Health Insurance Industry Fair Competition Act

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

Madam Speaker, H.R. 4626, the Health Insurance Industry Fair Competition Act, unfortunately doesn't do much. In fact, it has all the substance of a soup made by boiling the shadow of a chicken.

In his State of the Union address on January 27, President Obama challenged Congress to create a plan that ``will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses.'' The administration's health care plan does just the opposite. It increases premiums, increases taxes, and reduces Medicare benefits for seniors.

Will today's McCarran-Ferguson repeal bring down insurance premiums? No. The Congressional Budget Office says that ``whether premiums would increase or decrease as a result of this legislation is difficult to determine, but in either case the magnitude of the effects is likely to be quite small.''

So what's the point of the bill?

The CBO goes on to say that premium reductions from this bill are likely to be small because ``State laws already bar the activities that would be prohibited under Federal law if this bill was enacted.''

So what's the point of the bill?

The National Association of Insurance Commissioners pointed out that bid-rigging, price-fixing, and market allocation ``are not permitted under the McCarran-Ferguson Act, and are not tolerated under State law. Indeed, State insurance regulators actively enforce prohibitions in these areas.''

So, again, what's the point of the bill?

The McCarran-Ferguson Act's Federal antitrust exemption simply allows small and medium-sized insurers to aggregate information for underwriting purposes so they can compete effectively against larger companies. In other words, McCarran-Ferguson helps to promote competition by making small and medium-sized underwriters viable.

Eliminating the exchange of data provision that was included in earlier versions of this bill likely will impede new entry into the health insurance markets. This means that there could be less competition among health insurers.

That said, I believe, as does the Antitrust Modernization Commission, that antitrust exemptions should be rarely granted or created. Yet, if they are necessary, they should be written in as limited a way as necessary to meet a compelling public policy goal.

I can understand why some of my colleagues may want to support this bill, and given that it will have no meaningful impact, I don't oppose it. However, when repealing an existing antitrust exemption, we should be careful of the unintended consequences of our actions.

The majority has avoided one unintended consequence of this legislation by limiting its application solely to health insurers. Eliminating malpractice insurers goes a long way toward making this bill more reasonable. However, the majority should adopt further changes to this bill to demonstrate that they are more interested in legislating than in targeting an unpopular industry for no real policy reason.

Specifically, this legislation should be amended to define the term ``business of health insurance.'' Second, we should reinsert the exchange of data provision that was added to the bill in committee. Finally, we should clarify that this bill will not impinge upon State insurance regulations. None of these concepts are revolutionary. They were all included in earlier versions of this legislation that were passed by the House.

That said, if the majority really wants to help consumers, we should consider a measure that could actually achieve savings for patients: medical malpractice tort reform.

According to a study by the Harvard School of Public Health, 40 percent of all medical malpractice suits against doctors and hospitals are ``without merit.'' So every doctor must purchase malpractice insurance at great expense to protect themselves from frivolous lawsuits.

A Department of Health and Human Services study found that unlimited excessive damages add $70 billion to $126 billion annually to health care costs. Doctors are so concerned about frivolous lawsuits that they have to practice defensive medicine and order unnecessary tests and procedures. HHS estimates the national cost of defensive medicine is now more than $60 billion.

All of these expenses are then passed on to patients in the costs of health care. That is why some States, including my home State of Texas, have enacted tort reform, which limits the amount of excessive damages awarded in frivolous lawsuits. The result? Insurance premiums have fallen, and the availability of medical care has expanded. But this bill will do nothing to reduce the costs of health care.

Congress should set aside this bill, and it should take up lawsuit abuse reform, which could reduce health care costs for our constituents.

Madam Speaker, I reluctantly support this, unfortunately, ineffective bill.

I reserve the balance of my time.

I yield myself 1 minute.

Madam Speaker, let me say that I always appreciate what my colleagues state on the House floor, and I appreciate their good comments during debate. To the extent that they want to increase competition among insurance companies and want to reduce insurance premiums, I completely agree with them, but we should not think that any of those comments or any of those desires or any of those goals have anything to do with the bill that we are considering here today.

Once again, in case some of my colleagues missed it, let me read what the Congressional Budget Office said about this legislation. They said, ``Whether premiums would increase or decrease as a result (of this legislation) is difficult to determine, but in either case, the magnitude of the effects is likely to be quite small.'' So this bill has no point.

Madam Speaker, I yield 3 minutes to the gentleman from Wisconsin, the former chairman of the Judiciary Committee, Mr. Sensenbrenner.

I yield the gentleman an additional 2 minutes.

Madam Speaker, I yield 5 minutes to the gentleman from California (Mr. Daniel E. Lungren), a senior member of the Judiciary Committee.

Madam Speaker, I yield the gentleman 2 additional minutes.

Madam Speaker, first of all, I just want to say that I appreciated what the chairman of the Judiciary Committee just said a minute ago to Mr. Lungren. I understood him to make very positive comments about the so-called Brooks-Lungren amendment. And I hope that that augurs well for the majority's accepting our motion to recommit at the end of this debate. At least I would expect that.

At this point, Madam Speaker, I will yield 3 minutes to the gentleman from New Jersey (Mr. Garrett), a member of the Budget Committee and the Financial Services Committee.

Madam Speaker, I yield 2 minutes to the gentleman from California (Mr. Daniel E. Lungren).

Parliamentary Inquiry

Madam Speaker, I yield the gentleman an additional 2 minutes.

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

Madam Speaker, the bipartisan and very credible Congressional Budget Office has said that this bill will have little or no effect on insurance premiums. It further says that if there is any effect, it will be ``quite small.''

So I do appreciate all the comments that Members are making today, and I agree with a lot of them. But we should not think that any of them pertain to this bill, or that this bill is going to have any kind of a major impact on premiums.

However, I would like to discuss one subject that will have a major impact on insurance premiums, and that is health care tort reform.

The American medical liability system, quite frankly, is broken. According to one study, 40 percent of claims are meritless; either no injury or no error occurred. Attorneys' fees and administrative costs amount to 54 percent of the compensation paid to plaintiffs. The study found that completely meritless claims account for nearly a quarter of total administrative costs.

The American civil litigation system is the most expensive in the world, more than twice as expensive as nearly any other country.

Defensive medicine is widely practiced and it is very costly. Skyrocketing medical liability insurance rates have distorted the practice of medicine. Costly but unnecessary tests have become routine as doctors try to protect themselves from lawsuits.

According to a 2008 survey conducted by the Massachusetts Medical Society, 83 percent of Massachusetts physicians reported that they practiced defensive medicine. Another study in Pennsylvania put that figure at an astounding 93 percent.

While estimates vary, the Pacific Research Institute has put the cost of defensive medicine at $124 billion. Others have arrived at even higher figures. A new study by the Pacific Research Institute estimates that defensive medicine costs $191 billion a year, while a separate study by PricewaterhouseCoopers puts the number even higher, $239 billion every year.

Lawsuit abuse drives doctors out of practice. There is a well- documented record of doctors leaving the practice of medicine and hospitals shutting down, particularly practices that have high liability exposure. This problem has been particularly acute in several fields as well as in the rural areas of our country.

The absence of doctors in vital practice areas is, at best, an inconvenience; at worst, it can have deadly consequences. Hundreds or even thousands of patients may die annually due to a lack of doctors.

According to the Massachusetts study, 38 percent of physicians have reduced the number of higher risk procedures they provide, and 28 percent have reduced the number of higher risk patients they serve out of fear of liability. The American College of Obstetricians and Gynecologists have concluded that the ``current medico-legal environment continues to deprive women of all ages, especially pregnant women, of their most educated and experienced women's health care providers.''

Excessive litigation damages the doctor-patient relationship and impairs care. Beyond the dollars and cents, when doctors begin to see their clients as potential litigants, the quality of care patients receive is seriously compromised. In a recent survey, 76 percent of doctors said that their concern about being sued has hurt their ability to provide quality patient care. Nearly half of nurses say they are prohibited or discouraged from providing needed care by rules set up to avoid lawsuits.

The States have proven that legal reform works. While some in Washington talk about the need to study the problem, States have actually acted to address it. Several States have limited noneconomic damages such as those for pain and suffering and dramatically lessened the burden of lawsuits. In States with such limits, premiums are 17 percent lower than they are in States without them.

Madam Speaker, I'll reserve the balance of my time.

Madam Speaker, may I ask how much time remains on each side?

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

Madam Speaker, on October 9, the Congressional Budget Office pronounced that a tort reform or civil justice reform package would reduce the Federal budget deficit by an estimated $54 billion over 10 years.

CBO recognizes that civil justice reforms also have an impact on the practice of defensive medicine. Defensive medicine is when doctors order more tests or procedures than are necessary just to protect themselves from frivolous lawsuits. Studies show that defensive medicine does not advance patients' care or enhance a physician's capabilities, that billions of dollars in savings from tort reform could be used to provide health insurance for the uninsured without raising taxes on those who already have insurance policies.

As the administration rushes to enact a massive government takeover of health care, Congress must remember that there is the option of saving between $54 billion and more than $200 billion by embracing tort reform, but it will take the leadership to stand up to personal injury lawyers instead of taxing Americans and cutting Medicare benefits.

According to CBO, under the HEALTH Act, which includes tort reform, premiums for medical malpractice insurance ultimately would be an average of 25 percent to 30 percent below what they would be under current law.

Also, the Government Accountability Office, GAO, found that rising litigation awards are responsible for skyrocketing medical professional liability premiums. The report stated that GAO found that losses on medical malpractice claims--which make up the largest part of insurers' costs--appear to be the primary driver of rate increases in the long run.

The GAO also concluded that insurer profits are not increasing, indicating that insurers are not charging and profiting from excessively high premium rates, and that in most States insurance regulators have the authority to deny premium rate increases they deem excessive.

The reason the administration continues to refuse to add serious medical lawsuit reform to their health care legislation remains purely political, as was recently revealed by former Democratic National Committee Chair Howard Dean. At a recent health care town hall meeting, Mr. Dean responded to an angry constituent who wondered why a supposedly comprehensive reform of the health care system doesn't include tort reform to lower costs of malpractice insurance and reduce defensive medicine.

Mr. Dean responded, being remarkably candid, as follows: ``This is the answer from a doctor and a politician. Here is why tort reform is not in the bill. When you go to pass a really enormous bill like that, the more stuff you put in, the more enemies you make, right? And the reason why tort reform is not in the bill is because the people who wrote it did not want to take on the trial lawyers in addition to everybody else they were taking on, and that is the plain and simple truth.''

Medical malpractice premiums have risen more than 80 percent each year in some parts of the country and can cost almost half a million dollars a year in some specialties.

Regarding the offer of HHS demonstration projects--and this is what the administration has proposed--that offer rings hollow given that the Cabinet Secretary tasked with implementing this proposal for demonstration projects is Kathleen Sebelius. Before she was Governor of Kansas and the Insurance Commissioner of Kansas, she spent 8 years as the head of the Kansas Trial Lawyers Association, now the Kansas Association for Justice. And she is also the State executive who, according to The New York Times, ``failed to make significant improvement in health coverage or costs during her two terms as Governor.''

The top contributor to President Obama's Presidential campaign was the legal industry, whose donations came to more than $43 million. More than 80 percent of the money given to Congress by lawyers, mostly from the plaintiff's bar, went to the Democrats--almost $22 million.

More recently, when President Obama spoke to the American Medical Association in June of this year, he told the audience, ``I'm not advocating caps on malpractice awards.''

But the American people are demanding legal reform. A recent survey found that 83 percent of Americans believe that reforming the legal system needs to be part of any health care reform plan. As the Associated Press recently reported, most Americans want Congress to deal with malpractice lawsuits driving up the costs of medical care. Yet, Democrats are reluctant to press forward on an issue that would upset a valuable political constituency, trial lawyers, even if President Barack Obama says he's open to changes. The AP poll found that 54 percent of Americans favor making it harder to sue doctors and hospitals for mistakes made while taking care of patients.

Support for limits on malpractice lawsuits cuts across political lines, with 58 percent of Independents and 61 percent of Republicans in favor. Democrats are more divided. Still, 47 percent said they favor making it harder to sue. The survey was conducted by Stanford University with the nonprofit Robert Wood Johnson Foundation. In the poll, 59 percent said they thought

at least half the tests doctors order are unnecessary and ordered only because of fear of lawsuits.

That is the end of the AP story.

Madam Speaker, the USA Today editorial board also came out in support of tort reform, and USA Today wrote, A study last month by the Massachusetts Medical Society found that 83 percent of its doctors practice defensive medicine at a cost of at least $1.4 billion a year. Nationally, the cost is $60 billion-plus every year, according to the Health and Human Services Department--and that's the HHS of this administration. And a 2005 study in The Journal of the American Medical Association found that 93 percent of Pennsylvania doctors practice defensive medicine.

The liability system is too often a lottery; excessive compensation is awarded to some patients and little or none to others. As much as 60 percent of awards are spent on attorneys, expert witnesses, and administrative expenses. The current system is arbitrary, inefficient, and results in years of delay.

Madam Speaker, discussing the need for tort reform, the president of the American Medical Association said, If the health care bill doesn't have medical liability reform in it, then we don't see how it is going to be successful in controlling costs.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I will reserve my time.

Madam Speaker, how much time remains on each side?

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

Madam Speaker, President Obama's own doctor of over two decades also supports medical tort reform. David Scheiner was Mr. Obama's doctor from 1987 until he entered the White House. He vouched for the then- candidate's excellent health in a letter last year. This was recently reported in Forbes Magazine. Dr. Scheiner worries about whether the health care legislation currently making its way through Congress will actually do any good, particularly for doctors like himself who practice general medicine. ``I am not sure Obama really understands what we face in primary care,'' Dr. Scheiner says.

One of the Nation's top surgeons, with credibility and acclaim the world over for the pioneering surgeries he has

and his personal story of overcoming hardship, recently severely criticized the health care legislation before Congress. Benjamin Carson, Director of Pediatric Neurosurgery at the Johns Hopkins Children's Center in Baltimore, Maryland, and recipient of numerous awards, including the Presidential Medal of Freedom, criticized, in a recent interview, the current bill's lack of malpractice liability reform.

He pointed to excessive litigation, pointing out how much malpractice insurance and other forms of defensive medicine to protect against lawsuits add to medical costs. In an interview with a local television station, Carson insisted that tort reform must go hand in hand as part of any true health care reform.

``We have to bring a rational approach to medical litigation. We're the only nation in the world that really has this problem. Why is it that everybody else has been able to solve this problem but us? Simple. Special interest groups like the trial lawyers association. They don't want a solution.''

As Stanley Goldfarb, MD, and Associate Dean of Clinical Education at the Pennsylvania School of Medicine has written: ``The President points to for-profit insurance companies, but for-profit insurance companies only make up 25 percent of the system, and they are not that profitable, ranking 85th among all U.S. industries. `Reform' will redistribute the money, not reduce the overall costs. There is much that can be done to make our system more efficient. Tort reform is a great place to start.''

Even prominent Democrat strategist Bob Beckel has conceded medical tort reform is essential, recently writing that CBO has reviewed the few credible reports that do exist and concluded: ``A number of those studies have found that State-level tort reforms have decreased the number of lawsuits filed, lowered the value of claims and damage awards . . . thereby reducing general insurance premiums. Indeed, premiums fell by 40 percent for some commercial policies.''

From a CBO report in June 2004, one irrefutable fact remains: Between 1997 and 2007, medical tort costs, including insurance premiums, have risen from $15 billion to $30 billion a year. That fact alone should ensure that yearly savings in the billions for medical tort reform would pass the credibility test.''

As Kimberley Strassel has written in The Wall Street Journal: Tort reform is a policy no-brainer. Experts on left and right agree that defensive medicine--ordering tests and procedures solely to protect against Joe Lawyer--adds enormously to health costs. The estimated dollar benefits of reform range from a conservative $65 billion a year to perhaps $200 billion a year. In context, Mr. Obama's plan would cost about $100 billion annually. That the President won't embrace even modest change that would do so much, so quickly, to lower costs has left Americans suspicious of his real ambitions.

It's also a political no-brainer. Americans are on board. Polls routinely show that between 70 percent and 80 percent of Americans believe the country suffers from excess litigation. The entire health community is on board. Republicans and swing-State Democrats are on board. State and local governments, which have struggled to clean up their own civil justice systems, are also on board.

Mr. Speaker, Republican-sponsored legislation would make Federal law the same legal reforms California implemented over 30 years ago. That legislation, called the HEALTH Act, remains the gold standard for health care legal reform, and it continues to be supported by every major medical association.

The HEALTH Act does not limit in any way an award of ``economic damages'' from anyone responsible for harm. Economic damages include anything whose value can be quantified, including lost wages or home services, including lost services provided by stay-at-home mothers, medical costs, the cost of pain-reducing drugs, therapy and lifetime rehabilitation care, and anything else to which a receipt can be attached.

Only economic damages, which the Federal legislation does not limit, can be used to pay for drugs and services that actually reduce pain. So, nothing in the HEALTH Act prevents juries from awarding very large amounts to victims of medical malpractice, including stay-at-home mothers and children. California's legal reforms, just like the HEALTH Act, cap noneconomic damages at $250,000 but do not cap quantifiable economic damages.

The administration's health care bill not only fails to contain any of the tort reforms that CBO concluded would save at least $54 billion in health care costs, but it also contains a provision that actually deters States from enacting such reforms in the future by explicitly prohibiting tort reform ``demonstration project'' funds to States that enact limits on damages or attorneys' fees.

One section of an earlier bill states that ``the Secretary of HHS shall make an incentive payment . . . to each State that has an alternative medical liability law in compliance with this section,'' but then goes on to say a State can take advantage of such funds only if ``the law does not limit attorneys' fees or impose caps on damages,'' which are precisely the tort reforms the CBO concluded yield real health care cost savings.

Mr. Speaker, so not only does the administration's bill fail to contain any of the tort reforms we know bring health care costs down from decades of experience, but it even prohibits States that want to try such reforms from taking part in the government-funded tort reform demonstration projects. This is not only a blow to State reform efforts, it is a federally funded bribe discouraging States from enacting real reform, and, of course, it is a giant bailout for trial lawyers.

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

Mr. Speaker, I yield myself 1 minute.

Mr. Speaker, we have heard several speakers in the last few minutes say that there are only two industries exempted from the antitrust laws, insurance and baseball. This, of course, is not true. There are more than 20 such exemptions. If the majority is intent on eliminating simple exemptions, perhaps they would be willing to eliminate the labor union's antitrust exemption as well.

I reserve the balance of my time.

Mr. Speaker, I yield 5 minutes to the gentleman from California, the former Attorney General of that State, Mr. Lungren.

Mr. Speaker, I yield the gentleman an additional 1 minute.

Mr. Speaker, I have no further requests for time on this side, and I am prepared to close at the appropriate time.

I reserve the balance of my time.

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

Mr. Speaker, first of all, let me thank Chairman Conyers for his comments. He is always gracious in making those. He is right. We have had a good discussion today about this particular piece of legislation. And I also want to say that he and I have a very good working relationship on the Judiciary Committee as well.

In regard to this bill, Mr. Speaker, I have to say that as much as some might hope that it did something or hope that it accomplished something or might wish that the bill did something or might pretend that the bill did something, in point of fact, the Congressional Budget Office disagrees. Members are free to wish upon a star, but this bill is a dim bulb.

Mr. Speaker, the Congressional Budget Office says that ``whether premiums would increase or decrease as a result of this legislation is difficult to determine, but in either case, the magnitude of the effects is likely to be quite small.'' ``Quite small.''

So, Mr. Speaker, what's the point of this bill? CBO goes on to say that premium reductions from this bill are likely to be small because ``State laws already bar the activities that would be prohibited under Federal law if this bill was enacted.''

So again, Mr. Speaker, what's the point of this bill?

I could list all the reasons why this bill is ineffective, useless, unproductive, pointless, futile, and meaningless. Instead, I would like to highlight something we could do to actually drive down health care costs.

Last October, the CBO concluded that a tort reform package consisting of reasonable limits on frivolous lawsuits would reduce the Federal budget deficit by an estimated $54 billion over the next 10 years. That $54 billion in savings from tort reform could be used to provide health insurance for many of the uninsured without raising taxes on those who already have health insurance policies.

Also, according to the CBO, under a Republican-sponsored health care tort reform bill called the HEALTH Act, ``premiums for medical malpractice insurance ultimately would be an average of 25 percent to 30 percent below what they would be under current law.''

And a GAO report stated that ``losses on medical malpractice claims, which make up the largest part of insurers' costs, appear to be the primary driver of rate increases in the long run.''

Mr. Speaker, rather than spend time on a bill that the CBO said would yield a ``quite small,'' if any, change in health care premiums, we should instead take up a bill the CBO concluded would save us $54 billion. The American people deserve real health care reform, not a feeble and feckless substitute.

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

Mr. Speaker, I have a motion to recommit at the desk.

I am in its current form.

Mr. Speaker, I support this motion to recommit on H.R. 4626, the Health Insurance Industry Fair Competition Act. As I stated in my earlier comments, this legislation does little, if anything. However, if you are going to do nothing, you might as well do it better.

This motion corrects three drafting errors that create problems with the bill. First, it adds a definition for health insurers that was absent from the base bill. If we are going to eliminate McCarran- Ferguson for a limited subset of insurers, then we should clarify who those insurers are.

Second, this motion to recommit includes the exchange of data provision that Mr. Lungren added at the Judiciary Committee markup of a similar bill. It is necessary to ensure that small and medium health insurers can in fact compete in the marketplace.

Third, the motion to recommit includes language that protects the rate gathering and rate setting activities of State insurance commissions. The majority assumes this will be protected by the State action doctrine. But if Congress is going to repeal a 65-year-old law, shouldn't we make clear that we do not want this to undermine State insurance commissions?

Finally, the motion to recommit includes a GAO study on the impact of this legislation on competition in the health insurance market. Specifically, the GAO must report on whether or not this legislation has enhanced competition, resulting in lower prices and new competitors in the market. Let's put political rhetoric aside and see what the bill really does. We shouldn't be afraid of the truth.

In short, this motion to recommit includes definitions and clarifications that the majority has already included in earlier versions of this legislation that either were reported favorably by the Judiciary Committee or were passed by the full House. This isn't much of a bill, but let's try to improve what little there is.

I yield to the gentleman from California, a senior member of the Judiciary Committee.

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

I thank the ranking member for the time.

Let me say at the outset, I do not believe that health insurance companies should be exempt from our Nation's antitrust laws. As one of those who believes and hopes that those applauding would join me in supporting the idea of buying health insurance across State lines, when we reach that accomplishment, I think it is appropriate for us not to have a Federal antitrust exemption.

When health care has been primarily and in a very real sense exclusively the

province of the States, under their jurisdiction, the attorney generals of the States have retained the ability to enforce the antitrust laws of those States. So we're entering a new era, I would hope, where we would be able to, if, in fact, this one Republican idea finds its way into legislative enactment, find an opportunity to extend the universe of decisions that might be accessed by individuals or their employers by way of insurance policies that may be available in other States.

My intention is to vote in favor of this bill. However, my concern is that the bill before us is not nearly as good as it should be because normal bipartisan committee process has been circumvented.

As has been noted by some in advancing this bill, I did vote in favor of the Health Insurance Industry Antitrust Enforcement Act of 2009 when it marked up in the Judiciary Committee. At that time, I offered an amendment to the bill to allow the sharing of historical data and the performance of actuarial services by insurance companies. Not future trending data but rather looking-backward historical data. At that time, it was adopted unanimously by the committee, therefore, on a bipartisan basis. Our distinguished chairman of the committee supported my amendment, which he described at the time as ``a helpful clarification.''

If there's one thing that we ought to understand when we have this downturn in the economy, if you want to make sure things don't happen in the private economy, insert uncertainty. If you want to make sure that things cost more than they otherwise would, insert uncertainty. And that's what we are doing by not allowing that in the bill before us.

In fact, I should point out to my friends on the other side, section 262 of your health care bill, your health care bill, adopted on this floor, allowed for the sharing of such information. It contained the language of my amendment. Unfortunately, for whatever reason, it has been held out of the bill before us.

Unless anyone thinks I have risen to speak because of sour grapes because my amendment with my name on it was not included in this bill, let me clarify the case. I can give you assurance that is not the case for the simple reason that I cannot take personal credit for the guts or the contents of this amendment.

The truth of the matter is that the hard work done to repeal the McCarran-Ferguson Act began with the efforts of then Chairman Jack Brooks, Democratic chairman, in the 101st, 102d, and 103d Congresses. Ironically, at the beginning of our committee markup, our chairman described the repeal of McCarran-Ferguson ``as a tribute to Jack Brooks.'' So if we really wish to pay tribute to Jack Brooks, and I believe we should, perhaps a good place to start would have been to allow an amendment to include Chairman Brooks's language in any legislation before us. I'm hopeful that the motion to recommit might contain that language, and I would hope that people would set aside partisan differences and support it.

So aside from the issue of the denigration of the committee process-- and I think that's an important thing we ought to take into consideration. The subcommittee, committee, you act on this bill. You debate it. You consider amendments. You vote out the amendment on a unanimous bipartisan vote. Then you have bipartisan support for the bill as it comes out of committee. And then what happens? It's changed before it comes to the floor. And we had one of the members of the Rules Committee say she wasn't going to engage me in debate because, she said, I don't have the expertise on this issue. So I presume that means if you have expertise, and that's what committees are supposed to have, you ignore that so you can come to the floor and not allow debate utilizing that expertise because you prohibit that amendment from being considered on the floor.

H.R. 4626 will have precisely the opposite effect of its stated intention if, in fact, the notion of sharing historical data is not considered appropriate and legal. The economics of the insurance industry are such that companies depend on information. Why? In order to enable them to price their products. They have to base it on something.

I thank the gentleman.

It is better if they have actual data upon which to make their decisions.

And here's the rub: As was mentioned by the gentleman from Wisconsin, it is the small companies which depend on the availability of information the most. Smaller companies simply do not have a sufficiently large volume of information to price their products efficiently. So it's for this reason that it is of the utmost importance that insurers have the ability to share historical data.

Now, am I just saying this? No. In this record, a Congressional Research Service report raises the possibility that were such data not available to small insurance companies, we might see the ironic outcome of further concentration in the insurance industry. Again, not my conclusion; the conclusion of the Congressional Research report done most recently.

So, yesterday I did approach the Rules Committee to ask my amendment, the Brooks amendment, as I call it, be restored to the health insurance antitrust bill. And even though it was approved unanimously by my colleagues on the Judiciary Committee, my request was inexplicably rejected by the Rules Committee.

This is not the way, I would say, Madam Speaker, that this body should do business. Let's respect the integrity of the institution and the work that has been done in the duly established committee process.

I would hope that when this part of the recommittal motion is discussed, we'll discuss it in light of the history of this bill--the language taken from the Jack Brooks bill; the language taken from the majority's health care bill passed just this year.

Will the gentleman yield?

Madam Speaker, I would like to make an inquiry of the Chair.

Is it not correct that Members are supposed to address the Chair?

Thank you.

Since the gentleman refused to yield when I asked him to, despite the fact he was using my name and attributing motivations to me that are questionable under the rules of the House, I might say this. The gentleman is absolutely incorrect in his analysis. The report said that it would harm the small insurance companies if they were not able to get this historical data, number one.

Number two, the gentleman conflates two completely different things: one is historical data and the other is trending data. And they are two different things. My amendment does nothing about allowing insurance companies to work together and compare trending data, which is data going forward, despite the fact that some in the insurance industry wish that is the case. The dirty little secret is that some in the insurance industry don't want to have my amendment, they want it to be silent so that in addition to historical data, they can also have trending data. But the gentleman hasn't looked at the data in that way, hasn't examined or, I presume the gentleman would not have examined the reports to know the difference that was in that and my specific decision not to include trending data in my amendment.

Secondly, I find it interesting that the gentleman suggests that I am trying to do something other than what I say that I am doing. This is an interesting argument made on this floor, that if you disagree with someone you suggest that what they say can't possibly be true. The fact of the matter is I have quoted outside reports to support my position, number one. The fact of the matter is I have used the language from the Jack Brooks legislation, I have used language from the gentleman's party's health care bill, and I have used the language that was adopted on a bipartisan basis in Judiciary Committee unanimously.

Perhaps the gentleman is suggesting that all the Members on his side of the aisle who supported this amendment share in his description of the motivation of those of us who have presented it. I thought maybe we were above that. I thought maybe we were engaged in civil discourse here. But rather, if the gentleman or any gentleman wishes to talk about the motivations of others, I will tell you any idea about bipartisanship is lost in this House. The suggestion that all you have to do is shout louder than somebody else and accuse them of motivations other than what they articulated is just absolute nonsense.

The fact of the matter is, properly done, the sharing of historical data is not anticompetitive. The fact of the matter is the underlying bill, with my amendment, would still allow actions taken by the Justice Department and the various States Attorney General if there was bid rigging, if there was price setting, if there was determination before the hand of which markets you would act in and which markets you would not act in.

And so this is a lot of sound and fury signifying nothing, essentially. I have never seen such an attack on an amendment that was adopted on a bipartisan basis in the committee. Now, I realize it is only the committee of jurisdiction that has expertise in this area. I understand that those of us who have done antitrust law ought not to be listened to because those who have said on this floor that they have no expertise in this and they don't understand it, therefore, they don't want to debate it, should have the upper hand in the Rules Committee.

But frankly, I will say once again at some point in time you have to accept yes for an answer. I support the bill. I am trying to help the bill. I am trying to get it back to where it was when Jack Brooks introduced it. And in response to that, rather than saying hurray for bipartisanship, I hear from other people, well, we got to question your motivations. Hardly a high point in this Chamber.

Madam Speaker, once again I

know I run the risk of trying to introduce some expertise into this debate. For that, I apologize. But the American Bar Association appeared before the subcommittee of Judiciary dealing with the underlying bill, or the bill that was presented before our committee, and in there, they voice support, as they have for decades, for removal of the McCarran-Ferguson antitrust exemption for the health care insurance industry.

However, they said, as point number one of the five major points they made, insurers should be authorized to cooperate in the collection and dissemination of past loss-experience data so long as these activities do not unreasonably restrain competition, but insurers should not be authorized to cooperate in the construction of advisory rates or the projection of loss experience in the future in such a manner as to interfere with competitive pricing. That second part deals with trending data. I do not allow that under my amendment.

And as I presented my effort to have my amendment considered in the Rules Committee, I was told by the representative of the American Bar Association, they did support my position, they supported my amendment, and they supported the arguments that I made before the committee.

Now, maybe they're wrong because they have some expertise in this area, but perhaps this is one time we might look to them. The ABA has not been known as a Republican, conservative, pro-insurance company operation. Last time I looked, they have a major element of the bar association that's involved with antitrust law.

I thank the gentleman for yielding.

Mr. Speaker, as I've said repeatedly--and perhaps the gentlelady from Ohio who just spoke didn't hear--I support the bill. I think she also heard--well, maybe she wasn't here to hear the ranking Republican say he is not going to oppose the bill, so let's be clear about what we're talking about here.

While I do support this bill and while I do think it could be perfected and while I hope that the motion to recommit will be adopted to actually make it a better bill, I would say, however, this is not the first bill we should have on the floor dealing with the overall issue of health care. The first one should be the one the American people have asked us to look at, and that is reform of the medical malpractice system.

The interesting thing is, as the gentleman from Texas pointed out, that in the bill that we have in the Senate and the House, there is reference, as the President of the United States said, to medical malpractice litigation alternatives. That bill does give incentives, financial incentives, Federal moneys from the Federal Government to the States if they will engage in alternatives to the litigation system in areas of medical malpractice. But as the gentleman from Texas pointed out, there is a kicker in there, and it says that if your State dares to in any way put any limitations on attorneys fees or on any part of the recovery in medical malpractice cases, that State will be ineligible for the funds; in other words, you will be punished relative to other States.

Now, the gentleman from Texas referred to the landmark legislation we had in California called MICRA, which was adopted in the mid-1970s at a time when we had a crisis in medical malpractice premiums. We actually had an exodus of doctors, particularly in the specialties. Neurosurgeons, I remember anesthesiologists, other high specialties with high-risk practices were actually leaving the State of California because of the significant increase in premiums on a yearly basis as a result of the true historical data of what was happening in the courts.

I recall at this time, because I actually did some representation in the courts of doctors and hospitals and of even a couple of plaintiff cases--but primarily defense cases--that it was becoming a crisis.

So, in California, it came together on a bipartisan basis, and we passed legislation better known as MICRA. In there, we have a limitation on a sliding scale on the amount of money that can go to the attorneys, and it's a slightly higher percentage at the lower recoveries. As the recovery gets larger and

larger, the percentage of return to the attorneys, percentage-wise for that segment of the recovery, is less.

While putting no limitation whatsoever on recovery for loss of income and for all medical costs, there was a cap put on noneconomic damages. As one who has been in the courtroom and has seen what happens, that is logical because the one area in which you saw extraordinary amounts of money that really were not truly indicative of approvable damage--I'm not saying there isn't pain and suffering, but trying to quantify it is extremely difficult, and it proved to be impossible, and it proved to be the area in which you had the outrageous jury verdicts that had the impact of distorting the system. So California adopted both of those.

In other words, the bill that has been presented by the President and Democrats in the House and the Senate not only does not really deal with reform of the medical malpractice system, but it takes us back more than 30 years to the position in which we were then when we had not an academic exercise about the possibility of a crisis but a true crisis. We literally had a crisis in medical care in the State of California until we enacted this change.

So that is why it is at least as strange to ask and to see why we don't have some litigation reform moving through our Judiciary Committee and through the other committees that may have jurisdiction in the House of Representatives and placed on the floor. That's why it was very important for the gentleman from Texas to make reference to the California system, because that is one that has worked, and it specifically is the one that is singled out in the legislation that the President supports to be punished. Now, if that is not irony, I don't know what is.

So I would just hope that people would understand, as important as this bill is, that we should be at least listening to the American people, who have said number one on their issue list in dealing with this problem, as they see it, as they understand it, as they are affected by it, is the reform of the medical malpractice litigation system as it currently exists.

So it is somewhat disappointing that we don't have that even on the horizon. I think the gentleman, the ranking member on the committee, would agree we haven't seen anything on this subject that has been scheduled for our committee.

While I support this legislation--and let me repeat that--I support this legislation. I think it is good legislation. I think it may have a slightly bigger impact than, maybe, my ranking member thinks it will have, although not as large an impact as suggested by the other side. I would hope that the other side would look with open eyes and would listen with open ears to our motion to recommit because I think it will make a better bill, will clear up some definitions that are not defined in this bill and will help us move in the right direction.

Mr. Speaker, I would like to refer to that part of the motion to recommit that deals with the amendment that I offered and that was contained in the bill that passed out of the Judiciary Committee. It simply allows historical data to be utilized by insurance companies large and small. This is something that is requested by the small insurance companies, this is something supported by the American Bar Association. Their representative who testified before our subcommittee on behalf of or in support of the underlying legislation supported this amendment so that in fact small insurers would not be disadvantaged.

Let's get this right. There are some who have told me on the other side that, well, we don't need this because it will be allowed by the U.S. Justice Department or by the courts. We ought not to wait for that. We ought to give some real solid certainty to insurance companies, particularly the small insurance carriers. So if we wish to permit the collection of historical data, let's make it clear what we intend. Just because we haven't brought forward on this floor some answer to the medical malpractice litigation issue is no reason for us to commit legislative malpractice here. We ought to do our job. We ought to not pass it on.

Now, there are a few people who don't think that historical data should even be allowed. If that is the way they feel, I understand it. Most Members I have spoken to believe it ought to be allowed. They understand the absolute essence of it in terms of the continued existence of small insurers across the country.

Let's get it right. I have the language virtually the same that was contained in the majority's health care bill that passed just a couple of months ago. It is the same as contained in the bipartisan bill that came out of our committee. And most importantly, it is the same language contained in the various bills presented to this House by the late great Jack Brooks, chairman at that time of the House Judiciary Committee, about whom Members on the other side have waxed eloquently. And in tribute to him, I would hope they would support the gentleman's motion to recommit that contains my amendment.

Mr. Speaker, I ask that the gentleman's words be taken down.

Mr. Speaker, I ask the gentleman's words be taken down once more.

Reserving the right to object, has the Chair ruled as to whether the gentleman's words are inappropriate under the rules of the House and the precedents of the House?

I withdraw my reservation.

Mr. Speaker, I would like to ask unanimous consent if I might revise my remarks. I referred to Jack Brooks as the late great. I didn't mean to suggest that he is no longer with us. He is great but he is not late.

Madam Speaker, pursuant to House Resolution 1098, I call up the bill (H.R. 4626) to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers, and ask for its immediate consideration.

Madam Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and insert extraneous material on H.R. 4626.

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

Madam Speaker and my colleagues, the bill before us will allow, for the first time, competition to take hold in the health insurance marketplace, an important and vital step in the road to fixing our broken health insurance system and containing costs. I want to commend, in particular, my colleagues Tom Perriello of Virginia and Betsy Markey of Colorado for working with our committee on this important effort.

Experience has shown that Congress--and we hate to admit having made mistakes in the past, but we did make an error in 1945 in adding an antitrust exemption into the McCarran-Ferguson Act at the last minute during the debate. Not many of you were here at that time, and neither was I, but leading consumer groups and senior citizen groups, State attorneys general and others for years have been urging that we in the legislature fix this error that has been made so long ago.

The bipartisan Antitrust Modernization Commission established by this body and President Bush in 2002 echoed this call in its 2007 report. And now, as we work to fix what everyone mostly agrees is a broken health insurance market, it is about time to bring into that market what is an essential ingredient of any well-functioning market-- competition. And the way we make sure that happens here is the same way we made sure it happens in every other industry--to have the antitrust laws apply. These laws are the principal protector of free market competition and the prosperity it provides, the principal guarantee that businesses who want to offer choice and value to consumers can do so.

The blanket antitrust exemption in the McCarran-Ferguson Act shields health insurance companies from legal accountability for fixing prices, dividing up markets and customers they serve so as to deny meaningful choice, and using monopoly power to sabotage anyone who seeks to offer meaningful competitive choice to consumers. This, ladies and gentlemen, must end.

Antitrust court actions alleging each of these practices, and more, have been blocked routinely in the courts by invoking the McCarran- Ferguson antitrust exemption, and that is what we are here to repair today.

Now, an antitrust expert attorney, David Balto, with antitrust enforcement experience acquired both at the United States Justice Department and the Federal Trade Commission, has found that State insurance commissioners have not brought any actions in any State against health insurers for anticompetitive conduct during at least the last 5 years.

Health insurance premiums continue to spiral ever-upward each year, and copayments and deductibles keep taking further bites out of tight family budgets. Those families have a right to know that they are not being victimized by insurers any longer who should be competing to offer them choice and value but, instead, are, unfortunately, conspiring against them.

In its famous Topco ruling, the United States Supreme Court refers to the antitrust laws as the Magna Carta of free enterprise. The health insurance industry should not be exempt from them.

The Judiciary Committee has been working to remove this harmful exemption for a number of years. We made a lot of headway under the distinguished chairman, our former colleague, Jack Brooks of Texas, who

headed the committee after Peter Rodino and after Emanuel ``Manny'' Celler, and it is time to complete this effort in the area of health insurance since this is the number one subject, legislatively, before us being watched carefully by everyone in the Nation.

Last fall, our Judiciary Committee reported a similar bill which was incorporated into the comprehensive health care bill passed by the House. And so I commend my colleagues, Representatives Perriello and Markey, for their leadership in bringing this effort back to the House floor today as a freestanding measure.

With more and more people having to choose between having health insurance or food on the table, isn't it about time the health insurance companies' cozy antitrust exemption be taken off the books?

So I urge all my colleagues to support this long-overdue, pro- consumer legislation that will affect citizens and families in every State.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, before I yield to Sheila Jackson Lee, I yield myself 1 minute because my dear friend, the ranking member, asked, What is the point of this legislation?

We have made a long list of points of this legislation. To begin with, it is to increase competition in the health care industry. It also is to shine a light on industry practices that are currently unavailable and undetectable because of the exemption. That's why we are on the floor today.

I yield 3 minutes to a distinguished member of the committee, the gentlewoman from Houston, Texas, Sheila Jackson Lee.

Madam Speaker, the former chairman emeritus has raised a number of points that amount to verbal jujitsu that I will be addressing very shortly, but for now I yield 3 minutes to the distinguished chairman of the Judiciary Subcommittee on Courts and Antitrusts, a former magistrate in the courts of Georgia himself, Subcommittee Chair Hank Johnson.

Madam Speaker, I yield myself 2 minutes.

I want to respond to the senior member of the Judiciary Committee, a former attorney general of California and a friend of all of us on the committee, an effective member, and all I want him to know is that we approved his provision in the Judiciary Committee because we thought it was a good provision. It was unanimous. I don't recall that anyone voted against it or spoke against it. The problem, though, is that when we got to the Rules Committee, our leadership on both sides of the aisle, I hope, had come up with another bill and that bill omitted it. We were not able to get that put back in.

We think that their reasoning is not altogether strange or out of order or violating any procedure, but here's what it was. This is what they told me: They said, if there are no antitrust exemptions in this measure, then you don't need to specifically retain a part of the antitrust exemption relating to the safe harbors provision, because if it isn't an antitrust provision, they aren't going to be affected anyway.

So it's in that spirit that I appreciate the comments of the gentleman from California, and I hope that we can continue to work together as much as we can, and perhaps the final vote here will be more bipartisan than many thought that it would.

Madam Speaker, I now would like to yield 2 minutes to a senior member of the Congress from Iowa (Mr. Boswell).

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

Madam Speaker, no one has worked harder on this measure that is not a member of the Judiciary Committee than Peter DeFazio of Oregon. And I yield to him 3 minutes.

Madam Speaker, I am inclined to yield to the gentleman from Oregon (Mr. DeFazio) 1\1/2\ minutes.

Madam Speaker, I am pleased to recognize a senior member of the House Judiciary Committee from Los Angeles, Ms. Maxine Waters, for 3 minutes.

Madam Speaker, no one comes before the Judiciary Committee that I can think of offhand more frequently than Bill Pascrell of New Jersey. He's worked with us on a number of other issues besides this one, and we welcome his counsel. We yield him 2 minutes.

I yield the gentleman another 30 seconds.

Madam Speaker, I am pleased now to recognize David Scott, the gentleman from Georgia, who has been waiting patiently to get time here on this. I yield him 2 minutes at the point.

Madam Speaker, I am pleased now to recognize the gentleman from Rhode Island, Jim Langevin, a former Secretary of State, for 2 minutes.

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

Madam Speaker, I am very pleased to recognize the most experienced member of the civil rights struggle in the 20th century, the gentleman from Georgia, John Lewis, a strong advocate of universal health care, and I yield him 2 minutes.

Mr. Speaker, I am pleased now to recognize the distinguished Member of the House who has had insurance experience as a State commissioner, Earl Pomeroy of North Dakota, for 2 minutes.

If the gentleman will yield, I want to commend him for clearing up something that perhaps in more reasonable circumstances should not need to be cleared up.

I still have confidence in the courts that they can read the simple understanding that when we say ``health insurance,'' we don't mean life insurance. I mean, this is getting pretty fundamental here. But, of course, you are correct, Mr. Pomeroy. It's health insurance only; no disability income insurance, no long-term care insurance, no property insurance.

I yield the gentleman an additional 1 minute.

No casualty insurance, no other kind of insurance but the one plainly listed in a two-page

bill. So my confidence in the courts is unrestricted that they can get this right.

The lack of a statutory definition is intended solely to give the courts the ability to ensure that all forms of health insurance are appropriately included so that unreasonable and artificial distinctions do not arise between two essentially equivalent kinds of insurance products and how they are treated under antitrust laws.

I am glad that the gentleman raised this issue in the hearings.

Mr. Speaker, I yield 3 minutes to the gentleman from Virginia who has done so much in working with the committee on this bill, Mr. Perriello, who has been great.

Mr. Speaker, I would like to yield to Paul Kanjorski of Pennsylvania for a unanimous consent request.

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

Mr. Speaker, I recognize the distinguished Member who allowed us to testify in his subcommittee on universal single-payer legislation, Rob Andrews of New Jersey, and I yield him 2 minutes.

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

Mr. Speaker, I am now pleased to recognize Betsy Markey of Colorado. She has done yeoman's work on this measure in her first term, and I will yield her 3 minutes.

I yield the gentlewoman an additional 30 seconds.

Mr. Speaker, Mary Jo Kilroy of Ohio has worked hard on this legislation, and I would like to recognize her for 2 minutes.

Mr. Speaker, I yield 2 minutes to the leader of the Progressive Caucus in the House for so many years, the gentlewoman from California, Lynn Woolsey.

Mr. Speaker, I yield 2 minutes to the distinguished gentleman from California (Mr. Garamendi).

Mr. Speaker, I yield 2 minutes to a former member of the House Judiciary Committee, the gentlewoman from Ohio, Betty Sutton.

Mr. Speaker, I yield 2 minutes to the gentleman from Canton, Ohio, John Boccieri.

Mr. Speaker, this has been an important debate, and I would like to take this opportunity to commend the leader of the Republicans in the House, and especially one Member on the Judiciary Committee, Lamar Smith.

We have had a very civil debate. I think, in the course of the incredible amount of time that we have been allotted for this bill, that we have reached closure on some issues. There are now more things that we agree to on both sides of the aisle than there are things that we may have differences about.

I attribute it to the goodwill and the cooperation of my Republican colleagues on the House Judiciary Committee. I also solicit their vote, but I will respect any way that they may choose to dispose of this matter and our friendship will not be diminished or impaired in any way whatsoever.

Now, Lamar Smith mentioned the fact that there were other exemptions, and to be perfectly candid, I did not know that there were more than two exemptions, and it turned out that there are. As a matter of fact, there are 27. But many of them--and I haven't researched this yet. Many of them are partial exemptions. Many of them are very small exemptions that are very limited in terms of the economic scope of our reach in the United States. But they, nevertheless, exist.

Mr. Smith may remember that the baseball antitrust exemption was given very close scrutiny only 2 or 3 years ago, and it reminded them of the fact that their conduct hadn't always been such that deserved a continuation of the exemption, and I'm hopeful that baseball will still deserve it.

But here in the field of health care, I think it's hard to defend any argument that the health insurance industry deserves or requires or needs an exemption, and for that reason I am urging all of my colleagues to examine this two-page bill and scrutinize it. Let's see if we can get a refreshingly large bipartisan vote that could lead the American people to reflect on the fact that we can be liberals and conservatives without rancor or animosity or personalizing our philosophical differences, and that's the appeal that I offer to my colleagues on the other side.

There are those that wonder if this would create some kind of a chill or curtailment of creativity if this exemption were removed, and I don't think that that is very logical. We think that the antitrust laws are fairly elementary. They don't conspire against competition. They don't try to reserve creativity. We want competition, and it is the exemption from antitrust liability that this becomes very, very critical.

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

Mr. Speaker, I yield 1 minute to the gentleman from Maryland, Mr. Frank Kratovil.

Mr. Speaker, Nancy Pelosi is the first female Speaker of the House in American history. She is the third ranking person in our Federal Government. And we are all honored to recognize her for 1 minute at this time.

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

I thank my colleague from North Carolina for the time.

Mr. Speaker, I might say this is an interesting point. I don't think I've ever been on the floor in 16 years and have faced this kind of a rule. It is a closed rule. I've been here before with closed rules, but the effect of the closed rule is to prohibit me from providing or from presenting my amendment. Now, that is not unusual. Usually, you come to the floor, and you present an amendment to try and amend the bill to change it from the way it was reported out of the committee that did the work on it. But in this case, I am being prohibited from offering an amendment to change the bill back to the way it was as reported out of the committee on a bipartisan basis.

For whatever reason, the majority on the Rules Committee decided that an amendment that was cited by the Democratic chairman of the Judiciary Committee, Mr. Conyers, as an excellent clarifying amendment is not going to be here.

When one of the chief cosponsors of the bill, or coauthors of the bill, being presented on the floor today announced the bill last week, she said publicly that this was similar to the bill that was passed out of the Judiciary Committee with the bipartisan support of Congressman Lungren from California. So, naturally, I was interested to look at the bill that they were presenting to see how it was the same as the bill we presented. I found out that they'd left out my amendment which allowed for the sharing of historical data by insurers so that they might look at the experience evidence and utilize that in making their decisions with respect to how they conducted their business going forward.

I had been assured that my amendment was not necessary because committee staff on the Judiciary Committee had researched it. Nobody believed that the Justice Department of any administration going forward would find the compiling of historical data among the insurers to be noncompetitive and violative of the antitrust laws. I was further assured that they did not believe that that would be the case with any of the attorneys general of the States.

Now, I had the privilege of serving as attorney general of my State for 8 years, being a member of the National Association of Attorneys General--an organization which does support legislation of this type-- and of course, attorneys general of the various States have independent authority under their State laws to enforce antitrust laws, which I did during my 8 years. Sometimes we went beyond what the Federal Government did because we understood better the unique circumstances of our State.

I remember, one time, we were dealing with a merger between two large banks. They were national banks, and they had branches in the State of California. We were working in conjunction with the antitrust division of the Justice Department, and we were moving in the same direction, but I remember getting a phone call from one of the attorneys at the Justice Department in Washington, DC, who asked this question: Well, how close is San Jose to San Diego? About 400 miles, but they thought they were next to one another.

Why was that relevant? That would be relevant as to whether you had competition among the bank branches that were then going to be merged. Would that then give increased and illegal concentration of power in those areas?

The point I am making is that attorneys general of the States may know a little bit more about their States than attorneys working as hard as they can here in Washington, DC. So the idea that attorneys general are somehow impotent, from a legal standpoint, such that they cannot bring forward antitrust cases, is just not true.

At the same time, I voted for the bill coming out of committee because I thought it had, in fact, reached an appropriate balance. Interestingly enough, the gentlelady from New York, the chairperson of the Rules Committee, stated in her support for this rule and in support for the underlying bill that this is really a tribute to Jack

Brooks, who attempted to do this for years.

I was privileged to serve with Jack Brooks, an interesting Texan Member, someone who was the Chair of the Judiciary Committee for some time. When the bill in the Judiciary Committee was originally introduced this time around, the distinguished chairman of the committee, Mr. Conyers, cited Jack Brooks, and said, This was the Jack Brooks bill. So I went back, and I looked at it. I found out that my amendment, or the language that I had then put in in amendment form, was in the Jack Brooks bill but not in the bill before us. So I brought it forward.

So you might say, if we are doing this in homage to Jack Brooks, you would do him further homage by allowing the language of his bill to be put into this bill, and that's all I ask for. It's all I ask for.

Now, the other part of the bill that came out of the Judiciary Committee, which is not in this bill, is to remove the antitrust exemption that currently exists for medical malpractice insurance providers, but somehow that has been taken out of this bill with no explanation whatsoever.

So we have cherry-picked from the bill that came out of the Judiciary Committee with bipartisan support, and yet we acclaim the bill as being, essentially, the bipartisan bill that came out of committee.

As I said before the Rules Committee yesterday, sometimes you just have to learn to take ``yes'' for an answer. I support the underlying bill. I support this effort. I am trying to make it better. It was accepted on a bipartisan basis. Yet, in the Rules Committee, there wasn't one, in my judgment, credible argument about why you wouldn't have it.

On the one hand, I've heard from the staff of the Judiciary Committee that it is not necessary because no single administration will have a Justice Department that finds this to be anti-competitive. On the other hand, I hear from the chairperson of the committee, Well, we don't want to give this power to the insurance companies. We want the Justice Department to investigate it. Well, if that's the case, you can't have your cake and you can't eat it, too. It's either one or the other.

If it is, as I was told, unnecessary, redundant because nobody looking at it will find this to be noncompetitive because it is essential information--and by the way, the absence of this information will not hurt the big guys as much as it will hurt the little guys. Why? Because if you are a large carrier, you have a far greater experience database than if you are a small carrier. You understand the market better in terms of information that is at your fingertips. If you are a smaller provider, you need the information to understand the universe that you might be attempting to present your product to.

So we have, on the one side, being told that no reasonable antitrust division of any Justice Department of any administration will find this to be anti-competitive. Then you have the chairperson of the Rules Committee saying, No, no, we have to keep this in here because we want to make sure that the Justice Department will be able to determine whether or not it is.

So what does that give the market? What does it give the smaller insurers? It gives them uncertainty.

So the very thing that you are saying you want to do you are prohibiting from being accomplished by not allowing this amendment to be considered. This amendment, as I might say, was described by the chairman of the committee as an excellent clarifying amendment. We are therefore removing clarification, and we are replacing it with uncertainty.

Look, I can go down on the floor and bash the insurance companies as well as anybody here. Let's just knock them all around here. The point is we are making an adjustment in law, which is what is good for the people. So why not do it in an intelligent way, in a way that will actually assist in the marketplace and allow for greater competition? Outside studies have said, if, in fact, this information is not allowed to be collected together and shared among those in the industry, it might--they said ``might''--might have the impact of harming the smaller insurance carriers.

So I don't know why you're doing this. I don't know if there is a political reason for it. I don't know if it's because I happen to be a Republican. I'll give it up. Any Democrat who wants to put his name on it can add his name to Jack Brooks' and present it on the floor. But this kind of silliness on this floor has got to stop. You ask for bipartisanship, and you throw it away. We have complete bipartisanship in the committee, and you ignore it.

As one member of the committee, a Republican member who voted with me in support of this bill on a bipartisan basis, said afterwards when he found out that that bill wasn't going to be presented on the floor, Why do we need committees and subcommittees? What are we holding hearings for? Why are we having the experts testify before us if, in fact, somehow in the--I don't know where it is. There are closed doors somewhere that decided that this bill was going to come out instead of the bill we worked on in committee and then give no good answer.

It's such a shame you don't have TV cameras in the Rules Committee. If people could have seen the argument yesterday, if the public could have understood what we were talking about, I mean they would have shaken their heads and said, Do the people's business. Please do the people's business. Don't get involved in partisanship.

Again, I would say I give up my name on this amendment. I will gladly dedicate it to Jack Brooks in his memory. I'm glad to give it to any Member of the Democratic side. Let's do the people's business and get rid of this silliness of unstated partisanship, without any rationale, that undercuts the impact of the bill.

Once again, this is unique. I've spent 16 years in this place. This is the first time I've ever come to the floor and have been denied an amendment that would put back in something we voted on on a bipartisan basis in committee that has been removed at the direction of somebody, including the Rules Committee, so that we can't have the chance to work on the product that came out of a bipartisan effort in the committee.

Will the gentleman yield?

That's the most interesting thing. You did change it. You changed the bill from the bill that came out of committee. So don't tell me you didn't want it changed. You did change it. That's the whole point we're making.

The bill that we produced out of committee on a bipartisan basis that was called a clarifying amendment was taken out. So you're the folks that changed it. I didn't change it.

My God, is this 1984 doublespeak around this place?

I thank the gentleman for yielding.

Could I just ask my friend from California, isn't it true that if there was collusion utilizing this information, that would still be prosecutable under the amendment that I suggest because it is prosecutable at the present time under State action theory and has been pursued by various States?

Well, I know we have had people on this floor who say they have no expertise but they say this amendment does certain things. I did spend 8 years as the Attorney General of California. We had the most active antitrust public law office in the country other than the U.S. Justice Department.

I might just say, this is the first time I have ever heard that Jack Brooks was presenting legislation on the floor of the House or in Judiciary that was to protect insurance companies or allow collusion. The language I used is taken from the Jack Brooks bill. The language I use is specifically the language that was adopted on a bipartisan basis and said by the chairman of the Judiciary Committee was an excellent clarifying amendment.

The fact of the matter is that under the law under this bill, the State action still applies, State action principles still apply. States can still do what they will, including what the gentleman talked about before. So this is a red herring.

This is so silly that you would take something that got bipartisan support, unless you're suddenly suggesting that the chairman of the Judiciary Committee has a secret plan to somehow allow the insurance companies to gouge people and that Jack Brooks had that secret plan. This is total nonsense, to bring a bill to the floor and take out an essential element from committee and then suggest, when you want to put it back in committee for revision, you're trying to protect somebody.

I thank the distinguished chairman.

Madam Speaker, I rise to announce to the American public and to this body that, as we stand here today, over a year's time, 45,000 Americans die because they don't have health insurance. They don't have health insurance because the premiums have literally spiraled beyond any imagination. So, today, we are rising to create an opportunity for Americans to live and for lives to be saved because competition is the engine, not only of the economy, but it is the engine of better health care for all Americans.

Here is an example that shows how increased premiums are the complete opposite of commitment and service to our constituency: When the State of California passed a law in 1988 that eliminated the State antitrust exemption for the auto insurance industry, auto premiums for consumers in California rose 9.8 percent when the rest of the premiums in the Nation were going down. The Consumer Federation of America said that consumers would save over $50 billion in insurance premiums by repealing the 1945 McCarran-Ferguson Act.

I thank the distinguished colleague from our Judiciary Committee, Mr. Perriello, for his leadership, along with many others.

Removing the antitrust exemption will not only enable appropriate enforcement against these unjust practices when they are uncovered, but it will also give all health insurance companies healthy competitive incentives so you as a family of four, as a grandmother, as a single parent can get the

insurance possible as we move forward in health insurance.

The attorney general of New York, in his investigation, found that insurance companies engage in collusion. That's why we need this. We want to break the rules so we can help doctors with lower premiums and medical malpractice and with shielding our constituency from these Godforsaken prices.

Let me tell you that we have seen this in action in the Ocean State Physicians Health Plan v. Blue Cross and Blue Shield. Citing this act, this antitrust prevention act, the First Circuit overturned a jury verdict against the dominant health insurer for using its monopoly power to put financial pressure on area employers to refuse to do business with a competing HMO. The First Circuit, because of the exemption, blocked any opportunity for competition. We need to change this, and we have found that this collusion is hurting us.

So, Madam Speaker, I would say to you that, in order to save lives, like the lives in my 18th Congressional District, where Texas is the poster child for the most uninsured, 1.1 million--it has the dubious honor of being the largest uninsured State in the Nation. My county, Harris County, as we fight over and over for health insurance, does not have people who are insured. So this will help bring, along with the health reform that we will pass in the next couple of weeks, the idea of saving lives and of providing for our children and our families.

Chairman Conyers had the single-payer bill. That was the initiative that should have gone forward, but now we have a way of saving lives. This is fiscally secure, and it provides security to those who are in need. I ask that you support this legislation to, again, save lives.

Madam Speaker, I rise in support of H.R. 4626, Health Insurance Industry Fair Competition Act, a bill designed to restore competition and transparency to the health insurance market--by repealing the blanket antitrust exemption afforded to health insurance companies by the McCarran-Ferguson Act of 1945. Today 45,000 people a year die without health insurance and they die because they do not have health insurance! This is a matter of life and death.

Madam Speaker, competition is the engine that drives our economy, spurs innovation, and ensures that the American consumer receives a fair deal on goods and services. There is significant evidence that removing the antitrust exemption will increase competition in the insurance industry and will result in lower prices and other benefits for consumers. In fact, experience has shown time and time again the benefits of increased competition in the form of lower prices, increased choice, and greater innovation.

A healthy and competitive health insurance market will drive prices down in the health insurance industry, just as we have seen it do in so many other industries where competition is allowed to take hold. For example, since the state of California passed a law in 1988 that eliminated the state antitrust exemption for the auto insurance industry, auto premiums for consumers in California have risen by only 9.8% while the rest of the country has seen auto premiums rise by over 48 percent. The Consumer Federation of America has said that consumers would save over $50 billion in insurance premiums by repealing the 1945 McCarran-Ferguson Act for all lines of insurance. Further, it is estimated that subjecting health insurance companies to federal antitrust laws would lower premiums by 10% or more.

Removing this antitrust exemption will not only enable appropriate enforcement against these unjust practices when they are uncovered; it will also give all health insurance companies healthy competitive incentives that will promote better affordability, improved quality, increased innovation, and greater consumer choice, as the antitrust laws have done throughout the rest of the economy for over a century.

The antitrust exemption was enacted in 1945, as part of legislation whose main purpose was simply to reaffirm the authority of States to regulate insurance for the protection of their citizens. The antitrust exemption was quietly inserted at the end of the legislative process, in conference committee. As a result, insurance companies have been shielded from legal accountability for price fixing, dividing up territories among themselves, sabotaging their competitors in the marketplace in order to gain monopoly power, and other practices that unjustly harm consumers. Moreover, antitrust court actions alleging each of these practices, and more, have been blocked by invoking the McCarran-Ferguson antitrust exemption.

For far too long, the health insurance industry has played by a different set of rules. Shielding health and medical malpractice insurance companies from federal antitrust laws is a practice that must end.

Madam Speaker, the American public agrees that the special treatment the anti-trust exemption affords insurance companies must come to an end. A recent Rasmussen poll found that 65% of Americans favored removing the anti-trust exemption for health insurance companies. Of those polled, Democrats supported subjecting insurance companies to antitrust laws by a seven-to-one margin. Sixty-four percent (64%) of independent voters and 58% of Republicans also believe insurers should abide by antitrust laws. This data demonstrates that there is bi- partisan public support for demanding that health insurance companies play by the same rules as other companies in America.

Madam Speaker, I agree with the majority of the American public that shielding health and medical malpractice insurance companies from federal antitrust laws is a practice that must end. Eliminating the anti-trust exemption for the health care industry is a vital step toward reforming health care, lowering prices for consumers and doctors, and leveling the playing field for American businesses.

The Consumer Federation of America has said that consumers would save over $50 billion in insurance premiums by repealing the 1945 McCarran- Ferguson Act for all lines of insurance. Further, it is estimated that subjecting health insurance companies to federal antitrust laws would lower premiums by 10% or more. Moreover, in addition to bi-partisan support amongst the American public, repealing anti-trust exemptions for all health insurance is supported by conservative political leaders as well such as Governor Bobby Jindal of Louisiana, Senator Joseph Lieberman, and former Majority Leader Trent Lott.

This bill is also necessary because, over the years, health insurers have been able to use this antitrust exemption to block court actions regarding anti-competitive behavior. For example, in Ocean State Physicians Health Plan, Inc. v. Blue Cross & Blue Shield of Rhode Island, the First Circuit Court--citing the McCarran-Ferguson antitrust exemption--overturned a jury verdict against the dominant health insurer for using its monopoly power to put financial pressure on area employers to refuse to do business with a competing HMO.

Removing this antitrust exemption is supported by key law enforcement groups, including the National Association of Attorneys General. In 2007, the National Association of Attorneys General--representing both Democratic and Republican State Attorneys General--overwhelmingly adopted a resolution calling for repealing this exemption. As the resolution pointed out, ``the National Association of Attorneys General consistently has opposed legislation that weakens antitrust standards for specific industries because there is no evidence that such exemptions promote competition or serve the public interest.''

In addition, in a recent letter to Congress, nine State Attorneys General pointed out, ``Since 1977, and most recently in 2007, antitrust experts and enforcers have concluded that repealing the McCarran- Ferguson exemption would result in enhancing competition while allowing standard industry practices necessary for the proper functioning of these markets, such as sharing loss and other insured risk information.''

Removing this antitrust exemption is also supported by leading consumer groups. Numerous consumer groups--including the Consumers Union, Consumer Federation of America, U.S. PIRG, Center for Justice and Democracy, and Public Citizen--strongly support removing this antitrust exemption. In a joint letter to Congress, consumer groups pointed out that, under this legislation, health insurance companies ``would be required to play by the same rules of competition as virtually all other commercial enterprises operating in America's economy.''

In closing, I want to also take this time to reiterate my support for a public health care plan that covers every one of the 47 million people who live in our great nation without health insurance. Madam Speaker, my state of Texas has the dubious honor of being the uninsured capital of the nation. Further, with more than 1.1 million of the nation's uninsured living in my own county, Harris County, I represent what some have labeled as ground zero of the health care debate. Thus, the issue of universal health care coverage--something that would have been achieved by Chairman Conyers' Single Payer bill, which I supported, is more than an empty slogan; it's a matter of fiscal and physical life and death to the people of the 18th Congressional District. Therefore, no matter how the pending debate over the details of the health reform bill winds up, my constituents can count on me to continue fighting and continue working together with my colleagues of both parties, to ensure that everyone in my district, in Houston, in Texas, and in America has access to affordable and quality health care.