (AZ)
     Frelinghuysen
     Gallegly
     Garrett (NJ)
     Gerlach
     Gingrey (GA)
     Gohmert
     Goodlatte
     Granger
     Graves (GA)
     Graves (MO)
     Griffith
     Guthrie
     Hall (TX)
     Harper
     Hastings (WA)
     Heller
     Hensarling
     Herger
     Hoekstra
     Hunter
     Inglis
     Issa
     Jenkins
     Johnson, Sam
     Jordan (OH)
     King (IA)
     Kingston
     Kirk
     Kline (MN)
     Lamborn
     Lance
     Latham
     LaTourette
     Latta
     Lee (NY)
     Lewis (CA)
     Linder
     LoBiondo
     Lucas
     Luetkemeyer
     Lummis
     Lungren, Daniel E.
     Mack
     Manzullo
     Marchant
     Marshall
     Matheson
     McCarthy (CA)
     McCaul
     McClintock
     McCotter
     McHenry
     McKeon
     McMorris Rodgers
     Melancon
     Mica
     Miller (FL)
     Miller (MI)
     Miller, Gary
     Minnick
     Moran (KS)
     Murphy, Tim
     Myrick
     Neugebauer
     Nunes
     Nye
     Olson
     Paul
     Paulsen
     Pence
     Peterson
     Petri
     Pitts
     Platts
     Poe (TX)
     Posey
     Price (GA)
     Putnam
     Radanovich
     Rehberg
     Reichert
     Roe (TN)
     Rogers (AL)
     Rogers (KY)
     Rogers (MI)
     Rohrabacher
     Rooney
     Ros-Lehtinen
     Roskam
     Royce
     Ryan (WI)
     Scalise
     Schmidt
     Schock
     Sensenbrenner
     Sessions
     Shadegg
     Shimkus
     Shuler
     Shuster
     Simpson
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Space
     Stearns
     Sullivan
     Taylor
     Teague
     Terry
     Thompson (PA)
     Thornberry
     Tiahrt
     Tiberi
     Turner
     Upton
     Walden
     Wamp
     Westmoreland
     Whitfield
     Wilson (SC)
     Wittman
     Wolf
     Young (AK)

                               NAYS--244

     Ackerman
     Altmire
     Andrews
     Arcuri
     Baca
     Baird
     Baldwin
     Barrow
     Bean
     Becerra
     Berkley
     Berman
     Berry
     Bishop (GA)
     Bishop (NY)
     Blumenauer
     Boccieri
     Boren
     Boswell
     Brady (PA)
     Braley (IA)
     Brown, Corrine
     Butterfield
     Cao
     Capps
     Capuano
     Cardoza
     Carnahan
     Carney
     Carson (IN)
     Castor (FL)
     Chandler
     Childers
     Chu
     Clarke
     Clay
     Cleaver
     Clyburn
     Cohen
     Connolly (VA)
     Conyers
     Cooper
     Costa
     Costello
     Courtney
     Critz
     Crowley
     Cuellar
     Cummings
     Dahlkemper
     Davis (AL)
     Davis (CA)
     Davis (IL)
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Deutch
     Dicks
     Dingell
     Doggett
     Donnelly (IN)
     Doyle
     Driehaus
     Edwards (MD)
     Edwards (TX)
     Ellison
     Ellsworth
     Engel
     Eshoo
     Etheridge
     Farr
     Fattah
     Filner
     Foster
     Frank (MA)
     Fudge
     Garamendi
     Giffords
     Gonzalez
     Gordon (TN)
     Grayson
     Green, Al
     Green, Gene
     Grijalva
     Gutierrez
     Hall (NY)
     Halvorson
     Hare
     Harman
     Hastings (FL)
     Heinrich
     Herseth Sandlin
     Higgins
     Hill
     Himes
     Hinchey
     Hinojosa
     Hirono
     Hodes
     Holden
     Holt
     Honda
     Hoyer
     Inslee
     Israel
     Jackson (IL)
     Jackson Lee (TX)
     Johnson (GA)
     Johnson (IL)
     Johnson, E. B.
     Jones
     Kagen
     Kanjorski
     Kaptur
     Kennedy
     Kildee
     Kilpatrick (MI)
     Kilroy
     Kind
     King (NY)
     Kirkpatrick (AZ)
     Kissell
     Klein (FL)
     Kosmas
     Kratovil
     Kucinich
     Langevin
     Larsen (WA)
     Larson (CT)
     Lee (CA)
     Levin
     Lewis (GA)
     Lipinski
     Loebsack
     Lofgren, Zoe
     Lowey
     Lujan
     Lynch
     Maffei
     Maloney
     Markey (CO)
     Markey (MA)
     Matsui
     McCarthy (NY)
     McCollum
     McDermott
     McGovern
     McIntyre
     McMahon
     McNerney
     Meek (FL)
     Meeks (NY)
     Michaud
     Miller (NC)
     Miller, George
     Mitchell
     Mollohan
     Moore (KS)
     Moore (WI)
     Moran (VA)
     Murphy (CT)
     Murphy (NY)
     Murphy, Patrick
     Nadler (NY)
     Napolitano
     Neal (MA)
     Oberstar
     Obey
     Olver
     Ortiz
     Owens
     Pallone
     Pascrell
     Pastor (AZ)
     Payne
     Pelosi
     Perlmutter
     Perriello
     Peters
     Pingree (ME)
     Polis (CO)
     Pomeroy
     Price (NC)
     Quigley
     Rahall
     Rangel
     Reyes
     Richardson
     Rodriguez
     Ross
     Rothman (NJ)
     Roybal-Allard
     Ruppersberger
     Rush
     Ryan (OH)
     Salazar
     Sanchez, Linda T.
     Sanchez, Loretta
     Sarbanes
     Schakowsky
     Schauer
     Schiff
     Schrader
     Schwartz
     Scott (GA)
     Scott (VA)
     Serrano
     Sestak
     Shea-Porter
     Sherman
     Sires
     Skelton
     Slaughter
     Smith (WA)
     Snyder
     Speier
     Spratt
     Stark
     Stupak
     Sutton
     Tanner
     Thompson (CA)
     Thompson (MS)
     Tierney
     Titus
     Tonko
     Towns
     Tsongas
     Van Hollen
     Velazquez
     Visclosky
     Walz
     Wasserman Schultz
     Waters
     Watson
     Watt
     Waxman
     Weiner
     Welch
     Wilson (OH)
     Woolsey
     Wu
     Yarmuth

                             NOT VOTING--4

     Blunt
     Boyd
     Fallin
     Young (FL)


                Announcement by the Speaker Pro Tempore

  The SPEAKER tempore. The Chair will remind all persons in the gallery 
that they are here as guests of the House, and any manifestation of 
approval or disapproval of the proceedings are in violation of the 
rules of the House.

                              {time}  1529

  Mrs. NAPOLITANO, Messrs. BUTTERFIELD, SCHRADER, Ms. EDWARDS of 
Maryland, Ms. SPEIER, Messrs. CARSON of Indiana, SPRATT, BLUMENAUER, 
WELCH, and DELAHUNT changed their vote from ``yea'' to ``nay.''
  Mrs. LUMMIS, Messrs. GARRETT of New Jersey, POSEY, Ms. FOXX, Mrs. 
EMERSON, and Messrs. WITTMAN and COLE changed their vote from ``nay'' 
to ``yea.''
  So the motion to recommit was rejected.
  The result of the vote was announced as above recorded.
  The SPEAKER pro tempore. The question is on the passage of the bill.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.


                             Recorded Vote

  Mr. WAXMAN. Mr. Speaker, I demand a recorded vote.
  A recorded vote was ordered.
  The SPEAKER pro tempore. This is a 5-minute vote.
  The vote was taken by electronic device, and there were--ayes 268, 
noes 160, not voting 5, as follows:

                             [Roll No. 550]

                               AYES--268

     Ackerman
     Adler (NJ)
     Altmire
     Andrews
     Arcuri
     Baca
     Baird
     Baldwin
     Barrow
     Bean
     Becerra
     Berkley
     Berman
     Bishop (GA)
     Bishop (NY)
     Blumenauer
     Boccieri
     Boren
     Boswell
     Boucher
     Brady (PA)
     Braley (IA)
     Brown, Corrine
     Butterfield
     Cao
     Capps
     Capuano
     Cardoza
     Carnahan
     Carney
     Carson (IN)
     Castle
     Castor (FL)
     Chandler
     Childers
     Chu
     Clarke
     Clay
     Cleaver
     Clyburn
     Cohen
     Cole
     Connolly (VA)
     Conyers
     Costa

[[Page H7257]]


     Costello
     Courtney
     Critz
     Crowley
     Cuellar
     Cummings
     Dahlkemper
     Davis (AL)
     Davis (CA)
     Davis (IL)
     Davis (TN)
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Dent
     Deutch
     Dicks
     Dingell
     Doggett
     Donnelly (IN)
     Doyle
     Driehaus
     Edwards (MD)
     Edwards (TX)
     Ellison
     Ellsworth
     Engel
     Eshoo
     Etheridge
     Farr
     Fattah
     Filner
     Foster
     Frank (MA)
     Frelinghuysen
     Fudge
     Garamendi
     Gerlach
     Giffords
     Gonzalez
     Gordon (TN)
     Grayson
     Green, Al
     Green, Gene
     Grijalva
     Gutierrez
     Hall (NY)
     Halvorson
     Hare
     Harman
     Hastings (FL)
     Heinrich
     Herseth Sandlin
     Higgins
     Hill
     Himes
     Hinchey
     Hinojosa
     Hirono
     Hodes
     Holden
     Holt
     Honda
     Hoyer
     Inslee
     Israel
     Jackson (IL)
     Jackson Lee (TX)
     Johnson (GA)
     Johnson, E. B.
     Jones
     Kagen
     Kanjorski
     Kaptur
     Kennedy
     Kildee
     Kilpatrick (MI)
     Kilroy
     Kind
     King (NY)
     Kirk
     Kirkpatrick (AZ)
     Kissell
     Klein (FL)
     Kosmas
     Kratovil
     Kucinich
     Lance
     Langevin
     Larsen (WA)
     Larson (CT)
     Lee (CA)
     Levin
     Lewis (GA)
     Lipinski
     LoBiondo
     Loebsack
     Lofgren, Zoe
     Lowey
     Lujan
     Lungren, Daniel E.
     Lynch
     Maffei
     Maloney
     Markey (CO)
     Markey (MA)
     Marshall
     Matheson
     Matsui
     McCarthy (NY)
     McCollum
     McDermott
     McGovern
     McIntyre
     McMahon
     McNerney
     Meek (FL)
     Meeks (NY)
     Melancon
     Michaud
     Miller (MI)
     Miller (NC)
     Miller, George
     Minnick
     Mitchell
     Mollohan
     Moore (KS)
     Moore (WI)
     Moran (VA)
     Murphy (CT)
     Murphy (NY)
     Murphy, Patrick
     Murphy, Tim
     Nadler (NY)
     Napolitano
     Neal (MA)
     Nye
     Oberstar
     Obey
     Olver
     Ortiz
     Owens
     Pallone
     Pascrell
     Pastor (AZ)
     Payne
     Pelosi
     Perlmutter
     Perriello
     Peters
     Peterson
     Pingree (ME)
     Platts
     Polis (CO)
     Pomeroy
     Price (NC)
     Quigley
     Rahall
     Rangel
     Reyes
     Richardson
     Rodriguez
     Roe (TN)
     Ross
     Rothman (NJ)
     Roybal-Allard
     Ruppersberger
     Rush
     Ryan (OH)
     Salazar
     Sanchez, Linda T.
     Sanchez, Loretta
     Sarbanes
     Schakowsky
     Schauer
     Schiff
     Schrader
     Schwartz
     Scott (GA)
     Scott (VA)
     Serrano
     Sestak
     Shea-Porter
     Sherman
     Shuler
     Sires
     Skelton
     Slaughter
     Smith (NJ)
     Smith (WA)
     Snyder
     Space
     Speier
     Spratt
     Stark
     Stupak
     Sutton
     Tanner
     Taylor
     Teague
     Thompson (CA)
     Thompson (MS)
     Tierney
     Titus
     Tonko
     Towns
     Tsongas
     Van Hollen
     Velazquez
     Visclosky
     Walz
     Wasserman Schultz
     Waters
     Watson
     Watt
     Waxman
     Weiner
     Welch
     Wilson (OH)
     Woolsey
     Wu
     Yarmuth

                               NOES--160

     Aderholt
     Akin
     Alexander
     Austria
     Bachmann
     Bachus
     Barrett (SC)
     Bartlett
     Barton (TX)
     Berry
     Biggert
     Bilbray
     Bilirakis
     Bishop (UT)
     Blackburn
     Boehner
     Bonner
     Bono Mack
     Boozman
     Boustany
     Brady (TX)
     Bright
     Broun (GA)
     Brown (SC)
     Brown-Waite, Ginny
     Buchanan
     Burgess
     Burton (IN)
     Buyer
     Calvert
     Camp
     Campbell
     Cantor
     Capito
     Carter
     Cassidy
     Chaffetz
     Coble
     Coffman (CO)
     Conaway
     Cooper
     Crenshaw
     Culberson
     Davis (KY)
     Diaz-Balart, M.
     Djou
     Dreier
     Duncan
     Ehlers
     Emerson
     Flake
     Fleming
     Forbes
     Fortenberry
     Foxx
     Franks (AZ)
     Gallegly
     Garrett (NJ)
     Gingrey (GA)
     Gohmert
     Goodlatte
     Granger
     Graves (GA)
     Graves (MO)
     Griffith
     Guthrie
     Hall (TX)
     Harper
     Hastings (WA)
     Heller
     Hensarling
     Herger
     Hoekstra
     Hunter
     Inglis
     Issa
     Jenkins
     Johnson (IL)
     Johnson, Sam
     Jordan (OH)
     King (IA)
     Kingston
     Kline (MN)
     Lamborn
     Latham
     LaTourette
     Latta
     Lee (NY)
     Lewis (CA)
     Linder
     Lucas
     Luetkemeyer
     Lummis
     Mack
     Manzullo
     Marchant
     McCarthy (CA)
     McCaul
     McClintock
     McCotter
     McHenry
     McKeon
     McMorris Rodgers
     Mica
     Miller (FL)
     Miller, Gary
     Moran (KS)
     Myrick
     Neugebauer
     Nunes
     Olson
     Paul
     Paulsen
     Pence
     Petri
     Pitts
     Poe (TX)
     Posey
     Price (GA)
     Putnam
     Radanovich
     Rehberg
     Reichert
     Rogers (AL)
     Rogers (KY)
     Rogers (MI)
     Rohrabacher
     Rooney
     Ros-Lehtinen
     Roskam
     Royce
     Ryan (WI)
     Scalise
     Schmidt
     Schock
     Sensenbrenner
     Sessions
     Shadegg
     Shimkus
     Shuster
     Simpson
     Smith (NE)
     Smith (TX)
     Stearns
     Sullivan
     Terry
     Thompson (PA)
     Thornberry
     Tiahrt
     Tiberi
     Turner
     Upton
     Walden
     Wamp
     Westmoreland
     Whitfield
     Wilson (SC)
     Wittman
     Wolf
     Young (AK)

                             NOT VOTING--5

     Blunt
     Boyd
     Diaz-Balart, L.
     Fallin
     Young (FL)


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore (during the vote). There are 2 minutes 
remaining in this vote.


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore. The Chair will remind all persons in the 
gallery that they are here as guests of the House and any 
manifestations of approval or disapproval of the proceedings is in 
violation of the rules of the House.

                              {time}  1537

  Ms. ESHOO changed her vote from ``no'' to ``aye.''
  So the bill was passed.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.

                          ____________________