Michael Bilirakis

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in support of the Quality Care for the Uninsured Act. This bill is designed to increase access to care for millions of Americans who currently lack health coverage. It includes a proposal that I crafted to expand the ability of community health centers to provide quality care to individuals in need. Community health centers are not-for-profit health care providers. By law they are established in America's medically underserved areas and must make their sources accessible to everyone regardless of individuals' ability to pay. H.R. 2990 would expand the ability of community health centers to private affordable health care services to individuals who lack health coverage. It would authorize community health organizations to form networks of providers, to increase access to care and medically underserved areas. These networks will expand health options in communities that currently lack the necessary infrastructure to fully support the comprehensive delivery of health care services. Specifically, Mr. Speaker, the bill will authorize a waiver of State financial requirements that may prevent managed care organizations controlled by community health centers from fully participating in the private health care market. By allowing the establishment of alternative Federal solvency standards for community health organizations, this proposal recognizes the unique circumstances facing community health centers and the communities that they serve. Community health organizations will help expand the patient base of health centers while providing a cost-effective coverage option for the small employers. These networks will be operated by local providers whose primary mission is to meet the health care needs of the communities they serve. These networks will enhance competition among commercial managed care plans because they will deliver care that is responsive to local needs. Competition will drive quality up while driving costs down. Mr. Speaker, I was proud to cosponsor H.R. 2990, and I strongly urge Members to support its passage. The Census Bureau has underscored the urgent need for this legislation by announcing that the number of uninsured Americans rose to over 44 million last year. This legislation builds on the efforts of previous Congresses to expand health care to the uninsured. During the 103rd Congress I joined then Congressman Roy Rowland in leading a bipartisan coalition in support of consensus health reforms. Our targeted plan included significant measures to expand health care access to the uninsured. Among its key provisions, our plan would expand the role of community centers in providing access to care in medically underserved areas. We also proposed insurance reforms to help individuals with preexisting conditions obtain coverage and to help workers keep their insurance when they changed jobs. These insurance provisions were ultimately, I underline ultimately, enacted into law during the 104th Congress, but those individuals had to wait 2 years for assistance. Mr. Speaker, we should not repeat that mistake today. H.R. 2990 represents an important opportunity to expand coverage to the uninsured. It is not perfect, it can go further, it can consider some of the items that the gentleman from Michigan (Mr. Dingell) mentioned; but it would be an important opportunity to at least expand coverage, make available coverage to the uninsured. We should not make 44 million Americans wait any longer for access to the health care they need. I challenge those who support patients' rights to put people ahead of politics and join us in supporting passage of this critical measure. Mr. Speaker, I reserve the balance of my time.

Mr. BILIRAKIS. Mr. Speaker, I ask unanimous consent to control the remainder of the time in place of the gentleman from Virginia (Mr. Bliley).

Mr. BILIRAKIS. Mr. Speaker, I yield 3 minutes to the gentleman from Tennessee (Mr. Bryant).

Mr. BILIRAKIS. Mr. Speaker, I yield 2 minutes to the gentlewoman from Texas (Ms. Granger).

Mr. BILIRAKIS. Mr. Speaker, I yield the balance of my time to the gentleman from Arizona (Mr. Shadegg).

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Chairman, I yield 2 minutes to the gentleman from California (Mr. Gary Miller). (Mr. GARY MILLER of California asked and was given permission to revise and extend his remarks.)

Mr. BILIRAKIS. Mr. Chairman, I yield myself such time as I may consume. Mr. Chairman, I am pleased to bring H.R. 2506, the Health Research and Quality Act of 1999, to the floor today. This widely supported bipartisan bill was approved by voice vote in the Committee on Commerce and the Subcommittee on Health and Environment. In April, experts from both the public and private sector testified about the critical function of this agency at a hearing before the subcommittee. I introduced this measure jointly with the gentleman from Ohio (Mr. Brown), the ranking member of the House Commerce Subcommittee on Health and Environment, to reauthorize the Agency for Health Care Policy and Research and redefine its mission. Our bill renames it as the Agency for Health Research and Quality, or, one of those famous Washington acronyms, AHRQ. The purpose of this new name, and the reauthorization, is to foster comprehensive improvements in our health care system. Our bill refocuses the efforts of this critical agency to support private sector initiatives. Building on its current activities, the new agency will become a key partner to the private sector in improving the quality of health care in America. The bill specifically prohibits the agency from mandating national standards of clinical practice or quality health care standards. Instead, it emphasizes the agency's nonregulatory role in building the science of health care quality. The bill also includes provisions to overcome barriers to access to preventive health care through a public-private partnership. It authorizes grants for the establishment of regional centers to improve and increase access to preventive health care services. By approving the legislation before us, we can ensure the continued availability of the objective, science-based information this agency provides. I urge Members to join us in supporting passage of H.R. 2506, the Health Research and Quality Act of 1999. Mr. Chairman, I reserve the balance of my time.

Mr. BILIRAKIS. Mr. Chairman, I yield back the balance of my time.

Mr. BILIRAKIS. Mr. Chairman, I asked the gentleman to yield just to share with the House that the majority has had an opportunity to review his amendment which would require that the director bill private-public partnerships, enhance the quality of and access to health services regarding cancer and cardiovascular services for women. I would also report to the gentleman that we have a markup at my committee in a couple of days, a breast cancer markup, a very important piece of legislation. We are prepared, Mr. Chairman, to accept the amendment.

Mr. BILIRAKIS. Mr. Chairman, I yield back the balance of my time.

Mr. BILIRAKIS. I yield to the gentleman from Ohio.

Mr. BILIRAKIS. Mr. Chairman, this is an en bloc technical amendment to section 2 of the bill as reported by the Committee on Commerce. Section 2 of the bill is divided into three parts. Part A provides for the reauthorization of the agency for health care policy and research and renames it the Agency for Health Research and Quality and outlines the agency's mission and general authorities. Part A also establishes specific requirements that the agency must meet as well as limitations on the agency's authority and provides the agency with authority to support training programs. Part B outlines the specific programmatic authority of the agency in six broad areas and includes a seventh section to promote coordination and reduce unnecessary duplication of existing health services, research, quality research, and improvement activities. The six programmatic areas include outcomes research, organization and delivery research, quality and cost of care research, and data development information systems for health care improvement, primary care and access research, and practice and technology assessment. Part C governs the daily administration of the agency, establishes its national advisory counsel and sets the authorization levels for the agency. This section outlines the agency's authority to support grants and contracts and establishes requirements for scientific peer review of research funded by the agency and the dissemination of research findings. The committee was unable, Mr. Chairman, to make these technical corrections to the text of the bill before reporting it, however we have met with the minority and with the administration, and we are all in agreement that these amendments are technical in nature, improve the underlying text and do not make substantive changes in the bill as it was reported. For these reasons, I ask my colleagues for support of this en bloc amendment.

Mr. BILIRAKIS. Mr. Chairman, I offer an amendment.

Mr. BILIRAKIS. Mr. Chairman, we have no further requests for time.

Mr. BILIRAKIS. Mr. Chairman, I yield such time as he may consume to another gentleman from California (Mr. Bilbray).

Mr. BILIRAKIS. Mr. Chairman, I move to strike the last word. Mr. Chairman, I just want to say that the majority has had an opportunity to review this amendment, which would require that the director of the agency submit an annual report to the Congress beginning with fiscal year 2003 regarding prevailing disparities in health care deliveries as related to racial and socioeconomic factors in priority populations. We are prepared to accept the amendment and also commend the gentleman from Illinois (Mr. Davis) for his insight and preparation of this and the other amendments.

Mr. BILIRAKIS. Mr. Chairman, will the gentleman yield?

Mr. BILIRAKIS. Mr. Chairman, I rise in support of the amendment. Mr. Chairman, again, to reiterate, we have had an opportunity to review the amendment, which would establish this Office of Special Populations within the agency to which the director would carry out the requirements specified in said section 901(c). We are prepared to accept the amendment.

Mr. BILIRAKIS. Mr. Chairman, I thank the gentlewoman for yielding, and I say to her that the majority has had an opportunity to review the amendment, which would add inner-city areas to rural and frontier areas among the geographic priority populations included in the submission. I commend the gentlewoman for formulating this amendment, and we are prepared to accept it.

Mr. BILIRAKIS. Mr. Chairman, will the gentlewoman yield?

Mr. BILIRAKIS. Mr. Chairman, I rise in support of the amendment. Mr. Chairman, the majority has had an opportunity to review the amendment which would require, as the gentleman said, that the director in allocating health services training grants under section 902 take into consideration shortages in the number of trained researchers who are one of a number of priority populations, as well as shortages in the number of trained researchers who are addressing the priority of populations. We are prepared to accept the amendment.

Mr. BILIRAKIS. Mr. Chairman, I rise in support of the amendment offered by the gentlewoman from Connecticut (Mrs. Johnson). Mr. Chairman, the majority had a chance to review the amendment. It would provide graduate medical education payments to the children's hospitals by creating a financing system for pediatric physical training. The amendment was introduced as the Children's Hospital Education and Research Act, H.R. 1579, with significant bipartisan support. Mr. Chairman, few contest the historic inequity in GME funding for children's hospitals. Because Medicare is the largest single payer of GME and since freestanding children's hospitals treat few Medicare patients, as the gentlewoman from Connecticut said, their GME funding is very low. This gap in Federal support jeopardizes highly successful pediatric training programs. Since comprehensive GME reform may take more time to develop, this amendment will provide immediate financial assistance through a capped, time-limited appropriation of $280 million in fiscal year 2000 and 285 million in fiscal year 2001. This authorization would end after 2 years or with the enactment of GME reform, whichever occurs first. Although, Mr. Chairman, I am not going to make a motion to contest the germaneness of this amendment, I do wish to point out that the bill under consideration now which reauthorizes an agency with a primary research mission is a questionable vehicle for authorizing appropriations for funding GME and children's hospitals, and I am sure the gentlewoman understands that and would acknowledge that. Moreover, on process grounds I can make a strong argument for moving the children's GME bill through the normal committee process rather than as an amendment to H.R. 2506. But having said this, Mr. Chairman, of course I am a cosponsor of the Johnson GME bill, and I agree with my colleague from Connecticut that this authorization of appropriations will send an important message to the relevant appropriations committees that the Congress considers support of GME for doctors training in children's hospitals as a high, high priority, and therefore, Mr. Chairman, we are prepared to accept the amendment.

Mr. BILIRAKIS. Mr. Chairman, I move to strike the last word. Mr. Chairman, the majority has had an opportunity to review the amendment. I personally spoke with the gentleman regarding his amendment. I commend him for it, and I would agree with him. Certainly in Florida, where we have such a much bigger demand than most of the States in the country, we have a tremendous shortage of pharmacists. Most of the members of my family are pharmacists, and I am able to keep up with that. Mr. Chairman, we are prepared to accept the amendment.

Mr. BILIRAKIS. Mr. Chairman, will the gentleman yield?

Mr. BILIRAKIS

Mr. BILIRAKIS. Madam Speaker, I ask unanimous consent that, in the engrossment of the bill, H.R. 2506, the Clerk be authorized to correct section numbers, punctuation, and cross references and to make such other technical and conforming changes as may be necessary to reflect the actions of the House.