Pete Stark

Mr. STARK

Mr. STARK. Mr. Speaker, I offer a motion to recommit.

Mr. STARK. Mr. Chairman, I thank the gentleman for yielding. Mr. Chairman, we will be offering a motion to recommit, and I would like to talk with you a little bit about what this will do and what it will not do. It will provide some peace of mind to 3.5 million Americans who, as we debate tonight, are counting the months until they lose their health insurance. If nothing else, Mr. Chairman, this changes nothing in the bill except to extend their coverage as we granted them in 1985 by a unanimous vote of the Committee on Ways and Means. These people will lose their extended coverage because it expires between 18 and 36 months from the time they had a change in family status or lost their jobs for other reasons, and thereby would have lost their employee health insurance. No one will have to subsidize anyone. This is merely allowing those people to pay the full cost of their insurance, at no cost to the employer, no cost to the taxpayer. How can we deny these people, 16 million families have taken advantage of this since 1985. There are each year 3 or 4 million people who because of divorce, disability, the plant closes, would not have insurance, voluntary private sector insurance. How can we deny those people the opportunity to extend their insurance, protect their families in the best American way? Mr. Chairman, I urge you to consider this amendment. It has had bipartisan support. It is humane. It will not deter us from giving the deductibility to the self-employed. So I ask my friends on both sides of the aisle to consider tonight a motion to recommit which will not deter us from what many of us support, and that is the deductibility of insurance cost for the self- employed. But let us take the fear out of the hearts of 3.5 million Americans tonight who will know that they may extend this coverage for their families, themselves, their disabled children, whomever, at no cost. No cost to the budget, no cost to the employer, no cost to anyone except those people who will have to work hard to pay the premiums to the private insurance company under which they are covered. I urge Members to think hard and long about bipartisan support for the motion to recommit.

Mr. STARK. Mr. Speaker, as I indicated, I am opposed to H.R. 831 in its present form. We can do better and we can go home tonight, and without any cost to the Federal Government and without any cost to American employers we can lift the fear from 3\1/2\ or 4 million American families, the fear that they may lose their extended coverage which they received under a bill that we passed unanimously. This is a bill we passed unanimously in the Ways and Means Committee in 1985, under which over 36 million Americans have had continuation of group health insurance after they lost their employer- or would have lost their employer-based health insurance because of a change in family status, because of disability, because of a transfer, because a branch factory or factory closed. This is a bipartisan amendment which adds to every word in the Republican bill. And all it does is extend permanently these extensions that are known as COBRA to nearly 4 million Americans so that the time clock will stop ticking and they will stop worrying about losing this protection. Let me quickly address two concerns and they have only been raised modestly. One concern is it will take a little extra time. It will take 5 minutes of your time tonight, ladies and gentlemen, for a quick vote to add this amendment and to bring to thousands of people in your districts the peace of mind that their insurance will not end if they are currently under a group insurance plan with extended coverages. Second, it has been claimed that employers might be saddled with additional costs under a complicated thing known as adverse selection. That is not true. The reverse is true. Four million people becoming uninsured will add more costs through cost shifting to the total cost of all of our paying for health care coverage than a few people who might try and game the system. There will be no change in rate to employers. They will continue their same payment. The employee will pay 102 percent of the coverage instead of perhaps the 20 or 30 percent that he or she is paying now. It is as if I am paying $101 a month for Blue Cross under my Federal plan, just like many of you. If I were disabled and had to leave and did not have the generous continuation, I would then have to pay 400-some dollars plus $8 a month to the Clerk to bill me and I could continue my Blue Cross low option. I want to extend that peace of mind to every American. And as I say, this does not have a partisan difference in it. I ask Members' support for this so we can walk out of here tonight. This is a bipartisan bill. I subject this is a bipartisan motion to recommit, and I would ask Members to think about the people that will receive the good news that they will have a small tax deduction, those who are self-employed. Let us expand that. Both sides of the aisle have talked about the desirability of portability. This is not quite portability, but it is a step, it is a modest step toward getting the kind of health reform that we agreed last year was needed. This is a modest proposal that was agreed to in some of the bills last year on both sides of the aisle. So for a few minutes of inconvenience tonight, for one extra vote tonight, you can go home and say this, that for the 3,600,000 to 4 million people in America who sometime in the next 18 to 20 months will lose their health insurance--they are paying for it out of their own pockets, at no cost to the Federal budget, at no cost to their employer--we can extend that privilege. If there ever was a time for us to come together to help those people, it is tonight. Ladies and gentlemen, I implore you, we have our own Members who have children who are not covered because they are over 22 and they have to go off health insurance, buy COBRA insurance. We have many cases throughout the land where this insurance will help families. I urge you to think tonight that we have no partisan difference, we have no cost to the budget, we can only help a few Americans who will be desperate to find health insurance if we do not. Mr. Speaker, as stated, I am opposed to H.R. 831 in its present form. We can do better. We can do better for American workers--without cost to the Federal Government, without cost to employers, and without delay. Both the reason for moving this motion, and the remedy it contains, are very simple. The purpose of this motion is simply to help Americans keep the health insurance coverage they have when they lose their job or this is referred to as ``portability.'' This motion would improve health insurance portability through a very simple means--by eliminating the time restrictions contained in the current Federal health insurance continuation protections. These protections are often referred to as ``COBRA'' protections after the 1985 authorizing legislation. Today, nearly 4 million Americans have coverage because of these Federal protections. But under current law, the protections are limited, to a maximum of 18 to 36 months depending upon the qualifying event. For these Americans, the clock is ticking. Their protections may soon lapse. Supporting this motion would stop the clock, and lock these protections in place. Let me quickly address two concerns I have heard regarding this motion. Neither hold merit, and neither should delay us in protecting American workers and their families. First, supporting the motion to recommit would in no way delay or jeopardize the underlying bill. If my motion is agreed to, it will require one vote on the motion and one vote on final passage. But if we exclude these protections, there will still be one vote on my motion and one on final passage. The assistance to be provided the self- employed will not be delayed one minute by the inclusion of these protections for workers. It makes no sense to leave behind one group of Americans--America's workers--when we have a chance to simply and quickly pass legislation to give them all greater peace of mind. Second, some claim that employers will be saddled with additional costs if this amendment passes. Just the opposite will actually result. This motion will reduce the cost-shift from uninsured Americans on to employers. The individual or family member that chooses to continue coverage would pay 100 percent of the premium--150 percent in the case of disabled persons--plus a 2 percent administrative fee. The key for the former employee or their family member is having continued access to health insurance coverage at group rates. If this protection is allowed to lapse, these individuals and families are forced into the individual insurance market where rates easily become unaffordable as they can jump by 100 to 500 percent. We can all agree that the cost of health care for those without health insurance often ends-up in the premiums of employers and other who purchase health insurance. My motion would reverse this cost-shift trend. Rather than become a drain on business or on government insurance programs, those allowed to continue purchasing health insurance at the more affordable group rate will continue to pay for their coverage. By keeping more Americans under the umbrella of health insurance, businesses would see a drop, not an increase, in the burden of uncompensated care. We have been told of the need to take immediate action on H.R. 831 because the Federal income tax filing deadline is approaching. For the nearly 4 million Americans that have insurance as a result of the current time-limited insurance continuation protections, their deadlines are passing every day, and they are losing coverage. We need to act quickly on both of these measures. I ask your support for this motion. A vote in favor of this motion is a vote to strengthen the health insurance protections of all Americans, not just the self-employed. For literally millions of Americans, time is running out.

Mr. STARK

Mr. STARK. Mr. Speaker, on Friday, February 10, 1995, I missed six recorded votes because of a bad case of the flu. Rather than infect the rest of the House, I stayed home. If I had been present, I would have voted as follows: On rollcall No. 112, the amendment by Mr. Watts, to strike the automatic stay provisions relating to relief lawsuits brought by inmates, ``aye.'' reduce by $36 million over 5 years the authorization for prison grants, ``aye.'' On rollcall No. 114, the amendment by Mr. Chapman to make States eligible for both general and ``truth in sentencing'' prison grants rather than either one or the other, ``aye''. On rollcall No. 115, the amendment by Mr. Scott, to decrease by $2.5 billion the total funding for State and regional prison grants, ``aye.'' On rollcall No. 116, the motion to recommit by Mr. Conyers, to allocate any unallocated funds for public safety and community policing, ``aye.'' On rollcall No. 117, final passage, ``no.''

Mr. STARK

Mr. STARK. Mr. Speaker, managed care can be defined as a system that spends money on managers. That's OK, if the managed care plans also deliver quality health care to the plan's enrollees. The problem is that we don't have enough consumer safeguards, protections, and information available to the consumer to help the public buy into a good plan. During the 104th Congress, we should enact managed care consumer protections and require disclosure of managed care plan information. Such legislation will help the industry in its dealings with the public and weed out those who are managing people to death through the denial of services. Health care in America is in a state of tension. Fee-for-service medicine is subject to gross overutilization, abusive unnecessary testing and surgery, and runaway charges. Managed care medicine is subject to gross underutilization, denial of needed, life-essential services, and health care dollars drained away to pay managers, ad-men, and posh corporate overhead. What we need in America is moderation and a good middle ground in both fee-for-service and managed care. We need a system where fee-for-service cannot overutilize and where managed care can't deny necessary services. Achieving this balance will always be a tension and a difficult path to find. The newest hot solution to the Nation's unacceptable health care inflation, of course, is managed care. Managed care firms have been growing like weeds. Following is a staff review of 15 managed care company financial reports, generally for calendar 1993, that shows the percent they spend on health for their patients, the percent they take for general and administrative expenses, and their profit levels. Roughly 20 percent of every health care dollar in these firms is going for overhead, managers, and profit. I think the consumer should know how much of his health care dollar is spent on providing health care for himself, and how much is spent making sure he doesn't get unnecessary care--managing or controlling his or her access to doctors, nurses, and hospitals. Each consumer needs to decide for himself where the fine line is between medical efficiency and of mind. These overhead figures are particulary troubling when compared to the overhead figures in a not-for-profit HMO like Kaiser--about 5 percent-- and in Medicare--less than 3 percent. Mr. Speaker, I will provide periodic updates to these figures. In the meantime, caveat emptor. The table follows:

Mr. STARK

Mr. STARK. Mr. Speaker, yesterday, in the Ways and Means Committee, the contrast between the Democratic and Republican parties was made clear. The purpose of yesterday's committee activity was to help expand the net of health insurance coverage to a few more Americans. What began as a bipartisan effort was turned into a purely partisan affair by the new Republican majority. In vote after vote, the new Republican majority struck down on straight party-line votes measures that would bring fairness and assistance to working Americans. Some measures had no cost to the Government. Others that did were fully paid for. One amendment I proposed would have removed the time limitations on COBRA health continuation coverage. This would have had no cost to the Government nor to employers, because under COBRA former employees and their family members pay full health insurance premium plus an administrative fee. Our amendment would allow individuals and families to continue coverage at a group policy rate rather than convert to an individual policy rate--the difference is often the difference between having and losing coverage. This was voted down by the Republican majority. In the clearest example of how Republican partisanship operated without regard to the good of American workers and taxpayers, Republicans unanimously voted down an amendment offered by my colleague from Washington, Mr. McDermott, to extend deductibility of health insurance costs to employees when an employee is not eligible to participate in employer-sponsored health insurance coverage. Under the bill to be amended, self-employed individuals would be allowed to deduct 25 percent of the cost of health insurance. The cost of this assistance to working Americans was fully paid for--in large part by a change in tax law for individuals who renounce their U.S. citizenship in order to evade paying U.S. taxes. How anyone can justify creating a new permanent entitlement for the benefit of employers and leave out employees is amazing. But it appears to be the new order of the Republican day. I hope that before deliberations begin in the full House of Representatives on this bill, Republicans will have rethought their partisanship just long enough to allow the interests of all American workers to prevail.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise today to recognize the achievements of Ms. Marsha Grilli, a resident of the city of Milpitas in the 13th Congressional District. She has just been selected as the 1995 Milpitas Citizen of the Year by the Milpitas Chamber of Commerce. Marsha has been an active member of the Milpitas community for over 13 years but has really made her mark in our community's schools. She has been immersed in the education of her five children, as any parent would be. But Marsha's interest in their education has benefited all of the schoolchildren of Milpitas. She has served on numerous committees, including the Community Board Advisory Council, school site councils, and Curtner School Association. She was the cofounder of the Milpitas Foundation for Education, served foundation's purpose is to work with businesses to secure grants for both teachers and students. Under Marsha's leadership, the foundation has made a difference in Milpitas. Since Marsha was recently elected to the Milpitas Unified School District, she is no longer able to serve on its board of directors, but I am certain that she will continue to be even more dedicated--if that is possible--to our schools in her new capacity. In 1990, Mayor McHugh appointed Marsha to the Parks, Recreation and Cultural Resources Commission for the city of Milpitas. She currently serves as the commission's chair. She has also been an active member of the Milpitas Volunteer Partners Program for many years where she has participated in such programs as the Fall Fest and Milpitas USA Parade and Festival. Marsha also recently cochaired the Great Mall of the Bay Area Evening Gala which raised over $35,000. She has also been a member of several other organizations such as the Little League, Cub Scouts, Pal Soccer, the Milpitas Chamber of Commerce, and Trinity Episcopal Church. Marsha is also a successful businesswomen who, while raising a family and managing her child care business, has always taken the time to give back to her community. That is why I am proud to recognize Ms. Marsha Grilli as the 1995 Milpitas Citizen of the Year.

Mr. STARK

Mr. STARK. Mr. Speaker, I have just received a letter from a 59 year old self-employed realtor in California--a man who has no serious medical conditions. Several years ago, he was divorced and used COBRA to keep his wife's Prudential group rate policy of $275.96 per month. At the end of his COBRA health continuation period, he asked Prudential to convert to an individual policy. As the gentleman wrote me, that's when Prudential ``dropped a piece of the Rock'' on him. The monthly cost of a $100 deductible policy was $1,714.29--or $20,571 a year. For a $1,000 deductible, the monthly premium was $1,030--or $12,360 per year. To help stop these outrageous overcharges, I urge the Congress to simply extend the COBRA health continuation time periods indefinitely. Once you are in a group policy, you should be able to stay in at the group rate plus an appropriate administrative fee.

Mr. STARK

Mr. STARK. Mr. Speaker, we obviously have entered the world of ``Newtspeak.'' Unlike some of my colleagues, I do not have lapses in how to pronounce important messages. Medicare system into the world of Newtspeak and is suggesting a program that would rethink Medicare from the ground up. If I were going to cut $200 billion out of Medicare I would have to rethink it from the ground up too because I would have destroyed it, and that is exactly what the Speaker suggested in a speech over the weekend. He said that Medicare is the opposite of how America works. And I suspect that is true, if you are a Republican American. America does not work by having Golden Rule Insurance Co., be 1 of the 10 largest donors to GOPAC and then have the whole structure of the American Congress in its first 100 days deciding to revise the Medicare system for the convenience of certain insurance companies. I would like to bring the discussion of Medicare back to earth because it is the finest system in the United States. It has less than a 3-percent overhead. And the Speaker, in his speech, suggested we ought to give American seniors more choice. There is no program in the United States that gives its beneficiaries more choice than Medicare. If you are Medicare beneficiary you can go to any physician or any hospital in the United States if you can walk, ride, hitchhike, or have the bus fare to get there. And there are hundreds of managed care plans which are available to Medicare beneficiaries. As we speak today there are three or four dozen applications for new Medicare managed care programs to be opened to seniors. There is no insurance policy in the country that gives greater choice. Why are we discussing at this point the idea of turning Medicare into a voucher program? I submit it is political payback time, and it is a way to finance 200 or 300 billion dollars' worth of the cuts. The first hearing we had in the Committee on Ways and Means was a proposal on the first day of Congress to take $70 billion out of the Medicare Trust Fund. For what purpose? To finance tax cuts for the very 2 or 3 percent of the richest Americans in our country. This is Newtspeak. This is not how America operates, giving money to the rich, and taking it out of the trust fund that supports a medical care delivery system for the most fragile, needy people in the United States. Ladies and gentleman, Medicare is one of the wonders of our Government. Maybe many things do not work well and maybe many things are not efficient, but understand we have fewer than 4,500 bureaucrats serving 5 million people, and there is no insurance company in the country that comes close to that efficiency.

Mr. STARK

Mr. STARK. Mr. Speaker, today I am introducing legislation that would impose a tax and import controls on bullets expressly designed to penetrate the bulletproof vests of law enforcement personnel. This legislation, the Anti-Cop-Killer Bullet Act, would impose the same tax which currently exists on controlled firearms, such as submachine guns and sawed-off shotguns, to high-technology cop killer bullets like the rhino and black talon bullet. If enacted, the bullet manufacturer would be taxed at the rate of $200 for each bullet--a tax so high that the bullet obviously would never be produced. Over 10 years ago, a Teflon-coated bullet designed to pierce soft body armor was introduced. Due to strong public reaction, Congress in 1986 enacted the very first law to ban a round of ammunition. Since then other bullets manufactured from different materials but designed with the same purpose have been introduced. Only after threatening or actually carrying out our threat to ban these cop-killer bullets, have we in Congress been successful at stopping them from reaching our streets. However, as soon as we in Congress go through the motions of preventing a cop-killer bullet from going into production, along comes another manufacturer with a new bullet designed to penetrate protective armor. This pattern will continue as long as bullet manufacturers are allowed to exploit the loophole that exists in the 1986 law banning cop-killer bullets. Under the law, only metal alloy and Teflon-coated bullets were singled out leaving the door wide open for companies such as the Signature Products Corporation to develop plastic-based ammunition like the rhino bullet. My legislation would prevent these unscrupulous bullet manufacturers from taking advantage of this loophole in existing Federal law. Rather than attempting to add another amendment to the 1986 law, the Anti-Cop- Killer Bullet Act proposes an across-the-board tax on all bullets expressly manufactured or advertised to penetrate normal quality bulletproof vests worn by law enforcement personnel. The tax at $200 per bullet would surely make the business of manufacturing cop-killer bullets an economic impossibility. America's law enforcement officers are already out-gunned as it is. Having to worry about a bullet piercing their protective armor should be the last thing on their mind. By passing the Anti-Cop-Killer Bullet Act, we will be giving our law enforcement the support they need. I urge my colleagues to join with me to pass this legislation so that we can prevent these cop-killer bullets from endangering the lives of America's law enforcement officers.

Mr. STARK

Mr. STARK. Mr. Speaker, Today I am joined by Congresswoman Constance Morella, Congressmen Robert Matsui and William Coyne in introducing legislation that ensures that parents of emotionally disturbed and physically disabled children are not required to transfer custody of their children for the sole purpose of obtaining public services. At this moment, in many States, parents are confronted with a Hobson's choice of either surrendering their children into the custody of the State in order to receive necessary residential services, or retaining custody and, therefore, denying their children the services they need. These are not parents who have abused, neglected, or abandoned their children in any way, Mr. Speaker. They are simply parents who cannot afford to pay the full cost of the out-of-home treatment their child requires and have as a result, have sought the help of the State. There are many reasons why these parents are currently required to give up custody of their children, but key among them is the simple fact that--because our country has no system designed specifically for these children--parents are forced to rely on agencies that were not designed with their needs or situations in mind. Because many of these agencies were designed to serve children being placed because of abuse or neglect, their custody transfer requirements are not appropriate to families with children who have serious emotional or physical disabilities. Also key among the reasons, Mr. Speaker, is simple misunderstanding of the requirements of current Federal law. We believe that parents of these children should be able to keep custody of their children, continue their involvement in decisionmaking on their behalf, and work cooperatively with State authorities to secure needed services. The bill we are introducing today is designed to address--to the extent possible under Federal law--the multiple causes of the practice of requiring parents to relinquish custody of their children. These include: misinterpretation or misapplication of title IV-E requirements; the application of custody transfer children with emotional or physical disabilities--either because these requirements are an agency's standard operating procedure, or because of assumptions about the desired role of the family in treatment; and the lack of voluntary placement procedures in some States (which means that custody must be transferred to draw down title IV-E funds, or to place children out-of-home under other available funding streams, including Medicaid). In general, our bill would amend the six major Federal programs that may currently be used to provide out-of-home services to emotionally disturbed and physically disabled children. The amendment would require States to provide that parents not be required to transfer custody in order to have their child placed out- of-home, and that all such children be placed pursuant to a voluntary placement agreement. In addition, the bill would clarify existing Federal law regarding custody transfer requirements under title IV-E. As drafted, the bill would: ensure that custody transfer requirements are not imposed on children with emotional or physical disabilities; clarify that title IV-E does not require States to have legal custody over children in their physical custody, or to have legal custody in order to draw down Federal IV-E payments; prohibit States from requiring parents to transfer custody to access out-of-home Medicaid- EPSDT treatment services; and ensure that States have in place the necessary procedures to place these children without transferring custody. Mr. Speaker, we believe that a full resolution of the custody transfer dilemma--and indeed the larger issue of adequate access to needed services for emotionally disturbed and physically disabled children--will ultimately depend on the development of a designated system of care for these children. This legislation, however, will provide a significant firs step towards ensuring that these children are able to get needed services without unnecessarily disrupting families, and that no child is denied access to funding solely on the basis of their custody status. We are very excited about the possibility of enacting this piece of legislation. It will help thousands of families and will correct a practice that everyone agrees makes no sense--for children, for parents or for our governments. In the seven States that have enacted a similar State bill, the bill has passed with broad bipartisan support. It is our expectation that introducing the bill today will give interested people the opportunity to fully examine the bill before the 104th Congress begins. Though the concept of preventing the transfer of custody of children is a simple one, the legislative solution is more complicated. A draft copy of the bill has been well received by child welfare, mental health, and parent advocacy groups, as well as researchers who have studied this issue. We plan to reintroduce the bill January and look forward to its passage by the next Congress.

Mr. STARK

Mr. STARK. Mr. Speaker, the Republicans refuse to tell the American people how they will balance the budget, cut taxes, and increase defense spending. On November 22, 1994 I offered a $1,000 campaign contribution to any Republican Member who signed the so-called Contract With America and who plans on running for reelection who could explain in detail what cuts he or she would make to achieve a balanced budget in fiscal 1996. No one has taken me up on the offer. The Republican Contract With America will mean the destruction of Medicare, education aid, cancer research, and other programs the American people support. The Republicans know that and refuse to explain it to the American people. Mr. Speaker, I double my offer: I will contribute $2,000 for a charity in the district of any Republican who can explain exactly what they will cut to achieve a balanced budget while increasing defense and cutting taxes.