Bill Thomas

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, our belief is it will be up at the latest tomorrow after 6.

Mr. THOMAS. Mr. Speaker, I will tell the gentleman that I do appreciate the attention I am receiving and that I could run off a list of legislation for him if that would make him feel more comfortable; but, frankly, it would not be worth squat right now. We believe that WRDA will be up. That is something that was sent over to us by the Senate. And we believe, if we could move forward on that piece of legislation as we have done on a daily basis that that would be a continuing and significant step forward.

Mr. THOMAS. Mr. Speaker, I say to the gentleman, all things are possible if we only believe. That will be determined, I assume, as we continue our work schedule. As the gentleman knows, we have been functioning with 1-day CR's, and it has been difficult to predict beyond the 1 day. I have provided information which I believe the leadership would back up all the way through tomorrow to midnight or perhaps slightly beyond. That is stretching the 1-day CR to more than 1 day. And then we will make decisions after that. One day at a time I believe was the request that the President had made, and we have been following that.

Mr. THOMAS. Mr. Speaker, we are ready.

Mr. THOMAS. Mr. Speaker, I will tell the gentleman that the answer to that question probably lies more on his side of the aisle than ours.

Mr. THOMAS. Mr. Speaker, my understanding is that we are here tonight, that we have a functional CR for tomorrow and that that will be good until Thursday. So clearly, we will be here tonight, we will work all day Thursday, and we may very well be here on Friday. My understanding is that the House will convene at 6 p.m. tomorrow, and we will continue to work.

Mr. THOMAS. Mr. Speaker, I will tell the gentleman, as we move forward tonight, I will try to get that room number for him and we will continue to work the rest of the evening. We will be here tomorrow convening at 6 p.m., and we will work through Thursday evening and possibly into Friday morning.

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, I ask unanimous consent to take from the Speaker's table the bill (H.R. 4846) to establish the National Recording Registry in the Library of Congress to maintain and preserve sound recordings that are culturally, historically, or aesthetically significant, and for other purposes, with Senate amendments thereto, and disagree to the Senate amendments.

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, I thank the gentleman from Florida (Mr. Young) for yielding me this time. Mr. Speaker, in an attempt to improve the atmosphere here, I do want to reach out in a bipartisan way and indicate to the gentleman from Maryland (Mr. Hoyer) that he has had extensive legislative experience here in this body. He has seen a number of Presidents in terms of the way they have performed. He has indicated that this current President has been more active, more involved than any other President that he is aware of. So I guess I am a little confused, and I would like to reach out because why would quotes from third parties then be relied on, the liberal fourth estate newspaper folk who have not been in the room, to try to characterize the way in which we have operated? Why would the quote from the gentleman who has been most involved of any Presidents be relied on? So instead of looking at what some editorial writer writes, who has never been in the room, let us take a look again at what this President, who has been the most active President working with Congress in the minds of people who have been here a long time, and he said, quote, President Clinton, on October 30, just a couple of days ago, ``we,'' we, kind of an encompassing word, the government, the executive branch, the legislative branch, ``we have accomplished so much in this session of Congress in a bipartisan fashion.'' Now I take him at his word, the guy who has been more involved than any other President, we have accomplished so much in this session of Congress in a bipartisan fashion. ``It,'' this Congress, ``has been one of the most productive sessions.'' Now I know he has only been around 8 years, and others who have been around longer can grade how productive the sessions are, but if this President has been the most active of any President we have seen, I will accept his judgment. His judgment is, we have done a lot in a bipartisan fashion. This has been one of the most productive sessions ever. Why rely on third parties? Go to the horse's mouth.

Mr. THOMAS

Mr. THOMAS. On the programs and the amount.

Mr. THOMAS. Mr. Speaker, when the bill left, it was a bipartisan agreement.

Mr. THOMAS. Mr. Speaker, I just want to understand, because the gentleman from Arizona (Mr. Kolbe) went through a lengthy list of programs, extremely important ones, and identified dollar amounts associated with those programs. I believe it was implicit, but I think we really need to understand that every one of those programs were placed in this by bipartisan agreement and every one of the funding numbers were agreed to in those programs that the gentleman mentioned by bipartisan agreement. Is that correct?

Mr. THOMAS

Mr. THOMAS. Parliamentary inquiry, Mr. Speaker.

Mr. THOMAS. Mr. Speaker, since the gentleman introduced his motion and then spoke on his motion without an opportunity for other Members of the House to address the question, which some people would believe did not reflect fair play, would it be appropriate, for example, for the gentleman from Florida (Mr. Bilirakis) to ask unanimous consent to address the House for 5 minutes to provide some subject matter on the motion just withdrawn?

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, I ask unanimous consent to address the House for 1 minute.

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, some of us are sitting here somewhat confused. We have been listening carefully to the debate and hearing, for example, that these folks are legal but they are in fear of their status; that in fact we have chosen to give $34 billion to the HMOs. If anyone bothered to check the entire cost of this bill, which is money for the hospitals, Medicare+Choice, home health, preventive care, on and on and on, the entire package, according to CBO, scores at $31.5 billion over 5 years. Now, I know there has been a discussion on the Presidential trail about fuzzy math; but to be able to stand up last night and today and to continue to repeat that there is $34 billion for managed care in this bill is to simply ignore the fact that the entire package is $31.5 billion. By the way, the single largest percentage in this package goes to hospitals. That is appropriate because hospitals are the single largest cost factor in Medicare. As a matter of fact, the American Hospital Association, the largest hospital grouping in the country, has written a letter saying, we urge the Members to vote for the legislation; we urge the President not to veto the legislation. Now, when are we going to let the hospitals speak for themselves? We just heard repeated this apparent political mantra that is necessary that we are shorting the providers, the other providers, the hospitals. The hospitals said we should have voted for the bill. Frankly, some of the Democrats have been coming up to me and saying, gee, I would like to have another opportunity. My leadership led me astray. I did not realize exactly what was in the bill. Well, sorry, it came up, we voted on it, and it was passed. The providers themselves have written letters, more than four dozen home health associations, various specific acute hospitals, psychiatric hospitals, the providers; and they have said, sign the bill. Yet we continue to hear this argument, which is totally devoid of reality, that somehow we are spending $34 billion on the HMOs out of a $31.5 billion bill and that we are shorting the other providers, when the American Hospital Association said, we like it, deliver it, and please, Mr. President, sign it. Now, we are also not talking about the very, very nice package of preventive care provisions that are in there extending the preventive care, which was first put in by this majority in 1997, having not been done before. We have extended it in terms of digital mammography; we have increased the number of Pap smears available for those in risk groups; we have provided screening for glaucoma; we provided screening for colonoscopies. In fact, the second largest grouping in this bill is for preventive care and beneficiary assistance. One of the largest dollar amounts in the package is to put real dollars toward correcting the overpayment by beneficiaries on hospital bills because they have not been treated fairly and honestly by this administration in terms of what an actual percentage of the bill is. The beneficiaries are paying 20 percent of the listed price when HCFA is negotiating the price down, and that 20 percent becomes 30, 40 and 50 percent of the bill. That is shameful. We moved directly to start stopping that. That is the single largest chunk. We also, finally, allow immunosuppressive drugs to be available to those who have had organ transplants for the rest of their lives. Current administration has held it at 3 years. This bill is full of really good stuff supported by all of these groups, and what we continue to hear is a total misrepresentation. I know my colleagues will not stop it, but what they are saying is simply not true.

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, I thank the gentleman from Florida for yielding me this time. I do not have a copy of the bill that was introduced today. But if anyone wants to know what it contains, it would be a little bit like going to an editing room of a movie producer and picking up all the pieces that have been cut out of the movie on the floor and then stitching it together and calling it a movie, for example. It is my understanding that, for hospitals, instead of the negotiated agreement, which was more generous for hospitals than was contained, for example, in the Committee on Ways and Means Subcommittee on Health bill in which all of the Democrats on the subcommittee voted unanimously, it says that hospitals should get a 2-year market basket update. Does that sound fair? Let them have a 2-year market basket update. However, if one reviews the history of financing of hospitals, one will discover this, and I apologize for doing this, because, apparently, facts in history are supposed to be checked at the cloakroom door as we come to the floor of the House and simply make up whatever moves someone about dollar amounts or percentage payments. But for what it is worth, the last time hospitals got a 1-year market basket update was in 1985. The average over the last decade for market basket updates have been market basket minus 1.7. So what is being provided in the bill that passed the floor is market basket the 1st year, so for the first time since 1985, and then an adjustment from current law, which is market basket 1.1. That is six- tenths of a point better than what they have averaged over the last decade. We cut that in half. So it is twice as good as current law in terms of the percentage adjustment. We continue that for 2 more years. The hospitals have said that is fine. They are comfortable. Now, what I hear is one of the most amazing arguments one will ever hear anywhere. Well, but the providers would like our bill better. Well, if they thought it had a chance of becoming reality, they would. Who would turn down more money? The question that one really has to put to the providers: Do you want the bird in hand, or do you want try to get the bird in the bush? The answer is the providers are more than happy with what we have done. However, what one really needs to do is take a look at the bill, when and if we get a copy in legislative language. I know it was introduced about 20 minutes ago. What one will find is, for example, our friends on the other side using arguments like a 2-year freeze on the graduate medical education. The phrase they use is from their notes: Provides help to the Nation's premier teaching and research hospitals. Read that in New York City. New York City has ripped off the graduate medical education program for more than a decade, funding their basic welfare costs out of the Federal taxpayers. Last year, with the agreements of the gentleman from New York (Mr. Rangel) and the Senator from New York, Mr. Moynihan, that we would in the 1999 refinement bill make these modest adjustments to begin to create a more level playing field between all of our fine teaching hospitals; and this attempts to undo that agreement. But when one reads on, one finds that, in fact, just last night, we defeated a motion to instruct to require Medicare+Choice programs to stay in an area for 3 years. Of course all the arguments made were the correct ones. But here we go. They lost last night, and guess what? Off of the cutting room floor is another little snippet picked up and folded back in, exactly the same thing. But when one begins to read the fine print in terms of their reaching out to assist various groups, especially in the area of disabled children, who does not want to help disabled children? But while Al Gore points to Governor Bush and says he has a tax cut for the wealthiest 1 percent, what we have in this bill is a benefit for disabled children whose families, whose families have a 600 percent of poverty level. How ironic. The same 1 percent that Al Gore says are being benefited by George Bush's tax provision, they want to provide disabled children assistance, 600 percent of poverty. That is the kind of fine tuning they want for these government programs. When one takes a look at this package, it is all of the snippets from the cutting room floor. There really is not anything about patient protections. There is not anything about prescription drugs. It is a clear attempt to run through programs that were brought up, voted down in committee, but desired nonetheless to produce a package that is conservatively in the $50 billion to $60 billion range. But of course we do not know for sure. We have not seen the language of the bill itself. Of course, the Congressional Budget Office has not scored it.

Mr. THOMAS. Mr. Speaker, I thank the gentleman for yielding me this time. Mr. Speaker, I want just to briefly indicate, and I know the gentleman from Michigan (Mr. Levin) feels strongly about the issue, he referenced the current law of the land as having been written behind closed doors. Perhaps he was not in the room when I indicated that the gentleman from New York (Mr. Rangel) and the Senator from New York, Mr. Moynihan, were in the room when we dealt with the issues in the Refinement Act of 1999. I believe the closed door session he was referring to was the one that produced the Balanced Budget Act of 1997 on which was voted on in the Committee on Ways and Means, passed 34 to 1, came to the floor, was passed overwhelmingly, and which the administration negotiated and requested reductions, further reductions in payments to hospitals and other health care providers. In fact, the President's budget at that time said that the Medicare providers should be reduced by more than $125 billion over the 10 years. We fought the President. We thought it should not have been cut that much. Yet, here we are being criticized for making sure that they were not cut as much as their President wanted to cut them, and it was not behind closed doors. In fact, it was participated in by the administration. The gentleman from Michigan (Mr. Levin) should be pleased that Republicans fought back against the President's $125 billion additional cuts so that the adjustments that we are making now are modest ones referred to both in the 1999 bill and in this one as refinements instead of massive needs to infuse if, in fact, the President's program had been agreed to. We did not think it was right then. We do not think it is right now. The idea of a balanced modest refinement of about $30 billion is appropriate. This particular bill we believe is about $50 billion to $60 billion, consisting of all the items that were left on the cutting room floor when a reasonable and appropriate package were put together.

Mr. THOMAS. Mr. Speaker, I appreciate the gentleman yielding me this time. I just want to remind all my colleagues on the other side of the aisle that if they do want to support this legislation, they must understand that with the $20-plus billion they are putting in both for graduate medical education, for hospitals, and for the other payment increases, that it in fact increases the Medicare+Choice amount as well. For all of my colleagues on the other side of the aisle who have been indicating they do not want money to go to the Medicare+Choice programs, I just do believe as a matter of honesty that they need to know that if they support the language in their bill, the Medicare+Choice payments will go up significantly, perhaps as much as $10 billion to $15 billion.

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, it is now my pleasure to yield 2 minutes to the gentleman from North Carolina (Mr. Burr), a member of the Committee on Commerce.

Mr. THOMAS. Mr. Speaker, yield myself such time as I may consume. Mr. Speaker, I think first of all we should look at this motion to instruct. There are several levels of clearance that are required for a motion to instruct to be in order, and it has to deal with funding. Obviously, in this motion to instruct, it says that in resolving the differences between the two Houses on the funding level for program management of the Social Security Act. So it meets that test level. But then it goes on to say that through the funding mechanism, they are supposed to choose a level that reflects a requirement on Medicare+Choice organizations to offer a minimum contract period of 3 years. There is no funding mechanism that would require or even allow a 3-year contract under Medicare. Medicare+Choice programs are funded for 1 year under the Health Care Financing Administration. The amount that a Medicare+Choice program receives is based upon a number of factors: where it is located, the cost of medical services in the area, and, most importantly, the makeup of the beneficiaries that have signed up for that Medicare+Choice program. That is, what is their age, what is their medical condition? All of these factors are taken into consideration when the level of reimbursement to the Medicare+Choice plan is determined. The difference by the Medicare+Choice program of offering the statutory mandatory benefits is what the Health Care Financing Administration has determined to be its payment level. If there are dollar differences between those two areas, by law that plan must either offer additional benefits or that money has to be refunded back to the Health Care Financing Administration; but it can only be done on a 1-year basis under current law. Beneficiaries can sign up for a Medicare+Choice program and leave the program. That is, the patient profile of a plan can change from year to year to year. So it is nonsensical to think that a level of funding can produce a 3-year contract. It is also nonsensical to think that it can produce a set benefit package for a 3-year period. One of the reasons some of these plans are pulling out of areas is because they can no longer offer the benefits they had offered under their shrinking profit structure dictated and determined by the Health Care Financing Administration. So make no mistake, not only does this motion to instruct have no legal binding requirement, but it is nonsensical. It is germane. It does affect the funding level. But in no way does just affecting the funding level bring about any ability to create a 3-year contract or a guaranteed 3-year level of benefits. It is just nonsensical. Mr. Speaker, I reserve the balance of my time.

Mr. THOMAS. Mr. Speaker, I yield myself 30 seconds. Mr. Speaker, I would tell the gentleman that we certainly share his concern, but the idea of trying to get plans to stay for 3 years when there would be total uncertainty in the second and third year of what the contract might be will increase the chances of destabilizing the program, not decrease it, the exact opposite effect that the gentleman seeks. For example, in the Med Pac report, March 2000, one concern ``that may contribute to the lack of new plans and plan types and which may be discouraging current participants is uncertain future revenue streams for plans.'' Mr. Speaker, I yield 3 minutes to the gentleman from Louisiana (Mr. McCrery), a member of the subcommittee.

Mr. THOMAS. Mr. Speaker, I yield 1 minute to the gentleman from Louisiana (Mr. McCrery).

Mr. THOMAS. Mr. Speaker I yield 4 minutes to the gentleman from Tennessee (Mr. Bryant), a member of the committee that shares jurisdiction, the Committee on Commerce.

Mr. THOMAS. Mr. Speaker, I yield 2 minutes to the gentleman from Pennsylvania (Mr. English), a member of the Committee on Ways and Means.