To restore the operation of the Native American Veteran Housing Loan Program during fiscal year 2003 to the scope of that program as in effect on September 30, 2002.

Mr. Speaker, I offer a motion to instruct.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and include extraneous material on this motion to instruct.

Mr. Speaker, I yield myself as much time as I may consume.

I rise today to offer a motion to instruct the House conferees on H.R. 1, the Medicare Prescription Drug and Modernization Act of 2003, to strike the health savings security accounts. The $174 billion saved should be used to provide employer subsidies in order to prevent over 4 million retirees from losing their existing drug benefits.

Many of us believe that the House Medicare bill does not go far enough in providing an affordable and adequate prescription drug benefit to the 13 million senior citizens and persons with disabilities who lack coverage. There are, however, 12 million retirees who today enjoy better coverage through employer-sponsored insurance than the benefit included in H.R. 1. I suspect that very few of us would be willing to say that those 12 million retirees should lose the better coverage they have today.

In fact, one of the selling points of this bill is supposed to be that enrollment in the Medicare benefit is purely voluntary, that retirees can keep their existing coverage if they want; but, unfortunately, this is not the case. We know that from the July 22 Congressional Budget Office analysis of H.R. 1 that one in three out of those 12 million retirees would be worse off if we pass this bill. I want to repeat that. According to the CBO, one out of three of those 12 million retirees would be worse off if we pass this Medicare bill.

It seems to me that our theme ought to be at least first do no harm; but 32 percent of retirees with employer-sponsored insurance would lose that coverage, according not just to the CBO but to studies like the one recently released by Ken Thorpe, a health policy expert now working at Emory University. He agrees with the CBO figures and has given us state-by-state figures about the impacts of H.R. 1.

According to Dr. Thorpe's analysis, 163,000 retirees in my State and in the State of the gentleman who takes the opposite view would lose their coverage and be forced to pay more for their medications if H.R. 1 passes. In every State across our great Nation, there are retirees and retiree families who would be worse off under this bill: 252,000 in Florida; 45,000 in Iowa; 218,000 in Michigan; 55,000 in Louisiana, and on and on the litany of retirees who would do worse under this Medicare bill.

The devastating impact this bill would have on these 12 million retirees and their families is probably unintended. Many of my colleagues may not have known about this problem when H.R. 1 passed this body by a single vote; but now we know about those

impacts, and it is up to us to fix this problem.

Again, it may have been unintentional, but we now know that this bill includes perverse incentives that actually encourage employers to drop coverage and that penalize employers that have done the right thing, those employers who are struggling to pay for drug benefits for retirees and who want to continue to meet their commitment.

We have heard about this problem not just from groups like the AARP and the AFL-CIO, the National Committee to Preserve Social Security and Medicare, and Consumers Union, the National Breast Cancer Coalition and the American Foundation for the Blind. The analysis is coming from the Congressional Budget Office and the Heritage Foundation.

These concerns are, as my colleagues know, echoed by individual retirees across the country. Many of us have held town meetings on Medicare, have talked with senior groups and heard from individual retirees. Again and again, we hear concern that H.R. 1 will take away the benefits that they worked so very, very hard to earn.

As Francis Meehling, age 76, told a New York Times reporter, ``Congress says the new benefits are voluntary, but many people would lose the coverage they have.'' Once a retiree loses his or her coverage, the choice to enroll in an inadequate Medicare drug plan is no longer voluntary because there is no other option available. Let us be very clear. Unless we fix this problem, we will have taken away choice from 4 million retirees and their families.

My motion to instruct conferees is a way to find the resources necessary to provide the financial incentives to solve this problem. Because we are faced with a $400 billion cap on Medicare spending, which is imposed by the other side of the aisle, we have few choices. We can find the money by reducing the already meager Medicare benefit, we can cut Medicare payments to hospitals and doctors, or we could use the money going for health savings accounts, $174 billion, so that 4 million retirees do not lose their current benefits.

I have lots of concerns with the health savings accounts themselves because few of the uninsured have incomes high enough to take advantage of the health savings accounts, and I do not believe they will meet their purported goal of providing coverage to the uninsured. At a time when States are struggling financially, the Center on Budget and Policy Priorities says savings accounts will drain $20 billion to $30 billion from State treasuries.

It is really not my point today to argue that point. I urge even my colleagues who support savings accounts to support this motion. We have limited choices about where to get the money to prevent 4 million retirees from losing their coverage; and again, I am sure that none of my colleagues want a single one of their constituents to be worse off because of passage of this bill.

The example of the catastrophic health care bill of 1989 continues to loom over us, and I have issued a friendly warning about it in the past. That is the time when the angry senior citizens charged the then- chairman of the House Committee on Ways and Means and surrounded his car and demanded that that bill be repealed. In recent weeks, I have heard from so-called experts that this bill will not result in a rerun of major grass roots opposition created by the catastrophic bill because they say this is a voluntary bill and no one will be worse off because this Medicare drug benefit is not mandatory but voluntary; but that is really not true because I caution my colleagues to listen again to the words of senior citizen Francis Meehling who says, ``Congress says the new benefits are voluntary but many people would lose the coverage they have.''

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield myself such time as I may consume.

Let me just briefly respond that the purpose of this motion to instruct is to prevent 163,000 people from our State of Illinois from losing their coverage because their employers stop providing the benefit for prescription drugs for the retirees. So that is the point. It is to solve a problem that will cause millions of retirees and persons with disabilities to lose their benefit.

Mr. Speaker, I yield 5 minutes to the gentlewoman from California (Ms. Linda T. Sanchez), a State where 385,000 retirees are projected to lose their prescription drug coverage.

Mr. Speaker, I would like to inquire as to how much time is left on my side.

Mr. Speaker, I yield 3 minutes to the gentleman from New Jersey (Mr. Pallone), a State in which 143,000 retirees are projected to lose their prescription drug coverage.

Mr. Speaker, I yield 3 minutes to the gentleman from Texas (Mr. Sandlin), a State in which 280,000 retirees are projected to lose their employer-provided prescription drug coverage.

Mr. Speaker, I yield 3 minutes to the gentleman from Ohio (Mr. Brown), a State in which 243,000 retirees are projected to lose their employer provided prescription drugs.

Mr. Speaker, I yield 3 minutes to the gentleman from Washington (Mr. McDermott), a State in which 74,000 retirees could lose their benefits.

Mr. Speaker, I yield 3 minutes to the gentleman from New Jersey (Mr. Holt), a State in which 134,000 retirees may lose their employer-provided prescription drug benefit.

Mr. Speaker, I yield myself the balance of my time.

This motion is not about giving senior citizens more than they already have; this is about preventing something from being taken away from 4 million seniors. As my colleague stated, the entire Medicare bill is subject to a $400 billion spending limit because of the insistence of the Republican leadership. If we are going to provide the funding necessary so that 4 million retirees do not lose their coverage, we need to find the money somewhere. We can take it from the health savings accounts, or we can reduce the meager drug benefit even more, or we can cut provider payments.

My motion says that taking it from the health savings accounts is the best of all of the options that the other side has given us. We know what this motion means. It is a choice whether we vote to protect retiree health coverage, or we are going to vote for health savings accounts that will not meet their goal of covering the uninsured.

More important, the retirees who have employer-sponsored insurance and do not want to lose it know what this vote is about. They will be watching us. I urge support for the motion to instruct.

Mr. Speaker, on that I demand the yeas and nays.

Mr. Speaker, I yield myself such time as I may consume.

We have had several motions to instruct conferees that this House has voted down, and this is more of the same. The motion before us instructs conferees to reject division B of the House-passed Medicare bill. Division B in H.R. 1 allows for the creation of tax-favored health care savings accounts. The basic idea behind these accounts is to let people put their own money away for their future health care needs. They are completely portable and can be used for any health care expense such as prescription drugs or doctor visits.

Let me explain to my colleagues why these accounts are so important for seniors and all other Americans. In January, most insured Americans will see an estimated 14 percent increase in their health insurance premiums. This is the fourth consecutive year of double digit increases. Currently, there are more than 43 million Americans without health insurance, an increase of 2.4 million in the last year.

Health care costs are spiraling out of control throughout the United States. Seniors have the most pressing problem with health care costs because they have no further income opportunities after they retire; but make no mistake about it, all Americans are struggling with increasing health care costs.

The future looks bleak. We have an aging population. The fastest growing segment in our country is people 80 and older. We need to start looking at ways to handle the chronic and long-term care costs of our aging population. When the baby boomers retire, long-term care costs will skyrocket, driving prices even higher.

One piece of legislation is not going to solve all these problems. There is not a simple answer, but there is a necessity to take multiple steps now with one of the most important steps being health savings accounts.

This House has passed bipartisan legislation that for the first time gives all Americans the incentive to plan for the future. It gives people more options and flexibility. If an employer does not offer health coverage, an individual has an affordable way to purchase health insurance on his own.

A few months ago, I talked to a constituent from my district who told me a story similar to the stories many Members have heard from their constituents. He recently quit his job to start his own company. He has a wife and two daughters, and he has been pretty successful at getting his company off the ground, but he cannot find health insurance for his family that is not exorbitantly expensive. He knows he needs it. He has got two children. He makes enough money to be classified as middle class, and he provides well for his family; but he simply cannot afford to be self-employed and make sure his children can go to the doctor. Having had eight children of my own, I understand his frustration. By all accounts he is successful except he cannot find health insurance. Health savings accounts would be a viable option for him and his family.

Opponents of health savings accounts will say that we are only helping wealthy people, that health savings accounts are a tax shelter for the rich. The very opposite is true. These types of accounts are giving people in the middle class and workers who do not have benefits the ability to buy health insurance.

Medical savings accounts, the precursor to health savings accounts, have been very successful. According to the last report from the Internal Revenue Service and the U.S. Treasury, 73 percent of all medical savings account buyers were previously uninsured. So medical savings accounts are making health insurance affordable for the first time for many Americans and actually bringing them into the health insurance system.

According to the Coalition for Patient Care, medical savings account policy holders currently have at least $100 million in their medical savings accounts to use for health care now or in the future. Previously, that money used to go to insurance companies. With medical savings accounts, policy holders are benefiting from their wise consumption of medical care.

Health savings accounts and health savings security accounts are more flexible than medical savings accounts and, therefore, will be more attractive to people. If they are implemented, it is estimated that 40 million health savings accounts and health savings security accounts will be created by the end of the decade.

I simply cannot understand why my colleagues on the other side of the aisle persist in trying to pass a motion that will remove the ability of seniors to save for their out-of-pocket health costs that will keep 43 million Americans uninsured. I cannot understand a

motion that will limit health care options for Americans. I think some Members are under the assumption that if we strip health savings accounts from the bill that the money spent on health savings accounts will be redirected and used to provide enhanced prescription drug coverage.

I want to clarify what this motion does and does not do. The motion does not direct conferees to close the drug coverage gap. It does not direct conferees to spend more money on drug coverage. It does nothing more than eliminate health savings accounts.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, my colleagues on the other side of the aisle have one general theme when they talk about health care policy: if we cannot give everyone everything, why pass a Medicare drug benefit. If we cannot help everyone, why help anyone. It is flawed thinking. We all want to help seniors pay for their prescription drugs. We want everyone to have access to affordable quality health care, it is just that we are going about it in different ways.

Our side of the aisle believes that seniors are smart enough to be able to choose the health care that is best for them. They should be able to choose what services they want and what doctor they want to go to. We think that people have the capability to plan for their health care needs down the road. The other side of the aisle thinks that Americans need to be taken care of, that is, what is good for one person is good enough for everyone. Some Members continue to categorize health savings accounts unfairly. They have been called a number of things. They have been called a tax-free grant, a tax shelter for the wealthy, and my favorite, a radical proposal.

The sad truth is that health savings accounts are a radical proposal. We are giving all Americans, including seniors, a tool to save for their future health care needs. We are letting people keep more of their own money in order to buy health insurance. Ironically, that is a radical idea for some Members, letting people keep the money they earn to buy the health coverage they want. It has been argued that Republicans are being fiscally irresponsible. Some have said that, if the health savings account provisions are stripped from the Medicare bill, that we could afford to cover more of the seniors' prescription drug costs. This is simply not true. Even if health savings accounts were taken out of the bill, $174 billion will not close the so-called coverage gap.

Let me remind Members that the Democrats offered an alternative prescription drug bill which closed the coverage gap, and that bill cost $1 trillion. The entirety of the cost of H.R. 1, including the provision creating health savings accounts, is within the budget limits that this House passed earlier this year; a $1 trillion prescription drug bill is not. Some Members today have spent a lot of time talking about how important it is to close the coverage gap in H.R. 1; yet this motion has nothing to do with closing the so-called doughnut hole. The motion does not instruct conferees to devote any additional money at all toward prescription drug coverage. This motion is not meant to supplement our prescription drug proposal; it is meant to kill legislation that this House has passed which will give millions of Americans access to affordable health care. I urge my colleagues to reject this motion.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, I certainly want to thank the distinguished chairman of the Committee on Veterans' Affairs from New Jersey and our senior ranking member from Illinois for their leadership and for their sensitivity in bringing this legislation to the floor for consideration.

Mr. Speaker, as an original cosponsor of the original legislation that was offered 10 years ago, I think it is time that we no longer should call this legislation a pilot program. It has matured. I certainly want to urge my colleagues that we should increase not only the authorization as well as the funding levels for this important program.

I rise today in support of H.R. 2595, a bill to restore the operation of the Native American Veteran Housing Loan Program for fiscal year 2003. This program permits the Department of Veterans Affairs to provide direct home loans to Native American veterans who live not only on tribal lands but also on homestead lands and communal lands. Eligible native veterans can then use direct loan funding to purchase, construct or improve a home on Native American trust land. These loans may also be used simultaneously to purchase and improve a home or to refinance another VA direct loan.

This pilot program extends to Native Americans, native Hawaiians, and also to my constituents in American Samoa. As a result, this program has been crucial to providing American Samoan veterans the opportunity to build and own their own homes, an opportunity that would not otherwise be available to them. VA's annual report to Congress for fiscal year 2002 reports that over 62 loans have been closed; but for the 10-year period, hundreds of loans have been approved because of this program.

As I explained earlier, Mr. Speaker, for the benefit of my colleagues so we can better appreciate this unique home loan program for our native veterans, the thousands of American Indian veterans who live in reservations, when they returned to their homes, they could not obtain a commercial home loan as you would someone who lived in a commercially owned property, a fee simple, living in reservations. The same is true with our native Hawaiian veterans who live in what is known as ``homestead lands,'' in the same situation where commercial lending institutions would not lend us money to build homes under a veterans program. The same is also true with my own veterans who live on communal lands. This is a unique program. I am very, very happy that we are able to continue the funding levels but also more importantly we need to make sure that this program continues.

Mr. Speaker, the Native American Veteran Housing Loan Program has been successful in providing our native veterans the opportunity to build and own their own homes. It provides our native veterans the ability to continue to live in their own lands, to contribute to their communities, and to build a legacy to leave their families. This program needs increased authorization and funding in the years to come. I urge my colleagues to support this legislation.

Mr. Speaker, I would like to thank Chairman Chris Smith and Ranking Member Lane Evans for their support and diligent work regarding Native American issues. Today I rise in support of H.R. 2595, a bill to restore the operation of the Native American Veteran Housing Loan Program during Fiscal Year 2003. This pilot program permits the Department of Veterans Affairs to provide direct home loans to Native American veterans who live on tribal lands. Eligible native veterans can use direct loan funding to purchase, construct, or improve a home on Native American trust land. These loans may also be used to simultaneously purchase and improve a home or to refinance another VA direct loan.

This pilot program extends to Native Americans, Native Hawaiians and to my constituents in American Samoa. For the benefit of my colleagues and so that we can better appreciate this unique home loan program, I want to explain that most native veterans living on communal or tribal lands. This is true for American Indian veterans who live on reservation lands. The same is true of our Native Hawaiian veterans who live on what is known in Hawaii as Homestead lands. The same is also true with American Samoan veterans who live on communal lands which cannot be sold as commercial or as fee simple property.

Given the unique status of communal lands, thousands of native veterans have been denied loans by our commercial lending institutions and banks. However, with the creation of this pilot program, many of our native veterans are able to build and own their own homes and the VA reported that in 2002 it had closed on a total of 289 loans under the terms of this pilot program.

Recently, Public Law 108-7, Consolidated Appropriations Resolution, placed a cap of $5 million on the amount of loans that could be approved under the program. But, at the time this law was enacted, VA had already exceeded this cap. As a result, VA is unable to make new loans for the remainder of the fiscal year. Because of this new cap, veterans are unable to complete construction on homes already in progress. This is unfair to our native veterans and it is imperative that Congress remedy this situation. H.R. 2595 will accomplish this.

Mr. Speaker, I want to thank my colleague, the gentlewoman from Illinois, for putting together this motion to strike the Health Savings Account provisions and shore up employer-sponsored coverage.

The House Republican bill includes $174 billion over 10 years for Health Savings Accounts, and these accounts, Mr. Speaker, are bogus. This money should be used to subsidize employers to prevent employer- sponsored coverage erosion. The Health Savings Account provisions will undercut employer-provided health care coverage.

These benefits are available only if individuals are covered by high deductible plans. In other words, plans providing no coverage for at least the first $1,000 of medical expenses. A deductible that size is approximately double the deductible of most employer plans. The provisions will encourage employers to reduce coverage for workers and their families by increasing deductibles and shifting even more costs on to employees. The resulting cost savings will be enjoyed by the employer because there is no requirement that these savings be passed on to the employee.

For many American families, the tax benefits are completely worthless. The only thing they would receive from the Health Savings Account provision is reduced health care coverage. Most American families will not be able to take advantage of the tax shelter in these provisions because they do not have $4,000 per year in additional savings. The Health Savings Account provisions are designed to benefit employers and upper-income management not rank-and-file employees.

Now, Mr. Speaker, with the deficit at a record high, we ought to carefully consider how best to spend the scarce resources we have. It is fiscally and morally irresponsible to spend $174 billion on a tax shelter that will erode health insurance coverage and not improve it. This money would be much better spent by strengthening employer- sponsored retiree coverage, which currently covers about a third of all seniors.

The fate of employer-sponsored health coverage for retirees is a central issue in the Medicare prescription drug debate. As it currently stands, the House-passed Medicare bill encourages employers currently providing retiree health benefits to drop coverage. Unfortunately, the Republican bill states that any dollar an employer pays for an employee's prescription drug cost would not count towards the employee's out-of-pocket catastrophic cap. This disadvantages seniors with employer-sponsored coverage because it would be almost impossible for them to ever reach the bill's catastrophic cap over which Medicare would pay 100 percent of the drug costs. So, without a doubt, many employers will simply stop offering retiree coverage.

The potential loss of this valuable benefit that many unions and employers provide was reported recently in the New York Times. According to the lead story by Robert Pear, and I quote, ``About 12 million of the 40 million Medicare recipients has retiree health benefits, usually including some drug benefits. The Congressional Budget Office estimates that one-third of the people with such drug coverage could lose it under bills passed in June by the House.''

Now, the Republican conferees are unwilling to provide a final Medicare agreement that will provide seniors with an affordable, available, and guaranteed prescription drug benefit that

does not privatize Medicare. With the added threat of employers dropping retiree health benefits if a retiree is eligible for Medicare, we will no doubt have a public health crisis on our hands. Do not let this happen. Support the Schakowsky motion.

Mr. Speaker, I thank gentlewoman from Illinois for yielding me this time, and for her leadership on health care issues.

What is it, Mr. Speaker, what is it about Republicans and Medicare? There is always some Rube-Goldberg idea they have to change the public health system that has lifted millions of Americans out of poverty for the last 38 years, that has helped America's elderly live longer lives and healthier lives? Republicans always want to try some experiment, some Rube-Goldberg plan.

They tried means testing. They could not get that through the Congress. They tried to raise up eligibility age. They could not get that through the Congress. They tried these Medicare HMOs; and, unfortunately, they have gotten that through the Congress. And ask almost any senior how these Medicare HMOs are working, and they are not working very well.

They have tried an experimental medical savings account, a demonstration project which has not worked very well. Then the President said if you want a prescription drug benefit through Medicare, you have to get out of Medicare and get it through private insurance. That clearly is not flying with the American people. They always, always, always, over the last 30 years, every chance they have gotten, have tried to privatize Medicare.

Now, Mr. Speaker, they have this $174 billion tax scheme to, again, try to undercut and weaken Medicare. Medicare works because it is universal insurance. And universal insurance works because there are a lot of healthy people and a lot of people that are sick. Through universal coverage, it works for everybody. It works for the healthy 65-year-old who walks two miles every day and does not need much medical treatment, because she subsidizes the 80-year-old who may be sicker. Then when the 65-year-old gets sicker, other people will begin to help her, because it is a universal system.

Republicans, for whatever reason, I do not know if it is their friends in the insurance industry or what it is, or their political philosophy, or whatever, they want to fracture that universal coverage pool. I guess we really should not be surprised, Mr. Speaker. For 38 years, we have seen Republicans simply have not liked Medicare. They did not vote for it 38 years ago. Speaker Gingrich tried to cut $250 billion 10 years ago to, surprise, give tax cuts to the wealthiest people in this country. Dick Armey, the Republican leader 2 years ago, said, ``In a free society, we wouldn't have Medicare.'' Whatever that meant. The gentleman from California (Mr. Thomas), chairman of the Committee on Ways and Means, just in the past year, said he wants to end Medicare as we know it.

They simply do not like this program. I wish they would come to the floor instead of sending these Rube-Goldberg kind of constructs that nobody really understands, just come to the floor and say; we do not like Medicare; we want to privatize it; we want to let the insurance industry run it. That is what the Republicans do in every one of these Rube-Goldberg kind of schemes.

Perhaps the worst is this $174 billion tax shelter, tax scheme, they are trying with the medical savings accounts. That is why the Schakowsky motion to instruct makes sense. We can take that $174 billion, instead of putting it in some kind of tax shelter or tax scheme, and use it for something that will really matter and that will help the seniors in this country.