Floor Statements

Mr. Speaker, I rise today in support of H.R. 280 the National Aviation Heritage Area Act which includes in Title VI the Upper Housatonic Valley National Heritage Area Act. The Upper Housatonic Valley, encompassing 29 towns in the hilly terrain of western Massachusetts and northwestern Connecticut, is a singular geographical and cultural region that has made significant national contributions through its literacy, artistic, musical, and architectural achievements, its iron, paper, and electrical equipment industries and its scenic beautification and environmental conservation efforts.

The Upper Housatonic Valley National Heritage Area would extend from Lanesboro, Massachusetts 60 miles north to Kent, Connecticut. This region of New England is home to many of the Nation's first industrial iron sites. The iron produced at these sites was used to make weapons for the Revolutionary War. Furthermore, the area includes homes of historical significance belonging to Edith Wharton and author Herman Melville as well as the Monument Mountain Reservation, where Melville and Nathaniel Hawthorne picnicked. The area also has great outdoor recreational resources and is the base for much of Connecticut's agri- tourism business.

From the 1730s to the 1920s, it was home to many of the Nation's earliest iron industries. The first blast furance was built in 1762 by Ethan Allen and supplied the iron for the cannons that helped George Washington's army to win the American Revolutionary War. While most of the furnaces, mine sites and charcoal pits have been lost to development and time, the few that remain are in need of refurbishment. The Beckley Furnace in Canaan, Connecticut was designated an official project by the Millennium Committee to Save America's Treasures.

The Valley's history as a cultural retreat from the Boston and New York areas provides both past and current riches for the country. Since the 1930s visitors from all over have come to hear the music at Tanglewood, Music Mountain and Norfolk, see the paintings at the Norman Rockwell Museum, watch serious theater at Stockbridge and musical treats at Sharon. Today's local authors draw on a long tradition going back to the 19th century, when Herman Melville, Nathaniel Hawthorne and Edith Wharton lived and wrote here. The Upper Housatonic Area, with its remoteness from but ties to large cities, occupy a special niche in our national culture.

The Housatonic Valley is also rich with environmental and recreational treasures. The Housatonic River, just below Falls Village, Connecticut, is one of the prized fly-fishing centers in the Northeast and is enjoyed by fisherman from not only Connecticut and Massachusetts but the entire eastern seaboard. Olympic rowers have trained in this river as children have learned to swim, boat and fish and value its ecosystem.

Through this broad, flexible and locally led initiative, the states of Connecticut and Massachusetts will be able to make real progress in protecting the river and its heritage. Rather than depending on the Federal bureaucracy, States will be able to facilitate locally led, and truly voluntary programs that will help protect the river for future generations. This legislation encompassing all heritage areas has broad bipartisan support, I would like to thank the Resources Committee for bringing this legislation forward and I encourage my colleagues to support this legislation.

Mr. Speaker, I yield 2\1/2\ minutes to the gentlewoman from Washington (Ms. Dunn).

Mr. Speaker, I yield 2 minutes to the gentleman from Pennsylvania (Mr. English).

Mr. Speaker, I yield myself 1 minute and 15 seconds.

I would remind the gentleman from Michigan that 28 percent of his seniors will have no more costs than either $1 per generic or $2 per generic or $3 for prescription and $5, and 35 percent of Michigan seniors have incomes under 150 percent of poverty and will be totally protected under this bill.

Mr. Speaker, I think as we proceed in this discussion, we ought to remember that 38 States, 38 States provide Medicaid coverage for people whose income is 74 percent of the national poverty income. So 38 States are not even at 100 percent of poverty income. We cover people completely, everything, except $1 per generic or $2, depending on income, and $3 or $5 per prescription drug.

Do my colleagues understand that of the Medicare population, 57 percent are women? Mr. Speaker, 57 percent are women, and half of them, half of those women will pay no more than $2 per generic or $5 per prescription. They will have no other obligation, all the way up through catastrophic. Half the women on Medicare. This is a giant stride forward in women's health.

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

Mr. Speaker, I yield myself 15 seconds.

Mr. Speaker, if the gentleman will note and other Members will note, and the listening public will note, on pages 49 to 53 of the bill, which is all on the Internet, they will see that there is what we call a hard fall-back. That is, if private plans do not offer prescription drugs to our seniors, the government will. The seniors will be guaranteed a drug plan; that is in the statute.

Mr. Speaker, I yield 2 minutes to the gentleman from Arizona (Mr. Hayworth).

Mr. Speaker, I yield myself 15 seconds.

I do not consider the AARP a special interest group, or the Coalition to Ensure Patient Access a special interest

group, or the Alzheimer's Association a special interest group, or the Kidney Cancer Association a special interest group.

Mr. Speaker, it is my time.

The Mental Health Association of Central Florida, the Larry King Cardiac Foundation, the Latino Coalition.

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

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

Mr. Speaker, I yield 1 minute to my colleague, the gentleman from Pennsylvania (Mr. Peterson).

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

Mr. Speaker, I yield 1 minute to my colleague, the gentlewoman from Florida (Ms. Ginny Brown-Waite), who has experience legislating in the area of health care reform.

Mr. Speaker, I yield myself 10 seconds. I remind the gentleman from Maryland (Mr. Hoyer) that of his 713,000 seniors, 31 percent will get total drug coverage under this bill.

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

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

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

(Mr. YOUNG of Florida asked and was given permission to revise and extend his remarks.)

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

Mr. Speaker, I yield myself 30 seconds.

I would like to note that the 25 percent discount means you pay 25 percent less. And once the subsidies go into effect, you pay 75 percent less, and half the Medicare recipients are women and half of those women will be covered totally. So this is a big, powerful prescription drug bill that will help half the women on Medicare by providing all of their drug coverage.

Mr. Speaker, I yield 2 minutes to the gentleman from Iowa (Mr. Nussle), chairman of the Committee on the Budget.

Mr. Speaker, I yield 2\1/2\ minutes to the gentleman from Ohio (Mr. Portman), a member of the committee.

Mr. Speaker, I would like to inquire as to the time remaining.

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

Mr. Speaker, I yield 2 minutes to the gentleman from New York (Mr. Houghton).

Mr. Speaker, I ask what time remains on each side.

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

Mr. Speaker, I yield myself 10 seconds.

The gentlewoman from Oregon should know that with this prescription drug insurance plan Medicare recipients in Oregon who are covered will go from 60 percent up to 96.6 percent. This bill brings a benefit to Oregon.

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

Mr. Speaker, I yield myself the balance of

my time, and I rise in strong support of this legislation. And, indeed, I believe its founders would be proud that tonight we bring a voluntary, generous drug benefit to all seniors under Medicare.

This is a milestone. That is why AARP describes it as a historic breakthrough in the Nation's commitment to strengthen and expand health security for its citizens. Something that has not been talked about much here tonight is the new support for seniors with chronic illness. We forget that one-third of our seniors have five or more chronic illnesses and use 80 percent of the money under Medicare, and yet Medicare has no way of supporting them to prevent their chronic illness from progressing.

In this bill, we couple the drug benefit and the disease management program to help our seniors prevent their chronic illness from progressing and thereby keep them healthy and keep Medicare costs under control. This is particularly important for minorities, for they tend not to use the medical system early, and they tend not to be diagnosed early. In this bill, we provide an entry-level physical so we can see what early signs of chronic illness they have, and we can help them prevent their chronic illness from progressing.

This will be an extraordinary boon to the well-being of our senior citizens. This is a historic advancement in both bringing prescription drugs to Medicare and improving the quality of health care Medicare is able to deliver, and in assuring that Medicare will be able to deliver 21st-century, cutting-edge health care.

And this is a historic bill for the rural communities of our Nation. Without it, they will not be able to attract the next generation of physicians as the current generation retires. They will lose small hospitals. They will lose small home health agencies. In fact, without this, our inner-city hospitals will not be able to continue to provide clinics for the poor, clinics for those with mental health problems. This is an important payer package because it restores fairness to our payment system.

And lastly, it cuts prices dramatically. It cuts prices dramatically by bringing the bargaining power of the seniors to the table to reduce prices and piercing right through that price support system that keeps State prices high. I am proud to support this legislation, and I urge my colleagues to do likewise, for half of America's women will experience free health care under this bill.

I thank the gentleman for yielding. I certainly appreciate my colleague from Oregon's concern with his State's inventive approach and successful program in support of women on welfare, individuals on welfare seeking the independence of returning to the workforce. I am pleased that the next round of welfare reform will allow a great deal more flexibility in State programs.

As the gentleman is aware, a number of State waiver programs have expired in recent years. In June 2003, Oregon Senators were informed by Secretary Thompson that, despite the expiration of Oregon's waiver that month, Oregon was not in danger of failing to satisfy work rate requirements in the future. The reason is because Oregon's caseload reduction credits totally wipe out any effective work rate requirement in the State.

Here is how Secretary Thompson put it:

``Oregon is not in violation and, based on Oregon's history, is not expected to be in violation, and, therefore, Oregon will not be subject to penalties for the next 3 months or until reauthorization. Even without its waiver, Oregon's program would have met its all-family work participation requirement in 2002 because it effectively had no participation requirement. Should reauthorization not occur prior to the end of the fiscal year and current law be extended again, I would remain confident, based on the facts that I have before me, that Oregon could continue to operate its program without becoming subject to participation rate penalties.''

As the gentleman knows, the House-passed welfare reauthorization bill, H.R. 4, includes provisions that would allow States to apply for new waivers of the TANF program. That reflects additional flexibility for States and is a positive step. I will fight in conference for enhanced waiver authority for States in conference with the Senate.

It is simply my belief that within the time frame of this extension, we will be able to permanently reauthorize the welfare program and add to it the more flexible provisions that are in the underlying bill with some interest that the Senate has expressed in additional waivers.

It will certainly be an issue that we will discuss together before the expiration if we think reauthorization cannot be finalized.

Madam Speaker, will the gentleman yield?

Madam Speaker, I agree with the gentleman from Maryland. There is a lot of interest in the States having flexibility to tailor their programs to their own specific needs, but exactly the structure of that authority is a matter of disagreement at this time; and we will look to see how the Senate resolves those issues and then in conference find an agreement that we think will meet the needs of the majority of the States.

Madam Speaker, I would indicate to the gentleman that the bill that passed the House has a very broad waiver of authority in it. There are some that think it is too broad and would like narrower waiver authority. We will see what the Senate has done, and then we will see if the conference committee can come to a conclusion about the structure of the waiver authority in the future. But there was a waiver authority in the last welfare bill. I think there is universal agreement that States need flexibility to structure their programs to meet the specific needs and circumstances of their own people, and so this will be a significant issue that will be addressed.

I cannot tell the gentleman at this point whether there will be precisely the narrow State waiver authority there is under current law, but I would also remind the gentleman that that waiver authority under current law has a defect. The waivers expire and are not reauthorizable. Under current law, they have to reapply for them. So under current law there is a problem about how do we move the successful waivered program into the mainstream, and I think that is an issue that the conference needs to resolve as well because my State also has a waiver that has expired as well as the same kind of unemployment rate, unfortunately, that Oregon has.

So there will be a number of people in conference concerned about this issue, but I certainly cannot assure the gentleman that there will be exactly the same kind of state-based waiver authority in the reauthorization that there has been in the past bill. There is a lot more interest amongst many in a broader waiver authority that encompasses a greater variety of bills so that they could better integrate broad services for people coming off welfare. So it is a long debate. We are not going to resolve it here, but I do appreciate the gentleman from Oregon bringing to this floor his concern about his State's rights to tailor its welfare program to meet the needs of its people. In the end that is really what makes a Federal program successful or not successful is that local control and local power, and I agree with the gentleman that that is terribly important to the quality of Federal programs and their success.

Madam Speaker, will the gentleman yield?

Madam Speaker, this legislation is nearly identical to H.R. 3146, a bill the House unanimously approved last week. The only change is the addition of a 6-month extension of expiring Medicare payment provisions affecting hospitals in small cities and rural areas. These provisions need to be passed today and signed into law immediately to ensure the continued smooth operation of programs affecting health, welfare, and commerce throughout the country. I urge the support of this body.

Mr. Speaker, I rise today to recognize the Farmington River Watershed Association (FRWA) on its 50th anniversary of actively protecting one of our state's crown jewels, the Farmington River. The Farmington River is the most fished river in Connecticut, provides drinking water to over 600,000 residents of the Farmington Valley and Greater Hartford region, and was the first river in Connecticut and one of the first in New England to have a section designated as part of the National Wild and Scenic Rivers Act. While the river's outstanding value to fish, wildlife, and people speaks for itself, it would not be so today without the Farmington River Watershed Association.

Since its founding, the FRWA has always focused on substance over style, plugged away effectively behind the scenes rather than basked in the limelight, and worked locally to arrive at solutions to regional conservation issues. FRWA lives by the credo ``Eighty percent of success is showing up,'' and show up they do with compelling facts, figures, and enthusiasm. FRWA shows up at public hearings, provides their Congressional Representatives with great information, presents educational programs to the public, initiates research on key issues, shares its findings broadly, and unwaveringly focuses on its mission of river protection.

Fifty years ago, John Ellsworth and John Leonard discovered that the Farmington River was receiving over 3.4 million gallons of untreated industrial wastewater every day. They and other community leaders decided to do something about this and together, they founded the FRWA. As a result of dedicated, local leadership over many years, and the benefits of the Clean Water Act and designation under the Wild and Scenic Rivers Act, the Farmington River is today a healthy, vibrant river, beloved and protected by its people. Now the challenge for FRWA and for all of us is to continue to solve the parade of problems that threaten river life and preserve the outstanding quality of life enjoyed throughout the watershed.

On the occasion of this 50th anniversary, let me add a personal note. When I was elected 21 years ago, the FRWA had sought recognition of the river under our Wild and Scenic River program but had failed to be designated for study, the first step. Working together, we introduced a new bill and I maneuvered for a hearing. I can attest to the simple, plain fact that FRWA at that hearing won our case. Their testimony simply mowed down the opposition with solid facts and documentation of the river's problems and potential. Their answers to all questions were calm, in depth, and substantive. The committee was won over.

But that was just one battle. Over the next three years there were many, many challenges and it was always the steady, knowledgeable leadership of the FRWA board members and executive directors that got the needed volunteers to serve on the study committee, that helped all to lay aside their suspicions and differences and focus on the facts, and that helped me win additional funding for the national study when the need became clear. I am proud that together, the federal, state, and local team developed the best base data and analysis of any river in our state.

It has also been the FRWA that has helped towns learn how to implement the Wild and Scenic designation protections and round up funds when needed. Rivers run through many towns and river health depends on there being a strong river voice, focused, informed, dedicated and steady. That voice has been the Farmington River Water Association in the form of skilled executive directors and very active board members and volunteers.

I congratulate you all on your fine work over 50 years! We and our children are the richer in environment and spirit because you were there to fight like heck to reclaim the Farmington River and then to husband this outstanding natural resource. May you have many more anniversaries and continue to keep our Farmington River the beautiful, vital part of our lives it is today.

Mr. Chairman, I would like to enter a timeline of 50 Years of Accomplishment by FRWA into the Record in recognition of their outstanding efforts, and wish them well on the next 50 years of protecting the Farmington River.

50 Years of Accomplishment: FRWA Timeline

1952: Chief Engineer for the State Water Resources

Commission informs John Leonard that over 3.4 million gallons

of untreated industrial waste is entering the Farmington

River daily.

1953: 70 business leaders, farmers, sportsmen and teachers

meet at the Ensign-Bickford Toy Building and form the

Farmington River Watershed Association. John Leonard becomes

President.

1957: John E. Ellsworth reactivates FRWA (after John

Leonard's death in'55).

1958: FRWA hires its first Executive Director, Sydney Howe,

who begins the newsletter, educational lecture series, and

ecological demonstration site.

1960: FRWA expresses concern over Colebrook Dam design.

Army Corps incorporates FRWA comments in final design (1964).

1962: FRWA convinces Governor of CT to investigate effects

of DDT use. DDT banned nationally in 1972.

1964: FRWA helps secure Talcott Mountain as a State

Reservation.

1967: With the Appalachian Mountain Club, FRWA sponsors the

first white-water slalom races at Tariffville Gorge.

1970: FRWA publishes the first `Farmington River Guide.'

1970: FRWA initiates negotiations between the Stanley Works

and the State for a shad fishway at Rainbow Dam. Fishway is

completed in 1976 and shad pass dam for first time in 50

years.

1972: FRWA holds a public meeting to explain the Inland

Wetlands and Watercourses Bill.

1975: FRWA and the Granby Conservation Commission sponsor

an educational meeting on cluster housing.

1980: FRWA becomes first CT conservation organization to

receive U.S. Interior Department's highest award.

1981: FRWA launches a campaign to educate the public about

Metropolitan District Commission (MDC) plans to divert the

West Branch of the Farmington. Referendum is defeated.

1983: The FRWA Hazardous Materials Spill Plan is published

and over 120 copies distributed to watershed towns.

1985: Congresswoman Nancy Johnson introduces legislation

for Wild and Scenic feasibility study.

1987: FRWA receives the prestigious ``Outstanding River

Advocate'' award from American Rivers.

1989: FRWA sponsors 1st ``Annual River Clean-up.''

1990: FRWA hosts 1st ``RiverSplash'' river festival.

1990: FRWA builds public awareness and support for Wild and

Scenic designation.

1991: FRWA implements land protection program.

1992: All CT watershed towns show support for Wild and

Scenic designation.

1993: FRWA adopts Watershed Ecosystem approach, expanding

mission to include all watershed lands.

1994: Wild and Scenic legislation passes on August 26, 1994

creating protection for the 14 mile segment from Hogback Dam

in Hartland to Canton.

1996: FRWA incorporates GIS mapping technology as a

conservation tool.

1998: FRWA negotiates agreement with the MDC to establish a

Farmington River watershed withdrawal limit which would

require MDC to develop groundwater resources outside the

watershed for additional water.

1999: Farmington River Resource Center is established to

collect, analyze and disseminate scientific information and

encourage stakeholders to develop a long-term sustainable

watershed management plan.

2001: FRWA launches the Farmington Valley Biodiversity

Project with towns of Avon, Canton, East Granby, Farmington,

Granby, Simsbury, and Suffield.

2002: `State of the Farmington River Watershed' is studied.

Report published in 2003.

2003: FRWA publishes the Farmington Valley BioMap.

2003: FRWA launches Farmington Watershed Education Project.

2003: FRWA celebrates 50 years of protecting and preserving

the Farmington River

and its watershed at Peoples State Forest in Barkhamsted.

Mr. Speaker, I thank the gentleman for yielding me time.

I want to commend the chairman for crafting a bill that will reward average taxpayers for their generosity and eliminate unnecessary barriers to giving. This is a bipartisan bill that will expand our communities' ability to help each other. However, there are some additional provisions that I hope we will be able to work on with the Senate.

First of all, the social services block grant enables communities to address special needs in a very flexible and very local manner, and I am thrilled that this bill reinstates the 10 percent right of transferring money from the TANF block grant to the social services block grant. But more needs to be done, and the Senate bill does offer us that opportunity in the conference.

Secondly, I hope that it will look at some of the charitable incentives for conservation in the Senate bill, a higher deduction for donating land to qualified land trusts, for example, that will enable small landowners to be part of conservation and preservation in their communities.

Mr. Speaker, I rise in opposition to the motion to instruct, and I yield myself such time as I may consume.

Mr. Speaker, the gentleman from Maine has some very important concerns. It is unfortunate that he has not read the bill. This is the very best bill for rural America that this House has ever considered. It addresses the problems of rural hospitals, of rural physicians in a way that no preceding bill ever has.

And that is in part because of bipartisan support that it attracted in the House. It is also true that this bill provides a prescription drug benefit to every citizen, every senior. And it is a disservice to seniors to imply that it does anything else. It provides an entitlement to prescription drugs for seniors, every senior. Secondly, it does not allow plans to discriminate between healthy seniors and unhealthy seniors.

Now, I do not fault the gentleman from Maine (Mr. Michaud) for not really understanding this. He is not a member of the committee. He has not been deeply involved in this bill, but if he were involved in this bill, he would know that the administration has now developed ways to risk adjust in 62 different categories, and it is not going to be possible for these plans to select healthy seniors and discriminate against unhealthy seniors. That is an issue of the past.

So this bill does not in any way privatize Medicare. It provides exactly the same program for seniors that we have been providing but a far better program, a programming that meets the challenges of 21st century medicine to manage chronic illness, that meets the challenge of Medicare covering prescription drugs, that meets the challenge that our seniors face in their everyday lives in their battles with chronic illness and their need and desire and health demand for prescription drugs.

This is an extraordinarily progressive modernization of Medicare, and this motion to instruct the conferees in two portions of the bill is extremely misguided, and I urge my colleagues to vote against it. It is important that in Medicare, Medicare control all parts of the plan, fee-for-service and also the plans. We have had those plans for a number of years. All those plans are controlled.

All we want is for seniors to have a strong fee-for-service program, and for seniors to have the kind of choice that the Federal employees have, and that is exactly what this bill provides. But the government controls all the choice plans just like they control all the Federal employee health benefit choices as well. This is a progressive plan.

This is an ill-thought-out motion to instruct, and I urge my colleagues to vote against it.

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

Mr. Speaker, I yield myself 10 seconds.

Mr. Speaker, it is very important for everyone to understand that this Medicare bill provides to the choice for seniors. It is entirely voluntary.

Mr. Speaker, I yield such time as he may consume to the gentleman from Wisconsin (Mr. Ryan).

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

With all due respect to my friend from Maryland, for whom I have a lot of respect and have worked on many issues, his quote from Mr. Gradison is in regard to last Congress' bill, which was written entirely different. We do not hear anyone making that claim in regard to this bill. So to say that no one would offer this benefit about a bill that is not this bill is really misleading.

Secondly, my colleague's motion to move to strike the very section that guarantees Medicare's defined benefit package is duplicitous. I mean, why would they move to strike the section that guarantees, and here is the title, page 260, no change in Medicare's defined benefit package, no change. This is voluntary, this bill, and any senior who wants to continue to choose the Medicare defined benefit package and couple it with a prescription drug program is free to do so, and that defined benefit package is going to offer seniors a far more modern benefit than current Medicare because it is going to help them deal with chronic diseases which current Medicare does not help them deal with.

Thirdly, I am appalled that my Democrat colleagues want to provide this giveaway to the drug companies. CBO and CMS actuaries agree that the plans will be available to 95 percent of the beneficiaries, but CBS has said that if we choose the fallback provision in the Senate bill, it will cost 8 to $12 billion. My colleagues know who gets the 8 to $12 billion, the drug companies. They know what our bill does. It pierces the best price process in the States and goes below that and saves $18 billion for seniors; and if they are serious about doing something about drug prices, they will not put in law the fallback provision in the Senate bill because it will cost 8 to $12 billion and give it all directly to the drug companies.

I yield to the gentleman from Wisconsin.

Absolutely. That is exactly what I am saying. The fallback provision in the Senate bill will lead to drug prices that will cost our bill 8 to $12 billion more.

You bet it does. It gives every one of those pennies to the drug manufacturers.

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

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

It is too bad that in these debates we stray so far from the facts of the matter. The 1997 bill was passed unanimously by the Subcommittee on Health of the Committee on Ways and Means, almost unanimously by the full committee. I am proud to say that under Republican leadership we added coverage for the first preventive benefits under Medicare, mammograms and, since then, pap smears and also prostate cancer testing and a variety of other preventive benefits for diabetics and for other critical tests.

As Republicans led the effort to add preventive benefits to Medicare and President Clinton supported them, those bills had a lot of bipartisan support; and to say now that this bill privatizes Medicare when all it does is to strengthen both fee-for-service Medicare and the choice plans that can offer seniors some things that Medicare cannot offer them is simply a disservice to the seniors of America.

Just like Republicans led the effort to modernize Medicare by covering prescription drugs which had never been done before, so in this bill we are leading the effort to provide disease management and other tools to help seniors with chronic illnesses, never proposed by my Democrat colleagues. It pains me to have my Democrat colleagues just focus on the word ``privatization,'' which actually ignores the modernization of this plan and has no place in this debate because in every year from now to 2010, 2020, all seniors will have the choice of fee-for-service Medicare or these plans, and the government will pay for coverage under both of those options and will control both of those options.

So they are government-controlled, government paid-for options, all part of Medicare, with a voluntary choice by seniors, an entitlement under the law.

Mr. Speaker, I yield such time as he may consume to the gentleman from Pennsylvania (Mr. Greenwood).

Mr. Speaker, I yield such time as he may consume to the gentleman from Georgia (Mr. Norwood).

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

Mr. Speaker, I yield the balance of my time to the gentleman from California (Mr. Thomas), the chairman of the Committee on Ways and Means.

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

Mr. Speaker, I rise in support of this bill that names the Post Office in Signal Hill, California, after one of the most distinguished individuals to have served in this House, Congressman Steve Horn. Congressman Horn retired this past January after a lifetime of public service. He was known as an independent, intellectually honest individual who brought to his work a sharp mind, remarkably broad experience, and an outstanding understanding and respect for the needs and abilities of every person.

Congressman Horn has worked in the public policy arena throughout his life. He began his professional career as an aide for President Eisenhower's secretary of labor, James P. Mitchell. He then worked as a legislative assistant to former California Senator Tom Kuchel and served as a senior fellow at the Brookings Institute, Dean of American University and President of California State University at Long Beach from 1970 to 1988. After leading the University for eleven years, he was elected to Congress where his depth of knowledge of government, public administration, education, the arts, and community needs enabled him to provide valuable leadership to his colleagues and this body. Steve served his constituents with diligence, effectiveness, and honor. I wish Steve and his wife Nini the best in retirement.

Mr. Speaker, this is simple, serious, and sad. Significant errors of utterance and judgment were made by members of the Committee on Ways and Means of both parties this morning. The chairman responded to what were fast-paced comments and actions. There were good reasons for the chairman's judgments and actions and good reasons why he altered those judgments and actions as circumstances changed. For that he is to be commended. To elevate an incident of which no Member on either side of the aisle is proud is destructive to this body.

I regret the minority party's decision to enshrine in a resolution some facts while omitting others crucial to the flow of events. That does this House no good, and I urge opposition to this resolution.

Madam Chairman, I thank the gentleman for yielding me this time.

Study after study and the experience of nation after nation has demonstrated that the more knowledge women have of how to control their reproductive capability, the more the abortion rate declines. We have seen this in spades in Russia and in countries around the world. Give women the knowledge they need to assume their family planning responsibilities, and they do not have abortions.

So why would you want to deny the women of Haiti $2.8 million in family planning funds and all of the women's health that accompanies these funds, all of the education women gain about how to care for themselves, how to have healthy babies as opposed to unhealthy babies, how to have safe deliveries, how to recover postpartum?

Why would you want to deny the women of Nicaragua $1.1 million in women's healthcare and in safe pregnancies?

Why would you want to deny the women of El Salvador $600,000?

Nigeria, a country in which there is terrible starvation, terrible deprivation, women get terrible healthcare and children die of hunger routinely, why would you want to deny the women of Nigeria $5.3 million so they could have the knowledge to handle their reproductive capabilities responsibly, plan their families so their children are spaced far enough apart, so their children survive and they survive to care for their children?

Why would you want to deny the women of Pakistan $4.1 million, India $13 million, and so on?

I do not comprehend. Why? Because China has a policy we absolutely oppose. So let's withhold our funds from China, but not from the rest of the women of the world!

Why can we not help us focus, as we have been willing to, on the problem in China? But do not deny the women of the world the power of knowledge, because it is that power of knowledge that helps them have healthy pregnancies, healthy babies, and reduces the rate of abortions dramatically; and that is a fact that cannot be denied.

Mr. Speaker, I thank the gentleman for yielding me time.

First, let us get some facts straight. Any senior watching this debate needs to understand that the law provides a Medicare bundle of benefits, period. That bundle of benefits will be provided to seniors through the Medicare fee-for-service program and through any plan that cares to participate in Medicare. But the law defines that bundle of benefits, and there is nothing in this bill that changes that law. So do not scare seniors that something is going to happen to their benefits. There is not any plan that can participate under this bill that is not obliged to offer the Medicare bundle of benefits.

Then let us look at a statement made earlier about costs. All this bill does is allow the government to pay a plan the same amount per average senior beneficiary that we spend anyway per senior under Medicare. Not a penny more; not a penny less. So this is not going to increase Medicare spending. This is not going to explode spending.

That is why CBO and OMB disagreed, because in the private sector, yes, plan costs are rising, but in this program we are only paying the plan precisely what it costs us for the care of an average senior under Medicare; no more and no less. So that is not the issue.

There is only one issue here in terms of the plans in competition. In 2010, something important happens. Our seniors have the right to know in 2010 what the plan in any area where it provides the care for 20 percent of the seniors, what the average premiums are in those plans and what it is costing Medicare to provide care for the average senior under Medicare in those same areas. This is just a sort of ``right-to- know'' issue. Then, when you know, you can make the choice.

If by that time, 2010, the plans have gotten a lot more efficient and are either offering a lot more benefits for the same money or lower premiums or are inefficient and it is costing them more and Medicare turns out to be the more efficient provider, which many of you on the other side of the aisle have always claimed was true, then, Medicare's premiums will be lower and it will make the plans look bad. If in fact the plans are more efficient providers than Medicare, then the premium amount will be somewhat higher for the Medicare plan and seniors will have a choice.

The whole process is prejudiced toward weighting the Medicare premiums heavier than anyone else's premiums and phasing in any discrepancy. But the bottom line is that nobody in the private sector is going to be paid any more than the average we spend for a senior under Medicare. So if Medicare cannot compete on those terms, I will tell you, the seniors have a right to know, and, under this bill, they will.

Now, let us look at this fallback issue. One of the reasons our bill is so very efficient and the most efficient and rated by CBO as saving the most money for our seniors under the prescription drug program is because the plan's sponsors have not only the tools to manage prescription drugs in a cost-effective way, they have the motivation.

I will tell you, how many times have you seen your kid in college have all the preparation, have good skills, but they did not care enough to work hard and get an A instead of a B-plus? It is not just a matter of tools, of intelligence, of skills, it is a matter of will, of desire.

The reason CBO gives us so much higher an efficiency quota than any other plan is because our plans have not the big motivation we gave them a few years ago, we decided that was too hard for them to meet, but just a little motivation. They have a little reason to care whether or not they notice whether seniors are going to get the lowest cost prescription that will help them, the generic where it is appropriate, so on and so forth, or negotiate hard with the manufacturers to get the lowest prices.

So if you do a fallback and a guarantee, what plan in their right mind is going to get in? They are going to wait until you get to the fallback so they have no risk.

If you do not have that, two things happen. First of all, this is a very big market. A lot of companies cannot afford not to be plan sponsors. So they are going to get in, and they are going to get in early. Twenty-eight plans wanted to get in when the President offered his discount card just as a voluntary thing. Those same 28 companies are going to be interested when, under this bill, they get the right to offer a discount card. Why? Because they want to line up their participants so when the real plan comes along with the subsidies, the taxpayer subsidies, they will already have a constituency signed up in their program.

But this is entirely too big a business for plan sponsors not to want to be part of it, so they will accept that risk.

In our bill we guarantee not one fallback but two fallbacks: One that is a pure drug fallback, and one is a plan fallback. How are we going to get it? There are lots of way. You will have Federal Employee Health Benefit Plans that already contract the drug benefit with a plan sponsor. That plan sponsor might very well be interested in providing drugs-only to seniors. He is already in the district; he is already working with the Federal Government. That is one option.

Other options are to entice enhanced plans and advantage plans to provide that. There are lots of ways to do this. But if you check off and you check out the responsibility for some risk in the game, then you will never have the price cuts, you will never have the efficiency, and our seniors will be the victims.

Mr. Chairman, I raise a point of order against section 217(B) on page 57, lines 7 through 25, and page 58, lines 1 through 24, of this bill, H.R. 2660, on the grounds that this provision violates clause 2(b) of House rule XXI because it is legislation included in a general appropriations bill.

Mr. Chairman, I raise this point of order respectfully and regretfully, but it is important that this section be struck. In 2001, I helped author and pass in this House a requirement that providers be required as of this October to submit all Medicare claims electronically. Because most electronic billing systems eliminate inaccurate and duplicate claims, the user fee is unnecessary, as Medicare will get dramatically fewer mistakes after October. Harnessing a new claims processing and billing technology is preferable to using a punitive, per-claim tax to reduce mistakes.

In addition, current law gives small providers the leeway that they need. Hospitals with fewer than 25 full-time employees or a physician practice with fewer than 10 full-time employees are exempted from this requirement.

In sum, the current law that goes into effect October 1 covers this matter and provides the proper small business exemption. But in addition, the issue of what is a clean claim can be a very controversial issue and intermediaries have enormous power in this matter.

Mr. Chairman, I thank the gentleman, and I would be happy to work with him to see if we can resolve this problem, because I appreciate the gentleman's dedication to giving CMS the administrative funds they are going to need to implement some of the reforms. I look forward to working with the gentleman on that.

Mr. Chairman, in deference to all, and the time constraints we are under, I will not take the full minute, but I do want to say that often very small amendments are extremely important. This amendment is absolutely key to reducing the costs of drugs.

There are many expensive products on the market that are no better than aspirin, and we need to be able to demonstrate that and provide senior citizens and all Americans with that information so they can choose the most cost-effective, medically effective pharmaceutical for their particular needs. I commend the gentleman from Nebraska on his amendment.

Mr. Speaker, this bill does not allow the IRS to share your income information with insurance companies. The bill very clearly protects the confidentiality of your information, and there are criminal and civil penalties for violating those provisions. Violators can go to jail.

It is true that for 5 percent of the seniors, they will have a higher threshold for catastrophic coverage. I personally do not believe that someone with a $200,000 income living in a gated community should have exactly the same subsidy as someone struggling along on $25,000 or $30,000 of income. I think that is a strength of this bill. But if someone does not want the government to tell you what your catastrophic threshold is, you can opt out and just take the highest threshold. That is your right. But only 5 percent will fall above the threshold, and we think that is progressive. We think we need to target this benefit at those who need it the most, and that is what we do.

Mr. Speaker, scare tactics have no place in this debate. There are no vouchers in this bill. In 2010, a senior that wants to be in the Medicare program will be in the Medicare program exactly as they are now. They will be in that Medicare program and have that choice of the Medicare program in 2010, in 2011, in 2012, in 2013. They will never receive a voucher. That word is not in this legislation. It is used rhetorically to scare seniors. I want to assure the seniors listening that this bill represents the most dramatic expansion of benefits under Medicare since the program was founded, not only prescription drugs but additional preventive benefits and a whole system to support seniors with chronic illness.

Mr. Speaker, I thank the gentleman for yielding me the time.

Today, is an historic day for America's seniors. Congress is about to fulfill the promise and the potential of Medicare, which has been one of our greatest success stories in our history; but when Medicare was created in 1965, prescription drugs were few and far between. Instead, painful and invasive surgeries were standard treatment; but now, with the health security of our seniors tied directly to medicines, medicines that extend life and restore hope, we must add prescription drugs to Medicare for all our seniors.

A Medicare program without a drug benefit is a false promise in the 21st century. I am proud to stand here on this House floor and bring prescription drugs to Medicare for all of our seniors and a benefit that is simple, generous, and fair.

It is simple because it pays 80 percent of the first $2,000 of drug costs; and it guarantees the peace of mind of our seniors, protecting them against catastrophic drug costs, covering all costs above $3,500.

It is generous because the average senior spends $1,200 on prescription drugs every year. Yet in this bill we cover 80 percent of the cost up to $2,000.

It is fair because it helps the low-income seniors more than any other group. It not only helps the very poor, below 150 percent of poverty, but for the first time, by allowing State subsidies to help seniors toward that threshold of catastrophic coverage, we help the next income group to have that security that seniors depend on in their retirement.

In addition, there is fairness at both ends of this bill. Should someone with a $200,000 income have the same level of catastrophic protection as a low-income senior? Of course not.

But modernizing Medicare cannot be just about prescription drugs, as important as prescription drugs are. It

must also be about addressing the most crippling threat to our seniors' well-being and their retirement. It must address chronic illness.

Current Medicare is an old-fashioned illness treatment program. This bill will provide seniors with chronic illnesses a chance to have truly progressive care, whose goal it is to prevent the progression of chronic illness. Our goal must be to be sure that if you have diabetes, you do not end up on dialysis.

Disease management is the new frontier in medicine. It will slow, interrupt or reverse disease. It requires more sophisticated technology. It requires greater patient involvement in their own care. But it results in higher quality health care and much improved quality of life and lower costs for hospital care, emergency room care, and doctors' visits.

Mr. Speaker, this bill will bring the cutting edge of medical science and modern technology to the service of our seniors and disabled veterans. With over half of our seniors suffering from five or more chronic illnesses and using 80 percent of Medicare's resources, we must bring chronic disease management to the service of our seniors. And no bill to this point has ever done that. So I am proud to say that this bill brings both prescription drugs and preventive health care programs to Medicare and will provide unprecedented vitality to our Medicare program.

In conclusion, let me remind us all that this bill will revitalize our Medicare Choice plans and provide that reliable high-quality care year after year after year that seniors depend on, a more holistic integrated care than fee-for-service can provide. So I ask my colleagues tonight to support wholeheartedly and enthusiastically H.R. 1. It is historic. It brings prescription drugs into Medicare and it prepares Medicare to provide 21st century medicine to our seniors in the years to come.

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

Mr. Speaker, let us look at the facts behind the rhetoric here. What is going to be the impact of this Democratic substitute on seniors? My colleague from Louisiana just reminded us that 100 percent of employers are going to drop their plans. If there is one thing my senior citizens say to me when I go into senior centers it is, look, help those who need it, but do not destroy my employer-provided retiree plan. Do not touch it. This amendment destroys it, wipes it out. That is not in the interest of your seniors.

But let us look at what it will do to premiums. You were concerned that we did not sock a premium into law. Look what you do in your bill. You sock the premium into law and then you have it rise according to drug inflation. Drug inflation is double-digit. Do you not get it? Those premiums are going to rise steeply. Why would you do that to our seniors?

And let us look at the effect on prices. There is one thing seniors say to you over and over again, the prices are too high. Yet according to Dr. Holtz-Eakin's testimony of April 9, 2003, he says, ``If you subsidize 90 percent of any insurance product versus 70 percent of the product, the larger subsidy will lead to a lower incentive to control costs and will lead to higher prices and higher spending.'' Yours is a giveaway to the pharmaceutical industry. It will drive prices up because there is no incentive for the PBM or the plan to negotiate prices down and they can just pass it on to the government, because we are going to pay it all. Yours is going to drive prices up, premiums up and employer plans out of the market. I do not know why you think you are doing the seniors a good service.

And look at the impact on their kids, because they care about their kids and their grandkids. We have heard testimony over and over again that if you have a 10-year-old child, in 20 years when that kid is 30 and trying to pay back college loans, trying to buy a house, trying to get established, having to buy a car, that child will live in a Nation in which three-quarters of all the Federal revenues will go to Social Security, Medicare and Medicaid.

What is that child to do about education for their children? What is that young person to do to make a living? You shoulder so much debt on the next generation that they will not have public education the way we know it today. They will not have the roads and bridges that a strong economy depends on. They will not be able to defend this Nation in a world that is going to be far more dangerous than the one we have known. This is utterly irresponsible. It is so irresponsible that when the other body proposed this plan in the Senate the last session of Congress, they could not write a budget resolution because they did not know how to handle the extraordinary debt that this creates in the decades ahead.

I urge my colleagues to think that something that looks pretty for your seniors, in fact, will be terrible for their health.

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

Mr. Speaker, I yield 2 minutes to the gentleman from Iowa (Mr. Nussle), a member of the Committee on Ways and Means and esteemed chairman of the Committee on the Budget.

Mr. Speaker, it is my pleasure to yield 2 minutes to the gentleman from Wisconsin (Mr. Ryan), a member of the Committee on Ways and Means.

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

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Ohio (Mr. Portman).

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Virginia (Mr. Tom Davis).

Mr. Speaker, will the gentleman yield?

Mr. Speaker, yes, that is correct.

That is correct.

I thank the gentleman, and I look forward to working with the gentleman on this issue as the bill moves to conference.

Mr. Speaker, I yield myself 30 seconds.

This is a historic evening. It is our opportunity tonight to provide prescription drugs to all seniors under Medicare as an entitlement and to do it in a way that is fair, simple and generous and sustainable. It is our opportunity tonight to modernize the benefit program under Medicare to deal with chronic care for our seniors, a big concern for them, and to structure Medicare in such a way that it will be sustainable, the dollars will be there and Medicare will be able to provide the health retirement security in the future that it has in the past.

I urge support of H.R. 1 and defeat of the substitute.

Mr. Speaker, I yield the balance of my time to the gentleman from Texas (Mr. DeLay), the majority leader.

Mr. Speaker, I thank my colleague for yielding me this time.

This bill is not turning our back; it is facing reality. To pass the substitute would be turning your back on 12,000 people who live in States that do not yet have compliant programs and, therefore, will not be able to get the 65 percent subsidy of premiums that we offer now to people who are uninsured by reasons of trade competition.

This is a temporary waiver just to give States more time to get compliant plans in place. It only runs through December of 2004. That is only basically a little over a year from the time they were supposed to have their plans up and running. It does not supersede State law relating to consumer insurance protections. So anything a State thought was important for consumer protection and health plans is there. It is there for whatever plans are developed for these 12,000 people; it is there for everyone else in the State. We do not override State protections.

We are providing a temporary waiver so that for the very first time in our country, a certain group of people who are unemployed will have tremendous help in buying health insurance during that period of unemployment. It is disgraceful that we were not able to do this for all of the unemployed, but that will be the next step, and then all of the uninsured. But this is an extremely important initiative, because it sets up the structure through which we can deliver a two-thirds subsidy of premium to the uninsured in America.

There has long been, historically, bipartisan support for that kind of initiative to enable people who are uninsured or who do not make enough to pay for insurance or who are unemployed, to be able to have the personal security of health insurance, going way back to the debate stimulated by President Clinton's proposal. The bipartisan alternative that actually had a majority of the support in this House, our former colleague Roy Rowland and our former colleague and minority leader Bob Michel introduced a bipartisan initiative, and key to that was the delivery of these direct subsidies for the purchase of premiums.

Now, later on, once we get the system set up, we can think about whether some people need a higher subsidy than other people relative to income, but setting this system up is imperative. And in the 21 States that have not yet been able to set up a compliant program, if you are unemployed as a result of trade dislocation, you have a right to this; but you can only exercise it if you have COBRA, which most of the unemployed people in small businesses do not have by definition, or if your spouse works for a company that has family coverage.

Now, to say to the other unemployed people that have a right under Federal law that you cannot exercise that right because your State has not been able to work through the issues of developing a compliant program is simply wrong. So this waiver only allows a simpler process for those compliant plans to develop; it makes it simpler for a little over a year while they develop the more complex, but fully compliant program.

So talk about turning your back. All we are trying to do here is face reality so we will not turn our back on the 12,000 people to whom we granted deep premium assistance so they can buy insurance during a period of unemployment, so that they can realize that benefit under the law. And if we do not pass this amendment, then they will not have access to the very benefits that we gave them. That would be outrageous.

Our job is to assure that the needs of the people are met; and when there is a glitch, to develop a way around that glitch and, in this case, it is a temporary waiver so that ultimately everybody will have the access we guaranteed them, the subsidies we guaranteed them to compliant plans. It is a small adjustment. It is facing reality. If we do not face reality, we turn our backs on these 12,000 Americans, unemployed as a result of trade dislocation.