[Congressional Record (Bound Edition), Volume 146 (2000), Part 1]
[House]
[Pages 402-410]
[From the U.S. Government Publishing Office, www.gpo.gov]



    MOTION TO INSTRUCT CONFEREES ON H.R. 2990, QUALITY CARE FOR THE 
                         UNINSURED ACT OF 1999

  Mr. BERRY. Mr. Speaker, I offer a privileged motion to instruct 
conferees on 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 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.
  The SPEAKER pro tempore. The Clerk will report the motion.
  The Clerk read as follows:

       Mr. Berry moves that the managers on the part of the House 
     at the conference on the disagreeing votes of the two Houses 
     on the Senate amendment to the bill H.R. 2990 be instructed.
       (1) to take all necessary steps to begin meetings of the 
     conference committee in order to report back expeditiously to 
     the House; and
       (2) to insist on the provisions of the Bipartisan Consensus 
     Managed Care Improvement Act of 1999 (Division B of H.R. 2990 
     as passed by the House), and within the scope of conference 
     to insist that such provisions be paid for.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Arkansas (Mr. Berry) and the gentleman from California (Mr. Thomas), 
each will be recognized for 30 minutes.
  The Chair recognizes the gentleman from Arkansas (Mr. Berry).
  Mr. BERRY. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, it has been 3 months since the House passed a bipartisan 
Patients' Bill of Rights legislation. The American people still do not 
have protections they want and deserve. Mr. Speaker, last night, I 
offered the motion to instruct conferees. The conferees deserve the 
opportunity to meet on this legislation. We need to get to work on 
finishing the job the American people sent us here to do.
  Last October, the House passed a strong bill. That is what I am 
asking the House to do now. Let the conferees meet. Let the Congress 
vote on a strong bill that will give the American people the patient 
protection they deserve and are asking for.
  While we delay, millions of American families needlessly suffer from 
the consequences of allowing HMO bureaucrats to make medical decisions. 
Let us allow medical decisions to be made by doctors and patients, not 
someone behind a desk. Americans want a bill that has a strong 
independent review of HMO decisions. They want a bill that is going to 
address the unfortunate case when the HMO causes injury or wrongful 
death, that they will be held responsible like any other business in 
America.
  Congress needs to take action on passing the bipartisan legislation 
to provide the American people with basic protections and basic 
guarantees when it comes to managed care.
  Mr. Speaker, I reserve the balance of my time.
  Mr. THOMAS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, this is, once again, the kind of political move that 
belies the argument that people want to come to a successful conclusion 
on a Senate-passed bill and a House-passed bill. We would have no 
ability whatsoever to reconcile the differences between the bills if 
the Senate were to insist on its position and, in fact, the House 
voted, as this measure indicates they want us to vote, to lock 
ourselves into our position.
  Now, first of all, we know that motions to instruct are not binding; 
that Members do not have to follow the vote one way or the other. But 
it is a clear indication that somebody wants political game playing 
rather than a solution.
  Mr. Speaker, I stand prepared as a conferee, as I am sure all the 
other conferees are prepared, to sit down and, over some very difficult 
subject matter, come to mutual agreement so that, as the Constitution 
requires, bills that differ in passing the House and Senate can be 
reconciled, repassed by the House and Senate so the legislation can 
actually go to the President for his signature.
  If somebody wants a patient protection bill with solid standards and 
with the acceptable practices that several years ago we voted very 
noncontroversially in the Medicare provisions, like emergency rooms, 
like no-gag rules, like the other provisions that we have already 
passed, then this is exactly the wrong motion to offer.
  If Members want to keep a football kicking even after the Superbowl, 
if they want to play politics with the issue, this is exactly the kind 
of motion that they would offer.
  So, Mr. Speaker, I am sorry that we are beginning this year with this 
kind of deceptive action, and I certainly would urge Members that what 
they ought to do is allow the conference to do its work, come to a 
successful conclusion, and not inhibit it by making demands that on 
their face cannot be met.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BERRY. Mr. Speaker, I yield 1 minute to the gentleman from 
Michigan (Mr. Dingell).
  Mr. DINGELL. Mr. Speaker, this is a very simple resolution. It is one 
upon which the House has, in substance, voted not once, but twice 
before. It is a good resolution. It simply says two things: One, that 
the conference should commence its business quickly; and two, that the 
conference should keep in mind and support the House-adopted position 
with regard to Patients' Bill of Rights.
  I am rather distressed to hear the gentleman from California (Mr. 
Thomas), my old friend, talk about this as being political. It is not. 
It is simply orderly business of the House provided for in the rules. 
It is a resolution which is going to expedite the process. There is no 
politics here.
  The House has spoken on this matter not once, but twice. The people 
want it. The country needs it. The House should vote affirmatively on 
this so that we can proceed in an orderly and speedy fashion towards 
the adoption of a piece of legislation that the people have said is not 
only needed, necessary, but badly wanted and very, very useful to the 
people in the country.
  Mr. Speaker, I urge a favorable vote on the resolution, I commend my 
good

[[Page 403]]

friend for his resolution and I urge my colleagues to vote 
affirmatively and to do so amicably and in the goodwill that is 
deserved.
  Mr. THOMAS. Mr. Speaker, I yield 3 minutes to the gentleman from 
Georgia (Mr. Norwood), the cosponsor of the legislation. And I would 
tell the gentleman from Michigan (Mr. Dingell) that my point is 
substantiated by the next speaker. Most of us referred to that bill as 
the Dingell-Norwood bill.
  Mr. NORWOOD. Mr. Speaker, I thank the gentleman from California (Mr. 
Thomas) for yielding me this time. Mr. Speaker, I want to be very 
clear. I certainly support the conference committee taking action on 
managed care reform as soon as possible, as Members on both sides of 
the aisle would agree to.
  But we do have to ask ourselves why are we bringing this motion 
before the House again today? We have finally received a commitment 
from House and Senate leaders to produce a final bill by early April, 
which will include the ability to sue ERISA-governed HMOs that cause 
injury and death. This is a massive concession by many who have been 
opposed to restoring the rights to sue. They should be welcomed with 
open arms.
  Instead, I fear we may be poisoning the negotiations by rewarding 
them with a political slap in the face. I do not know of any 
nonpolitical reason why we have the motion today. However, because I 
fully support patient protections, I will not vote against this motion. 
This is only our second day back to voting. People who have been our 
hard-core opponents are now offering an olive branch. We need to take 
it and make the best of it that we possibly can make.
  For that reason, I will not vote for this new motion. For now I will 
simply vote ``present.'' We need to encourage negotiation. The GOP 
leadership should be able to compromise in good faith on liability. 
Democratic leaders should be able to do the same on accessibility. I 
believe that President Clinton, the Republican leadership, the 
Democratic leadership, should accept immediately the 90 percent of the 
reforms that everyone agrees on that were in both the Norwood-Dingell 
and the Coburn-Shadegg bills, and all three should work out a 
compromise on liability and access.
  Mr. Speaker, it can and it must be done, but now is not the time to 
embarrass anybody. Now is not the time for politics from either side. 
Now is the time for serious people to have a serious discussion about 
the policy, the health care policy in this Nation that affects every 
one of our constituents.
  Mr. BERRY. Mr. Speaker, I yield 1 minute to the gentleman from 
Maryland (Mr. Cardin).
  Mr. CARDIN. Mr. Speaker, it was last October when this House, this 
body acted on the Patients' Bill of Rights. Our colleagues ask why are 
we bringing this motion forward? We are bringing it forward because it 
is time for Congress to act. There is hardly a week that goes by that I 
don't receive letters and telephone calls from constituents that have 
been hurt by their HMOs, that have been denied access to emergency care 
and denied access to specialists, whose physicians spend more time on 
the telephone arguing with HMOs than treating their patients.

                              {time}  1530

  It is time for this Congress to act, and that is why my friend from 
Arkansas is offering this motion.
  This bill has been in conference for too long. It is not a new issue. 
It has been with us now for several years. Let us schedule a meeting of 
the conference committee. Let us meet and act on the bill. We do not 
need to wait until April or May. This issue has been debated. People 
are being hurt. We know we need national legislation. It has been 
acknowledged in a bipartisan way by Democrats and Republicans alike.
  So let us put the politics aside, and let us get down to work and 
bring this legislation forward. That is the essence of the motion of 
the gentleman from Arkansas (Mr. Berry). I urge my colleagues to 
support the motion.
  Mr. Speaker, I rise in support of this motion to instruct the 
conferees on H.R. 2990.
  The American people have been waiting for years for Congress to enact 
meaningful, enforceable HMO reform. With more than 120 million 
Americans enrolled in managed care plans across the nation, we cannot 
afford to delay action any longer.
  Mr. Speaker, our citizens worry that to save money, insurers are 
skimping on quality and endangering the health and lives of their 
members. Our papers and our mailboxes are filled with accounts of 
patients who are denied care on the basis of cost. Medical decisions 
are being made by insurance company accountants rather than by doctors 
and their patients.
  Right now, our country has an illogical patchwork of state laws. This 
patchwork has prevented the enactment of national standards that 
guarantee all patients a set of basic rights. The right to be fully 
informed of treatment options, the right to emergency care based on a 
prudent layperson standard, the right to see a specialist, the right to 
be treated by the drugs that their doctor prescribes for their 
condition, the right to appeal health plan decisions to an independent 
review board, and the right of action when they are harmed by a health 
plan's decisions.
  Our conferees have two bills before them that must be reconciled. 
Only the House bill, H.R. 2990, contains these important basic rights. 
Overwhelmingly, this body has supported not only the Norwood-Dingell 
Bipartisan Managed Care Improvement Act, but also my distinguished 
colleague from Michigan's motion on November 3 to instruct the 
conferees to adopt this bill as the final legislation.
  Without further delay, it's time for this Congress to present a bill 
to the President that provides meaningful standards for all Americans 
in managed care plans. I urge adoption of this motion.
  Mr. THOMAS. Mr. Speaker, I yield myself such time as I may consume to 
respond to my friend from Maryland by saying that the actual process is 
one of accommodation and compromise between the House and the Senate. 
And I certainly would concur if this resolution or motion to instruct 
had only the first section, which was to announce immediately a time 
for a meeting. But the gentleman well knows that the second section 
requires on the part of the House to, without change or amendment, 
accept the bill that was voted on the floor of the House. That is pure 
unadulterated politics.
  Mr. Speaker, I yield 2 minutes to the gentleman from Iowa (Mr. 
Ganske), a doctor himself and someone who has worked long and hard on 
this issue.
  Mr. GANSKE. Mr. Speaker, I thank my friends on both sides of the 
aisle who have supported patient protection legislation. We essentially 
have voted on this motion to instruct before, and I voted yes on that. 
But today I am going to vote present, and here is why.
  Today, the Speaker has said that he wants the conference to convene 
in the next couple of weeks. The Speaker kept his word about bringing 
this issue to the floor when we did, and I trust that he will keep his 
word on getting this conference started.
  Do I think, as one of the three coauthors of the bill that passed the 
House, that the House conferees should stick up for the bill that 
passed with a 275 vote margin? Of course I do. But I think that I am 
seeing some evidence of a softening of hard positions, and I think that 
it would be, as my colleague, the gentleman from Georgia (Mr. Norwood), 
said, if an olive branch is held out, we should take it in good spirit.
  I think that we should move to getting this legislation passed this 
year, and that is why I am going to vote present. It does not indicate 
any weakening of my resolve on getting good patient protection 
legislation passed. I just simply think that at this point in time this 
resolution is not warranted. Why do we not wait to see what happens in 
the next few weeks?
  Mr. BERRY. Mr. Speaker, could I ask how much time is remaining on 
each side?
  The SPEAKER pro tempore (Mr. Shimkus). The gentleman from Arkansas 
(Mr. Berry) has 26\1/2\ minutes remaining and the gentleman from 
California (Mr. Thomas) has 23 minutes remaining.
  Mr. BERRY. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from 
Texas (Mr. Doggett).
  Mr. DOGGETT. Mr. Speaker, I thank the gentleman for his leadership on 
this issue.
  Too often an insurance clerk gets right in the middle of the 
relationship

[[Page 404]]

between doctor and patient, and the consequences of that interference 
can be absolutely disastrous. We want to do something meaningful about 
that problem. It is called a Patients' Bill of Rights.
  The same Republican leadership that is up here today saying wait to 
the American people is the same leadership that fought tooth and nail 
to prevent us from ever taking up a Patients' Bill of Rights in the 
first place. The same folks that say wait today are the same people 
that came to this floor and voted for every amendment they could come 
up with to kill this Patients' Bill of Rights.
  The same Republicans that are here today saying wait are the same 
Republicans that after their amendments were defeated, they all voted 
against a meaningful Patients' Bill of Rights. The same Republicans 
that say wait today are the same Republicans that, after the Senate 
appointed its conferees, dillydallied around here, they waited, they 
delayed, they did anything they could except act. They waited until the 
week before we went out of session to even name conferees.
  The same Republicans that say wait today are the same Republicans 
that refused to even appoint the gentleman from Iowa (Mr. Ganske) and 
the gentleman from Georgia (Mr. Norwood), both doctors and Republicans 
who knew something about this issue and cared about patients. They 
would not even appoint them as conferees.
  They say wait to the American people. We say do something to give 
them a meaningful Patients' Bill of Rights. Is there politics at issue 
here? You bet there is politics at issue today. It is the politics of 
inaction, which is the whole story of this worthless Republican 
leadership.
  Mr. BERRY. Mr. Speaker, I yield 1 minute to the gentlewoman from 
Maryland (Mrs. Morella).
  Mrs. MORELLA. Mr. Speaker, I am not here to talk about the politics 
of the situation, except that this is the time. This session we must 
pass a bipartisan HMO reform bill.
  I want to encourage the conferees to maintain the many 
noncontroversial provisions in H.R. 2723 in the conference report, such 
as the requirements that managed care patients have access to emergency 
care without prior authorization; access to specialized treatment when 
it is medically necessary in the judgment of a health professional; and 
access to approved clinical trials where the plan must pay for the 
routine patient costs associated with the trials.
  Also, I want to encourage the conferees to exclude medical savings 
accounts in the FEHBP. I oppose MSAs because they would cause 
cherrypicking in the FEHBP, resulting in higher premiums for those who 
are less healthy as relatively healthy enrollees are included.
  So I just ask the conferees to meet, to resolve it. I believe that 
the Speaker is going to have a bill before us that will be bipartisan 
and that we can all agree on.
  Mr. BERRY. Mr. Speaker, I yield 1 minute to the gentlewoman from 
Illinois (Ms. Schakowsky).
  Ms. SCHAKOWSKY. Mr. Speaker, I rise in strong support of the 
gentleman's motion to instruct conferees, to act quickly, and to pass 
the bipartisan House bill.
  This morning I read a letter on the floor that I received from David 
and Suzanne Miller, two of my constituents from Niles, Illinois. They 
asked, and I quote, ``Why can't Congress just do what is right for the 
people whose well-being has been entrusted to them?'' Why indeed.
  Last November we passed a bill that held out great promise for 
millions of patients in managed care plans. That bill, that particular 
bill, would make it easier for patients to enroll in clinical trials; 
give direct access to women for obstetrician-gynecological services; 
ensure that children could get to see their pediatricians and pediatric 
specialists; make sure patients undergoing treatment for serious 
illnesses can stay with their own doctors rather than being forced to 
switch; let health care professionals, not insurance company bean 
counters, make medical decisions; and, finally, hold health care plans 
accountable and let patients sue if they are injured by HMO decisions.
  But, Mr. Speaker, it will do nothing if it is not enacted into law. 
Let us not let David and Suzanne Miller down or the millions of 
patients who count on us.
  Mr. BERRY. Mr. Speaker, I yield 1 minute to the gentleman from 
Illinois (Mr. Davis).
  Mr. DAVIS of Illinois. Mr. Speaker, one of my constituents, Miss 
Elizabeth Hines, stated very clearly my position on this issue when she 
wrote a letter to me saying, ``As a registered nurse, I urge you to 
persuade your colleagues on the conference committee to move ahead and 
pass H.R. 2990, to honor the clear imperative from the American people 
for enactment of strong, comprehensive and enforceable protections 
embodied by the bipartisan Norwood-Dingell legislation. The final bill 
must include protection for nurses and other professionals who blow the 
whistle so that they can be advocates for their patients.''
  I agree with Miss Hines. We need to move now, not tomorrow, not next 
week, not next year. The American people are saying, ``Pass it now.''
  Mr. BERRY. Mr. Speaker, I yield 1 minute to the gentlewoman from 
Texas (Ms. Eddie Bernice Johnson).
  Ms. EDDIE BERNICE JOHNSON of Texas. Mr. Speaker, let me thank the 
gentleman for his leadership and all those who stand here on behalf of 
the American people.
  Not anywhere can we go in this country that people are not begging 
for a sensible health care delivery system. We passed this bill 4 
months ago. There is no reason why the conference committee could not 
have acted back then. But we are desperate now and we do need this. 
People scream out for it.
  I am a registered nurse, and I see the difference in the quality if 
we do not have any accountability. These companies dictate to 
physicians. We want to put the health care back into the hands of the 
caregiver, not the bureaucrat. Because, my colleagues, what happens is 
they dictate to the physicians, they dictate to the nurses, but they do 
not want to take the responsibility for it.
  Patients need rights. They need to be able to complain when they have 
been wronged by the system. We cannot get it until we get a good, 
aboveboard nonpartisan approach to it. It is very, very important.
  Mr. THOMAS. Mr. Speaker, I yield myself such time as I may consume to 
simply say that I find it ironic that the gentleman from Texas used the 
phrase ``you Republicans,'' ``you Republicans,'' ``you Republicans,'' 
when, in fact, as the gentleman from Illinois said, this is a 
bipartisan bill.
  I also find it interesting that the two individuals on the bill who 
made it bipartisan, the gentleman from Georgia (Mr. Norwood) and the 
gentleman from Iowa (Mr. Ganske) were our first two speakers, and they 
said this does not make a lot of sense. They are not going to vote for 
it.
  It seems to me that the bipartisan part of my colleagues' argument 
has been shattered. If we have a procession of Democrats offering 1 
minutes saying this has to be passed now, but the Republicans who made 
it bipartisan say this does not make a lot of sense, it looks like 
politics is being played, then I think it is fairly obvious. The answer 
is, politics are being played.
  Mr. Speaker, I yield 5 minutes to the gentleman from Arizona (Mr. 
Shadegg), someone who has become very knowledgeable on this subject 
matter, has been a major contributor to the debate, and is a conferee.
  Mr. SHADEGG. Mr. Speaker, I thank the gentleman for yielding me this 
time, and I want to make it very clear that I oppose this motion to 
instruct, and I urge my colleagues to defeat it.
  I think it is important that we look at precisely what the motion to 
instruct does. There are two pieces to it, as my colleague, the 
gentleman from Michigan (Mr. Dingell), pointed out. The first one is 
that all necessary steps be taken to begin the meetings.
  On that point I think it is very important to note, and for all our 
colleagues to understand that, in fact, there has now been an agreement 
that a meeting of the conference committee will occur. It will occur 
either next week or the week after. It will precede

[[Page 405]]

the February break, which is the week after that. And so steps to begin 
meetings have in fact been agreed to, making the first point of the 
motion to instruct moot.
  I guess I would add on that point that I myself agree with the 
concern that the conferees should meet and that we should begin the 
process, because I wholeheartedly agree it is critically important 
work.
  But the second portion of the motion to instruct is the portion of 
the motion I think our colleagues should be concerned about and, quite 
frankly, which is the portion of the motion to instruct which makes it 
technically flawed. And that is that we instruct the conferees that 
they insist that H.R. 2723 be included in the conference report. What 
that means is that we insist on the House position and the House 
position only.
  Now, as a proud Member of the House, there might be occasions when I 
would like to insist on the House position and the House position only. 
But there is no one in this body, Republican or Democrat, who does not 
understand that in this conference committee if either the Senate or 
the House chooses to insist upon their position and their position 
only, the net effect will be tragic.
  My colleague, the gentleman from Arkansas (Mr. Berry), the proponent 
of this motion to instruct, said just a moment ago that people are 
suffering today and it would be tragic if we continued to delay because 
people will continue to suffer. Well, I think it is very important for 
our colleagues to understand that if either side, the House or the 
Senate, insists that it is their position in these negotiations or no 
position, then in fact what we will get is not a bill, it is not 
legislation, it is not relief for the American people, whom I believe 
are being abused, it is not legislation that will help them.
  If we do as this motion to instruct requires, indeed demands, if we 
insist that it is our bill and our bill only, the Norwood-Dingell bill, 
which is bipartisan, if we insist that it is that bill and that bill 
only, then what we are saying is we do not intend to legislate on this 
issue this year; we do not intend to send the President a bill that he 
can and will sign, and we do not intend to help the American people.

                              {time}  1545

  Rather what we intend is to save for the election a political issue. 
I understand there are people in this body who want a political issue. 
I urge them to rethink their position. The reality is we need a 
compromise between the House and the Senate version, and we need 
legislation to help the American people.
  And on that point, I would note that my colleagues, the gentleman 
from Iowa (Mr. Ganske) and the gentleman from Georgia (Mr. Norwood), 
who were plowing this ground long before I, and who know it well, stood 
up and noted that on the critical issue of liability, we have made 
great strides in just the last 3 weeks.
  Just a few weeks ago, barely a week and a half ago, Mr. Lott 
indicated that any legislation which passes this year must include a 
reasonable liability provision holding HMOs that hurt people 
accountable in a court of law for their conduct; that is a tremendous 
stride forward.
  And I compliment the gentleman from Iowa (Mr. Ganske) and the 
gentleman from Georgia (Mr. Norwood) for acknowledging that. But if we 
are making progress, then why step back from that? Why insist our way 
or no way? I suggest that is a tragic mistake being advocated by those 
who do not want to help the American people on this issue, but who 
rather want a political issue to go forward on.
  And, again, the net effect of insisting our way or no way is that 
people will continue to suffer, the very goal this motion to instruct 
is designed to alleviate.
  There is another critical important issue to be discussed here, and 
that is the contents of the bill on the issue of access. My colleagues 
on the other side, when the bill passed the House floor, every single 
one of them said, we do not want to accept nor will we embrace a single 
provision of H.R. 2990 that addresses the problems of access to care by 
the uninsured.
  There are several pieces in H.R. 2990 that would help America's 
uninsured get care. While I heard some movement in the Senate side on 
the issue of liability, I have not heard today any movement on the 
House side on the issue of access to care. I think that would be a 
tragic mistake.
  This is a once-in-a-lifetime chance for this Congress to do 
something, not just about HMOs and their abuses, but about America's 44 
million uninsured. Clearly, we need to do something about that. Indeed 
in his State of the Union address just last week, the President talked 
about access to care. He proposes three solutions.
  To sum it up briefly, the President in his State of the Union address 
proposed that we expand government-run health care from two ends, that 
we expand Medicaid to younger people and that we expand SCHIP. I would 
suggest that that is the best answer. But that the best answer is one 
that has a lot of bipartisan support and that is a tax credit, a 
refundable tax credit.
  And I would note that just last week, our Majority Leader Armey and 
Senator Breaux, a knowledgeable expert on the other side of this issue, 
proposed irrefundable tax credit. There are great things that can be 
done on health care this year. We can support a patients' bill of 
rights. We can enact legislation that will help the American people, 
but not by this motion to instruct, not by an arbitrary demand that it 
be our way or no way.
  Mr. BERRY. Mr. Speaker, I yield such time as she may consume to the 
gentlewoman from California (Ms. Waters).
  Ms. WATERS. Mr. Speaker, I rise in support of H.R. 2990.
  I rise in strong support of the motion to instruct the conferees to 
begin meetings of the House-Senate managed care conference committee 
and insist upon the provisions of the Dingell-Norwood Managed Care 
Reform bill. The Dingell-Norwood bill was passed by the House of 
Representatives by a strong bipartisan vote on October 7, 1999. 
Nevertheless, the Republican leadership has made no progress whatsoever 
towards the enactment of this critical legislation. There has not even 
been a single meeting of the conference committee since the bill was 
passed.
  The Dingell-Norwood Managed Care Reform bill, also known as the 
Patients' Bill of Rights, would protect patients and their families 
from irresponsible actions by HMO's. It would prevent health insurance 
companies from rewarding doctors for limiting access to health care, 
and it would hold managed care plans legally accountable when their 
decisions to withhold or limit health care result in injury or death. 
The Patients' Bill of Rights would ensure that medical decisions are 
made by health care professionals and not bureaucrats.
  Health care should be provided by doctors--not HMO bureaucrats! It is 
time that Congress hold health insurance companies accountable and 
protect the rights of American families to quality health care.
  I urge my colleagues to support this motion to instruct the conferees 
and send the Patients' Bill of Rights to the President's desk without 
any further delay.
  Mr. BERRY. Mr. Speaker, I yield 1 minute to the gentleman from New 
Jersey (Mr. Pallone) who has done great work on this issue and 
continues to provide great leadership, to try to help the American 
people get health care.
  Mr. PALLONE. Mr. Speaker, I want to thank my colleague from Arkansas 
for those kind remarks. And let me just say, I listened to the previous 
Republican speaker on the other side of the aisle, and after I listened 
to what he said, I am more than ever convinced why we need this motion 
to instruct. He said, well, we are going to schedule the conference. It 
will be scheduled sometime in February or early March.
  Well, the bottom line is it has not been scheduled. The bottom line 
is that it has not been scheduled. It is 4 months since we passed this 
bill. I am tired of hearing about it is going to be scheduled, it is 
going to happen. I hope he is right. But I think that we must insist 
that we move to the conference straight with.
  The other thing is there is a tremendous amount of frustration on the 
part of Democrats and myself on this side of the aisle because so many 
efforts have

[[Page 406]]

been made by the Republican leadership over the last 2 or 3 years to 
sabotage the effort to pass the Patients' Bill of Rights.
  For 2 years, we saw both Houses of Congress pass what I considered 
bad bills, it did not really do any reform. And now the gentleman 
suggested somehow we have to wait on the access provisions and the 
larger issues of dealing with the uninsured or other health-care issues 
have to be brought into this. Again, I think that is nothing more than 
an effort to try to delay and delay and delay the Patients' Bill of 
Rights.
  We know that there is almost unanimous support amongst the American 
people for this legislation the way the House passed it. We must insist 
on the House version. Because that is the only thing that is going to 
be signed into law. That is the only thing that will pass both Houses 
overwhelmingly, go to the President and be signed into law.
  If they mess up this legislation with the Senate version that has the 
MSAs, even one of my Republican colleagues talked about how bad that 
is, the health marts and all these other poison pills that have been 
placed in this legislation and get to those other issues, all that 
means is that they are going to ruin any possibility of passing the 
Patients' Bill of Rights in the way it was passed in the House, the way 
the American people want it passed.
  So I would maintain, after listening to my colleagues, I feel all the 
more we need this motion to instruct. We need to go to conference 
forthwith. We need to insist on the House version because that is the 
only thing that is going to pass.
  Let us get passed what we can get passed and show the American people 
that we can accomplish something that helps them rather than 
dillydallying for the rest of this year and the rest of this Congress.
  Mr. BERRY. Mr. Speaker, may I inquire how much time is remaining on 
each side?
  The SPEAKER pro tempore (Mr. Hastings of Washington). The gentleman 
from Arkansas (Mr. Berry) has 19 minutes remaining, and the gentleman 
from California (Mr. Thomas) has 16 minutes remaining.
  Mr. BERRY. Mr. Speaker, I yield 1 minute to the gentleman from Texas 
(Mr. Green).
  Mr. GREEN of Texas. Mr. Speaker, it has been 4 months since we passed 
the bipartisan Norwood-Dingell bill and nothing has been done. We have 
worked hard to reach that consensus, but the opposition continues to 
delay the real reform with gimmicks and watered down proposals that 
will wind up doing nothing for patients.
  Not only is the conference committee stacked with Members who voted 
against the bill, Mr. Speaker, there has not been one meeting since the 
bill was passed 4 months ago. This is unacceptable, Mr. Speaker.
  We have 48 million Americans who belong to self-funded health 
insurance plans that have very little protection from neglectful and 
wrongful decisions made by their insurance plans.
  Now, I would like to have access like my colleague from Arizona talks 
about, but it does not do any good to have access if we do not have a 
plan that is worth anything, it is not worth the dollar that their 
employer or they pay for it. It is not worth it.
  We cannot stand by and allow the delay and the maneuvering to 
continue to pass a weak bill. Millions of people need help and are 
suffering from the consequences and decisions not made by doctors but 
made by clerks. What I have heard is that some of the folks who are 
making those decisions do not even have the training that a first-year 
medical student may have even before they enter.
  So we need to pass a strong bill. I am pleased that my colleague from 
Arkansas is offering this motion to instruct conferees. We are going to 
be here every week until we see some action from the conference 
committee. And 4 months is too long.
  Mr. BERRY. Mr. Speaker, I yield 1 minute to the gentleman from Ohio 
(Mr. Strickland).
  Mr. STRICKLAND. Mr. Speaker, it has been over 100 days since this 
House passed the Patients' Bill of Rights, 100 days. Nothing has 
happened.
  I have here in my hand a little booklet ``How Our Laws Are Made.'' We 
give this booklet to schoolchildren so they will understand.
  I suggest the leadership of this House read this book. It is rather 
simple. The House passes a bill. The Senate passes a bill. And then 
conferees are appointed, and they come together and come up with a 
consensus that is then sent to the President for his signature.
  We have done step one. We have done step two. It is time for step 
three.
  I urge the leadership of this House to read this pamphlet and to get 
on with the business of the people of this country.
  Mr. BERRY. Mr. Speaker, I yield 1 minute to the gentleman from New 
Jersey (Mr. Andrews).
  Mr. ANDREWS. Mr. Speaker, I do not know if it is a miracle or a 
coincidence, but for over 100 days after the House passed the bill 
there was no meeting scheduled of the conferees. Then last night we 
filed this motion calling for a meeting of the conferees, and we hear 
there is a meeting going to be scheduled.
  It sounds to me like a trip to Lourdes took place and a miracle 
occurred, and we accept the miracle very happily.
  I have no doubt that there are people in good faith on both sides 
that want to pass a real accountability bill for managed care. But I 
worry that we might be like the fans of the Tennessee Titans, like my 
friend the gentleman from Tennessee (Mr. Ford), who believes that if 
they had time for just one more play the other night, they would have 
tied the game and gone on to win the Super Bowl.
  I do not want to be standing here in September or October and saying, 
if we just had one more week, just a little more time, we could have 
done what the huge majority of Americans want us to do.
  Let us get to work right now. Let us have the conference meet, and 
let us pass a real Patients' Bill of Rights.
  Mr. BERRY. Mr. Speaker, I yield 1 minute to the gentlewoman from 
North Carolina (Mrs. Clayton).
  Mrs. CLAYTON. Mr. Speaker, I thank the gentleman from Arkansas (Mr. 
Berry) for his leadership in this.
  Actually, this resolution should be encouraged from both sides of the 
aisle. Because health care for families and their children is the most 
pressing issue, and we should have to make sure we respond to this, not 
waiting and delay. We should be eager that this is here.
  This is an opportunity to respond to a pressing need. All across 
America, in thousands of communities, families are trying to struggle 
how to get the health care they already paid for. They want to make 
sure that their adults and their children have emergency care. They 
want to make sure they have specialty care. Women and children want to 
have protective care. And certainly we want to have long-term 
continuity of care.
  Patients want to know that their doctors are free to make medical 
necessity decisions, not just decisions based on how much to save the 
HMO. Good medical decisions by a physician is good for business, and it 
certainly should be good for the American people.
  I urge the support of this resolution.
  Mr. BERRY. Mr. Speaker, I yield 1 minute to the gentlewoman from 
Connecticut (Ms. DeLauro).
  Ms. DeLAURO. Mr. Speaker, we have begun a new year, some say a new 
millennium, and it is a new session of the Congress. Yet working 
families have come no closer, no closer, to reclaiming control of their 
medical decisions.
  It is long past due that we enact the Patients' Bill of Rights. Let 
us put health-care decisions where they belong, in the hands of doctors 
and families.
  Every single Member of this House has heard the heart wrenching 
accounts of the prescriptions and the procedures that have been denied. 
Quite frankly, that is why we were able to take that giant step forward 
last year when we passed a bipartisan Patients' Bill of Rights. It is a 
balanced bill. It would protect patients' rights without reducing 
health care coverage.

[[Page 407]]

  Unfortunately, the Republican leadership of this House has worked 
long and hard to try to kill managed care reform. It continues to stand 
in the way of this bill. Four months, 4 months they have taken, they 
stacked the deck against patient care when they chose to negotiate the 
final bill.
  The fact of the matter is they are in charge, they could bring this 
bill up anytime they want. They are stalling. Let us stop.
  Mr. BERRY. Mr. Speaker, I yield 1 minute to the distinguished 
gentleman from Tennessee (Mr. Ford).
  Mr. FORD. Mr. Speaker, I thank the gentleman from Arkansas (Mr. 
Berry) for all his leadership.
  I want to take just a personal privilege and thank the gentleman from 
New Jersey (Mr. Pallone). When this bill is eventually signed into law, 
and we hope it resembles the Norwood-Dingell bill, the gentleman from 
New Jersey (Mr. Pallone) should be standing right next to the 
President. There has not been a greater stalwart in the House in seeing 
this passed.
  I thank the gentleman from Arkansas (Mr. Berry) and all the others, 
but the gentleman from New Jersey (Mr. Pallone) has been a great 
leader.
  Cynicism abounds about what we do in this Congress and what we do not 
do. We passed a bill here in the Congress some 100 days or more, so 
many other colleagues have said, with clear instructions as to where 
this body stood on this issue, reflecting where the American people, 
regardless of what their political or party affiliations might be.
  I was delighted to hear my friend the gentleman from California 
(Chairman Thomas) say that we ought to adhere to what both the 
gentleman from Iowa (Mr. Ganske) and what the gentleman from Georgia 
(Mr. Norwood) have said. I would hope that if some of my colleagues on 
this side choose to vote ``present'' on this bill, and I have not made 
my mind up, that they might change their opinion on this and support 
the Norwood-Dingell bill itself, urge the conferees, the lead Senator 
on the Senate side, Mr. Frist, and all the others to do what is right 
on this bill, protect consumers and return medical decision making back 
to the doctors.
  We have an opportunity here today, I say to both my friend from Iowa 
(Mr. Boehner) and the gentleman from California (Mr. Thomas), to do 
right by the people and restore some confidence in this House in our 
ability to do our job.

                              {time}  1600

  Mr. THOMAS. Mr. Speaker, I yield myself such time as I may consume.
  I would only note that the gentleman who just spoke said that he 
hopes the bill that comes out of conference resembles Dingell-Norwood. 
If this motion to instruct passes, it has to look exactly like it. So I 
think it is fairly clear that, just as the gentleman from Ohio holding 
up the Constitution said, that what we need is a consensus. I think if 
anybody looks up ``consensus,'' it means an agreement by all parties. 
This motion to instruct says Members can only vote the bill that came 
off the floor. The gentleman from New Jersey said that is the only bill 
that will go to the President, which means, I guess, that they are 
going to be opposed to any reasonable compromise, or something that 
resembles Dingell-Norwood.
  Once again, I think it clearly underscores what we are about is 
politics.
  Mr. Speaker, I yield 2 minutes to the gentleman from Kentucky (Mr. 
Whitfield).
  Mr. WHITFIELD. Mr. Speaker, this obviously is quite an emotional 
issue. When people talk about patients' rights, all of us want to 
protect patients' rights. I can understand how the gentleman from Texas 
and other speakers on the other side would say this is a partisan 
issue, because we can make it quite a partisan issue. But the point 
that I would like to make is that politics is the art of compromise. As 
the gentleman from Arizona said, many on that side of the aisle have 
taken the position, it is either our way or it is no way. They also 
would make the argument that government can best solve this problem.
  Yes, I think government has a part and an important part in trying to 
solve this problem. But I would also remind everyone that this patient 
protection bill, we get the impression that it would affect every 
patient in America. That is really not true. It affects only those 
covered under ERISA plans, health plans provided by certain employers. 
Those employers have a vested interest in helping their employees with 
good health care. That is why they have initiated many of these plans. 
The reason that we want some flexibility for these conferees on the 
House side is that what the Senate passed is drastically different than 
what the House passed. It would be unwise, it could not work, if our 
conferees cannot have any flexibility whatsoever.
  So if the other side really wants to try to solve this problem and 
have a meaningful bill that can protect patients under ERISA plans, 
then we need to defeat this motion. They can go to conference; they can 
have disagreements. We can come back and vote on it again. But to tie 
their hands before they even get there I think is not only a disservice 
to the House, not only a disservice to the conferees, but a disservice 
to the patients whose rights we are trying to protect.
  Mr. BERRY. Mr. Speaker, I yield such time as he may consume to the 
distinguished gentleman from Michigan (Mr. Dingell), who without his 
leadership we would not have passed this bill. He has provided the 
leadership to get this issue this far in the Congress and hopefully to 
serve the American people well very soon in their effort to obtain good 
health care.
  Mr. DINGELL. Mr. Speaker, I want to thank my dear friend for his 
kindness to me for yielding this time. I do not need much. I would like 
to hear more from my distinguished friend from Arkansas.
  We have here a chance simply to support what has been done by the 
House in two prior votes and to do so with regard to a matter which was 
decided in a thoroughly bipartisan fashion with leadership from Members 
not necessarily in the leadership of both sides but on both sides of 
the aisle. I would observe that we have a chance here to instruct the 
conferees again. There is strong need for this because I would note to 
my colleagues that the leadership on the other side of the aisle has 
given no comfort whatsoever to those of us who favor this legislation. 
They have included no strong friends on either the Senate band of 
conferees or the conferees from the House side on the Republican side 
of the conference.
  How much better it would have been had we moved more speedily. How 
much better would it have been had we considered these matters in a 
fashion more consistent with the vote which was cast earlier by the 
House by including Members from the other side of the aisle who were in 
support of this. If the leadership wants to really demonstrate a 
measure of bipartisanship, they can show it. They can instruct the 
parties to the conference to move speedily. They also can construct a 
pattern of conference members who will give comfort to Members on this 
side.
  I, for example, would be much more comfortable if I were to see the 
distinguished gentleman from Georgia (Mr. Norwood) or the distinguished 
gentleman from Iowa (Mr. Ganske) or other Members on the Republican 
side who worked so hard in such a careful and thoughtful bipartisan 
fashion and see to it that the conferees in fact fairly represented the 
will of the House.
  Clearly, events to this time show no comfort to any of us who believe 
in this piece of legislation. The conferees are rigged against us, 
over-long delay in appointing those conferees and exclusion of the two 
principal leaders on the Republican side. Until that kind of action is 
taken by the leadership on the Republican side, there will not be much 
comfort on this side of the aisle, and there will be strong reason in 
the minds of almost every Member who has supported this legislation to 
see to it that this resolution and other matters which can be done to 
move the process forward towards the House-passed bill are taken.
  It is possible to say any number of things to the contrary, but 
nothing which is either factual or which will bear weight in the minds 
either of the

[[Page 408]]

average Member of this body or the ordinary citizens of the country.
  Mr. BERRY. Mr. Speaker, I yield 1 minute to the gentleman from 
Tennessee (Mr. Ford).
  Mr. FORD. Mr. Speaker, just to respond briefly to my dear friend, the 
gentleman from California (Mr. Thomas), all we want on this side are 
for meetings to be scheduled, for an opportunity for a consensus to be 
reached to actually be realized. Sure I would like the compromise or 
the consensus to look like the Norwood-Dingell, but I am not alone. 250 
of my colleagues wanted the same thing, including three out of the five 
Republicans from my own State, the gentleman from Tennessee (Mr. Wamp), 
the gentleman from Tennessee (Mr. Duncan), and the gentleman from 
Tennessee (Mr. Jenkins). Unfortunately I cannot convince either of my 
Senators, Senators Frist or Thompson, to support it; but hopefully if 
we can arrange the meetings, we can find a consensus.
  My other colleague mentioned how this would only affect a small 
number of people, that we ought to be concerned with the uninsured. 
There is serious and vast concern on this side of the aisle for the 
uninsured, but why should we ignore the 160 million plus that this bill 
would cover? I support State tax relief. That would affect a small 
number of people. I support the capital gains tax relief. That would 
affect a small number of people. I support special ed, fully funding at 
the federal level. That would affect a small number of people. Do not 
act as if we are unaccustomed in this Congress to passing bills or 
offering public policy that would not affect everyone in America.
  We have a chance to do what is right. Schedule the meetings and allow 
an opportunity or a forum for a consensus to be reached. Do not play 
games, leadership on the Republican side. Do what is right for the 
American people.
  Mr. THOMAS. Mr. Speaker, I yield myself such time as I may consume.
  I tell my friend, the gentleman from Tennessee, that if this 
resolution was the first section only, which reads, ``Take all 
necessary steps to begin meetings of the conference,'' that would have 
been a voice vote and it would have been agreed to, in my opinion, 
unanimously.
  The concern obviously, as indicated by the two cosponsors of the 
bipartisan legislation, the gentleman from Iowa (Mr. Ganske) and the 
gentleman from Georgia (Mr. Norwood), is that by adding the second 
provision, it clearly means there is more of an interest in politics 
than in getting the conference going. The gentleman himself has been 
ambivalent in terms of his statement as to whether he is really going 
to support this resolution or not. I think he and I would agree both of 
us could support the first item. It is the addition of the second item 
that makes it partisan, and indeed I will enjoy watching the gentleman 
from Tennessee's mental wrestling bout with himself as to whether he 
decides to make it partisan by voting ``yes'' or that his conscience 
controls and he votes ``no.''
  Mr. FORD. I will vote ``yes.''
  Mr. THOMAS. Mr. Speaker, it is my pleasure to yield 5 minutes to the 
gentleman from Ohio (Mr. Boehner), someone who has been involved 
extensively in this information, the chairman of a subcommittee which 
is crucial to the resolution of this issue.
  Mr. BOEHNER. Mr. Speaker, I want to thank my colleague from 
California for yielding me this time and remind my colleagues that this 
motion to instruct conferees is a nonbinding motion. It is within the 
rules of the House to allow the minority to bring the issue to the 
floor and to have a debate; but we all know that, any of us that have 
been in this body for some time, that it is an opportunity to make 
political hay. After all, it is an even-numbered year.
  Now, we all know in even-numbered years that all of the Members of 
the House are up for reelection or there is going to be an election and 
all the seats are going to be contested. What that means to me in most 
cases, unfortunately, is that the rhetoric in this body will certainly 
increase. I think it is a little early in the year for that to occur, 
but obviously it is not too early for some.
  We have had an awful lot of debate here, and we have heard mention 
about the 100 days that we have not acted on this bill. All of my 
colleagues know that we have been in recess, out of session, back in 
our districts for the last 2\1/2\ months. Since the week before 
Thanksgiving, we have been home with our families and our constituents 
trying to deal with what is happening out in the real world. To expect 
that Members were going to come back here over Christmas, as an 
example, to deal with this issue certainly is not realistic.
  Having said all of that, the chairman of the conference, Senator 
Nickles, has announced that the conferees are going to meet before the 
February recess. The Speaker of the House and the majority leader of 
the House, have made it clear that they want this issue on the floor of 
the House before the Easter recess.
  Mr. FORD. Mr. Speaker, will the gentleman yield?
  Mr. BOEHNER. I yield to the gentleman from Tennessee.
  Mr. FORD. Mr. Speaker, most Americans have to go to work every day. I 
know they appreciate the fact that we were out to enjoy time at home, 
being with our families.
  Mr. BOEHNER. Reclaiming my time, certainly all of us, even though we 
were not here in Washington, were back in our districts working. Part 
of our job occurs in our districts. I am sure the gentleman from 
Tennessee was back in his district working diligently, every day, as I 
was around my district. So we are going to have this bill back on the 
floor. But one of the concerns that I have heard raised here subtly 
today I heard raised more pointedly yesterday in a different forum when 
we talked about the need for patients' rights, and we all understand 
that there is a reasonable way we can approach this.
  But beyond the issue of patients' rights, we all know the number one 
issue in the health care system in America today is the fact that over 
44 million Americans have no health insurance at all. We have to be 
very careful as we move to enact patients' rights that we do not 
increase the number of uninsured. We ought to follow the Hippocratic 
oath that says first do no harm. But as we try to provide better access 
for people who have no health insurance, one of my colleagues on the 
other side of the aisle yesterday actually termed it a poison pill for 
patients' rights. We have heard other references here today, rather 
subtle, that that can wait, that we can deal with that later.
  Ladies and gentlemen, if we are going to move reasonable patients' 
rights to help the American people who are stuck in managed care, the 
least we can do is to do something to help the 44 million Americans who 
have no health insurance whatsoever. Why can we not provide association 
health plans for them, refundable tax credits for them, medical savings 
accounts if it will help? Anything that we can do to help employers 
provide more insurance to their employees, we ought to be doing it.
  But the reason I think that we are hearing access provisions, helping 
the uninsured, it being described as a poison pill, it is kind of a 
code word, kind of a code word to what the real plan here is, because I 
think, as I said before, this is an election year; and I think some of 
my colleagues on the other side of the aisle would just as soon have 
this as a political issue in November than actually do something on 
behalf of the American people.
  I am just listening, and I am watching and I am wondering why we are 
dealing with this motion to instruct on the floor today.

                              {time}  1615

  But I can tell you this: this conference will produce a reasonable 
approach to patients' rights and a reasonable approach to helping 
insure the 44 million Americans who have no health insurance. That bill 
will come back here to the floor of the House, and then I want to see 
where my colleagues are, whether they will be willing to stand up and 
deal with this issue in a balanced way. The time of truth will come 
very shortly.

[[Page 409]]


  Mr. BERRY. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I want to acknowledge and express my appreciation for 
the gentleman from Georgia (Mr. Norwood), the gentleman from Iowa (Mr. 
Ganske), the gentleman from Michigan (Mr. Dingell), the gentlewoman 
from Connecticut (Ms. DeLauro), the gentleman from New Jersey (Mr. 
Pallone), and all the others that have worked on this bill, that have 
worked so hard to see that the American people get the kind of health 
care that they are paying for. A majority of the Members of the House 
voted for the Norwood-Dingell bill. Fifty-two Republicans voted for 
this bill. If we are not going to conference this bill now, when are we 
going to conference it?
  Mr. Speaker, it is time that we move forward with the legislation 
that the American people have said they want, that we move forward with 
the legislation that the House has said it wants, in a bipartisan way. 
It is time that we deal with this issue and take the politics out of 
it.
  If this resolution offends those that voted for it only 3 months ago, 
then they should express that today. This is their opportunity. If they 
thought it was the wrong thing to do, to support this bill, then this 
is their opportunity to say, I do not think we need the Norwood-Dingell 
bill, and we should know that.
  This is a good bill. It is time for us to do this for the American 
people. I urge every Member to vote for this resolution and bring this 
issue to conference. Let us get the job done that the American people 
sent us here to do.


                             General Leave

  Mr. BERRY. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days within which to revise and extend their remarks 
and to include extraneous material on the motion to instruct conferees 
on H.R. 2990.
  The SPEAKER pro tempore (Mr. Shimkus). Is there objection to the 
request of the gentleman from Arkansas?
  There was no objection.
  Mr. BERRY. Mr. Speaker, I yield back the balance of my time.
  Mr. THOMAS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, if you listened to the debate today, virtually the first 
day that we are back, and the argument, as the gentleman from Ohio 
clearly pointed out, that for a majority of the days since this 
legislation passed we were not in session, it was over the holidays and 
we were in our districts working, that there really is only one purpose 
to this resolution.
  If my colleague from Arkansas (Mr. Berry) had presented a resolution 
with the first provision, as I said, it probably would have passed 
unanimously. If you are shopping for future motions to instruct after 
this one is defeated, I would suggest perhaps that you look at 
information that was made available to us during that period when we 
were in recess, information that hospitals and doctors today are 
killing close to 100,000 Americans. Now, if the Hippocratic Oath is 
``do no harm,'' it seems to me not killing the patient falls in that 
category.
  I listened carefully until the time was yielded back to see if one 
Member on the other side of the aisle thought that we ought to try to 
speed up the process to get an ability to get a handle on almost 
100,000 Americans being killed in hospitals and by doctors every year. 
If you are looking for a Patients' Bill of Rights, if you are looking 
for patient protection, it ought to start with the most fundamental 
protections, and that is do not kill anybody.
  But I listened in vain. All I heard was the usual rhetoric about 
taking their bill, as the gentleman from New Jersey (Mr. Pallone) said, 
the only bill that will be successful, and that it has to be done now 
``on our terms,'' clearly underscores the fact that this is a political 
endeavor.
  Two of the cosponsors of the bipartisan bill, the two Republicans, 
said this is not the thing to do, not now, it is not appropriate. I 
would support their position. It is not the thing to do; it is not 
appropriate.
  Those gentlemen, understanding that they are in a very difficult 
situation, my father used to tell a story about a dog and fleas, but I 
do not remember the details so I will not be able to elaborate on it, 
but it seems to me that those of us who want responsible patient rights 
protection should do the responsible thing, and that is rather than 
vote present on this measure, vote no.
  I would urge everyone on both sides of the aisle who want to speed up 
this process, to reach a consensus, to reach something that looks like 
the Dingell-Norwood bill, to vote no. By voting no, you actually 
enhance the opportunity for a true bipartisan agreement. If you vote 
yes, you guarantee the atmosphere around here becomes more partisan.
  Let us lower the partisan rhetoric. Let us increase the accommodation 
and compromise, and we will deliver a reasonable and appropriate 
product.
  Mr. Speaker, I would urge all my colleagues to vote no on this motion 
to instruct.
  Mr. CLAY. Mr. Speaker, I rise in support of the motion to instruct 
conferees regarding the Bipartisan Consensus Managed Care Improvement 
Act.
  Since this bill passed almost 4 months ago, the Republican leadership 
has purposefully delayed the start of the conference, giving more time 
to special interests seeking to undermine the strong support for 
patient protections demonstrated by the lopsided House vote in favor of 
the Norwood/Dingell bill. Well, Mr. Speaker, this tactic is clearly 
failing.
  Just 2 weeks ago, a survey by the Kaiser Family Foundation found 
overwhelming public support for a strong patient's rights bill. The 
survey found that almost three out of four registered voters (72 
percent) want strong protections against managed care abuses.
  Despite this strong public support, it has unfortunately become 
necessary for the Members of this body to once again send a message to 
the Republican leadership that Americans want the freedom to choose 
their health care providers. They want to have treatment decisions made 
by physicians and not insurance company bureaucrats. They want health 
insurance companies held responsible for the physical injuries they 
cause.
  Mr. Speaker, I urge the Republican leadership to stop stalling this 
critical managed care reform legislation.
  Mr. THOMAS. Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. Without objection, the previous question is 
ordered on the motion to instruct.
  There was no objection.
  The SPEAKER pro tempore. The question is on the motion to instruct 
offered by the gentleman from Arkansas (Mr. Berry).
  The question was taken; and the Speaker pro tempore announced that 
the noes appeared to have it.
  Mr. BERRY. Mr. Speaker, I object to the vote on the ground that a 
quorum is not present and make the point of order that a quorum is not 
present.
  The SPEAKER pro tempore. Evidently a quorum is not present.
  The Sergeant at Arms will notify absent Members.
  The vote was taken by electronic device, and there were--yeas 207, 
nays 175, answered ``present'' 28, not voting 24, as follows:

                              [Roll No. 6]

                               YEAS--207

     Abercrombie
     Ackerman
     Allen
     Andrews
     Baca
     Baird
     Baldacci
     Baldwin
     Barcia
     Barrett (WI)
     Becerra
     Bentsen
     Berkley
     Berman
     Berry
     Bilbray
     Bishop
     Blagojevich
     Blumenauer
     Bonior
     Borski
     Boswell
     Boucher
     Boyd
     Brady (PA)
     Brown (FL)
     Capps
     Capuano
     Cardin
     Clay
     Clayton
     Clement
     Clyburn
     Condit
     Conyers
     Costello
     Coyne
     Cramer
     Crowley
     Cummings
     Danner
     Davis (FL)
     Davis (IL)
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Deutsch
     Dicks
     Dingell
     Dixon
     Doggett
     Dooley
     Doyle
     Duncan
     Edwards
     Engel
     Eshoo
     Etheridge
     Evans
     Farr
     Filner
     Forbes
     Ford
     Frank (MA)
     Frost
     Gejdenson
     Gephardt
     Gibbons
     Gonzalez
     Gordon
     Green (TX)
     Gutierrez
     Hall (OH)
     Hall (TX)
     Hastings (FL)
     Hill (IN)
     Hilliard
     Hinchey
     Hoeffel
     Holden
     Holt
     Hooley
     Horn
     Hoyer
     Inslee
     Jackson (IL)
     Jefferson
     John
     Johnson, E.B.
     Jones (OH)
     Kanjorski
     Kaptur
     Kennedy
     Kildee
     Kilpatrick
     Kind (WI)
     Kleczka
     Klink
     Kucinich
     LaFalce
     Lampson
     Lantos
     Larson
     Leach
     Lee
     Levin
     Lewis (GA)
     Lipinski
     Lofgren
     Lowey
     Lucas (KY)
     Luther
     Maloney (CT)

[[Page 410]]


     Maloney (NY)
     Markey
     Martinez
     Mascara
     Matsui
     McCarthy (MO)
     McCarthy (NY)
     McDermott
     McGovern
     McIntyre
     McKinney
     McNulty
     Meehan
     Meek (FL)
     Meeks (NY)
     Menendez
     Millender-McDonald
     Miller, George
     Minge
     Mink
     Moakley
     Mollohan
     Moore
     Moran (VA)
     Morella
     Murtha
     Nadler
     Napolitano
     Neal
     Oberstar
     Obey
     Olver
     Ortiz
     Owens
     Pallone
     Pascrell
     Pastor
     Payne
     Pelosi
     Phelps
     Pickett
     Pomeroy
     Price (NC)
     Rahall
     Rangel
     Reyes
     Rodriguez
     Roemer
     Rothman
     Roybal-Allard
     Rush
     Sabo
     Sanders
     Sandlin
     Sawyer
     Schakowsky
     Scott
     Serrano
     Sherman
     Shows
     Sisisky
     Skelton
     Slaughter
     Smith (WA)
     Snyder
     Spratt
     Stabenow
     Stark
     Stenholm
     Strickland
     Stupak
     Tanner
     Tauscher
     Taylor (MS)
     Thompson (CA)
     Thompson (MS)
     Thurman
     Tierney
     Towns
     Traficant
     Udall (CO)
     Udall (NM)
     Velazquez
     Visclosky
     Watt (NC)
     Waxman
     Weiner
     Wexler
     Weygand
     Wise
     Woolsey
     Wu
     Wynn

                               NAYS--175

     Aderholt
     Archer
     Armey
     Baker
     Ballenger
     Bartlett
     Barton
     Bateman
     Bereuter
     Biggert
     Bilirakis
     Bliley
     Blunt
     Boehner
     Bonilla
     Burr
     Burton
     Buyer
     Callahan
     Calvert
     Camp
     Canady
     Cannon
     Castle
     Chabot
     Chambliss
     Chenoweth-Hage
     Coble
     Coburn
     Collins
     Combest
     Cox
     Crane
     Cubin
     Cunningham
     Davis (VA)
     Deal
     DeLay
     Diaz-Balart
     Dickey
     Doolittle
     Dreier
     Dunn
     Ehlers
     Ehrlich
     Emerson
     English
     Everett
     Ewing
     Fletcher
     Fossella
     Fowler
     Gallegly
     Gekas
     Gilchrest
     Gillmor
     Goode
     Goodlatte
     Goodling
     Goss
     Granger
     Green (WI)
     Greenwood
     Hansen
     Hastings (WA)
     Hayes
     Hayworth
     Hefley
     Herger
     Hill (MT)
     Hilleary
     Hobson
     Hoekstra
     Hostettler
     Houghton
     Hulshof
     Hutchinson
     Hyde
     Isakson
     Johnson (CT)
     Johnson, Sam
     Kasich
     Kingston
     Knollenberg
     Kolbe
     Kuykendall
     LaHood
     Largent
     Latham
     Lazio
     Lewis (CA)
     Lewis (KY)
     Linder
     Lucas (OK)
     Manzullo
     McCrery
     McInnis
     McIntosh
     McKeon
     Mica
     Miller (FL)
     Miller, Gary
     Moran (KS)
     Nethercutt
     Ney
     Northup
     Nussle
     Ose
     Oxley
     Packard
     Paul
     Pease
     Peterson (MN)
     Peterson (PA)
     Petri
     Pickering
     Pitts
     Pombo
     Portman
     Pryce (OH)
     Radanovich
     Ramstad
     Regula
     Reynolds
     Riley
     Rogan
     Rogers
     Rohrabacher
     Ros-Lehtinen
     Royce
     Ryan (WI)
     Ryun (KS)
     Salmon
     Scarborough
     Schaffer
     Sensenbrenner
     Sessions
     Shadegg
     Shaw
     Shays
     Sherwood
     Shimkus
     Shuster
     Simpson
     Skeen
     Smith (MI)
     Smith (TX)
     Souder
     Spence
     Stearns
     Stump
     Sununu
     Sweeney
     Talent
     Tancredo
     Tauzin
     Taylor (NC)
     Terry
     Thomas
     Thornberry
     Thune
     Toomey
     Upton
     Vitter
     Walden
     Walsh
     Wamp
     Watkins
     Watts (OK)
     Weldon (PA)
     Weller
     Whitfield
     Wicker
     Wilson
     Young (AK)

                        ANSWERED ``PRESENT''--28

     Bachus
     Barr
     Boehlert
     Bono
     Brady (TX)
     Cook
     Cooksey
     Foley
     Franks (NJ)
     Frelinghuysen
     Ganske
     Gilman
     Hunter
     Jenkins
     Jones (NC)
     Kelly
     King (NY)
     LaTourette
     LoBiondo
     McCollum
     McHugh
     Metcalf
     Norwood
     Roukema
     Saxton
     Smith (NJ)
     Weldon (FL)
     Wolf

                             NOT VOTING--24

     Barrett (NE)
     Bass
     Brown (OH)
     Bryant
     Campbell
     Carson
     DeMint
     Fattah
     Graham
     Gutknecht
     Hinojosa
     Istook
     Jackson-Lee (TX)
     Myrick
     Porter
     Quinn
     Rivers
     Sanchez
     Sanford
     Tiahrt
     Turner
     Vento
     Waters
     Young (FL)

                              {time}  1644

  Messrs. BATEMAN, WELLER, CAMP, PORTMAN, CANNON, DICKEY, and Mrs. 
WILSON changed their vote from ``yea'' to ``nay.''
  Mr. BACHUS changed his vote from ``yea'' to ``present.''
  So the motion to instruct was agreed to.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.
  Stated for:
  Ms. SANCHEZ. Mr. Speaker, during rollcall vote No. 6 on February 1, 
2000, I was unavoidably detained. Had I been present, I would have 
voted ``yea.''
  Stated against:
  Mr. PORTER. Mr. Speaker, I was absent for the vote on the motion to 
instruct the conferees on H.R. 2990, the Bipartisan Consensus Managed 
Care Improvement Act of 1999. Had I been present I would have voted 
``nay.''
  Mr. GUTKNECHT. Mr. Speaker, I was unavoidably detained earlier today 
and was not present for rollcall vote No. 6. Had I been present, I 
would have voted ``no.''

                          ____________________