[Congressional Record (Bound Edition), Volume 150 (2004), Part 4]
[House]
[Pages 4953-4954]
[From the U.S. Government Publishing Office, www.gpo.gov]




                               AMENDMENTS

  Under clause 8 of rule XVIII, proposed amendments were submitted as 
follows:

                            H. Con. Res. 393

                        Offered By: Mr. Emanuel

       Amendment No. 1: At the end, add the following new section:

     SEC. ___. SENSE OF THE HOUSE REGARDING A TRIGGER MECHANISM 
                   FOR PRESCRIPTION DRUG PRICE NEGOTIATION.

       (a) Findings.--The House finds the following:
       (1) The cost of the new Medicare law, estimated by the 
     Congressional Budget Office before its passage to be 
     $395,000,000,000 over ten years, has now been estimated by 
     the Department of Health and Human Services to be 
     $534,000,000,000 over ten years. Without taking steps to 
     control the cost of prescription drugs, the Medicare law will 
     become an unsustainable burden on the the Government and on 
     taxpayers. In addition, rising drug costs could end up 
     shifting additional cost burdens to Medicare beneficiaries.
       (2) Prescription drug costs increased 15.3 percent in 2003. 
     These rising costs are one of the primary drivers of 
     increasing health care costs, which ran at 9.3 percent last 
     year.
       (3) The Veterans' Administration as well as every private 
     insurer depends on bulk negotiation to keep drug prices down.
       (4) According to a study by the Inspector General of the 
     Department of Health and Human Services, Medicare payments 
     for 24 leading drugs in 2000 were $887,000,000 higher than 
     actual wholesale prices available to physicians and suppliers 
     and $1,9,000,000,000

[[Page 4954]]

     higher than prices available through the Federal supply 
     schedule used by the Department of Veterans Affairs and other 
     Federal purchasers.
       (5) Despite the fact that the private prescription drug 
     plans provided for in the Medicare law have the right to 
     negotiate with manufacturers, former CMS Administrator Tom 
     Scully said that the type of private plans created by the 
     Medicare law ``doesn't exist in nature''. Therefore, it is 
     impossible to predict whether these private plans will in 
     fact be able to acquire substantial discounts through 
     negotiation. In addition, private plans cannot take advantage 
     of the full purchasing power of 40,000,000 beneficiaries.
       (6) Secretary Tommy Thompson said that he does not 
     necessarily agree with the Administration's rationale for not 
     allowing him to negotiate, and that if he were given the 
     power to negotiate, he would use it.
       (b) Sense of the House.--It is the sense of the House 
     that--
       (1) legislation should be adopted which would establish a 
     trigger mechanism for negotiation of prescription drug prices 
     by the Secretary of Health and Human Services; and
       (2) this legislation would mandate that at any point when 
     the expected ten-year expenditures for fiscal years 2004 
     through 2013 for Public Law 108-173 exceed the Congressional 
     Budget Office estimate for this legislation, the Secretary of 
     Health and Human Services would be required to immediately 
     enter into direct negotiations with pharmaceutical 
     manufacturers for competitive drug prices.

                            H. Con. Res. 393

                        Offered By: Mr. Emanuel

       Amendment No. 2: Paragraph (1)(A) of section 101 (the 
     recommended levels of Federal revenues) is amended by 
     increasing revenues for the fiscal years set forth below as 
     follows:
       Fiscal year 2005: $875,000,000.
       Fiscal year 2006: $875,000,000.
       Paragraph (1)(B) of section 101 (the amounts by which the 
     aggregate levels of Federal revenues should be reduced) is 
     amended by reducing the reduction for the fiscal years set 
     forth below as follows:
       Fiscal year 2005: $875,000,000.
       Fiscal year 2006: $875,000,000.
       Paragraph (2) of section 101 (the appropriate levels of new 
     budget authority) is amended by increasing new budget 
     authority for fiscal year 2006 by $1,750,000,000.
       Paragraph (3) of section 101 (the appropriate levels of 
     total budget outlays) is amended by increasing total budget 
     outlays for fiscal year 2006 by $1,750,000,000.
       Paragraph (4) of section 101 (deficits (on-budget) is 
     amended by decreasing the deficit for fiscal year 2005 by 
     $875,000,000 and by increasing the deficit for fiscal year 
     2006 by $875,000,000.
       Paragraph (11) of section 102 (Education, Training, 
     Employment, and Social Services (500)) is amended by 
     increasing new budget authority and outlays for fiscal year 
     2006 by $1,750,000,000.