[Congressional Record (Bound Edition), Volume 156 (2010), Part 2]
[House]
[Pages 1770-1791]
[From the U.S. Government Publishing Office, www.gpo.gov]




             HEALTH INSURANCE INDUSTRY FAIR COMPETITION ACT

  Mr. CONYERS. Madam Speaker, pursuant to House Resolution 1098, I call 
up 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, and ask for its immediate consideration.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 4626

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Health Insurance Industry 
     Fair Competition Act''.

     SEC. 2. RESTORING THE APPLICATION OF ANTITRUST LAWS TO HEALTH 
                   SECTOR INSURERS.

       (a) Amendment to McCarran-Ferguson Act.--Section 3 of the 
     Act of March 9, 1945 (15 U.S.C. 1013), commonly known as the 
     McCarran-Ferguson Act, is amended by adding at the end the 
     following:
       ``(c) Nothing contained in this Act shall modify, impair, 
     or supersede the operation of any of the antitrust laws with 
     respect to the business of health insurance. For purposes of 
     the preceding sentence, the term `antitrust laws' has the 
     meaning given it in subsection (a) of the first section of 
     the Clayton Act, except that such term includes section 5 of 
     the Federal Trade Commission Act to the extent that such 
     section 5 applies to unfair methods of competition.''.
       (b) Related Provision.--For purposes of section 5 of the 
     Federal Trade Commission Act (15 U.S.C. 45) to the extent 
     such section applies to unfair methods of competition, 
     section 3(c) of the McCarran-Ferguson Act shall apply with 
     respect to the business of health insurance without regard to 
     whether such business is carried on for profit, 
     notwithstanding the definition of ``Corporation'' contained 
     in section 4 of the Federal Trade Commission Act.

  The SPEAKER pro tempore. Pursuant to House Resolution 1098, the 
gentleman from Michigan (Mr. Conyers) and the gentleman from Texas (Mr. 
Smith) each will control 60 minutes.
  The Chair recognizes the gentleman from Michigan.


                             General Leave

  Mr. CONYERS. Madam Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and insert extraneous material on H.R. 4626.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Michigan?
  There was no objection.
  Mr. CONYERS. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker and my colleagues, the bill before us will allow, for 
the first time, competition to take hold in the health insurance 
marketplace, an important and vital step in the road to fixing our 
broken health insurance system and containing costs. I want to commend, 
in particular, my colleagues Tom Perriello of Virginia and Betsy Markey 
of Colorado for working with our committee on this important effort.
  Experience has shown that Congress--and we hate to admit having made 
mistakes in the past, but we did

[[Page 1771]]

make an error in 1945 in adding an antitrust exemption into the 
McCarran-Ferguson Act at the last minute during the debate. Not many of 
you were here at that time, and neither was I, but leading consumer 
groups and senior citizen groups, State attorneys general and others 
for years have been urging that we in the legislature fix this error 
that has been made so long ago.
  The bipartisan Antitrust Modernization Commission established by this 
body and President Bush in 2002 echoed this call in its 2007 report. 
And now, as we work to fix what everyone mostly agrees is a broken 
health insurance market, it is about time to bring into that market 
what is an essential ingredient of any well-functioning market--
competition. And the way we make sure that happens here is the same way 
we made sure it happens in every other industry--to have the antitrust 
laws apply. These laws are the principal protector of free market 
competition and the prosperity it provides, the principal guarantee 
that businesses who want to offer choice and value to consumers can do 
so.
  The blanket antitrust exemption in the McCarran-Ferguson Act shields 
health insurance companies from legal accountability for fixing prices, 
dividing up markets and customers they serve so as to deny meaningful 
choice, and using monopoly power to sabotage anyone who seeks to offer 
meaningful competitive choice to consumers. This, ladies and gentlemen, 
must end.
  Antitrust court actions alleging each of these practices, and more, 
have been blocked routinely in the courts by invoking the McCarran-
Ferguson antitrust exemption, and that is what we are here to repair 
today.
  Now, an antitrust expert attorney, David Balto, with antitrust 
enforcement experience acquired both at the United States Justice 
Department and the Federal Trade Commission, has found that State 
insurance commissioners have not brought any actions in any State 
against health insurers for anticompetitive conduct during at least the 
last 5 years.
  Health insurance premiums continue to spiral ever-upward each year, 
and copayments and deductibles keep taking further bites out of tight 
family budgets. Those families have a right to know that they are not 
being victimized by insurers any longer who should be competing to 
offer them choice and value but, instead, are, unfortunately, 
conspiring against them.
  In its famous Topco ruling, the United States Supreme Court refers to 
the antitrust laws as the Magna Carta of free enterprise. The health 
insurance industry should not be exempt from them.
  The Judiciary Committee has been working to remove this harmful 
exemption for a number of years. We made a lot of headway under the 
distinguished chairman, our former colleague, Jack Brooks of Texas, who 
headed the committee after Peter Rodino and after Emanuel ``Manny'' 
Celler, and it is time to complete this effort in the area of health 
insurance since this is the number one subject, legislatively, before 
us being watched carefully by everyone in the Nation.
  Last fall, our Judiciary Committee reported a similar bill which was 
incorporated into the comprehensive health care bill passed by the 
House. And so I commend my colleagues, Representatives Perriello and 
Markey, for their leadership in bringing this effort back to the House 
floor today as a freestanding measure.
  With more and more people having to choose between having health 
insurance or food on the table, isn't it about time the health 
insurance companies' cozy antitrust exemption be taken off the books?
  So I urge all my colleagues to support this long-overdue, pro-
consumer legislation that will affect citizens and families in every 
State.
  Madam Speaker, I reserve the balance of my time.
  Mr. SMITH of Texas. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, H.R. 4626, the Health Insurance Industry Fair 
Competition Act, unfortunately doesn't do much. In fact, it has all the 
substance of a soup made by boiling the shadow of a chicken.
  In his State of the Union address on January 27, President Obama 
challenged Congress to create a plan that ``will bring down premiums, 
bring down the deficit, cover the uninsured, strengthen Medicare for 
seniors, and stop insurance company abuses.'' The administration's 
health care plan does just the opposite. It increases premiums, 
increases taxes, and reduces Medicare benefits for seniors.
  Will today's McCarran-Ferguson repeal bring down insurance premiums? 
No. The Congressional Budget Office says that ``whether premiums would 
increase or decrease as a result of this legislation is difficult to 
determine, but in either case the magnitude of the effects is likely to 
be quite small.''

                              {time}  1245

  So what's the point of the bill?
  The CBO goes on to say that premium reductions from this bill are 
likely to be small because ``State laws already bar the activities that 
would be prohibited under Federal law if this bill was enacted.''
  So what's the point of the bill?
  The National Association of Insurance Commissioners pointed out that 
bid-rigging, price-fixing, and market allocation ``are not permitted 
under the McCarran-Ferguson Act, and are not tolerated under State law. 
Indeed, State insurance regulators actively enforce prohibitions in 
these areas.''
  So, again, what's the point of the bill?
  The McCarran-Ferguson Act's Federal antitrust exemption simply allows 
small and medium-sized insurers to aggregate information for 
underwriting purposes so they can compete effectively against larger 
companies. In other words, McCarran-Ferguson helps to promote 
competition by making small and medium-sized underwriters viable.
  Eliminating the exchange of data provision that was included in 
earlier versions of this bill likely will impede new entry into the 
health insurance markets. This means that there could be less 
competition among health insurers.
  That said, I believe, as does the Antitrust Modernization Commission, 
that antitrust exemptions should be rarely granted or created. Yet, if 
they are necessary, they should be written in as limited a way as 
necessary to meet a compelling public policy goal.
  I can understand why some of my colleagues may want to support this 
bill, and given that it will have no meaningful impact, I don't oppose 
it. However, when repealing an existing antitrust exemption, we should 
be careful of the unintended consequences of our actions.
  The majority has avoided one unintended consequence of this 
legislation by limiting its application solely to health insurers. 
Eliminating malpractice insurers goes a long way toward making this 
bill more reasonable. However, the majority should adopt further 
changes to this bill to demonstrate that they are more interested in 
legislating than in targeting an unpopular industry for no real policy 
reason.
  Specifically, this legislation should be amended to define the term 
``business of health insurance.'' Second, we should reinsert the 
exchange of data provision that was added to the bill in committee. 
Finally, we should clarify that this bill will not impinge upon State 
insurance regulations. None of these concepts are revolutionary. They 
were all included in earlier versions of this legislation that were 
passed by the House.
  That said, if the majority really wants to help consumers, we should 
consider a measure that could actually achieve savings for patients: 
medical malpractice tort reform.
  According to a study by the Harvard School of Public Health, 40 
percent of all medical malpractice suits against doctors and hospitals 
are ``without merit.'' So every doctor must purchase malpractice 
insurance at great expense to protect themselves from frivolous 
lawsuits.
  A Department of Health and Human Services study found that unlimited

[[Page 1772]]

excessive damages add $70 billion to $126 billion annually to health 
care costs. Doctors are so concerned about frivolous lawsuits that they 
have to practice defensive medicine and order unnecessary tests and 
procedures. HHS estimates the national cost of defensive medicine is 
now more than $60 billion.
  All of these expenses are then passed on to patients in the costs of 
health care. That is why some States, including my home State of Texas, 
have enacted tort reform, which limits the amount of excessive damages 
awarded in frivolous lawsuits. The result? Insurance premiums have 
fallen, and the availability of medical care has expanded. But this 
bill will do nothing to reduce the costs of health care.
  Congress should set aside this bill, and it should take up lawsuit 
abuse reform, which could reduce health care costs for our 
constituents.
  Madam Speaker, I reluctantly support this, unfortunately, ineffective 
bill.
  I reserve the balance of my time.
  Mr. CONYERS. Madam Speaker, before I yield to Sheila Jackson Lee, I 
yield myself 1 minute because my dear friend, the ranking member, 
asked, What is the point of this legislation?
  We have made a long list of points of this legislation. To begin 
with, it is to increase competition in the health care industry. It 
also is to shine a light on industry practices that are currently 
unavailable and undetectable because of the exemption. That's why we 
are on the floor today.
  I yield 3 minutes to a distinguished member of the committee, the 
gentlewoman from Houston, Texas, Sheila Jackson Lee.
  Ms. JACKSON LEE of Texas. I thank the distinguished chairman.
  Madam Speaker, I rise to announce to the American public and to this 
body that, as we stand here today, over a year's time, 45,000 Americans 
die because they don't have health insurance. They don't have health 
insurance because the premiums have literally spiraled beyond any 
imagination. So, today, we are rising to create an opportunity for 
Americans to live and for lives to be saved because competition is the 
engine, not only of the economy, but it is the engine of better health 
care for all Americans.
  Here is an example that shows how increased premiums are the complete 
opposite of commitment and service to our constituency: When the State 
of California passed a law in 1988 that eliminated the State antitrust 
exemption for the auto insurance industry, auto premiums for consumers 
in California rose 9.8 percent when the rest of the premiums in the 
Nation were going down. The Consumer Federation of America said that 
consumers would save over $50 billion in insurance premiums by 
repealing the 1945 McCarran-Ferguson Act.
  I thank the distinguished colleague from our Judiciary Committee, Mr. 
Perriello, for his leadership, along with many others.
  Removing the antitrust exemption will not only enable appropriate 
enforcement against these unjust practices when they are uncovered, but 
it will also give all health insurance companies healthy competitive 
incentives so you as a family of four, as a grandmother, as a single 
parent can get the insurance possible as we move forward in health 
insurance.
  The attorney general of New York, in his investigation, found that 
insurance companies engage in collusion. That's why we need this. We 
want to break the rules so we can help doctors with lower premiums and 
medical malpractice and with shielding our constituency from these 
Godforsaken prices.
  Let me tell you that we have seen this in action in the Ocean State 
Physicians Health Plan v. Blue Cross and Blue Shield. Citing this act, 
this antitrust prevention act, the First Circuit overturned a jury 
verdict against the dominant health insurer for using its monopoly 
power to put financial pressure on area employers to refuse to do 
business with a competing HMO. The First Circuit, because of the 
exemption, blocked any opportunity for competition. We need to change 
this, and we have found that this collusion is hurting us.
  So, Madam Speaker, I would say to you that, in order to save lives, 
like the lives in my 18th Congressional District, where Texas is the 
poster child for the most uninsured, 1.1 million--it has the dubious 
honor of being the largest uninsured State in the Nation. My county, 
Harris County, as we fight over and over for health insurance, does not 
have people who are insured. So this will help bring, along with the 
health reform that we will pass in the next couple of weeks, the idea 
of saving lives and of providing for our children and our families.
  Chairman Conyers had the single-payer bill. That was the initiative 
that should have gone forward, but now we have a way of saving lives. 
This is fiscally secure, and it provides security to those who are in 
need. I ask that you support this legislation to, again, save lives.
  Madam Speaker, I rise in support of H.R. 4626, Health Insurance 
Industry Fair Competition Act, a bill designed to restore competition 
and transparency to the health insurance market--by repealing the 
blanket antitrust exemption afforded to health insurance companies by 
the McCarran-Ferguson Act of 1945. Today 45,000 people a year die 
without health insurance and they die because they do not have health 
insurance! This is a matter of life and death.
  Madam Speaker, competition is the engine that drives our economy, 
spurs innovation, and ensures that the American consumer receives a 
fair deal on goods and services. There is significant evidence that 
removing the antitrust exemption will increase competition in the 
insurance industry and will result in lower prices and other benefits 
for consumers. In fact, experience has shown time and time again the 
benefits of increased competition in the form of lower prices, 
increased choice, and greater innovation.
  A healthy and competitive health insurance market will drive prices 
down in the health insurance industry, just as we have seen it do in so 
many other industries where competition is allowed to take hold. For 
example, since the state of California passed a law in 1988 that 
eliminated the state antitrust exemption for the auto insurance 
industry, auto premiums for consumers in California have risen by only 
9.8% while the rest of the country has seen auto premiums rise by over 
48 percent. The Consumer Federation of America has said that consumers 
would save over $50 billion in insurance premiums by repealing the 1945 
McCarran-Ferguson Act for all lines of insurance. Further, it is 
estimated that subjecting health insurance companies to federal 
antitrust laws would lower premiums by 10% or more.
  Removing this antitrust exemption will not only enable appropriate 
enforcement against these unjust practices when they are uncovered; it 
will also give all health insurance companies healthy competitive 
incentives that will promote better affordability, improved quality, 
increased innovation, and greater consumer choice, as the antitrust 
laws have done throughout the rest of the economy for over a century.
  The antitrust exemption was enacted in 1945, as part of legislation 
whose main purpose was simply to reaffirm the authority of States to 
regulate insurance for the protection of their citizens. The antitrust 
exemption was quietly inserted at the end of the legislative process, 
in conference committee. As a result, insurance companies have been 
shielded from legal accountability for price fixing, dividing up 
territories among themselves, sabotaging their competitors in the 
marketplace in order to gain monopoly power, and other practices that 
unjustly harm consumers. Moreover, antitrust court actions alleging 
each of these practices, and more, have been blocked by invoking the 
McCarran-Ferguson antitrust exemption.
  For far too long, the health insurance industry has played by a 
different set of rules. Shielding health and medical malpractice 
insurance companies from federal antitrust laws is a practice that must 
end.
  Madam Speaker, the American public agrees that the special treatment 
the anti-trust exemption affords insurance companies must come to an 
end. A recent Rasmussen poll found that 65% of Americans favored 
removing the anti-trust exemption for health insurance companies. Of 
those polled, Democrats supported subjecting insurance companies to 
antitrust laws by a seven-to-one margin. Sixty-four percent (64%) of 
independent voters and 58% of Republicans also believe insurers should 
abide by antitrust laws. This data demonstrates that there is bi-
partisan public support for demanding that health insurance companies 
play by the same rules as other companies in America.
  Madam Speaker, I agree with the majority of the American public that 
shielding health and

[[Page 1773]]

medical malpractice insurance companies from federal antitrust laws is 
a practice that must end. Eliminating the anti-trust exemption for the 
health care industry is a vital step toward reforming health care, 
lowering prices for consumers and doctors, and leveling the playing 
field for American businesses.
  The Consumer Federation of America has said that consumers would save 
over $50 billion in insurance premiums by repealing the 1945 McCarran-
Ferguson Act for all lines of insurance. Further, it is estimated that 
subjecting health insurance companies to federal antitrust laws would 
lower premiums by 10% or more. Moreover, in addition to bi-partisan 
support amongst the American public, repealing anti-trust exemptions 
for all health insurance is supported by conservative political leaders 
as well such as Governor Bobby Jindal of Louisiana, Senator Joseph 
Lieberman, and former Majority Leader Trent Lott.
  This bill is also necessary because, over the years, health insurers 
have been able to use this antitrust exemption to block court actions 
regarding anti-competitive behavior. For example, in Ocean State 
Physicians Health Plan, Inc. v. Blue Cross & Blue Shield of Rhode 
Island, the First Circuit Court--citing the McCarran-Ferguson antitrust 
exemption--overturned a jury verdict against the dominant health 
insurer for using its monopoly power to put financial pressure on area 
employers to refuse to do business with a competing HMO.
  Removing this antitrust exemption is supported by key law enforcement 
groups, including the National Association of Attorneys General. In 
2007, the National Association of Attorneys General--representing both 
Democratic and Republican State Attorneys General--overwhelmingly 
adopted a resolution calling for repealing this exemption. As the 
resolution pointed out, ``the National Association of Attorneys General 
consistently has opposed legislation that weakens antitrust standards 
for specific industries because there is no evidence that such 
exemptions promote competition or serve the public interest.''
  In addition, in a recent letter to Congress, nine State Attorneys 
General pointed out, ``Since 1977, and most recently in 2007, antitrust 
experts and enforcers have concluded that repealing the McCarran-
Ferguson exemption would result in enhancing competition while allowing 
standard industry practices necessary for the proper functioning of 
these markets, such as sharing loss and other insured risk 
information.''
  Removing this antitrust exemption is also supported by leading 
consumer groups. Numerous consumer groups--including the Consumers 
Union, Consumer Federation of America, U.S. PIRG, Center for Justice 
and Democracy, and Public Citizen--strongly support removing this 
antitrust exemption. In a joint letter to Congress, consumer groups 
pointed out that, under this legislation, health insurance companies 
``would be required to play by the same rules of competition as 
virtually all other commercial enterprises operating in America's 
economy.''
  In closing, I want to also take this time to reiterate my support for 
a public health care plan that covers every one of the 47 million 
people who live in our great nation without health insurance. Madam 
Speaker, my state of Texas has the dubious honor of being the uninsured 
capital of the nation. Further, with more than 1.1 million of the 
nation's uninsured living in my own county, Harris County, I represent 
what some have labeled as ground zero of the health care debate. Thus, 
the issue of universal health care coverage--something that would have 
been achieved by Chairman Conyers' Single Payer bill, which I 
supported, is more than an empty slogan; it's a matter of fiscal and 
physical life and death to the people of the 18th Congressional 
District. Therefore, no matter how the pending debate over the details 
of the health reform bill winds up, my constituents can count on me to 
continue fighting and continue working together with my colleagues of 
both parties, to ensure that everyone in my district, in Houston, in 
Texas, and in America has access to affordable and quality health care.
  Mr. SMITH of Texas. I yield myself 1 minute.
  Madam Speaker, let me say that I always appreciate what my colleagues 
state on the House floor, and I appreciate their good comments during 
debate. To the extent that they want to increase competition among 
insurance companies and want to reduce insurance premiums, I completely 
agree with them, but we should not think that any of those comments or 
any of those desires or any of those goals have anything to do with the 
bill that we are considering here today.
  Once again, in case some of my colleagues missed it, let me read what 
the Congressional Budget Office said about this legislation. They said, 
``Whether premiums would increase or decrease as a result (of this 
legislation) is difficult to determine, but in either case, the 
magnitude of the effects is likely to be quite small.'' So this bill 
has no point.
  Madam Speaker, I yield 3 minutes to the gentleman from Wisconsin, the 
former chairman of the Judiciary Committee, Mr. Sensenbrenner.
  Mr. SENSENBRENNER. Madam Speaker, listening to the arguments that 
have been advanced by the proponents of the bill, all I can say is what 
you hear is not what you are going to get if this bill is enacted into 
law.
  There is a reason this antitrust exemption has survived now for 65 
years, which is that it actually has encouraged competition because it 
allows smaller insurers to use the actuarial data that larger insurers 
are able to amass. If the smaller insurers can't get this actuarial 
data, which is what will happen if this bill is enacted into law, then 
they will either be gobbled up by the larger insurers, which get the 
data in-house, or they will go out of business. As a result, there will 
be less competition rather than more. So what you hear today about 
competition is not what you are going to get if this exemption is 
repealed.
  Now, repealing the limited exemption that health insurance carriers 
have under the McCarran-Ferguson Act is, at best, going to change 
little and, at worst, is going to be counterproductive. As the CBO 
concluded in October, repealing the exemption would have little or no 
effect on insurance premiums because State laws already bar the 
activities that would be prohibited under Federal law should the bill 
be enacted. Instead, additional regulatory burdens on insurers will 
likely be passed on to the policyholders in the form of higher 
premiums.
  This, my friends, is the majority's higher health insurance premium 
bill in the name of competition. It's not going to happen. The bill 
would subject to new Federal enforcement a variety of ongoing 
collaborative practices among health insurers which are currently 
permitted by the States because they allow the small insurers to 
compete.
  Now, shouldn't we be for small insurers? Shouldn't we be for having 
new companies enter the market? This bill will prohibit that.
  Small insurance companies rely on the data collected from their 
larger competitors, and share it industrywide in order to accurately 
set their rates. However, this would be forbidden under the bill. If 
small insurers can't get the data, further consolidation is likely. 
Small insurance will either merge to gain a competitive edge or get 
swallowed up by the big insurance giants. Again, the majority is 
putting together an insurance company consolidation bill--less 
competition rather than more. Worse, a repeal could result in the small 
insurers' going out of business altogether. Meanwhile, for the big 
insurance companies, the big, bad insurance companies with the means to 
collect and analyze this data in-house, it would simply be business as 
usual.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. SMITH of Texas. I yield the gentleman an additional 2 minutes.
  Mr. SENSENBRENNER. This legislation attempts to solve a problem that 
doesn't exist.
  First, there is no evidence that the exemption has increased health 
insurance prices or profits or that it has contributed to higher market 
concentration. Second, the effort to repeal McCarran-Ferguson is based 
on the belief that it allows individual insurers to collude on prices 
and policy coverage.
  State laws prohibit insurers from bid-rigging, price-fixing and 
market allocation to restrain competition. State insurance regulators 
actively enforce the prohibition in these areas, and this legislation 
would only add another layer of Federal regulation and litigation to an 
industry that operates under a robust and well-established State 
regulatory regime.
  There are ways, however, to promote competition in the health 
insurance market. One change Congress should

[[Page 1774]]

consider is permitting individuals and businesses to buy their health 
insurance policies from any willing provider in any State. Under 
current law, an insurance firm registered in one State may not cover 
individuals in another without registering in the second State and 
being subject to all its taxes and laws. This raises the cost of doing 
business across State lines, and it prevents many smaller or mid-sized 
companies from entering the markets to compete. Simply put, this is not 
the type of reform that is needed, and it is not the type of reform 
that Americans were promised.

                              {time}  1300

  I challenge my colleagues on the other side of the aisle, Madam 
Speaker, to come up with commonsense reforms, one that will do in fact 
what appears in speech. This bill fails on both counts.
  Mr. CONYERS. Madam Speaker, the former chairman emeritus has raised a 
number of points that amount to verbal jujitsu that I will be 
addressing very shortly, but for now I yield 3 minutes to the 
distinguished chairman of the Judiciary Subcommittee on Courts and 
Antitrusts, a former magistrate in the courts of Georgia himself, 
Subcommittee Chair Hank Johnson.
  Mr. JOHNSON of Georgia. I thank the chairman for yielding.
  Madam Speaker, last week I was shocked to learn that in the middle of 
the great recession, which was caused by the deregulation, hands-off 
policies of the prior administration, and during this time when 
families across my district and across the Nation are struggling with 
rising unemployment and while health insurance companies have recently 
announced that last year was their best year on record as far as 
profits are concerned, $12 billion last year in profits for the 
insurance industry, and while that's the case, they are announcing 
plans to raise insurance premiums by 40 percent in some markets. During 
this time of hurt and pain and also making money by the insurance 
industry off these people who are hurting and in pain, we are 
considering today removing the antitrust exemption that insurance 
companies have enjoyed for over 60 years. And it's time for this 
protection and immunity from antitrust law and this anticompetitive 
behavior, it's time for it to come to an end.
  This insurance industry which delivers health care to the people has 
been broken for a long time. We all know it, and it's time to change 
it. And this is a good place to change it. It will help with 
competition if we pass this law today. That will happen only if we 
start applying anticompetitive, antitrust legislation to the insurance 
industry. There's simply no reason why they should continue to benefit 
from it.
  Don't listen as the health insurance industry tries to tell you that 
they can't live under the antitrust laws. Every other industry does. 
It's high time that they do too. Consumers will benefit, the economy 
will benefit, and health insurance insurers who want to compete 
honestly will too.
  Let's give struggling American families an honest health insurance 
market by enacting this important bill.
  Mr. SMITH of Texas. Madam Speaker, I yield 5 minutes to the gentleman 
from California (Mr. Daniel E. Lungren), a senior member of the 
Judiciary Committee.
  Mr. DANIEL E. LUNGREN of California. I thank the ranking member for 
the time.
  Let me say at the outset, I do not believe that health insurance 
companies should be exempt from our Nation's antitrust laws. As one of 
those who believes and hopes that those applauding would join me in 
supporting the idea of buying health insurance across State lines, when 
we reach that accomplishment, I think it is appropriate for us not to 
have a Federal antitrust exemption.
  When health care has been primarily and in a very real sense 
exclusively the province of the States, under their jurisdiction, the 
attorney generals of the States have retained the ability to enforce 
the antitrust laws of those States. So we're entering a new era, I 
would hope, where we would be able to, if, in fact, this one Republican 
idea finds its way into legislative enactment, find an opportunity to 
extend the universe of decisions that might be accessed by individuals 
or their employers by way of insurance policies that may be available 
in other States.
  My intention is to vote in favor of this bill. However, my concern is 
that the bill before us is not nearly as good as it should be because 
normal bipartisan committee process has been circumvented.
  As has been noted by some in advancing this bill, I did vote in favor 
of the Health Insurance Industry Antitrust Enforcement Act of 2009 when 
it marked up in the Judiciary Committee. At that time, I offered an 
amendment to the bill to allow the sharing of historical data and the 
performance of actuarial services by insurance companies. Not future 
trending data but rather looking-backward historical data. At that 
time, it was adopted unanimously by the committee, therefore, on a 
bipartisan basis. Our distinguished chairman of the committee supported 
my amendment, which he described at the time as ``a helpful 
clarification.''
  If there's one thing that we ought to understand when we have this 
downturn in the economy, if you want to make sure things don't happen 
in the private economy, insert uncertainty. If you want to make sure 
that things cost more than they otherwise would, insert uncertainty. 
And that's what we are doing by not allowing that in the bill before 
us.
  In fact, I should point out to my friends on the other side, section 
262 of your health care bill, your health care bill, adopted on this 
floor, allowed for the sharing of such information. It contained the 
language of my amendment. Unfortunately, for whatever reason, it has 
been held out of the bill before us.
  Unless anyone thinks I have risen to speak because of sour grapes 
because my amendment with my name on it was not included in this bill, 
let me clarify the case. I can give you assurance that is not the case 
for the simple reason that I cannot take personal credit for the guts 
or the contents of this amendment.
  The truth of the matter is that the hard work done to repeal the 
McCarran-Ferguson Act began with the efforts of then Chairman Jack 
Brooks, Democratic chairman, in the 101st, 102d, and 103d Congresses. 
Ironically, at the beginning of our committee markup, our chairman 
described the repeal of McCarran-Ferguson ``as a tribute to Jack 
Brooks.'' So if we really wish to pay tribute to Jack Brooks, and I 
believe we should, perhaps a good place to start would have been to 
allow an amendment to include Chairman Brooks's language in any 
legislation before us. I'm hopeful that the motion to recommit might 
contain that language, and I would hope that people would set aside 
partisan differences and support it.
  So aside from the issue of the denigration of the committee process--
and I think that's an important thing we ought to take into 
consideration. The subcommittee, committee, you act on this bill. You 
debate it. You consider amendments. You vote out the amendment on a 
unanimous bipartisan vote. Then you have bipartisan support for the 
bill as it comes out of committee. And then what happens? It's changed 
before it comes to the floor. And we had one of the members of the 
Rules Committee say she wasn't going to engage me in debate because, 
she said, I don't have the expertise on this issue. So I presume that 
means if you have expertise, and that's what committees are supposed to 
have, you ignore that so you can come to the floor and not allow debate 
utilizing that expertise because you prohibit that amendment from being 
considered on the floor.
  H.R. 4626 will have precisely the opposite effect of its stated 
intention if, in fact, the notion of sharing historical data is not 
considered appropriate and legal. The economics of the insurance 
industry are such that companies depend on information. Why? In order 
to enable them to price their products. They have to base it on 
something.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. SMITH of Texas. Madam Speaker, I yield the gentleman 2 additional 
minutes.

[[Page 1775]]


  Mr. DANIEL E. LUNGREN of California. I thank the gentleman.
  It is better if they have actual data upon which to make their 
decisions.
  And here's the rub: As was mentioned by the gentleman from Wisconsin, 
it is the small companies which depend on the availability of 
information the most. Smaller companies simply do not have a 
sufficiently large volume of information to price their products 
efficiently. So it's for this reason that it is of the utmost 
importance that insurers have the ability to share historical data.
  Now, am I just saying this? No. In this record, a Congressional 
Research Service report raises the possibility that were such data not 
available to small insurance companies, we might see the ironic outcome 
of further concentration in the insurance industry. Again, not my 
conclusion; the conclusion of the Congressional Research report done 
most recently.
  So, yesterday I did approach the Rules Committee to ask my amendment, 
the Brooks amendment, as I call it, be restored to the health insurance 
antitrust bill. And even though it was approved unanimously by my 
colleagues on the Judiciary Committee, my request was inexplicably 
rejected by the Rules Committee.
  This is not the way, I would say, Madam Speaker, that this body 
should do business. Let's respect the integrity of the institution and 
the work that has been done in the duly established committee process.
  I would hope that when this part of the recommittal motion is 
discussed, we'll discuss it in light of the history of this bill--the 
language taken from the Jack Brooks bill; the language taken from the 
majority's health care bill passed just this year.
  Mr. CONYERS. Madam Speaker, I yield myself 2 minutes.
  I want to respond to the senior member of the Judiciary Committee, a 
former attorney general of California and a friend of all of us on the 
committee, an effective member, and all I want him to know is that we 
approved his provision in the Judiciary Committee because we thought it 
was a good provision. It was unanimous. I don't recall that anyone 
voted against it or spoke against it. The problem, though, is that when 
we got to the Rules Committee, our leadership on both sides of the 
aisle, I hope, had come up with another bill and that bill omitted it. 
We were not able to get that put back in.
  We think that their reasoning is not altogether strange or out of 
order or violating any procedure, but here's what it was. This is what 
they told me: They said, if there are no antitrust exemptions in this 
measure, then you don't need to specifically retain a part of the 
antitrust exemption relating to the safe harbors provision, because if 
it isn't an antitrust provision, they aren't going to be affected 
anyway.
  So it's in that spirit that I appreciate the comments of the 
gentleman from California, and I hope that we can continue to work 
together as much as we can, and perhaps the final vote here will be 
more bipartisan than many thought that it would.
  Madam Speaker, I now would like to yield 2 minutes to a senior member 
of the Congress from Iowa (Mr. Boswell).
  Mr. BOSWELL. I thank the chairman for this opportunity. I appreciate 
it.
  Madam Speaker, I rise today in support of the Health Insurance 
Industry Fair Competition Act.
  An original cosponsor of this legislation, I believe that our health 
insurance companies need to be held to the competitive standard our 
free market demands.
  For too long, these companies have told our constituents what they 
will insure and what they will be paid. Just recently, 80,000 Iowans 
were told that their insurance rates would jump by an average of 18 
percent, with many facing increases of as much as 25 percent. These 
same individuals have seen their rates increase by 10\1/2\ percent each 
year since 2005.
  I insist that light be shed on the pricing of health care costs and 
that consumers have access to how their premiums and copays are 
determined. I would particularly like this information for my 
constituents whose premium increase is twice what it was in 2009.
  Iowans in the Third District are struggling to make ends meet. They 
deserve to know how a company can spend as much as perhaps $200 million 
on a new headquarters and turn around and double their premium 
increases from 2009 to 2010 and then claim these two things have 
nothing to do with one another.

                              {time}  1315

  Our support for this legislation will make it illegal for companies 
to price fix, practice bid rigging, and market allocation simply to 
drive up costs on American consumers.
  Mr. SMITH of Texas. Madam Speaker, first of all, I just want to say 
that I appreciated what the chairman of the Judiciary Committee just 
said a minute ago to Mr. Lungren. I understood him to make very 
positive comments about the so-called Brooks-Lungren amendment. And I 
hope that that augurs well for the majority's accepting our motion to 
recommit at the end of this debate. At least I would expect that.
  At this point, Madam Speaker, I will yield 3 minutes to the gentleman 
from New Jersey (Mr. Garrett), a member of the Budget Committee and the 
Financial Services Committee.
  Mr. GARRETT of New Jersey. Madam Speaker, I rise in opposition to the 
bill for a number of substantive reasons. But also, quite honestly, 
after hearing the comment from the gentleman from California, I also 
was about to say I rise with concerns as to the process as well.
  I appreciate the ranking member's comment as far as potentially 
moving forward on this. I too have been there in the past, where we do 
things in committee, in the relevant committees I serve on, serve on 
Financial Services Committee and have agreements with the other side of 
the aisle and with the chairman specifically of Financial Services, 
with Chairman Frank, and then things go to the Rules Committee, and I 
don't know whether it was a bipartisan obstacle in this case, but be it 
as it may, problems happen with Rules Committee. And I can tell you 
with my working with Chairman Frank, he was able to actually get things 
done then on the floor as far as the substantive amendments done here 
to get it done. So I hope that we see similar action with regard to 
this as well that we have seen in other committees.
  But I do rise in opposition or concern about this bill with regard to 
the repeal of the McCarran-Ferguson aspect. And I do so for three 
points. One has been touched upon, but I want to go into a little bit 
more detail with regard to the CBO. CBO, Congressional Budget Office, 
nonpartisan entity, has noted the States already have the laws on the 
books to prevent what we are really trying to deal with here, price 
fixing and bid rigging, et cetera.
  Furthermore, State insurance commissioners already typically review 
the rates charged by insurance companies. So what does this basically 
mean in a nutshell? Basically, States are working in this direction 
already, and that the passage of this legislation will have a minimal 
positive impact.
  Just a side note. When we talk about State insurance regulation in 
general, you have to remember when we are talking about the financial 
situation that we are in right now, it was not the fault of the State 
regulators of the financial marketplaces that brought us to where we 
are, it is the fault largely to errors and omissions in the Federal 
regulators. So if we are trying to cast blame or aspersion on any 
regulators out there, it should not be on the State regulators, because 
in essence they have done their jobs, and we should not be throwing 
other impediments to that getting done.
  Second point, someone already mentioned about a report out of the 
CBO. Let me go into a little bit more specifics about what the CBO said 
with regard to costs. CBO said, and I quote, ``To the extent that 
insurers would become subject to additional litigation, their costs and 
thus their premiums might increase.'' Let me repeat that. Their 
premiums might increase. So to all the points of the other side of the

[[Page 1776]]

aisle saying that we are doing this with the good intention of trying 
to get premiums to come down, what do the experts, the nonpartisan CBO, 
say? Just the opposite, premiums might go up. So the conclusion there 
is here is a case where increased litigation costs would actually drive 
up the cost of insurance, and not bring it down.
  Third and final point, touched upon a little bit, and let me go in 
more detail. This legislation could have the effect of shutting out new 
entrants, not folks already there, but shutting out new entrants into 
the marketplace.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. SMITH of Texas. Madam Speaker, I yield the gentleman 2 additional 
minutes.
  Mr. GARRETT of New Jersey. Thank you.
  This legislation would have the effect of shutting out new entrants 
into the marketplace. The other side of the aisle has already talked 
about the fact that they want to have greater competition in this area 
of health insurance, and I am assuming insurance across the board. But 
what this will do, as the gentleman and others have already said on the 
floor, is basically say to the new entrants, to the small companies who 
want to get into this marketplace, to be able to compete against the 
large entrenched companies that are already there, you are pushed out, 
you are locked out. So is that what we want to do with this 
legislation? That will be the impact.
  Let me conclude then. In a letter to Speaker Pelosi, the National 
Association of State Insurance Commissioners says the following: ``The 
business of insurance, while exempted from Federal antitrust law, is 
still subject to State antitrust enforcement actions.'' That is 
important. ``In fact, even if the McCarran-Ferguson antitrust 
exemptions were repealed, the State action doctrine exempting them 
would continue to apply. The most likely result of this repeal would 
therefore not be increased competition, but a series of lawsuits 
testing the limits of the State action doctrine, with associated 
litigation costs being passed along to the consumers in the form of 
higher premiums.''
  The conclusion, Madam Speaker, is more litigation, more harmful 
consolidation, and more increase to the cost to the consumer, all 
things that we should be working to oppose. And that is why I do not 
support the underlying legislation.
  Mr. CONYERS. Madam Speaker, no one has worked harder on this measure 
that is not a member of the Judiciary Committee than Peter DeFazio of 
Oregon. And I yield to him 3 minutes.
  Mr. DeFAZIO. I thank the distinguished chairman for bringing this 
issue before us.
  We have heard on the Republican side this is just about the little 
guys. They only want to help the little guys. Except that the loopholes 
that they would create with the Lungren provisions could be used by the 
big guys. So if you like the status quo, if you like the fact that some 
of the largest insurance companies in America saw their profits go up 
by 56 percent last year, if you like the fact that in many States we 
are seeing huge, double-digit increases, over 50 percent in Michigan, 
40 percent in California, 20 percent in my State, if you think the 
system's working today, then you should support Mr. Lungren's idea, 
preserve the status quo. That is what they are saying. Keep the 
loopholes. Allow them to continue to collude and price fix.
  Now, there are a few other people who disagree with them. In fact, we 
had a bipartisan commission created by the Republican Congress when 
they controlled the House and the Senate and signed into law by 
President George Bush. The members were appointed by George Bush, the 
Republican heads of the House and the Senate. And their conclusions 
considered Mr. Lungren's arguments and they rejected them.
  A bipartisan, professional commission created by the Republicans and 
George Bush said, after saying, yes, there are these arguments being 
made, but they say, ``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.'' 
They don't want the Justice Department to have that capability. They 
don't want any additional levels of review.
  Mr. DANIEL E. LUNGREN of California. Will the gentleman yield?
  Mr. DeFAZIO. There are many States that are totally incapable of 
dealing with these issues, particularly with multistate, multinational 
companies that operate outside their borders, set rates outside their 
borders, and then import those rates into the State saying, well, that 
was our experience. We operate in 27 States after all, and you are part 
of our system.
  So if you like the status quo, if you like the double-digit rate 
increases, if you like the limits on market competition, if you like 
the concentration that has been going on in the industry, then you 
would support the status quo, which is essentially what Mr. Lungren has 
offered. And I don't. And I don't think the American people do either. 
I think we have tremendous consensus around the country that it is time 
for this abusive industry to play by the same rules as every other. And 
the small companies will still be able to obtain the data as long as 
they don't use it in a collusive manner. But it is always just about 
the small companies, except that the exceptions they want to provide 
are for the big companies also.
  We have expert testimony from the director of the Center for Health 
Law Studies, St. Louis University, saying that is not the case, it will 
not disadvantage small companies. We have Mr. David Balto, an antitrust 
expert, saying it will not disadvantage the small companies. But the 
Republicans are purporting that it would.
  Finally, on the CBO report that it won't lower premiums, that was 
based on the Lungren language. Without the Lungren language, it will 
save money, $10 billion for consumers.
  Mr. SMITH of Texas. Madam Speaker, I yield 2 minutes to the gentleman 
from California (Mr. Daniel E. Lungren).


                         Parliamentary Inquiry

  Mr. DANIEL E. LUNGREN of California. Madam Speaker, I would like to 
make an inquiry of the Chair.
  The SPEAKER pro tempore. The gentleman will state his inquiry.
  Mr. DANIEL E. LUNGREN of California. Is it not correct that Members 
are supposed to address the Chair?
  The SPEAKER pro tempore. The gentleman is correct.
  Mr. DANIEL E. LUNGREN of California. Thank you.
  Since the gentleman refused to yield when I asked him to, despite the 
fact he was using my name and attributing motivations to me that are 
questionable under the rules of the House, I might say this. The 
gentleman is absolutely incorrect in his analysis. The report said that 
it would harm the small insurance companies if they were not able to 
get this historical data, number one.
  Number two, the gentleman conflates two completely different things: 
one is historical data and the other is trending data. And they are two 
different things. My amendment does nothing about allowing insurance 
companies to work together and compare trending data, which is data 
going forward, despite the fact that some in the insurance industry 
wish that is the case. The dirty little secret is that some in the 
insurance industry don't want to have my amendment, they want it to be 
silent so that in addition to historical data, they can also have 
trending data. But the gentleman hasn't looked at the data in that way, 
hasn't examined or, I presume the gentleman would not have examined the 
reports to know the difference that was in that and my specific 
decision not to include trending data in my amendment.
  Secondly, I find it interesting that the gentleman suggests that I am 
trying to do something other than what I say that I am doing. This is 
an interesting argument made on this floor, that if you disagree with 
someone you

[[Page 1777]]

suggest that what they say can't possibly be true. The fact of the 
matter is I have quoted outside reports to support my position, number 
one. The fact of the matter is I have used the language from the Jack 
Brooks legislation, I have used language from the gentleman's party's 
health care bill, and I have used the language that was adopted on a 
bipartisan basis in Judiciary Committee unanimously.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. SMITH of Texas. Madam Speaker, I yield the gentleman an 
additional 2 minutes.
  Mr. DANIEL E. LUNGREN of California. Perhaps the gentleman is 
suggesting that all the Members on his side of the aisle who supported 
this amendment share in his description of the motivation of those of 
us who have presented it. I thought maybe we were above that. I thought 
maybe we were engaged in civil discourse here. But rather, if the 
gentleman or any gentleman wishes to talk about the motivations of 
others, I will tell you any idea about bipartisanship is lost in this 
House. The suggestion that all you have to do is shout louder than 
somebody else and accuse them of motivations other than what they 
articulated is just absolute nonsense.
  The fact of the matter is, properly done, the sharing of historical 
data is not anticompetitive. The fact of the matter is the underlying 
bill, with my amendment, would still allow actions taken by the Justice 
Department and the various States Attorney General if there was bid 
rigging, if there was price setting, if there was determination before 
the hand of which markets you would act in and which markets you would 
not act in.
  And so this is a lot of sound and fury signifying nothing, 
essentially. I have never seen such an attack on an amendment that was 
adopted on a bipartisan basis in the committee. Now, I realize it is 
only the committee of jurisdiction that has expertise in this area. I 
understand that those of us who have done antitrust law ought not to be 
listened to because those who have said on this floor that they have no 
expertise in this and they don't understand it, therefore, they don't 
want to debate it, should have the upper hand in the Rules Committee.
  But frankly, I will say once again at some point in time you have to 
accept yes for an answer. I support the bill. I am trying to help the 
bill. I am trying to get it back to where it was when Jack Brooks 
introduced it. And in response to that, rather than saying hurray for 
bipartisanship, I hear from other people, well, we got to question your 
motivations. Hardly a high point in this Chamber.

                              {time}  1330

  Mr. CONYERS. Madam Speaker, I am inclined to yield to the gentleman 
from Oregon (Mr. DeFazio) 1\1/2\ minutes.
  Mr. DeFAZIO. Madam Speaker, you know, the law has evolved over time, 
and the law has evolved significantly since the era of Jack Brooks in 
terms of decisions regarding antitrust, antitrust immunity.
  And as the current Assistant Attorney General of the Antitrust 
Division says, it says, moreover, the application of antitrust law's 
potentially to pro-competitive collective activity has become far more 
sophisticated in the 62 years since the industry was exempted from the 
law. And some forms of joint activity that might have been prohibited 
under earlier, more restrictive doctrines are now clearly permissible, 
or at least, very least, analyzed under a rule of reason that takes 
appropriate account of the circumstances.
  So what we're saying is, let's, you know--you're saying, oh, the 
States can take care of it. Let's say, the State of Montana can oversee 
an industry, a multistate, multinational, you know, conglomerate, and 
they can get into their books and they can examine and see that the 
rates that were imported from outside the State were set fairly. No. We 
need the help of the Federal Antitrust Division. They should not have 
their hands tied only in respect to the industry of insurance. Every 
other industry in America has learned to live with truly free markets 
with antitrust law. This industry can do the same, and it will benefit 
consumers. This is a false argument that somehow they need this special 
privilege, this special exemption, and that somehow this will hurt only 
little companies, not the big guys.
  We've seen tremendous consolidation already under the existing total 
exemption. And if we continue a partial exemption, we'll only see more.
  Mr. SMITH of Texas. Madam Speaker, I yield 2 minutes to the gentleman 
from California (Mr. Daniel E. Lungren).
  Mr. DANIEL E. LUNGREN of California. Madam Speaker, once again I know 
I run the risk of trying to introduce some expertise into this debate. 
For that, I apologize. But the American Bar Association appeared before 
the subcommittee of Judiciary dealing with the underlying bill, or the 
bill that was presented before our committee, and in there, they voice 
support, as they have for decades, for removal of the McCarran-Ferguson 
antitrust exemption for the health care insurance industry.
  However, they said, as point number one of the five major points they 
made, insurers should be authorized to cooperate in the collection and 
dissemination of past loss-experience data so long as these activities 
do not unreasonably restrain competition, but insurers should not be 
authorized to cooperate in the construction of advisory rates or the 
projection of loss experience in the future in such a manner as to 
interfere with competitive pricing. That second part deals with 
trending data. I do not allow that under my amendment.
  And as I presented my effort to have my amendment considered in the 
Rules Committee, I was told by the representative of the American Bar 
Association, they did support my position, they supported my amendment, 
and they supported the arguments that I made before the committee.
  Now, maybe they're wrong because they have some expertise in this 
area, but perhaps this is one time we might look to them. The ABA has 
not been known as a Republican, conservative, pro-insurance company 
operation. Last time I looked, they have a major element of the bar 
association that's involved with antitrust law.
  Mr. CONYERS. Madam Speaker, I am pleased to recognize a senior member 
of the House Judiciary Committee from Los Angeles, Ms. Maxine Waters, 
for 3 minutes.
  Ms. WATERS. Madam Speaker, the consumers of this country are finally 
getting the attention they deserve. For far too long, consumers have 
been ripped off by collusion and concentration of the health insurance 
industry. For far too long, public policymakers have turned a blind eye 
to the special antitrust exemption that health insurers have enjoyed, 
to the detriment of the American people.
  We must pass this legislation, the Health Insurance Industry Fair 
Competition Act. This bill finally, after 65 years, amends the 
McCarran-Ferguson Act. Health insurers will be investigated and held 
accountable for price fixes, dividing up territories among themselves, 
sabotaging their competitors in order to gain monopoly power, and all 
anticompetitive practices. The Justice Department will have a mandate 
to prosecute this criminal activity.
  And finally, the health insurance industry will have to compete. No 
more legally protected collusion. Let the marketplace work. No more 
protection for health insurance companies from the very people who have 
been elected to protect the best interests of the people. That's us.
  The health insurance industry has gouged us long enough. They have 
increased premiums, higher copayments, higher deductibles. The health 
insurance industry, to add insult to injury, have thumbed their noses 
at both the consumers and legislators and left too many families at 
risk. In the middle of our debate about health insurance reform, health 
insurers are raising the premiums. They're denying lifesaving 
procedures. They're dropping too many of the insured who have been 
paying premiums for years if they deem the cost of their health care 
too costly. The CEOs of some of the biggest insurance companies are 
paying themselves

[[Page 1778]]

unreasonably high salaries. Most of them are earning $10 million or 
more per year.
  Ladies and gentlemen, it is time to put an end to the practices of 
the health insurance companies. That time is now. Let us stand up for 
the consumers. Let us do what the consumers elected us to do--come here 
and give some protection from these kinds of practices. Sixty-five 
years is too much, too long. The time is now. Let's get the job done. 
Let's pass this legislation.
  Mr. SMITH of Texas. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, the bipartisan and very credible Congressional Budget 
Office has said that this bill will have little or no effect on 
insurance premiums. It further says that if there is any effect, it 
will be ``quite small.''
  So I do appreciate all the comments that Members are making today, 
and I agree with a lot of them. But we should not think that any of 
them pertain to this bill, or that this bill is going to have any kind 
of a major impact on premiums.
  However, I would like to discuss one subject that will have a major 
impact on insurance premiums, and that is health care tort reform.
  The American medical liability system, quite frankly, 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 account for nearly a quarter of 
total administrative costs.
  The American civil litigation system is the most expensive in the 
world, more than twice as expensive as nearly any other country.
  Defensive medicine is widely practiced and it is very 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 Massachusetts physicians reported that they 
practiced defensive medicine. Another study in Pennsylvania put that 
figure at an astounding 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. A new study by the Pacific Research Institute estimates 
that defensive medicine costs $191 billion a year, while a separate 
study by PricewaterhouseCoopers puts the number even higher, $239 
billion every year.
  Lawsuit abuse drives doctors out of practice. There is a well-
documented record of doctors leaving the practice of medicine and 
hospitals shutting down, particularly practices that have high 
liability exposure. This problem has been particularly acute in several 
fields as well as in the rural areas of our country.
  The absence of doctors in vital practice areas is, at best, an 
inconvenience; at worst, it can have deadly consequences. Hundreds or 
even thousands of patients may die annually due to a lack of doctors.
  According to the Massachusetts study, 38 percent of physicians have 
reduced the number of higher risk procedures they provide, and 28 
percent have reduced the number of higher risk patients they serve out 
of fear of liability. The American College of Obstetricians and 
Gynecologists have concluded that the ``current medico-legal 
environment continues to deprive women of all ages, especially pregnant 
women, of their most educated and experienced women's health care 
providers.''
  Excessive litigation damages the doctor-patient relationship and 
impairs care. Beyond the dollars and cents, when doctors begin to see 
their clients as potential litigants, the quality of care patients 
receive is seriously compromised. In a recent survey, 76 percent of 
doctors said that their concern about being sued has hurt their ability 
to provide quality patient care. Nearly half of nurses say they are 
prohibited or discouraged from providing needed care by rules set up to 
avoid lawsuits.
  The States have proven that legal reform works. While some in 
Washington talk about the need to study the problem, States have 
actually acted to address it. Several States have limited noneconomic 
damages such as those for pain and suffering and dramatically lessened 
the burden of lawsuits. In States with such limits, premiums are 17 
percent lower than they are in States without them.
  Madam Speaker, I'll reserve the balance of my time.
  Mr. CONYERS. Madam Speaker, no one comes before the Judiciary 
Committee that I can think of offhand more frequently than Bill 
Pascrell of New Jersey. He's worked with us on a number of other issues 
besides this one, and we welcome his counsel. We yield him 2 minutes.
  Mr. PASCRELL. Thank you, Mr. Chairman, and thank you for your 
leadership and persistence on this critical matter.
  ``Mischaracterization,'' I think, is the word of the day. When you 
look back at the beginning of the discussions of health care, there's 
been more mischaracterizations of what was in the bill.
  But this bill that is before us, H.R. 4626, is only two pages--not 
2,000, not 2 million--two pages, very clear and to the point. So what 
this bill seems to do--if I had my way, I would have brought this bill 
up when we discussed the beginning, back last summer. But I'm one 
person. To call them out, to call out the other side, and to call out 
the other end of the building.
  I mean, we've passed 290 pieces of legislation that they haven't even 
looked at yet. And this is critical. This is to end the 
anticompetitive, antitrust exemption. Now we have a new administration. 
Talk is cheap about how we're going to bolster antitrust laws. I 
haven't seen anything yet so far, but I'm hopeful.
  In all the industries in America, there are only two that have 
antitrust exemptions--baseball, America's pastime; and the health 
insurance industry, America's nightmare--and I think it's long past 
time we get rid of their exemption.
  Now, I've heard so many terms since the parties last summer, through 
the fall, through the winter, about uncompetitiveness. We want open 
markets.
  Now we look at the system, and it's price fixing and collusion over 
and over and over again. Ninety-four percent of the health insurance 
markets are concentrated.
  Here's what that means, Mr. Chairman. In every State of the Union, 
maybe, through the Chair, there's three or four companies that are 
selling insurance, that are writing insurance. This is why we are where 
we are today. No other reason. Because there is a lack of insurance. We 
have been accused of socialism. That is the biggest joke.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. CONYERS. I yield the gentleman another 30 seconds.
  Mr. PASCRELL. We're talking about the biggest profits ever, just like 
Wall Street declared the biggest profit year they've ever had in 2009. 
That's interesting.
  We talk about we want to save the smaller insurance companies. We've 
saved nobody. In the last 60 years, all that we've done is concentrate 
power, and the result of it is higher cost to the average citizen that 
lives in my district and every district here on the floor.
  I thank you, Mr. Chairman. Be persistent. Call the other folks out at 
the other end of the building and we'll see who really cares about the 
policyholders in this country.

                              {time}  1345

  Mr. SMITH of Texas. Madam Speaker, may I ask how much time remains on 
each side?
  The SPEAKER pro tempore. The gentleman from Texas has 27 minutes, and 
the gentleman from Michigan has 33\1/2\ minutes.
  Mr. SMITH of Texas. Madam Speaker, I yield myself such time as I may 
consume.

[[Page 1779]]

  Madam Speaker, on October 9, the Congressional Budget Office 
pronounced that a tort reform or civil justice reform package would 
reduce the Federal budget deficit by an estimated $54 billion over 10 
years.
  CBO recognizes that civil justice reforms also have an impact on the 
practice of defensive medicine. Defensive medicine is when doctors 
order more tests or procedures than are necessary just to protect 
themselves from frivolous lawsuits. Studies show that defensive 
medicine does not advance patients' care or enhance a physician's 
capabilities, that billions of dollars in savings from tort reform 
could be used to provide health insurance for the uninsured without 
raising taxes on those who already have insurance policies.
  As the administration rushes to enact a massive government takeover 
of health care, Congress must remember that there is the option of 
saving between $54 billion and more than $200 billion by embracing tort 
reform, but it will take the leadership to stand up to personal injury 
lawyers instead of taxing Americans and cutting Medicare benefits.
  According to CBO, under the HEALTH Act, which includes tort reform, 
premiums for medical malpractice insurance ultimately would be an 
average of 25 percent to 30 percent below what they would be under 
current law.
  Also, the Government Accountability Office, GAO, found that rising 
litigation awards are responsible for skyrocketing medical professional 
liability premiums. The report stated that GAO found that losses on 
medical malpractice claims--which make up the largest part of insurers' 
costs--appear to be the primary driver of rate increases in the long 
run.
  The GAO also concluded that insurer profits are not increasing, 
indicating that insurers are not charging and profiting from 
excessively high premium rates, and that in most States insurance 
regulators have the authority to deny premium rate increases they deem 
excessive.
  The reason the administration continues to refuse to add serious 
medical lawsuit reform to their health care legislation remains purely 
political, as was recently revealed by former Democratic National 
Committee Chair Howard Dean. At a recent health care town hall meeting, 
Mr. Dean responded to an angry constituent who wondered why a 
supposedly comprehensive reform of the health care system doesn't 
include tort reform to lower costs of malpractice insurance and reduce 
defensive medicine.
  Mr. Dean responded, being remarkably candid, as follows: ``This is 
the answer from a doctor and a politician. Here is why tort reform is 
not in the bill. When you go to pass a really enormous bill like that, 
the more stuff you put in, the more enemies you make, right? And the 
reason why tort reform is not in the bill is because the people who 
wrote it did not want to take on the trial lawyers in addition to 
everybody else they were taking on, and that is the plain and simple 
truth.''
  Medical malpractice premiums have risen more than 80 percent each 
year in some parts of the country and can cost almost half a million 
dollars a year in some specialties.
  Regarding the offer of HHS demonstration projects--and this is what 
the administration has proposed--that offer rings hollow given that the 
Cabinet Secretary tasked with implementing this proposal for 
demonstration projects is Kathleen Sebelius. Before she was Governor of 
Kansas and the Insurance Commissioner of Kansas, she spent 8 years as 
the head of the Kansas Trial Lawyers Association, now the Kansas 
Association for Justice. And she is also the State executive who, 
according to The New York Times, ``failed to make significant 
improvement in health coverage or costs during her two terms as 
Governor.''
  The top contributor to President Obama's Presidential campaign was 
the legal industry, whose donations came to more than $43 million. More 
than 80 percent of the money given to Congress by lawyers, mostly from 
the plaintiff's bar, went to the Democrats--almost $22 million.
  More recently, when President Obama spoke to the American Medical 
Association in June of this year, he told the audience, ``I'm not 
advocating caps on malpractice awards.''
  But the American people are demanding legal reform. A recent survey 
found that 83 percent of Americans believe that reforming the legal 
system needs to be part of any health care reform plan. As the 
Associated Press recently reported, most Americans want Congress to 
deal with malpractice lawsuits driving up the costs of medical care. 
Yet, Democrats are reluctant to press forward on an issue that would 
upset a valuable political constituency, trial lawyers, even if 
President Barack Obama says he's open to changes. The AP poll found 
that 54 percent of Americans favor making it harder to sue doctors and 
hospitals for mistakes made while taking care of patients.
  Support for limits on malpractice lawsuits cuts across political 
lines, with 58 percent of Independents and 61 percent of Republicans in 
favor. Democrats are more divided. Still, 47 percent said they favor 
making it harder to sue. The survey was conducted by Stanford 
University with the nonprofit Robert Wood Johnson Foundation. In the 
poll, 59 percent said they thought at least half the tests doctors 
order are unnecessary and ordered only because of fear of lawsuits.
  That is the end of the AP story.
  Madam Speaker, the USA Today editorial board also came out in support 
of tort reform, and USA Today wrote, A study last month by the 
Massachusetts Medical Society found that 83 percent of its doctors 
practice defensive medicine at a cost of at least $1.4 billion a year. 
Nationally, the cost is $60 billion-plus every year, according to the 
Health and Human Services Department--and that's the HHS of this 
administration. And a 2005 study in The Journal of the American Medical 
Association found that 93 percent of Pennsylvania doctors practice 
defensive medicine.
  The liability system is too often a lottery; excessive compensation 
is awarded to some patients and little or none to others. As much as 60 
percent of awards are spent on attorneys, expert witnesses, and 
administrative expenses. The current system is arbitrary, inefficient, 
and results in years of delay.
  Madam Speaker, discussing the need for tort reform, the president of 
the American Medical Association said, If the health care bill doesn't 
have medical liability reform in it, then we don't see how it is going 
to be successful in controlling costs.
  Madam Speaker, I reserve the balance of my time.
  Mr. CONYERS. Madam Speaker, I am pleased now to recognize David 
Scott, the gentleman from Georgia, who has been waiting patiently to 
get time here on this. I yield him 2 minutes at the point.
  Mr. SCOTT of Georgia. Thank you, Mr. Chairman. Let me commend you for 
the excellent leadership that you have provided on this issue.
  In this debate today, the one point that has been missing is this: 
What about the American people? That's what this debate should be 
about.
  As we speak, 14,000 American citizens and families are losing their 
health care insurance every single day. And the number one reason 
they're losing it is because of the high costs of health care 
insurance. And one of the major reasons why we have the high cost of 
health care insurance is because the insurance companies do not have 
competition. And the biggest reason they don't have competition is 
because they have this shield. They are exempt from competition. That's 
why we passed the antitrust laws in the very beginning. Go back to John 
D. Rockefeller and the American Standard Oil companies. That's what it 
was all about. It was so we could have that competition.
  Now, there has been much argument on the other side about the sharing 
of this information. Madam Speaker, I call to your point and the point 
of this Congress what the Supreme Court said about the sharing of the 
information in the 1925 case of Maple Flooring Manufacturers' 
Association v. The United States. It said the pooling of statistics 
does not violate the antitrust laws. As a matter of fact, it's there, 
and it helps

[[Page 1780]]

both small and large businesses. He said it's legitimate. But they said 
the collusive joint coordination of future pricing, of output, of 
marketing decisions to take meaningful choice away from customers, to 
rob the American people of the benefits they would receive from 
competition, must not be allowed.
  That's what the antitrust provision prohibits. That's why it's 
important to us to remove it today for the American people.
  Mr. SMITH of Texas. Madam Speaker, I will reserve my time.
  Mr. CONYERS. Madam Speaker, I am pleased now to recognize the 
gentleman from Rhode Island, Jim Langevin, a former Secretary of State, 
for 2 minutes.
  Mr. LANGEVIN. I thank the gentleman for yielding.
  Madam Speaker, I rise in strong support of H.R. 4626, the Health 
Insurance Industry Fair Competition Act, which will finally require the 
health insurance industry to comply with the same Federal antitrust 
laws as virtually every other industry in the United States.
  The recent economic recession dealt a crushing blow to Rhode 
Islanders. Many are out of work and simply don't have insurance 
coverage. The ones who do are struggling to afford the perpetual rate 
increases year after year. Although Rhode Island is a State with strong 
health insurance consumer protections, this fact provides little 
comfort to the thousands of people who will lose their coverage because 
it's simply too expensive.
  Madam Speaker, we must do everything in our power to hold down the 
rising costs of insurance premiums, which includes ensuring healthy 
market competition. After all, competition is the driving force of 
economic prosperity. And even in the time of FDR and numerous Supreme 
Court decisions, it established the fact that there is a legitimate 
public policy interest in ensuring competition.
  But for over 65 years, the health insurance industry has played by a 
different set of rules, allowing them to engage in anticompetitive 
practices which drive up the costs of premiums.
  Well, this bill before us today will outlaw existing health insurance 
practices like price-fixing, bid-rigging, and market allocations that 
drive up costs for all Americans. It will protect honest competition 
from collusion and other destructive practices within the health 
insurance industry so we can achieve greater affordability, improve 
quality, increase innovation, and more consumer choice, just as the 
antitrust laws have done for the rest of the economy for over a 
century.
  Madam Speaker, Americans can no longer afford to give insurance 
companies special treatment. I urge my colleagues to vote in favor of 
the Health Insurance Industry Fair Competition Act so that we can 
finally break the vise grip that the insurance companies have on the 
lives of the American people and their health care.
  Mr. SMITH of Texas. Madam Speaker, how much time remains on each 
side?
  The SPEAKER pro tempore. The gentleman from Texas has 20 minutes. The 
gentleman from Michigan has 29\1/2\ minutes.
  Mr. SMITH of Texas. I will reserve my time.
  Mr. CONYERS. Madam Speaker, I am very pleased to recognize the most 
experienced member of the civil rights struggle in the 20th century, 
the gentleman from Georgia, John Lewis, a strong advocate of universal 
health care, and I yield him 2 minutes.

                              {time}  1400

  Mr. LEWIS of Georgia. Thank you, Mr. Chairman, for yielding.
  Madam Speaker, I still believe that health care is a right and not a 
privilege, and this Congress must not rest until we make health care a 
reality for all Americans. I know we will get the job done for the 
American people, but until that day comes, we must do what we can to 
make health insurance work for people who depend on it.
  This bill, this piece of legislation is long overdue. The health 
insurance industry has been treated differently for over 60 years, and 
they have abused that privilege. In too many States there is no 
competition and no choice for consumers.
  Insurance companies are raising rates, denying care, and dropping 
people when they get sick, all the while making record profits. We need 
to put people first and not profits.
  For too long, insurance companies have had the upper hand. It is not 
fair, it is not just, and it is not right. Today, at this hour, we 
said, ``No more.'' It is time to repeal the antitrust exemption and put 
the American people first.
  Mr. SMITH of Texas. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, President Obama's own doctor of over two decades also 
supports medical tort reform. David Scheiner was Mr. Obama's doctor 
from 1987 until he entered the White House. He vouched for the then-
candidate's excellent health in a letter last year. This was recently 
reported in Forbes Magazine. Dr. Scheiner worries about whether the 
health care legislation currently making its way through Congress will 
actually do any good, particularly for doctors like himself who 
practice general medicine. ``I am not sure Obama really understands 
what we face in primary care,'' Dr. Scheiner says.
  One of the Nation's top surgeons, with credibility and acclaim the 
world over for the pioneering surgeries he has and his personal story 
of overcoming hardship, recently severely criticized the health care 
legislation before Congress. Benjamin Carson, Director of Pediatric 
Neurosurgery at the Johns Hopkins Children's Center in Baltimore, 
Maryland, and recipient of numerous awards, including the Presidential 
Medal of Freedom, criticized, in a recent interview, the current bill's 
lack of malpractice liability reform.
  He pointed to excessive litigation, pointing out how much malpractice 
insurance and other forms of defensive medicine to protect against 
lawsuits add to medical costs. In an interview with a local television 
station, Carson insisted that tort reform must go hand in hand as part 
of any true health care reform.
  ``We have to bring a rational approach to medical litigation. We're 
the only nation in the world that really has this problem. Why is it 
that everybody else has been able to solve this problem but us? Simple. 
Special interest groups like the trial lawyers association. They don't 
want a solution.''
  As Stanley Goldfarb, MD, and Associate Dean of Clinical Education at 
the Pennsylvania School of Medicine has written: ``The President points 
to for-profit insurance companies, but for-profit insurance companies 
only make up 25 percent of the system, and they are not that 
profitable, ranking 85th among all U.S. industries. `Reform' will 
redistribute the money, not reduce the overall costs. There is much 
that can be done to make our system more efficient. Tort reform is a 
great place to start.''
  Even prominent Democrat strategist Bob Beckel has conceded medical 
tort reform is essential, recently writing that CBO has reviewed the 
few credible reports that do exist and concluded: ``A number of those 
studies have found that State-level tort reforms have decreased the 
number of lawsuits filed, lowered the value of claims and damage awards 
. . . thereby reducing general insurance premiums. Indeed, premiums 
fell by 40 percent for some commercial policies.''
  From a CBO report in June 2004, one irrefutable fact remains: Between 
1997 and 2007, medical tort costs, including insurance premiums, have 
risen from $15 billion to $30 billion a year. That fact alone should 
ensure that yearly savings in the billions for medical tort reform 
would pass the credibility test.''
  As Kimberley Strassel has written in The Wall Street Journal: Tort 
reform is a policy no-brainer. Experts on left and right agree that 
defensive medicine--ordering tests and procedures solely to protect 
against Joe Lawyer--adds enormously to health costs. The estimated 
dollar benefits of reform range from a conservative $65 billion a year 
to perhaps $200 billion a year. In context, Mr. Obama's plan would cost

[[Page 1781]]

about $100 billion annually. That the President won't embrace even 
modest change that would do so much, so quickly, to lower costs has 
left Americans suspicious of his real ambitions.
  It's also a political no-brainer. Americans are on board. Polls 
routinely show that between 70 percent and 80 percent of Americans 
believe the country suffers from excess litigation. The entire health 
community is on board. Republicans and swing-State Democrats are on 
board. State and local governments, which have struggled to clean up 
their own civil justice systems, are also on board.
  Mr. Speaker, Republican-sponsored legislation would make Federal law 
the same legal reforms California implemented over 30 years ago. That 
legislation, called the HEALTH Act, remains the gold standard for 
health care legal reform, and it continues to be supported by every 
major medical association.
  The HEALTH Act does not limit in any way an award of ``economic 
damages'' from anyone responsible for harm. Economic damages include 
anything whose value can be quantified, including lost wages or home 
services, including lost services provided by stay-at-home mothers, 
medical costs, the cost of pain-reducing drugs, therapy and lifetime 
rehabilitation care, and anything else to which a receipt can be 
attached.
  Only economic damages, which the Federal legislation does not limit, 
can be used to pay for drugs and services that actually reduce pain. 
So, nothing in the HEALTH Act prevents juries from awarding very large 
amounts to victims of medical malpractice, including stay-at-home 
mothers and children. California's legal reforms, just like the HEALTH 
Act, cap noneconomic damages at $250,000 but do not cap quantifiable 
economic damages.
  The administration's health care bill not only fails to contain any 
of the tort reforms that CBO concluded would save at least $54 billion 
in health care costs, but it also contains a provision that actually 
deters States from enacting such reforms in the future by explicitly 
prohibiting tort reform ``demonstration project'' funds to States that 
enact limits on damages or attorneys' fees.
  One section of an earlier bill states that ``the Secretary of HHS 
shall make an incentive payment . . . to each State that has an 
alternative medical liability law in compliance with this section,'' 
but then goes on to say a State can take advantage of such funds only 
if ``the law does not limit attorneys' fees or impose caps on 
damages,'' which are precisely the tort reforms the CBO concluded yield 
real health care cost savings.
  Mr. Speaker, so not only does the administration's bill fail to 
contain any of the tort reforms we know bring health care costs down 
from decades of experience, but it even prohibits States that want to 
try such reforms from taking part in the government-funded tort reform 
demonstration projects. This is not only a blow to State reform 
efforts, it is a federally funded bribe discouraging States from 
enacting real reform, and, of course, it is a giant bailout for trial 
lawyers.
  Mr. Speaker, I reserve the balance of my time.
  The SPEAKER pro tempore (Mr. Serrano). The Chair will note that the 
gentleman from Texas has 13 minutes remaining and the gentleman from 
Michigan has 28 minutes remaining.
  Mr. CONYERS. Mr. Speaker, I am pleased now to recognize the 
distinguished Member of the House who has had insurance experience as a 
State commissioner, Earl Pomeroy of North Dakota, for 2 minutes.
  Mr. POMEROY. I thank the chairman for yielding for the purpose of a 
colloquy.
  I would like to thank Chairman Conyers, Congressman Tom Perriello of 
Virginia, Congresswoman Betsy Markey of Colorado, and others for their 
leadership in bringing to the floor this important bill aimed at 
creating greater competition in the health insurance marketplace in 
order to promote greater affordability, improve quality, and greater 
consumer choice.
  In particular, I appreciate that the bill is narrowly tailored to 
repeal the McCarran-Ferguson antitrust exemption only for the business 
of health insurance. But despite the clear wording of the bill, I have 
heard concerns from some that courts might somehow interpret the bill 
broadly to include nonhealth lines of insurance such as life insurance, 
long-term care insurance, disability income insurance, even property/
casualty insurance.
  As one of only two former State insurance commissioners in the U.S. 
House of Representatives, I know health insurance is different than 
these other insurance lines. I would appreciate, Mr. Chairman, your 
confirmation of my understanding that the bill we are now debating does 
not apply to any insurance except for health insurance, and your 
expectation that courts will interpret it properly to not include 
nonhealth lines of insurance.
  Is the gentleman's understanding of my expectation correct?
  Mr. CONYERS. If the gentleman will yield, I want to commend him for 
clearing up something that perhaps in more reasonable circumstances 
should not need to be cleared up.
  I still have confidence in the courts that they can read the simple 
understanding that when we say ``health insurance,'' we don't mean life 
insurance. I mean, this is getting pretty fundamental here. But, of 
course, you are correct, Mr. Pomeroy. It's health insurance only; no 
disability income insurance, no long-term care insurance, no property 
insurance.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. CONYERS. I yield the gentleman an additional 1 minute.
  Mr. POMEROY. I yield to the chairman.
  Mr. CONYERS. No casualty insurance, no other kind of insurance but 
the one plainly listed in a two-page bill. So my confidence in the 
courts is unrestricted that they can get this right.
  The lack of a statutory definition is intended solely to give the 
courts the ability to ensure that all forms of health insurance are 
appropriately included so that unreasonable and artificial distinctions 
do not arise between two essentially equivalent kinds of insurance 
products and how they are treated under antitrust laws.
  I am glad that the gentleman raised this issue in the hearings.
  Mr. POMEROY. I thank the chairman.
  Reclaiming the time, I believe the chairman's words are very clear 
and will make a very clear part of the legislative record on this bill.
  Mr. SMITH of Texas. Mr. Speaker, I reserve the balance of my time.
  Mr. CONYERS. Mr. Speaker, I yield 3 minutes to the gentleman from 
Virginia who has done so much in working with the committee on this 
bill, Mr. Perriello, who has been great.
  Mr. PERRIELLO. Thank you, Mr. Chairman, thank you to Chairwoman 
Slaughter, as well, for their great leadership on this bill. This is a 
great day.
  It's a great day for consumers, it's a great day for competition, and 
it's a great day for common sense. I am new to Washington, and I know 
this is a town full of grays, but sometimes things are as simple as 
black and white. This is a chance for people to decide whether they 
stand for patients or whether they stand for the profiteering of health 
insurance monopolies, whether they stand for competition or for 
collusion.
  This is a victory for common sense in the midst of the health care 
reform debate. Only inside the beltway would those people argue that 
the best way to protect competition is to protect monopolies. Only 
inside the beltway would people try to argue that the best way to help 
the little guy is to make sure that we protect monopolies.
  The status quo is not working for the small insurers. There are those 
with very good intentions who want to talk about safe harbors, but I 
have not had constituents come up to me and say, Congress, please have 
more carve-outs. Congress, please have more exemptions and exceptions, 
please make the bills even longer. Here we have a two-page bill, 24 
lines long--one that is supported by conservatives and liberals

[[Page 1782]]

alike in my district--that makes a simple rule that health insurance 
companies should have to play by the same rules as everyone else.
  If two plumbers in my district get together and start to collude and 
set prices, they will go to jail. Why should the biggest health 
insurance companies in the country not have to play by the same rules? 
People say to us, How about a shorter bill? Two pages. People say to 
us, What about bipartisanship? Well, in 2007, all of the attorneys 
general across the country, without a single dissenting vote across 
party lines, said we want this bill. We want more Federal power for us 
to be able to go after these monopolies that are sticking it to 
consumers.

                              {time}  1415

  This will not solve every problem in the health care debate, but if 
we can't come together and agree on something this simple--pro-
competition, pro-consumer, two pages long--how will we ever come 
together on anything?
  It is estimated to save consumers $10 billion. In States that have 
removed such protections before, premiums have risen at one-fifth the 
rate of other folks. This means real money in the pockets of working 
and middle class Americans. Voters say, who is standing up for us--
working and middle class Americans who play by the rules--instead of 
for the interest groups? Here is a chance for a victory for common 
sense and for consumers.
  If you are a health insurance company and you are not engaged in 
monopolistic practices, you're not colluding, you have nothing to worry 
about. But if you are, be afraid, be very afraid, because you are no 
longer going to enjoy the monopoly protections you have enjoyed for 65 
years.
  We are going to stand up for patients today with no loopholes and no 
monopolies to ensure a basic sense of accountability, competition, and 
Main Street values, and maybe take one step forward towards 
bipartisanship and common sense in this health care reform debate.
  Mr. SMITH of Texas. Mr. Speaker, I reserve the balance of my time.
  Mr. CONYERS. Mr. Speaker, I would like to yield to Paul Kanjorski of 
Pennsylvania for a unanimous consent request.
  Mr. KANJORSKI. Mr. Speaker, I rise in support of H.R. 4626.
  Mr. Speaker, as the Chairman of the House Financial Services 
Subcommittee on Capital Markets, Insurance and Government Sponsored 
Enterprises and on behalf of the Financial Services Committee and its 
Chairman (the gentleman from Massachusetts, Mr. Frank), I would like to 
thank the Chairman of the Judiciary Committee (the gentleman from 
Michigan, Mr. Conyers), the gentleman from Virginia (Mr. Perriello), 
the gentlewoman from Colorado (Ms. Markey), and others for their 
leadership in bringing this important legislation to the floor. I also 
appreciate their cooperation with the Financial Services Committee--
which has primary jurisdiction over most insurance regulatory issues, 
except for health insurance matters--in developing this bill. In 
particular, I appreciate that the legislation before us is narrowly 
tailored to repeal the McCarran-Ferguson antitrust exemption only for 
the business of health insurance.
  Today, Congress is engaged in robust debate on reforming the health 
insurance marketplace for the nation. There are also many additional 
types of insurance that impact citizens' lives on a daily basis. When 
looking broader at insurance regulatory reform and allowing insurers to 
cross state lines, Congress should look at these matters 
comprehensively across all lines of insurance. I look forward to 
working together with House leadership and multiple committees on these 
important matters in the future.
  Mr. CONYERS. Mr. Speaker, I recognize the distinguished Member who 
allowed us to testify in his subcommittee on universal single-payer 
legislation, Rob Andrews of New Jersey, and I yield him 2 minutes.
  Mr. ANDREWS. Mr. Chairman, thank you for your leadership on this 
bill. I would like to thank and congratulate Mr. Perriello, Ms. Markey 
and Ms. Slaughter for their leadership.
  Members of the House have a choice to make this afternoon: If you 
believe that the Members of the two parties can work together to solve 
a problem in our health care system, then the correct vote is ``yes''; 
if you believe that there can be simple and clear solutions that do not 
involve thousands of pages of legislative language, then the correct 
vote is ``yes''; if you believe that health insurance companies should 
be held to the same standard that car dealers, supermarkets, television 
networks, candy stores, all kinds of people are held to in this 
country, then the correct vote is ``yes.''
  The choice here is competition versus crony capitalism. Competition 
means the best competitors get the market share and get the business. 
It means that health insurance companies cannot meet behind closed 
doors and fix the prices of their product. We've seen enough of crony 
capitalism on Wall Street, we have seen enough of crony capitalism in 
our banking industry, and I think we've seen more than enough of crony 
capitalism in health insurance.
  This is the chance for the Members to come together and say we want 
the health insurance industry to compete for the business of the 
American people the same way everybody else does. It is pro-consumer, 
it is pro-competition. It should be profound evidence that the two 
parties can work together and start to solve the health care problem.
  I congratulate the authors. I would urge my friends on both sides to 
vote ``yes'' in favor of this bill.
  Mr. SMITH of Texas. Mr. Speaker, I reserve the balance of my time.
  Mr. CONYERS. Mr. Speaker, I am now pleased to recognize Betsy Markey 
of Colorado. She has done yeoman's work on this measure in her first 
term, and I will yield her 3 minutes.
  Ms. MARKEY of Colorado. Thank you, Mr. Chairman, for your work on 
this very important bill.
  A few years ago, before I ever even decided to run for Congress, I 
owned a small coffee shop in Old Town, Fort Collins. As a business 
owner, I knew that my success or failure depended on my business plan 
and my ability to compete. None of the other shopowners needed the 
government to offer them some sort of special protection in order to 
survive. Capitalism is the basis of our democracy, and a competitive 
marketplace is at the heart of capitalism.
  Since 1945, just two industries have enjoyed special protection from 
antitrust laws by the United States Government: Major League Baseball 
and the health insurance industry. Since Americans don't rely on 
baseball tickets to vaccinate their children or get cancer screenings, 
the gentleman from Virginia and I felt it important that we tackle the 
special protections offered to the health insurance industry today.
  I consider myself a pragmatic person. I think companies should be 
left alone to succeed or fail based on the fitness of their business 
plan and on the quality of the products they offer to consumers, not 
because they got a special deal from Washington.
  I believe that consumer protection laws keep our markets competitive 
and are crucial to our democracy and economy, and that the exceptions 
offered to the insurance industry for over half a century leave the 
doors wide open to price-fixing that can't be regulated.
  If any Member of this body were to come and suggest that the United 
States Government give one industry immunity from protection and from 
price-fixing, the outrage from the American public would be swift and 
heartfelt. It is not fair that small business owners across America--
many of them struggling to survive in today's economy--have to play by 
a separate set of rules.
  The underlying premise of this bill is not a partisan issue. 
Prominent Members of both parties have advocated removal of McCarran-
Ferguson for 2 years. In 2007, Senator Trent Lott cosponsored 
legislation with Patrick Leahy that would have repealed an even broader 
swath of antitrust exemptions benefiting the entire insurance industry. 
At the same time, Senator Lott made the astute point that if the 
industry were not engaging in price-fixing, it wouldn't have to worry 
about losing its antitrust exemption.
  When Lott testified before the Judiciary Committee in 2007, he said, 
``I cannot for the life of me understand why we have allowed this 
exemption to stay in place so long.'' Perhaps even

[[Page 1783]]

more telling, the National Association of Attorneys General strongly 
supports the repeal of McCarran-Ferguson. One assistant attorney 
general noted, ``The most egregiously anticompetitive claims, such as 
naked agreements, fixing price, or reducing coverage, are virtually 
always found immune'' from prosecution under the law.
  The SPEAKER pro tempore. The gentlewoman's time has expired.
  Mr. CONYERS. I yield the gentlewoman an additional 30 seconds.
  Ms. MARKEY of Colorado. For years, one industry has enjoyed an unfair 
advantage over every other business in the United States. I don't think 
this has anything to do with being a Republican or a Democrat, I think 
it has to do with being fair.
  Mr. SMITH of Texas. Mr. Speaker, I yield myself 1 minute.
  Mr. Speaker, we have heard several speakers in the last few minutes 
say that there are only two industries exempted from the antitrust 
laws, insurance and baseball. This, of course, is not true. There are 
more than 20 such exemptions. If the majority is intent on eliminating 
simple exemptions, perhaps they would be willing to eliminate the labor 
union's antitrust exemption as well.
  I reserve the balance of my time.
  Mr. CONYERS. Mr. Speaker, Mary Jo Kilroy of Ohio has worked hard on 
this legislation, and I would like to recognize her for 2 minutes.
  Ms. KILROY. Thank you, Chairman Conyers, for allowing me this 
opportunity. Also, I want to give thanks to the work of my freshman 
colleagues, Tom Perriello and Betsy Markey, for their work on this 
important piece of legislation that I am very proud to be a cosponsor 
of.
  I have been listening to this debate this afternoon, and it is very 
surprising--and actually highly ironic--to hear the opposition from the 
Republican side of the aisle to a bill that would simply make the 
health insurance industry operate fairly in a competitive marketplace. 
After all, it was a great Republican President, Teddy Roosevelt, who 
was the great trust buster, the one who brought antitrust principles 
into American jurisprudence and legislation. And as we have heard this 
afternoon from others, versions of this bill have had bipartisan 
support over the course of the years when there have been attempts to 
introduce antitrust legislation addressing this issue with respect to 
the health insurance industry. After all, competition is the engine 
that drives our economy, spurs innovation, and ensures that the 
American consumer would receive a fair deal. But for far too long the 
insurance industry has been able to avoid accountability by dividing up 
the territories among themselves like the robber barons once did on the 
backs of ordinary Americans.
  I also serve with several of my colleagues on the Competitiveness 
Task Force, and I know that for our economy to regain its footing, we 
need central Ohio and American business to be competitive, something 
this bill will help to ensure.
  This bill is needed because the health insurance industry is sick, 
and we need to fix it. We know that we have an unhealthy insurance 
system because we see that the signs and symptoms are there. Ninety-six 
percent of all health insurance markets are highly concentrated, 
meaning consumers have little or no choice between insurers, and it is 
too easy for insurance industries to conspire on practices.
  I urge my colleagues to support passage of the Health Insurance 
Industry Fair Competition Act.
  Mr. SMITH of Texas. Mr. Speaker, I yield 5 minutes to the gentleman 
from California, the former Attorney General of that State, Mr. 
Lungren. 
  Mr. DANIEL E. LUNGREN of California. I thank the gentleman for 
yielding.
  Mr. Speaker, as I've said repeatedly--and perhaps the gentlelady from 
Ohio who just spoke didn't hear--I support the bill. I think she also 
heard--well, maybe she wasn't here to hear the ranking Republican say 
he is not going to oppose the bill, so let's be clear about what we're 
talking about here.
  While I do support this bill and while I do think it could be 
perfected and while I hope that the motion to recommit will be adopted 
to actually make it a better bill, I would say, however, this is not 
the first bill we should have on the floor dealing with the overall 
issue of health care. The first one should be the one the American 
people have asked us to look at, and that is reform of the medical 
malpractice system.
  The interesting thing is, as the gentleman from Texas pointed out, 
that in the bill that we have in the Senate and the House, there is 
reference, as the President of the United States said, to medical 
malpractice litigation alternatives. That bill does give incentives, 
financial incentives, Federal moneys from the Federal Government to the 
States if they will engage in alternatives to the litigation system in 
areas of medical malpractice. But as the gentleman from Texas pointed 
out, there is a kicker in there, and it says that if your State dares 
to in any way put any limitations on attorneys fees or on any part of 
the recovery in medical malpractice cases, that State will be 
ineligible for the funds; in other words, you will be punished relative 
to other States.
  Now, the gentleman from Texas referred to the landmark legislation we 
had in California called MICRA, which was adopted in the mid-1970s at a 
time when we had a crisis in medical malpractice premiums. We actually 
had an exodus of doctors, particularly in the specialties. 
Neurosurgeons, I remember anesthesiologists, other high specialties 
with high-risk practices were actually leaving the State of California 
because of the significant increase in premiums on a yearly basis as a 
result of the true historical data of what was happening in the courts.

                              {time}  1430

  I recall at this time, because I actually did some representation in 
the courts of doctors and hospitals and of even a couple of plaintiff 
cases--but primarily defense cases--that it was becoming a crisis.
  So, in California, it came together on a bipartisan basis, and we 
passed legislation better known as MICRA. In there, we have a 
limitation on a sliding scale on the amount of money that can go to the 
attorneys, and it's a slightly higher percentage at the lower 
recoveries. As the recovery gets larger and larger, the percentage of 
return to the attorneys, percentage-wise for that segment of the 
recovery, is less.
  While putting no limitation whatsoever on recovery for loss of income 
and for all medical costs, there was a cap put on noneconomic damages. 
As one who has been in the courtroom and has seen what happens, that is 
logical because the one area in which you saw extraordinary amounts of 
money that really were not truly indicative of approvable damage--I'm 
not saying there isn't pain and suffering, but trying to quantify it is 
extremely difficult, and it proved to be impossible, and it proved to 
be the area in which you had the outrageous jury verdicts that had the 
impact of distorting the system. So California adopted both of those.
  In other words, the bill that has been presented by the President and 
Democrats in the House and the Senate not only does not really deal 
with reform of the medical malpractice system, but it takes us back 
more than 30 years to the position in which we were then when we had 
not an academic exercise about the possibility of a crisis but a true 
crisis. We literally had a crisis in medical care in the State of 
California until we enacted this change.
  So that is why it is at least as strange to ask and to see why we 
don't have some litigation reform moving through our Judiciary 
Committee and through the other committees that may have jurisdiction 
in the House of Representatives and placed on the floor. That's why it 
was very important for the gentleman from Texas to make reference to 
the California system, because that is one that has worked, and it 
specifically is the one that is singled out in the legislation that the 
President supports to be punished. Now, if that is not irony, I don't 
know what is.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. SMITH of Texas. Mr. Speaker, I yield the gentleman an additional 
1 minute.

[[Page 1784]]


  Mr. DANIEL E. LUNGREN of California. So I would just hope that people 
would understand, as important as this bill is, that we should be at 
least listening to the American people, who have said number one on 
their issue list in dealing with this problem, as they see it, as they 
understand it, as they are affected by it, is the reform of the medical 
malpractice litigation system as it currently exists.
  So it is somewhat disappointing that we don't have that even on the 
horizon. I think the gentleman, the ranking member on the committee, 
would agree we haven't seen anything on this subject that has been 
scheduled for our committee.
  While I support this legislation--and let me repeat that--I support 
this legislation. I think it is good legislation. I think it may have a 
slightly bigger impact than, maybe, my ranking member thinks it will 
have, although not as large an impact as suggested by the other side. I 
would hope that the other side would look with open eyes and would 
listen with open ears to our motion to recommit because I think it will 
make a better bill, will clear up some definitions that are not defined 
in this bill and will help us move in the right direction.
  Mr. CONYERS. Mr. Speaker, I yield 2 minutes to the leader of the 
Progressive Caucus in the House for so many years, the gentlewoman from 
California, Lynn Woolsey. 
  Ms. WOOLSEY. Thank you, Congressman Conyers, for your great 
leadership.
  Mr. Speaker, can you imagine the health care industry being exempt 
from the McCarran-Ferguson antitrust rules right now, particularly 
after Anthem raised their rates 39 percent a couple of weeks ago when 
their parent company had just announced that they had had--I believe it 
was 2.9--around a $2 billion profit last quarter, and when one of their 
subsidiaries has to raise their rates 39 to 40 percent?
  H.R. 4626 will lift the antitrust exemptions that health insurance 
companies have enjoyed for far too long. It will protect us from the 
Anthems of the world. These exemptions have given the companies a near 
monopoly control of health insurance markets--preventing meaningful 
competition, competition that would bring down the cost of premiums and 
competition that would make health care affordable for all Americans, 
which we know is not right now. Through the lifting of the insurance 
companies' antitrust exemptions and through the creation of an 
exchange, we will increase competition. The insurance industry will 
then have to control their costs, control their premiums and control 
their copays because they will have competition.
  Another important way to increase competition is to give the American 
people a choice, a choice of a public health insurance option--an 
option that will compete with private health insurance companies and 
will bring down the costs of premiums and the costs of coverage.
  The CBO, the Congressional Budget Office, has stated that a public 
option would save at least $25 billion if we included that right now in 
our health care bill. That $25 billion could be used for subsidies to 
ensure the affordability of all health insurance plans.
  Mr. SMITH of Texas. Mr. Speaker, I have no further requests for time 
on this side, and I am prepared to close at the appropriate time.
  I reserve the balance of my time.
  Mr. CONYERS. Mr. Speaker, I yield 2 minutes to the distinguished 
gentleman from California (Mr. Garamendi).
  Mr. GARAMENDI. Chairman Conyers, thank you so very much.
  Mr. Speaker, I keep thinking about that movie ``Casablanca.'' The guy 
says, I am shocked to learn that the Republican Party that has 
championed itself with the free market economy would oppose a measure 
that would, in fact, allow for competition.
  Now, a lot has been said on the floor today, but the fact of the 
matter is--and I spent 8 years of my life as the insurance commissioner 
in California, and I am here to tell you that the insurance companies, 
using the exemption from the antitrust laws, are able to conspire to 
fix prices on premiums and on payments to doctors. That has been proved 
in cases, national cases, brought by States and by private attorneys as 
well as by the attorney general of New York.
  Similarly, they are able to vertically integrate. In a case that took 
place in New York, where UnitedHealthcare owns a company called 
Ingenix, which actually sets the reimbursement rates, they are able to 
have a serious conflict of interest. The lower the normal reimbursement 
rates, the more the copay to consumers.
  So there are varieties of practices that take place in the insurance 
industry, practices which are anticompetitive and anticonsumer. What we 
are doing here is very simple and very, very straightforward. It is 
this:
  Under the antitrust laws that have been in place since Teddy 
Roosevelt is a long history of people pushing back against the powerful 
interest groups--in this case, the powerful interest groups of the 
insurance industry. It is time for us to simply say, You must compete 
as every other part of the American economy must. Vertical integration 
to the detriment of consumers: not allowed. Price-fixing on selling the 
products: not allowed. Not able to use that market power to set prices 
on the payment to doctors and hospitals. All of those things have taken 
place. The proof is there.
  With regard to the States' ability to do this, yes, many States do 
have antitrust laws, and we are thankful for that, but the Federal 
Government, the Federal Attorney General, is precluded from involving 
in the matter of competition in this industry.
  Mr. CONYERS. Mr. Speaker, I yield 2 minutes to a former member of the 
House Judiciary Committee, the gentlewoman from Ohio, Betty Sutton. 
  Ms. SUTTON. Thank you, Mr. Chairman, for the time.
  Mr. Speaker, I rise in strong support of this bill, to repeal the 
antitrust exemption for health insurance companies.
  For far too long, the health insurance industry has been exempted 
from playing by the rules that most other American businesses must live 
by. Since 1945, they have been operating beyond the reach of these 
important consumer protection laws. The result has been excessive 
consolidation in the health insurance industry and the insurance 
companies taking advantage of honest, ordinary Americans. This 
legislation will finally put an end to insurance company collusion, and 
it will bring much needed competition to the industry.
  According to the Consumer Federation of America, repealing these 
antitrust exemptions will save consumers more than $40 billion in 
insurance premiums. I, for one, want consumers to save that money. The 
families that I proudly represent have the right to be confident that 
the cost of their insurance and the actions of their health insurance 
providers are reflective of competitive market conditions, not of 
collusion.
  This bill is a historic step to ensure competition in the insurance 
industry and to provide access to quality, affordable health care for 
all Americans. Now, who would be against that?
  The choice is clear and easy. It is a two-page bill, easily 
understood, hard to mischaracterize. A vote for the bill is a vote for 
our constituents. A vote against the bill is doing exactly what the 
insurance industry wants. Let's think about that. For our constituents 
versus for the health insurance industry. It's an easy choice. Because 
the American people need all of us to be on their side, I urge people 
on both sides of the aisle to vote for this bill.
  Mr. CONYERS. Mr. Speaker, I yield 2 minutes to the gentleman from 
Canton, Ohio, John Boccieri.
  Mr. BOCCIERI. Thank you, Mr. Chairman.
  Mr. Speaker, the American people have asked for common sense in their 
government, but all too often it is just not that common.
  You see, our friends on the other side have asked for simplicity, for 
substance, and for competition in the health care debate, but only in 
Washington will we argue that competition

[[Page 1785]]

doesn't reduce costs. Only in Washington will we argue that we haven't 
had time to read a two-page bill. Only in Washington will we argue 
process over results for consumers.
  What does it mean for consumers in Ohio?
  Well, let me tell you, small businesses in Ohio, their premiums have 
risen about 129 percent. There are 7.4 million people in Ohio who get 
their insurance on the job, averaging about $13,000. Small businesses 
make up 72 percent of all business in Ohio, while only 47 percent of 
them can afford to offer health insurance for their people.
  We have seen 400 mergers in the health care industry over the last 14 
years, so 95 percent. According to the Department of Justice, health 
insurance markets are highly concentrated. It means there is collusion. 
It is simple economics. We increase competition. We lower prices.
  On this matter, we have to know who we will stand with at this hour. 
Are we going to stand for families or are we going to stand for 
monopolies? Are we going to stand for competition or are we going to 
stand for price-fixing and collusion? Are we going to be Congress men 
and women who stand for consumers and for open markets or are we going 
to be Congress men and women who stand for collusion and corruption in 
the industry? There are not all bad actors out there, but on this day, 
at this hour, we need to stand with consumers.
  Mr. CONYERS. Mr. Speaker, this has been an important debate, and I 
would like to take this opportunity to commend the leader of the 
Republicans in the House, and especially one Member on the Judiciary 
Committee, Lamar Smith.
  We have had a very civil debate. I think, in the course of the 
incredible amount of time that we have been allotted for this bill, 
that we have reached closure on some issues. There are now more things 
that we agree to on both sides of the aisle than there are things that 
we may have differences about.

                              {time}  1445

  I attribute it to the goodwill and the cooperation of my Republican 
colleagues on the House Judiciary Committee. I also solicit their vote, 
but I will respect any way that they may choose to dispose of this 
matter and our friendship will not be diminished or impaired in any way 
whatsoever.
  Now, Lamar Smith mentioned the fact that there were other exemptions, 
and to be perfectly candid, I did not know that there were more than 
two exemptions, and it turned out that there are. As a matter of fact, 
there are 27. But many of them--and I haven't researched this yet. Many 
of them are partial exemptions. Many of them are very small exemptions 
that are very limited in terms of the economic scope of our reach in 
the United States. But they, nevertheless, exist.
  Mr. Smith may remember that the baseball antitrust exemption was 
given very close scrutiny only 2 or 3 years ago, and it reminded them 
of the fact that their conduct hadn't always been such that deserved a 
continuation of the exemption, and I'm hopeful that baseball will still 
deserve it.
  But here in the field of health care, I think it's hard to defend any 
argument that the health insurance industry deserves or requires or 
needs an exemption, and for that reason I am urging all of my 
colleagues to examine this two-page bill and scrutinize it. Let's see 
if we can get a refreshingly large bipartisan vote that could lead the 
American people to reflect on the fact that we can be liberals and 
conservatives without rancor or animosity or personalizing our 
philosophical differences, and that's the appeal that I offer to my 
colleagues on the other side.
  There are those that wonder if this would create some kind of a chill 
or curtailment of creativity if this exemption were removed, and I 
don't think that that is very logical. We think that the antitrust laws 
are fairly elementary. They don't conspire against competition. They 
don't try to reserve creativity. We want competition, and it is the 
exemption from antitrust liability that this becomes very, very 
critical.
  Mr. Speaker, I reserve the balance of my time.
  Mr. SMITH of Texas. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, first of all, let me thank Chairman Conyers for his 
comments. He is always gracious in making those. He is right. We have 
had a good discussion today about this particular piece of legislation. 
And I also want to say that he and I have a very good working 
relationship on the Judiciary Committee as well.
  In regard to this bill, Mr. Speaker, I have to say that as much as 
some might hope that it did something or hope that it accomplished 
something or might wish that the bill did something or might pretend 
that the bill did something, in point of fact, the Congressional Budget 
Office disagrees. Members are free to wish upon a star, but this bill 
is a dim bulb.
  Mr. Speaker, the Congressional Budget Office says that ``whether 
premiums would increase or decrease as a result of this legislation is 
difficult to determine, but in either case, the magnitude of the 
effects is likely to be quite small.'' ``Quite small.''
  So, Mr. Speaker, what's the point of this bill? CBO goes on to say 
that premium reductions from this bill are likely to be small because 
``State laws already bar the activities that would be prohibited under 
Federal law if this bill was enacted.''
  So again, Mr. Speaker, what's the point of this bill?
  I could list all the reasons why this bill is ineffective, useless, 
unproductive, pointless, futile, and meaningless. Instead, I would like 
to highlight something we could do to actually drive down health care 
costs.
  Last October, the CBO concluded that a tort reform package consisting 
of reasonable limits on frivolous lawsuits would reduce the Federal 
budget deficit by an estimated $54 billion over the next 10 years. That 
$54 billion in savings from tort reform could be used to provide health 
insurance for many of the uninsured without raising taxes on those who 
already have health insurance policies.
  Also, according to the CBO, under a Republican-sponsored health care 
tort reform bill called the HEALTH Act, ``premiums for medical 
malpractice insurance ultimately would be an average of 25 percent to 
30 percent below what they would be under current law.''
  And a GAO report stated that ``losses on medical malpractice claims, 
which make up the largest part of insurers' costs, appear to be the 
primary driver of rate increases in the long run.''
  Mr. Speaker, rather than spend time on a bill that the CBO said would 
yield a ``quite small,'' if any, change in health care premiums, we 
should instead take up a bill the CBO concluded would save us $54 
billion. The American people deserve real health care reform, not a 
feeble and feckless substitute.
  Mr. Speaker, I yield back the balance of my time.
  Mr. CONYERS. Mr. Speaker, I yield 1 minute to the gentleman from 
Maryland, Mr. Frank Kratovil.
  Mr. KRATOVIL. Mr. Speaker, for months we have been debating how to 
improve the health care system. We have focused on two major goals: One 
is increasing the number of those who have coverage, and the second 
major goal is doing what we can to reduce the costs for those that do. 
One way, obviously, to accomplish these goals is to increase 
competition. In fact, it's one of the few areas where, in this debate, 
we have seen bipartisanship. There have been recommendations, various 
recommendations, on how to do that. One is the bill that we have today. 
There have been other suggestions, allowing for competition across 
State lines.
  The point is we all know that one of the ways to accomplish the major 
goals that we seek to accomplish is to create competition, and that is 
what this bill does. We need to ask the question: Why would we allow 
this exemption to continue when we do not do that for other industries? 
Why would we do that when no public interest is served by doing so?
  Now, this may not be the silver bullet, but certainly everyone agrees 
that

[[Page 1786]]

in order to improve our health care system, we must increase 
competition. That's not a partisan issue. That's what this bill does. 
And for that reason, I ask my colleagues to support it.
  Mr. CONYERS. Mr. Speaker, Nancy Pelosi is the first female Speaker of 
the House in American history. She is the third ranking person in our 
Federal Government. And we are all honored to recognize her for 1 
minute at this time.
  Ms. PELOSI. I thank the chairman for his generous remarks and for his 
tremendous leadership in bringing this important legislation to the 
floor. Mr. Conyers is well known as a champion of the people, and today 
he demonstrates that once again.
  This House of Representatives, Mr. Chairman, is called the people's 
House, and you are a leader in the people's House. Today we live up to 
that name by passing legislation that increases leverage for people. By 
changing the playing field, a playing field that has been dominated by 
the insurance industry for over 65 years. And now it's the people's 
turn. The insurance companies will now be playing on the people's 
field.
  Mr. Conyers, thank you for your ongoing leadership, for fairness, for 
competition, for a better deal for the American people.
  I also want to commend chairwoman of the Rules Committee, Louise 
Slaughter, for her ongoing and persistent insistence that this 
legislation come to the floor. When she served in the State legislature 
in New York, she was fighting this fight.
  This antitrust exemption was passed, again, over 60 years ago and it 
was supposed to last 3 years. Sixty-five years later we are on the 
floor of the House to finally repeal the special exemption that 
insurance companies have that no other industry, except Major League 
Baseball, has in our country.
  I also want to commend Mr. DeFazio, who has been a champion on this 
issue, Congressman DeFazio from Oregon. He has worked with our new 
Members of Congress, and they have been a source of energy to move this 
legislation: Congresswoman Betsy Markey of Colorado; Congressman Tom 
Perriello of Virginia, the author of this bill. We're grateful to them 
for their courage and their leadership, because the insurance companies 
don't want this bill but the American people do, and I commend those 
who have worked so hard.
  Another new Member of Congress, Congressman Garamendi, a former 
insurance commissioner of the State of California, played a role 
effective from the start as soon as he arrived to get this legislation 
to the floor. And, again, I believe that the legislation has many 
Republican supporters as well. So that, of course, is really a source 
of confidence to us as we go forward into the health care debate.
  One year ago, we began this debate on health care, quality, 
affordable health care for all Americans. We got a running start on it 
in the recovery package with big investments in basic biomedical 
research and health information technology, so we were on the cutting 
edge of science and technology for this. We had a running start on it 
by passing the SCHIP in a bipartisan way, State Children's Health 
Insurance Program, insuring 11 million children in America. And then 
the debate has gone on from the summit the President had a year ago in 
a bipartisan way to a summit he will have tomorrow as well. But in the 
meantime, this very important piece of legislation is before us today.
  I have always said that any health care reform had to make the AAA 
test. It had to have affordability for the middle class, accessibility 
for many more people, and accountability for the insurance companies. 
Accountability for the insurance companies. No longer would they have 
it all their way. And that's what this legislation does.
  We had this on the agenda, and then the snows came and we had to put 
it off. And in between the time when we all got snowed out or snowed 
in, Anthem in California announced that it was going to raise its rates 
39 percent: 39 percent, Anthem Insurance Company; 39 percent for health 
insurance.

                              {time}  1500

  Over the past decade, insurance rates have gone up over 150 percent. 
And this continues in Michigan, Kansas, other places in the country 
these insurance rates have gone up because the insurance companies 
simply have not been accountable. And this has worked to the 
disadvantage of the American people.
  So again, I commend all of those who played a part in bringing this 
to the floor, to the bipartisan discussion that took place in committee 
that has been mentioned, and for hopefully the strong bipartisan 
support we will see today.
  But again I want to come back to Chairman Conyers, because he is the 
person when it comes to speaking out for the people, chairman of the 
Judiciary Committee, a very prestigious position, one with a great deal 
of responsibility to make sure that the pledge we take each day, with 
liberty and justice for all, is lived up to. And today we are providing 
much more competition, much more freedom for the American people by 
expanding their choices with this important legislation.
  I urge our colleagues to support the legislation, once again salute 
all those who made it possible to bring this before the people's House 
today. Thank you, Mr. Chairman.
  Mr. VAN HOLLEN. Mr. Speaker, as an original cosponsor, I rise in 
strong support of legislation that will end the unfair advantages that 
health insurance companies currently enjoy today. I want to commend my 
colleagues Representatives Perriello and Betsy Markey for their 
leadership and advocacy on this very important issue.
  I hope most of us would agree that health insurance companies should 
play by the same rules as every other industry in America. For far too 
long, the health insurance industry has been exempt from the Federal 
antitrust laws that govern other businesses. As a result, they are not 
subject to Federal laws banning price fixing, market manipulation, 
collusion, or other anticompetitive business practices.
  It is apparent that there is no real competition in parts of the 
health insurance market. In the last few weeks, we have seen health 
insurance companies impose huge premium increases on consumers. Anthem 
Blue Cross of California announced a 39 percent price hike in premiums 
for their consumers. The Department of Health and Human Services has 
reported that several large health insurance companies across the 
country have requested premium increases of anywhere between 16 percent 
and 56 percent. These huge premium increases come after a year of 
record profits for the top five health insurance companies in America. 
Last year, as Americans struggled to pay their health insurance costs, 
insurance companies' profits jumped by 56 percent.
  Quite simply, the legislation we are considering today will repeal 
the blanket antitrust exemption afforded to health insurance companies 
under the McCarran-Ferguson Act. We must hold health insurers 
accountable when they engage in anti-competitive behaviors that benefit 
their profit margins at the expense of American families.
  Mr. Speaker, we are taking a small but very critical step towards 
health insurance reform and fixing a part of our broken health care 
system while Congress continues to work on comprehensive health care 
reform to bring more affordable and accessible care for all Americans. 
I urge my colleagues to support this much-needed bill.
  Mr. HOLT. Mr. Speaker, I rise in strong support of the Health 
Insurance Industry Fair Competition Act, H.R. 4626, legislation that 
would remove the health insurance industry's antitrust exemption. As a 
cosponsor of this important legislation, I urge my colleagues to join 
me in supporting this bill to expand competition, improve the 
affordability of health insurance, and give families more choices.
  I have heard from many hard-working New Jerseyans, who are struggling 
under the current insurance system. The system is too expensive and 
leaves too many people without good, secure coverage. Families are 
paying higher and higher premiums for less coverage. Our businesses are 
struggling to afford health care for their employees and find 
themselves at a competitive disadvantage compared to companies in other 
countries. Those problems have not gone away and must be addressed.
  The legislation we are considering today would lower costs and 
provide new insurance options for families by repealing the insurance 
special exemption to antitrust law. This exemption was created by the 
1945 McCarran-Ferguson Act with the intention of helping new small 
insurance companies by allowing them to access historical insurance 
data for setting their premiums and left all antitrust regulation to 
the states.

[[Page 1787]]

  Instead of encouraging new small insurance companies, this antitrust 
exemption has stifled competition. A single insurance company controls 
more than half the insurance market in 16 states, while in New Jersey 
the top two companies control almost 60 percent of the market. Lack of 
competition has led to growing insurer profits, increased costs and 
reduced coverage for patients, and an epidemic of deceptive and 
fraudulent conduct.
  By repealing the special antitrust exemption for health insurance 
companies, health insurers would be held accountable for fixing prices, 
dividing up market territories, using predatory pricing, or rigging 
bids. This bill makes the federal government a partner with states who 
lack the resources to go after insurance companies that have violated 
the law.
  This bill is one part of reform needed to improve the health care 
that all Americans receive by holding health insurance companies to the 
same good-competition rules that other industries face. I encourage my 
colleagues to vote in favor of this bill to lower costs and provide new 
options for patients.
  Mr. LOEBSACK. Mr. Speaker, I am submitting the following statement 
for the record in support of the Health Insurance Industry Fair 
Competition Act, which would end the anti-trust exemption that 
currently gives special privileges to health insurance companies.
  If we do not pass this legislation, American consumers will continue 
to pay more for health insurance, if they can afford it at all, because 
of a lack of competition in the insurance market.
  According to the AFL-CIO, profits at 10 of the country's largest 
publicly traded health insurance companies rose 428 percent from 2000 
to 2007. At the same time, consumers paid more for less coverage. At 
the root of this problem is the growing lack of competition in the 
private health insurance industry that has led to near monopoly 
conditions in many markets.
  There is no reason why health insurance companies should continue to 
receive this favored treatment from the federal government while 
millions of Americans pay the price.
  Mr. GENE GREEN of Texas. Mr. Speaker, I rise today as an original 
cosponsor and strong supporter of H.R. 4626 the Health Insurance 
Industry Fair Competition Act.
  Since 1940s, the McCarran-Ferguson Act has exempted the insurance 
industry from all federal antitrust laws giving health insurers freedom 
to raise premium prices, deny coverage for preexisting conditions, and 
change their reimbursement rates.
  Right now millions of Americans are at the mercy of the health 
insurance companies with premium increases going up in the double digit 
percentage points across the country. These premium increases are not 
to enhance insurance plans, but to add to the extremely large profit 
margins of insurance companies.
  Seemingly, there is no end in sight to this business practice because 
there is little competition in the health insurance market that 
benefits the consumer. If this continues health insurance premiums will 
continue to rise as long as we allow the insurance companies to control 
markets.
  We know that competition in the marketplace leads to lower prices and 
more options that benefit the consumer. There is no reason why the 
health insurance industry, with their outrageous spending on lavish 
retreats and executive salaries at the expense of the consumer, should 
not be forced to compete for business on a level playing field and 
control their costs and spending on non-health care related items.
  Right now, health insurance costs are out of control and if 
individuals cannot afford health insurance they end up in emergency 
rooms forcing the health care system and the taxpayer to pay for their 
expenses. Yet, the insurance companies continue to see increased 
profits while making it nearly impossible for individuals to gain 
access to or afford a policy.
  H.R. 4626 is one way we can fix the monopolies the health insurance 
industry has over the consumer and will make insurance coverage more 
affordable for individuals and small businesses.
  This is a step in the right direction, but we desperately need health 
reform in this country. All individuals should have access to quality 
and affordable health insurance and we will not accomplish that without 
reforms throughout our health care system.
  I strongly support H.R. 4626 because insurance anti-trust reform is 
one piece of the pie as we move forward.
  Ms. DeLAURO. Mr. Speaker, this past summer, in my home state of 
Connecticut, Anthem tried to raise health insurance premiums by up to 
32 percent. Right now, in California, the same company is trying to 
pull the same trick--trying to increase their rates by as much as 39 
percent.
  Unfortunately, we now know that the top five insurers in America saw 
record-breaking profits in 2009. We have seen increases in profits of 
91 percent at WeIlPoint, and a whopping 346 percent at Cigna.
  How is this happening, in the midst of an historic recession? A lot 
of reasons, and central among them the fact that, according to long-
established antitrust standards, there is no real competition in the 
insurance market today. In fact, there have been more than 400 mergers 
among health insurers in the past 14 years. So, insurers get away with 
price-gouging mainly because they can.
  We have coddled this industry far too long. It is time to remove 
insurers' special antitrust exemption and to make them play on the same 
level playing field as every other business in America. I hope that all 
my colleagues who consistently espouse the virtues of a free market 
will join us in passing this bill today.
  Mr. STUPAK. Mr. Speaker, the insurance industry and Major League 
Baseball are the last industries in our country not subject to Federal 
anti-trust laws.
  The insurance industry can collude to set rates, resulting in higher 
premiums than true competition would achieve.
  Because of the exemption, rate increases are not reviewed by the 
Federal Government.
  Today I held a hearing of the Energy and Commerce Subcommittee on 
Oversight and Investigations evaluating the most recent and egregious 
example of this. In California, WellPoint's Anthem Blue Cross plan 
recently raised premiums by an astounding 39 percent.
  One of the most effective actions Congress can take to lower health 
care costs is to remove the health insurance industry's anti-trust 
exemption.
  This legislation would create competition in the health insurance 
market and lower the overall cost of health insurance for consumers.
  According to the American Medical Association, 94 percent of 
insurance markets in the United States are now highly concentrated. In 
my state of Michigan, one company controls 63 of the health insurance 
market.
  Insurers are thriving in the anti-competitive marketplace, raking in 
enormous profits and paying out huge salaries to top executives.
  Meanwhile, American families are struggling to pay their mortgages, 
credit card bills and medical expenses. Many are losing their health 
insurance altogether with the loss of their jobs.
  Yet health insurance companies continue to thrive, at the expense of 
struggling Americans.
  It is about time that insurance companies play by the same rules as 
every other American industry.
  I urge Members to support this legislation, to a establish a fair 
insurance market that encourages competition and lower costs.
  Mr. ETHERIDGE. Mr. Speaker, I rise today in support of H.R. 4626, 
Health Insurance Industry Fair Competition Act. This legislation is 
another step in Congress' work to reform health care to bring down 
costs and expand choices for all Americans. Last year, we worked to 
make sure seniors could keep their doctors by reforming the Medicare 
payment system. This bill cracks down on insurance companies that are 
taking advantage of obsolete laws to manipulate premiums. The next step 
will be to protect North Carolina families from additional insurance 
company abuses, bring down health care costs and turn around the 
crushing effects of skyrocketing health care costs on our national 
debt.
  H.R. 4626 will restore competition and transparency to the health 
insurance market. Competition is the engine that drives our economy, 
spurs innovation, and ensures that the American consumer receives a 
fair deal on goods and services. But for far too long, the health 
insurance industry has played by a different set of rules. Since 1945, 
the McCarran-Ferguson Act has exempted the business of insurance from 
federal antitrust laws. This bill repeals that blanket antitrust 
exemption afforded to health insurance companies. Under H.R. 4926, 
health insurers will no longer be shielded from legal accountability 
for price fixing, dividing up territories among themselves, sabotaging 
their competitors in order to gain monopoly power, and other such anti-
competitive practices.
  When NC families are hurting, doing nothing really isn't an option 
for me. I've heard from thousands of neighbors in my district who are 
suffering under the current system. I receive calls, letters and emails 
on health care literally every day.
  Sheila is a woman from Raleigh who fears she will suffer the same 
fate as her sister who died from asthma because she couldn't get 
coverage. Linda from Sanford is a nurse who's tired of insurance 
industry bureaucrats interfering with patient care. Nancy from 
Louisburg says she's not looking for a handout, just a fair playing 
field because everyone should be able to get insurance. Dan is a young 
man

[[Page 1788]]

from Raleigh whose fiance's coverage was denied when she got sick. 
Peggy from Rocky Mount wants affordable coverage for small business 
workers and the self-employed who pleads, ``please don't let the 
insurance companies win this time.'' These are the voices of regular 
folks on North Carolina's Main Streets and country roads.
  Mr. Speaker, making sure every American has access to affordable 
health insurance and high-quality health care is one of the most 
important challenges of our time. The health reform debate is about 
saving money and saving lives. At its core, health reform is all about 
ensuring that American families and businesses have more choices, 
benefit from more competition, and have greater control over their own 
health care. Repealing this exemption is an important part of that 
effort. I urge my colleagues to join me in taking a stand for the 
American people.
  Ms. ESHOO. Mr. Speaker, I rise today in support of the Health 
Insurance Industry Fair Competition Act.
  The McCarran-Ferguson Act, passed in 1945, exempted insurance 
companies from antitrust legislation that applies to most other 
business. The Health Insurance Industry Fair Competition Act removes 
the antitrust exemption for health insurance companies, requiring them 
to compete fairly and adhere to the same antitrust laws as others. No 
longer will health insurers be allowed to price-fix, divide up 
territories among themselves, or sabotage their competitors in order to 
gain a monopoly in the marketplace. Such practices have been outlawed 
in other industries for decades.
  The Health Insurance Industry Fair Competition Act will bring much 
needed reform to the health insurance industry by allowing true 
competition between health insurers. Competition is what drives our 
economy, spurs innovation, and ensures that the American consumer gets 
a fair deal. More competition means lower health insurance costs for 
higher quality healthcare.
  For too long, the health insurance exemption has led to higher 
premiums for consumers and contributed to the unsustainable increases 
in health care costs. As a result, 94% of all health insurance markets 
are ``highly concentrated''--meaning consumers have little or no choice 
between insurance providers. There are only two industries in our 
country that are exempt from antitrust laws--the health insurance 
industry and major league baseball.
  The American people deserve better than this and I'm proud to cast my 
vote in support of the Health Insurance Industry Fair Competition Act.
  Mr. CONYERS. Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. All time has expired.
  Pursuant to House Resolution 1098, the previous question is ordered.
  The question is on the engrossment and third reading of the bill.
  The bill was ordered to be engrossed and read a third time, and was 
read the third time.


                           Motion to Recommit

  Mr. SMITH of Texas. Mr. Speaker, I have a motion to recommit at the 
desk.
  The SPEAKER pro tempore. Is the gentleman opposed to the bill?
  Mr. SMITH of Texas. I am in its current form.
  The SPEAKER pro tempore. The Clerk will report the motion to 
recommit.
  The Clerk read as follows:

       Mr. Smith of Texas moves to recommit the bill (H.R. 4626) 
     to the Committee on the Judiciary, with instructions to 
     report the bill back to the House forthwith with the 
     following amendments:
       Strike subsection (a) of section 2 of the bill and insert 
     the following (and make such technical and conforming changes 
     as may be appropriate):
       (a) Amendment to McCarran-Ferguson Act.--Section 3 of the 
     Act of March 9, 1945 (15 U.S.C. 1013), commonly known as the 
     McCarran-Ferguson Act, is amended by adding at the end the 
     following:
       ``(c)(1) Nothing contained in this Act shall modify, 
     impair, or supersede the operation of any of the antitrust 
     laws with respect to the business of health insurance. For 
     purposes of the preceding sentence, the term `antitrust laws' 
     has the meaning given it in subsection (a) of the first 
     section of the Clayton Act, except that such term includes 
     section 5 of the Federal Trade Commission Act to the extent 
     that such section 5 applies to unfair methods of competition.
       ``(2) Paragraph (1) shall apply only to health insurance 
     issuer (as that term is defined in section 2791 of the Public 
     Health Service Act (42 U.S.C. Sec.  300gg-91) to the extent 
     that the issuer engages in the business of health insurance.
       ``(3)(A) Paragraph (1) shall not apply to--
       ``(i) collecting, compiling, classifying, or disseminating 
     historical loss data;
       ``(ii) determining a loss development factor applicable to 
     historical loss data;
       ``(iii) performing actuarial services if doing so does not 
     involve a restraint of trade, or
       ``(iv) information gathering and rate setting activities of 
     a State insurance commission or other State regulatory entity 
     with authority to set insurance rates.
       ``(B) The term `historical loss data' means information 
     respecting claims paid, or reserves held for claims reported, 
     by any person engaged in the business of insurance.
       ``(C) The term `loss development factor' means an 
     adjustment to be made to the aggregate of losses incurred 
     during a prior period of time that have been paid, or for 
     which claims have been received and reserves are being held, 
     in order to estimate the aggregate of the losses incurred 
     during such period that will ultimately be paid.''.
       At the end of the bill, add the following (and make such 
     technical and conforming changes as may be appropriate):

     SEC. 3. GAO REPORT.

       Three years after date of enactment of this Act, the 
     Government Accountability Office shall submit, to the 
     Committee on the Judiciary of the House of Representatives 
     and the Committee on the Judiciary of the Senate, a report on 
     whether this Act has reduced unfair competition in the health 
     insurance market in each of the 50 States. Such report shall 
     specify whether, as a result of this Act, the reduction in 
     unfair competition, if any, has resulted in increased price 
     competition in the business of health insurance.

  Mr. SMITH of Texas (during the reading). Mr. Speaker, I ask unanimous 
consent that the motion be considered as read.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  Mr. DeFAZIO. Mr. Speaker, reserving the right to object, is this the 
one previously noticed and delivered a couple hours ago? Is that the 
motion to recommit? I just want to make sure it is exactly the same 
language.
  The SPEAKER pro tempore. The pending motion is at the desk.
  Mr. DeFAZIO. I withdraw my reservation.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Texas is recognized for 5 minutes in support of the motion.
  Mr. SMITH of Texas. Mr. Speaker, I support this motion to recommit on 
H.R. 4626, the Health Insurance Industry Fair Competition Act. As I 
stated in my earlier comments, this legislation does little, if 
anything. However, if you are going to do nothing, you might as well do 
it better.
  This motion corrects three drafting errors that create problems with 
the bill. First, it adds a definition for health insurers that was 
absent from the base bill. If we are going to eliminate McCarran-
Ferguson for a limited subset of insurers, then we should clarify who 
those insurers are.
  Second, this motion to recommit includes the exchange of data 
provision that Mr. Lungren added at the Judiciary Committee markup of a 
similar bill. It is necessary to ensure that small and medium health 
insurers can in fact compete in the marketplace.
  Third, the motion to recommit includes language that protects the 
rate gathering and rate setting activities of State insurance 
commissions. The majority assumes this will be protected by the State 
action doctrine. But if Congress is going to repeal a 65-year-old law, 
shouldn't we make clear that we do not want this to undermine State 
insurance commissions?
  Finally, the motion to recommit includes a GAO study on the impact of 
this legislation on competition in the health insurance market. 
Specifically, the GAO must report on whether or not this legislation 
has enhanced competition, resulting in lower prices and new competitors 
in the market. Let's put political rhetoric aside and see what the bill 
really does. We shouldn't be afraid of the truth.
  In short, this motion to recommit includes definitions and 
clarifications that the majority has already included in earlier 
versions of this legislation that either were reported favorably by the 
Judiciary Committee or were passed by the full House. This isn't much 
of a bill, but let's try to improve what little there is.
  I yield to the gentleman from California, a senior member of the 
Judiciary Committee.

[[Page 1789]]


  Mr. DANIEL E. LUNGREN of California. Mr. Speaker, I would like to 
refer to that part of the motion to recommit that deals with the 
amendment that I offered and that was contained in the bill that passed 
out of the Judiciary Committee. It simply allows historical data to be 
utilized by insurance companies large and small. This is something that 
is requested by the small insurance companies, this is something 
supported by the American Bar Association. Their representative who 
testified before our subcommittee on behalf of or in support of the 
underlying legislation supported this amendment so that in fact small 
insurers would not be disadvantaged.
  Let's get this right. There are some who have told me on the other 
side that, well, we don't need this because it will be allowed by the 
U.S. Justice Department or by the courts. We ought not to wait for 
that. We ought to give some real solid certainty to insurance 
companies, particularly the small insurance carriers. So if we wish to 
permit the collection of historical data, let's make it clear what we 
intend. Just because we haven't brought forward on this floor some 
answer to the medical malpractice litigation issue is no reason for us 
to commit legislative malpractice here. We ought to do our job. We 
ought to not pass it on.
  Now, there are a few people who don't think that historical data 
should even be allowed. If that is the way they feel, I understand it. 
Most Members I have spoken to believe it ought to be allowed. They 
understand the absolute essence of it in terms of the continued 
existence of small insurers across the country.
  Let's get it right. I have the language virtually the same that was 
contained in the majority's health care bill that passed just a couple 
of months ago. It is the same as contained in the bipartisan bill that 
came out of our committee. And most importantly, it is the same 
language contained in the various bills presented to this House by the 
late great Jack Brooks, chairman at that time of the House Judiciary 
Committee, about whom Members on the other side have waxed eloquently. 
And in tribute to him, I would hope they would support the gentleman's 
motion to recommit that contains my amendment.
  Mr. SMITH of Texas. I yield back the balance of my time.
  Mr. DeFAZIO. Mr. Speaker, I rise in opposition to the motion to 
recommit.
  The SPEAKER pro tempore. The gentleman is recognized for 5 minutes.
  Mr. DeFAZIO. I thank the Speaker.
  Simple question before the House today. Should the health insurance 
industry live under the same antitrust rules and have the same consumer 
protections as are provided for every other major industry in America 
without special exception, without carve-outs, without loopholes? No 
more collusion to get together, to conspire to limit markets, coverage, 
and drive up rates. The American people want and they need this 
protection.
  Now, they say there is a study throughout that says this won't save 
money. That study was actually based on the language they are offering. 
Yes, if we provide these loopholes it well may not bring down rates. 
But if we don't vote for their loopholes, we will bring down rates. The 
Consumer Federation of America says we will save $10 billion in 
ratepayer premiums next year if we adopt this amendment straight up 
without their loopholes.
  With that, I yield to the gentleman from California.
  Mr. GARAMENDI. Thank you.
  Mr. Speaker, directly to Mr. Lungren's proposed amendments, actually 
there are three major elements. If you look at those major elements, 
they do in fact give the insurance industry the opportunity to collude, 
because that is the data that sets future prices for consumers as well 
as payments for doctors.
  I know this business. I was the Insurance Commissioner in California 
for 8 years. And I know that if an insurance company is able to collude 
in collecting, compiling, classifying, or disseminating historic data 
and determining a loss development factor, and finally, using actuarial 
services, they have the power to collude. This is an incredible 
loophole. It should never be allowed.
  And the final point having to do with the insurance commissioners 
collecting data, nowhere in any antitrust laws are States precluded 
from any collection of data. This ought not be put forth. I ask for a 
``no'' vote.
  Mr. DeFAZIO. I yield to the gentleman from New York.
  Mr. WEINER. You know, you got to love these Republicans. I mean, you 
guys have chutzpah. The Republican Party is . . . That is the fact. 
They say that, well, this isn't going to do enough, but when we propose 
an alternative to provide competition, they are against it. They say 
that, well, we want to strengthen State insurance commissioners, and 
they will do the job. But when we did that in our national health care 
bill, they said we are against it. They said they want to have 
competition, and when we proposed requiring competition, the 
Republicans are against it. They are . . . That is the fact.
  Mr. DANIEL E. LUNGREN of California. Mr. Speaker, I ask that the 
gentleman's words be taken down.
  The SPEAKER pro tempore. The gentleman will suspend. The gentleman 
from New York will be seated.
  The Clerk will report the words.
  Mr. WEINER. Mr. Speaker, I ask unanimous consent to address the House 
for the purpose of amending my remarks.
  The SPEAKER pro tempore. Does the gentleman seek unanimous consent to 
withdraw his words?
  Mr. WEINER. I would request unanimous consent to substitute other 
words.
  The SPEAKER pro tempore. That would require a withdrawal.
  Mr. WEINER. I ask unanimous consent to withdraw my words.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New York?
  There was no objection.
  Mr. WEINER. How much time do I have remaining?
  The SPEAKER pro tempore. The gentleman from Oregon has 3 minutes 
remaining.
  The gentleman from New York is recognized.
  Mr. WEINER. Make no mistake about it: . . .
  Mr. DANIEL E. LUNGREN of California. Mr. Speaker, I ask the 
gentleman's words be taken down once more.
  The SPEAKER pro tempore. The gentleman will suspend. The gentleman 
from New York will be seated.
  The Clerk will report the words.
  Mr. WEINER. Mr. Speaker, I ask unanimous consent to withdraw the 
offending comments.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New York?
  Mr. DANIEL E. LUNGREN of California. Reserving the right to object, 
has the Chair ruled as to whether the gentleman's words are 
inappropriate under the rules of the House and the precedents of the 
House?
  The SPEAKER pro tempore. There has been no ruling at this time. The 
gentleman has offered to withdraw the words.
  Mr. DANIEL E. LUNGREN of California. I withdraw my reservation.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New York?
  There was no objection.
  Mr. DeFAZIO. May I inquire as to the time now that is left?
  The SPEAKER pro tempore. The gentleman from Oregon has 2 minutes and 
50 seconds remaining.
  Mr. DeFAZIO. I yield to the gentleman from New York.
  Mr. WEINER. I thank you very much. But the point is very simple. 
There are inequities in the present way we distribute insurance, the 
way we distribute health care. There are winners, and there are losers. 
The winners are the insurance industry. And our efforts to reel in the 
insurance profits, not just because they shouldn't make profits--
they're doing what they're supposed to. But what they're doing is 
driving up taxes, they're driving our economy into the ground, and we 
need competition and choice to deal with that. That's what this 
legislation does, and the motion to recommit undermines it.

[[Page 1790]]

  I've heard a couple of times today, well, we have an effort for 
bipartisanship here. No, there is not bipartisanship on this 
fundamental issue; and that is, the people who sit on this side, at the 
risk of offending anyone, generally support the idea of standing up for 
the American people in their daily battles against high insurance. And 
the people, generally speaking, who sit on this side of the Chamber, 
and specifically speaking as well, in a lot of cases, simply won't 
permit that to happen and haven't for a generation.
  That's going to end now. That is going to end because we are going to 
have competition. We are going to make sure that there are regulations, 
and we're going to make sure that the American people aren't gouged. 
That's what the American people stand for. And time and time again 
people say, well, I don't really want to undermine this bill, I just 
want to weaken it to the point that it's meaningless.
  And then I've heard my good friend from Texas say, well, this doesn't 
do anything. But every single time we've tried to do something, like a 
tiny sliver of competition called the public option, they've said, no; 
we can't withstand competition. We can't have that.
  Enough of the phoniness. We are going to solve this problem because 
for years our Republican friends have been unable to and unwilling to. 
Deal with it.
  Mr. DeFAZIO. I thank the gentleman for those remarks.
  The SPEAKER pro tempore. The gentleman from Oregon has 1\1/2\ minutes 
remaining.
  Mr. DeFAZIO. We have before us a simple question: Will we repeal a 
62-year old artifact that is a special favor for the insurance 
industry, an exemption from the laws of the land of antitrust, which 
are designed to promote competition, to protect consumers, and for a 
free market economy.
  You can't have a free market economy when people can collude, when 
they can get together to limit markets and competition, when companies 
become so huge they dominate urban areas and entire States; one 
company. Consumers have virtually no choice in much of America. They 
have to eat those huge rate increases or not. We can take a meaningful 
step here today to bring down the cost of health insurance for all 
Americans. The Consumer Federation of America says this will save 
consumers $10 billion next year, and they say that's nothing. Well, say 
that to your consumers at home if you vote against this bill.
  Creating these loopholes undermines the entire effort here today. We 
do not need these loopholes. We need this industry to play by the same 
rules as every other industry in America.
  Vote against the motion to recommit, and vote for competition and 
consumer protection for all Americans in health insurance.
  With that, I yield back the balance of my time.
  Mr. DANIEL E. LUNGREN of California. Mr. Speaker, I would like to ask 
unanimous consent if I might revise my remarks. I referred to Jack 
Brooks as the late great. I didn't mean to suggest that he is no longer 
with us. He is great but he is not late.
  The SPEAKER pro tempore. Without objection.
  There was no objection.
  The SPEAKER pro tempore. All time has expired.
  Without objection, the previous question is ordered on the motion to 
recommit.
  There was no objection.
  The SPEAKER pro tempore. The question is on the motion to recommit.
  The question was taken; and the Speaker pro tempore announced that 
the noes appeared to have it.
  Mr. SMITH of Texas. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 and clause 9 of rule 
XX, this 15-minute vote on the motion to recommit will be followed by 
5-minute votes on passage of H.R. 4626, if ordered; and suspension of 
the rules with regard to House Resolution 1085.
  The vote was taken by electronic device, and there were--yeas 170, 
nays 249, not voting 13, as follows:

                             [Roll No. 63]

                               YEAS--170

     Aderholt
     Adler (NJ)
     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
     Capito
     Carter
     Cassidy
     Castle
     Chaffetz
     Coble
     Coffman (CO)
     Cole
     Conaway
     Crenshaw
     Culberson
     Deal (GA)
     Dent
     Diaz-Balart, L.
     Diaz-Balart, M.
     Dreier
     Duncan
     Ehlers
     Emerson
     Fallin
     Flake
     Fleming
     Forbes
     Fortenberry
     Foxx
     Franks (AZ)
     Frelinghuysen
     Gallegly
     Garrett (NJ)
     Gerlach
     Gingrey (GA)
     Gohmert
     Goodlatte
     Granger
     Graves
     Griffith
     Guthrie
     Hall (TX)
     Harper
     Hastings (WA)
     Heller
     Hensarling
     Herger
     Hunter
     Inglis
     Issa
     Jenkins
     Johnson (IL)
     Johnson, Sam
     Jordan (OH)
     Kilroy
     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
     Marshall
     McCarthy (CA)
     McCaul
     McCotter
     McHenry
     McKeon
     McMorris Rodgers
     Mica
     Miller (FL)
     Miller (MI)
     Miller, Gary
     Moran (KS)
     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
     Sensenbrenner
     Sessions
     Shadegg
     Shimkus
     Shuster
     Simpson
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Souder
     Stearns
     Sullivan
     Teague
     Terry
     Thompson (PA)
     Thornberry
     Tiahrt
     Tiberi
     Turner
     Upton
     Walden
     Wamp
     Westmoreland
     Whitfield
     Wittman
     Wolf
     Young (AK)
     Young (FL)

                               NAYS--249

     Abercrombie
     Ackerman
     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
     Cao
     Capps
     Capuano
     Cardoza
     Carnahan
     Carney
     Carson (IN)
     Castor (FL)
     Chandler
     Childers
     Chu
     Clarke
     Clay
     Cleaver
     Clyburn
     Cohen
     Connolly (VA)
     Conyers
     Cooper
     Costa
     Costello
     Courtney
     Crowley
     Cuellar
     Cummings
     Dahlkemper
     Davis (AL)
     Davis (CA)
     Davis (IL)
     Davis (TN)
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Dicks
     Doggett
     Donnelly (IN)
     Doyle
     Driehaus
     Edwards (MD)
     Edwards (TX)
     Ellison
     Ellsworth
     Engel
     Eshoo
     Etheridge
     Farr
     Fattah
     Filner
     Foster
     Frank (MA)
     Fudge
     Garamendi
     Giffords
     Gonzalez
     Gordon (TN)
     Grayson
     Green, Al
     Green, Gene
     Grijalva
     Gutierrez
     Hall (NY)
     Halvorson
     Hare
     Harman
     Hastings (FL)
     Heinrich
     Herseth Sandlin
     Higgins
     Hill
     Himes
     Hinchey
     Hinojosa
     Hirono
     Hodes
     Holden
     Holt
     Honda
     Hoyer
     Inslee
     Israel
     Jackson (IL)
     Jackson Lee (TX)
     Johnson (GA)
     Johnson, E. B.
     Jones
     Kagen
     Kanjorski
     Kaptur
     Kennedy
     Kildee
     Kilpatrick (MI)
     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
     Markey (CO)
     Markey (MA)
     Massa
     Matheson
     Matsui
     McCarthy (NY)
     McClintock
     McCollum
     McDermott
     McGovern
     McIntyre
     McMahon
     McNerney
     Meek (FL)
     Meeks (NY)
     Melancon
     Michaud
     Miller (NC)
     Miller, George
     Minnick
     Mitchell
     Mollohan
     Moore (KS)
     Moore (WI)
     Moran (VA)
     Murphy (CT)
     Murphy (NY)
     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
     Shuler
     Sires
     Skelton
     Slaughter
     Smith (WA)
     Snyder
     Space
     Speier
     Spratt
     Stupak
     Sutton
     Tanner
     Taylor
     Thompson (CA)
     Thompson (MS)
     Tierney
     Titus
     Tonko
     Towns
     Tsongas
     Van Hollen
     Velazquez
     Visclosky
     Walz
     Wasserman Schultz
     Waters

[[Page 1791]]


     Watson
     Watt
     Waxman
     Weiner
     Welch
     Wilson (OH)
     Woolsey
     Wu
     Yarmuth

                             NOT VOTING--13

     Barrett (SC)
     Blunt
     Buyer
     Davis (KY)
     Dingell
     Hoekstra
     Maloney
     Pitts
     Radanovich
     Reichert
     Schock
     Stark
     Wilson (SC)

                              {time}  1545

  Ms. ESHOO, Messrs. BERRY, BOSWELL, GONZALEZ, BUTTERFIELD, Ms. 
BERKLEY, Messrs. CLEAVER, GEORGE MILLER of California, ORTIZ, WALZ, 
GUTIERREZ, Ms. VELAZQUEZ, Ms. ROYBAL-ALLARD, Mr. CROWLEY, Ms. SUTTON, 
and Mr. CHILDERS changed their vote from ``yea'' to ``nay.''
  Messrs. GINGREY of Georgia and COLE changed their vote from ``nay'' 
to ``yea.''
  So the motion to recommit was rejected.
  The result of the vote was announced as above recorded.
  The SPEAKER pro tempore. The question is on the passage of the bill.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. SMITH of Texas. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. This will be a 5-minute vote.
  The vote was taken by electronic device, and there were--yeas 406, 
nays 19, not voting 8, as follows:

                             [Roll No. 64]

                               YEAS--406

     Abercrombie
     Ackerman
     Aderholt
     Adler (NJ)
     Alexander
     Altmire
     Andrews
     Arcuri
     Austria
     Baca
     Bachmann
     Bachus
     Baird
     Baldwin
     Barrow
     Bartlett
     Barton (TX)
     Bean
     Becerra
     Berkley
     Berman
     Berry
     Biggert
     Bilbray
     Bilirakis
     Bishop (GA)
     Bishop (NY)
     Bishop (UT)
     Blackburn
     Blumenauer
     Boccieri
     Bonner
     Bono Mack
     Boozman
     Boren
     Boswell
     Boucher
     Boustany
     Boyd
     Brady (PA)
     Braley (IA)
     Bright
     Brown (SC)
     Brown, Corrine
     Brown-Waite, Ginny
     Buchanan
     Burgess
     Burton (IN)
     Butterfield
     Calvert
     Camp
     Campbell
     Cantor
     Cao
     Capito
     Capps
     Capuano
     Cardoza
     Carnahan
     Carney
     Carson (IN)
     Carter
     Cassidy
     Castle
     Castor (FL)
     Chaffetz
     Chandler
     Childers
     Chu
     Clarke
     Clay
     Cleaver
     Clyburn
     Coble
     Coffman (CO)
     Cohen
     Cole
     Conaway
     Connolly (VA)
     Conyers
     Cooper
     Costa
     Costello
     Courtney
     Crenshaw
     Crowley
     Cuellar
     Culberson
     Cummings
     Dahlkemper
     Davis (AL)
     Davis (CA)
     Davis (IL)
     Davis (KY)
     Davis (TN)
     Deal (GA)
     DeFazio
     DeGette
     Delahunt
     DeLauro
     Dent
     Diaz-Balart, L.
     Diaz-Balart, M.
     Dicks
     Doggett
     Donnelly (IN)
     Doyle
     Dreier
     Driehaus
     Duncan
     Edwards (MD)
     Edwards (TX)
     Ehlers
     Ellison
     Ellsworth
     Emerson
     Engel
     Eshoo
     Etheridge
     Fallin
     Farr
     Fattah
     Filner
     Flake
     Fleming
     Forbes
     Fortenberry
     Foster
     Foxx
     Frank (MA)
     Frelinghuysen
     Fudge
     Gallegly
     Garamendi
     Gerlach
     Giffords
     Gingrey (GA)
     Gohmert
     Gonzalez
     Goodlatte
     Gordon (TN)
     Granger
     Graves
     Grayson
     Green, Al
     Green, Gene
     Griffith
     Grijalva
     Guthrie
     Gutierrez
     Hall (NY)
     Hall (TX)
     Halvorson
     Hare
     Harman
     Harper
     Hastings (FL)
     Hastings (WA)
     Heinrich
     Heller
     Hensarling
     Herger
     Herseth Sandlin
     Higgins
     Hill
     Himes
     Hinchey
     Hinojosa
     Hirono
     Hodes
     Holden
     Holt
     Honda
     Hoyer
     Hunter
     Inglis
     Inslee
     Israel
     Issa
     Jackson (IL)
     Jackson Lee (TX)
     Johnson (GA)
     Johnson (IL)
     Johnson, E. B.
     Johnson, Sam
     Jones
     Kagen
     Kanjorski
     Kaptur
     Kennedy
     Kildee
     Kilpatrick (MI)
     Kilroy
     Kind
     King (NY)
     Kingston
     Kirk
     Kirkpatrick (AZ)
     Kissell
     Klein (FL)
     Kline (MN)
     Kosmas
     Kratovil
     Kucinich
     Lance
     Langevin
     Larsen (WA)
     Larson (CT)
     Latham
     LaTourette
     Latta
     Lee (CA)
     Lee (NY)
     Levin
     Lewis (CA)
     Lewis (GA)
     Lipinski
     LoBiondo
     Loebsack
     Lofgren, Zoe
     Lowey
     Lucas
     Luetkemeyer
     Lujan
     Lummis
     Lungren, Daniel E.
     Lynch
     Mack
     Maffei
     Maloney
     Manzullo
     Marchant
     Markey (CO)
     Markey (MA)
     Marshall
     Massa
     Matheson
     Matsui
     McCarthy (CA)
     McCarthy (NY)
     McCaul
     McClintock
     McCollum
     McCotter
     McDermott
     McGovern
     McHenry
     McIntyre
     McKeon
     McMahon
     McMorris Rodgers
     McNerney
     Meek (FL)
     Meeks (NY)
     Melancon
     Mica
     Michaud
     Miller (FL)
     Miller (MI)
     Miller (NC)
     Miller, Gary
     Miller, George
     Minnick
     Mitchell
     Mollohan
     Moore (KS)
     Moore (WI)
     Moran (VA)
     Murphy (CT)
     Murphy (NY)
     Murphy, Patrick
     Murphy, Tim
     Myrick
     Nadler (NY)
     Napolitano
     Neal (MA)
     Neugebauer
     Nunes
     Nye
     Oberstar
     Obey
     Olson
     Olver
     Ortiz
     Owens
     Pallone
     Pascrell
     Pastor (AZ)
     Paulsen
     Payne
     Pelosi
     Pence
     Perlmutter
     Perriello
     Peters
     Peterson
     Petri
     Pingree (ME)
     Platts
     Poe (TX)
     Polis (CO)
     Pomeroy
     Posey
     Price (NC)
     Putnam
     Quigley
     Rahall
     Rangel
     Rehberg
     Reyes
     Richardson
     Rodriguez
     Roe (TN)
     Rogers (AL)
     Rogers (KY)
     Rogers (MI)
     Rohrabacher
     Rooney
     Ros-Lehtinen
     Roskam
     Ross
     Rothman (NJ)
     Roybal-Allard
     Royce
     Ruppersberger
     Rush
     Ryan (OH)
     Salazar
     Sanchez, Linda T.
     Sanchez, Loretta
     Sarbanes
     Scalise
     Schakowsky
     Schauer
     Schiff
     Schmidt
     Schock
     Schrader
     Schwartz
     Scott (GA)
     Scott (VA)
     Serrano
     Sessions
     Sestak
     Shadegg
     Shea-Porter
     Sherman
     Shimkus
     Shuler
     Shuster
     Simpson
     Sires
     Skelton
     Slaughter
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Smith (WA)
     Snyder
     Souder
     Space
     Speier
     Spratt
     Stearns
     Stupak
     Sullivan
     Sutton
     Tanner
     Taylor
     Teague
     Terry
     Thompson (CA)
     Thompson (MS)
     Thompson (PA)
     Thornberry
     Tiberi
     Tierney
     Titus
     Tonko
     Towns
     Tsongas
     Turner
     Upton
     Van Hollen
     Velazquez
     Visclosky
     Walden
     Walz
     Wamp
     Wasserman Schultz
     Waters
     Watson
     Watt
     Waxman
     Weiner
     Welch
     Whitfield
     Wilson (OH)
     Wilson (SC)
     Wittman
     Wolf
     Woolsey
     Wu
     Yarmuth
     Young (AK)
     Young (FL)

                                NAYS--19

     Akin
     Boehner
     Brady (TX)
     Broun (GA)
     Buyer
     Franks (AZ)
     Garrett (NJ)
     Jenkins
     Jordan (OH)
     King (IA)
     Lamborn
     Linder
     Moran (KS)
     Paul
     Price (GA)
     Ryan (WI)
     Sensenbrenner
     Tiahrt
     Westmoreland

                             NOT VOTING--8

     Barrett (SC)
     Blunt
     Dingell
     Hoekstra
     Pitts
     Radanovich
     Reichert
     Stark


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore (during the vote). There are 2 minutes 
remaining in the vote.

                              {time}  1555

  So the bill was passed.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.

                          ____________________