[Congressional Record (Bound Edition), Volume 156 (2010), Part 2]
[House]
[Pages 1760-1769]
[From the U.S. Government Publishing Office, www.gpo.gov]




  PROVIDING FOR CONSIDERATION OF H.R. 4626, HEALTH INSURANCE INDUSTRY 
                          FAIR COMPETITION ACT

  Ms. SLAUGHTER. Mr. Speaker, by direction of the Committee on Rules, I 
call up House Resolution 1098 and ask for its immediate consideration.
  The Clerk read the resolution, as follows:

                              H. Res. 1098

         Resolved, That upon the adoption of this resolution it 
     shall be in order to consider in the House the bill (H.R. 
     4626) to restore the application of the Federal antitrust 
     laws to the business of health insurance to protect 
     competition and consumers. All points of order against 
     consideration of the bill are waived except those arising 
     under clause 9 or 10 of rule XXI. The bill shall be 
     considered as read. All points of order against provisions in 
     the bill are waived. The previous question shall be 
     considered as ordered on the bill to final passage without 
     intervening motion except: (1) two hours of debate equally 
     divided and controlled by the chair and ranking minority 
     member of the Committee on the Judiciary; and (2) one motion 
     to recommit.

  The SPEAKER pro tempore (Mr. Driehaus). The gentlewoman from New York 
is recognized for 1 hour.
  Ms. SLAUGHTER. Mr. Speaker, for the purpose of debate only, I am 
pleased to yield the customary 30 minutes to the gentlewoman from North 
Carolina, Dr. Foxx. All time yielded during consideration of this rule 
is for debate only.


                             General Leave

  Ms. SLAUGHTER. I ask unanimous consent that all Members have 5 
legislative days within which to revise and extend their remarks and 
insert extraneous materials into the Record.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from New York?
  There was no objection.
  Ms. SLAUGHTER. I yield myself such time as I may consume.
  Mr. Speaker, like all of my colleagues, I have spent a lot of time 
talking with people in my district about health care and what is 
happening to them. They were in no way prepared for the influx of 
incredible rate increases that seemed to come out of nowhere and fall 
like rain upon them, to the extent that most of them really are not 
sure they can even stay insured.
  Invariably, the conversation turns to health premium increases. I 
hear about insurers that deny coverage. I heard from a father who had 
just had a child who was born with a condition that would make him 
uninsurable for the rest of his life. I listened to someone tell me 
that her husband's new insurance policy won't cover her because she has 
preexisting conditions or simply because it doesn't cover her.
  But now this Congress is on the brink of some commonsense changes to 
the health insurance industry that will help to level the playing field 
a bit between ordinary Americans and the giant corporations that exert 
such power over our day-to-day lives.

                              {time}  1045

  And I say ``our'' because I personally am caught in the same trap as 
most of my constituents. I don't have any kind of special coverage 
because I'm a Member of Congress. I have always been on my husband's 
policy at home from Eastman Kodak that has covered us since he retired, 
but it no longer will cover spouses. We are halfway through dropping 
spouses, and all the benefits that we got as spouses were taken away 
about 4 years ago. So it's not the worst plan, but it's not the best 
either.
  Under the health care bill endorsed by House Democrats, the insurance 
companies will no longer be able to deny insurance coverage based on 
preexisting conditions or just premiums based on gender, which they 
do--you may not know that single women are charged 48 percent more for 
health insurance--or for their occupation.
  They wouldn't be able to drop coverage if you get sick. I was talking 
to a man just this morning who talked about all the money he had paid 
into

[[Page 1761]]

health insurance, and when he made his first claim at the age of 30, 
they decided already he was going to be trouble and denied his claim. 
They cannot anymore tell you that it costs too much to take care of 
your child. Insurance companies would have to publicize their rates and 
no longer can charge older Americans twice as much as the younger ones.
  For my money, though, there is one part of our reform package that is 
simple to explain, easy to justify, and 60 years overdue, and that part 
is to repeal the antitrust exemption given to the health insurance 
industry in 1945 by Congress. That is why we are here today. There is 
no reason any industry in the United States, including baseball, which 
was exempt as well, should be exempt from the one consumer protection 
the Federal Government gives everybody against chicanery, collusion, 
and rate setting.
  Even though the broader effort to pass the final health care bill is 
underway, we have an opportunity today to make a simple, 
straightforward statement about how we think health insurance should 
operate in this country. By repealing this unjustifiable exemption, we 
will enable--this is very important. People do not understand that 
during the last 60 years the Justice Department has not been able to 
enforce anything against them because they were exempt. This will 
enable the Justice Department to begin aggressively enforcing the laws 
that protect the consumers against the cartel of health insurance who 
wield such outsized influence in the health care industry.
  As it stands now, the insurance industry is allowed to fix prices and 
engage in other anticompetitive behavior. Because these companies are 
allowed to pool and share data and to jointly establish premiums and 
types of coverage, there is very little prospect for an average family 
to price shop. It is almost too tempting for big insurers not to cheat 
a little bit. Moreover, regulating the insurance industry is left up to 
individual States--most of them will tell you that they really are not 
up to it--which often suffer from a lack of resources to effectively 
crack down on abuses.
  Each of the 50 States and the District of Columbia has its own 
regulatory framework, traditions, and intentions, which leads to a 
spotty patchwork of enforcement. In fact, according to a report from 
the Center for American Progress, there has been only extremely limited 
and sporadic State enforcement by State insurance commissioners 
throughout the 60 years. In the void, insurance companies have been 
free to engage in anticompetitive and anticonsumer behavior, resulting, 
as we said just recently, in some insurance premiums costing as much as 
70 percent.
  As a result, this exemption thwarts free market pricing and is 
impossible to defend today or at any other time. What we will be doing 
by removing this exemption is to tell the health insurance companies 
that they need to start behaving like every other industry. We tell 
them that colluding and conspiring to set prices at a certain level to 
harm consumers is not going to work in America anymore.
  As I said, the history of this provision dates back to 1944, when 
some insurance companies went to court to challenge the notion that the 
Federal Government could enforce antitrust laws. Despite their best 
efforts, the Supreme Court ruled that the insurance business was 
subject to antitrust laws just like everybody else. Unhappy with that 
decision, the insurers effectively got Congress to invalidate the 
ruling of the top court. It was an amazing piece of legislation, Mr. 
Speaker. Both Houses, Senate and the House, passed legislation giving 
the insurance industry a 3-year transition period while they moved to 
be covered by what everybody else is covered by, antitrust. Both bills 
had passed, and when it came out of conference, the exemption was made 
permanent.
  Over the years, opponents of McCarran-Ferguson--and I have been one 
of them for about 30--have been stymied. The last serious effort was 
led by Representative Jack Brooks in 1991, who tried and failed to 
change the law.
  Last year, when we again started in a serious effort to change the 
law, the industry geared up for a big fight. We heard from the American 
Insurance Association and the American Academy of Actuaries, among 
others, who argued that changing this law would somehow cost consumers 
more money. Other interest groups claimed the provision was poorly 
written, too broad, or a solution in search of a problem.
  Interestingly, some lobbyists have quietly begun to whisper that this 
provision will not have impact on their rates. They say it is too 
narrow in scope. Frankly, I would much have preferred to lift this 
exemption from the entire insurance industry instead of just health. 
But they are firmly opposed, make no doubt about that, and are lobbying 
to prevent it, which makes we wonder if they are sort of whistling past 
the graveyard.
  Now, let's look back for a minute at the last major investigation of 
the health industry. Two years ago, the attorney general for the State 
of New York, Andrew Cuomo, investigated the collusion of health 
insurers. Those companies were using Ingenix, a billing data 
clearinghouse, to set rates even though the company was owned by one of 
them. The evidence showed the insurers were conspiring together to 
artificially depress a level of reasonable and customary charges they 
would reimburse to health care providers, which shifted additional 
costs onto the policyholder. In the face of a threat from Cuomo, the 
clearinghouse agreed to disband, and the insurance companies paid a 
sizable sum to resolve the charges.
  As recently as this week, there were fresh news reports out of 
California about abuses by a major insurer there. It is important to 
remember that many people assume that conspiring to set rates is 
illegal in our country. I assume most people believe that. Every high 
school student in America is taught about the Sherman Antitrust Act and 
the how the creation of the Federal Trade Commission came about to 
level the playing field. Part of the motivation was to make sure that 
small businesses, who make up the backbone of our economy and fuel 
small towns from coast to coast, would have a chance against the big 
corporate interests. These creative new entrepreneurs needed to have 
confidence they would not be frozen out of the market by the big boys. 
Sadly, that is exactly what happened. In many States and regions across 
the country, there are often just a couple of health insurance 
companies operating. In New York, two companies control half the 
market. Many States have it even worse, including our neighbor Vermont, 
where two companies have 90 percent of the market share.
  Of course, some people will continue to insist that government should 
just stay out of this whole business. My colleagues on the other side 
often say no government is the best government and free market works 
best if there is no attempt to regulate it. But I would argue that any 
of that is far outweighed by the benefit we gain by having more 
competition, less concentration, and the assistance of a powerful 
watchdog.
  I strongly encourage all of my colleagues to join me today in 
supporting the repeal of the McCarran-Ferguson Act.
  Mr. Speaker, I reserve the balance of my time.
  Ms. FOXX. I thank the gentlewoman from New York for yielding time.
  Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, at the beginning of the 110th Congress, the new majority 
came to power full of promises for a bipartisan working relationship 
and a landmark pledge to create the ``most honest, most open, and most 
ethical Congress in history''; however, this rule and this bill are the 
antithesis of that statement.
  The bill we consider today, H.R. 4626, the Health Insurance Industry 
Fair Competition Act, is not the language that passed the House 
Judiciary Committee in November of 2009 as H.R. 3596. In fact, the bill 
we have before us today was not considered by any committee and was 
introduced only 2 days ago, on Monday, February 22, 2010.

[[Page 1762]]

  It is hard to understand what is the sudden rush. Yesterday, the 
gentlewoman from New York said we have waited 60 years to get this 
bill; today, she says this is long overdue. But she doesn't point out 
that in all that period of time, the Democrats have been in charge of 
Congress except for 2 years in the fifties during the Eisenhower 
administration and the years 1995 to 2006. So why didn't they get it 
passed when they were in control before? Why have they been waiting 60 
years to get it done?
  The language in H.R. 4626 is substantially different from the bill 
the Judiciary Committee passed. That bill dealt with both health 
insurance and medical liability insurance, but medical liability 
insurance has since been stricken from the language. In addition, my 
colleague, Mr. Lungren from California, offered an amendment that was 
accepted with bipartisan support by the House Judiciary Committee 
during markup. That amendment was stricken from the language of the 
current bill that we see in H.R. 4626. During the Rules Committee 
debate yesterday, Mr. Lungren offered that same amendment; however, it 
was not made in order. Instead, we have yet another closed rule where 
Members are shut out from offering any amendments to a bill that did 
not see the proper vetting process. It is high time that we open this 
process up and that we hold the majority to their promise to make this 
an open Congress and allow amendments to be offered on the floor and 
fully debated.
  Mr. Speaker, I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I ask unanimous consent that the 
gentlewoman from Maine (Ms. Pingree) control the remainder of my time.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from New York?
  There was no objection.
  Ms. PINGREE of Maine. Mr. Speaker, I yield 2 minutes to the 
gentlewoman from Florida (Ms. Castor).
  Ms. CASTOR of Florida. I thank the gentlewoman from Maine for 
yielding the time. I also want to salute the chairwoman of the Rules 
Committee, Ms. Slaughter, who has been a champion for American families 
when it comes to standing up for their needs, especially in health 
care.
  Mr. Speaker, I rise in strong support of H.R. 4626, the Health 
Insurance Industry Fair Competition Act, and the underlying rule. It is 
time for policymakers in Washington to determine whose side are they 
on; are they on the side of the health insurance companies or are they 
on the side of American families and small businesses?
  I urge my colleagues to stand up for hardworking families across 
America and pass this Health Insurance Industry Fair Competition Act 
today because the state of the current law is unfair. Health insurance 
companies currently enjoy an exemption from antitrust laws with no good 
justification. Meanwhile, American families are held hostage to rising 
health care costs and a nagging insecurity that even though they pay 
their premiums and they pay their copays, they could be canceled at any 
time, even when they get sick, or they're going to have to fight 
through the red tape to get the benefits they're entitled to.
  Last year, the five largest health insurance companies made a record 
$12.2 billion profit, a 56 percent jump, while dropping coverage for 
2.7 million Americans. Health insurers appear to be cherry-picking who 
they will cover in order to make a huge profit.
  In my home State of Florida, from 2000 to 2007, health care premiums 
for families rose on average by 72 percent; meanwhile, their paychecks 
only went up 20 percent during the same time. So our action in removing 
the antitrust exemption will spur fair prices and real competition.
  Again, it's time to choose; whose side are you on? Who will we 
protect, American families or the health insurance companies? The 
answer is clear: No more favors to private insurance companies.
  I urge a ``yes'' vote on the rule and on the underlying bill.
  Ms. FOXX. Mr. Speaker, I now yield such time as he may consume to my 
distinguished colleague from California, the former attorney general of 
California, Mr. Daniel E. Lungren.

                              {time}  1100

  Mr. DANIEL E. LUNGREN of California. I thank my colleague from North 
Carolina for the time.
  Mr. Speaker, I might say this is an interesting point. I don't think 
I've ever been on the floor in 16 years and have faced this kind of a 
rule. It is a closed rule. I've been here before with closed rules, but 
the effect of the closed rule is to prohibit me from providing or from 
presenting my amendment. Now, that is not unusual. Usually, you come to 
the floor, and you present an amendment to try and amend the bill to 
change it from the way it was reported out of the committee that did 
the work on it. But in this case, I am being prohibited from offering 
an amendment to change the bill back to the way it was as reported out 
of the committee on a bipartisan basis.
  For whatever reason, the majority on the Rules Committee decided that 
an amendment that was cited by the Democratic chairman of the Judiciary 
Committee, Mr. Conyers, as an excellent clarifying amendment is not 
going to be here.
  When one of the chief cosponsors of the bill, or coauthors of the 
bill, being presented on the floor today announced the bill last week, 
she said publicly that this was similar to the bill that was passed out 
of the Judiciary Committee with the bipartisan support of Congressman 
Lungren from California. So, naturally, I was interested to look at the 
bill that they were presenting to see how it was the same as the bill 
we presented. I found out that they'd left out my amendment which 
allowed for the sharing of historical data by insurers so that they 
might look at the experience evidence and utilize that in making their 
decisions with respect to how they conducted their business going 
forward.
  I had been assured that my amendment was not necessary because 
committee staff on the Judiciary Committee had researched it. Nobody 
believed that the Justice Department of any administration going 
forward would find the compiling of historical data among the insurers 
to be noncompetitive and violative of the antitrust laws. I was further 
assured that they did not believe that that would be the case with any 
of the attorneys general of the States.
  Now, I had the privilege of serving as attorney general of my State 
for 8 years, being a member of the National Association of Attorneys 
General--an organization which does support legislation of this type--
and of course, attorneys general of the various States have independent 
authority under their State laws to enforce antitrust laws, which I did 
during my 8 years. Sometimes we went beyond what the Federal Government 
did because we understood better the unique circumstances of our State.
  I remember, one time, we were dealing with a merger between two large 
banks. They were national banks, and they had branches in the State of 
California. We were working in conjunction with the antitrust division 
of the Justice Department, and we were moving in the same direction, 
but I remember getting a phone call from one of the attorneys at the 
Justice Department in Washington, DC, who asked this question: Well, 
how close is San Jose to San Diego? About 400 miles, but they thought 
they were next to one another.
  Why was that relevant? That would be relevant as to whether you had 
competition among the bank branches that were then going to be merged. 
Would that then give increased and illegal concentration of power in 
those areas?
  The point I am making is that attorneys general of the States may 
know a little bit more about their States than attorneys working as 
hard as they can here in Washington, DC. So the idea that attorneys 
general are somehow impotent, from a legal standpoint, such that they 
cannot bring forward antitrust cases, is just not true.
  At the same time, I voted for the bill coming out of committee 
because I thought it had, in fact, reached an appropriate balance. 
Interestingly

[[Page 1763]]

enough, the gentlelady from New York, the chairperson of the Rules 
Committee, stated in her support for this rule and in support for the 
underlying bill that this is really a tribute to Jack Brooks, who 
attempted to do this for years.
  I was privileged to serve with Jack Brooks, an interesting Texan 
Member, someone who was the Chair of the Judiciary Committee for some 
time. When the bill in the Judiciary Committee was originally 
introduced this time around, the distinguished chairman of the 
committee, Mr. Conyers, cited Jack Brooks, and said, This was the Jack 
Brooks bill. So I went back, and I looked at it. I found out that my 
amendment, or the language that I had then put in in amendment form, 
was in the Jack Brooks bill but not in the bill before us. So I brought 
it forward.
  So you might say, if we are doing this in homage to Jack Brooks, you 
would do him further homage by allowing the language of his bill to be 
put into this bill, and that's all I ask for. It's all I ask for.
  Now, the other part of the bill that came out of the Judiciary 
Committee, which is not in this bill, is to remove the antitrust 
exemption that currently exists for medical malpractice insurance 
providers, but somehow that has been taken out of this bill with no 
explanation whatsoever.
  So we have cherry-picked from the bill that came out of the Judiciary 
Committee with bipartisan support, and yet we acclaim the bill as 
being, essentially, the bipartisan bill that came out of committee.
  As I said before the Rules Committee yesterday, sometimes you just 
have to learn to take ``yes'' for an answer. I support the underlying 
bill. I support this effort. I am trying to make it better. It was 
accepted on a bipartisan basis. Yet, in the Rules Committee, there 
wasn't one, in my judgment, credible argument about why you wouldn't 
have it.
  On the one hand, I've heard from the staff of the Judiciary Committee 
that it is not necessary because no single administration will have a 
Justice Department that finds this to be anti-competitive. On the other 
hand, I hear from the chairperson of the committee, Well, we don't want 
to give this power to the insurance companies. We want the Justice 
Department to investigate it. Well, if that's the case, you can't have 
your cake and you can't eat it, too. It's either one or the other.
  If it is, as I was told, unnecessary, redundant because nobody 
looking at it will find this to be noncompetitive because it is 
essential information--and by the way, the absence of this information 
will not hurt the big guys as much as it will hurt the little guys. 
Why? Because if you are a large carrier, you have a far greater 
experience database than if you are a small carrier. You understand the 
market better in terms of information that is at your fingertips. If 
you are a smaller provider, you need the information to understand the 
universe that you might be attempting to present your product to.
  So we have, on the one side, being told that no reasonable antitrust 
division of any Justice Department of any administration will find this 
to be anti-competitive. Then you have the chairperson of the Rules 
Committee saying, No, no, we have to keep this in here because we want 
to make sure that the Justice Department will be able to determine 
whether or not it is.
  So what does that give the market? What does it give the smaller 
insurers? It gives them uncertainty.
  So the very thing that you are saying you want to do you are 
prohibiting from being accomplished by not allowing this amendment to 
be considered. This amendment, as I might say, was described by the 
chairman of the committee as an excellent clarifying amendment. We are 
therefore removing clarification, and we are replacing it with 
uncertainty.
  Look, I can go down on the floor and bash the insurance companies as 
well as anybody here. Let's just knock them all around here. The point 
is we are making an adjustment in law, which is what is good for the 
people. So why not do it in an intelligent way, in a way that will 
actually assist in the marketplace and allow for greater competition? 
Outside studies have said, if, in fact, this information is not allowed 
to be collected together and shared among those in the industry, it 
might--they said ``might''--might have the impact of harming the 
smaller insurance carriers.
  So I don't know why you're doing this. I don't know if there is a 
political reason for it. I don't know if it's because I happen to be a 
Republican. I'll give it up. Any Democrat who wants to put his name on 
it can add his name to Jack Brooks' and present it on the floor. But 
this kind of silliness on this floor has got to stop. You ask for 
bipartisanship, and you throw it away. We have complete bipartisanship 
in the committee, and you ignore it.
  As one member of the committee, a Republican member who voted with me 
in support of this bill on a bipartisan basis, said afterwards when he 
found out that that bill wasn't going to be presented on the floor, Why 
do we need committees and subcommittees? What are we holding hearings 
for? Why are we having the experts testify before us if, in fact, 
somehow in the--I don't know where it is. There are closed doors 
somewhere that decided that this bill was going to come out instead of 
the bill we worked on in committee and then give no good answer.
  It's such a shame you don't have TV cameras in the Rules Committee. 
If people could have seen the argument yesterday, if the public could 
have understood what we were talking about, I mean they would have 
shaken their heads and said, Do the people's business. Please do the 
people's business. Don't get involved in partisanship.
  Again, I would say I give up my name on this amendment. I will gladly 
dedicate it to Jack Brooks in his memory. I'm glad to give it to any 
Member of the Democratic side. Let's do the people's business and get 
rid of this silliness of unstated partisanship, without any rationale, 
that undercuts the impact of the bill.
  Once again, this is unique. I've spent 16 years in this place. This 
is the first time I've ever come to the floor and have been denied an 
amendment that would put back in something we voted on on a bipartisan 
basis in committee that has been removed at the direction of somebody, 
including the Rules Committee, so that we can't have the chance to work 
on the product that came out of a bipartisan effort in the committee.
  Ms. PINGREE of Maine. Thank you to the gentleman from California (Mr. 
Lungren). I will not give you all of the answers I am sure you are 
looking for, and I feel confident that, when this bill is debated on 
the floor, there will be many more questions raised from the members of 
the committee who sat through this debate.
  I can only say, as a member of the Rules Committee, I, too, sat there 
while this conversation was going on. I am not an expert in this 
particular area. I am very pleased, and I want to talk a little bit 
about how pleased I am that we are taking on this exemption of the 
insurance companies.
  I did hear people say, and the reason that I voted the way I did 
yesterday, is that I heard that the Lungren safe harbor amendment was a 
loophole in the McCarran repeal. I heard that consumer groups had said 
that this was anti-consumer. A safe harbor isn't needed because the 
bill does not prohibit information sharing. On the other hand, putting 
in a safe harbor statute would automatically immunize the insurance 
companies, and it would not permit a case-by-case review of companies 
that go too far.
  Honestly, I am not in a position to argue this amendment, but I know 
it will be discussed when the bill is discussed.
  I want to go back to the original issue, because that is why I am 
standing here today.
  Mr. Speaker, I am a proud cosponsor of H.R. 4626, the Health 
Insurance Industry Fair Competition Act.
  I have seen firsthand how health insurance companies have used their 
exemption from antitrust regulation to profit off the backs of 
hardworking individuals and small business owners in my home State of 
Maine. If you want

[[Page 1764]]

to buy an individual insurance policy in my State, it doesn't seem like 
you have much choice. Anthem Blue Cross Blue Shield of Maine became so 
big and swallowed up so much of the market that, at one point, nearly 8 
out of 10 people buying an individual policy ended up with them as 
their insurance provider.
  How did Anthem reward them? With skyrocketing rate increases that are 
impossible to keep up with.
  In Maine, Anthem's rates have gone up 250 percent in the last 
decade--10 times the rate of inflation. Last year, they asked for a 19 
percent rate increase. People in Maine were shocked. Anthem, 
apparently, was just getting started. This year, Anthem is demanding a 
23 percent increase in their rates.
  Mr. Speaker, the only thing rising as fast as the premiums big 
insurance companies charge is their profit margin. Last year, profits 
for the five biggest insurance companies rose by 56 percent over the 
year before. I don't know about you, but I don't know anyone else in 
this economy who got a 56 percent rate increase last year or a raise.
  Anthem has turned a deaf ear to the concerns of Mainers who are 
struggling to pay premiums. Last year, when they asked for a 19 percent 
increase, our insurance superintendent, Mila Kofman, denied the 
request, allowing them 11 percent instead, which seemed reasonable. So 
what did Anthem do? They immediately turned around and sued the State 
of Maine. As our attorney general, Janet Mill, said, ``In this economy, 
it's hard to believe the greed of it.''
  Also last year, I learned that Anthem had suddenly and quietly 
changed a policy that allowed them to deny claims at our State's VA 
hospital. The VA staff caught the switch, but very quickly, the 
hospital was out $500,000. You might ask yourself, How can a company 
get away with that? How can a company get away with denying claims for 
veterans and with demanding outrageous rate increases while pocketing 
record profits?
  The answer is pretty simple. They don't have any real competition.
  I say enough is enough, Mr. Speaker. Anthem clearly demonstrated that 
their monopoly on the individual insurance market in Maine leaves 
consumers with little choice but to either pay escalating premiums or 
to go without coverage. You will hear this more than once today, and we 
already did from the Chair. Unbelievably, health insurance companies 
and Major League Baseball are the only two entities exempt from 
antitrust laws, and it is high time we gave the insurance companies a 
little competition.
  I know it's not what Anthem wants. It is why they have lobbied so 
hard against health care reform that would lower health care costs 
overall. It's what the American people want. The American people 
believe in fair play, a level playing field, and in free and open 
competition, not a system where one massive corporation can run 
roughshod over consumers.
  We need to put families before insurance companies and people before 
profits. H.R. 4626 is an essential step in achieving meaningful health 
reform and in giving Americans choice. I urge my colleagues to join me 
in voting ``yes'' on this rule, this unamended rule, and ``yes'' on the 
underlying bill.
  I reserve the balance of my time, Mr. Speaker.
  Ms. FOXX. Mr. Speaker, I yield such time as he may consume to the 
distinguished ranking member of the Rules Committee, the gentleman from 
California (Mr. Dreier).
  Mr. DREIER. I thank my friend for yielding, and I want to 
congratulate her on her superb management of this as well as of other 
rules that she has brought to the floor.

                              {time}  1115

  I just don't get it, Mr. Speaker. My very good friend, my Rules 
Committee colleague, would not yield to the author of the Brooks-
Conyers-Johnson-Lungren amendment, the bipartisan, agreed-to amendment 
out of the committee, because she said she wasn't an expert on this and 
didn't want to engage in a discussion with Mr. Lungren on the issue.
  All we're asking is, let's not force you to have this discussion. 
Let's allow Members of this House to debate it. That's the only request 
that we were making.
  Mr. Speaker, the American people get it. I've been on the Rules 
Committee for many years, and many of my colleagues on both sides of 
the aisle say, Don't talk about process, don't talk about the ins and 
outs of the Rules Committee. People's eyes glaze over when you start 
doing that.
  But last June 24, that changed. It changed dramatically, when, at 3 
o'clock in the morning, we were dealing with the cap-and-trade bill and 
a special rule was being reported out at that moment, and a 300-page 
amendment, still warm off the copying machine, was dropped in our laps 
as we sat there.
  And what happened after that, Mr. Speaker? What happened was the 
mantra ``Read the Bill'' became a household term. People around the 
country, for the first time, began to focus on process and what has 
happened in this institution, and they were sick and tired of it.
  The next day, our distinguished Republican leader, Mr. Boehner, 
proceeded to take his 1-minute that is granted to the Speaker, the 
majority leader and the minority leader, and he utilized much more than 
that 1 minute. Why? Because we had been presented this 300-page 
amendment in the middle of the night; no one had seen it; and he, 
fortunately, took time to go through that 300-page amendment.
  Mr. Speaker, what we are having here today is a continuation of that. 
Mr. Lungren said he had a discussion with one of his committee 
colleagues. The bottom line that we're seeing here is, the committee 
process be damned. The committee process be damned is what has really 
come about. To me, it's a sad commentary, not for Republicans or 
Democrats, but for the American people.
  I am happy to yield to my friend if she'd like me to yield.
  Ms. PINGREE of Maine. Well, thank you very much. I didn't even have 
to ask and I appreciate your offering.
  Mr. DREIER. When I saw you get to your feet, I suspected you might.
  Ms. PINGREE of Maine. Thank you.
  I knew you wanted to hear my very brief answer on this, and I just 
want to clarify. I appreciate your desire to discuss the process, and I 
hope you take as much time as you choose to do so. But I just want to 
clarify----
  Mr. DREIER. Well, if I could reclaim my time, we would simply like a 
chance to offer the amendment, and my friend could vote against it, the 
bipartisan amendment that had, in fact, full unanimous consent from 
Democrats and Republicans, to make sure that small insurance companies 
will not have their future jeopardized. That's all we're asking for.
  I am happy to further yield to my friend.
  Ms. PINGREE of Maine. And I will just be brief. I want to have plenty 
of time for my colleagues who want to talk more about the substance of 
this issue. But I would say, I felt there was plenty of time for the 
process in the Rules Committee. There was a lively conversation with 
some of my colleagues and your colleagues, bipartisan, back and forth. 
But I disagreed. I did not think that we needed to change this 
exemption about data in the rule, in this particular amendment. I am 
happy to allow the Justice Department to have a decision about this 
later.
  Mr. DREIER. If I could reclaim my time, Mr. Speaker.
  Mr. DANIEL E. LUNGREN of California. Will the gentleman yield?
  Mr. DREIER. I am happy to yield.
  Mr. DANIEL E. LUNGREN of California. That's the most interesting 
thing. You did change it. You changed the bill from the bill that came 
out of committee. So don't tell me you didn't want it changed. You did 
change it. That's the whole point we're making.
  The bill that we produced out of committee on a bipartisan basis that 
was called a clarifying amendment was taken out. So you're the folks 
that changed it. I didn't change it.
  My God, is this 1984 doublespeak around this place?

[[Page 1765]]

  I thank the gentleman for yielding.
  Mr. DREIER. I thank my friend.
  I think the point is very clear. We have the author of a bipartisan 
amendment who enjoyed the support of the committee chairman and others, 
which was focused on small insurance companies. Small insurance 
companies. The big guys aren't going to be affected by this, Mr. 
Speaker. The idea here is to ensure that we don't see an increase in 
premiums or, as Mr. Lungren said in testimony before the Rules 
Committee yesterday, potentially these small insurance companies going 
out of existence.
  Now we heard Democrats and Republicans alike in the Rules Committee 
argue on behalf of the free market process, and we believe that we 
should do everything that we can to ensure that there is a wider range 
of competition, greater competition. And so what is happening is that 
when this rule passes, it prevents an opportunity to have any chance to 
discuss this bipartisan amendment. It's a very, very sad day that we 
continue with a process that is so closed.
  Last year, we set a record. For the first time in the 220-, almost 
221-year history of the Republic, we went through a year without a 
single rule that allowed for an open debate. In fact, since my 
California colleague, Ms. Pelosi, has been Speaker of the House, we've 
gone through now a 3-year period. In that 3-year period of time, save 
the appropriations process, we have had a grand total of one bill 
considered under an open rule.
  Again, this is not a partisan issue. This is to do with the American 
people having their voices heard in this institution. And so while we 
are supportive of the underlying legislation, this change is absolutely 
outrageous. I urge my colleagues to vote ``no'' on this rule so that we 
can bring back some kind of positive recognition of what the Framers of 
our Constitution wanted, and that is, a viable committee structure.


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore. All Members are reminded to address their 
remarks to the Chair.
  Ms. PINGREE of Maine. Mr. Speaker, I do appreciate the clarification 
on the issue of a change.
  I will just clarify my own remarks, that I agreed with the sentiment 
that came out in this final rule that we did not need to make this 
exemption for the data.
  I would like to yield 1 minute to the gentleman from New York (Mr. 
Owens).
  Mr. OWENS. Mr. Speaker, I rise in support of the Health Insurance 
Industry Fair Competition Act.
  Mr. Speaker, I would like to thank Chairwoman Slaughter for allowing 
me to speak today, along with Representative Pingree.
  Each month we hear of record profits for insurance companies and 
their CEOs, while we see health care costs rise for middle class 
families. One reason for this unjust discrepancy is the antitrust 
exemption status afforded to big insurance allowing them to create 
their own market and set their own prices.
  A middle class family that has to choose between paying doctor bills 
and feeding their children is not a Democratic or Republican issue, and 
neither is extending quality care to those who do not have it.
  I have 27 years of experience in the health care industry, and I can 
tell you there is no rational, legal, or moral reason to grant these 
companies this status. In Congress, our top priority should be job 
creation, and taking away insurance companies' legal trust status will 
improve our system in the right way by lowering insurance costs for 
small business owners, and encourage them to create quality jobs.
  Health care reform is a matter of fiscal responsibility. Without it, 
our nation is on track to spend 20 cents of every dollar we earn on 
health care. This current path is unsustainable and unacceptable.
  Mr. Speaker, I would like to thank Representatives Perriello and 
Markey for introducing the Health Insurance Industry Fair Competition 
Act. The bill is an important step toward creating jobs and 
strengthening our economy, and I urge support for the rule and for the 
underlying bill.
  Ms. FOXX. Mr. Speaker, I yield myself such time as I may consume.
  The debate that we've been having on this rule has brought up issues 
that we have been bringing up this entire session. Two major questions: 
No. 1, where are the jobs?--we keep asking that question--and, No. 2, 
what is the other side afraid of?
  As Mr. Lungren pointed out, the bill that passed the committee passed 
with a bipartisan vote. People were very happy with it. They were very 
happy with his amendment.
  And yet somewhere between that committee and here, the bill was 
changed substantially. We assume it was changed in the Speaker's 
office. But we don't understand what our colleagues are afraid of. Why 
are they afraid of debating this amendment? They can't even allow 
debate on something that they don't want in a bill.
  And yet that's what the American people want from us. They are sick 
and tired of things being done behind closed doors. They want to see us 
debating things. They know we're going to have disagreements 
occasionally on philosophy, and that's fine. That's what this country's 
about. But people should be able to see the debate, instead of one or 
two people in this House making all the decisions for the 435 Members 
of the House.
  Let me say a word also about, again, the underlying bill that this 
rule is dealing with. The bill is not going to accomplish what our 
colleagues across the aisle are saying. They're saying it's going to 
bring down the cost of health insurance and add more competition to the 
marketplace. In fact, the bill will probably do just the opposite.
  Let me say what the Congressional Budget Office said when they 
reviewed H.R. 3596. They said, the bill could ``affect the costs of and 
premiums charged by private health insurance companies; whether 
premiums would increase or decrease as a result is difficult to 
determine, but in either case the magnitude of the effects is likely to 
be quite small. That effect is likely to be small because State laws 
already bar the activities that would be prohibited under Federal law 
if this bill was enacted.''
  However, with the new language in the underlying bill and no CBO 
score, there's no telling what the effect will be.
  And the reason we don't have a CBO score is because the bill was 
introduced, as I said, 2 days ago and brought directly to the floor 
under a closed rule. This is a pattern of the ruling party here. And 
``ruling party'' is really the appropriate term, because that's how 
they act; that's how the party acts, as a ruling party.
  We see this same thing happening with the new health care proposal 
from President Obama. Here we have from him what's basically a 10-page 
proposal which melds elements of the House and Senate-passed health 
care bills, along with a few new provisions. But both of those bills 
were written behind closed doors, no committee involvement, or very 
little committee involvement; none in the Senate, some in the House; 
but basically the bills written in the Speaker's office and in the 
Majority Leader's office.
  However, the White House hasn't revealed any legislative text, and no 
CBO score is available. We can't pass a proposal in here. We must have 
exact legislative language.
  Let me mention again the CBO and its reaction to the proposal put 
forth by President Obama. An article in the Washington Times entitled 
CBO: Obama Health Bill Too Sketchy published yesterday states:
  ``The administration did not post the bill's text on the White House 
Web site, but outlined what the legislation would do. It said the 
measure would cost $950 billion over 10 years.'' That's fine for the 
White House to say that, but we don't know that's what it's going to 
cost.
  ``The information wasn't enough for the nonpartisan Congressional 
Budget Office, the official keeper of budget costs, to even venture an 
estimate of the bill's price tag.
  ```Although the proposal reflects many elements that were included in 
the health care bills passed by the House and Senate last year, it 
modifies

[[Page 1766]]

many of those elements and also includes new ones,' CBO Director 
Douglas Elmendorf said in a blog post.''

                              {time}  1130

  The CBO goes on, ``Preparing a cost estimate requires very detailed 
specifications of numerous provisions. The materials that were released 
this morning do not provide sufficient detail on all of the 
provisions.'' So we don't have the information that we need in the 
Obama health care proposal either. This is the way this administration 
and this Democrat-controlled Congress is doing things.
  I now would like to yield 3 minutes to my colleague from Virginia 
(Mr. Goodlatte).
  Mr. GOODLATTE. I thank the gentlewoman from North Carolina for 
yielding me this time.
  Mr. Speaker, I believe in enforcing our Nation's antitrust laws. And 
this bill has been improved since Judiciary Committee consideration. 
However, this legislation is still flawed, and in my opinion is meant 
to distract attention away from the fact that the majority is not 
working on the real issues the American people want us to address. 
Americans want policies that will reduce premiums and increase the 
quality of health care services in the U.S. Unfortunately, it is 
questionable whether this bill will accomplish these goals.
  I am also very disappointed in the rule for this bill, which was 
closed from the beginning, and blocks well-intentioned amendments 
offered by Republicans to make the bill better. Specifically, an 
amendment was offered by Representative Dan Lungren, a fellow member of 
the Judiciary Committee, to allow small health insurance companies to 
continue to be able to share historic loss data so that they can 
compete with big insurance companies. Under the text of the current 
bill, this type of sharing would be illegal, which would hinder new and 
smaller companies from entering the market, competing with the big 
guys, and offering lower premiums.
  The shocking thing is that this amendment was actually adopted in the 
Judiciary Committee on a bipartisan basis. The provision was then 
stripped by the majority in this new bill. So stifling this amendment 
today represents the second time the majority has blocked 
Representative Lungren's amendment, which had bipartisan support, and 
which would have likely reduced health care premiums for citizens.
  Instead of bringing flawed legislation to the floor, we should be 
working together to pass real reforms, like legislation to allow 
citizens to take their health insurance across State lines if they 
move, legislation to help those with preexisting conditions find 
affordable coverage, and legislation to curb frivolous lawsuits against 
doctors, which drive up health insurance premiums and provide increased 
costs due to defensive medicine.
  The American medical liability system is broken. According to one 
study, 40 percent of claims are meritless: either no injury or no error 
occurred. Attorneys' fees and administrative costs amount to 54 percent 
of the compensation paid to plaintiffs. The study found that completely 
meritless claims, which are nonetheless successful approximately one in 
four times, account for nearly a quarter of total administrative costs.
  Defensive medicine is widely practiced and costly. Skyrocketing 
medical liability insurance rates have distorted the practice of 
medicine. Costly but unnecessary tests have become routine, as doctors 
try to protect themselves from lawsuits. According to a 2008 survey 
conducted by the Massachusetts Medical Society, 83 percent of 
physicians reported that they practiced defensive medicine. Another 
study in Pennsylvania put the figure at 93 percent. While estimates 
vary, the Pacific Research Institute has put the cost of defensive 
medicine at $124 billion. Others have arrived at even higher figures.
  I urge my colleagues to oppose this rule.
  We should be working to eliminate these hundreds of billions of 
dollars of waste from our medical system in order to drive down 
premiums to make health care more affordable. We should be working to 
help those with preexisting conditions get affordable coverage. 
Unfortunately, we are doing neither today. We can do better.
  Mr. Speaker, while I may vote for this bill it could have been made 
better by an open rule and the allowance of the Lungren amendment. But 
this bill is hardly a cure all and there is so much more we could do if 
the majority would open up the health insurance process to good 
proposals that the American people support.
  Ms. PINGREE of Maine. Mr. Speaker, I yield 4 minutes to the gentleman 
from Oregon (Mr. DeFazio).
  Mr. DeFAZIO. I thank the gentlelady for yielding.
  Mr. Speaker, during this health care debate over the last 6 months, 
we have heard we should listen to our constituents. And you know, I 
did. I did 14 town halls in August, and they were attended by over 
8,000 people. And there was one item of agreement between the extremes 
in the debate, between the folks representing the tea party and those 
representing single payer, and that was consensus that this industry, 
the health insurance industry, should not enjoy a special exemption 
under the law. They should not be able to collude to drive up prices, 
limit competition, price gouge consumers. They should play by the same 
rules as every other industry in America. And this archaic exemption 
from antitrust law passed in the 1940s should go to the dustbin of 
history. There was consensus on that.
  Now come the Republicans, oh, wait a minute, we are not protecting 
the industry, we don't want to allow them to still have antitrust 
exemption, it is about the little guys. It is always about the little 
guys, isn't it? So let's give the little guys a loophole. And oops, 
wait a minute, the big guys can use the same loophole.
  Now, the other thing I have heard is let's be bipartisan. Well, there 
is nothing much more bipartisan than the report of the Antitrust 
Modernization Commission from April 2007. This was a commission created 
by the Republican Congress when they controlled both the House and the 
Senate and the White House, with the members named by President George 
Bush and the Republican leadership of Congress. They came to the 
conclusion that this loophole that they are advocating here today 
should not exist.
  I will quote briefly from the conclusions of the bipartisan 
Republican-created commission. They said, ``A proposed exemption should 
be recognized as a decision to sacrifice competition''--oops, I thought 
they were for competition--``and consumer welfare''--I thought they 
were for the consumers--``and should be allowed only if Congress 
determines that a substantial and significant countervailing societal 
value outweighs the presumption in favor of competition and the 
widespread benefits it provides.''
  They go on to address their arguments and they say there are those 
who will argue the small companies that need aggregate data and all 
this, they will need the safe harbor. They say, no, actually not. This 
again is the Republican-created commission. ``Like all potentially 
beneficial competitor collaboration generally, however, such data 
sharing would be assessed by antitrust enforcers and the courts under a 
rule of reason analysis that would fully consider the potential 
procompetitive effects of such conduct and condemn it only if, on 
balance, it was anticompetitive. Insurance companies would bear no 
greater risk than companies in other industries engaged in data sharing 
and other collaborative undertakings. To the extent that insurance 
companies engage in anticompetitive collusion, however, they would then 
be appropriately subject to antitrust liability.''
  They want to give a safe harbor that is so big that the Justice 
Department could never review it. They are objecting to the fact that 
the Justice Department might look at, investigate, the activities 
surrounding data sharing and potential collusion by the industry that 
continues to price-gouge consumers and benefit unreasonably and profit 
unreasonably. They want to create that loophole. That loophole is 
unnecessary.
  If you adopt that loophole, we might as well just not pretend that we 
care

[[Page 1767]]

about consumers, consumer welfare, and that we are going to 
meaningfully address this industry playing by the same rules as every 
other industry. This industry should play by the same rules as all 
others, plain and simple. Americans get that. They are not happy with 
seeing their health insurance double every 10 years, or now it is more 
on a doubling rate of 3 to 5 years. They know that they are being taken 
to the cleaners. They know the industry is trying to cherry-pick. They 
know there is anticompetitive activity going on. It is time for that to 
change. No loopholes.
  Ms. FOXX. Mr. Speaker, I reserve the balance of my time.
  Ms. PINGREE of Maine. Mr. Speaker, I yield 2 minutes to the gentleman 
from Texas (Mr. Doggett).
  Mr. DOGGETT. Mr. Speaker, for 65 years health insurance companies 
have enjoyed a special interest exemption from laws prohibiting price 
fixing, bid rigging, and carving up the insurance market. Consumers' 
health insurance premiums go up, while coverage gets worse and worse. 
In the past six years, health insurance premiums have increased at a 
rate four times the increase in the average American worker's wages.
  Twenty-seven years ago, as a young Texas State Senator, I authored 
the Texas Free Enterprise and Antitrust Act. But one industry, one 
industry among all others, was exempted because of this Federal law. So 
no action could be taken against the anticompetitive practices of one 
industry, the insurance industry. And we see the results. In the last 
decade, health insurance premiums in Texas have gone up over 100 
percent.
  Protecting consumers and fostering competition are American values. 
Families and small businesses will benefit when the health care 
industry has to compete like other industries. With this reform and a 
newly reinvigorated Department of Justice, which forgot about antitrust 
enforcement under the Bush administration, together we can now have the 
oversight that was overlooked for eight years under that 
administration.
  Hopefully, President Obama will correct a major omission in the 
health care legislation that he proposed by including this vital 
reform--repeal of the antitrust loophole for the health insurance 
industry. It is time for competition. It is time for open markets. And 
it is time to block the closed-door collusion that Americans are paying 
for in higher and higher premiums by letting competition work.
  Ms. FOXX. Mr. Speaker, I continue to reserve my time.
  Ms. PINGREE of Maine. Mr. Speaker, I yield 2 minutes to the gentleman 
from California (Mr. Garamendi).
  Mr. GARAMENDI. Mr. Speaker, members of the House, we have before us a 
very simple but extremely important proposal by our Republican 
colleagues to provide the insurance industry with the opportunity to 
continue to collude, to set prices, and to harm the consumers. Call it 
a safe harbor. It is indeed a very safe harbor to do what is illegal in 
every other portion of the American economy except for baseball.
  So why should we approve what the Republicans want here? No good 
reason at all. Competition is necessary. A safe harbor is specifically 
designed to allow the insurance companies to continue to gather 
specific information that they then use to set prices and to collude 
and to harm the consumers as well as the providers.
  There are two cases out there over the last decade in which the 
industry has clearly colluded and harmed providers, a case in New York 
and another case that was put against the insurance companies by the 
doctors. This proposed amendment by Congressman Lungren would harm both 
the providers as well as the consumers, and provide a safe harbor to do 
what is illegal in every other part of the American economy, that is to 
set prices. We ought not to do it. We ought to put this aside.
  Mr. DANIEL E. LUNGREN of California. Will the gentleman yield?
  Mr. GARAMENDI. I yield to the gentleman from California.
  Mr. DANIEL E. LUNGREN of California. Could I just ask my friend from 
California, isn't it true that if there was collusion utilizing this 
information, that would still be prosecutable under the amendment that 
I suggest because it is prosecutable at the present time under State 
action theory and has been pursued by various States?
  Mr. GARAMENDI. The proposed amendment opens the door for collusion. 
It gives the tools for collusion to the companies. We ought not do 
that. And there is no other part of the American economy that such 
collusion and such an open door and invitation to collusion is 
provided.
  Ms. FOXX. I yield 30 seconds to the distinguished gentleman from 
California (Mr. Daniel E. Lungren).
  Mr. DANIEL E. LUNGREN of California. Well, I know we have had people 
on this floor who say they have no expertise but they say this 
amendment does certain things. I did spend 8 years as the Attorney 
General of California. We had the most active antitrust public law 
office in the country other than the U.S. Justice Department.
  I might just say, this is the first time I have ever heard that Jack 
Brooks was presenting legislation on the floor of the House or in 
Judiciary that was to protect insurance companies or allow collusion. 
The language I used is taken from the Jack Brooks bill. The language I 
use is specifically the language that was adopted on a bipartisan basis 
and said by the chairman of the Judiciary Committee was an excellent 
clarifying amendment.

                              {time}  1145

  Ms. PINGREE of Maine. I yield 30 seconds to the gentleman from 
California (Mr. Garamendi).
  Mr. GARAMENDI. When my colleague from California was attorney 
general, I was insurance commissioner, and we had a grand fight over 
this very issue, the very issue of whether the State of California 
would allow the insurance companies to continue to use rating bureaus 
to get their price information and to continue to set prices in what 
could be a collusion. We put that aside. The regulations that I put 
into effect were adopted, and the end result was, when they could no 
longer use a rating bureau, which this proposal would allow, the prices 
began to drop in homeowners and auto insurance in California.
  Ms. FOXX. Mr. Speaker, I yield 30 seconds to the gentleman from 
California.
  Mr. DANIEL E. LUNGREN of California. The fact of the matter is that 
under the law under this bill, the State action still applies, State 
action principles still apply. States can still do what they will, 
including what the gentleman talked about before. So this is a red 
herring.
  This is so silly that you would take something that got bipartisan 
support, unless you're suddenly suggesting that the chairman of the 
Judiciary Committee has a secret plan to somehow allow the insurance 
companies to gouge people and that Jack Brooks had that secret plan. 
This is total nonsense, to bring a bill to the floor and take out an 
essential element from committee and then suggest, when you want to put 
it back in committee for revision, you're trying to protect somebody.
  Ms. PINGREE of Maine. Mr. Speaker, I yield 1\1/2\ minutes to the 
gentleman from Georgia (Mr. Scott).
  Mr. SCOTT of Georgia. I thank the gentlewoman from Maine (Ms. 
Pingree). I appreciate her courtesy in allowing me to speak.
  Mr. Speaker, this is an important, important issue. It is at the 
crucible of this entire debate on health care. And the crucible is 
this: We must bring down the cost of health care. And in a free 
economy, the surest way of bringing down the cost of a product or a 
service is through competition.
  The antitrust laws were put on the books during Standard Oil with 
John D. Rockefeller to break that up so we could bring competition. 
Here we have now, almost a hundred years later, the only industry that 
is exempted from antitrust is the insurance industry, the health 
insurance industry. Surely we can agree on this.
  Mr. Speaker, let me just say one other thing, too, to my friends on 
the

[[Page 1768]]

other side of the aisle. It was a great Republican who said a house 
divided against itself shall surely fall. Well, this Nation is tired of 
seeing us divided. They want to see us find something, one or two 
things, that we can agree on. America is yearning for Republicans and 
Democrats to come together on something that will help bring down the 
cost of health care insurance, and nothing will more surely do that 
than to remove this exemption from antitrust that is beholden to the 
insurance companies. As long as they have it, they are free to do the 
monopoly. They are free to price fix.
  We can agree on both sides of the aisle here today to bring down the 
cost of health care insurance by removing this exemption.
  Ms. PINGREE of Maine. Mr. Speaker, I have no further requests for 
time, and I reserve the balance of my time.
  Ms. FOXX. Mr. Speaker, Mr. Scott just made Mr. Lungren's case for him 
as far as I'm concerned. He just said we want to work together on 
issues. Mr. Lungren said that's what we've done. A bipartisan amendment 
passed. The Democrats took the bipartisan amendment out of the bill.
  We want to work together. Many Republicans are going to vote for this 
bill. I hope they won't vote for the rule, because it's a bad rule, but 
they will vote for the bill.
  The Democrats, time and again, tout their plan will increase 
competition and lower premiums. We don't think that's true.
  I want to urge the American people to read the summary the White 
House has put out on their bill and see the increased Federal control 
of health care in this country.
  The SPEAKER pro tempore. The time of the gentlewoman has expired.
  Ms. PINGREE of Maine. Mr. Speaker, I thank my colleague on the other 
side of the aisle.
  We've heard a variety of reasons and excuses today about why this 
bill shouldn't pass, whether it was about the committee process or a 
loophole, debating it back and forth. But the fact is we cannot have 
meaningful health care reform in this country until we finally decide 
to put an end to insurance company greed and insurance company 
monopolies. We must stop companies like Anthem who demand rate 
increases that are many times the rate of inflation, which puts health 
care insurance out of reach for many, many Americans.
  I urge a ``yes'' vote on the previous question and on the rule.
  Mrs. BIGGERT. Mr. Speaker, I rise today in opposition to this closed 
rule for H.R. 4626, the Health Insurance Industry Fair Competition Act. 
Last night, I offered an amendment to crack down on fraud in Medicare, 
which costs taxpayers as much as $50 billion a year. My language, an 
update of my bill, the Medicare Fraud Prevention and Enforcement Act of 
2009, was actually endorsed by President Obama in the White House 
blueprint that was released early Monday. It was most recently included 
in the Medical Rights and Reform Act, introduced by my good friend Mr. 
Kirk.
  This amendment would have reduced waste, fraud and abuse by 
strengthening the Medicare enrollment process, expanding certain 
standards of participation, and reducing erroneous payments. The 
amendment also provides additional tools to pursue fraudulent 
healthcare providers, suppliers and billing agencies. These are 
bipartisan goals, and my language has true bipartisan support. 
Unfortunately, Democrats on the Rules Committee refused to even allow 
an up-or-down vote on the House floor that would have added this 
important, cost-cutting measure to a bill that is otherwise lacking in 
substance.
  I expect more political healthcare votes in the coming weeks, and I 
am prepared to offer my piece of the Obama healthcare plan as an 
amendment each time. If Democrats are serious about reducing costs and 
passing stand-alone bipartisan solutions, then I ask them to accept my 
language. The billions in waste that we save could go a long way toward 
providing health insurance for the millions of Americans who cannot 
afford it.
  I urge my colleagues to oppose this closed rule.
  Ms. PINGREE of Maine. I yield back the balance of my time.
  Ms. FOXX. The gentlewoman from Maine did not yield time to me so that 
I could explain that I did not urge opposition to the underlying bill 
but only the rule.
  Ms. PINGREE of Maine. I move the previous question on the resolution.
  The previous question was ordered.
  The SPEAKER pro tempore. The question is on the resolution.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Ms. FOXX. 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, this 15-
minute vote on adoption of House Resolution 1098 will be followed by 5-
minute votes on motions to suspend the rules on:
  House Resolution 1074; and
  House Resolution 944, if ordered.
  The vote was taken by electronic device, and there were--yeas 238, 
nays 181, not voting 13, as follows:

                             [Roll No. 60]

                               YEAS--238

     Abercrombie
     Ackerman
     Adler (NJ)
     Altmire
     Andrews
     Arcuri
     Baca
     Baird
     Baldwin
     Barrow
     Bean
     Becerra
     Berkley
     Berman
     Berry
     Bishop (GA)
     Bishop (NY)
     Blumenauer
     Boccieri
     Boren
     Boswell
     Boucher
     Boyd
     Brady (PA)
     Braley (IA)
     Brown, Corrine
     Butterfield
     Capps
     Capuano
     Cardoza
     Carnahan
     Carney
     Carson (IN)
     Castor (FL)
     Chandler
     Chu
     Clarke
     Cleaver
     Clyburn
     Cohen
     Connolly (VA)
     Conyers
     Cooper
     Costa
     Costello
     Courtney
     Crowley
     Cuellar
     Cummings
     Davis (AL)
     Davis (CA)
     Davis (IL)
     Davis (TN)
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Dicks
     Doggett
     Donnelly (IN)
     Doyle
     Driehaus
     Edwards (MD)
     Edwards (TX)
     Ellison
     Engel
     Eshoo
     Etheridge
     Farr
     Fattah
     Filner
     Foster
     Frank (MA)
     Fudge
     Garamendi
     Gonzalez
     Gordon (TN)
     Grayson
     Green, Al
     Green, Gene
     Grijalva
     Gutierrez
     Hall (NY)
     Halvorson
     Hare
     Harman
     Hastings (FL)
     Heinrich
     Herseth Sandlin
     Himes
     Hinchey
     Hinojosa
     Hirono
     Hodes
     Holden
     Holt
     Honda
     Hoyer
     Inslee
     Israel
     Jackson (IL)
     Jackson Lee (TX)
     Johnson (GA)
     Johnson, E. B.
     Kagen
     Kanjorski
     Kaptur
     Kennedy
     Kildee
     Kilpatrick (MI)
     Kilroy
     Kind
     Kirkpatrick (AZ)
     Kissell
     Klein (FL)
     Kosmas
     Kratovil
     Kucinich
     Langevin
     Larsen (WA)
     Larson (CT)
     Lee (CA)
     Levin
     Lewis (GA)
     Lipinski
     Loebsack
     Lofgren, Zoe
     Lowey
     Lujan
     Lynch
     Maffei
     Maloney
     Markey (CO)
     Markey (MA)
     Marshall
     Massa
     Matheson
     Matsui
     McCarthy (NY)
     McCollum
     McDermott
     McGovern
     McIntyre
     McMahon
     McNerney
     Meek (FL)
     Meeks (NY)
     Melancon
     Michaud
     Miller (NC)
     Miller, George
     Mollohan
     Moore (KS)
     Moran (VA)
     Murphy (CT)
     Murphy, Patrick
     Nadler (NY)
     Napolitano
     Neal (MA)
     Nye
     Oberstar
     Obey
     Olver
     Ortiz
     Owens
     Pallone
     Pascrell
     Pastor (AZ)
     Payne
     Perlmutter
     Perriello
     Peters
     Peterson
     Pingree (ME)
     Polis (CO)
     Pomeroy
     Price (NC)
     Quigley
     Rahall
     Rangel
     Reyes
     Richardson
     Rodriguez
     Ross
     Rothman (NJ)
     Roybal-Allard
     Ruppersberger
     Rush
     Ryan (OH)
     Salazar
     Sanchez, Linda T.
     Sanchez, Loretta
     Sarbanes
     Schakowsky
     Schauer
     Schiff
     Schrader
     Schwartz
     Scott (GA)
     Scott (VA)
     Serrano
     Sestak
     Shea-Porter
     Sherman
     Sires
     Skelton
     Slaughter
     Smith (WA)
     Snyder
     Space
     Speier
     Stupak
     Sutton
     Tanner
     Taylor
     Teague
     Thompson (CA)
     Thompson (MS)
     Tierney
     Titus
     Tonko
     Towns
     Tsongas
     Van Hollen
     Velazquez
     Visclosky
     Walz
     Wasserman Schultz
     Waters
     Watson
     Watt
     Waxman
     Weiner
     Welch
     Wilson (OH)
     Woolsey
     Wu
     Yarmuth

                               NAYS--181

     Aderholt
     Akin
     Alexander
     Austria
     Bachmann
     Bachus
     Bartlett
     Barton (TX)
     Biggert
     Bilbray
     Bilirakis
     Bishop (UT)
     Blackburn
     Boehner
     Bonner
     Bono Mack
     Boozman
     Boustany
     Brady (TX)
     Bright
     Broun (GA)
     Brown (SC)
     Brown-Waite, Ginny
     Buchanan
     Burgess
     Burton (IN)
     Calvert
     Camp
     Campbell
     Cantor
     Cao
     Capito
     Carter
     Cassidy
     Castle
     Chaffetz
     Childers
     Coble
     Coffman (CO)
     Cole
     Conaway
     Crenshaw
     Culberson
     Dahlkemper
     Davis (KY)
     Deal (GA)
     Dent
     Diaz-Balart, L.
     Diaz-Balart, M.
     Dreier
     Duncan
     Ehlers
     Ellsworth
     Emerson
     Fallin
     Flake
     Fleming
     Forbes
     Fortenberry
     Foxx
     Franks (AZ)
     Frelinghuysen
     Gallegly
     Garrett (NJ)
     Gerlach
     Giffords
     Gingrey (GA)
     Gohmert
     Goodlatte
     Granger
     Graves
     Griffith
     Guthrie
     Hall (TX)
     Harper
     Hastings (WA)
     Heller
     Hensarling
     Herger
     Hill
     Hunter
     Inglis
     Issa

[[Page 1769]]


     Jenkins
     Johnson (IL)
     Johnson, Sam
     Jones
     Jordan (OH)
     King (IA)
     King (NY)
     Kingston
     Kirk
     Kline (MN)
     Lamborn
     Lance
     Latham
     LaTourette
     Latta
     Lee (NY)
     Lewis (CA)
     Linder
     LoBiondo
     Lucas
     Luetkemeyer
     Lummis
     Lungren, Daniel E.
     Mack
     Manzullo
     Marchant
     McCarthy (CA)
     McCaul
     McClintock
     McCotter
     McHenry
     McKeon
     McMorris Rodgers
     Mica
     Miller (FL)
     Miller (MI)
     Miller, Gary
     Minnick
     Mitchell
     Moran (KS)
     Murphy (NY)
     Murphy, Tim
     Myrick
     Neugebauer
     Nunes
     Olson
     Paul
     Paulsen
     Pence
     Petri
     Platts
     Poe (TX)
     Posey
     Price (GA)
     Putnam
     Rehberg
     Roe (TN)
     Rogers (AL)
     Rogers (KY)
     Rogers (MI)
     Rohrabacher
     Rooney
     Ros-Lehtinen
     Roskam
     Royce
     Ryan (WI)
     Scalise
     Schmidt
     Schock
     Sensenbrenner
     Sessions
     Shadegg
     Shimkus
     Shuler
     Shuster
     Simpson
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Souder
     Stearns
     Sullivan
     Terry
     Thompson (PA)
     Thornberry
     Tiahrt
     Tiberi
     Turner
     Upton
     Walden
     Wamp
     Westmoreland
     Whitfield
     Wilson (SC)
     Wittman
     Wolf
     Young (AK)
     Young (FL)

                             NOT VOTING--13

     Barrett (SC)
     Blunt
     Buyer
     Clay
     Dingell
     Higgins
     Hoekstra
     Moore (WI)
     Pitts
     Radanovich
     Reichert
     Spratt
     Stark

                              {time}  1215

  Messrs. KIRK and SIMPSON changed their vote from ``yea'' to ``nay.''
  So the resolution was agreed to.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.

                          ____________________