Congressional Record, Volume 156 Issue 133 (Wednesday, September 29, 2010)

[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.

____________________