[Congressional Record (Bound Edition), Volume 149 (2003), Part 22]
[House]
[Pages 30729-30736]
[From the U.S. Government Publishing Office, www.gpo.gov]




    WAIVING REQUIREMENT OF CLAUSE 6(a) OF RULE XIII WITH RESPECT TO 
                  CONSIDERATION OF CERTAIN RESOLUTIONS

  Ms. PRYCE of Ohio. Mr. Speaker, by direction of the Committee on 
Rules, I call up House Resolution 459 and ask for its immediate 
consideration.
  The Clerk read the resolution, as follows:

                              H. Res. 459

       Resolved, That the requirement of clause 6(a) of rule XIII 
     for a two-thirds vote to consider a report from the Committee 
     on Rules on the same day it is presented to the House is 
     waived with respect to any resolution reported on the 
     legislative day of November 21, 2003, providing for 
     consideration or disposition of a conference report to 
     accompany the bill (H.R. 1) to amend title XVIII of the 
     Social Security Act to provide for a voluntary program for 
     prescription drug coverage under the Medicare Program, to 
     modernize the Medicare Program, to amend the Internal Revenue 
     Code of 1986 to allow a deduction to individuals for amounts 
     contributed to health savings security accounts and health 
     savings accounts, to provide for the disposition of unused 
     health benefits in cafeteria plans and flexible spending 
     arrangements, and for other purposes.

  The SPEAKER pro tempore (Mr. Bass). The gentlewoman from Ohio (Ms. 
Pryce) is recognized for 1 hour.
  Ms. PRYCE of Ohio. Mr. Speaker, for the purpose of debate only, I 
yield the customary 30 minutes to the gentlewoman from New York (Ms. 
Slaughter), pending which I yield myself such time as I may consume. 
During consideration of this resolution, all time yielded is for the 
purpose of debate only.
  Mr. Speaker, yesterday the Committee on Rules met and passed this 
resolution waiving clause 6(a) of rule XIII, requiring a two-thirds 
vote to consider a rule on the same day it is reported from the 
Committee on Rules against certain resolutions reported from the 
Committee on Rules. The resolution applies the waiver to a special rule 
reported on or before the legislative day of Friday, November 21, 2003, 
providing for consideration or disposition of the conference report to 
accompany the bill, H.R. 1, the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003.
  Mr. Speaker, as my colleagues are aware, the conference committee has 
completed its work and the conference report has been filed. In the 
spirit of bipartisanship to accommodate the request of the minority, 
the Committee on Rules met this morning, as opposed to last night, to 
give members of the minority an opportunity to come to the Committee on 
Rules at a convenient time and so that the witnesses could come to the 
Committee on Rules at a convenient time to talk about this 
extraordinarily important conference report which delivers to America's 
seniors a voluntary, universal, and guaranteed prescription drug 
benefit.
  This morning, the Committee on Rules received testimony for more than 
4 hours on this conference report from many Members in anticipation of 
reporting a rule to bring this very important and historic legislation 
before the House. Adoption of this same-day rule and a subsequent rule 
will simply allow us to consider the historic prescription drug and 
Medicare modernization plan today, hopefully moving us one day closer 
to sending this measure to the President of the United States for his 
signature and sending a strong message to the American people that this 
Congress is committed to ensuring our seniors that they have access to 
affordable medications that will keep them healthy and active.
  Mr. Speaker, I strongly urge my colleagues to support this rule and 
allow the House to complete its work on this landmark legislation. 
America's seniors have waited far too long. It is time for us to act.
  Mr. Speaker, I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I thank the gentlewoman from Ohio for 
yielding me the customary 30 minutes, and I yield myself such time as I 
may consume.
  Mr. Speaker, the rules of this body require that before considering a 
conference report, a copy of the report and the joint explanatory 
statement must be available to Members for 3 business days. The 
Medicare drug conference report and accompanying explanatory statement 
were filed very early this morning, 1:17 a.m. But here we are, Mr. 
Speaker, debating a special rule waiving the House rule prohibiting the 
same-day consideration of the Medicare conference report that is more 
than 1,000 pages long. This defies common sense. This tramples on the 
rights of the Members of this body. How are we to make the best 
informed decisions for our constituents and the Nation about monumental 
legislation when we do not have the required opportunity to examine 
this report? What should be bipartisan conference committees are, in 
fact, clandestine meetings held behind closed doors. Democratic House 
Members were deliberately excluded from the conference committee. The 
only African Americans on the Committee on Ways and Means were banned 
from a place at the negotiating table speaking for our African American 
citizens. That included the ranking member of the Committee on Ways and 
Means, who was appointed to the conference by the Speaker of the House. 
Key policy bargains were made out of sight of Members and hidden from 
public inspection.
  What is it that we and the American people are not supposed to see in 
the fine print? Does this plan hand billions of dollars to the wealthy 
drug companies and insurance industry? Does this plan hurt seniors more 
than it helps? Will seniors end up paying more and receiving less? What 
will the impact be on minority seniors? They were not represented at 
the table. Is this bill a Trojan horse of privatizing and dismantling 
Medicare? If this bill is the answer to seniors' cries for help 
combating the skyrocketing prices charged for medications, why are we 
not allowed to carefully review the hundreds of pages of this report? 
News reports and a quick glance at the bill indicate that nothing is 
done to freeze or control out-of-control drug prices.
  Just this morning, Thomas Scully, administrator of the Centers for 
Medicare and Medicaid Services, told a senior Member of the other body 
that he misunderstood this plan and needs to read the bill. That is a 
wonderful suggestion, Mr. Speaker. Too bad that we will not have that 
chance as the Senate has. Medicare is much too precious to kill because 
we will never, ever in our lifetimes and probably anybody else's in my 
voice's range be able to institute another program like this in 
America.
  I remind my colleagues of the Medicare Catastrophic Coverage Act 
which was passed without providing Members and seniors sufficient 
opportunity to read the pages and pages of fine print. The result was a 
momentous backlash. American seniors were outraged by the legislation, 
so outraged that Congress was forced to repeal the law the very next 
year.
  Mr. Speaker, I reserve the balance of my time.
  Ms. PRYCE of Ohio. Mr. Speaker, I yield such time as he may consume 
to the gentleman from California (Mr. Dreier), chairman of the 
Committee on Rules.
  Mr. DREIER. Mr. Speaker, I rise in strong support of this rule, and 
obviously we at this moment have begun the debate on what is clearly 
one of the most important issues that we will face in our entire 
careers here. We all know that 38 years ago the Medicare program was 
established, and it has met the very important needs of many retirees, 
many of our seniors. But we are also well aware of the fact that there 
have been more than a few problems with the Medicare program, and for 
years and years and years people have talked about bringing about 
reform of Medicare. There has been a lot of talk; and in just a few 
hours, we are going to finally have an opportunity to vote ``yes'' on 
this conference report which will effectively address many of those 
concerns which have existed for many, many years.
  We all know, Mr. Speaker, that this measure will include a number of 
other very important items. Back in 1987, I

[[Page 30730]]

had the privilege of introducing in this House legislation calling for 
the establishment of what we then called MSA, medical savings accounts, 
the opportunity for people to put dollars aside, tax deductible, so 
that they could plan for their future health care needs purchasing 
either health insurance or direct health benefits. Health needs that 
they had could be addressed with those dollars. We have already 
proceeded with bipartisan support in putting into place pilot programs, 
and there has been a great deal of success. Why? Because it does help 
diminish the demand for Federal programs by allowing people to again 
privately plan and privately save with some incentive as they look 
toward those health care needs in the future.
  We also, Mr. Speaker, with this plan are doing something that is 
unprecedented, and it is a need which Democrats and Republicans alike 
have said needs to be met. We know that in the last Presidential 
campaign, both Vice President Al Gore, who was a candidate, and now 
President George Bush, when he was a candidate, talked about the need 
to ensure that we for our seniors provide an opportunity for them to 
have access to affordable prescription drugs. One of the things that is 
often said, our majority leader points it out, I have said it for a 
long period of time, 38 years ago when the Medicare program was 
established, the only prescription drug available was that doctors 
would say, ``Take two aspirin and call me in the morning.'' We know 
that if today we were putting into place a Medicare program, there 
would clearly be a prescription drug component included in that 
program. That is why, Mr. Speaker, I believe we are taking this very 
bold and important step to enhance the availability of prescription 
drugs for our retirees.
  Mr. Speaker, having said that, we know that we included $400 billion 
in our budget, but there are many who have projected that this program 
could in fact spiral out of control, that it could become another 
massive new entitlement program which would get us into a great deal of 
fiscal trouble for the future. That is why I am very pleased at the 
direction of the Speaker, who, as we all know, has been intimately 
involved in working on health care issues for years.
  He was very involved, of course, in the medical savings account issue 
earlier. He has headed task forces on this issue. He instructed me and 
my colleagues on the Committee on Rules to work on a cost-containment 
vehicle that would help us take steps to diminish the prospects of 
having this program spiral out of control so that there would be a 
degree of accountability here in this institution. That is why I say, 
Mr. Speaker, this legislation that we are going to be voting on later 
this evening includes this unprecedented cost-containment requirement 
that will ensure the fiscal integrity of Medicare for more than just a 
generation of Americans.
  The legislation protects Medicare in two ways. First, it instructs 
the Medicare trustees to keep a constant vigil over the ebbs and flows 
of revenues in their different systems. We need that kind of monitoring 
mechanism to make sure that the programs are working and to make sure 
that the cost stays within our expectations. More important than that, 
Mr. Speaker, however, this legislation defends against the creation of 
another out-of-control entitlement program. As Members know, this is 
one of the most serious and debilitating and unintended consequences of 
the good intentions of so many of our programs here, that the costs run 
way, way beyond what are anticipated. There are already too many 
entitlement programs, we know, over which we have very little or, in 
fact, no fiscal control. We know them as mandatory programs. This 
legislation is different because it sets up an early warning system 
that alerts us to unexpected and unintended spending increases and 
gives us a mechanism for applying the brakes if spending is driven out 
of control by events and circumstances we could not have foreseen.
  Under this legislation, the Medicare trustees are required to notify 
the Congress if 45 percent or more of Medicare outlays are predicted to 
be funded through general revenue.

                              {time}  1545

  Two such notifications in consecutive years require both Presidential 
and congressional action. Within 15 days of his annual budget 
submission, the President then has to propose legislation to resolve 
the funding difficulties. Continuing under expedited procedures, the 
House then has 3 legislative days to introduce the measure, and any 
such legislation introduced on the President's behalf, or any 
legislation introduced by a Member with the same purpose, must be 
certified by the chairman of the Committee on the Budget to ensure that 
it adequately address the problem.
  At this point, Mr. Speaker, it would be easy for some in Congress to 
take the path of least resistance and let the difficult solutions die 
in the committee process. I want to underscore to the Members that this 
legislation does not allow that to happen. It does not allow us to just 
push it off to the committee process. By July 30 of any year after a 
Medicare Funding Warning is issued, it is in order, under this 
legislation's special provisions, to move to discharge any committee 
that is holding up any legitimate attempt to address the funding gap. 
The motion to discharge would be in order with the support of one-
fifth, one-fifth, of the House Members; that is, 87 Members can stand 
up.
  After the legislation has been discharged, the measure would have to 
be considered on the floor within 3 days and must result in a vote. Mr. 
Speaker, this mechanism ensures that we are not going to in any way 
abrogate our constitutional duty to watch over the Federal Treasury 
even in the case of what is considered to be entitlement spending.
  I want to congratulate the gentlewoman from North Carolina (Mrs. 
Myrick), my Committee on Rules colleague, for working very closely with 
us on this issue, and I believe that taking this step, putting this 
mechanism into place which has never been put in place before, to help 
us ensure that we do not see the spending spiral out of control will go 
a long way towards addressing the need of making sure that we have a 
prescription drug program for our seniors and at the same time making 
sure that we do it in a fiscally responsible way. We do have a very 
unique opportunity ahead of us, and again I want to congratulate the 
gentleman from Illinois (Speaker Hastert) for the vision that he has 
shown on this, the fact that we have worked in a bipartisan way.
  And I want to say that as we proceed with work on the same-day rule 
and the rule that will allow for consideration of the conference 
report, we want to ensure that every Member has an opportunity to be 
heard. We will have an hour on this rule, an hour on the second rule, 
and then the traditional hour on the conference report; and we have 
been working on an arrangement which will allow an opportunity to at 
least double the amount of time on the conference report.
  So I believe we have a very good measure here. I think that it is 
deserving of strong bipartisan support since both Democrats and 
Republicans have consistently said that we do need to address this need 
of both reforming Medicare and at the same time making sure that 
seniors have access to affordable prescription drugs.
  So I thank my friend for yielding me this time for me to provide this 
explanation for our colleagues, and we look forward to strong passage 
of this rule, the next rule, and the conference report itself.
  Ms. SLAUGHTER. Mr. Speaker, I yield myself such time as I may 
consume.
  I feel compelled to say that two-thirds of this bill could have been 
paid for by the money that the United States owes the Medicare Trust 
Fund today, $270 billion.
  Mr. Speaker, I yield 3 minutes to the gentleman from New York (Mr. 
Rangel), ranking member of Committee on Ways and Means, who stood at 
the door and knocked.
  Mr. RANGEL. Mr. Speaker, let me congratulate the chairman of the 
Committee on Rules for the splendid job he

[[Page 30731]]

has done in explaining, as he sees it, a 1,000-page bill to this House, 
and why we should shove this down the throats of the Members of the 
House of Representatives without being privy to what he is privy to.
  I do not know how in the world anybody can get to this well and say 
we are talking about a bipartisan bill when they had the Sergeant of 
Arms blocking out Democrats from the House from getting anywhere near 
the preparation of this bill.
  Some people claim that they know what is in it. The eloquence of the 
chairman of the Committee on Rules was overwhelming. Why will he not 
allow the rest of the House to take a look at this 1,000-page bill so 
that they can be just as eloquent as he.
  Let me tell the Members one thing. There are people in this House 
today that believe that in that 1,000-page bill is a plan to eliminate 
completely the Medicare system as we know it.
  I know that you know better.
  There are people here that really believe this is a payoff to the 
pharmaceuticals, to the HMOs, and even some of the folks that run 
around saying they represent old folks.
  I know you know better.
  There are people who truly believe that employees and retirees are 
going to lose out in this bill.
  Republicans know better, but they want to keep it a secret. It is a 
Republican thing. Democrats not invited.
  All we are saying is you put this bill together yourselves. You think 
you know what is the best for the Nation. You believe that Democrats 
have no contribution to make, whether they belong to the Congressional 
Black Caucus, you do not have one; the Hispanic Caucus; you do not have 
one; the nonexistent Jewish caucus, you have got one. No matter what 
you have got, you really believe that we have to be excluded until you 
decide what is best for us.
  You know something, you just may be right. All we are asking for is 
let us have a day to take a look at it. Let us see what makes you 
right. Let us see why all of these people are calling us every day say 
that you are wrong, and you are trying to kill the system. Tell us why 
would you not let into the conference the gentleman from Michigan (Mr. 
Dingell), the son of the author of the Medicare bill, the dean of the 
House of Representatives? Why is it that you believe that he would have 
nothing to offer to this bill? All I am saying is that you know what is 
in the bill. Give the House of Representatives, not the Republicans, 
not the Democrats, but the people's House, give us a chance to see what 
we truly believe is going to be good for the American people and our 
seniors. If you do that, maybe you are right. If you are afraid, you 
will not give us any more time.
  Ms. PRYCE of Ohio. Mr. Speaker, I yield myself such time as I may 
consume.
  This bill has been online on the Committee on Ways and Means Web site 
and the Committee on Rules Web site since last night. This is no secret 
to anyone, least of all the American public, and anyone is free to look 
it up and read it at their leisure.
  Mr. Speaker, I yield 2 minutes to the gentleman from Georgia (Mr. 
Linder), my friend and colleague of the Committee on Rules.
  Mr. LINDER. Mr. Speaker, I would like to say something about the 
rule. It is a fair rule. It is a rule that was used often as long as I 
have been here toward the end of a session to get pieces of legislation 
to the floor. The rule gives an extra hour for those opposing this bill 
to argue about it, and we are going to hear lots of arguing and lots of 
whining. But in the event we get through this rule and the rule on 
Medicare reformation and get to the bill, I think the public is going 
to know an awful lot about what is in it. Frankly, the substance of 
this agreement was known last Sunday, several days ago. And the 3-day 
rule layover that we are avoiding this time is normal for the end of 
year.
  I just want to make one comment about something that I heard twice in 
a 4-hour hearing today in the Committee on Rules, and we will hear it 
later on the floor. On two occasions, it was said that former Speaker 
Gingrich said in a speech to the Blue Cross organization, or Blue 
Shield, that he wanted Medicare to wither on the vine. That was made 
into a commercial by AFL-CIO and run across the country. And Brooks 
Jackson on July 15, 1996, did an expose on that. He showed the entire 
speech, and he showed that what they had done was cut up a piece. What 
Newt Gingrich was talking about was not Medicare or its beneficiaries, 
but the bureaucracy that runs it. He said that given the opportunity to 
make free choices, our seniors will voluntarily, voluntarily, opt out 
of the Health Care Financing Administration, and it will wither on the 
vine. When Brooks Jackson did that expose, he said what the unions were 
doing was dishonest.
  I want to make this point before the debate starts because I want you 
to know that we know that you know you are dishonest.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
New Jersey (Mr. Pascrell).
  Mr. PASCRELL. Mr. Speaker, I just heard the epitome of hypocrisy from 
the gentleman from California when he tried to interrupt the gentleman 
from New York (Mr. Rangel) and he would not let the gentleman from New 
York (Mr. Rangel) into the room and the likes of the leadership. If 
this is not hypocrisy, what is? The movie ``Thelma and Louise,'' watch 
it. Louise turns to Thelma and says ``You get what you settle for.'' 
And how right she was.
  This prescription drug bill is the worst example of accepting what we 
are given. The administration is telling seniors that they should 
settle. They have convinced that the AARP that they are getting half a 
loaf, which is, of course, better than no bread at all. But, seniors, 
beware. They are not getting a slice even, they are not getting a half 
a loaf. These are the crumbs off the table. Our seniors will be 
settling for crumbs while the special interests are getting fat, and 
are they happy this week.
  Today, the leaders on the other side are here to try to pass a bill 
that provides a weak prescription drug benefit, that fails to lower 
drug costs because the bill prohibits the government to try to help 
negotiate down the cost of the drugs. They specifically put that into 
the legislation. And it privatizes Medicare. It changes Medicare as we 
know it, pushing millions of seniors into HMOs. And this is fiscally 
irresponsible. Do the Members know what HMOs have done in New Jersey? 
They have shoved 79,000 people out of those HMOs since 1999. That is 
what awaits our seniors.
  You cannot ignore that. Democrats have led the charge for years to 
add a prescription drug benefit, but we are not going to settle. We 
will compromise. We will discuss, but at least invite us to the table 
to compromise. This is America, not the Soviet Union.
  Ms. PRYCE of Ohio. Mr. Speaker, I yield such time as he may consume 
to the gentleman from the great State of Texas (Mr. Sessions), my 
friend and colleague from the Committee on Rules.
  Mr. SESSIONS. Mr. Speaker, I thank the gentlewoman from Ohio (Ms. 
Pryce) for yielding me this time.
  There is a lot of talk today about what is occurring with procedures 
and whether it is right or wrong, but I want to stand up today and talk 
about the bill. I want to talk about the bill and the things that it 
does for not only families like mine, but also for millions of other 
families across this great Nation.
  What this bill does is it modernizes Medicare and so much more 
because it then gets into health care for families. It talks about the 
opportunity for families to be able to save money on a pretax and tax-
free basis. Why is that important to my family? That is important to me 
because I have got a beautiful wife of 19 years, I have got a son who 
is 14 years old, who plays football and wrestles, and he sometimes gets 
hurt, and I have a 9-year-old Down's syndrome son who spends an 
extensive amount of time needing help with physicians and health care 
professionals. Not always do we get an answer back from the insurance 
company that they want to cover the needs of my family. Sometimes the 
needs of my family go well beyond those needs of

[[Page 30732]]

what insurance pays for. But my family, like millions of other 
families, will now be helped because of the extreme generosity of the 
gentleman from California (Mr. Thomas) and the gentleman from Louisiana 
(Mr. Tauzin) who have written a bill that will allow families to save 
up to $5,000 a year. Even if it is just $2,000 a year, if that is what 
we have got left over, then we can put that money in there, and it 
means that this money can grow, tax free, and then be used, tax free, 
on health care. It means that my family and myself will now be able to 
supplement those things that may not be covered under our health care. 
It means that we will be able to be decision-makers to get the right 
things if we need something that goes beyond what insurance pays for.
  I cannot tell the Members how important that is because there are 
millions of other families that are less fortunate than mine who many 
times go without the ability to have the services that are necessary 
for their children.

                              {time}  1600

  This is a way that people can help. They can help their children. 
They can help their families. They can make sure that they supplement 
those things that insurance provides, and that is good.
  We have heard today that all this is about is about rich people or 
about rich organizations. Let me tell my colleagues, when you have 
someone who is sick or hurt in your family and you find out that 
insurance does not cover everything you need, and then you look at the 
tab that is out there, you will look and say, thank goodness for what 
Republicans have done.
  I am proud of what this bill does. It modernizes health care today 
the way it ought to be, where we can participate, where we can do the 
right things. So I am proud of what the gentlewoman from Ohio (Ms. 
Pryce) is standing up for today, to stand for this House to confirm 
this rule, to make sure that this Republican body can deliver to 
Americans and their families and senior citizens not only the health 
care that they need, but as a result of listening to what people need, 
we will deliver prescription drugs and those things that America has 
been asking for.
  And then we will have a President who will sign this bill and do the 
right thing. And in the scheme of things, us doing the right things to 
help people today and to make sure families can be prepared for 
tomorrow is part of the oath and obligation that I took when I said I 
will support and defend this Constitution and make sure that the people 
I represent get the best from what we can come up with.
  Mr. Speaker, I support this rule. I support this bill. I encourage 
every single Member to think about what this is about. It is not about 
politics. It is not about ourselves. It is about our families, our 
children, and our future.
  Ms. SLAUGHTER. Mr. Speaker, I yield 3 minutes to the gentleman from 
New Jersey (Mr. Pallone).
  Mr. PALLONE. Mr. Speaker, I appreciate that the gentleman from Texas 
is proud of this legislation, but I want to tell him, I am ashamed of 
this legislation, and I am ashamed of what we are about to do; and I 
hope we do not do it.
  Secondly, he said his constituents are going to be helped. They are 
not going to be helped; they are going to be hurt. When he says this is 
a good bill, it is not a good bill; it is a bad bill. My constituents 
are calling, the gentleman from New York (Mr. Rangel) said his 
constituents are calling, and they are calling me because they are 
scared to death about what you are going to do, because they think that 
Medicare is going to die, to disappear and that they are not going to 
get any kind of decent prescription drug benefit.
  Let me tell my colleagues why they are right. There is no question 
that you are not going to get any kind of drug benefit under this bill 
unless you go private. You have to join an HMO. If you do not join an 
HMO and lose your choice of doctor or your choice of hospital, then you 
are not going to get the drug benefit. They are scared, because they do 
not want to do that. They do not want to have to trade and lose their 
doctor in order to get some kind of drug benefit.
  Secondly, they are upset because there is no benefit here. There is 
nothing here for them to benefit from. They are going to have to pay 
more out, shell more out of their pocket than they are going to get 
back in terms of a prescription drug benefit. If we look at what this 
bill does, first of all, we do not know what the premium is going to 
be. You might have a premium of $75, $85 month. You have to pay a 
deductible of $275 a month. After you pay out $2,200, for the next 
$3,000 or so, you get no benefit at all, no drug benefit. You have to 
pay 100 percent out-of-pocket while you continue to pay probably a very 
high premium.
  So they figure, I am going to lose my choice of doctor. I may lose my 
choice of hospital. And at the same time, I am not getting any benefit 
because of this doughnut hole and what you are causing me to pay out.
  Then they say, they are expecting there is going to be some kind of 
controls on the price of prescription drugs, but you have a clause in 
the bill that says that we cannot even negotiate price. So the costs of 
prescription drugs will continue to rise, as all of these other 
terrible things are happening.
  Then they say, my constituents say to me, Congressman, is it true 
that this bill does not even take effect until 2006 with the drug 
benefit? The answer is yes. That is what the bill says. Read the bill: 
2006 before the drug benefit kicks in. You know what my constituents 
say? That is a joke. What kind of a joke is this? You are going to have 
some election in 2004 and then you are all going to run for election 
and say what a great thing this is and this is not even going to kick 
in. They want a prescription drug benefit now. Why can it not start 
January 1 of 2004?
  Lastly, the reason they are really scared is because of the 
privatization. I heard the gentleman from California (Mr. Dreier) say 
``privatize'' three times. That is what this is all about: privatizing, 
not just the prescription drug benefit, but Medicare as a whole. 
Because even though we are only going to have these demonstration 
programs in certain parts of the country, the bottom line is they are 
going to impact the whole country and ultimately, by the year 2010, you 
are going to force people to take a voucher, try to go out in the 
private sector and buy their Medicare as a whole, and if they cannot 
find it or they do not like what they are offering for that voucher, 
that set amount of money, then they are not going to be able to stay in 
traditional Medicare, fee-for-service Medicare.
  Privatize Medicare, privatize the drug benefit, it does not even 
start until 2006, and you lose your doctor. That is why they are scared 
to death.
  Ms. PRYCE of Ohio. Mr. Speaker, I must take 1 minute to say that the 
gentleman has misspoken. Our most needy seniors, the seniors who need 
it most will be getting help with their prescription drugs, the best 
tool medicine has to offer, by next spring if we pass this bill. But if 
we delay, if we continue to defeat our efforts, the Republican efforts 
to bring prescription drugs to the American people, we will never 
provide them help. We have to start and we have to pass this bill 
today.
  Mr. Speaker, I yield 2 minutes to the distinguished gentleman from 
Georgia (Mr. Gingrey), someone who should know a lot about this.
  Mr. GINGREY. Mr. Speaker, I thank the gentlewoman from Ohio for 
yielding me this time, and I promise to tone down the rhetoric just for 
a couple of minutes.
  Mr. Speaker, I rise today in support of the rule for the Medicare 
agreement. Today, we face a Medicare reality, a reality that requires 
change, reform, and willing leadership.
  Though not a perfect solution, the Medicare agreement is a big step 
in the right direction, a step in the right direction by providing our 
seniors with assistance to pay for the rising cost of prescription 
medications, medications that will help them live longer and help their 
lives; a step in the right direction by supplying appropriate 
reimbursement updates for hospitals, and updates to ensure that 
hospitals sustain the ability to provide needed

[[Page 30733]]

goods and quality services for their patients; a step in the right 
direction by blocking the proposed cut in Medicare reimbursements to 
physicians and, instead, provide a positive update, reimbursements that 
will allow physicians to properly serve their patients and curb the 
trend of reduced access.
  I urge my colleagues to take this step to help our seniors, our 
hospitals, and our physicians and adopt this rule so we can pass the 
Medicare conference report.
  Ms. SLAUGHTER. Mr. Speaker, I am pleased to yield 2 minutes to the 
gentleman from Rhode Island (Mr. Langevin).
  Mr. LANGEVIN. Mr. Speaker, I thank the gentlewoman for yielding me 
this time.
  I rise in strong opposition to the proposed rule to consider the 
Medicare Modernization and Prescription Drug Act of 2003. We are about 
to vote on legislation that will have an enormous impact on every 
single American. While we know very little about the details, since we 
were only given this bill late last night, what we do know is that it 
offers a completely inadequate drug benefit, does nothing to contain 
the rapidly increasing cost of prescription drugs, and takes steps 
toward privatizing Medicare. When our seniors find out about the truth 
of what this bill will do to their health plans, they will be outraged. 
This is shameful, because it does not have to be this way.
  We are poised to make the most significant changes to Medicare in 
history, and we are proposing to vote on it while the ink is still 
drying, a 600-page bill that we have scarcely been able to read. This 
is no way to make good public policy.
  Mr. Speaker, as President Woodrow Wilson once said, ``Whenever any 
business affecting the public is conducted, wherever any plans 
affecting the public are laid, over that place a voice must speak with 
the divine prerogative of the people's will the words `let there be 
light.''' Mr. Speaker, there is no light in our work here today, and 
the Members of this House and the people that we represent deserve 
better.
  I urge all of my colleagues, regardless of their position on this 
bill, to vote against this rule.
  Ms. PRYCE of Ohio. Mr. Speaker, I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I am happy to yield 3 minutes to the 
gentleman from Oregon (Mr. DeFazio).
  Mr. DeFAZIO. Mr. Speaker, I thank the gentlewoman for yielding me 
this time.
  Would every Member who is on the floor and who has read all 691 pages 
of this bill since it was made available at 1:30 in the morning please 
raise your hand. I do not see any hands raised, but we are going to 
vote on it very soon. We are not doing a service to the American public 
by violating the rules of the House and not allowing this bill to be 
held over for 3 days, as required by the rules, so Members of Congress, 
and maybe even members of the public and the fourth estate, could read 
it, analyze it, and report it so we could better hear the opinion of 
the American people. But from what I know of it and the bits I have 
read, it is not much of a benefit, and it is not what seniors need.
  Americans pay more for U.S. manufactured, FDA-approved drugs than 
anybody else in the world. Our neighbors in Canada pay half as much, on 
average, for drugs manufactured in the United States of America. Now, 
how could that be? Well, the government of Canada bargains lower prices 
on behalf of Canadians. Well, maybe that would be a solution to the 
problem here in the United States: let us lower the extortionate price 
of drugs. Let us put the 40 million people in Medicare into a buying 
group, that would not cost anything, and let us negotiate lower prices. 
No.
  This bill, at the behest of the pharmaceutical industry, a generous 
contributor to the Republican Party and the President, prohibits the 
Government of the United States of America, unlike any other industrial 
nation or democracy on Earth, from negotiating lower drug prices for 
its citizens with these multinational conglomerate pharmaceutical 
companies. There is no pain for the pharmaceutical industry in this 
bill. In fact, their stock has gone up dramatically in the last week. 
The analysts have read it, and they said, what a sweet deal for the 
pharmaceutical industry. Too bad it will not give seniors what they 
need.
  Well, there are $400 billion of taxpayer money, copayments, premiums, 
deductibles, the doughnut exclusion. There is a nice $20 billion 
subsidy to private HMO insurance companies who might or might not offer 
benefits. But seniors, on average, are going to get a benefit that is 
less than they could get by mail-ordering their drugs from Canada. Oh.
  Well, the bill is going to take care of that problem too. Despite the 
fact that this House of Representatives is on record by a large margin 
allowing the free reimportation of U.S.-manufactured, FDA-approved 
drugs for Americans from other industrialized nations that regulate 
safely those drugs, this bill is going to begin to block that process. 
They say, oh, well, that is not in the bill. We give the authority to 
the Secretary of Health and Human Services to allow the importation if 
he sees fit. Yes, sure. Except he has already said that he does not see 
fit and he will never, ever do that; and the FDA commissioner has said 
oh, no, we are not going to ever do that. We cannot certify that those 
U.S.-manufactured, FDA-approved drugs that took a little vacation in 
Canada are safe.
  This is simply legislation that is not going to provide the benefits 
that seniors need at an extraordinary cost to the ultimate detriment of 
the core Medicare program. Vote ``no.''
  Ms. PRYCE of Ohio. Mr. Speaker, I continue to reserve my time.
  Ms. SLAUGHTER. Mr. Speaker, the gentleman is absolutely correct. 
There is no great list of dead Canadians from taking bad medicines.
  Mr. Speaker, I yield 2 minutes to the gentleman from Washington State 
(Mr. Baird).
  Mr. BAIRD. Mr. Speaker, at the beginning of this debate, the 
distinguished chairman of the Committee on Rules pointed out that this 
is one of the most important bills we have faced possibly in our 
careers. Indeed, he is correct. Yet, we are given less than 24 hours to 
consider this. The most important bill in our careers, 24 hours to 
consider it.
  It is part of a very troubling pattern, and I call my colleagues' 
attention to this: in the last 7 legislative days in this Congress, we 
have either authorized or appropriated more than $1.26 trillion of the 
people's money. The defense authorization bill we were given 3 hours to 
read before the vote. The Medicare bill, we may have a total of about 
28 hours, clock hours, if we read around the clock to read this. The 
intelligence authorization bill, 8 hours. A total of $1.26 trillion, 
and we are going to have an omnibus appropriation bill shortly.
  I would like to yield, if I may, to the gentlewoman from Ohio. I have 
asked one of the pages to take her a piece of text from this 
legislation, and I would like her to explain this to me. If we have had 
adequate time to study it, then we should know what is in it.
  The text reads as follows, and I will invite the gentlewoman to 
explain what it means.

                              {time}  1615

  On page 13, actually of the interpretive paper from the Republican 
party, it reads, ``Plans would be permitted to substitute cost-sharing 
requirements for costs up to the initial coverage limit that were 
actuarially consistent with an average expected 25 percent coinsurance 
for costs up to the initial coverage limit. They could also apply 
tiered copayment, provided such copayments were actuarially consistent 
with the average 25 percent cost-sharing requirement.''
  I yield to the gentlewoman from Ohio (Ms. Pryce) to explain what that 
means.
  Ms. PRYCE of Ohio. Mr. Speaker, I thank the gentleman from Washington 
(Mr. Baird) for yielding. This was just put in front of me. I would 
defer to the chairman of the Committee on Ways and Means or a member of 
the Committee on Ways and Means because this is their jurisdiction and 
certainly not

[[Page 30734]]

the jurisdiction of the Committee on Rules.
  Mr. BAIRD. Mr. Speaker, reclaiming my time. I believe the gentlewoman 
from Ohio (Ms. Pryce) has pointed out we have had adequate time to 
study the legislation. I presume she is going to vote on it. This is a 
summary provided by her Republican party, yet she fails to be able to 
explain it.
  I would invite anyone here present with us today from the majority 
party, or who plans to vote from the minority party, to please explain 
what it is we are voting on. I would invite the next person to offer 
that explanation.
  Ms. PRYCE of Ohio. Mr. Speaker, I will continue to reserve my time. 
We do not have any more speakers at this point.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Texas (Ms. Jackson-Lee).
  Ms. JACKSON-LEE of Texas. Mr. Speaker, my good friend has really laid 
it out for us. We are not yet debating the bill. I thank the 
distinguished gentlewoman from New York (Ms. Slaughter) from the 
Committee on Rules, both of them in fact, we are debating the process. 
I think it is important because this is historic.
  I sat for 2\1/2\ hours in the Committee on Rules, and I want to thank 
the Committee on Rules for giving me the 2\1/2\ hours to sit, and then 
the opportunity to express my opposition and challenges to this 
legislation. I have been taught as a child that it is all about who 
shows up. Not about whether you can finish or whether or not you are 
the best, but who shows up. Who shows up in school, who stays in 
school.
  Let me tell about this legislation and what I went to the Committee 
on Rules about. I asked them to reserve what we call points or order. 
Because I believe this bill is fatally flawed. It has killer bees in 
the midst. It has a lot of roses in it. And people are talking about 
hospitals and doctors. I am glad to see the American Nurses Association 
is against this bill. But roses have thorns and thorns make you bleed. 
And there is a lot of bleeding going on in this bill.
  This bill is a subsidy for HMOs and a subsidy, if you will, for 
prescription drug companies. And as I said, it is all about who shows 
up. And HMOs do not show up.
  Take any city and any county and any State and when an HMO finds out 
they cannot make a profit, they close up. Take Harris County, 4 years 
ago, six HMOs, they closed up shop on our seniors because they could 
not make a profit.
  And what does this bill do? It hurts low-income seniors and those who 
are disabled. I cannot imagine how we would vote for a bill that 
unravels Medicare by its premium support, even if it is an example 
program. It gives premium support to defer you over to a private 
insurance program and leaves Medicare unraveling on the vine.
  In addition, it does not take a law graduate to understand what 
anticompetitiveness means. We call that antitrust violations. And how 
can you give benefits to private insurance companies and pharmaceutical 
companies when you allow them to establish the cost of the drugs, and 
you do not allow the Federal Government to compete fairly by bringing 
down the cost of the drugs. Some people say it is dumber than dumb. 
This is a dumber than dumb plan. We should have the opportunity to take 
3 days to review this. This is a dumb plan, a dumb procedure. And, Mr. 
Speaker, how can you leave Democrats off the conference committee and 
say this is a good plan.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Tennessee (Mr. Cooper).
  Mr. COOPER. Mr. Speaker, this is a very sad day for this House. I 
bring a unique perspective, I think, to this legislation because I 
represent probably more hospitals than any other Member of this body. 
Because Nashville, Tennessee, is the headquarters town for most of the 
for-profit hospitals in America. We also have a leading academic 
medical center and many nonprofit hospitals with some 300 health care 
companies headquartered in our city. We are Health Care U.S.A.
  I have also been a professor of health care policy at Vanderbilt 
Business School; the last 7 years studying these issues. And in my 
prior service in Congress, I was one of the leaders in trying to craft 
bipartisan health care policy, getting Democrats and Republicans to 
work together, to do the right thing for our Nation's seniors and for 
all of our citizens.
  This bill, which we were finally allowed to see a few short hours 
ago, is a travesty. First of all, very few, if any, Members really know 
what is in it. There simply has not been enough time. And our seniors 
deserve better than a martial law rule. Why not at least the regular 3 
days, so Americans can see what is in this bill? What is the other side 
afraid of? What are they afraid of?
  Sunshine is the best policy. Sunshine is the best disinfectant for 
what may or may not be in this bill.
  Now, I had a head start, I have been trying to follow proceedings 
closely over the last several months of the conference from which all 
Democrats have been excluded in the House. But I have tried to pick up 
bits and pieces here or there. I have tried to read everything 
available on this. And the best I can tell, the policies in this bill 
come up way short.
  Now, our hospitals in Nashville are proud of the 3 to 5 percent of 
the bill that covers their activities, but the rest of the bill, the 
other 95 percent, has severe policy shortcomings that I am afraid the 
other side feels cannot stand the light of day, cannot stand full 
debate.
  So our seniors deserve better, Mr. Speaker. Let us give them a better 
bill. Let us take the time to do it right.
  Ms. PRYCE of Ohio. Mr. Speaker, I yield myself such time as I may 
consume.
  And in light of the comments of the gentleman from Tennessee (Mr. 
Cooper), the last speaker, I would say that every major hospital 
association in this Nation is on board with this legislation. He should 
be supportive of it. Not only the hospital associations, but the 
American Association of Retired Persons, the AARP, who speaks for every 
senior in this country. They are on board. The AIDS Institute, the 
Alzheimer's Association, the Coalition for Medicare Choices, Hepatitis 
C Global Foundation, International Patient Advocacy Association, Kidney 
Cancer Association, National Alliance for the Mentally Ill, the 
National Council on the Aging, the Seniors Coalition, United Seniors 
International Association, We Are Family Foundation, Academy of Family 
Practice Residence Directors, Alliance for Quality Nursing Home Care, 
Alliance to Improve Medicare, American Academy of Dermatology 
Association, American Academy of Family Practitioners and Physicians, 
American Academy of Home Care Physicians, American Academy of 
Neurology, Ophthalmology, Osteopathy, Pharmaceutical Physicians.
  Mr. Speaker, this list is pages and pages long. Every significant 
health care provider, every significant person in this country who is 
touched by health care and feels the pain of seniors and understands 
their health care needs is on board with this legislation. Anyone who 
cares about the future of health care for seniors should be on board as 
well.
  Mr. Speaker, I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I am interested in the list that the 
gentlewoman from Ohio (Ms. Pryce) read off. I hope that they know what 
is in the bill, because we sure do not.
  Mr. Speaker, I yield 3 minutes to the gentleman from Arkansas (Mr. 
Ross).
  Mr. ROSS. Mr. Speaker, I thank the gentlewoman from New York (Ms. 
Slaughter).
  And to the gentlewoman from Ohio (Ms. Pryce), let me assure you that 
AARP no longer speaks for America's seniors. The National Committee to 
Preserve Social Security and Medicare is the Nation's second largest 
senior advocacy group. Unlike AARP, they are not in the pharmacy 
business, and they are not in the discount prescription card business. 
And Max Richmond, their executive director said what? He said, ``You 
ever heard of Medicare fraud? This Republican prescription drug bill is 
Medicare fraud.'' And let me tell you why: It is obscene that the 
Republicans in Congress would lock the door and refuse to allow the 
Democratic conferees in the room while this

[[Page 30735]]

bill was being finalized. If that is not enough, now they are trying to 
use a parliamentary procedure to immediately bring this bill up for a 
vote, a bill that is 681 pages. It was received in my office just a few 
hours ago. I have not read it all. It is 681 pages, and I just got it.
  If there is any Republican here who has already read it, then they 
have been through some kind of speed reading course that I have not 
been through. But I have gotten through a few pages. Page 54 is a good 
place to start. Surely to goodness, no one here has read page 54, 
because if they have, they would not be asking for this bill to be 
brought up immediately. They would want time to read it, because page 
54 says what? It says the Federal Government shall be prohibited from 
negotiating with the big drug manufacturers to bring down the high cost 
of medicine. And they call this a seniors bill? Give me a break.
  And if that is not enough, my colleagues can turn to page 18 of the 
bill. Page 18 of the bill tells us what seniors are going to get, or, 
really, what seniors are not going to get. This is clearly a bill 
written by the big drug manufacturers and the big insurance companies, 
not to benefit our seniors, not to bring down the high cost of 
medicine, but to benefit the big drug manufacturers and the big 
insurance companies.
  Make no mistake about it, seniors, it is important the Members here 
understand, understand what the seniors get in this bill. There is a 
$420 yearly premium, $35 a month. There is a $250 deductible, and then, 
from $250 to $2,250, Medicare pays 75 percent of the bill leaving the 
senior to pay 25 percent. That part sounds pretty good. But then from 
$2,250 all the way up to $5,100, guess what? The senior is back stuck 
paying the full price for the prescription drug while still being 
required, under this bill, to pay a $35-a-month premium.
  This legislation boils down to this: Of the first $5,100 worth of 
medicine, seniors are going to still be stuck paying $4,020 while 
Members of Congress, who wrote and approved this bill, only pay $1,275.
  Ms. PRYCE of Ohio. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, the gentleman from Arkansas (Mr. Ross) says that the 
AARP does not speak for seniors of America? The AARP represents 35 
million seniors, dues-paying, card-carrying voting seniors. These 
seniors care what we do, and they are watching what we do, and we 
better do right by them.
  Mr. Speaker, I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Mississippi (Mr. Taylor).
  Mr. TAYLOR of Mississippi. Mr. Speaker, a little over a year ago, the 
President of the United States, Secretary of Defense Donald Rumsfeld, 
Under Secretary of Defense Paul Wolfowitz all told me, me, that not 
only did the Iraqis have weapons of mass destruction, but that they had 
their finger on the trigger and were getting ready to use them. Now, 7 
months after we have occupied Iraq, the only thing harder to find than 
a Republican who will tell me where those weapons of mass destruction 
are is a Republican who will tell me how they are going to pay for this 
bill.
  In the 29 months since the passage of their budget, their spending, 
their tax cuts, they have increased our Nation's debt by 
$1,229,407,000.

                              {time}  1630

  This bill alone will add another $400 billion to our staggering $6.8 
trillion debt.
  But if you have noticed, not one of my Republican colleagues will say 
how they are going to pay for it, because they do not want you to know 
that a few seniors will benefit from this, but all of us will end up 
paying interest on it. And we are already squandering $1 billion of 
your money a day on that interest.
  This is nothing but an auction to the insurance companies and the 
pharmaceutical companies of this Nation, for campaign contributions to 
the Republican party. And I want one Republican to hold up one 
prescription and just tell me how much less it is going to be 1 year 
from today, 2 years from today, because that is what seniors really 
want. They do not want another bureaucracy. They do not want $400 
billion worth of debt.
  The people who are seniors now are the Greatest Generation, and the 
last thing the Greatest Generation wanted is the country they fought 
for in World War II and Korea to be bankrupted by some political prank 
now.
  So I ask the gentlewoman from Ohio (Ms. Pryce) how are you going to 
pay for it, and please name one drug that will be cheaper 1 year from 
today.
  Ms. PRYCE of Ohio. Mr. Speaker, I yield myself such time as I may 
consume.
  I would just like to remind the gentleman that last year's Democrat 
prescription drug bill cost $1 trillion, $1 trillion, almost three 
times what this bill costs.
  Mr. Speaker, I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, whether you support this bill or not, the Members should 
be very concerned that we are about to cast a vote on a major, major 
piece of legislation that only a small handful of House Members have 
actually read because it was not finalized and filed until 1:30 this 
morning.
  They should be very concerned that this marshal law rule waives the 
House rule that requires the conference report layover for 3 days 
before coming to the floor for a vote. Of course, it was not supposed 
to be this way.
  Just a few weeks ago, 44 members of the Republican Study Committee 
demanded that the Republican leadership allow Members 3 days to read 
the conference report after it was filed and before forcing them to 
vote on it. It was a reasonable demand since that is what the rules of 
the House say.
  The gentleman from Illinois (Mr. Hastert) agreed to it as has been 
publicly reported. Here is how the November 3, 2003, edition of Roll 
Call reported it: ``At a GOP conference meeting that was called 
exclusively to update Members on the Medicare talks, Hastert assured 
his troops that they would now get regular briefings on the Medicare 
bill and would have at leave 3 days to look over the conference report 
before having to vote on it, according to several Members who attended.
  ```The Speaker wants to make sure that Members are comfortable making 
this historic change' to Medicare, said Hastert spokesman John 
Feehery.''
  The November 7, 2003, edition of Congress Daily quoted the gentleman 
from Georgia (Mr. Norwood) ``referring to a promise made by House 
Speaker Hastert.''
  The gentleman from Georgia (Mr. Norwood) said, ``The thing I'm 
happiest about is we get 3 days with the language.''
  Now, we all know the Speaker of the House is an honorable man, but 
apparently the Republican leadership is willing to renege on his 
commitment and to ensure Members do not get 3 days with the language. 
Because while various summaries, press releases, and drafts may have 
been posted on Web sites of today, the final language of that 
conference report was not filed until early this morning. And 3 days 
from Friday morning is Monday morning, not Friday afternoon.
  For that reason, Mr. Speaker, I urge Members to join me in opposing 
the important parliamentary vote known as the previous question. If it 
is defeated, I will amend the rule so that it no longer waives the 
House's rule requiring a 3-day layover for all conference reports.
  Voting no will not defeat the Republican Medicare bill, but it is the 
only way to uphold the commitment of the Speaker of the House and to 
allow Members and the public to examine this 700-page $400 billion 
Medicare bill before voting on it.
  I urge Members to vote ``no'' on the previous question.
  Mr. Speaker, I yield back the balance of my time.
  Ms. PRYCE of Ohio. Mr. Speaker, I yield myself such time as I may 
consume.

[[Page 30736]]

  I remind my colleagues that this body is about to embark on a 
monumental endeavor. We are about to consider the most significant 
benefit America's seniors have ever seen since the creation of the 
Medicare program nearly 40 years ago. We are about to give seniors the 
best tool that medicine has to offer, prescription drugs. A tool that 
they have been denied, that our government has not supplied to them. We 
are about to give that to them, Mr. Speaker. That is not even to 
mention the most significant and deliberative reform that Medicare has 
ever seen.
  I urge my colleagues to support American seniors, to support the 
future of the Medicare program, and to support this Congress in one of 
the most promising endeavors I have ever been a part of in my years in 
this esteemed body. Join me in taking a bold step closer to 
consideration of this extraordinary legislation. I ask the Democrats, 
stop defeating these attempts, stop delaying help to our seniors, and 
stop destroying their trust in their government.
  Mr. Speaker, I yield back the balance of my time, and I move the 
previous question on the resolution.
  The SPEAKER pro tempore (Mr. Bass). The question is on ordering the 
previous question.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Ms. SLAUGHTER. 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.

                          ____________________