[Congressional Record (Bound Edition), Volume 145 (1999), Part 19]
[House]
[Pages 27996-27999]
[From the U.S. Government Publishing Office, www.gpo.gov]



   PROVIDING FOR CONSIDERATION OF RESOLUTION AGREEING TO CONFERENCE 
REQUESTED BY SENATE ON H.R. 2990, QUALITY CARE FOR THE UNINSURED ACT OF 
                                  1999

  Mr. GOSS. Mr. Speaker, by direction of the Committee on Rules, I call 
up House Resolution 348 and ask for its immediate consideration.
  The Clerk read the resolution, as follows:

                              H. Res. 348

       Resolved, That the House disagrees to the Senate amendment 
     to the bill (H.R. 2990) to amend the Internal Revenue Code of 
     1986 to allow individuals greater access to health insurance 
     through a health care tax deduction, a long-term care 
     deduction, and other health-related tax incentives, to amend 
     the Employee Retirement Income Security Act of 1974 to 
     provide access to and choice in

[[Page 27997]]

     health care through association health plans, to amend the 
     Public Health Service Act to create new pooling opportunities 
     for small employers to obtain greater access to health 
     coverage through HealthMarts; to amend title I of the 
     Employee Retirement Income Security Act of 1974, title XXVII 
     of the Public Health Service Act, and the Internal Revenue 
     Code of 1986 to protect consumers in managed care plans and 
     other health coverage; and for other purposes, and agrees to 
     the conference requested by the Senate thereon.

  The SPEAKER pro tempore. The gentleman from Florida (Mr. Goss) is 
recognized for 1 hour.
  Mr. GOSS. Mr. Speaker, for the purposes of debate only, I yield the 
customary 30 minutes to the gentlewoman from Rochester, New York (Ms. 
Slaughter), my colleague and friend on the Committee on Rules, pending 
which I yield myself such time as I may consume. During consideration 
of this resolution, all time yielded is for the purpose of debate on 
this subject only.
  This resolution before us, Mr. Speaker, does two things. It provides 
that the House disagrees with the Senate amendment to the bill, H.R. 
2990, the Quality Care for the Uninsured Act, and it provides that the 
House agrees to the conference requested by the Senate.
  While this may seem arcane or inside-the-Beltway talk to folks 
watching at home, the translation is that it allows us to move the 
process forward on health care reform. That is what we are doing, going 
forward on health care reform as promised. We can go to conference with 
the Senate to try to resolve our extensive differences and hopefully to 
improve the lives of our constituents if we can pass this resolution.
  Because H.R. 2990 was not reported by a committee of jurisdiction, no 
motion to go to conference could be authorized by a committee. While 
these motions are usually done by unanimous consent, the minority 
declined to agree to the traditional process, so here we are with this 
resolution this evening.
  I am concerned that the other side of the aisle seems to prefer 
conflict and confrontation over progress on health care reform. We did 
pass H.R. 2990 less than a month ago. I would point out it was 
certainly during the most hectic budget and appropriations season that 
I recall in a while, and, yet, the minority still objects and protests 
that we should have appointed conferees earlier. I would point out this 
is the same minority that was complaining not 2 hours ago on the House 
floor that we were moving legislation too rapidly. Hopefully we will 
get something right in their eyes before we end the 106th.
  Mr. Speaker, arbitrary time lines and partisan spin games indicate to 
me that the Democrat minority leadership is not presently really 
interested in helping more Americans get health insurance because 
health access is a big piece of this. While they say they are 
interested in joining our efforts to improve the quality of care for 
Americans in HMOs, they, instead, drive an agenda of gridlock, of 
conflict for the sake of conflict, of trying to stall to give some 
credibility to the minority leader's publicly repeated spin that this 
is a ``do-nothing'' Congress.
  Well, Mr. Speaker, we reject this sad and cynical approach of doing 
the Nation's business, especially on something as important as health 
care. Speaker Hastert should be commended for keeping his word, for 
keeping the process moving forward, which is what it is doing.
  This resolution is another clear signal that we are committed and 
serious about health care reform and that we are interested in more 
than just the next 30-second sound bite.
  I would point out that we have had recently a very fine debate in 
this House on the subject of health care, patient protection, and 
access. We have come up with a piece of legislation that is 
significantly different than the other body's. Obviously we need to 
continue to work forward to sort out those differences. That is what 
this resolution allows us to do. I am urging a yes vote on this 
noncontroversial resolution.
  Mr. Speaker, I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I thank the gentleman from Florida (Mr. 
Goss), my good friend, for yielding me the time; and I yield myself 
such time as I may consume.
  Mr. Speaker, I rise to speak on the rule governing this motion to go 
to conference on H.R. 2990, what the majority is calling the Quality 
Care for the Uninsured Act of 1999. Many of my friends on the other 
side of the aisle do not want a Patients' Bill of Rights. They have 
scrubbed those words from the title of the bill and have assigned it a 
bill number intended to disguise its heritage. But in, amongst 
everything else, there is a Patients' Bill of Rights, and this is an 
extremely important motion.
  The American people have spoken with a clear and compelling voice. 
They want reform in managed care, and they want protection from denials 
and delays which literally threaten their quality of life.
  This House responded in overwhelming fashion passing the Norwood-
Dingell managed care reform bill by a 275 to 151 vote margin. It was a 
genuine rout, a convergence of political courage and public support 
resulting in a good bill which will do the right thing by the American 
people.
  In fact, it was a little too good for our friends who want to scuttle 
the HMO reform legislation. They are playing their ace in the hole, a 
parliamentary procedure which combines this very agreeable HMO bill 
with H.R. 2990, a very disagreeable bill which barely passed the House.
  But the trump card will be the will of the American people. They will 
no longer tolerate being denied access to specialists or to clinical 
trials. They will not tolerate having medical decisions made by 
bureaucrats with a clipboard instead of a physician with a stethoscope. 
They are ready to make a stand. Those of us who voted for the Norwood-
Dingell bill are standing with them.
  Earlier this year, the other body passed a bill which pales in 
comparison to the House version. The House needs to send a strong, 
clear message to the conference committee that it should stand by the 
Patients' Bill of Rights which the House passed, that we should refuse 
to swallow the poison pills intended to kill this bill.
  Mr. Speaker, I also want to take just a moment to suggest that the 
conference take action on the vital issue of preventing genetic 
discrimination in health insurance. The Senate bill at least mentions 
the issue. The House bill is silent. But this is an issue that must be 
heard.
  Mr. Speaker, I humbly suggest that this is the next frontier of the 
health care debate. In the next few months, the human genome map will 
be complete. We are entering an era where we can know whether a person 
has a gene which might result in conditions from Alzheimer's disease to 
breast cancer.
  This gives us tremendous potential to act in a preventive manner, but 
this is a double edged sword. If insurance companies are able to use 
this information against people, if they find out that one has the 
potential for a disease that is expensive to treat, and they thus deny 
the coverage, then the advances in research will cut the other way in a 
very cruel fashion.

                              {time}  1900

  I have authored legislation to prevent discrimination based on 
genetic information, and I offered with my good friend, the gentleman 
from Ohio (Mr. Ney), an amendment to include such protection in this 
bill. But the Committee on Rules declined to allow the House to have 
that debate. Thus, the House bill is perilously silent on this issue. I 
encourage and hope that the House negotiators will work to improve the 
genetic discrimination protections included in the Senate bill and 
protect every American.
  Mr. Speaker, let me conclude by saying that we are going to insist 
that the conferees remain true to the bipartisan vote on this floor in 
favor of a real patients' bill of rights. I have compared this debate 
to a card game, and here the majority may very well refuse to even deal 
a hand to the people who support the Norwood/Dingell approach by 
refusing to give the supporters of the

[[Page 27998]]

bill a seat at the conference table. That would be an insult to the 
Members of this House who represent the millions of Americans who want 
action on managed care reform.
  It has taken far too long to get to this point in the debate. The 
other body passed a bill earlier this summer; we passed a bill a month 
ago. The other body appointed conferees 2 weeks ago; the majority in 
this House is just getting around to it. Maybe it has taken that long 
for the majority to try to stack the deck, but I am betting the 
American people will not let them get away with it.
  Mr. Speaker, I yield 2 minutes to the gentleman from New Jersey (Mr. 
Menendez).
  Mr. MENENDEZ. Mr. Speaker, I thank the gentlewoman for yielding me 
this time, and I rise in opposition to the rule, and I rise in strong 
support of what will be the Dingell motion to instruct conferees that 
will follow, should the rule pass. This motion would guarantee 
protections for all Americans in managed care plans.
  The Republican leadership's strategy has been obvious since this 
debate began: delay, dilute, and deny.
  First, they have pulled out every obstacle in the Republican play 
book to delay consideration of any patient protections. Then, once the 
Republican leadership realized they were losing that battle, they moved 
on to plan B, which was to dilute meaningful reform with a watered down 
bill they passed in the Senate. Again, the American people overcame the 
Republican opposition, and we won passage in the House of a strong 
patients' bill of rights sponsored by the gentleman from Michigan (Mr. 
Dingell) and the gentleman from Georgia (Mr. Norwood).
  The bill had overwhelming bipartisan support both in Congress and 
across this country. But even this overwhelming support has not stopped 
the Republican leadership. They have simply moved on to another phase 
in their strategy, denying supporters of the Norwood/Dingell bill a 
representative voice on the conference committee and creating a bill 
that is not supported by the bipartisan majority of this House or by 
the American people.
  I must admit the Republican leadership has been successful in one 
aspect. Their strategy continues to protect their generous industry 
contributors. But we will continue to work to overcome whatever 
obstacle is thrown our way and protect the hard-working American 
families who are being denied health care coverage in this process who 
are denied the best advice of their doctors and the ability to enforce 
those rights we seek to provide.
  We will have a meaningful patients' bill of rights, and we will do so 
with the help of the American people, who have spoken very clearly and 
very loudly that they do not want to see any more loved ones have to 
suffer under the present system.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
West Virginia (Mr. Wise).
  Mr. WISE. Mr. Speaker, I prefer that major pieces of legislation be 
worked out on a bipartisan basis, but it is clear that it is the 
Republican leadership that controls this House; and it is clear that it 
is the Republican leadership, regrettably, that is delaying getting 
this bill to conference.
  The House of Representatives passed this important patients' bill of 
rights 4 weeks ago, and yet has not yet gone to conference with the 
Senate so that we can get passage of a final bill. Four weeks ago. If 
this were a patient awaiting surgery, this would be an offense even 
under the nonexistent patients' bill of rights, even under managed care 
as it is today. This is shameful. So that is why it is so important 
that this bill that is now before us go to conference.
  Clearly, we need a patients' bill of rights in this country; 200,000 
citizens in West Virginia alone in HMOs, and thousands more in managed 
care plans, need an appeals process. We need to make sure that they can 
see the specialists that they have been working with. We need to make 
sure that they have more choice, particularly in choosing their OB-
GYN's and their pediatricians.
  So why can we not get the Republican leadership to permit this bill 
to go to conference? It is a shame that we have to come to the floor 
like this. But if we have to keep forcing it, we will, because the 
American people are quite clear: they want a patients' bill of rights. 
They want to make sure in their managed care plans they have rights. 
They want to make sure that they have some choice. If they can choose a 
mechanic who works on their car, they ought to be able to choose the 
doctor that delivers their baby or looks at their children.
  That is what this bill is about, and that is why we are trying to 
force this vote. We are determined to get this bill passed, a patients' 
bill of rights for all Americans, Mr. Speaker.
  Ms. SLAUGHTER. Mr. Speaker, I yield 3 minutes to the gentlewoman from 
Texas (Ms. Jackson-Lee).
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I thank the gentlewoman from 
New York for yielding me this time, and, Mr. Speaker, I think that we 
should take this particular motion to instruct conferees to go to 
conference as a step forward.
  I hope it is a step forward. I hope it is a response to 80 percent of 
the American people who have asked us repeatedly to give them HMO 
reform. I hope it is a response to many of us who procedurally were so 
anxious to get a patients' bill of rights that we signed a discharge 
petition, because we were not being heard by the Speaker of the House. 
Finally, we have gathered together to secure for the people of the 
United States a bipartisan patients' bill of rights, now called the 
Quality Care for the Uninsured Act.
  Mr. Speaker, this bill is crucial, first of all, because it equalizes 
the relationship between patient and physician. It puts that 
relationship above the pencil pushers or the bureaucrats who would deny 
service. It allows us to escape the drive-by emergency room situations 
of which we saw the tragedies of in the case before us on the floor of 
the House when the young boy came here who had gangrene in both his 
hands and his feet. It also says to us, Mr. Speaker, that women should 
have the opportunity to have as their primary caretaker an OB-GYN.
  The most important aspect of this motion, though, is to ensure that 
we do not put conferees on that are going to throw poison pills into 
this process. Put Republican conferees on who will work in a bipartisan 
way, who have supported this patients' bill of rights, who are part of 
the bipartisan effort. If we do that, Mr. Speaker, we will respond to 
the needs of the American people. We will respond to the disparate 
health care that I see in African American communities, in my 
community, where there are less people having access to health care 
because of this convoluted system that we have.
  We need to fix the public health system. But right now we need to 
reform the current system. The HMOs need to be fixed. We need this 
quality care for the uninsured. We need this process because we need to 
ensure that we can fix this system that is not working for the American 
people.
  In particular I want to emphasize again, as I was already stating, 
the inequity in access to health care and what happens when one cannot 
access quickly doctors, emergency rooms, and specialists. That is a 
denial of service, because someone says an individual cannot have the 
service. These are the kinds of things we hear when we go home to our 
districts.
  So besides, as I said, fixing the public health system, which is 
another issue all together, besides fixing the disparity in health 
access, which is also another issue, we can do something today. And I 
would hope, Mr. Speaker, that we would do something, by ensuring that 
the conferees on this particular conference are those who will work 
together to get a common good; that is to pass a good health management 
reform bill that we have before us.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Texas (Mr. Green).
  Mr. GREEN of Texas. Mr. Speaker, I thank my colleague for yielding me 
this time and allowing me to speak on the rule for appointing the 
conferees to the conference committee.

[[Page 27999]]

  I am proud to have been a cosponsor of H.R. 2723. This was a 
bipartisan vote as it passed this House. I would hope our conferees, as 
they are named, would remember that this House sent that bill to the 
Senate with a strong majority. It was a bipartisan majority because it 
addressed the issues that dealt with managed care reform: an outside 
appeals process, obviously to eliminate the gag rule, also allowing 
where a reasonable person or a medical necessity could be included in 
there.
  The most important, and I know this will be the toughest issue on the 
conference committee, was the accountability section in there. And, 
again, going on the experience that Texas has, it does not do any good 
not to have the ability to go to the courthouse. Because, ultimately, 
that makes the appeals process work.
  In the State of Texas, in the last 3 years that we have had our bill, 
we have had actually about half the cases that are being taken to the 
outside appeals process are being found in favor of the patient. Even a 
little bit more, 51, 52 percent. But the important part is that the 
insurance companies then will let that person have that care that they 
need. And the ones who are losing, well, they have already laid out 
that they could not make a medical case even to the outside appeals, 
much less to go to the court. But without the threat of the courthouse 
there, if people do not have that right, then we do not have that 
appeals process.
  And I think we will not have a lot of lawsuits filed. In fact, in 
Texas we have had, I think, no more than five; three by one attorney, I 
understand, in Fort Worth, Texas. So we have not had a groundswell of 
lawsuits.
  I would hope our conferees would remember how strong this bill came 
out of the House and how it spent a whole day debating it. I know it is 
a hard issue, but for the people in our country, we need to make sure 
we stay as close to the House bill as we can. So I support this rule.
  Ms. SLAUGHTER. Mr. Speaker, I have no further requests for time, and 
I yield back the balance of my time.
  Mr. GOSS. Mr. Speaker, I yield myself such time as I may consume, and 
would just simply say since this appears to be noncontroversial, I only 
heard one speaker across the aisle oppose the rule, and it would seem 
to me that that would be confounding to that speaker's goal, which is 
to move the process. That is what we are trying to do. So I see no 
justification for opposing this resolution, if we are trying to move 
the process forward, and I believe we all are trying to do that, 
because I agree we have had a great debate in the House about that; and 
we have come up with product, and it is now time to deal with the other 
body.
  I would point out that the product we have come up with provides for 
both patient protection and access for those 40-some million Americans 
who do not have the blessing of any kind of health insurance. And I 
think that that is a very strong menu for consideration at the 
conference.
  I do think we have lived up to our promise to move the process 
forward, in my view in a very rapid way, given the way most things move 
around here.
  Mr. Speaker, I have no further requests for time, I yield back the 
balance of my time, and I move the previous question on the resolution.
  The previous question was ordered.
  The resolution was agreed to.
  A motion to reconsider was laid on the table.
  The SPEAKER pro tempore (Mr. Hayes). The Chair will appoint conferees 
tomorrow.

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