To amend the Lobbying Disclosure Act of 1995 to require lobbyists to disclose the candidates, leadership PACs, and political party committees for whom they collect or arrange contributions, and for other purposes.

Mr. Speaker, I move to suspend the rules and pass the Senate bill (S. 1) to provide greater transparency in the legislative process, as amended.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days to revise and extend their remarks and include extraneous material on the bill under consideration.

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

Ladies and gentlemen of the House, if there is one message that was abundantly clear based on the results of last year's election results, it was that the American people want us to end the culture of corruption that has enveloped the legislative process.

For far too long, Americans have seen business as usual where time and time again special interests trump the public interest.

So we've heard that message loud and clear. For the past several months, the House and the Senate have diligently worked together to fuse a legislative response that combines the best of the measures passed by both Houses earlier this year.

The measure that we consider today will go a long way toward bringing back accountability to the Congress and to restoring the trust of the American people in their government. S. 1 accomplishes these critical goals in four ways.

First, S. 1 puts an end to the K Street Project, an insidious effort that employed threats and intimidation to control the legislative process. S. 1 ensures that such efforts will no longer be permitted. It specifically prohibits Members and senior staff from influencing hiring decisions or practices of private entities for partisan political gain.

Second, S. 1 shines a disinfecting spotlight on lobbying activities by mandating full and enhanced public disclosure on these activities. Pursuant to this measure, lobbyists will have to file reports on their lobbying activities twice as often each year. They will be required to disclose their contacts with Congress. They must certify that they did not give a gift or pay for travel in violation of the rules and, for the first time, file these reports electronically in a public, searchable database so that anyone can review them.

Third, S. 1 closes loopholes in the current law that have been exploited to avoid the clear intent of the Lobbying Disclosure Act. It does this by mandating the disclosure of contributions in excess of $5,000 by businesses or organizations that actively lobby through certain coalitions and associations. And, it also requires the disclosure of the past executive and congressional employment of registered lobbyists.

Importantly, S. 1 prohibits a Member's spouse who becomes a lobbyist after the Member's election from making direct lobbying contacts to the Member or the Member's office.

In addition, the bill addresses the process by which political contributions are bundled by campaign committees. It requires each committee to disclose to the Federal Election Commission, on a semiannual basis, specified information for each currently registered lobbyist who has either forwarded or been credited for raising contributions totaling at least $15,000 during the reporting period.

Fourth, and perhaps most significantly, S. 1 puts real teeth into enforcement. It increases the penalties for violations of the Lobbying Disclosure Act to deter and punish corrupt activity. It substantially increases civil penalties from the current level of $50,000, to four times as much, to $200,000 and provides for the imposition of criminal penalties of up to 5 years for knowing and corrupt violations of the Act.

These are some of the major reforms that S. 1 offers. This bill recognizes the importance of lobbying to responsive and effective congressional and executive decision-making. And these reforms will help strengthen the sound foundation of the Lobbying Disclosure Act and go a long way toward restoring the trust of the American people in our system of government.

I want to respectfully point out the contributions from the other side, particularly the ranking member of Judiciary, Lamar Smith, in this endeavor, and so I urge my colleagues all to join me in supporting the Honest Leadership and Open Government Act.

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

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

I thank my colleague for his examination of the bill. We've worked on this bill together. I think we're in support of it, and I hope to enjoy the gentleman's continued success and cooperation in the matter.

It's very important that we understand that we are ending the pay-to- play K Street Project which, under this bill before us, now prohibits Members and their staff from influencing hiring decisions of private organizations on the sole basis of partisan political gain.

It subjects those who violate this provision to a fine and imprisonment of up to 15 years.

We prohibit lobbyists from providing gifts or travel to Members of Congress who have knowledge that the gift or travel is in violation of the Senate or the House rules.

We require now lobbyist disclosure filings to be filed twice as often by decreasing the time from filing from semiannually to quarterly.

We require lobbyist disclosures in both the Senate and the House to be filed electronically and creates a public and searchable Internet database of such information.

We increase civil penalties for knowing and willful violations of the Lobby Disclosure Act. We increase them by four times as much, from $50,000 to $200,000, and imposes a criminal penalty up to 5 years for knowing and corrupt failure to comply with the Act.

We require the GAO to audit annually lobbyists' compliance with these disclosure rules and, further, require lobbyists to certify that they've not been given gifts or travel that would violate either Senate or House rules.

We require the disclosure of businesses or organizations that contribute in excess of $5,000 and actively participate in lobbying activities by certain coalitions and associations.

We're requiring disclosure to the Federal Election Commission when lobbyists bundle over $15,000 semiannually in campaign contributions for any federally elected official, including the Senate, the House or presidential, or leadership PACs.

We require lobbyists to disclose to the Secretary of the Senate and the House Clerk their campaign contributions and payments to presidential libraries, inaugural committees or entities controlled by the name for or honoring Members of Congress.

Ladies and gentlemen, this is an extremely difficult and new way of controlling lobby operations. I think we are restoring the trust of the American people and our system of government, and I think we are living up to the title of this measure, honest leadership and open government.

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

Mr. Speaker, how much time remains on each side?

Mr. Speaker, I yield 1 minute to the distinguished majority leader, Mr. Steny Hoyer, from Maryland.

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

I want to thank my colleagues on the other side, the gentleman from Georgia, and of course the ranking member, for pointing out additional refinements that we must continue to concern ourselves with. The Lobbying and Ethics Reform bill is not over with with today's work. Our job continues, and I will be looking forward for these constructive comments that they will be bringing to our attention.

Mr. Speaker, I submit for printing in the Record a letter from the Campaign Legal Center and others that support this legislation, and I would like you to know that the organizations' authors that signed this are among the most watchful and effective critics of the subject of ethics and lobbying that we have in the country.

The letter was signed by the U.S. PIRG, the Public Citizen, the League of Women Voters, Democracy 21, Common Cause, the Campaign Legal Center, all who have said that:

Our organizations strongly urge you to vote for the lobbying and ethics reform legislation when it is considered by the House on the Suspension Calendar.

The legislation being presented to the House constitutes landmark reform of the Nation's lobbying disclosure laws and landmark reform of the Senate ethics rules. It is designed to help address the worst congressional corruption scandals in 30 years that were revealed during the last Congress.

Under the legislation, for the first time citizens will be provided with a wealth of information about the multiple ways in which lobbyists and lobbyist organizations provide financial support to assist Members. For the first time, candidate campaign committees, leadership PACs, and political party committees will be required to disclose the bundled contributions raised for them by lobbyists and lobbying organizations. The legislation also includes fundamental reforms of the Senate ethics rules very similar to the landmark House ethic reforms adopted at the beginning of the year.

July 30, 2007.

Re Vote for the lobbying and ethics reform bill.

Dear Representative: Our organizations strongly urge you to

vote for the lobbying and ethics reform legislation when it

is considered by the House on the suspension calendar.

The organizations include the Campaign Legal Center, Common

Cause, Democracy 21, the League of Women Voters, Public

Citizen and U.S. PIRG.

The legislation being presented to the House constitutes

landmark reform of the nation's lobbying disclosure laws and

landmark reform of the Senate ethics rules. It is designed to

help address the worst congressional corruption scandals in

30 years that were revealed during the last Congress.

Under the legislation, for the first time citizens will be

provided with a wealth of information about the multiple ways

in which lobbyists and lobbying organizations provide

financial support to assist Members. For the first time,

candidate campaign committees, leadership PACs and political

party committees will be required to disclose the ``bundled''

contributions raised for them by lobbyists and lobbying

organizations.

The legislation also includes fundamental reforms of the

Senate ethics rules very similar to the landmark House ethics

reforms adopted at the beginning of the year.

The process being used in the House to vote on this

legislation is the result of a Republican Senator, Jim DeMint

(R-SC), blocking the House and Senate from going to

conference on the lobbying and ethics reforms and bringing a

conference report to the House and Senate floors for an up-

or-down vote. There is absolutely no basis for a House member

to vote against this legislation on process or substance

grounds.

A vote against this legislation is a vote against landmark

lobbying and ethics reforms.

Our organizations strongly urge you to vote for the

lobbying and ethics legislation when it comes to the House

floor for a vote.

Campaign Legal Center.

Common Cause.

Democracy 21.

League of Women Voters.

Public Citizen.

Mr. Speaker, I rise only to advise my colleague that starting at page 51 on our bill, we have so many felonies that are listed that they run for three pages. And I don't have the time to go through them today, but some of them are the ones that the gentleman mentioned.

I don't see it here.

The answer is, it is not included in here.

But every other one is. So I just wanted to refer the distinguished gentleman to the numbers of pages of felonies that are included in here, and I thank him for the one that concerns him mostly.

I am going to conclude my remarks by thanking all of my colleagues who have put time in on this matter. I want to thank the ranking member and the leadership on both sides of the aisle.

We have a major accomplishment on our hands. What we need to do is to continue to follow through on implementing and improving anything in this measure that anybody would like to bring to our attention. But what we are doing is finally ending the cynical business as usual environment where big business and special interests dominate the legislative process to the detriment of the public interests. That is what all of these months and continuing wrangling and what our good government groups have been looking at and criticizing us for far too frequently is now being corrected.

This is a measure that every Member in the Congress can be proud of and support fully. A vote for this measure is a vote to end the culture of corruption. The time for S. 1 is now, and I accordingly urge my colleagues to support the measure.

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

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

Mr. Speaker, I yield myself 2 minutes.

(Mr. STARK asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I urge my colleagues to support H.R. 6331. For whatever reasons, people may be concerned with process. To me, that is a snare and a delusion. Basically, this bill protects the physicians from their 10 percent cuts. If you vote against it, you're voting to cut physicians by 10 percent.

It improves benefits for seniors and people with disability, it ends discriminatory mental health copayments. So vote against the bill and seniors don't get mental health treatment. It targets extra help to low-income people. Vote against the bill and you're, as Republicans like to do, trashing low-income people for the benefit of rich insurance companies, the only one group that opposes this bill.

It delays the durable medical equipment competitive bidding demonstration, which we have agreed on a bipartisan basis should be delayed. Vote against the bill and let the medical equipment competitive bidding go ahead. It makes improvements in quick pay for pharmacists. Vote against the bill and talk to your local pharmacists, my Republican friends, and see what they think about your voting against the bill, which would otherwise provide them prompt payment.

The clinical labs, therapy services, rural providers, psychologists, social workers, dialysis patients all get help in this bill. So vote against it and go back and talk to your constituents who depend on those services for their quality of life.

I am ready to have you do that because all of this is paid for in a balanced, fair method, suggested, I might add, by the administration's own actuary, and the Government Accountability Office and MedPAC all say that trimming the payments to Medicare Advantage is the right thing to do, and will extend the life of the Medicare trust fund.

So it's not a bill I wish we were considering. The CHAMP Act, which many of you voted, is one. But this is a modest compromise. I urge its support.

For several years now, I have pushed to modernize Medicare's reimbursement for ESRD, consistent with longstanding recommendations from the Medicare Payment Advisory Commission, MedPAC, and the Government Accountability Office, GAO. The current payment system includes a perverse financial incentive to dose higher levels of the anti-anemia drug, Epogen, which can put patients at risk of death and serious cardiovascular events. Both MedPAC and GAO recommend replacing this system by reimbursing providers with one ``bundled'' payment for dialysis services and related drugs and labs, thereby removing the incentive to overuse items and services that are currently separately billed. This will encourage more efficient provider behavior while maintaining and improving patient care. This modernized payment system is consistent with the philosophy governing many of Medicare's other payment systems.

It is imperative bundling be done in a way that is sensitive to individual patient needs, protects against provider stinting, and is not ``one-size-fits all.'' Including an outlier pool, risk adjustment, and a strong quality performance system all work to ensure that appropriate care is ensured.

That is why I was very proud when the Children's Health and Medicare Protection, CHAMP, Act, which passed the House in August 2007, advanced ESRD bundling with these patient protections. That is also why I am disheartened by the ESRD bundling proposal before us today, as I have several serious concerns with this package.

First, I am very disappointed to see that much of this package is designed to appease the profit-hungry interests of the dialysis and pharmaceutical companies. I have long believed that dialysis providers should meet strong quality standards in order to receive increased payments. I oppose the automatic updates in this bill. I hope that when structuring the quality incentive program, CMS pushes dialysis providers to meet a rigorous set of standards in order to get payment increases. In CHAMP, providers had to meet a clear and strong set of quality measures in order to receive bonus payment.

Unfortunately, the initial anemia management quality measure in this bill is seriously flawed. The MIPPA quality measure tells providers that they are providing acceptable care as long as they haven't gotten worse than their past track record. That's like telling a D-student that they are doing fine as long as they keep getting at least D grades.

This is wrong. We should be encouraging providers to improve the care provided. There are serious health issues at stake, with the FDA warning that using anti-anemia drugs in a way that raises red blood cell levels too high puts ESRD patients at risk of death or cardiovascular events. Sadly, the measure in MIPPA gives providers a pass as long as the care provided just doesn't get worse.

Instead, we should be encouraging providers to get more patients within FDA's recommended range for anemia management. We tried to do this in CHAMP when we designed something that pushed providers to at least meet the national average, with the bar getting raised in subsequent years. If the MIPPA quality measure is enacted into law, I intend to work to override or modify it. I hope that the Centers for Medicare and Medicaid Services will instead develop a system that pushes providers toward improved performance and assesses them against anemia management measures that are consistent with the FDA label.

A second flaw in this package is that it allows the large dialysis organizations, LDOs, to

benefit from a mandated low-volume adjustment. I have no problem with a low-volume adjustment if it is warranted and set right. However, LDOs don't need it, and they shouldn't get it. Repeated studies by the HHS Office of Inspector General show that LDOs are able to get much better prices on dialysis-related drugs than smaller dialysis organizations. Even if an LDO has a low-volume facility, that facility still benefits from the price discounts negotiated with the parent corporation. Giving LDOs a low-volume adjustment is an unnecessary waste of money.

Another flaw with the MIPPA package is that it only lets facilities fully opt-in to the bundled payment system in the first year of the phase-in. I suspect that facilities will find the incentives for practice patterns under the old system and new systems to be in conflict, and may quickly realize that moving directly to bundling in year two is easier. To the extent bundling incentivizes more efficient behavior and has the necessary patient protections, if a facility wants to opt-in in year two or three, I see no reason to stop them.

I would also like to clarify something about the bundle itself. MedPAC has repeatedly pushed for a broader ESRD bundle. My understanding of the MIPPA language is that it provides for inclusion of all oral dialysis-related drugs in the bundle, including calcimimetics and phosphate binders. Specifically the term ``items and services'' at clause (14)(B)(iv) of the Social Security Act, as amended by MIPPA, and the reference to ``other drugs and biologicals'' at clause (14)(B)(iii), both afford the Secretary broad discretion to include oral drugs furnished to an individual for the treatment of end stage renal disease that don't necessarily have an IV equivalent.

I know why some pharmaceutical companies want to exclude these drugs from the bundle. They want another product line where they can play their separately billable game and try to drive up utilization and corporate profits. That is contrary to the philosophy of bundling and not the intent of Congress.

These drugs should be included in the bundle to prevent cost shifting to Part D in order to circumvent the new bundled payment. Most importantly, it would ensure that decisions as to which drug a patient receives are driven by clinical decisions not reimbursement policy. This will also ensure that all drugs furnished to patients for the treatment of ESRD are captured in the new bundled payment.

I also believe the bundle should set in a way, including any appropriate adjustments, so that more frequent home dialysis, both peritoneal and hemodialysis, is adequately paid and encouraged.

ESRD bundling is long overdue, but it is unfortunate that industry has demanded such a high price for it. If this bill becomes law, I intend to keep pushing for these changes and will be watching and weighing-in heavily as CMS moves forward with implementation.

Announcement By the Speaker Pro Tempore

Mr. Speaker, I yield 1 minute to the gentleman from Georgia (Mr. Lewis).

Mr. Speaker, I would like to yield to the gentlewoman from Kansas (Mrs. Boyda) for a unanimous consent request.

(Mrs. BOYDA of Kansas asked and was given permission to revise and extend her remarks.)

Mr. Speaker, I yield to the gentleman from Rhode Island (Mr. Kennedy) for the purpose of making a unanimous consent request.

(Mr. KENNEDY asked and was given permission to revise and extend his remarks.)

I yield to the gentleman from Washington (Mr. McDermott) for the purpose of making a unanimous consent request.

(Mr. McDERMOTT asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I am happy to yield 1 minute to the distinguished gentleman from California (Mr. Becerra).

Mr. Speaker, I recognize the distinguished gentlewoman from California (Mrs. Davis) for a unanimous consent request.

(Mrs. DAVIS of California asked and was given permission to revise and extend her remarks.)

I would like to yield 1 minute to the distinguished gentleman from California (Mr. Thompson).

Mr. Speaker, I am pleased to yield 1 minute to the distinguished gentleman from Illinois (Mr. Emanuel).

Mr. Speaker, I yield myself the balance of my time, and urge my colleagues to support the bill.

The distinguished gentleman from Louisiana was quite correct; we have worked together on this. But for us now to depend on the other body is sheer folly. We quite have an idea of what they will send us, and it will be much less. There will be no prompt pay for pharmacists in the other body's bill. They will cut payment to oxygen providers and wheelchair providers. There will be less for low income seniors. There will be no preventative services. The only difference will be a slightly less cut to the private fee for service plans, and the administration actuaries have just recently sent us an e-mail saying this will extend the life of the Medicare trust fund.

And I apologize also to my distinguished ranking member on the Health Subcommittee, and I understand when we have 50 groups supporting our bill and you only have one, the lobbyists for the private fee for service plan, it gets a little annoying. But we will see if we can find one other group to support your bill. I doubt it, but we will try.

I urge this. This may be the last chance. I won't discuss process, but we all know that we cannot rely on the other body to come together and work as well as we have on a bipartisan basis.

Every part of this bill has had support on a bipartisan basis over the last year in this House. It is put together to get as much as we can for as little cost to the providers, to extend benefits to the seniors, to provide preventative care, to give mental health parity, and pay the doctors what they are entitled to. Please support the bill, and let us finish our work this week.

Mr. Speaker, I would ask unanimous consent that the gentleman from Michigan (Mr. Camp) be allowed to control 10 minutes for debate purposes of the time that I control.

Mr. Speaker, I yield myself 2 minutes.

Mr. Speaker, I rise today in opposition to H.R. 6331, the Medicare bill that is put before this Congress today on a suspension vote.

Somehow I missed it, but I didn't see the notice of the legislative hearing in the Energy and Commerce Committee hearing on this. I didn't see the notice of the subcommittee markup on this bill. I didn't see the full committee notice to have a markup. I didn't get any notice of the technical corrections of the bill, which we received at 10 minutes until 10 a.m. this morning.

The majority seems to be under the mistaken impression that the less input and the less Republicans know about major bills, the more likely we are to vote for them. Well, I have a news flash. When we were not a part of the process, when we don't have any input into the policy, there is over a 95 to 100 percent we are going to be ``noes'' regardless of the substance of the bill.

On this particular bill, had we had some input, we would have strongly opposed the cuts to Medicare Advantage. A large number of us would have opposed the delay in the durable medical equipment competitive bidding that's supposed to go into effect on July 1 and, under the current bill, is also delayed for 18 months. There is obviously a need to fix the current physician reimbursement system. We have been in session now in this Congress almost 18 months, perhaps longer. You would think that in that time period, there could have been some legislative hearings. There could have been some draft proposals floated. There could have been some markups and some discussion and some give and take, and we could have found a compromise that would pass on the suspension calendar. But that has not been the case, as it was not the case on the CHAMP Act that my good friend from New Jersey just referred to.

So, Mr. Speaker, on this particular piece of legislation for this morning, I would strongly urge a ``no'' vote and ask all Members of this body that believe in regular process and give and take in policy reform to vote ``no,'' and then sometime when we come back after the July 4th work period, perhaps we can work together to do what needs to be done.

Mr. Speaker, I rise today to oppose H.R. 6331, the Medicare bill put before this Congress today on a suspension vote. While I a agree that we should do something to address the Medicare physician payment cut that will take affect in just a few days, I do not support cutting Medicare Advantage to pay for this short-term fix.

This legislation cuts close to $50 billion from Medicare Advantage, a program that benefits seniors in every State and a program in which our seniors are deeply satisfied. I believe people benefit when they have the kind of choices that only market competition can provide, and that certainly includes choice in health care. As we have seen with the Medicare Part D drug benefit, when an entitlement program is subjected to market forces, everyone is a winner. The taxpayer gets lower spending in an entitlement program; the beneficiary pays lower premiums and co-pays; and we get to provide broader access to affordable and accountable health care for our seniors.

Yes, it is true that this bill provides temporary relief for payment cuts for physician services for the next year or so. So I guess as

Members we can rest assured that this problem will disappear for the next 18 months.

But what else have we signed on to if we are to pass this bill today? We have signed on to massive entitlement expansion through the revisions to the low-income subsidy and Medicare savings program. We have signed on to eliminating private, fee-for-service Medicare Advantage plan options that are currently available in 48 States. We have signed on to significant cuts in payment to all Medicare Advantage plans that work with teaching hospitals across this country. And last but not least, we have signed on to a process by which our own committees are now rendered useless in this Congressional body.

Over the course of the past year, there has not been one single Medicare hearing in the Energy and Commerce Committee. Not one. I guess the doc fix is so important that it justifies taking a significant, political, and complex bill straight to the floor under a vote by suspension of the rules.

That means no consideration by the committees of jurisdiction and no amendments on the floor. For an issue that the Democrats like to consider bipartisan--avoiding a physician payment crisis--one has to ask, why not work with Republicans to enact something earlier and more meaningful?

We know why we are here today. If the Speaker is able to jam this down our throats today, we know that it will hit a brick wall in the Senate. How do we know this? Because this bill is just about like the one that recently failed in the Senate. And, the President has indicated that he will veto it, in the unlikely event that it passes both bodies.

So, we see that today's vote for a physician payment fix is merely the political exercise Republicans must endure so that Democrats may turn to their constituents when they return for the holiday next week and say, ``See, I tried to help you but those abominable old Republicans, why they just wouldn't let me. They don't even like puppies, I heard.''

This bill temporarily stops the hemorrhaging, but it does not fix the long-term problem of physician payment. And the cure is likely worse than the illness--the doc fix is at the expense of our senior who enjoy their MA benefit.

I oppose this bill. I oppose the process--no committee hearings; no committee markups; no mention of the word Medicare in our committee at all.

Last year, I decried the politics of some of debates we had, and I was told that politics is a good thing for this body. Well, we're all elected to these seats, so we know a thing or two about politics, but at some point the people who elected us expect us to quit politicking and start governing. Too often this new Democratic Majority lacks the ideas they need to govern, and so they revert to politics.

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

Mr. Speaker, I want to yield 2 minutes to a member of the Energy and Commerce Committee, the gentlewoman from Tennessee (Mrs. Blackburn).

Mr. Speaker, I yield myself 30 seconds.

I think we are entitled to cabal about the process. We represent about 48 percent of the American people and have had absolutely no input into a multi, multibillion-dollar temporary fix. This would only go into effect for 1 year. It doesn't solve the long-term program. So I think we are entitled to a little caballing, as they said.

I want to yield 2 minutes to the distinguished gentlewoman from Florida (Ms. Ginny Brown-Waite).

Mr. Speaker, I yield myself 1 minute.

Mr. Speaker, again, I have missed the legislative hearing on this issue in the last 18 months. Maybe they had it in the other body, but we haven't had it here. The actual bill that we are addressing, we got it at 10 minutes until 10 this morning. This is the same group that passed a farm bill that left out a complete title, and we are passing a 278 page bill that the original substance I think we got Friday or Monday, the technical corrected copy we got at 10 until 10.

I may be mistaken, but I believe if we had a process that worked and had enough time to think about it, if we had actually been holding hearings and substantive markups and all that is on the books of how the Congress is supposed to work, we would probably have a bill for the suspension calendar that both parties could work for. But the way our friends in the majority are operating these days, the proof is in the pudding.

I would strongly recommend a ``no'' vote, and then let's do it right. Let's do it right so we can vote for it.

Mr. Speaker, can I inquire as to the time remaining on the four sides.

Mr. Speaker, I have no other speakers, so I reserve the balance of my time and am prepared to close.

Mr. Speaker, I am prepared to close if everybody else is prepared to close.

I yield myself the balance of my time.

We do have a serious issue here, Mr. Speaker. We have known for several years that we needed to fix the current system for physician reimbursement. We also have known that in some of the other issues that have been put into this bill, that there are areas of reform that need to be implemented. One of the things that I have worked on for over 12 years is a competitive bidding process for durable medical equipment which is supposed to go into effect July 1 of this year. The pending bill has a moratorium on that implementation I believe for 18 months, which I think is ill-advised.

But I do think that when each of us gets elected to this body, when we go out and campaign and ask for Members and voters to support us, we don't say: If you vote for me, I will go to Washington and I will make sure that I have no input into major issues, and when they are put up at the last minute I will go vote ``yes'' on the suspension calendar. That is not what we say.

This is a serious issue. There are serious issues that need to be addressed in this bill. I am not sure this bill is even a House bill. My understanding is that it is a failed version of a Senate bill that has been patched together for purposes of a vote today just in case there is not a bipartisan compromise later in the week, as Congressman McCrery spoke about earlier.

Process does count. Policies are better if there is bipartisan input and you go through the give and take of subcommittee, full committee markup where stakeholders and Congressmen and women on both sides of the aisle can be involved. That has not happened here.

Again, this is a multibillion-dollar bill. Even if it were to be passed, it only has the effect for the rest of this year and the next calendar year. It is not a permanent fix. It doesn't address long term these issues. And all of the groups that are supporting the bill today that have been enunciated by the majority, when they have been in to see me they are talking about a permanent fixes, they are not talking about a temporary quick fix, patch it, go on down the road, kick the can fixes, which is what this is if it were to be implemented.

So I really hope that we can vote against this. Since it is a suspension vote, it only needs 146 ``no'' votes and it would fail, and then we could work together to perhaps on a permanent way fix some of these in a bipartisan way. So I urge a ``no'' vote.

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

Mr. Speaker, we all deplore unethical conduct by Members of Congress and their staff. Each party has their fair share of examples. The public wants and deserves honest government. Unfortunately, this legislation does not bode well for this Congress' ability to deliver it.

In May, this House brought up a base bill that seemed very familiar to Republicans because the increased disclosures required in the bill were largely those contained in H.R. 4975, which was introduced by Congressman David Dreier, and which passed the House in the last Congress.

Last year's H.R. 4975 contained all of the following provisions: a requirement for Members to disclose post-employment negotiations with private entities; a prohibition on partisan influences on an outside entity's employment decisions; and increased quarterly electronic filing in a public database of lobbyist campaign contributions linked to Federal Election Commission filings.

That Republican legislation also increased civil and criminal penalties for failures to comply; required disclosure by lobbyists of all past executive branch and congressional employment; and contained a prohibition on lobbyists' violation of House gift ban rules.

Legislation the Democrats introduced this Congress, in the form of H.R. 2316, largely replicated Republican efforts from the previous Congress.

At the Judiciary Committee's markup of H.R. 2316, several additional Republican amendments that would strengthen this bill were adopted by voice vote. One provided for a 1-year revolving door ban that would prohibit private lawyers and law firms who enter into contracts with congressional committees from lobbying Congress while under contract to such committee and for 1 year thereafter.

That amendment by Representative Chris Cannon was adopted by voice vote at the committee, and was passed out of the House of Representatives. But it is nowhere to be found in the bill before us today.

Also, in May, Democrats supported and passed two motions to recommit offered by Republicans that contained even more ethics reforms. Those reforms required lobbyists to disclose which special projects they lobbied for.

If a special interest lobbyist is having closed-door meetings with Members of Congress regarding programs that do not benefit all Americans but only benefit a small group of people in one part of the country, then those projects should be disclosed.

The Republican motion to recommit also closed the existing loophole that allows State and local government entities to give gifts and travel to Members and their staff that other entities cannot give. It makes little sense to exempt entities that operate on taxpayer dollars from the gift and travel ban.

Current rules allow taxpayer-funded entities to give gifts and travel to Members and staff while they try to convince those same Members and staff to send more Federal taxpayer dollars their way. That is not fair, and the Republican motion to recommit, which was adopted, would have ended that practice.

The Republicans' motion to recommit also contained a reverse revolving door provision that would have prohibited a congressional employee who was a registered lobbyist prior to their congressional employment from engaging in official business with their former private employer for a period of 1 year.

The Republicans' motion to recommit also included the Republican- amended text to H.R. 2317, which required that bundled contributions to political action committees, often referred to as PACs, be fully disclosed.

Viewed in the harsh light of recent history, the legislation we consider

today is a hollow shell of reform. Just listen to the following list of reforms that Democrats have abandoned.

The provisions in this bill requiring the disclosure of contributions bundled together by lobbyists is weaker than the reforms passed in May, as this legislation requires the disclosure of bundled contributions exceeding $15,000 rather than the original $5,000.

That means less disclosure and less accountability to the American people. The weakened bundling disclosure provisions in this bill do not even cover bundled disclosures to PACs, a reform that 33 Democrats supported when it was accepted as part of the Republicans' motion to recommit H.R. 2317, and that 158 Democrats supported when it was accepted as part of the Republicans' motion to recommit H.R. 2316.

The newspaper Roll Call reported yesterday that, ``The average Democratic incumbent raised over 63 percent more from PACs during the first half of this year than during the same period in 2005.'' Could that be why Democrats don't want to disclose the bundled contributions lobbyists give to PACs?

This bill also fails to contain the following reforms that 158 Democrats supported in May. The length of this list defines the credibility chasm that now separates the Democratic Party from American voters.

The provision requiring the disclosure of bundled contributions by political action committees? Gone.

The provision requiring lobbyists to disclose the special projects they lobby for? Gone.

The provision prohibiting State and local governments from giving expensive gifts and lavish travel to Members of Congress in return for taxpayer dollars? Gone.

The provision prohibiting congressional employees who were lobbyists from engaging in official business with their former lobbyist employers? Gone.

Last May, the Washington Post reported that the Democrats brought up their original legislation ``after scrapping most key elements of an ethics package meant to deliver on Democratic promises to bring unprecedented accountability to Congress.''

Today, essential reforms have been thrown overboard, and the Democratic pledge of reform is sinking fast.

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

Mr. Speaker, I yield 5 minutes to the gentleman from California, the current ranking member and former chairman of the Rules Committee, Mr. Dreier.

Mr. Speaker, I yield myself 1 minute.

First of all, I would like to thank the majority leader for acknowledging this bill that we considered today largely mirrors the Republican legislation on ethics from the last Congress. As I mentioned in my opening statement a few minutes ago, I went through all the provisions that, in fact, had been carried over from the Republican bill last year.

But I would correct the majority leader in one respect, and that is many of the Republican reforms that were included in our motion to recommit which passed successfully with largely Democratic support earlier, all of those Republican reforms were eliminated. So this bill would have been much improved and much better if all the Republican reforms had, in fact, been included. I regret that was not the case.

Mr. Speaker, I yield 4\1/2\ minutes to my friend and my colleague from Georgia (Mr. Gingrey).

Mr. Speaker, I would inquire how much time remains for each side.

Mr. Speaker, I yield the balance of my time to my friend and colleague from Illinois (Mr. Kirk).

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

Mr. Speaker, I rise today in strong support of H.R. 6331, the ``Protecting the Medicaid Safety Net Act of 2008.'' I would like to thank my colleague from New York, Chairman Charles Rangel for his leadership in this important issue.

This legislation could not come at a more crucial time. Americans are in need of support. Rising gas prices, food costs at an all-time high, and a rocky housing market have pushed this great Nation towards an economic downturn. Families are clinging to basic necessities and quality healthcare is one of those essential needs.

I am pleased to see that there is no language that inhibits physician ownership of general acute care hospitals. I have worked tirelessly with Members of leadership and with the Texas delegation to support general acute-care hospitals and their future development. Physicians who have decided to build in areas

where often no other hospital will--should not be penalized for their commitment to work on the clinical and business side of health care.

General acute-care hospitals still need to be able to: maintain a minimum number of physicians available at all times to provide service; provide a significant amount of charity care; treat at least 1/6 of their outpatient visits for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; maintain at least 10 full-time interns or residents-in-training in a teaching program; advertise or present themselves to the public as a place which provides emergency care; serve as a disproportionate share provider, serving a low income community with a disproportionate share of low income patients; and have at least 90 hospital beds available to patients.

This issue is of the utmost importance to me because I, like others in the Democratic Caucus, have hospitals and hospital systems such as University Hospital Systems of Houston in my district that would have been greatly affected by this provision.

For example, 2 years ago, St. Joseph Medical Center, downtown Houston's first and only teaching hospital, was on the verge of closing its doors. However, a hospital corporation in partnership with physicians purchased it, and as a result of proper and responsible management, has made it the premier hospital in the region, with a qualified emergency room responsive to a heavily populated downtown Houston. St. Joseph Medical Center is also in the process of reopening Houston Heights Hospital, the fourth oldest acute care hospital in Houston. This hospital will be serving a large Medicare/Medicaid population.

I am committed to this issue and to the issue of health care for all Americans. Provisions that could end the expansion of truly compassionate hospital care in places like Texas, Maryland, New York and California have no place in healthcare legislation.

What I do support is legislation that seeks to aid our elderly, our disabled, our veterans, our children and our indigent populations. I stand here today to show my support not only for the physicians and medical care providers of Houston, Texas, but for all of our healthcare providers across this country. We need them to continue to be able to care for our underserved and elderly--this bill allows them to do just that.

This bill provides a delay of 18 months for the competitive bidding program for Durable Medical Equipment, DMEPOS. It also prevents the 10.6 percent pay cut to physicians that is scheduled to take place on July 1, and provides a 1.1 percent update starting January 1, 2009.

This bill also includes important beneficiary improvements such as Medicare mental health parity, improved preventive coverage, and enhanced assistance for low-income beneficiaries.

It contains provisions that will protect the fragile rural health care safety net. In my home State of Texas, we have not only great urban areas such as Houston, Dallas and Austin, we have over 300 rural areas in Texas with cities such as Rollingwood and Hamilton.

Our rural health care providers are scheduled to receive steep cuts in Medicare reimbursement rates on July 1 unless we take action now. Such cuts are catastrophic in rural America, where a disproportionate number of elderly Americans live. These seniors are, per capita, older, poorer and sicker (with greater chronic illnesses) than their urban counterparts. Additionally, recruitment and retention of providers to much of rural America is often daunting. Provider shortages are rampant throughout many rural and most frontier regions.

Additionally, H.R. 633 also includes several other critical provisions for rural providers which, cumulatively, create a rural package that will help protect both the rural health safety net and the health of tens of millions of seniors who call rural America home.

H.R. 6331 focuses on strengthening primary care and takes significant strides in protecting rural seniors' access to care by correcting certain long-standing inequities between rural and urban providers.

Thank you both for your continued concern for the health of rural Americans. So many enduring inequities in health care must be faced by rural patients and providers daily. H.R. 6331 offers critical assistance and will go far to improving the health of millions of rural Medicare beneficiaries.

Quality measures must continue to be adequately funded in order to promote quality, cost-effective health care for consumers and employers. The uncertainty of Medicare payments makes it increasingly difficult for surgeons and their practices to plan for the expenses that they will incur as they serve their patients.

The provisions included in H.R. 6331 would enable surgeons and surgical practices to plan for the rising costs that they will continue to face over the next year and a half.

By addressing payment levels through 2009, Chairman Rangel has given us more time to study the payment issues surrounding Medicare and allow us to look at the systemic reforms needed to preserve access to quality surgical care and other physician services.

As a long-time advocate for universal health care, I believe we must continue to support our essential medical providers so that they can focus on patient care. We need more physicians as we seek to expand health care for all Americans. Yet, how can we expect to grow that workforce when we continue to cut their reimbursement levels? We must support our physicians so that they may support and care for their patients. We have to continue to look at how we can save Medicare and expand it to care for those who need it most.

I am proud to cosponsor legislation that will add support for our healthcare workforce. I urge my colleagues to join me in supporting this legislation.