HEALTH INSURANCE REFORM LEGISLATION
(House of Representatives - August 01, 1996)

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[Pages H9834-H9836]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  HEALTH INSURANCE REFORM LEGISLATION

  The SPEAKER pro tempore (Mr. Forbes). Under the Speaker's announced 
policy of May 12, 1995, the gentleman from New Jersey [Mr. Pallone] is 
recognized for one-half of the remaining time as the designee of the 
minority leader.
  Mr. PALLONE. Mr. Speaker, I do not plan to use all of the time. But I 
did want to take to the floor tonight to talk about the health 
insurance reform legislation that was passed today on a bipartisan 
basis and certainly start off by saying that I am pleased that the bill 
did pass, that we have agreement between the House and the Senate, and 
that this legislation will go to the President and that the President 
has indicated, obviously, that he will sign it, because at least we 
will be able to say that this year there has been some progress, albeit 
small progress, but some progress toward expanding health insurance 
opportunities for Americans.
  I have been very concerned over the last 2 years that we would not 
get this legislation passed because of inaction, which I put the blame 
on the Republican leadership here in the House. One of the things that 
Democrats, that we as Democrats did at the beginning of this session of 
Congress, was to establish a health care task force whose goal 
primarily was to try to expand health insurance opportunities for the 
many Americans who either do not have health insurance or who have 
problems obtaining health insurance even if they can afford to pay for 
it. I think this is one of the major issues that we must address not 
only in this Congress, but also in future Congresses.
  The bottom line is that more and more people every day in this 
country do not have health insurance. The estimates now are that it may 
be as many as 40 million Americans. I think it is unconscionable that 
that number continues to grow, and I think that government, and the 
Federal Government

[[Page H9835]]

in particular, must do whatever it can to try to increase opportunities 
for health insurance and ultimately to bring down the number of 
Americans who do not have health insurance, who are not covered by 
health insurance.
  Let me just point out today why I think that the bill that was 
approved, which I call the Kennedy-Kassebaum bill, for the two Senators 
who initially sponsored it in this session of Congress. What it does 
essentially, it does a lot of things but I would just like to highlight 
four things that I think are most important.
  One is, and most importantly, it deals with the whole issue of what 
we call portability, where an individual or a family, the head of the 
household I should say, loses their job or has to change jobs. 
Increasingly, that becomes a difficult problem for that individual or 
that head of the household or the family as a whole to find health 
insurance when they change a job or when they lose their job. In 
addition, we have a lot of Americans who in that circumstance or in 
other circumstances cannot find health insurance because they have a 
preexisting medical condition. The bill that we passed today addresses 
those problems in significant ways.
  First, it provide health insurance portability for workers and 
protection against exclusion from group insurance coverage in a new job 
because of preexisting condition. A group health plan cannot exclude 
you for more than a year from the coverage it gives others because of a 
preexisting condition. If you had a year or more of coverage and 
switched jobs and then have less than a 63-day, 2-month break in 
service between the jobs, the new plan cannot exclude you because of 
preexisting conditions. Of course, that sounds a little legalese, but 
it is a significant breakthrough for people who have been denied health 
insurance because of preexisting conditions.

  The bill also guarantees renewability of insurance regardless of 
health record or the size of the group. It also provided opportunity to 
go from group to individual insurance. If you have exhausted your group 
insurance possibilities and have been covered under a group plan for 1 
year for 1 year or more, you have the right to buy a type of individual 
policy without preexisting condition exclusions.
  Finally, there is also a gradual increase in tax deduction for the 
self-employed to 80 percent by 2006.
  There are other things in the bill, but those are the ones I want to 
highlight. From the beginning of this debate, which is really almost 2 
years now in this Congress, I have said that if we can, if we can at 
least improve the situation in terms of portability job to job or 
making sure that people are able to get insurance for preexisting 
conditions, if that is all we do in this year and with this 
legislation, we have accomplished a lot. And all the other things that 
were added and all the other special interest provisions which I am 
going to go into a little bit now, I think, were basically not 
important, should have been excluded from the beginning, and 
unfortunately were not, but today we finally came to a conclusion and 
we have a relatively clean bill and deals with those preexisting 
conditions and portability provisions of the original Kennedy-Kassebaum 
bill.
  Let me talk a little bit about what I consider the politics of this, 
because I have to say that I believe that as Democrats, as a Democrat 
and as a party, we have really taken the leadership to try to get this 
legislation passed this year in this Congress. More than anyone else, 
the President has taken a leadership role. He announced in his State of 
the Union address this year that if he was sent this bill with the 
preexisting condition provisions and with the portability provisions as 
a clean bill that he would sign it. Basically, President Clinton 
deserves most of the credit for the fact that this legislation finally 
passed tonight, and he is going to sign it.
  However, what I hear from my Republican colleagues on the other side 
and what I am sure I am going to be hearing for the next month or so is 
this effort, I guess part of a massive election-year campaign, to try 
to convince the American voters that the Republican Party, or the 
Republican leadership, is responsible for improving access to health 
insurance through the legislation that we passed today.
  The truth is that it has been the Democrats who have led the charge 
to expand access to health care for all Americans. Over the last 40 
years, Democrats have promoted and succeeded in enacting legislation to 
improve the health care system, most importantly through the 
establishment of Medicare and Medicaid health programs in the 1960's 
and Democratic have consistently fought for the health reform 
provisions that were in the bill that we passed today. The Democratic 
lead on these reforms started in this Congress when Senator Kennedy 
first introduced his bill in July of last year. The Democratic advocacy 
of these health insurance reforms dates back even further.
  I have to say, because I have been to the well, I have been here on 
the floor many times to point out how the Republican leadership refused 
to take any action on the legislation until President Clinton finally 
put pressure on them by calling for passage of the bill in his State of 
the Union address last January, gradually the Republican leadership 
started moving on the Kennedy bill, by very slowly, In fact, the House 
and the Senate did not even vote on the bill until the end of March.

  I think that what essentially happened here is that the Republican 
leadership and Speaker Gingrich realized more and more as the year went 
on that their Contract With America provisions, that their extreme 
agenda was not working, and they started to reach out with this bill as 
a vehicle to show that they are moderate and they were actually trying 
to do something for the average American.
  Even though that was true and even though the political pressure was 
on them to try to do that and hopefully to move this bill, we still had 
a holdup because the leadership, Speaker Gingrich, the Republican 
leadership, insisted on including the medical savings accounts as a 
provision in this legislation.
  I have stated over and over again that the medical savings accounts 
were the poison pill, essentially the delay, and the fact that this 
bill did not come to the floor in this form until today was largely due 
to the Speaker's insistence and the Republican leadership's insistence 
that medical savings accounts be included in the legislation. I have 
pointed out and I will point out again, I believe the major reason for 
that push was because they received so much money, the Republican Party 
did, from the Golden Rule Insurance Co., which is the main company that 
sells these kind of policies.
  Let me just say briefly why, and I have said it before, but I want to 
say it again briefly, why medical saving accounts are not a positive 
provision in this legislation.
  Fortunately, again due to Senator Kennedy's insistence primarily and 
other Democrats, the medical savings accounts provision in this bill 
that came to the floor today were whittled down, so it is now only a 
pilot program that does not impact a lot of people. And so I am hopeful 
that whatever negative aspects exist for MSA's have been whittled down 
and will not have a terribly negative impact on this bill. But it is 
still in the bill, and I do think that we should be worried about the 
impact of MSA's.
  What MSA's do basically is to break the insurance pool. You have 
wealthy people, you have poor people in the insurance pool. You have 
healthy people, you have unhealthy people in the insurance pool. The 
idea of the insurance pool is you put all these people together and you 
basically have a balance, and you do not charge a great deal because 
everybody pays an average premium. What MSA's do basically is to 
separate the health insurance risk pool and actually result in premium 
increases for many Americans because the people that opt out and go for 
the umbrella or the catastrophic policy, if you will, that exists with 
the MSA's are mainly healthy and wealthy people, people that can afford 
to pay out of pocket if necessary, people who do not think that they 
are going to have to have that many occasions when they visit a doctor 
or go to a hospital. And so what happens is the healthy and wealthy 
people opt for the medical savings accounts and the insurance pool is 
left with poorer people and people who are largely unhealthy, and 
premium rates go up.
  The reason that I think that is such a terrible thing is because the 
whole

[[Page H9836]]

purpose of health insurance reform is to try to expand opportunities 
for health insurance coverage for people that do not have it. If 
premium rates go up, then fewer people can afford health insurance. 
Fewer people are able to afford health insurance and more and more 
people go without health insurance.
  Why did they try to incorporate these accounts, these MSA's in the 
bill? Because the Republican leadership was getting a lot of special 
interest money from the Golden Rule Insurance Co., which was the main 
company that was trying to sell these policies.
  The Republican leadership went so far that they even tried to put 
MSA's in their medical proposal even though the CBO, the Congressional 
Budget Office, a nonpartisan organization, scored the MSA's as draining 
Medicare by over $3 billion. So we had this MSA problem not only with 
this bill, but also with Medicare.
  At one point, we had the Republican leadership in the Senate saying 
that they would not even allow the minimum wage increase legislation to 
be considered until they had their way with the health insurance reform 
bill that included the MSA's. Fortunately, they dropped that.
  Tomorow we are going to be considering the minimum wage bill. Once 
again, it is because of Democratic persistence in saying, ``No, we're 
not going to link these two, we're not going to include the provisions 
on the medical savings accounts the way you want it. We want to pass a 
clean health insurance reform bill to address portability and 
preexisting conditions, and we want to pass a clean minimum wage 
bill.''

                              {time}  2330

  I have to say, once again, that I believe very strongly that the 
reason that this bill came to the floor today is because of the 
insistence of the Democrats that it come before us in its clean form 
and in the way that would actually be helpful to the average American.
  Now, let me stress, and I guess I am basically going to conclude with 
this, that while this legislation that is before us today and that we 
voted on is not the end-all in health insurance reform, it is an 
important first step down the road to helping Americans maintain their 
health care security. However, I think a lot more work needs to be 
done.
  Some of the Democrats who spoke on the floor today stressed the fact 
that this is only a small step and that we need to do a lot more in 
order to achieve that goal of bringing all Americans under some kind of 
health insurance coverage. That is certainly true. This is only a 
beginning, an important beginning, but nonetheless a beginning. Only a 
beginning.
  What are we proposing then as Democrats? Well, the next step, the 
next incremental step, I believe, and probably the most important one, 
is a proposal that the Democrats have put forward as part of their 
family first agenda to create kids only health insurance policies, 
ensuring that every American child has health insurance.
  We have obviously dealt in an important way now with the portability 
and the preexisting condition problems, but one of the biggest gaping 
holes in the lack of health insurance, so to speak, is the fact that so 
many children now do not have health insurance. So as part of our 
agenda we want to make sure that there are ways in which people who can 
afford to buy health insurance, but maybe have problems because they 
have difficulty buying it for their children or difficulty buying it 
for their whole family, at least have the option that they can buy it 
for their children. If their children are covered, obviously that is 
important to them and it gives them some sense of security about their 
ability to provide and take care of their children.
  At the same time, Democrats remain committed to protecting Medicare 
and Medicaid from Republican raids on those programs primarily to pay 
for tax breaks for the wealthy. Over the last year and a half, 
Republicans have made several attempts at cutting Medicare and 
Medicaid, and I have again talked about those a great deal on the House 
floor.

  If we make these severe cuts in Medicare and Medicaid that had been 
proposed by the Republican leadership, the net effect would increase 
the number of uninsured and underinsured. That is the opposite of what 
the goals should be of this Congress. Not only the Democratic goal, but 
the bipartisan goal of this Congress and of this Federal Government is 
to get more people health insurance. We are not going to accomplish 
that if we cut Medicare and Medicaid. Ultimately, it is going to mean 
that fewer people have health insurance and the quality of service and 
the level of service goes down.
  Mr. Speaker, I just want to conclude, because I know there is not 
much time left and I do not want to use all the time, but I just feel 
very strongly that what we have witnessed in this Congress, when we 
talk about Medicare, when we talk about Medicaid, or even when we talk 
about this health care reform bill which we finally passed today, is 
that the Republican policy has essentially been the opposite of what 
the Democratic principles are about.
  Democrats have said that they want to increase the number of people 
that have health insurance. What we have been seeing from the 
Republican leadership basically is the opposite: Cut health care 
programs, repeal health care programs and, finally, be dragged sort of 
fighting and kicking to pass a health care reform bill that addresses 
one problem, or at least one small problem affecting millions of 
Americans.
  I suppose, ending on an optimistic note, I have to say that maybe 
they have been dragged kicking to the point where they had to bring up 
the bill today, but at least the bill was brought up, and there are 
millions of Americans who will be positively impacted by this health 
insurance reform legislation that was passed today on a bipartisan 
basis. If it took all the kicking and screaming and complaining by 
Democrats to get us to that point, that is fine. We have accomplished 
something and it is certainly a victory for all Americans.
  Mr. Speaker, I yield back the balance of my time.

                          ____________________