Bill Thomas

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, reserving the right to object, I will not object if the request is something other than an imploring of the chairman that someone else be allowed to offer an amendment. If the request is something other than that, I will not object.

Mr. THOMAS. I yield to the gentleman from New York.

Mr. THOMAS. Mr. Speaker, I withdraw my reservation of objection.

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, I am pleased today to introduce the Advanced Medical Device Assurance Act of 1995 in order to clarify the scope of coverage and amount of payment under the Medicare Program of items and services associated with the use of certain medical devices approved for investigational use. Questions have been raised as to whether Medicare should reimburse for hospital and physician services when procedures involving a medical device approved for use by the Federal Drug Administration [FDA] under the Investigational Drug Device [IDE] is used. Our Nation's leading clinical researchers and doctors, and the patients who depend on these improved medical technologies are losing because of this confusion. Additionally, the use of these advanced devices is dramatically declining around the country. Many of the medical technology companies are moving all of their research out of the United States to Europe, Canada, and Japan where payment policy is not an issue. These advanced medical devices reduce length of surgical procedure, hospitalization, patient mortality, and the need for repeat procedures. All of these patients, whether they get an advanced device or not, would be in the hospital anyway receiving medically indicated care. Clarifying the policy to provide coverage for newer devices would not increase costs because the DRG pays a set rate for set therapies regardless of whether there is a clinical trial involved. The American Academy of Orthopedic Surgeons, American College of Cardiology, American Hospital Association, American Medical Association, Association of American Medical Colleges, Association of Professors of Medicine, California Health Institute, Catholic Health Association, Cleveland Clinic, Coalition of Boston Teaching Hospitals, Federation of American Health Systems, Greater New York Hospital Association, Health Industry Manufacturers Association, Mayo Clinic, North American Society of Pacing and Electrophysiology, and the Society of Thoracic Surgeons all believe we need to clarify this policy. These are all well-respected health care organizations and I believe this bill brings about the clarity that is needed. I strongly encourage my colleagues to cosponsor this important, cost- neutral legislation and to work for its prompt enactment so that Medicare beneficiaries will have access to safe and high-quality medical care.

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, I thank the gentleman for yielding time to me. Mr. Speaker, if anybody tuned in and listened to the arguments on the other side of the aisle, they would think that this was a free for all debating here on any subject that any Member wanted to speak on. In fact, that is not the case. What is in front of us is a motion to instruct conferees. The House passed 408 to 14 a measure to extend Medicare Select. Medicare Select is a so-called MediGap. It is one of those insurance policies available to folk to create a whole package around part A and part B Medicare. There are currently 10 MediGap insurance type policies that have been approved by the Department of Health and Human Services. Medicare select is simply an 11th offering. It says, instead of the traditional structure, you may go out into a network to get this wrap-around health care package. That is all it is. That is all it ever was. That is all it is ever going to be. It is simply the 11th, the addition to 10 other small programs. What the minority is trying to do, Mr. Speaker, is argue the entire Medicare issue on their motion to instruct. What a bizarre motion to instruct. It says that ``will be instructed to resolve the differences between the House 8\1/2\ year extension and the Senate 5-year extension of Medicare Select policies.'' Eight and one-half years, 5 years? The House bill that was passed said extend it for 5 years. The Senate bill that was passed said extend it for 18 months. Extension in the unabridged dictionary right over here says ``An additional period of time from the current time;'' adding time, an extension. Where in the world the Democrats got 8\1/2\ years and 5 years as extensions is beyond me. But that is what they say here. In addition, to make this motion germane, they say the scope of the conference, but what they really want to do is talk about the large program of Medicare. They do not offer specific proposals to fix Medicare that the trustees of the trust fund said is going broke in 7 years. No. They do not offer constructive alternatives. They stand up and complain. What a whimpering group the Democrats have been reduced to in this House. Where are your ideas? Where are your alternative proposals to what we are offering? This is a simple motion to instruct conferees about extending a program that is currently in 15 States, very high success rate, to allow any of the 50 States to participate in the program. For how long? 5 years. And guess what? After that 5-year period, the Secretary of Health and Human Services has to come to the Congress and say that this program has not resulted in savings, that those enrolled in Medicare Select policies are not provided with comparable coverage, and if that is the case, we do away with it. But if they are provided with comparable coverage, if it does provide savings, then we are going to go ahead and continue the program. That is what this debate is about. A bill that passed 408 to 14 and by unanimous vote in the Senate, are we going to extend this modest little program? I want Members to listen to this side of the aisle during this debate on what is supposed to be a motion to instruct. They are going to throw all kinds of garbage to scare the seniors about what is going to happen to the Medicare Program. I will tell you what is going to happen. If we listen to them and do nothing, the Medicare Program is going to go bankrupt. Mr. Speaker, Republicans as the majority are going to offer constructive alternatives which will not only make sure that the program does not go bankrupt but it creates real choice in today's health care market like a modest little program called Medicare Select. When we listen to the stories over here, it is going to be about making political hay, not about the program that the House and the Senate are going to reconcile their differences over to give seniors one small additional choice in the arsenal of making sure they have adequate health care protection.

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, well, I guess we are not going to talk about the motion to instruct. Obviously, that was not the reason you offered what purportedly is a motion to instruct conferees. The factual information in the motion to instruct is simply wrong. There is no instruction in the motion to instruct. It simply says that you want to talk about what is going on in this year's budget process. That is what the motion to instruct says. So, if you do not want to talk about your motion to instruct, and I am quite sure you do not expect it to pass because it would be rather bizarre to pass a motion to instruct that has no instructions to the conferees, so what you really want to do is talk about the issue of Medicare, and you want to talk about the issue of Medicare in terms of what Republicans are trying to do to make sure that the Medicare trust fund does not go bankrupt. I think you need to remember that in April the trustees of the health insurance trust fund, the Secretary of Health and Human Services, Donna Shalala, the Secretary of the Treasury, Mr. Rubin, Secretary of Labor, all President Clinton's appointees to the Board of Trustees, said if we do nothing, if we do nothing, Medicare goes bankrupt in 2002. What Republicans are proposing to do is take the $4,700 that is spent on each senior today and grow that to $6,400 in 2002. If we can do that, if we can accomplish an increase in the program at that rate, we save Medicare from bankruptcy. The Democrats have had some difficulty in understanding that concept. I want to commend the gentlewoman from Connecticut [Mrs. Kennelly] because the gentlewoman from Connecticut said it right. What we are talking about is reducing the increase. The job for all of us is to create a Medicare which has more choice for seniors, which grows in the amount that is available, but that fundamentally makes sure the program does not go bankrupt. You have heard the word ``cut'' over here from virtually every speaker. It is a word that is somewhat pejorative, that is loaded, that is a political term that they want to use. They cannot deny themselves the use of the term ``cut.'' The gentlewoman from Connecticut [Mrs. Kennelly], to her commendable credit, did not say ``cut,'' because she knows it is not a cut. It is a reduction in the increase, and, frankly, when you have increases going up at 10.5 and 11 percent a year in an old 1960's bill-paying structure, when today's marketplace is half that, taxpayers should want us to make sure that we get the savings from the marketplace in the Medicare Program. That is what we propose to do. And we are looking for people to join us in the effort to save Medicare. I did not hear one person on this floor today talk about joining in the effort to save Medicare. But I want this voice to be heard on the floor. I want my Democrat colleagues and friends to listen carefully to the words of this individual. This is what he said: ``Today, Medicaid and Medicare are going up at 3 times the rate of inflation. We propose to let it go up at 2 times the rate of inflation. That is not a Medicare or Medicaid cut.'' Repeat, ``That is not a Medicare or Medicaid cut.'' So when you hear all of this business about cuts, let me caution you that is not what is going on. Who said that? William Jefferson Clinton, President of the United States and a Democrat. He believes we have to reduce the rate of increase, just as the gentlewoman from Connecticut [Mrs. Kennelly] said. We have to reduce the rate of increase. What we are proposing is to reduce the rate of increase. What President Clinton has said must be done, what he believes should be done is to reduce the rate of increase. How we do that is going to be a very, very positive exercise as we open up a 1960's fee-for-service bill-paying bureaucracy to all of the exciting changes that are going on out there in the health care world, one very small, modest change that has been a pilot program for 3 years, called Medicare Select, that has almost a half million folks in that program, with only nine complaints to date. It is a program that we want to continue for a 5-year period. We have told the Secretary of Health and Human Services, ``Keep an eye on that program. If it does not do what it is supposed to do, that is, increase choice and save money, we will sunset the program. We will come up with another idea.'' Right now what we need are new ideas, not the same old arguments, new ideas. Medicare Select is a promising new idea. We want to send the program to the 50 States who want to join it. The States voluntarily take up the program. it is not imposed upon them. People voluntarily buy their insurance. It is not imposed upon them. It is a slightly different way of doing business in the insurance and health care area. We want to see if it has some promise. We are going to try some other ideas. We are going to bring the sunshine from the outside, the positive reduction in expenses from the outside, into this archaic system, by choice. Republicans are going to do that. We would really love to have our Democratic colleagues join their President in reducing the increase in positive ways. Instead, what you hear is pure political propaganda. They do not want to talk about Medicare Select. I will tell you, you just heard a number of Democrats come to the microphone, the gentlewoman from Connecticut [Mrs. Kennelly], the gentleman from Texas [Mr. Doggett], the gentleman from California [Mr. Waxman], the gentleman from Massachusetts [Mr. Moakley], the gentleman from New Jersey [Mr. Pallone], the gentleman from Pennsylvania [Mr. Klink], they all voted for the Medicare Select measure when it left here, 408 to 14. This is a good idea. What you have here today on the part of the Democrats is an exercise largely in futility. They are now the minority party. They do not get to ram proposals down people's throats by pure quantitative measures because they have more votes than someone else. We are asking them to come to the table with your ideas. Let us hear them. Over the next several months there is going to be a feeding frenzy of ideas in the Health Subcommittee of Ways and Means and Health Subcommittee of Commerce. We are going to put together a proposal that will make sure the Medicare trust fund will not go broke, that seniors will have a better choice, we will grow the Medicare Program from today's $4,700 to $6,400 for every American. We will save the program. This is a modest beginning. Vote down the motion to instruct, which instructs nothing, and let us get on with change.

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Florida [Mr. Weldon].

Mr. THOMAS. Mr. Speaker, I want to thank the minority leader for a wonderful speech as he leaves the floor because it is not a speech for this particular bill at this particular time. It is an excellent political speech for some time in the future, perhaps. Today we have on the floor H.R. 1590. What it does is ask the trustees to tell us what their suggestions are as to how to save the trust fund. Last week, the full Committee on Ways and Means met and the trustees presented their report. In the conclusion, the trustees said that experience to date suggests that the prospective payment system has worked but extension of this payment system to other providers could provide another 5 to 10 years before the fund is depleted. We are asking them to give us the specifics on their recommendation, on their conclusion of their report. In addition, the report goes on to say, to facilitate this effort, the trustees further recommend legislation. They go on to suggest legislation in their report. The minority leader was feeling very good about talking about tax cuts and Medicare. That is simply oil and water on the floor this morning. The bill says to report back, submit to the Congress recommendations for specific program legislation designed solely-- solely--one, to control Medicare hospital insurance program costs and to address the projected financial imbalance in the Federal hospital insurance trust fund in both the short and long range, and to more effectively control Medicare supplementary medical insurance costs-- period. That is what H.R. 1590 asks for. On the committee hearing, we asked the Secretary to provide some suggestions. She said she would be providing none. Had the administration been willing to cooperate and address the shortfall of funds in an openhanded, working together method, we would not be here on the floor asking this House to pass H.R. 1590. We must require the trustees to provide us with what they hinted at as one of the sources for changes. As the minority leader attempted to raise the specter of partisanship in trying to solve the health care funding program for our seniors, I just would suggest that perhaps he and a few other Democrats look at health affairs, winter 1994, and an article by Guy King. Who was Guy King? Guy King was the chief actuary of the Health Care Financing Administration from 1978 until July 1994, and played a significant role in developing the cost estimates for the Clinton administration's health care reform proposal. One of the chief architects of the President's health care reform proposal said, ``Even President Clinton's proposed health care reform legislation, with its ambitious and highly controversial cuts in the Medicare Program, would have had only a minor effect on the deepening financial crisis of the program by only a couple of years at most.'' The program has been in trouble for several years, the President's proposal would have bought only a couple of years, with all due respect to my friend from Florida, the trustees say this program is in trouble. Regardless of the arguments of making it a partisan argument, the seniors expect and deserve solutions to make sure that Medicare is sound. Who else but the trustees of the program should be asked, what are your ideas to make the program sound? Pass H.R. 1590.

Mr. THOMAS. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Arizona [Mr. Kolbe]. (Mr. KOLBE asked and was given permission to revise and extend his remarks.)

Mr. THOMAS. Mr. Speaker, I yield 1 minute to the gentleman from Nebraska [Mr. Christensen], a valued member of the Committee on Ways and Means.

Mr. THOMAS. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 1590) to require the Trustees of the Medicare trust funds to report recommendations on resolving projected financial imbalance in Medicare trust funds.

Mr. THOMAS. Mr. Speaker, I yield 3 minutes to the gentleman from Florida [Mr. Bilirakis], chairman of the Subcommittee on Health and Environment of the Committee on Commerce. (Mr. BILIRAKIS asked and was given permission to revise and extend his remarks.)

Mr. THOMAS. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, before us today is H.R. 1590, a bill which would have the Board of Trustees for the Federal Hospital Insurance and Supplementary Medical Insurance trust funds submit specific recommendations on how to resolve the financial crisis facing Medicare in a reasonable timeframe. Mr. Speaker, I reserve the balance of my time.

Mr. THOMAS. Mr. Speaker, I yield myself the balance of my time. Mr. Speaker, the gentleman from California is quite right. Last year the attempts to adjust the Medicare program were contained in an ill- conceived, comprehensive national health care program that had three things wrong with it: A majority of the Democrats did not support it, a majority of the Republicans did not support it, and a majority of the American people did not support it. I will also say, in his attempt to reach for rhetoric, I am personally embarrassed for the gentleman from California to say the members of the board of trustees of the HI trust fund and the supplemental Medicare insurance trust program. Perhaps the gentleman, in his wisdom, forgot that one of the trustees was the Secretary of the Treasury, Mr. Rubin. Perhaps he forgot one of the trustees was the Secretary of Health and Human Services who oversees the entire Medicare program. She is one of the trustees. Perhaps the gentleman, in his rhetorical splendor, forgot that Shirley F. Chater, Commissioner of Social Security, is one of the trustees. Those are all President Clinton's appointees who are charged with running the program, besides statutorily being trustees of the trust fund. They have responsibility. In their report they suggested in a general way legislative changes. Read the conclusion of the trustees' report. They said generally we should take programs that are in effect and extend them to other areas. What H.R. 1590 asks is to be specific in the recommendations that those trustees made, including the Secretary of Health and Human Services. In addition, there has been great weight placed on linking fixing Medicare with tax cuts and arguing that our attempt to fix Medicare is because we want to spend it on taxes. Where were you folks a couple of months ago when the House of Representatives voted out tax cuts that were fully funded? Was a piece of Medicare funding used for those tax cuts? Yes. What was it? The only Medicare cuts suggested by President Clinton in his fiscal year 1996 budget. They totaled a munificent $10 billion, and they were extenders of current limitations. That is all the Democrats have offered from the Clinton administration. We accepted those and included them in the fully funded tax cuts. What is in front of us is the bankruptcy of Medicare. Listen carefully: ``Today Medicaid and Medicare are going up at 3 times the rate of inflation. We propose to let it go up at 2 times the rate of inflation. Today Medicare beneficiaries get $4,700. In 2002, we propose $6,300.'' That is going up, that is not going down. Who said, ``Today Medicaid and Medicare are going up at 3 times the rate of inflation. We propose to let it go up at 2 times the rate of inflation?'' President Clinton 2 years ago. How interesting when you see an opportunity to make political hay with seniors. You refuse to give responsible suggestions for change. H.R. 1590 is a responsible suggestion for change, and we urge its passage.

Mr. THOMAS

Mr. THOMAS. I thank the gentleman for yielding. I would like to point out there have been nine recorded votes on your side today, none on ours.

Mr. THOMAS. Mr. Chairman, I ask unanimous consent that the voice vote be vacated.

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

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, I rise today to praise Ms. Julia Robinson, who on May 4 will be honored by her peers as the 1995 Kern County Registered Nurse of the Year. In the person of Julia Robinson we do not have to look far to find an every day hero and role model for our children. While it may not be obvious when you look at Ms. Robinson's profession, a nurse, to see why she is a role model. There are many nurses. Nor is it obvious by her career, teaching. There are many teachers. To understand why Ms. Robinson is an every day hero and a role model, you must look at the totality of her work. Ms. Robinson has risen to do good things throughout her career. She is both teacher and student--a teacher of nurses to be as an Associate Professor of Nursing at California State University, Bakersfield for over 10 years and as a doctoral student at the University of San Diego. As an associate professor Ms. Robinson is the team leader and coordinator of the medical/surgical course of the nurses junior year and teaches course in advanced health assessment for graduate students. And for her efforts, her students honored Ms. Robinson in 1993 during the pinning ceremony. Julia Robinson also does not back away from great challenges and has recently taken on what some in the teaching world would consider the unenviable task of preparing the department for the reaccreditation process slated to begin in the fall of 1995. Ms. Robinson has remained active in the day-to-day world of nursing by acting as a volunteer nurse practitioner for the Salvation Army and as a volunteer in the Student Health Center at the university. The list of Julia's accomplishments, degrees and honors stretches over years and I expect that given her past record of achievement and commitment to her profession they will continue long into the future. We offer congratulations to Julia Robinson on this honor that is very well deserved.

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, today I ask you to join me in commemoration of the 80th anniversary of the Armenian genocide. On April 24, 1915, under the direction of the Turkish Ottoman Empire, a campaign of Armenian extermination began. By 1923, 1.5 million Armenians were murdered, with another 500,000 forced into Russian exile. Today we recognize the struggle of the Armenian people to live peacefully in their historic homeland. Armenians in the United States and elsewhere should know that their history of suffering has not and will not be ignored. Like the Jewish and Cambodian holocausts, the Armenian genocide stands out as one of the world's most morally reprehensible acts. We need to address and trace the causal factors leading to the rise of totalitarian governments, and ensure that the seeds of Fascism are never again planted. On this day, we all should take a moment to remember those Armenians who died 80 years ago. The United States and our allies should also reaffirm our resolve to ensure that no nation will ever again have the opportunity to participate in mass genocide.

Mr. THOMAS

Mr. THOMAS. I thank the gentleman for yielding me the time. Mr. Chairman, if Members will examine the proponents of the substitute's argument, what they are saying is that we really do want Medicare select, we just want to improve it, we want to help. That would be akin to having you cross the street against the light. Urge you to go down a tunnel with a light ahead and say it is daylight. Turn on the gas with the pilot light out. They do not want to improve the Medicare program. Their position is clear. They stalled in the last Congress, hoping it would die. It took a Herculean effort at the 11th hour to get the pilot program renewed. And here they are once again, a wolf in sheep's clothing saying all we want to do is try to improve the program. The substitute says it is going to extend for only 5 years. The underlying bill says if after 5 years on a finding of the Secretary of HHS it saves money, we make it permanent. If it is good and it works, we make it permanent. What does the substitute do? Notwithstanding saving money after 5 years, the program is dead. That is improving? That is helping? That is a wolf in sheep's clothing. All they say they want is a level playing field. In fact, what they are trying to do is set up hurdles specific to Medicare select. If what they advocated for Medicare select is good, why is it not applied across-the-board to all MediGap programs? If in fact what they are urging for Medicare select is something that creates 15 States having one program and 35 States having another, so that you are guaranteed not to have a uniform program over 50 States, that is helping? That is creating an impossible standard to meet. Let's talk about really taking care of seniors. The gentleman from North Dakota is the only person in the Congress who has done this kind of work. I have great admiration for his courage to stand up and say, after 8 years, not one complaint. He is someone who has been in the trenches. He was a member of the National Association of Insurance Commissioners, and I received a letter from those commissioners, from the National Council of State Legislatures, and from the National Governors Association. This is what they said to me: Dear Chairman Thomas, in an effort to promote consumer choice in the offering of affordable health care coverage for senior citizens, the National Governors Association, the National Conference of State Legislatures, the National Association of Insurance Commissioners call to your attention an urgent problem facing over 400,000 Medicare beneficiaries: the imminent expiration of the Medicare select program. This program has provided significant savings to Medicare beneficiaries in demonstration project States. We urge its permanent extension and expansion to all 50 States. They have seen these programs every day. They do not have the nine pages of improvements. They do not have the 45 points of consumer protection. They agree with our colleague from North Dakota, the program is good the way it is. It should be permanent. The underlying bill says if we save money, it is going to be permanent. Under the guise of protecting seniors, they want to guarantee that this program will not succeed. Why in the world would they do that? The answer is very simple. The gentleman from California exposed his hole card. He told you what we were going to do with Medicare. I will tell you what their great fear is, that we will be able to convert an old-fashioned, bloated, government-run, fee-for-service program into an efficient, cost-effective program that gives seniors more than they are getting now. This is the good step in the right direction. His old program will be changed. He does not want the new program. Their substitute will kill Medicare select. Vote against it. Vote for the underlying bill. National Governors' Association, National Conference of State Legislatures, National Association of Insurance Commissioners, March 15, 1995. Hon. Bill Thomas, Chairman, Subcommittee on Health of the Committee on Ways and Means, Longworth House Office Building, Washington, DC. Dear Chairman Thomas: In an effort to promote consumer choice and the offering of affordable health care coverage for senior citizens, the National Governors' Association (NGA), the National Conference of State Legislatures (NCSL), and the National Association of Insurance Commissioners (NAIC) call to your attention an urgent problem facing over 400,000 Medicare beneficiaries: the imminent expiration of the Medicare SELECT program. This program has provided significant savings to Medicare beneficiaries in demonstration project states. We urge its permanent extension and expansion to all fifty states. As you are aware, the Medicare SELECT program is a three year demonstration project (extended another six months by the 103rd Congress) that authorizes managed care networks to offer Medicare Supplement policies in the fifteen demonstration states. Medicare SELECT offers significant savings to seniors, many of whom live on fixed incomes. It also offers seniors a choice among health plans. In the absence of Congressional action on this issue, more than 400,000 Medicare beneficiaries will be faced with higher premiums and less choice. If the Medicare SELECT program is not continued, Medicare SELECT carriers could not enroll new members after June 30, 1995. This will result in significant increases in premiums for Medicare beneficiaries already enrolled in the program. Further, those beneficiaries not enrolled in the program will no longer have the opportunity to choose this low-cost and choice-enhancing option. Nearly every federal health reform proposal before the 103rd Congress included a permanent extension of this program to all fifty states. The momentum and broad-based political support behind this program should not be allowed to dissipate simply due to the absence of more comprehensive Congressional action in the health care reform area. The health care coverage of too many Americans is at stake. As we testified before two House subcommittees on this issue, we urge you to support the provisions of H.R. 483 that extend and expand the Medicare SELECT program to all fifty states. The NGA, NCSL and NAIC would be happy to answer any questions and provide you with any additional technical background upon request. Please contact Mary Beth Senkewicz at the NAIC Washington office. Thank you for consideration of this recommendation. Sincerely, Raymond C. Scheppach, Executive Director, NGA. Carl Tubbesing, Director, Washington Office, NCSL. Kevin T. Cronin, Washington Counsel, NAIC.

Mr. THOMAS

Mr. THOMAS. Mr. Chairman, I thank the gentlewoman for yielding time to me. I do have to compliment the minority. I thought perhaps they were not learning to become the minority quite as quickly as we had hoped they would. But what we have just heard on the part of the minority is an absolute denouncement of the rule because it denies them the privileges of the minority on the 3-day rule. And then less then 20 minutes later, standing up and deciding, maybe they really did not want that 3-day period. They talked about the fact that this does not need to be rushed through at all. And then less than an hour later, gee, we might as well expedite the business of the House. I compliment them that both sides of the mouth is working well.

Mr. THOMAS. Mr. Speaker, I would tell the gentleman from California, my friend and colleague who is a freshman, that at the beginning of the 104th Congress it was my privilege to follow the gentleman from California [Mr. Stark] as the chairman of the Health Subcommittee of the Committee on Ways and Means. What he probably does not realize is that this program was supposed to be a permanent program back in 1990. It moved through the Congress as a permanent program. At the 11th hour, behind closed doors, with pulled curtains, they made it a demonstration program. This whining about, gee, what is the delay--I will not yield-- the delay is in the gentleman's lap completely. It took us until 11:30 at night the last day of the 103d Congress to extend this program. I loved the gentleman from Michigan asking what is the problem. We have plenty of time to move legislation. At 1:30 a.m. the Senate acted to extend this program. Why do they not want to move forward? They want to see the about seniors. What they are scared to death about is that this one little choice program among 10 other MediGap policies will show, by people choosing it, that managed care is a better way to go in the Medicare Program. They cannot stand one chink in the armor of the old- fashioned fee-for-service system to be tested at all. Now we moved this bill through the Committee on Ways and Means on March 8. The first week in March we moved this bill. How many members of the Committee on Ways and Means opposed this? Two. There is one of them. He convinced one other member to oppose making this permanent. The gentleman from Florida [Mr. Gibbons], a senior himself representing a number of seniors, he is for it. The gentleman from California [Mr. Matsui], outspoken in terms of the protection of seniors' rights, he voted for it. Thirty-one members of the Committee on Ways and Means said, ``You're right. This program should be made permanent.'' What is the rush? There are only about 18 legislative days between now and when this program expires. They want to take all the time in the world. This objection about rights under this rule? ``How many times, when you were the majority, did you not even give us the right to recommit?'' I say to my colleagues, ``You've got two bites at the apple. You can offer your own substitute, and then you can have the motion to recommit. You can change it twice. You've got an opportunity to convince folks that making it permanent is wrong. You couldn't convince the Commerce Committee. You could only convince two members of the Ways and Means Committee.'' The idea that we did not give them 3 days to examine this rule? Notice carefully he said we are violating the 3-day rule, not on the bill, but on the rule itself. Those folks need 3 days to study a two- paragraph rule? I say to my colleagues, ``You've got your full 3 days guaranteed to the minority on the bill.'' Now, finally, what I consider absolutely egregious and outrageous, for the gentleman from California to stand up and say that the gentlewoman from Connecticut is wrong about Federal protections on this program. She said there were some; he said there were none. I would invite the gentleman's attention to the Federal Register, August 21, 1992, beginning on page 37993, which is section 10, Medicare Select Policies and Certificates. This section shall apply to Medicare select policies and certificates, and on, and on, and on, page, after page, after page of a Federal structuring that is to be followed by the States to make sure that the seniors are protected in this program area. This rule is a good rule, it is a fair rule, it is an appropriate rule, it is a timely rule. We will pass this rule, and then, more importantly, we will finally being to move permanently, Medicare select. The seniors deserve a choice. These detractors continue to try to stand in the way, and we will not let them.

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, will the gentleman yield?

Mr. THOMAS. Mr. Speaker, I ask unanimous consent for the immediate consideration of the bill (H.R. 1421) to provide that references in the statutes of the United States to any committee or officer of the House of Representatives the name or jurisdiction of which was changed as part of the reorganization of the House of Representatives at the beginning of the 104th Congress shall be treated as referring to the currently applicable committee or officer of the House of Representatives.

Mr. THOMAS. Mr. Speaker, I thank the gentleman for yielding. What this bill does is attempt to conform the statutes that are on the books with the changes that were made at the beginning of the 104th Congress. As we know, there were three committees that were dissolved, there were significant restructurings in terms of jurisdictions, and all this bill does is to treat references to the old structure in public law as referring to the new structure. References to the old committees are to be treated as referring to the new committees. This is, in essence, a conforming bill. It does not make policy. Indeed, it simply conforms to policy that has already been passed allowing the new committees to reference themselves in the statutes that are already on the books. Mr. Speaker, this bill provides that references in public law to any committee or officer of the House whose name or jurisdiction was changed as a part of the reorganization of the House at the beginning of this Congress, shall be treated as referring to the currently applicable committee or officer. Mr. Speaker, on the first day of the 104th Congress, the new Republican majority lived up to its commitment to the American people by passing major reforms. Among these reforms was the wholesale restructuring of the committee system, which included elimination of three major committees. Committee jurisdictions were consolidated, and the names of several committees were changed. The primary purpose of this bill is to treat references to the old structure in public law as referring to the new structure. References to the old committees are to be treated as referring to the new committees. In the course of restructuring the internal operations of the House, we also eliminated the positions of Director of Non-Legislative and Financial Services and the House Doorkeeper. We created the position of Chief Administrative Officer, and we redefined the responsibilities of the Clerk and the Sergeant-at-Arms. The Committee on House Oversight has been charged in House rules with providing policy direction for and oversight of the House officers, and is continuing to direct the restructuring of the internal operations of the House. References in public law to the function, duty, or authority of a House officer are to be treated as referring to the officer exercising that function, duty, or authority, as determined by the Committee. Mr. Speaker, enactment of this bill will result in no changes in policy, rather it will reflect policy changes already made.