[Congressional Record (Bound Edition), Volume 149 (2003), Part 18]
[House]
[Pages 24367-24372]
[From the U.S. Government Publishing Office, www.gpo.gov]




MOTION TO INSTRUCT CONFEREES ON H.R. 1, MEDICARE PRESCRIPTION DRUG AND 
                       MODERNIZATION ACT OF 2003

  Ms. SCHAKOWSKY. Mr. Speaker, I offer a motion to instruct.
  The SPEAKER pro tempore. The Clerk will report the motion.
  The Clerk read as follows:

         Ms. Schakowsky 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. 1 be 
     instructed to reject division B of the House bill.

                              {time}  1730

  The SPEAKER pro tempore (Mr. Murphy). Pursuant to clause 7 of rule 
XXII, the gentlewoman from Illinois (Ms. Schakowsky) and the gentleman 
from Illinois (Mr. Crane) each will control 30 minutes.
  The Chair recognizes the gentlewoman from Illinois (Ms. Schakowsky).


                             General Leave

  Ms. SCHAKOWSKY. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days within which to revise and extend their 
remarks and include extraneous material on this motion to instruct.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Illinois?
  There was no objection.
  Ms. SCHAKOWSKY. Mr. Speaker, I yield myself as much time as I may 
consume.
  I rise today to offer a motion to instruct the House conferees on 
H.R. 1, the Medicare Prescription Drug and Modernization Act of 2003, 
to strike the health savings security accounts. The $174 billion saved 
should be used to provide employer subsidies in order to prevent over 4 
million retirees from losing their existing drug benefits.
  Many of us believe that the House Medicare bill does not go far 
enough in providing an affordable and adequate prescription drug 
benefit to the 13 million senior citizens and persons with disabilities 
who lack coverage. There are, however, 12 million retirees who today 
enjoy better coverage through employer-sponsored insurance than the 
benefit included in H.R. 1. I suspect that very few of us would be 
willing to say that those 12 million retirees should lose the better 
coverage they have today.
  In fact, one of the selling points of this bill is supposed to be 
that enrollment in the Medicare benefit is purely voluntary, that 
retirees can keep their existing coverage if they want; but, 
unfortunately, this is not the case. We know that from the July 22 
Congressional Budget Office analysis of H.R. 1 that one in three out of 
those 12 million retirees would be worse off if we pass this bill. I 
want to repeat that. According to the CBO, one out of three of those 12 
million retirees would be worse off if we pass this Medicare bill.
  It seems to me that our theme ought to be at least first do no harm; 
but 32 percent of retirees with employer-sponsored insurance would lose 
that coverage, according not just to the CBO but to studies like the 
one recently released by Ken Thorpe, a health policy expert now working 
at Emory University. He agrees with the CBO figures and has given us 
state-by-state figures about the impacts of H.R. 1.
  According to Dr. Thorpe's analysis, 163,000 retirees in my State and 
in the State of the gentleman who takes the opposite view would lose 
their coverage and be forced to pay more for their medications if H.R. 
1 passes. In every

[[Page 24368]]

State across our great Nation, there are retirees and retiree families 
who would be worse off under this bill: 252,000 in Florida; 45,000 in 
Iowa; 218,000 in Michigan; 55,000 in Louisiana, and on and on the 
litany of retirees who would do worse under this Medicare bill.
  The devastating impact this bill would have on these 12 million 
retirees and their families is probably unintended. Many of my 
colleagues may not have known about this problem when H.R. 1 passed 
this body by a single vote; but now we know about those impacts, and it 
is up to us to fix this problem.
  Again, it may have been unintentional, but we now know that this bill 
includes perverse incentives that actually encourage employers to drop 
coverage and that penalize employers that have done the right thing, 
those employers who are struggling to pay for drug benefits for 
retirees and who want to continue to meet their commitment.
  We have heard about this problem not just from groups like the AARP 
and the AFL-CIO, the National Committee to Preserve Social Security and 
Medicare, and Consumers Union, the National Breast Cancer Coalition and 
the American Foundation for the Blind. The analysis is coming from the 
Congressional Budget Office and the Heritage Foundation.
  These concerns are, as my colleagues know, echoed by individual 
retirees across the country. Many of us have held town meetings on 
Medicare, have talked with senior groups and heard from individual 
retirees. Again and again, we hear concern that H.R. 1 will take away 
the benefits that they worked so very, very hard to earn.
  As Francis Meehling, age 76, told a New York Times reporter, 
``Congress says the new benefits are voluntary, but many people would 
lose the coverage they have.'' Once a retiree loses his or her 
coverage, the choice to enroll in an inadequate Medicare drug plan is 
no longer voluntary because there is no other option available. Let us 
be very clear. Unless we fix this problem, we will have taken away 
choice from 4 million retirees and their families.
  My motion to instruct conferees is a way to find the resources 
necessary to provide the financial incentives to solve this problem. 
Because we are faced with a $400 billion cap on Medicare spending, 
which is imposed by the other side of the aisle, we have few choices. 
We can find the money by reducing the already meager Medicare benefit, 
we can cut Medicare payments to hospitals and doctors, or we could use 
the money going for health savings accounts, $174 billion, so that 4 
million retirees do not lose their current benefits.
  I have lots of concerns with the health savings accounts themselves 
because few of the uninsured have incomes high enough to take advantage 
of the health savings accounts, and I do not believe they will meet 
their purported goal of providing coverage to the uninsured. At a time 
when States are struggling financially, the Center on Budget and Policy 
Priorities says savings accounts will drain $20 billion to $30 billion 
from State treasuries.
  It is really not my point today to argue that point. I urge even my 
colleagues who support savings accounts to support this motion. We have 
limited choices about where to get the money to prevent 4 million 
retirees from losing their coverage; and again, I am sure that none of 
my colleagues want a single one of their constituents to be worse off 
because of passage of this bill.
  The example of the catastrophic health care bill of 1989 continues to 
loom over us, and I have issued a friendly warning about it in the 
past. That is the time when the angry senior citizens charged the then-
chairman of the House Committee on Ways and Means and surrounded his 
car and demanded that that bill be repealed. In recent weeks, I have 
heard from so-called experts that this bill will not result in a rerun 
of major grass roots opposition created by the catastrophic bill 
because they say this is a voluntary bill and no one will be worse off 
because this Medicare drug benefit is not mandatory but voluntary; but 
that is really not true because I caution my colleagues to listen again 
to the words of senior citizen Francis Meehling who says, ``Congress 
says the new benefits are voluntary but many people would lose the 
coverage they have.''
  Mr. Speaker, I reserve the balance of my time.
  Mr. CRANE. Mr. Speaker, I yield myself such time as I may consume.
  We have had several motions to instruct conferees that this House has 
voted down, and this is more of the same. The motion before us 
instructs conferees to reject division B of the House-passed Medicare 
bill. Division B in H.R. 1 allows for the creation of tax-favored 
health care savings accounts. The basic idea behind these accounts is 
to let people put their own money away for their future health care 
needs. They are completely portable and can be used for any health care 
expense such as prescription drugs or doctor visits.
  Let me explain to my colleagues why these accounts are so important 
for seniors and all other Americans. In January, most insured Americans 
will see an estimated 14 percent increase in their health insurance 
premiums. This is the fourth consecutive year of double digit 
increases. Currently, there are more than 43 million Americans without 
health insurance, an increase of 2.4 million in the last year.
  Health care costs are spiraling out of control throughout the United 
States. Seniors have the most pressing problem with health care costs 
because they have no further income opportunities after they retire; 
but make no mistake about it, all Americans are struggling with 
increasing health care costs.
  The future looks bleak. We have an aging population. The fastest 
growing segment in our country is people 80 and older. We need to start 
looking at ways to handle the chronic and long-term care costs of our 
aging population. When the baby boomers retire, long-term care costs 
will skyrocket, driving prices even higher.
  One piece of legislation is not going to solve all these problems. 
There is not a simple answer, but there is a necessity to take multiple 
steps now with one of the most important steps being health savings 
accounts.
  This House has passed bipartisan legislation that for the first time 
gives all Americans the incentive to plan for the future. It gives 
people more options and flexibility. If an employer does not offer 
health coverage, an individual has an affordable way to purchase health 
insurance on his own.
  A few months ago, I talked to a constituent from my district who told 
me a story similar to the stories many Members have heard from their 
constituents. He recently quit his job to start his own company. He has 
a wife and two daughters, and he has been pretty successful at getting 
his company off the ground, but he cannot find health insurance for his 
family that is not exorbitantly expensive. He knows he needs it. He has 
got two children. He makes enough money to be classified as middle 
class, and he provides well for his family; but he simply cannot afford 
to be self-employed and make sure his children can go to the doctor. 
Having had eight children of my own, I understand his frustration. By 
all accounts he is successful except he cannot find health insurance. 
Health savings accounts would be a viable option for him and his 
family.
  Opponents of health savings accounts will say that we are only 
helping wealthy people, that health savings accounts are a tax shelter 
for the rich. The very opposite is true. These types of accounts are 
giving people in the middle class and workers who do not have benefits 
the ability to buy health insurance.
  Medical savings accounts, the precursor to health savings accounts, 
have been very successful. According to the last report from the 
Internal Revenue Service and the U.S. Treasury, 73 percent of all 
medical savings account buyers were previously uninsured. So medical 
savings accounts are making health insurance affordable for the first 
time for many Americans and actually bringing them into the health 
insurance system.
  According to the Coalition for Patient Care, medical savings account

[[Page 24369]]

policy holders currently have at least $100 million in their medical 
savings accounts to use for health care now or in the future. 
Previously, that money used to go to insurance companies. With medical 
savings accounts, policy holders are benefiting from their wise 
consumption of medical care.
  Health savings accounts and health savings security accounts are more 
flexible than medical savings accounts and, therefore, will be more 
attractive to people. If they are implemented, it is estimated that 40 
million health savings accounts and health savings security accounts 
will be created by the end of the decade.
  I simply cannot understand why my colleagues on the other side of the 
aisle persist in trying to pass a motion that will remove the ability 
of seniors to save for their out-of-pocket health costs that will keep 
43 million Americans uninsured. I cannot understand a motion that will 
limit health care options for Americans. I think some Members are under 
the assumption that if we strip health savings accounts from the bill 
that the money spent on health savings accounts will be redirected and 
used to provide enhanced prescription drug coverage.
  I want to clarify what this motion does and does not do. The motion 
does not direct conferees to close the drug coverage gap. It does not 
direct conferees to spend more money on drug coverage. It does nothing 
more than eliminate health savings accounts.
  Mr. Speaker, I reserve the balance of my time.
  Ms. SCHAKOWSKY. Mr. Speaker, I yield myself such time as I may 
consume.
  Let me just briefly respond that the purpose of this motion to 
instruct is to prevent 163,000 people from our State of Illinois from 
losing their coverage because their employers stop providing the 
benefit for prescription drugs for the retirees. So that is the point. 
It is to solve a problem that will cause millions of retirees and 
persons with disabilities to lose their benefit.
  Mr. Speaker, I yield 5 minutes to the gentlewoman from California 
(Ms. Linda T. Sanchez), a State where 385,000 retirees are projected to 
lose their prescription drug coverage.

                              {time}  1745

  Ms. LINDA T. SANCHEZ of California. Mr. Speaker, I thank the 
gentlewoman for yielding me this time, and I rise in support of her 
motion to reject the use of the $174 billion for Health Savings 
Security Accounts included in the Republicans' prescription drug bill.
  On June 26, I voted against the Health Savings and Affordability Act, 
H.R. 2595. While it sounds like a great idea to let folks save for 
their out-of-pocket costs, in reality these Health Savings Accounts are 
a $174 billion tax cut for the wealthy. Republicans tell us that these 
accounts will help those without health insurance, but in reality those 
without health insurance have incomes that are too low to take 
advantage of the tax breaks in this bill. The truth is these folks do 
not have the additional $2,000 to $4,000 a year to put into these 
savings accounts.
  When America is experiencing record deficits, this Republican 
Congress' highest priority remains increased tax cuts, and I am 
outraged that they are placing them into the Medicare prescription drug 
bill. When is this type of deception going to stop? All I ask is that 
my colleagues be honest with the American people. I do not think it is 
asking a lot for them to really be honest and level with Americans 
about what they are really getting in this bill.
  I ask this Congress if $174 billion could not be better used? At a 
time when retirees are struggling with rising prescription drug costs, 
could the $174 billion not be used to increase incentives for employers 
not to drop prescription drug coverage for their retirees? If passed as 
is, the Medicare prescription drug bill will make those receiving 
employee retirement plans worse off. Currently, this is the largest 
source of prescription drug coverage for Medicare beneficiaries, and 
these plans are significantly better than anything that they would 
receive under the Republican bill.
  Under the Republican bill, the likelihood that employers will drop 
prescription drug coverage is great because retirees will not be able 
to use their health plans towards the gap in coverage. Therefore, these 
higher costs do not provide an incentive for employers to make 
prescription drug coverage available to their retirees. The 
Congressional Budget Office projects that approximately one-third of 
employers who are currently providing retiree prescription drug 
benefits would drop the coverage if the Republican prescription drug 
bill becomes law, making some 4 million retirees worse off.
  In fact, this possibility of losing drug benefits from former 
employers is the biggest fear currently facing retirees. Already we are 
seeing a decline in retiree coverage due to increased prescription drug 
costs, which accounts for 40 to 60 percent of an employer's retiree 
health care costs.
  We cannot stand here and allow the Republican bill to expedite this 
process. Therefore, I urge my colleagues to support the Schakowsky 
motion and reject more tax cuts for the wealthy. Instead, why not be 
honest and do something that is right for the American people and use 
the $174 billion for employer subsidies to help ensure that employers 
do not drop their current prescription drug plans for their retirees.
  Mr. CRANE. Mr. Speaker, I reserve the balance of my time.
  Ms. SCHAKOWSKY. Mr. Speaker, I would like to inquire as to how much 
time is left on my side.
  The SPEAKER pro tempore (Mr. Murphy). The gentlewoman from Illinois 
(Ms. Schakowsky) has 16 minutes remaining, and the gentleman from 
Illinois (Mr. Crane) has 24 minutes remaining.
  Ms. SCHAKOWSKY. Mr. Speaker, I yield 3 minutes to the gentleman from 
New Jersey (Mr. Pallone), a State in which 143,000 retirees are 
projected to lose their prescription drug coverage.
  Mr. PALLONE. Mr. Speaker, I want to thank my colleague, the 
gentlewoman from Illinois, for putting together this motion to strike 
the Health Savings Account provisions and shore up employer-sponsored 
coverage.
  The House Republican bill includes $174 billion over 10 years for 
Health Savings Accounts, and these accounts, Mr. Speaker, are bogus. 
This money should be used to subsidize employers to prevent employer-
sponsored coverage erosion. The Health Savings Account provisions will 
undercut employer-provided health care coverage.
  These benefits are available only if individuals are covered by high 
deductible plans. In other words, plans providing no coverage for at 
least the first $1,000 of medical expenses. A deductible that size is 
approximately double the deductible of most employer plans. The 
provisions will encourage employers to reduce coverage for workers and 
their families by increasing deductibles and shifting even more costs 
on to employees. The resulting cost savings will be enjoyed by the 
employer because there is no requirement that these savings be passed 
on to the employee.
  For many American families, the tax benefits are completely 
worthless. The only thing they would receive from the Health Savings 
Account provision is reduced health care coverage. Most American 
families will not be able to take advantage of the tax shelter in these 
provisions because they do not have $4,000 per year in additional 
savings. The Health Savings Account provisions are designed to benefit 
employers and upper-income management not rank-and-file employees.
  Now, Mr. Speaker, with the deficit at a record high, we ought to 
carefully consider how best to spend the scarce resources we have. It 
is fiscally and morally irresponsible to spend $174 billion on a tax 
shelter that will erode health insurance coverage and not improve it. 
This money would be much better spent by strengthening employer-
sponsored retiree coverage, which currently covers about a third of all 
seniors.
  The fate of employer-sponsored health coverage for retirees is a 
central issue in the Medicare prescription drug debate. As it currently 
stands, the House-passed Medicare bill encourages employers currently 
providing retiree

[[Page 24370]]

health benefits to drop coverage. Unfortunately, the Republican bill 
states that any dollar an employer pays for an employee's prescription 
drug cost would not count towards the employee's out-of-pocket 
catastrophic cap. This disadvantages seniors with employer-sponsored 
coverage because it would be almost impossible for them to ever reach 
the bill's catastrophic cap over which Medicare would pay 100 percent 
of the drug costs. So, without a doubt, many employers will simply stop 
offering retiree coverage.
  The potential loss of this valuable benefit that many unions and 
employers provide was reported recently in the New York Times. 
According to the lead story by Robert Pear, and I quote, ``About 12 
million of the 40 million Medicare recipients has retiree health 
benefits, usually including some drug benefits. The Congressional 
Budget Office estimates that one-third of the people with such drug 
coverage could lose it under bills passed in June by the House.''
  Now, the Republican conferees are unwilling to provide a final 
Medicare agreement that will provide seniors with an affordable, 
available, and guaranteed prescription drug benefit that does not 
privatize Medicare. With the added threat of employers dropping retiree 
health benefits if a retiree is eligible for Medicare, we will no doubt 
have a public health crisis on our hands. Do not let this happen. 
Support the Schakowsky motion.
  Ms. SCHAKOWSKY. Mr. Speaker, I yield 3 minutes to the gentleman from 
Texas (Mr. Sandlin), a State in which 280,000 retirees are projected to 
lose their employer-provided prescription drug coverage.
  Mr. SANDLIN. Mr. Speaker, I thank the gentlewoman for yielding me 
this time. Mr. Speaker, we have a very important question to answer 
today: Should we provide prescription drugs for all seniors, or should 
we provide tax shelters for the few? That is our question.
  Mr. Speaker, I rise today to join my colleagues in instructing the 
conferees on H.R. 1 to make our Nation's seniors our top priority as 
set forth in the Schakowsky motion to instruct.
  The prescription drug bill that is before us is supposed to help and 
not harm our seniors, and yet H.R. 1 has 12 million seniors in this 
country running scared. These are supposedly the fortunate seniors, the 
ones who work for companies that promised they would provide retiree 
health coverage if the employees put in the time required.
  But the flawed structure of H.R. 1 will ultimately destroy that 
commitment. The Congressional Budget Office has estimated that up to 32 
percent of retirees will lose their employer-sponsored coverage and 
drug benefits under the House bill. Thirty-two percent of America's 
seniors, the retirees, will lose their employer-sponsored coverage 
under the House bill. That is unacceptable.
  A separate study by economist Ken Thorpe came to similar conclusions 
and noted that in my home State of Texas, 280,000 retirees would lose 
coverage. That is one-quarter of a million seniors. Now, Mr. Speaker, 
that is just not exactly the kind of thing that you want to put in your 
constituent newsletter that you send back home.
  Now, this is ridiculous. Why are we pretending to fix one problem 
while causing another? The CBO has noted that H.R. 1 would provide, and 
this is a quote, ``provide a clear financial disincentive for employers 
to supplement the part D benefit.'' A disincentive. It blatantly 
discriminates against employers who provide retiree health coverage by 
providing better Federal subsidies when an employer drops coverage than 
when an employer retains coverage. What kind of reasoning is that?
  The Republicans like to say this is a voluntary benefit, but that 
implies, ``voluntary,'' that our seniors have a choice. I can say with 
full certainty that none of our seniors with retiree coverage would 
choose this detrimental program to be enacted into law. I know Texans 
would not. I know the 32 percent who will be losing their coverage 
would not. So let us spend our money wisely. Let us direct it at 
protecting our retirees' hard-earned benefits. We can do that by 
eliminating HSAs today.
  The majority claims we cannot afford, we cannot afford, to offer 
comprehensive coverage for our seniors' drug needs. But we can afford 
to allocate over $174 billion in tax cuts to the inclusion of Health 
Savings Accounts. That shows where our priorities are. HSAs will 
certainly help the wealthiest individuals for whom they offer yet 
another opportunity for another tax shelter. But for middle America, 
for the people I represent and most of us represent, HSAs will result 
in employers reducing coverage for American families by, one, 
increasing deductibles; and two, shifting cost to employees.
  Understand, there is no requirement to pass on the savings. We need 
prescription drugs for all, not a shelter for the few.
  Ms. SCHAKOWSKY. Mr. Speaker, I yield 3 minutes to the gentleman from 
Ohio (Mr. Brown), a State in which 243,000 retirees are projected to 
lose their employer provided prescription drugs.
  Mr. BROWN of Ohio. Mr. Speaker, I thank gentlewoman from Illinois for 
yielding me this time, and for her leadership on health care issues.
  What is it, Mr. Speaker, what is it about Republicans and Medicare? 
There is always some Rube Goldberg idea they have to change the public 
health system that has lifted millions of Americans out of poverty for 
the last 38 years, that has helped America's elderly live longer lives 
and healthier lives? Republicans always want to try some experiment, 
some Rube Goldberg plan.
  They tried means testing. They could not get that through the 
Congress. They tried to raise up eligibility age. They could not get 
that through the Congress. They tried these Medicare HMOs; and, 
unfortunately, they have gotten that through the Congress. And ask 
almost any senior how these Medicare HMOs are working, and they are not 
working very well.
  They have tried an experimental medical savings account, a 
demonstration project which has not worked very well. Then the 
President said if you want a prescription drug benefit through 
Medicare, you have to get out of Medicare and get it through private 
insurance. That clearly is not flying with the American people. They 
always, always, always, over the last 30 years, every chance they have 
gotten, have tried to privatize Medicare.
  Now, Mr. Speaker, they have this $174 billion tax scheme to, again, 
try to undercut and weaken Medicare. Medicare works because it is 
universal insurance. And universal insurance works because there are a 
lot of healthy people and a lot of people that are sick. Through 
universal coverage, it works for everybody. It works for the healthy 
65-year-old who walks two miles every day and does not need much 
medical treatment, because she subsidizes the 80-year-old who may be 
sicker. Then when the 65-year-old gets sicker, other people will begin 
to help her, because it is a universal system.
  Republicans, for whatever reason, I do not know if it is their 
friends in the insurance industry or what it is, or their political 
philosophy, or whatever, they want to fracture that universal coverage 
pool. I guess we really should not be surprised, Mr. Speaker. For 38 
years, we have seen Republicans simply have not liked Medicare. They 
did not vote for it 38 years ago. Speaker Gingrich tried to cut $250 
billion 10 years ago to, surprise, give tax cuts to the wealthiest 
people in this country. Dick Armey, the Republican leader 2 years ago, 
said, ``In a free society, we wouldn't have Medicare.'' Whatever that 
meant. The gentleman from California (Mr. Thomas), chairman of the 
Committee on Ways and Means, just in the past year, said he wants to 
end Medicare as we know it.
  They simply do not like this program. I wish they would come to the 
floor instead of sending these Rube Goldberg kind of constructs that 
nobody really understands, just come to the floor and say; we do not 
like Medicare; we want to privatize it; we want to let the insurance 
industry run it. That is what the Republicans do in every one of these 
Rube Goldberg kind of schemes.

[[Page 24371]]

  Perhaps the worst is this $174 billion tax shelter, tax scheme, they 
are trying with the medical savings accounts. That is why the 
Schakowsky motion to instruct makes sense. We can take that $174 
billion, instead of putting it in some kind of tax shelter or tax 
scheme, and use it for something that will really matter and that will 
help the seniors in this country.

                              {time}  1800

  Ms. SCHAKOWSKY. Mr. Speaker, I yield 3 minutes to the gentleman from 
Washington (Mr. McDermott), a State in which 74,000 retirees could lose 
their benefits.
  Mr. McDERMOTT. Mr. Speaker, it is my desire not to be repetitive, but 
the gentleman from Ohio (Mr. Brown) really said it all: Medicare is a 
program that we all agree we ought to fix, we ought to add a 
prescription drug benefit.
  Now Members know that the $400 billion that we have put into it is 
simply not enough. The plan has a great big doughnut hole in it. Most 
seniors will pay more than they will ever get out of the program, and 
when we talk about let us fully fund it so everybody gets what they 
need, we are told there is not enough money. Then if we look a little 
further into the bill, we find the medical savings accounts. Now I do 
not know if Members watching this on their television all understand, 
$400 billion is what they say, and they have $190-some-odd billion for 
medical savings accounts. Who gets the benefit from that? How many 
people in this society are able to put money aside in anticipation of 
an illness?
  We buy insurance; we cannot save up for it unless you are rich. This 
is a plan for the rich to shelter some more of their money. That money 
could much better be used for providing a good pharmaceutical benefit. 
Now, the motion of the gentlewoman from Illinois (Ms. Schakowsky) 
simply says let us get rid of one more tax break for the rich which is 
all the President and the Republican majority seem to be able to come 
up with. In a time when we are losing jobs everywhere and everything 
else is going wrong, they can find money to keep putting money out for 
tax breaks. Let us take that money and put it into a pharmaceutical 
benefit for seniors.
  Why should we put a man out that everybody predicts 30 percent of the 
seniors who are covered now by their former employment will lose that 
benefit? Why should 74,000 people in the State of Washington who right 
now have a benefit lose it so we can give another tax break to the 
rich? It makes no sense. We should all vote for the motion of the 
gentlewoman from Illinois because it makes good sense, it is good 
public policy, and it is humane.
  Ms. SCHAKOWSKY. Mr. Speaker, I yield 3 minutes to the gentleman from 
New Jersey (Mr. Holt), a State in which 134,000 retirees may lose their 
employer-provided prescription drug benefit.
  Mr. HOLT. Mr. Speaker, I rise in support of the motion to instruct, 
and I thank the gentlewoman from Illinois for her leadership on this 
issue. The motion addresses two rather disturbing aspects of H.R. 1, 
the troublesome Medicare legislation passed earlier this year.
  The first problem with this bill is, of course, it is, as so many 
things this year, a loss of revenue so that benefits can be given to 
people who need the benefits least. The Center for Budget and Policy 
Priorities has estimated that the health savings accounts would cost 
the Federal Government $174 billion over 10 years.
  These health savings accounts are a way of saying to the American 
people they are on their own. The beauty of Medicare and its sister 
program, Social Security, is we are all in it together. We all know we 
are all in it together. But the message that the majority is sending 
here is you are on your own. You can save for these expenses that you 
will incur, you can save for these prescriptions that you will need, 
you can save and you will be in good shape. I can hear the President 
saying to the Vice President, It worked for you, did it not, Dick?
  Yes, George, it worked for me.
  That is the message that they are giving to the American people, that 
you are on your own and you will be okay.
  At the end of the line of this is channeling all beneficiaries into 
private insurance. As the chairman of the Committee on Ways and Means 
said, for those who think that we are trying to change Medicare as we 
know it, the answer is, I certainly hope so. Yes, that is what the 
chairman said. This is a fundamental change in Medicare.
  Now, there are millions of Americans out there who are saying all 
this debate about prescription medicine under Medicare does not really 
affect me. They may not like turning people out on their own like this, 
but we can hear these millions of Americans saying thank goodness that 
my former employer has given me a good retirement package and I have 
prescription drug coverage. In fact, in New Jersey where there are 1.2 
million Medicare beneficiaries, of these 434,000 have employer-
sponsored coverage. It sounds good, but unfortunately we have got bad 
news for those people who think that they are covered.
  The Congressional Budget Office says perhaps one-third of employers 
could drop retiree coverage under the new bill, one-third. Well, in New 
Jersey it might be any of 134,000 beneficiaries who would lose their 
employer-sponsored coverage under H.R. 1. This certainly is an 
unpleasant surprise for many seniors. The gentlewoman from Illinois 
(Ms. Schakowsky) has pointed out that the money set aside in H.R. 1 for 
the health savings accounts could be much better spent, addressing this 
second failing of the legislation, its effect on retiree prescription 
drug coverage, a fine idea, worthy of Members' support. I think we can 
create this fix by passing the motion to instruct of the gentlewoman 
from Illinois (Ms. Schakowsky). I will vote for it and urge my 
colleagues to do the same.
  Mr. CRANE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, my colleagues on the other side of the aisle have one 
general theme when they talk about health care policy: if we cannot 
give everyone everything, why pass a Medicare drug benefit. If we 
cannot help everyone, why help anyone. It is flawed thinking. We all 
want to help seniors pay for their prescription drugs. We want everyone 
to have access to affordable quality health care, it is just that we 
are going about it in different ways.
  Our side of the aisle believes that seniors are smart enough to be 
able to choose the health care that is best for them. They should be 
able to choose what services they want and what doctor they want to go 
to. We think that people have the capability to plan for their health 
care needs down the road. The other side of the aisle thinks that 
Americans need to be taken care of, that is, what is good for one 
person is good enough for everyone. Some Members continue to categorize 
health savings accounts unfairly. They have been called a number of 
things. They have been called a tax-free grant, a tax shelter for the 
wealthy, and my favorite, a radical proposal.
  The sad truth is that health savings accounts are a radical proposal. 
We are giving all Americans, including seniors, a tool to save for 
their future health care needs. We are letting people keep more of 
their own money in order to buy health insurance. Ironically, that is a 
radical idea for some Members, letting people keep the money they earn 
to buy the health coverage they want. It has been argued that 
Republicans are being fiscally irresponsible. Some have said that, if 
the health savings account provisions are stripped from the Medicare 
bill, that we could afford to cover more of the seniors' prescription 
drug costs. This is simply not true. Even if health savings accounts 
were taken out of the bill, $174 billion will not close the so-called 
coverage gap.
  Let me remind Members that the Democrats offered an alternative 
prescription drug bill which closed the coverage gap, and that bill 
cost $1 trillion. The entirety of the cost of H.R. 1, including the 
provision creating health savings accounts, is within the budget limits 
that this House passed earlier this year; a $1 trillion prescription

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drug bill is not. Some Members today have spent a lot of time talking 
about how important it is to close the coverage gap in H.R. 1; yet this 
motion has nothing to do with closing the so-called doughnut hole. The 
motion does not instruct conferees to devote any additional money at 
all toward prescription drug coverage. This motion is not meant to 
supplement our prescription drug proposal; it is meant to kill 
legislation that this House has passed which will give millions of 
Americans access to affordable health care. I urge my colleagues to 
reject this motion.
  Mr. Speaker, I yield back the balance of my time.
  Ms. SCHAKOWSKY. Mr. Speaker, I yield myself the balance of my time.
  This motion is not about giving senior citizens more than they 
already have; this is about preventing something from being taken away 
from 4 million seniors. As my colleague stated, the entire Medicare 
bill is subject to a $400 billion spending limit because of the 
insistence of the Republican leadership. If we are going to provide the 
funding necessary so that 4 million retirees do not lose their 
coverage, we need to find the money somewhere. We can take it from the 
health savings accounts, or we can reduce the meager drug benefit even 
more, or we can cut provider payments.
  My motion says that taking it from the health savings accounts is the 
best of all of the options that the other side has given us. We know 
what this motion means. It is a choice whether we vote to protect 
retiree health coverage, or we are going to vote for health savings 
accounts that will not meet their goal of covering the uninsured.
  More important, the retirees who have employer-sponsored insurance 
and do not want to lose it know what this vote is about. They will be 
watching us. I urge support for the motion to instruct.
  Mr. MORAN of Virginia. Mr. Speaker, I rise in support of the 
Schakowsky motion which would strike the House-passed provisions 
establishing new tax-free savings accounts for medical expenses, 
estimated to cost $174 billion over ten years.
  On June 26, 2003, I voted against the Health Savings and 
Affordability Act, which established these new tax-free personal 
savings accounts that employers could offer to their employees, along 
with high-deductible insurance policies.
  As the House and Senate conferees continue to discuss the Medicare 
prescription drug legislation, the facts are still coming in that this 
bill will be a blow to the 12 million Medicare beneficiaries who 
currently receive prescription drug coverage through their employer 
retiree plans.
  In most cases, their employer prescription drug coverage is 
significantly better than what they would receive under the Republican 
Medicare Prescription Drug plans.
  It is also troubling to note that about one-third of employers who 
are currently providing retiree prescription drug benefits will drop 
that coverage if H.R. 1 becomes law. This means more than 4 million 
Medicare beneficiaries will be worse off.
  Both H.R. 1 and S. 1 exclude employer-provided coverage as counting 
towards meeting the catastrophic cap on beneficiary spending in their 
``true out of pocket'' definition.
  Retirees with employer-provided coverage will get less of a benefit 
than other seniors.
  In fact, these retirees would need closer to $10,000 in drug costs 
before the stop-loss protection would apply, well after the $5800 cap 
that applies to all other beneficiaries.
  This will, in effect, encourage employers to drop their retiree 
benefits, at a difficult time when steep drug prices are prompting 
employers to eliminate drug benefits or cap their contributions.
  I urge all my colleagues to vote in favor of the Schakowsky motion to 
reject the creation of the Health Savings Security and Health Savings 
Accounts provision and use the $174 billion dollars to help save 
employer retiree prescription drug plans for our Nation's seniors.
  The SPEAKER pro tempore (Mr. Murphy). 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 gentlewoman from Illinois (Ms. Schakowsky).
  The question was taken; and the Speaker pro tempore announced that 
the noes appeared to have it.
  Ms. SCHAKOWSKY. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

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