[Congressional Record (Bound Edition), Volume 145 (1999), Part 16]
[House]
[Pages 23396-23397]
[From the U.S. Government Publishing Office, www.gpo.gov]



                       RIGHT TO SUE AN ERISA HMO

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Georgia (Mr. Norwood) is recognized for 5 minutes.

  Mr. NORWOOD. Mr. Speaker, Members on both sides of this aisle have 
joined together to address one of the most egregious violations of the 
individual rights upon which our Nation was founded, the right to due 
process in court.

  Since 1974, federally governed managed care insurance plans have 
enjoyed a near total immunity from any legal accountability for 
injuring and killing the citizens of this country for monetary gain. No 
thinking, feeling American can agree to let that stand. I tell my 
colleagues today, Mr. Speaker, that will not stand.

  But, Mr. Speaker, the industry lobbyists who have profited behind the 
skirts of ERISA are now engaged in a last-ditch fight to deceive the 
Members of this body and the American public concerning the truth of 
what we seek. So, tonight, Mr. Speaker, I want to set the record 
straight.

  The bipartisan Consensus Managed Care Improvement Act that I have 
cosponsored with the gentleman from Michigan (Mr. Dingell) provides 
full relief from the travesty of current law while providing full 
protection for employers and decent insurers against frivolous and 
vicarious lawsuits.

  The managed care lobby has told us that employers could be sued for 
simply offering a health plan to their employees, they are actually 
going around saying that, or could be sued just by choosing a 
particular plan.

  Mr. Speaker, read page 60 of the bill beginning on line 33. The bill 
says, ``Does not authorize any cause of action against an employer, or 
other plan sponsor maintaining the group health plan, or against an 
employee of such an employer.''

  One cannot be any clearer than that. Employers cannot be sued for 
offering health insurance in our bill or choosing any particular 
specific plan. Now, the HMO argues that lawyers could find a way around 
that protection. But the United States Supreme Court has held that 
``plain meaning'' interpretations would prevail. Who do you believe, 
the lobbyists or the Supreme Court?

  There is only one way under this bill that employers can be sued. If 
an employer decides to do more than offer health insurance, by trying 
to practice medicine, yes, then they can be sued. If an employer 
decides to weigh in on a decision of medical necessity, they will be 
held responsible for that decision, as they should be. But if that 
employer chooses to stay out of the dispute and leaves the decision up 
to medically trained professionals, they remain shielded from any type 
of liability, as they should be.

  Read the bill. Page 61, beginning on line 13, an employer can only be 
sued if, and I quote out of the bill, Mr. Speaker, ``The employer's . . 
. exercise of discretionary authority to make a decision on a claim for 
benefits covered under the plan . . . resulted in personal injury or 
wrongful death.''

  Would a Member of this body like to argue that anyone should be able 
to wrongfully cause the death of a human being and then be shielded 
from that responsibility? Let us have that debate. I think they will 
not argue that.

  Under this bill, an employer is free to buy any health plan on the 
market for their employees and face no liability whatsoever for having 
done so. If the employer is asked to step into the middle of the 
dispute between the employee and the health plan, they simply should 
refuse, leave the matter up to the doctors, and face no liability 
whatsoever.

  The managed care lobby has told us that this bill opens the door for 
unlimited punitive damages against health plans, with jury awards 
soaring into the hundreds of millions of dollars.


[[Page 23397]]


  Read the bill. We have left a way for insurance companies to remain 
shielded from any punitive damages, not one nickel.

  Read the bill. Page 60, beginning on line 13, and I quote again, Mr. 
Speaker, ``The plan is not liable for any punitive, exemplary, or 
similar damages . . . if the plan or issuer complied with the 
determination of the external appeal entity.'' It cannot be any simpler 
than that.

  There is only one option left the HMO lobby to defeat the 
legislation: Distort the issue, scare the employers into believing it. 
We know it, and they know it.

  I believe that truth and justice will prevail during next week's vote 
on this issue. No amount of lies, Mr. Speaker, no amount of threats 
will deter the Members of this body who know the truth from moving 
forward on this issue.

  Mr. Speaker, I ask my fellow Members who support this bill to spread 
the truth to those who may not know it yet. This evil cannot be allowed 
to stand.

  Mr. Speaker, I look forward to seeing my colleagues next week on the 
floor of this House when the truth will come forward as to what is 
happening to health care in the United States of America.

  Mr. DINGELL. Mr. Speaker, will the gentleman yield?

  Mr. NORWOOD. I yield to the gentleman from Michigan.

                              {time}  1745


              In Agreement With Right to Sue an ERISA HMO

  Mr. DINGELL. Mr. Speaker, I first want to say that I have worked in 
this place for a long time, and I have worked with a lot of people. 
None have been more steadfast, courageous, harder working, more able or 
more dedicated on the matters upon which we work, and I want to commend 
the gentleman from Georgia and thank him.

  I want to make the observation that I hope my colleagues will have 
listened to the gentleman from Georgia, because what he is talking 
about is people who are desperately in need of the protection he and I 
seek to provide. I want to point out that what he is seeking to do here 
is to assure that employers who do not intrude into the every day 
management of the particular fund that is set up for the health care 
and for the procurement of health care are absolutely protected against 
liability. The gentleman is totally correct in that. And the only time 
that an employer would incur a liability under this legislation is if 
he had actively intervened against the beneficiary.

  And so I want to first commend the gentleman. Second of all, I want 
to urge my colleagues to listen to him. He has been speaking great 
wisdom. He has also been speaking of justice and decency and something 
that the health care industry has not always been providing to the 
recipients of health care. It is an extremely important point in this 
legislation.

  Honest and decent employers have nothing to fear, and HMOs which have 
been denying people the health care to which they are entitled under 
the contract do have something to fear. And, indeed, they should. They 
are the folks that I happen to be after.

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