(House of Representatives - August 01, 1996)

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[Pages H9776-H9785]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


  Mr. GOSS. Mr. Speaker, by direction of the Committee on Rules, I call 
up House Resolution 502 and ask for its immediate consideration.
  The Clerk read the resolution, as follows:

                               H. RES 502

       Resolved, That upon adoption of this resolution it shall be 
     in order to consider the conference report to accompany the 
     bill (H.R. 3103) to amend the Internal Revenue Code of 1986 
     to improve portability and continuity of health insurance 
     coverage in the group and individual markets, to combat 
     waste, fraud, and abuse in health insurance and health care 
     delivery, to promote the use of medical savings accounts, to 
     improve access to long-term care services and coverage, to 
     simplify the administration of health insurance, and for 
     other purposes. All points of order against the conference 
     report and against its consideration are waived. The 
     conference report shall be considered as read.

  The SPEAKER pro tempore (Mr. Ney). The gentleman from Florida [Mr. 
Goss] is recognized for 1 hour.
  Mr. GOSS. Mr. Speaker, for the purposes of debate only, I yield the 
customary 30 minutes to the gentleman from California [Mr. Beilenson], 
pending which I yield myself such time as I may consume. During 
consideration of this resolution, all time yielded is for the purposes 
of debate only.
  Mr. Speaker, House Resolution 502 is a standard rule providing for 
consideration of a conference report. It waives all points of order and 
allows for 1 hour of general debate and provides that the conference 
report shall be considered as read.
  But that is where the standard nature of this discussion ends--
because what we are about to do is anything but standard. This is truly 
a red letter day, not just for this Congress, but for the American 
people. With this conference report we have proven that meaningful 
health care reform is achievable, even in such a politically charged 
climate as this. This agreement represents a reasoned, commonsense 
approach to the problems affecting millions of working Americans. It 
offers a stark contrast to the extreme efforts of the past Congress--
which were largely highly bureaucratic and big government solutions in 
search of a problem. In this bill we take responsible steps to make 
health coverage more affordable and accessible for working Americans. 
While this legislation has been labeled ``incremental'', its impact on 
real Americans is profound. No longer will an ambitious worker be stuck 
in a dead-end job because of concerns about retaining health coverage 
for a sick child or spouse. The self-employed entrepreneur, who could 
not afford the high cost of health insurance before, will be able to 
deduct 80 percent of health care costs. These are real people that will 
directly benefit from this legislation. Of course, given the fact that 
it was born of an excruciatingly painful negotiation and required 
compromises from all sides, this package will not be described as 
perfect by anyone. For instance, I am disappointed that medical savings 
accounts will only be available to a small number of working Americans. 
This innovative alternative to traditional insurance--which has 
substantial bipartisan support--was unfairly demonized and demagogued 
by a handful of opponents. Those who deride MSA's do so because they 
directly conflict with the liberal wing goal of a government-run and 
government-managed health care system. While MSA's critics seem to 
believe in an even more expansive Federal bureaucracy than we already 
have making health care decisions for individuals, MSA supporters 
believe in the ability of Americans to make prudent health care choices 
for themselves.
  Finally, this legislation attacks fraud and abuse by increasing the 
penalties on those who knowingly cheat the system. If there is one 
criticism my constituents have, it is that administration has not 
adequately addressed the billions of dollars in waste and abuse in our 
health care system. This Congress has listened and we have acted.

[[Page H9777]]

  Mr. Speaker, it is time to stop the delay. This legislation has 
already been held up too long by political shenanigans--enough is 
enough. This is the commonsense legislation that Americans have been 
asking for--let's give it to them--today. I urge support for this rule 
and the bill.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BEILENSON. Mr. Speaker, I thank the gentleman from Florida [Mr. 
Goss] for yielding me the customary half-hour of debate time, and I 
yield myself such time as I may consume.
  Mr. Speaker, we support the rule that provides for the consideration 
of the conference report on H.R. 3103, the health insurance reform 
bill. As most Members know, this is a modest attempt to bring about 
some basic needed changes in our system of health insurance.
  Virtually everyone agrees that we need to increase the portability of 
health insurance. Workers who change or lose their jobs should not be 
denied health care coverage. Nor should individuals be denied health 
care insurance because of preexisting conditions. To the degree that 
this legislation accomplishes those incremental but important reforms, 
we strongly support it.
  But we are troubled by some other provisions of the conference 
report, and I just want to take a moment, Mr. Speaker, to point them 
  Many of us are concerned about the provisions setting up medical 
savings accounts, even though the original House language has, we 
believe, been greatly improved by the conferees. Still, we are 
approving a tax subsidy for plans that will appeal to the wealthiest 
and healthiest in our society, and by taking the healthiest people out 
of insurance pools, the new MSAs could cause higher premiums for those 
remaining in traditional insurance plans. Fortunately, the conference 
agreement limits the number of those plans that can be sold and 
requires the Congress to revisit that issue in the near future.
  We are also concerned about some of the anti-fraud provisions in the 
agreement, including one that would require the Federal Government to 
provide advisory opinions on the legality of certain actions. When the 
House considered this particular provision earlier in the year, the 
Department of Justice expressed opposition to it on the grounds that it 
might eviscerate important anti-kickback laws.
  The legislation also includes anti-privacy provisions that have 
caused some alarm. We need to be concerned about the increasing erosion 
of privacy concerning personal medical matters, and we hope that this 
provision will receive the necessary oversight from the Congress and 
elsewhere to keep those fears from becoming a reality.
  As we will hear from other Members, the bill also includes a 
provision that was added by the conferees for one particular 
pharmaceutical company. We regret that we know so little about the 
provision. The inability to have a conference report available for 3 or 
4 days in fact does work against our best interests in the long run, as 
this special language proves.
  All in all, Mr. Speaker, we support the modest but useful health 
insurance reforms in the bill before us. Those of us who support health 
care reform that will ensure all Americans access to affordable health 
care wished that we could do more. But we know that was impossible this 
year, despite the continued skyrocketing cost of medical care and the 
devastating effect those costs have had and will continue to have on 
the Federal budget.
  We hope that this is just a first step, and that the Congress will 
start tending to the needs of the uninsured and underinsured in our 
society in the very near future.
  But because of the groundwork that has been done this year, Congress 
will, I hope, be encouraged to return to the issue next year with a 
better understanding of how we might extend health care coverage and do 
a better job of controlling health care costs.
  Mr. Speaker, as I stated earlier, we have no objections at all. We do 
in fact support the rule for this conference report, although many of 
us remain concerned about a number of provisions in the agreement 
itself. We shall likely have an opportunity to vote to send it back to 
conference to deal with the important issue of mental health parity and 
the special language that was included for the benefit of one 
particular pharmaceutical company. For now, we urge our colleagues to 
approve the rule so that we can proceed with the debate on the 
conference report for H.R. 3103.
  Mr. Speaker, I reserve the balance of my time.
  Mr. GOSS. Mr. Speaker, I am obliged for the gentleman's support of 
the rule, and I share his optimism that we are getting on with health 
care. To share in that optimism, I yield such time as he may consume to 
the distinguished gentleman from New York [Mr. Solomon], the chairman 
of the Committee on Rules.
  Mr. SOLOMON. I thank the gentleman for yielding me the time.
  Mr. Speaker, in supporting this vital piece of legislation, I just 
want to pay tribute to the hard work done by Chairman Bliley and 
certainly Denny Hastert, Chairman Archer, Bill Thomas, Mr. Fawell, 
including my Rules Committee member, Mr. Goss, who helped us mold 
together the 3 bills that originated this legislation in the first 
  It truly is a historic week here in this Congress. It is amazing what 
this body can do when we have the cooperation of the Senate and, yes, 
even the President.
  Yesterday in the House we passed with enormous bipartisan support a 
truly great, I think, welfare reform bill, by a vote of 328 to only 101 
negative votes, which the President has indicated that he will sign.
  In addition to the comprehensive welfare bill, with the passage of 
this rule the House will take up the health insurance conference 
report. This conference agreement is a bipartisan effort which the 
President has indicated he will also sign.
  I might point out that by focusing our efforts on several limited 
aspects of health insurance which the public is very interested in, 
this conference report will make it through the legislative process. 
These reforms were not made by a secret White House task force, as was 
attempted in the 103d Congress that went down in flames. Yet the 
reforms contained in this piece of legislation answer the primary 
concerns of the American people with our system as it stands today.
  One of its most important provisions is portability. This provision 
will improve the availability and the portability of health insurance 
for American workers. Portability will allow a worker to move from one 
job to another, and I think we have to refine this later on, without 
the burden of worrying about health insurance.
  Just as important, Mr. Speaker, the bill requires insurance companies 
to cover preexisting conditions when people are forced to change jobs, 
and that is one of the flaws in the current medical care delivery 
  In addition, the conference report contains medical savings accounts. 
These accounts are an innovation which will increase flexibility for 
employees of small businesses in handling their health insurance.
  In the United States we do have the best medical care delivery system 
in the entire world, and we want to keep it that way. Just go to any of 
the hospitals. I just spent a stay at Leahy Clinic over in Boston. In 
that hospital, in that clinic, there were people from all over the 
world that came here because we do have this great medical care 
delivery system. We do not want to spoil that.
  But this system is in need of some reform. The conference report 
provides this country with the necessary reform, I think, to give us 
what we need.
  This conference report is an accomplishment which has taken a 
tremendous amount of time and hard work. I want to commend all of the 
conferees. It truly is a bipartisan piece of legislation.
  I might point out it was even signed by Senator Ted Kennedy, who had 
been blocking this legislation for a long time. So now that we have him 
on board, I think we can all pass this bill unanimously. I urge strong 
support of it.
  Mr. BEILENSON. Mr. Speaker, I yield 3 minutes to the distinguished 
gentleman from California [Mr. Stark], the ranking subcommittee member.
  (Mr. STARK asked and was given permission to revise and extend his 
  Mr. STARK. Mr. Speaker, the Kennedy-Kassebaum bill is a modest 
improvement. The elephants mated and

[[Page H9778]]

begat a mouse. It could have been a great bill, but, in effect, it 
snatched mediocrity from the jaws of greatness.
  It would have been a much greater bill if it had avoided MSA's, if it 
had guaranteed group health insurance policies to firms of all sizes, 
not just to those with under 50 employees. It could have been a great 
bill if it had truly addressed medical privacy issues. There are some 
real dangers in the privacy being opened up by a national data computer 
system. And it holds terrible dangers for privacies of our citizens and 
their medical records being available to insurance companies across the 
  It would have been a great bill if it had not been loaded up with 
secret last-minute multimillion-dollar breaks for one particular 
pharmaceutical company. And indeed it would have been a memorial bill 
if it had provided some modest health insurance protections which would 
cost relatively nothing.
  Senators Domenici and Wellstone were willing to offer a most 
inexpensive proposal to limit caps on mental health services to the 
same kind of caps that may exist on physical health. It is really a 
slap in the face to those families who must suffer mental health and 
pay for it out of their own pocket.
  For these reasons, I am inclined to support a motion to recommit the 
bill with instructions to get rid of that drug company welfare 
loophole--we have not really ended all welfare as we know it, there is 
still welfare for big contributors to the Republican Party--and a 
return to work with the Senate to develop a reasonable mental health 
benefit with modest if no cost to employers or employees.
  There is no rush, by the way. None of this goes into effect until the 
middle of 1997 for anybody. So anybody who thinks they are going to 
quit their job now cannot possibly think about it until next spring. 
Another week, another day might produce decent legislation without a 
risk to our privacy, without an affront to the ethic of the House and 
the Senate, and, by including mental health, a serious disability for 
many Americans, in this bill.
  I would hope that we could have followed a process. None of the 
Democrats in the House signed this conference report.

                              {time}  1730

  None of the Democrats in the House met in any conference. This was a 
closed-door, late at night secret session between Republicans with 
Republicans, and the effort, as a result, is mediocre. I think we could 
have improved it had we been allowed to participate.
  Mr. GOSS. Mr. Speaker, I yield 2 minutes to the distinguished 
gentlewoman from Connecticut [Mrs. Johnson], the chairwoman of the 
Subcommittee on Oversight of the Committee on Ways and Means.
  Mrs. JOHNSON of Connecticut. Mr. Speaker, it gives me great pleasure 
to rise in support of this very important legislation. Finally, we will 
give working families the peace of mind that they will not, they will 
not lose their health care coverage when they change jobs or leave 
  Five years ago, I introduced the first insurance portability 
proposal. It was a radical concept. Last Congress, we debated far more 
comprehensive health care reform legislation that included a very 
detailed, thoroughly worked out provision guaranteeing portability, as 
this bill does. Today, we finally complete legislative work 
accomplishing the commonsense goal that I and so many others have been 
pursuing for 5 years. It took Republican leadership.
  Under this bill, people who play by the rules and have health 
insurance coverage are guaranteed the right to keep coverage, even if 
they develop a serious but permanent medical condition, and even if 
they change employers or work for a small employer and lose their 
coverage for any reason. But with today's technology in genetic 
testing, an individual does not even have to be sick to be denied 
  An important amendment I offered during committee consideration will 
protect people who know they carry a predisposition for breast cancer 
or Huntington's disease from discrimination by their health insurance 
carrier or future plans.
  Finally, I am very pleased this bill is offering very real solutions 
to families worried about the catastrophic costs of long-term care. I 
have long proposed tax deductions for the purchase of long-term care 
insurance, along with my colleague, the gentlewoman from Connecticut, 
Barbara Kennelly, so that fewer elderly Americans will need to spend 
themselves into poverty in order to get coverage for nursing home care.
  The tax incentive of premium deductibility for policies covering 
long-term care at home or in a nursing home will potentially save 
billions of dollars in the fastest growing part of the Medicaid program 
and better serve seniors.
  Moreover, this bill requires policies to meet consumer protections, 
to protect seniors' investments in their policies; another initiative 
of mine and a number of members of the Subcommittee on Health.
  Mr. Speaker, this is truly a landmark day for those of us who have 
spend years to bring these common sense reforms to us, and I urge my 
colleagues to support this bill.
  Mr. BEILENSON. Mr. Speaker, I yield 7 minutes to the distinguished 
gentleman from California [Mr. Waxman], a member of the Subcommittee on 
Health and Environment of the Committee on Commerce.
  Mr. WAXMAN. Mr. Speaker, I thank the gentleman for yielding me this 
  Today, thanks to the tenacity and moderation of Senator Kennedy and 
Senator Kassebaum, this House has before it legislation to make some 
small improvements, but improvements nevertheless, in the health 
insurance protections available to Americans.
  Today, we finally provide that people who lose their insurance 
because they move or lose their job or their employer stops providing 
coverage, that those people will be assured that they have at least 
access to health insurance coverage and will not have to face a waiting 
period for any preexisting condition. That is good and long overdue.
  Unfortunately, this bill could have been and should have been 
significantly better. We have failed to seize the opportunity this bill 
presented to take long overdue and much needed steps to assure parity 
of treatment of mental health benefits with other health benefits, and 
that is inexcusable.
  We had the opportunity in this conference to agree to the bipartisan 
Domenici-Wellstone amendment, adopted overwhelmingly in the Senate, to 
end the discriminatory treatment of mental health conditions in 
insurance plans. This provision had broad and significant support in 
the House with more than 100 Senators urging us to adopt it. It had 
significant support among the conferees, yet the Republican Members who 
controlled the conference would not allow us to meet to discuss this 
provision. They lacked the courage to let the public see them debate 
and vote on this issue.
  The losers are the American people. It is every person and every 
family who has known the tragedy of struggling with mental illness and 
having no adequate insurance coverage for the services they needed to 
treat it.
  There is simply no place in this country for discrimination against 
mental health coverage in this day and age. This House should demand 
that the conference return to the drawing boards and bring back a 
conference return which includes a mental health parity amendment.
  The irony here is that while the majority would not let us consider 
adopting protections for mental health benefits, they had no 
compunctions at all about adding a multimillion-dollar giveaway for 
their friends in the drug industry.
  In the dark of night they added a patent extension for a drug called 
Lodine. There is no reason to do this, except to help one drug company 
make more money. And how will they make more money? By having people 
pay a higher price for that drug by denying a competitor to come on the 
  It demonstrates again that no matter how important a bill is for 
ordinary people, the Republican majority cannot help seeing it as yet 
another opportunity to take care of a special interest.
  So what the Republicans did was they snuck this provision in without 
anyone knowing about it. It was not in the House bill. It was not in 
the Senate bill. Ordinarily, that would be beyond

[[Page H9779]]

the scope of the conference, and a point of order could be made against 
it. But this rule waives that point of order. So when we vote to adopt 
a rule to consider this bill, many Members might not even realize that 
they are protecting the special interest giveaway. This is exactly what 
the American people are so sick of.
  I also regret that this bill does so little to help people with the 
problems they have in securing health care coverage. It is important to 
assure access to insurance for people who have had coverage and lose 
it. But accessibility without affordability is a small step, indeed.
  This reform will prove to be a cruel hoax if people find they cannot 
afford the coverage that they gain access to.
  Of the 40 million Americans who have no health insurance coverage at 
all, what help will they get with this bill? Almost none at all. Their 
needs are unaddressed. They cannot afford insurance. They do not have 
it at their jobs. They go without health care coverage, and they will 
still have no health care coverage.
  They will still have no health care coverage when all is said and 
done because it will not be available for them even to buy because they 
did not have it before.
  I hope my colleagues do not see the adoption of this bill as a reason 
to brag about their achievements. We should be humbled by the magnitude 
of what we did not do. For in the end there is only a small downpayment 
that we get out of this legislation on the kind of action that the 
American people have a right to expect and receive from the people they 
elected to this House.
  Mr. Speaker, I think we should give credit for moving at least to 
this extent to President Clinton, for having raised the fact that 
people do not have health insurance, even those who have had a job and 
want to change it. They are afraid to leave that job for fear health 
insurance will no longer be provided to them.
  To the extent that this bill will correct that problem, we should all 
vote for it and be happy about it. To the extent that after this bill 
is adopted people will still be uninsured, because insurance was not 
offered to them or because they could not afford it, it is a disgrace 
for America to have all those people without the ability to get care 
when they need it.
  Mr. GOSS. Mr. Speaker, I yield myself such time as I may consume to 
say that we do not want perfect to get in the way of good, but we also 
would like to achieve perfect health care on this side of the aisle.
  Mr. Speaker, I yield 3 minutes to the distinguished gentleman from 
Illinois [Mr. Fawell], the chairman of the Subcommittee on Employer-
Employee Relations of the Committee on Economic and Educational 
  (Mr. FAWELL asked and was given permission to revise and extend his 
  Mr. FAWELL. Mr. Speaker, I rise in support of this rule and of the 
conference report on the health insurance reform.
  As one who has been involved in moving this legislation from the 
beginning, I know that this truly is a remarkable achievement.
  I would like to especially give special mention to my colleague and 
neighbor, the gentleman from Illinois, Congressman Dennis Hastert, who 
has headed up the Speaker's task force and has had that opportunity of 
bringing everybody together to put this legislation in final form. He 
has done, I think, a great job.
  As is often the case, the Chicago Tribune hit the nail right on the 
head in a recent editorial about this legislation. It is entitled ``Two 
Cheers for Health Reform.'' The first cheer is for finally addressing 
the problem many Americans who have preexisting medical conditions face 
in maintaining health insurance coverage when they change or lose their 
job. The second cheer is for taking the first step toward allowing 
medical savings accounts, or the MSA's.
  The missing third cheer is for the provision that I sponsored that 
passed the House but unfortunately did not make it into the final bill. 
This provision was the only one that would, from my viewpoint, make 
significant strides in expanding health insurance coverage to the 40 
million Americans who are uninsured, to which the previous speaker made 
some reference.
  This reform would have allowed small businesses to band together 
under the auspices of national trade associations, whether it is the 
NFIB, the Farm Bureau, the Restaurant Association or what have you, and 
self-insure so they could gain all of the cost advantages and economies 
of scale that large corporations and their employees enjoy and take for 
  In short, this provision would have made health insurance instantly 
affordable to hundreds of thousands of small businesses that cannot now 
afford it, and to millions, yes, to millions of their employees and 
their families who today make up the bulk of the uninsured population 
who are employed by small businesses who cannot, because of lack of 
economies of scale, be able to afford health care.
  We made tremendous progress, nevertheless, in moving this provision 
along, in spite of the misguided yet withering assault by some of the 
insurance industry and some State insurance commissioners also. Believe 
me, we will be back next year fighting for this reform with renewed 
vigor and even broader support. I predict that our small employer 
pooling provision will pass in the next Congress.
  Mr. Speaker, I again enthusiastically support this health care. What 
we have here, it is good and sound and I think progressive, and I think 
it is good for the Nation and I urge its adoption.
  Mr. BEILENSON. Mr. Speaker, I yield 2 minutes to the distinguished 
gentleman from New Jersey [Mr. Pallone].
  Mr. PALLONE. Mr. Speaker, the Democrats must declare victory today. 
The Democrats can take credit for the health insurance reform 
legislation that we will be shortly voting on. Thanks to President 
Clinton's leadership, Senator Kennedy's perseverance and a democratic 
commitment to health insurance reform, millions of Americans will no 
longer have to worry about losing their health care in between jobs.
  In addition to other much needed reforms, many of the poison pill 
special interest provisions that the Republican leadership insisted on 
for the last several months were finally dropped.
  I believe that President Clinton deserves much credit here. He 
brought health insurance to the forefront once again with his January 
State of the Union address and pushed Republican leaders from inaction 
to moving health insurance legislation forwards.
  In April, many of us remember the Senate passed Senator Kennedy's 
legislation overwhelmingly, 100 to 0. Unfortunately, Speaker Gingrich 
and the Republican leaders in the House were more interested in 
placating the special interests than passing meaningful reform.
  Day after day on this floor we heard about medical savings accounts, 
a special interest provision that I believe would increase premiums for 
many Americans and make health insurance unaffordable. As a result, 
health insurance reform, for a while, appeared doomed.
  After increasing Democrat pressure and Presidential leadership, the 
Republicans finally caved in to our demands and largely removed all the 
controversial provisions.

                              {time}  1745

  MSA's, as the Speaker, knows, will be limited to a pilot program that 
I hope will not have a negative impact.
  Mr. Speaker, I have to say the Democrats have long been advocates of 
health care for all Americans, and this legislation moves us one step 
closer to that reality. I realize that it is only a small step that we 
are taking today and, as the gentleman from California, [Mr. Waxman] 
said, we have to point that out. But in a year when Republicans have 
tried to slash Medicare and repeal Medicaid, I am pleased that they 
have come to their senses on at least one health care initiative that 
may benefit as many as 25 million Americans, and I think that in itself 
is a major victory for the Democrats today.
  Mr. GOSS. Mr. Speaker, I yield 2 minutes to the gentleman from 
Florida [Mr. Bilirakis], my friend and colleague, the chairman of the 
Subcommittee on Health and Environment of the Committee on Commerce and 
an author of this, from which much of the foundation came from the 
Rowland-Bilirakis bill, and we owe him a great deal of thanks.

[[Page H9780]]

  (Mr. BILIRAKIS asked and was given permission to revise and extend 
his remarks.)
  Mr. BILIRAKIS. Mr. Speaker, those of us who have been fighting for 
the passage of health reform legislation for many years are pleased and 
proud to see that it finally has arrived and that by the end of this 
week Congress will send President Clinton a bipartisan health reform 
bill that he will sign into law.
  During the 103d Congress, then Congressman Rowland and I introduced 
consensus health reform legislation. The Rowland-Bilirakis bill was the 
only true bipartisan bill considered during the Congress and included 
health consensus items for which there was broad agreement in Congress. 
Unfortunately, the Members of the House were not given the opportunity 
by the leadership then to vote on any health reform package.
  Almost 2 years later, attitudes have changed dramatically. Today the 
House of Representatives will cast a historic vote on a health reform 
package that is similar to the Rowland-Bilirakis bill.
  Is it perfect? No. Should it include other needed provisions? Yes. 
But at least it is a good start by this Congress.
  The items in our conference agreement are nothing new. Many of the 
components, insurance portability, fraud and abuse reform and 
administrative simplification, have all been included in past health 
bills. These issues have been discussed in great detail by Members of 
both the House and Senate, including these vital components essential 
to any health reform bill.
  Everyone agrees that people should not be denied health coverage 
because they have been sick. Everyone agrees that job lock must be 
unlocked so that people can move from job to job without losing health 
  The conference agreement addresses these and others of our Nation's 
most critical health problems. These are problems we can solve now, and 
in doing so, we will improve the lives of millions of working 
Americans. As chairman of the Subcommittee on Health and Environment of 
the Committee on Commerce, I am pleased and proud to be a part of this 
historic and bipartisan agreement.
  Today we make health care in this country both accessible and, just 
as important, affordable.
  Mr. BEILENSON. Mr. Speaker, I yield 3 minutes to the gentleman from 
Ohio [Mr. Sawyer].
  (Mr. SAWYER asked and was given permission to revise and extend his 
  Mr. SAWYER. Mr. Speaker, I rise in support of the rule and the 
conference report on health insurance reform. The conference report 
contains modest reforms to expand health care coverage. The bill would 
make health insurance more portable, as we have heard, and would limit 
the ability of insurers to exclude care for preexisting conditions.
  The conference report also contains important health care 
administrative simplification provisions. These provisions help address 
the problems of excess paperwork and substantial administrative costs 
associated with health care. The bill would establish a framework for 
health date elements that would facilitate the coordination of benefits 
between different systems and help track fraud and abuse. While many 
health plans already transmit data electronically, the data is 
nonstandard, often incomplete.
  The bill would also establish strict security standards for health 
information because Americans clearly want to make sure that their 
health care records can only be used by the medical professionals that 
treat them. Often we assume that because doctors take an oath of 
confidentiality that in fact all who touch their records operate by the 
same standards. Clearly they do not.
  Administrative simplification is the result of a cooperative effort 
between public and private sectors and has been accomplished, at least 
this segment of this bill, in a bicameral and bipartisan fashion.
  The concept arose from a clear need to address rising health care 
costs, and I want to particularly call attention to and thank the 
efforts of the gentleman from Ohio [Mr. Hobson], my friend and 
colleague, who brought an expertise in health care policy with him from 
the Ohio legislature and came to me three years ago and suggested that 
we work together, using my experience in large scale information 
systems. In 1994, our language was part of virtually every health care 
reform effort. Thanks largely to that ongoing commitment by Congressman 
Hobson, we are about to see this important reform become law.
  Let me comment just briefly, however, on the remarks of my friend and 
colleague from California, Pete Stark, and my friend from Oregon, Jim 
McDermott, who has expressed concerns similar to Mr. Stark's in a 
``Dear Colleague.''
  They have both raised concerns about privacy and about Social 
Security numbers, and just let me add as an aside that both Congressman 
Hobson and I over the last three years have developed language that 
addressed precisely those concerns, and as we engage in the next 
Congress in the continuing and broader effort to address many of the 
matters that have been begun in this language today, we offer our 
commitment to continue that effort to address these concerns.
  Mr. GOSS. Mr. Speaker, I yield 2 minutes to the distinguished 
gentleman from Ohio [Mr. Hobson], who was just referred to by his 
  (Mr. HOBSON asked and was given permission to revise and extend his 
  Mr. HOBSON. Mr. Speaker, the final version of the Health Insurance 
Portability and Accountability Act includes the provision that you just 
heard about that Congressman Sawyer and I wrote to modernize the way 
health care financial transactions are conducted, and we have worked 
for a number of years in a bipartisan fashion through a couple of 
Congresses to achieve this.
  Americans have the most advanced health care services in the world 
largely because of the technological advances that have been made. It 
is time we make the same technology apply to the way our health care 
system is run. The same high-speed electronic networks that modernized 
banking can be applied to our health care system so that bills can be 
filed easier, payments paid faster, and efficiency improved.
  In addition, the reductions in paperwork and improvement in speed, 
security and efficiency in billing helps get at one of the biggest 
problems currently facing the health care industry: fraud. Today we try 
to fight fraud with rooms full of clerks checking bills after they are 
paid, but billions of dollars of fraud simply slips by. Fraud will be 
easier to fight if every transaction can be coordinated electronically.
  Again, my thanks and congratulations to everyone who worked on this 
project. It has been a model of cooperation between the private and 
public sectors and between congressional Republicans and Democrats. I 
am looking forward to voting for this provision in the bill and 
encouraging everyone here to vote for not only the rule but the bill, 
this is truly a bipartisan bill.
  Mr. BEILENSON. Mr. Speaker, I yield 1 minute to the gentlewoman from 
New York [Mrs. Maloney].
  (Mrs. MALONEY asked and was given permission to revise and extend her 
  Mrs. MALONEY. Mr. Speaker, four words sum up this health care bill: 
Thank you, Mr. President. President Clinton made health care reform a 
top priority of his administration. His original bill did not pass, but 
it cast light and forced voluntary reforms on insurance company 
practices that put profits ahead of people.
  The President's focus on health care pressured insurance and drug 
companies to voluntarily hold down their rising costs. Above all, it 
challenged Congress to act.
  Over time, this bill will give more health security to millions of 
American families. It allows people to change jobs or lose jobs and 
keep their health insurance. It reduces discrimination against people 
with preexisting conditions. But our work is not finished. We need 
parity coverage for mental health and universal coverage, especially 
for all children.
  Democrats have fought for years for health care reform. We never gave 
up. The Republicans finally gave in. It is an important step forward. 
Vote for this bill.
  Mr. GOSS. Mr. Speaker, I yield 2 minutes to the gentle judge from 
Ohio, Ms. Pryce, a distinguished member of our Committee on Rules.

[[Page H9781]]

  Ms. PRYCE. Mr. Speaker, I thank the gentleman from Florida [Mr. Goss] 
for yielding me this time and for his tireless work on this landmark 
  Mr. Speaker, today marks another historic day in the House as we move 
one step closer to enacting common sense health care reform. For years 
the American people have asked us to enact meaningful reform, and today 
Congress has come together in a bipartisan way to break Washington 
gridlock and accomplish this important task.
  In 1994, the American people soundly rejected the health care reform 
plan that put the Federal Government in the driver's seat, controlling 
prices, benefits, and physician choice. The legislation we will vote on 
today offers a more practical, even-handed approach to reform that 
leaves American individuals in control, not government bureaucrats.
  I have said all along, through these years of the debate on health 
care, let us get on with it. Let us at least fix what we can all agree 
upon. And finally, lo and behold, through the hard work of so many, 
today we are about to do just that: Portability provisions to relieve 
job lock and no more, nor more exclusions because someone is 
unfortunate enough to have a preexisting condition.
  Both Republicans and Democrats can claim victory today. This is truly 
a bipartisan effort. This is a happy day for our country. Much, much 
good will come of this.
  Mr. Speaker, our vote today on this conference report is about more 
than just reform. It represents a giant step forward in our effort to 
ensure that as many Americans as possible will have access to the most 
advanced and reliable health care system in the world.
  Mr. Speaker, I urge my colleagues to answer the call of the American 
people for health care reform that ensures them greater access, 
security and freedom by supporting this fair rule on the underlying 
  Mr. BEILENSON. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Connecticut [Ms. DeLauro].
  Ms. DeLAURO. Mr. Speaker, this bill is a real victory for hard 
working American families, and after 20 months of gridlock and 
shutdowns I am pleased that the Republican leadership has finally 
relented to getting something done for the American people. It is about 
time. The health reform bill makes long overdue changes to our Nation's 
health care system. This bill will free working families from unfair 
insurance company practices that deny coverage due to a preexisting 
condition and deny workers the right to keep their health insurance 
when they change jobs. This bill will make a real difference in the 
lives of working families struggling to get and to keep health care 
  The construction worker in Wallingford, CT will be helped when he 
told me that his biggest fear if his company downsizes is that his 
daughter has a terminal illness and that he stays awake every single 
night worried about what happens if he loses that job, how will he pay 
for health insurance for his daughter? And it has taken us 20 months, 
20 months to help give some peace of mind to this construction worker 
in Wallingford, CT.
  Let me tell you this achievement would not have been possible were it 
not for the will and the determination of congressional Democrats. The 
Republican leadership roadblocked this much-needed legislation, left 
the health care security of families hanging in the balance. The 
leadership of the Congress was more concerned about special interest 
campaign contributions than in the progress and the security of working 
American families.
  Mr. Speaker, we still have a very long way to go. I was disappointed 
that the conference dropped the mental health parity provision in the 
bill, and I have introduced legislation to achieve this needed reform. 
I am committed to working in a bipartisan fashion to enact mental 
health parity.
  Mr. Speaker, today is a good day, a great day for working families 
and, thanks to the pressure from ordinary citizens in this country, we 
will make these small and yet important changes in our private health 
care system. Vote for the health care reform bill.

                              {time}  1800

  Mr. GOSS. Mr. Speaker, I yield 2 minutes to the gentleman from 
Florida [Mr. Stearns], my colleague and friend, and a member of the 
Committee on Commerce.
  (Mr. STEARNS asked and was given permission to revise and extend his 
  Mr. STEARNS. Mr. Speaker, I would say to the gentlewoman from 
Connecticut that their party has had 40 years to accomplish this bill, 
and yet it took our party just 2 short years to get portability of 
preexisting condition. I have to make that point.
  I rise in strong support of this rule. This legislation we will vote 
on today addresses the most fundamental and important issue that 
currently prevents a large majority of the uninsured from accessing 
health care. In his medical essays Oliver Wendell Holmes said, the 
truth is that medicine is as sensitive to outside influences, 
political, religious philosophical, imaginative, as well as a barometer 
to the changes of atmospheric pressure.
  Having been involved with the debate in 1993, all of us have been 
involved, and here we are today. Throughout the course of this 
congressional debate, I believe we have battled all the forces that Mr. 
Holmes has talked about. We have prevailed finally and achieved our 
common goal of providing what the American people said they wanted from 
health care reform.
  Passage of this bill will benefit all Americans, especially the 39 
million who lack any type of health care coverage. These individuals 
must live in constant fear of becoming sick and not having the 
necessary insurance to meet their medical needs.
  Lastly, I am particularly pleased that through our Committee on 
Commerce and working with the gentleman from Florida [Mr. Bilirakis], 
the chairman of the Subcommittee on Health and Environment, we had 
inserted the two words, ``genetic information,'' in the definition of 
health status agreed to in the final package.
  This will start to ensure that genetic privacy is with the American 
public and in the medical and insurance industries. Just these two 
words, ``genetic information,'' for the first time in the history of 
this country we have put those in this package. I believe it will go a 
long way to enhancing and making a better piece of legislation.
  Mr. BEILENSON. Mr. Speaker, I yield 2 minutes to the gentleman from 
Montana [Mr. Williams], whose presence around here will be greatly 
missed next year.
  Mr. WILLIAMS. Mr. Speaker, I thank the gentleman for yielding me the 
  Mr. Speaker, this meager bill, a very long time coming, is the symbol 
of the inability of this Congress to even reach obvious compromise in a 
timely manner. This bill is wildly insufficient. It represents not 
health care reform but congressional retreat from bold legislative 
  This bill is not a bold first step. It is a final, sad stumble toward 
the pretense of health reform. Of course, there are a few good elements 
in this bill. However, the legislation will increase health insurance 
costs for millions of Americans. It does nothing to create 
comprehensive reform, nothing to ensure universal coverage, little to 
restrain the inequities caused by the American health care insurance 
  Will most of my colleagues vote for this bill? Of course. Because it 
is the very best bill the President can get out of a very bad Congress.
  Mr. BEILENSON. Mr. Speaker, I yield 2 minutes to the gentleman from 
West Virginia [Mr. Wise].
  Mr. WISE. Mr. Speaker, I, of course, will rise in support of this 
bill. It is a small bill. It is important to certain segments of our 
community, provisions here that cry out to be done and need to have 
been done for a long time.
  I also want to talk about what is not in the bill. What is not in the 
bill is mental health. I guess I have great concerns about that because 
as co-chair of the mental health working group, a bipartisan group in 
Congress, there were 116 of us who signed a letter to the conferees 
asking that the Senate provisions on parity, that is, that mental 
health be treated by insurance companies as so-called physical health 
problems, be retained. There is nothing in this bill for mental health.
  There is no language concerning parity. There is not the language 
that was

[[Page H9782]]

proposed about raising the lifetime caps on insurance policies on 
mental health to at least the same level and other types of health care 
policies. There is not even a commission to study.
  Yet we have 20 percent of Americans at sometime who are going to 
experience mental health or substance abuse problems; 30 million 
Americans will have some kind of problems with mental health and mental 
illness, yet only 20 percent of those are able to seek help, only 20 
percent of those.
  Some say you cannot have mental health in there because it is a lot 
different. You do not treat mental health the same as physical health. 
You know a broken arm, you can treat that.
  How do you treat low back pain, how do you treat arthritis, how do 
you treat migraine headaches, how do you treat hypertension? All of 
these are compensable under regular insurance policies but for some 
reason mental health does not factor in there.
  I would also point out that depression alone has a higher morbidity 
rate than heart disease, lung disease and hypertension. So mental 
health needs to be a vital element in this. Yes, this is a small area 
of reform, but mental health needs to be included. I would urge all of 
us to continue focusing to make sure that mental health has the same 
priority because mental health is every bit the same priority as the 
other areas that are so important in this bill.
  Mr. GOSS. Mr. Speaker, I yield 2 minutes to the gentleman from 
Florida [Mr. Weldon], my friend and colleague on the Committee on 
Economic and Educational Opportunities.
  Mr. WELDON of Florida. Mr. Speaker, I thank the gentleman from 
Florida for yielding the time to me. I would like to echo his comment 
that this is a red letter day.
  As a practicing physician in the past, I have seen firsthand the 
consequences of people not having health insurance and how they will 
often let minor illnesses go for extended periods of time until they 
become a serious complication and ultimately lead to greater costs than 
what they would have been otherwise. I have also seen the consequences 
of people being excluded from health insurance because of a preexisting 
medical illness and the consequences of job lock that that can 
sometimes cause.
  I honestly looked on with horror and amazement when the Clinton 
administration put forward their health care plan, which essentially 
constituted a major power grab of the Federal Government of a huge 
sector of our economy, a Federal Government that does not have a track 
record of running things efficiently or better. I felt so strongly that 
it was possible to introduce reforms that would go a long way to deal 
with the problems of the high cost of health insurance and the problems 
of lack of portability of coverage as well as the problem of 
preexisting illness exclusion.
  I felt it was really honestly possible to produce a piece of 
legislation that would take our system which is the best health care 
system in this country and make modifications in it that would help so 
many people who do not have health insurance get insurance. Is this a 
perfect bill? No. But we should never make the perfect the enemy of the 
  There are provisions that some of my other colleagues have talked 
about that were left out of this bill that need to be considered in 
future legislation. But let us remember this bill addresses 
portability. It addresses preexisting illness exclusions. It addresses 
problems of waste, fraud and abuse. It has small business 
deductibility, tax deduction allowed for long-term care for our 
  This is a good bill. It is accomplishing these things without a 
Government takeover of the health care. I urge all my colleagues to 
support the rule and support the conference report.
  Mr. GOSS. Mr. Speaker, I yield 2 minutes to the distinguished 
gentleman from Iowa [Mr. Ganske].
  Mr. GANSKE. Mr. Speaker, I rise in support of the rule and the 
conference report. This bill is long overdue. Americans have wanted 
health insurance reform for a long time. This bill will help make 
health care more affordable and more available.
  The bill addresses portability. It allows the self-employed an 
increase in their health care tax deductibility, and that will help 
make health insurance much more affordable. It establishes medical 
savings accounts, and that will help make health insurance more 
affordable. It provides tax deductions for long-term care expenses, and 
that will help make health care much more affordable.
  The bill cracks down on fraud and abuse, and that will help make 
health care more affordable.
  Let me go into a few details on the fraud and abuse sections. The 
bill establishes a national health care fraud control program to 
coordinate Federal, State and local efforts to fight fraud. It extends 
antifraud rules for Medicare and Medicaid to other Federal programs. It 
requires the Secretary of Health and Human Services to provide seniors 
with better explanations of benefits so they can scrutinize their bills 
for waste, fraud and abuse. And the Secretary can provide a reward to 
seniors who have identified those problems. It excludes people found 
guilty of health care fraud felonies from participating in Medicare and 
other health care programs for at least 5 years.
  It creates a new crime for people who knowingly dispose of their 
assets to qualify for Medicaid benefits. It creates a stiff civil money 
penalty for practitioners who falsely certify that a Medicare enrollee 
meets the test for home health care services.
  Mr. Speaker, this is a win-win proposition for the American people. 
It will provide expanded health care coverage without creating huge new 
bureaucracies. In fact, we give more power to individuals to make their 
own decisions when it comes to health insurance.
  This week we will have helped reform, both welfare and health care. 
The debate gets pretty hot sometimes, but I salute my colleagues on 
both sides of the aisle who have made this a productive week in 
  Mr. GOSS. Mr. Speaker, I yield 2 minutes to the distinguished 
gentleman from Georgia [Mr. Norwood], a member of both the Committee on 
Commerce and the Committee on Economic and Educational Opportunities.
  Mr. NORWOOD. Mr. Speaker, I detect, as we go into this debate, some 
frustration on the other side of the aisle from those who would have 
federalized health care in this country just 2 years ago or socialized 
medicine. But, Mr. Speaker, I am going to rise today in support of this 
rule and this conference report. While this version of H.R. 3103 does 
not include many of the provisions I think that are necessary to really 
increase access to health care, this bill is the best bill we could get 
in this Congress with this President.
  During this debate, I have been amazed at how political the right 
thing to do can become. Rather than doing what we need to do, some 
Members of this Congress delayed consideration of this bill for months. 
I assume they were afraid to cede power from the Federal Government to 
the people. This is unfortunate.
  Mr. Speaker, I am going to continue to fight for what is right. We 
need tort reform, expanded access to medical savings accounts, small 
employer pooling and other options meant to provide access to lower 
cost health care.
  This bill does make health care more available and affordable for 
millions of Americans without a government take over of health care.
  I am absolutely amazed at what my friend, the gentleman from New 
Jersey, Mr. Pallone said. He said that the Democrats need to take 
credit. Well, they could have had credit just 4 years ago if they had 
allowed Mr. Rowland and the gentleman from Florida, Mr. Bilirakis, to 
produce their bill and bring it out on this floor. But they kept that 
from coming out and these 40 million Americans could have had this 
advantage 3 or 4 years ago, had they not been so interested in 
socializing medicine.
  My friend, the gentleman from California, Mr. Waxman, says that all 
40 million people, not one of them will be helped by this bill. Yet my 
friend, Mr. Pallone, says yes, 25 million of the 40 million will be 
helped by this bill because he knows this bill will pick up small 
business owners. It will take care of preexisting conditions and many 
other people will get insurance.
  Mr. BEILENSON. Mr. Speaker, I yield 3 minutes to the gentleman from 
New Jersey [Mr. Andrews].

[[Page H9783]]

  (Mr. ANDREWS asked and was given permission to revise and extend his 
  Mr. ANDREWS. Mr. Speaker, I thank the gentleman from California [Mr. 
Beilenson] for yielding me this time. He will be missed, his presence, 
around here as well next year.
  This is a good bill and I rise in support of it and the rule that 
supports it. It is a good bill because it works for a number of 
Americans. But we have some work left to do for a lot of other 
  This bill says to someone who has had breast cancer or a triple 
bypass operation, if you lose your job and you have to look for new 
coverage, you cannot be denied that coverage because you were so 
unlucky that you got sick. That is a good thing. I believe there are 
mechanisms in this bill that would make sure that you would be offered 
that coverage at about the same rate everybody else would, and that is 
a very good thing.

                              {time}  1815

  This bill says to the person who is the next victim of corporate 
downsizing that they will have the right to stay in the health care 
plan that they were in when they were working until they find their 
next job, or maybe even after they find their next job for awhile. They 
will have to pay for it, and that is very difficult for a lot of 
people, but the fact of the matter is it is a lot better to be able to 
write a check to stay in the plan that they are already in than to have 
to go look for new coverage after they have lost their job, and that is 
a very good thing.
  It is a good thing that self-employed people are going to be able to 
deduct more of their premiums now than they were before from their 
income tax return. They ought to be able to deduct 100 percent of it, 
but it is a very good thing that we have increased that.
  It is a good thing that people who buy long-term care insurance, who 
if they have to go into a nursing home will have to have an insurance 
policy to cover it, can get some help on their tax return if they do. 
That is a good thing.
  But there is work we have left to do. This bill works in that way for 
a lot of people. There is work we have left to do.
  This bill does not really help the family that is sitting there 
tonight, that is so upset because one of the people in the family has a 
severe mental illness, is a manic depressive, let us say, and they are 
worried that that person's next hospitalization is going to bankrupt 
the family because there is a $10,000-a-year limit on mental health 
  There are good things, but there is work we have left to do. I 
support the bill and the rule.
  Mr. GOSS. Mr. Speaker, I yield 2 minutes to the distinguished 
gentleman from Connecticut [Mr. Shays].
  Mr. SHAYS. Mr. Speaker, I salute the gentleman from Illinois, Mr. 
Hastert, the gentleman from California Mr. Thomas, the gentleman from 
Texas Mr. Archer, the gentleman from Virginia Mr. Bliley, and my 
colleague from Connecticut, Mrs. Johnson, on our side of the aisle, and 
I know there are Members on the other side who deserve credit as well 
because this is a bipartisan effort.
  I am grateful in a bipartisan effort we have ensured portability of 
insurance, limited preexisting condition exclusions, required health 
insurance providers that serve small group plans to accept every small 
employer, and I am grateful that we have made health care more 
affordable and available by reducing administrative costs, but I want 
to speak to title 2 of the bill, particularly, which attempts to 
address the $100 billion of health care fraud.
  Both presidents Bush and Clinton had advocated that we deal with 
this. Unfortunately, President Clinton's proposal was in his socialized 
medicine plan, but that part of the plan that said deal with fraud had 
merit. It was what President Bush also had suggested.
  The gentleman from New Mexico [Mr. Schiff] and the gentleman from New 
York [Mr. Towns] and I on our committee had worked on this, and we are 
happy to see it included in the bill, because in the past we dealt with 
fraud such as wire and mail fraud and attempted to get someone who 
cheated the system when we had hundreds of billions of dollars of 
fraud. Now we are making health care fraud a Federal offense, not just 
for Medicare but also for Medicaid, for CHAMPUS and all private 
providers. This obviously makes sense, and I salute my colleagues for 
doing it.
  We just need to know that those who commit fraud have a tough test. 
They should have known for a civil penalty the issue is that there has 
to be knowing and willful attempt to defraud the system. This does not 
go at individuals who have unknowingly miscoded. This goes after the 
real pattern of continued fraud, and I salute this bill and those on 
both sides of the aisle who have, for the first time in decades, 
attempted to get at waste, fraud, and abuse in a very real way.
  Mr. BEILENSON. Mr. Speaker, I yield such time as he may consume to 
the gentleman from California [Mr. Miller].
  (Mr. MILLER of California asked and was given permission to revise 
and extend his remarks.)
  Mr. MILLER of California. Mr. Speaker, I rise in support of the 
conference report.
  Mr. Speaker, I rise in support of the conference report on H.R. 3103 
as a reasonable first step in helping families get the health insurance 
coverage they deserve, but I think this legislation only marks a very 
modest starting point. The provisions of the bill ensuring portability 
of health insurance and protections against discriminatory coverage for 
a preexisting condition will provide some important new benefits for 
America's working families. But they will only be benefits to those who 
already are fortunate enough to have access to affordable health 
  A recent report by the Department of Labor on health benefits shows 
the real challenge we face as employers are backing off a commitment to 
providing health benefits. The share of full-time workers covered by 
health insurance dropped from 96 percent in 1983 to 82 percent in 1993. 
Hopefully, the recent drop in health insurance costs to all-time lows 
will turn this trend around, but I don't think we can count on it. We 
must rekindle our commitment to real health care reform that will 
extend health care coverage to the 37 million people who are left 
  Those of us who have supported the Kennedy-Kassebaum-Roukema bill 
from the beginning are pleased that the objectionable provisions added 
in the House bill were eliminated in conference, including the medical 
malpractice and MEWA provisions. The Medical Savings Account has no 
place in a bill that seeks to expand access and affordability of health 
insurance, but I think that Senator Kennedy did a very admirable job in 
striking a compromise on this issue so that even this modest progress 
towards health reform was not derailed.
  I will support the motion to recommit that addresses two remaining 
problems with this conference report. One was the dropping of the 
Domenici-Wellstone amendment. We have missed a critical chance to 
achieve parity in health insurance coverage for mental illness in this 
conference report. I worked on this issue extensively when we 
considered health care reform in the 103d Congress. Prejudice and 
stigma against the mentally ill has no place in the development of 
sound health care policy in this Nation. Studies have shown that in 
contrast to being an added cost, mental health parity would save the 
national economy and the Nation's small businesses more that $2 billion 
annually. It is terribly shortsighted to fail to recognize that mental 
health disorders cost the American economy as much as $162 billion per 
year in lost productivity, absenteeism, disability and death, and that 
such disorders are so treatable when treatment is available. I will 
continue to work with the many other Members of Congress who recognize 
that our Government cannot stop short from including parity for mental 
illness as part of any health care reform effort.
  I am also sad to see that greedy special interests have once again 
gotten their way in this Congress by last night's sleight of hand 
providing a patent extension for Lodine. This inexcusable assault on 
consumer interests should be stopped, just as similar relief for Lodine 
was stopped several other times in this Congress.
  Mr. BEILENSON. Mr. Speaker, I yield 3 minutes to the gentleman from 
Massachusetts [Mr. Olver].
  (Mr. OLVER asked and was given permission to revise and extend his 
  Mr. OLVER. Mr. Speaker, I thank the gentleman from California for 
yielding time.
  I rise to support the Kennedy-Kassebaum health insurance bill that is 
before us, Mr. Speaker. The passage of this incremental health 
insurance bill is long overdue, but it barely scratches

[[Page H9784]]

the surface of what needs to be improved in this country's health care 
  Oh, yes; it does help people who already have insurance through their 
employers but who are suffering from job lock. Under this bill they are 
guaranteed coverage through another employer's group plan or through 
individual coverage, regardless of preexisting conditions, and the bill 
allows the self-employed to deduct 80 percent of their health insurance 
premiums, which is up from the current 30 percent in present law. These 
are important changes.
  But this bill is only a small first step. We need to go much further. 
We need to help those who do not already have insurance, the millions 
of people whose employers do not offer coverage, or the self-employed 
whose kids go to school sick because their parents cannot afford to 
take them to the doctor, the people who do not have insurance at all, 
the 40 plus millions of people who do not have insurance at the present 
  We need to help make insurance more affordable for people who are not 
covered at work and cannot afford to buy insurance on their own, and we 
should require health plans to offer good benefits and assure quality 
care. People can still end up with bare-bone policies that drop them 
and put lifetime limits on their care, and provisions that were in this 
bill which guaranteed equal treatment for mental health care have been 
dropped, and that is a tragedy.
  So this bill is a good first step, but it is not health care reform 
as we ought to be doing it. We should support this bill and then get on 
with the job of making health insurance affordable and accessible to 
every single American.
  Mr. GOSS. Mr. Speaker, I yield 1 minute to the distinguished 
gentleman from Nebraska [Mr. Christensen], a member of the Committee on 
Ways and Means.
  Mr. CHRISTENSEN. Mr. Speaker, today we are keeping our promise to 
pass real health care reform legislation, legislation that will improve 
the availability and portability of health insurance across America.
  It is hard to believe that just a little over 2 years ago we were 
looking at the Clintons' takeover, the Government takeover of our 
health care system, one-seventh of our GDP. Do my colleagues remember 
the bureaucracy that was set up through this nationalized health care 
program that the Clintons put forth?
  Well, our program is nothing like that bureaucracy. Our program 
allows private sector solutions. It allows the insurance to be more 
available and more affordable for all Americans. it allows preexisting 
conditions not to be a problem any more. It cracks down on waste, 
fraud, and abuse, and it allows for the creation of 100 percent 
portable medical savings accounts.
  Simply put, Clinton care was about helping government. Our 
legislation is about helping people.
  I urge my colleagues to support this historic commonsense health care 
reform legislation.
  Mr. GOSS. Mr. Speaker, I yield 30 seconds to the distinguished 
gentlewoman from New Jersey [Mrs. Roukema].
  Mr. BEILENSON. Mr. Speaker, if I may, I yield 1 additional minute to 
the gentlewoman from New Jersey.
  The SPEAKER pro tempore (Mr. Ney). The gentlewoman from New Jersey is 
recognized for 1\1/2\ minutes.
  Mrs. ROUKEMA. Mr. Speaker, I am rising here, proud to be here today 
as the prime sponsor of the Kassebaum bill on the House side. With this 
bill today we definitely are again responding to our constituents' 
pleas, namely that we should stop the bickering and the political 
gamesmanship and the gridlock and deal with the issues that count with 
the American people. That is what we are about to do tonight, and I 
strongly support it. We are responding.
  I know the medical savings accounts have been talked about. This is a 
good pilot project despite the controversy that it provoked, but this 
bill will bring peace of mind and health insurance security to more 
than 30 million Americans, and we can all be proud of that.
  But, Mr. Speaker, I am sorry to say that we were unable to stop the 
blatant discrimination against mental health patients. Ignorance and 
apathy, I am afraid, defeated this provision in the conference.
  But I want to pledge here and now that I stand ready to work with 
Senator Domenici and others to bring this issue back and educate our 
colleagues on this humane and intelligent reform. That is a problem for 
another day, but tonight we stand here ready to deliver relief to the 
American people.
  Mr. Speaker, I rise in support of the compromise that is incorporated 
by H.R. 3103, an omnibus package of health reform proposals.
  I am proud to be here as the prime sponsor here in House, the heart 
and soul of the bill before us today is the so-called Kassebaum-
Kennedy-Roukema health insurance reform package, which make health 
insurance portable for workers who want to change jobs and bring their 
current plan with them; allows small businesses to pool together in 
order to buy health insurance more affordably more their workers; and 
cracks down on the ability of health insurance carriers to refuse 
coverage for people who have been sick in the past.
  We are here today responding to the pleas of our constituents to stop 
the gridlock and bickering and deal with the issues that count. With 
this bill we have responded to their pleas. This legislation will bring 
peace of mind and health insurance security to 30 million Americans.
  And I'm very pleased to see that the conference committee retained a 
provision that allows the self-employed to deduct up to 80 percent of 
their health insurance premiums by the year 2002, which was not in the 
original Kassebaum legislation but that subsequently added.
  And although I voiced grave reservations about the medical savings 
account provisions that were added to the House version of this 
legislation--because it appeared that they might serve to kill the 
underlying reforms--the conferees worked very diligently to reach an 
agreement on MSA's that both the Congress and President can support. 
This agreement brings a credible first step in the form of a pilot 
  For this, I congratulate my House and Senate colleagues because they 
have reached a historic agreement. The American people can be proud of 
the fact that this valuable legislation is here today, and headed 
toward enactment because President Clinton will sign this bill into 
  A very strong and broad coalition has worked long and hard to bring 
the Kassebaum-Kennedy-Roukema legislation this far. Some of the more 
notable members of this coalition have included: The National Governors 
Association; the American Medical Association; the American Hospital 
Association; the Chamber of Commerce, the National Association of 
Manufacturers; the Business Roundtable, and the AFL-CIO; the Healthcare 
Leadership Council, and the Independent Insurance Agents Association; 
the ERISA Industry Committee [ERIC], and the American Association of 
Retired Persons [AARP], are just a few of the more prominent supporters 
of the Kassebaum-Kennedy-Roukema legislation.
  Some of the provisions included in the House version of this bill--
such as medical malpractice reform legislation--are proposals I have 
vigorously supported in the past, and will continue to support in the 
future as freestanding measures.
  Nevertheless, I am sorry we are unable to stop here and now the 
blatant discrimination against mental patients. Mental Health parity 
was eliminated in conference. Ignorance and apathy defeated mental 
health parity in the conference.
  I stand, nevertheless, ready to continue to work with Senator 
Domenici to bring this back and educate our colleagues on this humane 
and intelligent reform.
  The time has come for the Congress to stop playing games, the 
American people are sick and tired of bickering and political 
  We must immediately enact commonsense, incremental health insurance 
reforms contained in the bill before us today.
  The General Accounting Office [GAO] has estimated that up of 30 
million American citizens would benefit from the health insurance 
reforms incorporated in the Kassebaum-Roukema plan.
  In closing, Mr. Speaker, I urge my colleagues to join me in 
supporting H.R. 3103, because its the right thing to do for the 
American people now.
  Mr. BEILENSON. Mr. Speaker, I yield back the balance of my time.
  Mr. GOSS. Mr. Speaker, it is my intent to yield all of the remaining 

[[Page H9785]]

on our side to the gentleman from Illinois [Mr. Hastert] to close. It 
is often said that it takes a lot to make something happen around here. 
This is a gentleman who has given a lot to make something happen around 
here, and I am proud to yield him the closing time.
  Mr. HASTERT. Mr. Speaker, I thank the gentleman from Florida for 
yielding me this time to talk a few minutes about this bill.
  This bill gives people availability of insurance and affordability of 
insurance. These were the guide words, the words we talked about to 
make this happen.
  That means that a mother who wants to change jobs and has a child 
that is asthmatic can take that next job. It means a father who wants 
to move up and do a better job for his family and get a better area or 
level of his occupation can move to the competitor in the next job over 
and know his wife with the heart condition can get that care when he 
changes jobs.
  It also means that families have choice; that if they choose to ask a 
doctor what is the price of this care or if they ask their health care 
giver what is the cost, that they can get a cost and they can make a 
decision on where they go because of medical savings accounts.
  It also tells a barber in Elgin, IL who wants to have a deductibility 
that is fair with other companies he can do that. He can deduct his 
cost of health care up to 80 percent off his income tax.
  It is a bill of fairness, it is a bill of availability, and I just 
want to thank some folks before I leave this podium. Certainly this 
would not have been done without a fine staff: Ed Cutler, Howard Cohen, 
Chip Kahn, Phil Mosley, Bitzie Beavin, Russ Mueller, and the Senate 
staff that worked with us.
  And also the chairmen who gave freely of their time and their work to 
make this happen: Chairman Archer, Chairman Bliley, Chairman Hyde, and 
Chairman Goodling, and the subcommittee chairs, Mr. Thomas, Mr. Fawell, 
Mr. Bilirakis, and Mr. McCollum.
  But most of all I would like to thank the gentleman from Florida [Mr. 
Goss] who spent unending hours listening to meetings, so when this bill 
came together it came together in the right way and it came together in 
the Committee on Rules.
  I thank all of them. This is a good day, and I look forward to 
passage of this bill.
  Mr. GOSS. Mr. Speaker, I yield back the balance of my time, and I 
move the previous question on the resolution.
  The previous question was ordered.
  The resolution was agreed to.
  A motion to reconsider was laid on the table.