Bill Thomas

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, I thank the gentleman, the Chairman of Appropriations, for yielding me the time. Mr. Speaker, we are supposed to be talking about a rule. But, obviously, we are into the substance of these measures. There has been a characterization of some of that substance by the gentleman from California (Mr. Stark), and I would like to take just a couple of minutes to set the stage for those of our colleagues who may be nervous about the fact that the body does not know what we are doing in terms of the Medicare reform or that items have been slipped into this bill. Perhaps the gentleman does not remember that we had a subcommittee mark-up on October 15. We examined the bill at that time and voted it favorably to the full committee. In between subcommittee passage and the full committee vote, the President wrote a letter to me dated October 19 and said, ``Dear Mr. Chairman, I am writing to respond to your request about administrative actions.'' He goes on and provides an outline for what the administration has been trying to do notwithstanding the Y2K computer problems that the administration has had the day after he signed the Balanced Budget Act of 1997. We were not aware of them prior to signing the bill, but they discovered them immediately after they signed the legislation. His next-to-last paragraph said this: ``We believe that our administrative actions can complement legislative modifications to refine BBA payment policies. These legislative modifications should be targeted to address unintended consequences of the Balanced Budget Act of 1997 that can expect to adversely affect beneficiary access to quality care.'' That was exactly what we did. We targeted it. This is a refinement bill. And on October 21, it passed the full committee with a bipartisan vote. This is not something that was done in the dead of night at 3 a.m. in the morning. It went through the subcommittee. It went through the full committee. And then it came to the floor on November 5. And with 388 Members of the House supporting the very specific provisions that have been characterized as insidious or give-backs or rip-offs, 388 Members of the House voted for it. But beyond that, after we worked with our sister committee on this side in jurisdiction, the Committee on Commerce, with the Senate Finance Committee, and with the White House to craft an agreement that looked virtually exactly like the House bill, there was a comment by White House representative Chris Jennings, who is identified as the health policy coordinator at the White House, in news stories published on November 11, Mr. Jennings said, ``This is an honorable compromise. It lays down a foundation for more significant Medicare reforms next year.'' It is quite true that the gentleman from California tried to offer a number of killer amendments to fundamentally alter Medicare, to change the entire structure on a modest bill that the President agreed needed to correct some flaws in the Balanced Budget Act of 1997 refinements. No refinement bill could carry the kind of amendments the gentleman from California offered. And clearly, the purpose of those amends was to be able to stand up on the floor and then make a statement that somehow we refused to provide prescription drugs to seniors. It seems to me that if less of that kind of hyperbole were employed and more of a willingness to work together, as has been indicated by the White House, health care coordinator, we could accomplish much. In a letter dated November 15 that was addressed to the Speaker signed by John Podesta, Chief of Staff to the President of the United States, in which he said, for example, in the third paragraph, ``As Office of Management and Budget Director Lew indicated in his letter to Mr. Thomas on October 18, findings or clarifications by Congress do not change the law and do not result in scoring. Therefore, the attached clarifying language on the hospital outpatient department policy would not be scored by the OMB. With this in mind, we would not characterize such legislation as having an adverse effect in any way on the Social Security surplus.'' A letter from the White House says it does not affect the Social Security surplus. The comments from the White House people we worked with said it was an ``honorable compromise''. CBO has scored it, and I will put it in the Record in terms of the dollar amounts on a 1-year, 5-year, 10-year, in fact, a detailed scoring. Why anyone would stand up on the floor of this House and characterize the Medicare legislation as reckless or inappropriate, when Democrats that we worked with to put the package together, such as the gentleman from Maryland (Mr. Cardin), White House representatives, Chief of Staff John Podesta and their health care coordinator say this is an honorable agreement, that we have it scored that it does not affect the important hospital outpatient area, any adverse effect on Social Security, I have got to say it sounds a little desperate on the part of some individuals who voted no in subcommittee, no on the floor, and are voting no now that, frankly, their colleagues do not agree with them. This is a good package. People are pleased to and it is endorsed by Republicans, some Democrats, most Democrats, 388 votes on the floor of the House, and the White House. I am pleased to work together with those who want to improve Medicare to make sure that it is better for our seniors today and tomorrow. Mr. Speaker, I include the following for the Record: The White House, Washington, November 15, 1999. Hon. Dennis Hastert, Speaker of the House of Representatives, Capitol Building, Washington, DC. Dear Mr. Speaker: We are pleased that we have been able to work out a strong, bipartisan agreement on the Balanced Budget Refinement Act of 1999. All parties to the agreement, in particular Mr. Thomas, Mr. Bliley, Mr. Dingell, Mr. Rangel, Mr. Stark, Mrs. Johnson, Mr. McCrery, Senator Roth, Senator Moynihan and Senator Nickles, played critical roles in achieving this outcome. We know that this was as high a priority for you as it has been for the President and we appreciate your leadership. As you know, a technical drafting change in the BBA has resulted in some confusion over the outpatient payment formula that could result in a reduction in payments. Aside from correcting a payment formula flaw, the hospital outpatient PPS was not designed to impose an additional reduction in aggregate payments. We continue to believe that such a reduction would be unwise. During our deliberations on the balanced Budget Refinement Act, we agreed to resolve any confusion through a Congressional intent clarification provision. Earlier today, language to this effect was worked out between the White House and Mr. Thomas. As Office of Management and Budget (OMB) Director Law indicated in his letter to Mr. Thomas on October 18, findings or clarifications by Congress do not change the law and do not result in scoring. Therefore, the attached clarifying language on the hospital outpatient department policy would not be scored by OMB. With this in mind, we would not characterize such legislation as having an adverse effect in any way on the Social Security surplus. Achieving a bipartisan consensus on addressing the unintended consequences of the BBA is an important accomplishment. The President hopes that we can build on this achievement and pass legislation to strengthen and modernize Medicare. Sincerely, John D. Podesta, Chief of Staff to the President. Enclosure. BUDGETARY IMPACT OF THE ``MEDICARE, MEDICAID, AND S-CHIP BALANCED BUDGET

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, reserving the right to object, and I shall not object, I rise to allow the House to recognize a public servant who for 21 years served this House, went into retirement 11 years ago and when the House asked would Bob Berry please come back and help us attend to the business of the House, Bob Berry came out of retirement in a very difficult time and allowed this House to function as we would like to function. Bob Berry, the House owes to you our gratitude. Mr. Speaker, I withdraw my reservation of objection.

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, on rollcall No. 574, had I been present, I would have voted ``yea.''

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, on rollcall No. 575, had I been present, I would have voted ``yea.''

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, on rollcall No. 576, had I been present, I would have voted ``yea.''

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, I yield 1 minute to the gentleman from Louisiana (Mr. McCrery), a member of the Subcommittee on Health of the Committee on Ways and Means, again without whose tireless work this bill would not be possible.

Mr. THOMAS. Mr. Speaker, I object to the vote on the ground that a quorum is not present and make the point of order that a quorum is not present.

Mr. THOMAS. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, first of all, again I want to thank all of the Members who worked across the aisle in a bipartisan fashion to fashion this refinement bill. I want to thank the staff. It is always difficult when we are attempting to provide assistance and it is an unlimited resource. I want to underscore, this bill is paid for by on-budget surplus. One movie role most Members of Congress would not have to audition for was the scene in Oliver when he holds his porridge bowl up and says, ``More, please.'' It is always ``more, please.'' But this is a refinement, not a reform. As the Members on both sides of the aisle have indicated, there needs to be adjustments. As a matter of fact, the President of the United States, in a letter dated October 19, said, ``We believe that our administrative actions can complement legislative modifications to refine BBA payment policies. These legislative modifications should be targeted to address unintended consequences of the BBA that can expect to adversely affect beneficiary access to quality care.'' He did not say do a prescription drug program. He did not say rewrite the program. He said refine it where those areas have unintended consequences. That is exactly what this bill does. That is the intention and purpose of the bill. It just seems to me this is a modest effort, it is a meaningful effort. I would urge those who continue to say they want to really deal with prescription drugs to sit down with us tomorrow and deal with prescription drugs the only responsible way. That is an integrated prescription drug program for all our seniors, not an add-on, not a tack-on, not something that uses gimmicks like formulas or numbers, but a prescription drug program that integrates health care delivery with numerical prescription drugs. That is what seniors deserve. That is what we offered that the President refused to participate in and the Medicare Commission. They could have deducted the cost of those in the tax bill that he vetoed. But we stand ready tomorrow to sit down and work on this important problem. Today, let us make those adjustments that the President said were needed in areas that we had not fully understood at the time we passed the bill needed to be changed. Mr. Speaker, let me conclude that more than three dozen organizations, including the American Hospital Association, the American Medical Association, more than two dozen specialty medical groups including the American Geriatrics Society are in support of this. It seems to me that this modest adjustment needs to go forward. I thank all of those Democrats who spoke harshly but who will, of course, vote for the bill. I urge all to vote for the bill.

Mr. THOMAS. Mr. Speaker, I yield such time as he may consume to the gentleman from Florida (Mr. Foley), a member of the committee. (Mr. FOLEY asked and was given permission to revise and extend his remarks.)

Mr. THOMAS. Mr. Speaker, I yield myself 1\1/2\ minutes. Contrast the speech we just heard on the floor with the statement from the White House. Chris Jennings, who is the White House health person, said recently, ``We were partners with the Congress when we passed the Balanced Budget Act, and we are going to be partners when we address the rough edges of that law.'' I have been pleased with Members on both sides of the aisle in terms of their understanding of just what this bill is. It is a refinement bill. It is not a reform bill. We still need to address prescription drugs. But Members need to remember that the 1997 act created the bipartisan Medicare Commission. On that Commission, the public and the private members agreed, the Senate and the House Members agreed, Democrats and Republicans agreed. We had 10 votes. We needed 11. The President had four appointees. Not one of the President's appointees supported the reform package, which would have integrated prescription drugs into that program. In the recent tax bill, there was a tax deduction for prescription drugs. The President vetoed that plan. We stand ready to sit down tomorrow with the President and any Democrats who work in a positive way to deal with integrating prescription drugs into Medicare. It needs to be done. But this very narrow, very shallow canoe cannot support that kind of an issue today. It is a refinement bill. I am very pleased with the comments of the Members who understand our objective today. This is a modest change. We will continue.

Mr. THOMAS. Mr. Speaker, I yield such time as he may consume to the gentleman from Wisconsin (Mr. Ryan). (Mr. RYAN of Wisconsin asked and was given permission to revise and extend his remarks.)

Mr. THOMAS. Mr. Speaker, I yield 1 minute to the gentleman from Arizona (Mr. Hayworth), a member of the Committee on Ways and Means. (Mr. HAYWORTH asked and was given permission to revise and extend his remarks.)

Mr. THOMAS. Mr. Speaker, I yield 1\1/4\ minutes to the gentleman from Iowa (Mr. Nussle), a member of the Committee on Ways and Means and someone who has worked on this bill especially for rural hospitals.

Mr. THOMAS. Mr. Speaker, I yield 1 minute to the gentleman from Florida (Mr. Shaw), the chairman of the Subcommittee on Social Security of the Committee on Ways and Means, who represents the district with the greatest number of seniors in the United States.

Mr. THOMAS. Mr. Speaker, I yield 15 seconds to the gentleman from New York (Mr. Engel).

Mr. THOMAS. Mr. Speaker, it is my pleasure to yield 1 minute to the gentlewoman from Washington (Ms. Dunn), a member of the Committee on Ways and Means and someone who supplied a very important component to this bill.

Mr. THOMAS. Mr. Speaker, it is my pleasure to yield such time as he may consume to the gentleman from Florida (Mr. Canady). (Mr. CANADY of Florida asked and was given permission to revise and extend his remarks.)

Mr. THOMAS. Mr. Speaker, we appreciate the support of the gentleman from Michigan (Mr. Dingell), the ranking member of the Committee on Commerce. Mr. Speaker, it is my pleasure to yield 2 minutes to the gentlewoman from Connecticut (Mrs. Johnson), a member of the Subcommittee on Health who, without all of her hours of work, this bill would not have been possible.

Mr. THOMAS. Mr. Speaker, it is now my pleasure to yield 2 minutes to the gentleman from Florida (Mr. Bilirakis), chairman of the Subcommittee on Health of the Committee on Commerce.

Mr. THOMAS. Mr. Speaker, I yield 3 minutes to gentleman from Virginia (Mr. Bliley), chairman of the Committee on Commerce. (Mr. BLILEY asked and was given permission to revise and extend his remarks, and include extraneous material.)

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, I thank the Chairman, the gentleman from Virginia for yielding me the time. I just think that in case someone thinks that what we are doing here is significant and important, you have to understand under the rules that either body, the House or the Senate, in this case the House, can instruct its conferees; and this is a motion to instruct. It has no binding on a conference between the House and the Senate. It is an attempt on the part of the folks who offered the motion to try to tilt the relationship between the House and the Senate. Now, the measure that we are taking to conference was already debated and voted on in the House and we passed it, so the House's position is well known. The motion to instruct is to, in fact, insist on the provisions of the bipartisan Consensus Managed Care Improvement Act. But there is no way that this motion to instruct can make anything happen. Remember in the Constitution in article 1, coming from the old Connecticut compromise between the large States and the small States, that both were concerned about the powers, and so there was created the concept of two separate Houses, one based upon geography, two representatives, or Senators, from each State and one based upon population, which continues to grow. There is no limit on the size of the House; it is tied to the population of the United States. And so you have State interests; and remember, initially under the Constitution, those Senators were appointed by State legislatures. Now, the Senate is an entirely different body than the House. They have different rules. They are elected in a different way. And so when the House and the Senate come together in a conference, it is because the Constitution says that the House and the Senate have to agree exactly on the same piece of legislation that is then sent to the President; and if they cannot agree, then notwithstanding the effort in both the House and the Senate, the legislation passed in both the House and the Senate does not go anywhere. So our job as conferees will be to go over with the Senate and sit down, equal bodies, both with the same ability to pass a piece of legislation but both of us helpless if we cannot come together. The House-passed one cannot get to the President; the Senate-passed one cannot get to the President unless the House and the Senate agree. And you have already heard the significant difference between the Senate- passed bill and the House-passed bill. So what we are going to have to do is something that is uniquely American in terms of the political environment. That is, from the very beginning, decisions made in this country in part, because of the two fundamentally different houses, has been based on accommodation and compromise. We cannot go anywhere without accommodation and compromise. The Senate feels strongly about their position. They passed it. There is a majority backing their position. The House feels strongly about its position, those who voted for that measure. They had a majority backing them. But when we go to conference, if the House's position is, United States Senate, we don't care what you did, we're not going to look at what you're going to do, you have to accept everything in our bill, that is exactly the position that we take, and we ain't changing it. How successful do you think that is going to be? It is kind of absurd. So understand, this is a political exercise. There is no reason to vote this motion to instruct. We have the bill; let us get on with our work. Let us vote down the motion to instruct. Let us not insult the Senate the very first day we are supposed to sit down with them and try to reconcile the differences between the two bills. Let us live up to what the American people expect us to do, sit down, accommodate, compromise, produce a good product and get it to the President, instead of posturing as this motion to instruct clearly is. Vote ``no.''

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, I move to suspend the rules and pass the bill (2303) to direct the Librarian of Congress to prepare the history of the House of Representatives, and for other purposes, as amended.

Mr. THOMAS. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, this measure would require that there be created a history of the House of Representatives. The intent is to create a popular illustrated and chronologically ordered volume that covers the entire history of the House of Representatives. Notwithstanding the fact that the House has a House historian, this particular history is required in the bill to be prepared with no appropriated funds. Mr. Speaker, I reserve the balance of my time.

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 3122) to permit the enrollment in the House of Representatives Child Care Center of children of Federal employees who are not employees of the legislative branch.

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and include extraneous material on the subject of H.R. 2303, the legislation just considered.