quorum call:

a senator: mr. president? the presiding officer: the senator from pennsylvania. craze craze mrpennsylvania. mr. casey: thank you very much. i ask that the quorum call be vitiated. the presiding officer: without objection. mr. casey: thank you very much. i rise today to address a top take we've been debating for many weeks and months, but especially the last couple of weeks, than is health care. we spent a good deal of time in washington talking about the details of various provisions, the different ideas that have been -- have been introduced in

bills and through the work of the committee. i'm a -- i happen to be a member of the health, education, labor and pension committee, known by the acronym "help", h-e-l-p. in our committee, we spent 60 hours in hearings and 25 hours or so in discussions with our democratic and republican colleagues, working through some ideas. we offered -- or considered -- i should say accepted, is the right word, accepted about 160 republican amendments before a bill came out of committee. as you might know, the vote in committee was 13 democrats voted for it, 10 republicans voted against it. but even despite that divide in the vote, there was a good exchange on important issues. and i think, mr. president, you know, as well ace do, some of the -- as well as i do, some of the issues we're wrestling with. we want to provide to the president a bill that does a

number of things. first of all, in a general sense, provides stability. stability with regard to costs, lowering the costs and also controlling costs. stability with regard to choices. what we're going to send to the president this fall, i believe, will allow people to keep the health care that they want to keep, if they like what they have and they're happy with that, they he can keep it. if you don't have any health care or you have a plan that's -- that costs too much or has poor quality, you can choose another option. i would hope that the options would be both private plans and a public option, but that's a point of contention we'll be talking a lot about that as well. and, finally, we want to make sure that there's quality. at long last that we reach a point where we're introducing quality measures into o health care system. theories and proposals and strategies that have been talked about too much and not enacted

or put into the law. a lot of good examples by private companies across the country that have wellness policies, that invest in keeping people healthy so they don't have to spend money from our health care system on treating a disease. getting out ahead of the problem so to speak. prevention, all kinds of ways to save lives, to improve quality and to save money as well. but i wanted to walk through some provisions in some detail. not take too much time because i know we're at the end of our week here. the fundamental urgency of where we are now. i believe we can't wait. we've talked this issue to death for the last 15 years especially since the early 1990's, but even if you look beyond that, for about 60 years or so, since president truman introduceed this idea of doing something substantial on health care, we've talked about it. so i believe the time for action is now. and this is no longer, in my

judgment, just a nice thing to do. as it necessity for our economy. you can't even go begin to imagine a strong economy over the next decade or longer without health care reform. more american families are unable to get the coverage they need. so where we are now, the status quo is not just unacceptable, it is economically, in my judgment, unsustainable, as we -- as we debate this today. let me go to the second chart with that same concept about it being unsustainable, the status quo, staying on the road that we're on. premiums have doubled over the last nine years. three times faster than wages. three times faster. if we do nothing, in the next 30 years, one-third of our economy will be spent on healthth care. that's unsustainable. health care spending could increase from $2.5 trillion to $7 trillion in the period between now and 2050.

this might be the most stunning set of numbers. every week 44,230 people lose their healt health insurance. we can't repeat that number enough. how can you build an economy -- how can you be a successful, vibrant, growing economy, when every single week 44,230 people lost their health insurance? you could chart this just from the time our committee voted the bill out of committee a couple of weeks ago in the "help" committee. every week since then more than 44,000 losing their health insurance. this pennsylvania number, roughly a three-year number, january 2008 to december of 2010, the projection is 17520 people in our state lose their coverage. for our state, for the commonwealth of pennsylvania, that is unsustainable. we can't grow our economy -- we can't build an economy with those numbers.

without reform, and this is a state of pennsylvania number, but without reform family coverage would cost $26,679 in 2016, consuming 51.7% of projected pennsylvania family median income. i don't know of any family in america, even a very wealthy family, that can pay half their income to health care. certainly not a middle-income family. but that's the road we are on. that's going to happen if we stay where we are and stay with the status quo. and that's seven years away. that's not 25, 30, or 50 years. in seven years staying on the road that we're on means the average family in pennsylvania's going to have to pay more than half their income to health care. to say that's unsustainable is something that's a -- something that is an assertion of an

understatement by a mile. just the fundamental -- some of the themes that i talked about before -- stable costs, secure choices and quality care. some of the things that we have to keep mentioning. just a little bit on the lower cost issue. preventing illness and disease, as i mentioned before, does have a cost implication. it is not all the savings, but we know there will be savings from that we know that. from our research and experience. uncompensated care -- this is a factor to consider today. people think, i have health care, there are uninsured people out there, maybe 50 million people uninsured. some who have health care might think, i wish they would get coverage, but if they get coverage, i will pay more. that's the debate. what we fail to realize sometimes in the debate is that people are paying right now for the uninsured. having uninsured americans is not free we all pay for that.

by one estimate is $1,000 per year for every american that has health insurance. one of the things that we're trying to do in this legislation is to cover 97%, or one bill might have it at 95%, but above 90% of smerns the goal for -- of americans is the goal for coverage. we go to the next chart on reducing waste, fraud, and abuse by one estimate is $60 billion per year for a savings. let's say it's wrong. let's say it is not quite $06 billion a year. what if it's off by a little? what if it's $40 billion, still a lot of savings? what if it's $30 billion? that's way 0. that's a lot of savings every year. we're not doing it today. we're not preventing that kind of waste, fraud and abuse. capping out-of-pocket limits. one of the problems that families have even when they have health care or the benefit

of health care delivery, the out-of-pocket costs go up and up and up. so many small businesses worry about this when -- they're forced if they want to employ people to pay more and more and forcing people to pay more out of their pocket of the small businesses and individuals joining purchasing pools for lower rates. the reason why that's important is because of the -- all of the desks in this chamber. every one of us has health care. really good health care. if you're a fur federal employ yeevment i'm blessed -- employee. i'm blessed with that health care. my wife and four daughters are blessed with that just like everybody in the house, senate. that's good news. one of the reasons why we have health care and a choice of lots of options and plans is because we pool all of those people, millions of americans who happen to be connected in some way to the federal government pool their -- their -- they're in one

pool, and that keeps costs down. why is that good enough for senators and congressmen and members of the house and the senate? why is that available to them but small businesses don't have the same plan or the same option available to them? i think every small in america should have the benefit, the cost reduction benefit at a minimum that comes from pooling our -- pooling our resources and our individuals. and that's part of the reform we're talking about. it's -- reform we're talking about. it's not a concept. in the bill -- it's in the bill. that's important to emphasize. if you like what you have, you can keep it. sharing coverage even when families move, lose a job or have an illness. why in america when we figured out so many complicated things, we can't guarantee when someone loses their job, they lose their health care? it makes no sense that we have accepted that.

that we've tolerated that inequity for so long. the gateway is a concept of a word that we're hearing a lot of about. what does that mean? it's a marketplace. it allows people to go to a website and to find out what they want in their health care plan. not having to read hundreds of pages of fine print that the best lawyers in america sometimes don't understand. a marketplace is the gateway that allows families an businesses to -- and businesses to compare rates, benefits, plans, both private and, we hope -- we hope a public option. why can you go online and learn about a car or some other major purchase in your life and you can't do the same thing for health care? it's ridiculous in a word. and that's what this would allow is giving people the ability to do just that. just like they do for every other major purchase in their life. secure choices is important in this. individuals will have their choice of doctors an individualized care.

government insurance will not interfere with the doctor-patient treatment decision. i know that's said a lot there's a lot of talk about government getting in the middle of all of that. it's not true. but i think that we have to make sure that people understand that that is a fundamental building block of what we're talking about here. we want people to be empowered. we want them to have more choices and we want them to have the choice of both the public option and private -- private plans as well. and we're almost done here, mr. president. my colleague from arizona is here, and i want to make sure he has his time on a friday to be able to speak. this is bill language. you know, sometimes we -- we talk about concepts and the american people never get to the point of seeing in front of the language from a bill that is actually understandable. and is focused on a real

problem. one of the biggest problems people in our state and a lot of states have run up against is a preexisting condition keeps them from getting treatment. that is unbelievable that we tolerated that for so long as well. why can't we pass a law that says at long last that a preexisting condition will not prevent you or your son or your daughter or your spouse or loved one from getting the care that they deserve? we shouldn't have to do it. insurance companies have forced us to have to legislate to make this the law. here's the leang wage. not compli -- language. it's not complicated, it's not mysterious, it's not lawyer language. a group health plan and a health insurance issuer offering group or individual health insurance coverage may not impose any preexisting condition or exclusion with respect to such a plan. that is in the bill. not a fuzzy concept. it is very specific.

one of the reasons why i, and so many others, are saying we cannot stay on the path we're on, we cannot accept again and again the status quo is because of that. because the status quo means that may not impose any preexisting condition or exclusion does not become part of the law and we have to continue to deal with the horrific and inexcusable night painightmare of a preexisting condition preventing someone in america, someone who might be very sick in america from getting treatment -- from getting the benefit of health care that they ought to have a right to expect. so when we pass this bill, we've got to make sure that people understand that that is in the bill and that's very specific and it's very pointed and focused on a real problem for families. mr. president, finally, children. one of the goals here obviously is to make sure that no child,

especially poor children and those with special needs, no child is worse off as a result of this bill. children are different from adults. they can't be treated in the same way. they need -- they need strategies and treatment that adults don't have. they have different health care needs. it's critical that children, especially those who are disadvantaged, that happen to be poor or special needs, get the highest-quality care that they deserve, and that's why i have a resolution as part of that that i've introduced. and finally, with regard to children, no child worse off because we want them to grow into healthy and productive adults to get the highest quality care throughout their childhood. so they can get from that picture in a crib to that picture getting their diploma. so they can have the kind of care, quality health care that will allow them -- allow us to prevent disease and illness in a child early enough and allow them to lead a productive life and get ready to contribute to our great economy and to our

great country. there's a lot to do here. there's still more work to do, but we need to continue to talk about what's in these bills and to have a vigorous debate. we're a long way from getting this done, but i believe we're on the right track. i believe it's not only important but unless we do this, i think we're heading down a path that is unsustainable for our economy, for our country, and especially for our families. mr. president, i would yield the floor and note the absence of a quorum. the presiding officer: the clerk will call the roll. the presiding officer: the senator from arizona. mr. mccain: i ask unanimous consent that further proceedings under the quorum call be suspended. the presiding officer: without objection. mr. mccain: mr. president, i rise to talk for a few minutes about the actions taken by the house of representatives yesterday which passed the defense appropriations bill. not a small piece of legislation, it provides

$636 billion for defense and it avoided one veto fight by stripping out funding for advanced procurement of the f-22 fighter jet, but it chose to ignore veto threats over fund for an alternative engine for the f-35 joint strike firearm. and the vh-71 presidential helicopter. the house bill provides $560 million to continue pursuing $560 million to continue pursuing an alternative engine and $485 million for continuation of the vh-71 helicopter. the vh-71 helicopter is the presidential helicopter which secretary gates has, i think very accurately, derided as one of the most outrageous examples of overspending for system that

the defense department has ever acquired. it provides $674 million for three c-17 cargo aircraft not requested in the administration's budget. we -- it's been determined time after time that there is no need for additional c-17 aircraft. so what did they do in return for continuation of things like a presidential hop hear that cost more than -- helicopter that cost more than a 747 and a -- all of these other pork-barrel projects? well, the house bill reduces funding by $1.9 billion for our request for mraps. for mraps, the vehicles that are protecting the young men and women who are fighting in iraq

and afghanistan. they reduce the number from what the administration thinks we need, 5,244, to 2,000. it's remarkable. but what i really want to talk about for a minute is the 1,100 earmarks totaling $2.8 bill. of those, 540, totaling $1.3 billion, are slated to go to specific private companies without competition. remarkable. $1.3 billion. you know, the bill may have language saying that funding should be competed, but in reality, it's not the case when the specific company is identified in report language. also, incredibly, there are 70 earmarks in the bill for former clients of the p.m.a. group, the people whose offices have been raided and shut down.

it's currently under investigation by both the justice department and the house ethics committee. you know, concerning earmark reform, president obama saidy marks must have legitimate and worthy public purpose. earmarks that members do see must be aired on those members web sites in advance so the public and press can examine them and judge their merits for themselves. each earmark must be open open to scrutiny at public hearings where members will have to justify their expense to the taxpayer. none of that has happened. the earmarks in the house fail woefully in meeting scrutiny at public hearings. as representative jeff lake, a courageous and a man of incredible integrity so rightfully pointed out when he addressed the earmarks in the bill -- and i quote him -- "these earmarks received scant scrutiny by the house appropriations committee. the committee's markup of the bill lasted all of 18 minutes."

he went on to say, "given the way this bill's been earmarked, you'd never know that serious ethical questions have been raised about this process." finally, represent flake said -- quote -- "simply put, members of congress should not have the ability to award no-bid contracts. even worse, many times recipients of these earmarks are campaign contributors. the practice has created an ethical cloud over congress and it must end." now, congressman flake talked about the ethical cloud over congress. we know about p.m.a. every day there's a -- there's a new story about one of these earmarks. i'd like to just cite two quick examples. mr. president, this time i'd like to ask -- at this time i'd like to ask to include in the record entitled "software companies, one earmark earmarksn

medical health records." and another "funds steered to blimp research." the presiding officer: without objection. mr. mccain: the first one about adra, adra networks, allegations it received important software code in advance of winning a sole-source contract to provide hardware and software for a new military electronic health records service system, has only between 20 and 50 employees and revenue of $8 million. but the company had powerful friends in washington. senator thad cochran inserted earmarks in the 2008-2009 defense appropriations committee funding work by adra on defense health records system. also has a pending earmark for adara in the 2010 defense appropriations bill. according to the center for responsive politics, adaira has

paid $140,000 in lobbying fees to gage l.l.c., a consulting and government affairs firm whose partners include former senator conrad burns, r, montana. the firm is headed by burns' former chief of staff, leo a. giacometto. the bulk of the fees, $160,000, went to gage last year, making adaira one of the company's biggest sources of revenue in 2008. the adaira lobbying tab from gage last year matched the fee paid to the lobbying firm by verisign, an internet security company that had revenues of $255 million in the first quarter of this year. according to a database of federal contract awards, adaira won defense contracts valued at $7.2 million in 2007 and $13.7 million in 2008.

the earmarks steered $4 million to adaira last year for work on what was described as a -- quote -- "next-generation networking electronic medical record projects" and $1.1 million in 2009 for the strategic tactical resource interoperability kinetic environments project. also sought $10 million in adaira funding for the strike project in 2010. anyway, an internal e-mail, shows that the military health system tapped adara to provide software as well as hardware for a new enterprise architecture, including a means of exchanging data and a graphical user interface to view medical records. in that e-mail, major frank tucker, chief of product development for the defense health information management system at m.h.s., charged he was directed to provide adara with

software source code and documentation which he viewed as unethical because this would give the company a leg up in any competition. tucker alleged adara was awarded a sole-source contract by the military health system but did not specify the contract's value. there should be a full investigation of that. the "politico" story, representative piec pete sessioe chief of the republicans am pain arm in the house said that earmarks have become -- quote -- "a symbol of a broken washington to the american people. " yet in 2008, sessions himself steered a $1.6 million earmark for deridgable research to an illinois company whose president acknowledges having no experience in government contracting, let alone in building blimps. what the company did have, the help of adrian plesha, a former

sessions aide with a criminal record who has made more than $446,000 lobbying on its behalf. the company that received the earmarked funds, j.g. ferguson n and associates, is based with an office in chicago and another in san antonio, nearly 300 miles from dallas. and while sessions used a dallas address for the company when he submitted his earmark request to the house appropriations committee last year, one of the two men who control the company say that address is merely the home of one of his close friends. ferguson acknowledged that neither he nor his father has a background in the defense or aviation industries nor engineer -- nor any engineering or research expertise. finally, it goes on, "the $1.6 million earmark, more than half was to go toward research

and engineering costs. the remainder was for overhead and administrative costs." mr. president, this is the result and there are myriad examples of this earmarking which goes on and on and on. in this year's defense appropriations bill from the house -- and there will be more from the senate -- there's 1,102 earmarks. we can't do that. we've got to stop. the american people are very tired of it. and just let me remind my colleagues again about p.m.a., of which there are some 70 earmarks. the p.m.a. group was a d.c. lobbying firm with deep ties to capitol hill and a reputation for securing lucrative earmarks for its clients, especially defense earmarks. it boasted more than $15 million in revenue last year. p.m.a. group clients reportedly

received $300 million in defense earmarks for fiscal year 2008 and $317 million for fiscal year 2009. p.m.a. group and its clients spread around a lot of campaign contributions in an attempt to curry favor with lawmakers. according to one report, the firm had been credited with $1.8 million in contributions since 2001, and that's just to members of the defense appropriations committee. last november, the federal bureau of investigations raided p.m.a.'s offices and the home of its founder, paul nagliaciatti. according to news reports, prosecutors were initially focused on whether mr. nagliaciatti used a florida wine steward and a golf club executive as a front to funnel illegal donations to lawmakers. "the washington post" examined campaign contributions

reportedly given by employees of the p.m.a. group and found listed in donor records -- quote -- "several people who were not reg i registered lobbyd did not work for the lobbying firm, including a 75-year-old california man who had never even heard of the firm." since then, the department of justice has raided the offices of a number of p.m.a. clients and their business partners. one former p.m.a. client is accused of giving kickbacks to an ex-air force contracting official. a federal grand jury reportedly subpoenaed records from one u.s. representative's congressional and campaign offices, and the f.b.i. is interviewing his staffers. mr. president, it upsets my colleagues when i talk about corruption and earmarking. i know it is like this

p.m.a. situationfluence of specl here at a time where we have nearly 10% unemployment in the united states america and people not able to stay in their homes, people not being able to keep their jobs, if it was ever unacceptable, which it always was, it certainly is unacceptable now. now, mr. president, at some point the defense appropriations bill will come to the floor of the senate. if it has anything like the defense appropriations bill that the house of representatives passed yesterday we're going to have a long, long, long, long process here because we have got to bring this practice to an end. now, the president of the united states turned -- during the campaign said we would review every appropriations line by line and do away with those that were unnecessary and unwanted

and a waste of the taxpayers' dollars. there's nore than there is now t to say i appreciate the president's v in ending production of the f-22, involvement in saying that the alternate engine is unsustainable for the f-35 but the earmarks are a waste of taxpayers' dollars and has bread corruption and the reason why we have former members of congress residing in federal prison. it has to be stopped. no contract should be allowed on a noncompetitive basis to be appropriated by the congress of the united states. mr. president, i suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

the presiding officer: the majority leader. mr. reid: i ask unanimous consent the call of the quorum be vitiated. i ask unanimous consent the call of the quorum be vitiated. the presiding officer: without objection, so ordered. mr. reid: it is my understanding we are in a period of morning business. the presiding officer: correct. mr. reid: i ask unanimous consent the senate proceed to h.con. res. 72. the presiding officer: the clerk will report. the clerk: h.con. res. 172 providing for continual adjournment of the house of representatives and a continual recess or adjournment of the senate. the presiding officer: is there objection to proceeding to the measure? without objection.

mr. reid: i ask unanimous consent the concurrent resolution be agreed to, the motion to reconsider be laid upon the table. i ask unanimous consent the senate proceed to executive session to consider the california during 265, 267, 319, 329, 330, 334, up to 367, all nominations on the secretary of desk in the air force, army, navy en bloc and the nominations be confirmed, en bloc, the motions to reconsider be laid upon the table, en bloc, and no further motions be in order and any statements related thereto appear in the appropriate place in the record, as if read. the president then be immediately notified of the senate's action. the presiding officer: without objection, so ordered.

mr. reid: mr. president, i ask unanimous consent the agriculture committee be discharged from further consideration of presidential nomination 386 and the senate proceed to the consideration of the nomination and the nom nation be confirmed, the motion to reconsider be laid upon the table en bloc, no further motions be in order and any statements relating to this matter appear at the appropriate place in the record as if given and the president be immediately notified of the senate's action. the presiding officer: without objection, so ordered. mr. reid: i ask unanimous consent when the senate complete it business today it adjourned until 2 p.m. monday, august 3 and following the prayer and the pledge, the journal of proceedings be approved to date and the time for the leaders be reserved with one hour of morning business with senators peopled to speak for up to ten minutes each with the time equally divided and controlled between the two leaders or designees and senator begich controlling the first 30 minutes

and the republicans controlling the final 30 minutes. i ask following morning business the senate resume consideration of h.r. 297, the appropriations bill related to agriculture. the presiding officer: without objection. mr. reid: mr. president, under a previous order, at 5:30 p.m. on monday, the senate will vote on cloture on the substitute amendment to the appropriations bill tealing with agriculture. dealing with agriculture. mr. reid: i ask unanimous consent the action on executive cammer 370 be vitiated. the presiding officer: without objection. mr. reid: if there is in further business to come before the senate today i ask it stand

adjourned under the previous order. the presiding officer: the senate will stand adjourned until monday, august

>> stack the former surfing court correspondent linda greenhouse. hosted by the american university law school, this runs about 40 minutes. >> good evening. i think we'll get started.

thank you. well done. good evening. my name is richard gordon. i am the president of american jewish congress and i want to welcome each of you to gender and justice conference. thank you all for being here. i hope you have enjoyed it as much as i have. it is a more spirited debate than even i even expected. i thought it was excellent. thank you all for participating. thank you all for being here, and i think we are off to a great start. considering the long history of the american jewish congress, and i worked on women's issues, it is only fitting that we organized this vitally important conference. the american jewish conference as many of you know is an association of jewish-american organized to defend jewish issues at home and abroad using

public-policy. we use diplomacy, legislation, and most importantly for our discussion these couple of days, the courts. we are at the forefront of some of the most important issues of our time. helping to protect the safety of the state of israel from such issues as the extras and you'll threat posed by iran, -- okay. anybody know how to turn the microphone on? do you push this button do on? high. do i need to start this all over again? may i suggest for those of you to article appeared in the. i am richard gordon and welcome to the conference. i hope you all had an enjoyable day as i have. considering the long history of the american jewish congress and

women's history issues it is only fitting that we organized a discomfiture to american jewish conference is an association of jewish americans organized for family interests at home and abroad using public-policy such as diplomacy, legislation and the courts. now i am back to where we were. we were at the forefront of some of the most important cutting issues of our time. protecting israel against the threat posed by iran by helped to elevate its relationship with nato leading the fight against terrorist groups and the use of human shields and also the misuse of the court system through terrorism. we advocate religious freedom and separation of church and state have been working very hard on energy independence issues so that the interest that oppose the united states and israel we are not buying oil from them. and further the issues of

women's empowerment, it is our issue that brings us together tonight and for this conference this week. american jewish congress has always been the leader in the jewish community and beyond the jewish community on women's issues. we have been founded on such strong supporters of women's rights. and our ranks have included such luminaries as golda my ear, they'll address, steinberg and ruth bader ginsburg. interesting, the american jewish congress allowed women to vote in our perceiving many, many years before the united states allowed women to vote in election. something we've been very proud of. the women's division itself which is a division of american jewish conference has long championed the rights of women to vote they let the boycott of the nazis that they opposed the soviet unions anti-semitism, and

they have been leaders of the right of reproductive choice. and that some of you may not know, one of the leaders. throughout all of this, the american jewish conference, women's division has commission on women's equality. i have been a leading voice not just for jewish women but for equal rights for all regardless of race, religion, or national heritage. that is why the historic domination of sonia sotomayor for nomination of the supreme court presents us with no better opportunity to explore the many issues of challenges facing women judges throughout the world. the women's division of the american jewis congress is proud to bring together such a lustrous group and i welcome you and i thank you for the long trip that many of you made this

evening. we hope that this conference will provide the platform for which an examination of critical issues women face today will lead to real solutions, not just for today and tomorrow but for the future as well. let me just take a moment to thank a few people who have made this possible. first, let me think the executive director of the women's division. my dear friend harriet kurlander. [applause] >> well, most people see a good idea if i take credit for. i thought it was a good idea and told harriet to run with a. she did a great idea, a great thing this is her idea. harriet, thank you. i would like to thank conference chair for all of her hard work. [applause] >> and someone who is not here tonight but who i need to thank is leona whose incredible

generosity has made this event possible. her involvement with the american jewish congress and the women's group for many, many years has made so much of our work possible. so, who is in here tonight, just know how much we appreciate how much you have done for. but for making this event possible with such a great success. now, onto the real reason we are here. it's an honor for me to introduce tonight's speaker, linda. many people have called her the most accomplished journalist in the history of legal journalism. she has covered the united states supreme court for "the new york times" for over 30 years. she has written about over 2800 decisions. i can't even imagine how many articles that is. but 2800 decisions is one heck of a lot. i think is probably 20 more than i read in law school.

as many of you know she wanted to surprise for her reporting on the united states supreme court in 1998, and has won many other journalistic awards. i would read into you but we would be here probably until breakfast. so i will not. she is the author of the book becoming justice blackmun, who is one of my heroes, and currently linda is the ninth distinguished journalist residents at the a lot school. it is indeed an honor to welcome linda. [applause] >> thanks very much. i have had the most -- which one of these is working? i had a most interesting day here. and enjoy hearing that you've are really deep and interesting talk at lunch. some of the points i'm going to make some of you have been here

today, will have her today few broader context because my interest of course is in women and judging, but it's also in judging. and my inquiry is how the judges know what they know? what are the sources of their knowledge? but first i will talk a little bit about his more specifically our topic of this conference. 25 years ago the great shirley abramson -- that's the sound system problem. >> how is this?

no? i think they try to cut the feedback and maybe cut it too much. who here knows anything about this? does this work? yes, okay. we will go to that. 25 years ago, the great shirley abramson who was just reelected fortunately as chief justice of wisconsin offered some reflections on the day in augu august 1976 when the governor of wisconsin danger to the state supreme court. with her appointment, she became not only the first woman to serve on wisconsin's highest court, and that was a distinction that went without saying in 1976, but she became the only woman to sit as a judge at that time anywhere in the state of wisconsin. in her brief memoir, later

published as an article in the title of the woman has ropes, justin davidson recalled the question she was asked at the press conference that you are a considerable surprise, she found herself conducting that day in 1976. these were the questions. one, will you avoid because you are a woman? two, were you appointed to be a token woman on the bench? three, do you view yourself as a representing women in the courts? four, do you think women judges will make a difference? as judge sotomayor's nomination to the supreme court has made abundantly clear, these are questions that have lost none of their ability to unsettle a conversation about the craft of judging. indeed, there seems to be no right answer. yet, those in the audience who are or who have been judges were probably asked one or more of those questions yourself. and if you were you had to come up with some answers.

and you probably gave answers similar to those that shirley abramson gave, at least for the first three. having graduated first at the her class she replied her up on his odyssey based on merit, but that she was not a token anything, and that she planned to represent all the people of the state of wisconsin just as she assumed the male members of the state's judiciary did. the fourth question, do you think women judges will make a difference, was and remains as pat talk to at lunch reminded us that tricky one. do women judges make a difference? quote, i always take a deep breath when i hear this question or one of this very is, just as abramson said. and this is what she explain. quote, the question are usually has a stock list of wonderful qualities he or she associates with women. now i'm trapped. naturally i want all those wonderful traits attributed to me. what do i believe that, i have spent a lifetime fighting societies urge to stereotype both men and women. so what am i to do now?

what she did tell her questioners on that day, is that she would necessarily bring to the bench all of her life experiences, south america? including growing up as a child of hard-working immigrants who had little formal education, of having practiced and taught tax and business law of marriage and parenthood, and yes, female parish she was once an insider and outsider. someone who would work with success inside the system, but who at the same time have demonstrated throughout her life a willingness to act contrary to the expectations of others. all those experiences and qualities would contribute to the kind of judge she would be. we live today, of course, in a much different role, although the response to judge sotomayor's now famous remarks and contact not very different from shirley abramson's suggest that the world is not quite as different as we might have hoped. her saying that a wise latina woman might at times reach a

better conclusion than a white male judge, sonia sotomayor has been denounced by some as a racist. yet in the very next paragraph of that speech, eight years ago, a paragraph that is almost never quoted, she went on to say this. quote, we should not be so myopic as to believe that others of different expenses or backgrounds are incapable of understanding the values and needs of people from a different group, unquote. and a few paragraphs after that, she said she was aware that in deciding cases she owed those who came before her in court, quote, constant and complete vigilant in checking my assumptions, presumptions and respected, and ensuring that to the xmi limited abilities and capabilities permit me, that i reevaluate them and change as circumstances and cases before me require. i can and do expire to be greater than the sum total of my experiences, and quote.

it is unfortunate that the thought and nuance behind those remarks almost were completely lost in the frenzied search for the damaging soundbite, a search that itself suggest how great our inquiry with remains after all these years. yet as i noted a moment ago and as you heard during this day there had been progress. shirley abramson was in fact the only woman in her law school class at indiana university. ruth ginsburg was one of nine women in the harvard law school class of 1959. and today, as you heard, women make up half the classes in most law schools. 20 or so, maybe it's the way one out of the 50 state court chief justice's are women. and the list of states where women sit at the head of the court systems are not nesser known as the cutting edge for social progress. alabama, georgia, louisiana, missouri, north carolina, south carolina, tennessee, and a very progressive state, utah.

in state court systems as a whole women make up 26% of the g. chari and 29% of the judges in state court with final appellate jurisdiction, there are 100 cities and women acting as a federal district judges and women hold 29% of the currently filled active positions on the federal appellate circuit court. so these numbers are not far off the mark, women now constituting about one third of all lawyers in the country. of course there are outliers to this progress. judge sandra lynch on the first circuit. but nevertheless, it's no longer the slightest bit unusual to walk into a courtroom anywhere in the united states and find a woman sitting on the bench. but the question of whether it makes a difference remains a delicate one. all of these years after shirley abramson held her press conference, and for the very reason that she expressed.

we cringe than the stereotyped thinking suggested by the question. and we all know justice sandra day o'connor's favorite answer about at the end of the day a wise old and a wise old woman going to reach the same decision, and is obviously the well-known remark that sonia sotomayor was going off of when she made her own remark about the wise latina. that was a context for it. and yet how many of us when we read an opinion on reproductive rights written by a judge for whom pregnancy was never even a theoretical possibility, muttered through gritted teeth no woman could have come out without. and justice ginsburg, as you know doubt read already about in u.s.a. today article this spring, discussed the two case -- discusses two cases which were pending before the court and indicated that she thought her male colleagues were lacking a perspective that would have enabled them to see the issues in a different light. one was about the strip search of a 13 year old middle school

girl. in that case has not yet come down. by the other was the case that was pending at the time of the interview and has since been decided. by the way, it was quite surprising that justice ginsburg was willing to discuss on the record in this interview two cases that were then submitted and pending the for the supreme court. the second case is a case on whether a federal statute aimed at preventing employment discrimination against pregnant workers require an employer to make women all if they should have earned during maternity leave taken before the statute took effect, when men could get medical leave for any, for maternity leave which is considered a women's problem. the hold taking a couple weeks ago rejected the claim on the ground that congress did not intend the retroactively.

just scans were dissenting along with justice breyer says that properly understood, the claim was not through retroactive benefits at all, but rather for as she put it, quote, pension benefits now and in the future equal to the benefits received by others and would do the same length of time, unquote, under a statute that was supposedly to bring an end to those attitudes about pregnancy and childbirth that as justice ginsburg put it quote to a throughout human history has sustained pervasive often lost sanctions restrictions on women's place among paid workers and active citizens, unquote. in the interview conducted two weeks before the decision came down, justice ginsburg said with characteristic understatement that her colleagues showed quote a certain lack of understanding unquote about prejudice that women who face on the job. there's been a lively academic about whether female judges make a difference. for years, the results of the research work were unequivocal

due to poor data and faulty models. in recent studies which in 2071 prestigious award for the best paper presented at the annual meeting of the midwest political science association, makes a persuasive and nuance case that in one area of the law discrimination the presence of a female judge does make a difference. while there is no discernible difference in other areas, women rule in favor of the discrimination claim significantly more than male judges do and male judges themselves and judge wald mentioned this, have become more favorably inclined toward sextus commission claim when sitting on a palette panels with at least one woman. i will not go to for the details about the study because the precise date at the really matter to the point, and neither do the data themselves provide an explanation for why the presence of a female judge should matter to the outcome of discrimination cases. in fact, the database more questions than they answer. are the male judges become more

open to discrimination claims when served with a female colleague just being polite or politically correct? that hardly seems likely. can it be that they actually learned something from the women? and what about the women themselves, it hardly takes a lot of fancy numbers crunching to suppose that women's life experience may have something to do with the outcome of these cases. these are questions that need further study. i for one would be interested to know whether this study that retrospective conclusions will also apply prospectively with the younger women on the bench who are part of a larger cohort and dumay will not see themselves as very ranking high pioneers in discrimination cases. rather than attending to answer these questions, i want to get to the framing of my larger question, which is how do judges know what they know? or what they think they know about discrimination or about anything. this question is especially pertinent at the appellate level where when it comes to facts on

which to base a legal conclusion, judges generally are bound by the factual findings below. unless they can demonstrate that those findings are purely erroneous. so they are largely captive to the information presented to them by the parties and by the parties making a. there was a dramatic example in the supreme court just about a year ago of the limits of appellate judges knowledge. as you might remember, the supreme court ruled at the end of this last term that the death penalty is it unconstitutional punishment for the crime of raping a child. justice kennedy's opinion for the five, four relied on a conclusion that there was a general consensus in this country against punishing this particular crime by death, and that capital punishment for the rape of a child was therefore cruel and unusual within the meaning of the eighth amendment. justice kennedy noted only six states make child rape a capital offense. and he served as congress during

the mid 1990s, child rape was not included among the new capital crimes. there was just one problem. congress in fact had acted in 2006 to make child rape subject to the death penalty under the uniform code of military justice. true, this new provision to the relevance of course of the eighth amendment jurisprudence was thus far from obvious. but what was obvious was that the majority insertion that there was no federal law on the books that made the rape of a child a capital offense was simply untrue. this case, kennedy against louisiana, is one of the most high profile cases on the court docket during its last term. yet nobody, not the parties, not their gut not the federal government itself thought to bring his recent legislation to the court's attention. the government in fact filed no breach in the case. a clear sign that they saw no federal interest at stake. obviously nobody involved in this case at any level was even

aware of the new law. it came to light only as a result of a post via devoted to military law written by a civilian specialist in the military death penalty three days after the court ruling. that only four have acted as both a state of losing and the united states was under general filed a brief asking the court to reconsider its decision. ultimately, the request was denied and the decision was reaffirmed. so here surely was an incident where judges did not know what they thought they knew. it might be tempting to assume that judges would be on safer ground if only they could watch a video and see for themselves what really happened in that case they are reviewing. factual and the duties would be dispelled and judges would know what they needed to know, but not quite so fast. a supreme court case from two terms ago illustrates the weakness of that assumption. the question in scott against harris said that police officers acted reasonably in chasing and

forcing a speeding driver off the road. the driver, a teenager who was not suspected of any event other than driving dangerously, was rendered a quadriplegic by the ensuing accident and said the police officers for violating his right to due process. the video camera mounted on the dashboard of the chase card recorded the events. the justices watched the video and then posted it on the courts website as part of the majority opinion. which concluded that the fleeing driver was so obviously a menace to public safety that quote no reasonable juror would have quarreled with the officer's decision to use deadly force to take them out. indeed the video showed a scary drive at breakneck speed on a dark and winding road and a scary indie. as the police officer having received the authority he asked for, rams the driver's car with his own, forcing the teenager to lose control as the car plunges over an embankment. well, this was not unanimous.

it was 8-1. the dissenter was john paul stevens. certainly justice stevens is a reasonable man or is as reasonable as his colleagues ricky had in fact learned to drive many years ago on dark and winding roads and he didn't do the driver's behavior was justifying deadly force. his own life experience, in other words, determined his view of the facts of the case. my colleague of yale law school was sufficiently intrigued by this case to conduct a social science experience. he showed the tape to a sample of 1350 people and steadied their reactions. well it turned out that most people about the supreme court was correct, not everyone did. in a demographic portrait of the two groups proved to be quite distinct. those who agreed with the court were likely to be white male and from the south and west. those who disagreed were more likely to be nonwhite, female, and from the northeast. in other words, responses to the

view on which the court based its conclusion turned out to be at least to some measurable degree call truly determined. so who is the reasonable juror or the reasonable justice? how do judges know what they know? two years ago, the court upheld the federal so-called partial-birth abortion ban act of 2003. this decision, gonzalez versus carhart, was based on a remarkable collection of premises and told him in the 5-4 majority and by the majority opinion of justice kennedy. one premise was while any abortion is the occasion for sorrow and regret, quote it is self-evident unquote that a woman who's a doctor performs the abortion by the method that this statute criminalizes quote was struggle with grief, more anguish, uncle when she realizes what has happened. what's quite amazing your and i will not even try to top the eloquence of justice ginsburg dissenting opinion, was not only

the patronizing assumption that reduces the woman seeking to terminate a pregnancy to a childlike state of deterrence, but also that justice kennedy offers no citation, no factual backup for his assertion about what goes on in a woman's heart and head, it is simply self-evident. he any others in the majority buy into the myth of the postabortion symptom and it is discredited by the psychological literature as described by medical organizations as long ago as 1989. an editorial in the medical journal of obstetrics and gynecology criticized justice kennedy for quote his rejection of evidence -based facts by failing to include a single medical reference in support of his opinion. in the editorial had a headline and i will redo. the headline on this editorial in this medical journal was the supreme court joins the multispecialty group backing the congress and the president. how do judges know what they

know? the supreme court abundant encounters subject of abortion offer a more heartening example of trajectory of judicial knowledge. the year after justice o'connor's arrival at the court, the court was facing a society constitutionality of restriction on access to abortion that had been adopted by the city of akron, ohio. the majority declared these discussions unconstitutional on the basis of roe v. wade which has been decided just 10 minutes earlier. justice o'connor confronting her first abortion case on the supreme court dissented in an opinion that was broadside attack on roe itself. noting that premature instance would bring say that younger and younger gestational ages quote is certainly reasonable to believe that he's a liability in the first trimester of pregnancy may be possible in the not-too-distant future, justice o'connor wrote quote the roe framework that is clearly on a collision course with itself.

she concluded as a quote the point of viability is moved farther back to where conception. well, what everyone thought about roe v. wade as law, justice o'connor's reasonable belief was simply incorrect. as a matter of obstetrics. there was no prospect of fetal viability moving back into the first trimester. well, the medical community made it business to inform justice o'connor of the fact six years later, in a subsequent case, the webster case, in which the court continued adherence for our country and roe v. wade. in this case, the american medical association, the american academy of pediatrics and other organizations filed a brief explaining the anatomic threshold, as it is no, that makes survival before about 24 weeks of pregnancy impossible, even with mechanically respiration due to the incapacity of fetal lungs. quote, improvements are not

expected in the foreseeable future unquote debris concluded. need an webster nor any subsequent opinion that justice o'connor referred to this brief. but she never mentioned the so-called collision course of roe v. wade again. and as everybody knows, she came to play a key role in preserving the constitutional right to abortion. so a good judge is not necessarily one who start out knowing everything, but one who is willing to learn. which brings us back to the question of discrimination. one of the most notable and notorious decisions of a notorious supreme court term, october term two cows and six, was the title vii age discrimination case of lilly ledbetter against goodyear tire & rubber. everybody here knows that case. lilly ledbetter, the underpaid tire manufacturing plant supervisor was title vii claim was foreclosed by the supreme court's interpretation of what constitutes an act of discrimination has become a

symbol of the roberts court parsimonious attitude toward access to courts of citizens of a corporation. as you recall from her appearance at the democratic national convention she has carried that undesired role with grace and has in fact become something of a folk hero in. more people know the ledbetter case that have actually read it, so just refresh your recollection. the question was how to apply title vii 180 day statute of limitations in the context of the claim of pay discrimination. what was the discriminatory act? the unlawful employment practice, was that the initial pacesetting decision? or was it the issue of the subsequent paycheck that reflected or more to the point perpetuated the initial discrimination? the equal employment opportunities provision long-standing paycheck recruit rule provide the latter definition that this policy was repudiated in the supreme court by the bush administration which entered the case on behalf of the employer.

the company won by a vote of imac-4. the court held that her court was time-barred because she showed up while the charge and not during the year she left the company which is when she became aware that her monthly pay was as much as 40% lower than the men she worked with, but many years earlier when her pay and out of her coworkers begin to diverge. she was by the way the only woman of her rank at the plant. my point is not to rehash the argument in this case. it is history. on january 29 the lilly ledbetter fair pay act of 2009 became in fact the first bill that president obama signed into law. his signature was to fruition as it was in her pinnacle, once again the ball is in congress' court, she wrote. rather my point is to examine this decision but i just used to look at these other recent cases. what do judges know?

. . the government establish precedent in a slightly different context the established precedent holds a lead their 100 a day charging iran's from any discrete active discrimination paris such as termination, a lawyer to

promote, i was transferred to a refusal to hire. all the majority did was add a pacesetting decision to this list that was a slightly different context that meant that was the end of the case. by justice ginsberg pointed out in dissent the realities of the workplace show the majority made a category or pay discrimination does not occur in a slightly different context, it is a completely different context from a of a public release them immediately ascertainable events of determination, a killer to promote or refusal to hire pending compensation disparities in contrast are often hidden from sight justice ginsburg wrote. she noted this very employer can sour is confidential as do some 90% of private employers. she served as a female employe received periodic raises has ledbetter to read well assume she is moving along with the others despite the fact that without her knowledge the disparity that my ear originally

have been too small to complain about is wrong with a passing year because featured percentage increases rests on a smaller base. the majorities here to understand this reality mention that the court has strayed from the interpretation of title seven with a fidelity to they core purpose. so have the judges know what they know and recognize what they still lead to larry? as we move forward in this time of challenge and change for our courts, we cannot hope for judges, women and men with the wisdom and the humility to know the difference in this ranch. [applause] >> that was exciting and interesting, and i think we all learned a lot. on behalf of all of us here present you with a very small token of thank you. [laughter] [applause]

i said it was a small token. i just want to thank you all for coming and, please, insure the rest of the evening and also want to thank our sponsors who have been so helpful, the law firm, thank you all and have a good evening. thank you. [applause] [inaudible conversations] [inaudible conversations] the house energy and commerce committee is continuing work today on health care legislation. chairman henry waxman says he plans to finish of the bill today, the committee right now a brick some members can vote on

the house floor. here on c-span2 since in the senate has recessed for the day you can watch continuing coverage of the house energy and commerce committee with members resume work in right here on c-span 2 live. until then a look at the healthcare market up, so far today we take it from the top this morning shortly after 10:00 a.m.. >> the meeting will please come to order. with [inaudible conversations] we are still considering amendments to titles and a and b. mr. barton, i believe you had him in and you wish to offer at this time. >> mr. chairman, can we have a colloquy first began again. >> iraq's.

>> certainly. >> i was not privy to the fan club meeting out in the hallway. did you bring of the committee on when you told the world price. >> we have tried to bring to the democrats together and i wish we continue with us. [laughter] >> perhaps we will. >> we are going to have a series of amendments. they will be shared and must be available for two hours in advance that will include and we are looking at is the overall package that will include the blue dog eminence and several other amendments. and we hope members will look kindly on these amendments to read well, hope springs eternal. and perhaps some of them will. because i looked upon, i hope so. could you educate the committee

on your timetable for concluding. >> i would like to conclude the market by 2:00 o'clock this afternoon. i know that is a very tight time frame and there are lots of amendments but i think we ought to set that as a goal and try to stick to its. i would hope that we could in there for restrict the time for debate, we were doing 10 minutes on each side yesterday, five on each side would be better in discussing this with you privately here and if you think that we shouldn't go to five on each side, encourage all members to stay within five minutes. >> we will try to adhere to that mr. chairman. >> i think that is with some exceptions and that will work, i think that will be very helpful. >> can we now amended the bill at any point franks. >> we are still on a and b but we will get to the awful.

>> i have a transparency amendment and see that i think may be accepted here in the congresswoman eshoo has a biologics amended with me also that we think will be accepted. >> we are going to get to all of these amendments. we do want to ask members to pressure as your eminence so that we can conclude our deliberations and that afternoon, but all amendments will be considered. >> thank you mr. chairman. with that understanding, -- >> all will be considered within the time limits we have. >> we are appreciative of the way conducted this markup and we do hope on the republican side that it has a happy conclusion for all. >> thank you. >> without mr. chairman i do have an amendment at the desk. >> clerk will report the eminence. >> amendment to the amendment in

the nature of a substitute to h.r. 3200 opera by mr. brian. >> without objection will be considered as read and mr. burton will be recognized for five minutes. >> mr. chairman, one of the most controversial and contentious points in the pending legislation is the public plan and the public plan is put into the legislation to provide coverage or insurance coverage for all americans who currently do not have it forever reason. the problem with that is that you have found an hour during the course of this markup is is very expensive, it's very controversial, it's very difficult to figure out how to put it together. there is an easier way, this amendment is not the only easier way, but it is an easier way. it would simply strike some title be entitled to a division

fey which relates to the public health insurance options, we take that out and then we put in a guaranteed that we would help set up in each state, what we call a qualified state reinsurance program and/or a qualifying stage high-risk pool and we would totally funded with federal dollars so that every individual in that particular state has the option to go in to this re insurance program are this high risk pool and get the insurance that they wish. it's that simple. we believe that the score on this for over a 10 year time it would be in the neighborhood of $16 billion so it certainly is less than a trillion and is simple and straightforward.

we have every indication that it would work, there is no need for massive bureaucracy. you could use of existing state and a stretch of that exists for the medicaid and the schip program of that is what distinguishes this they can set up a separate system and they wish to do back. seoul is a toupees imminent or three page amendment. the state high-risk pool has to offer assistance for low-income individuals, it has to offer a variety of covered options, it must be funded with a stable funding source, it has to cover all of the existing conditions, and is pretty straightforward and so i would hope that you might look and favor upon it to manage the gentleman yield back the bonds of this time to read mr. pallone command thank you, mr. chairman. i don't want to -- i am opposed

to mr. burton's amendment but i do want to point out that he has been a champion who for individuals harmed by abusive practices of like the rescission practices that have been looked into quite a bit by the oversight and investigations committee, but i think that mr. barton that you kind of, i don't want to say don't understand, but don't believe it into what is so great about what we have done with this bill. i am so proud of this bill and i am so proud of president obama because he has managed to get say insurance companies to come in and say that they will support to health care reform and eliminate this discriminatory practices based on the health preconditions, based on gender whatever. five of the matter is that the public plan and the exchange's

self gives the people the choice of a new coverage option that does not have a track record of discriminatory behavior that many private insurers have exhibited an this is one of the unique aspects of this bill that we talk about it be the american plane, not the french plan, not the canadian plan, it is the american plan because what it says is if you have insurance and through your employer or through medicare or medicaid or the virginia or whatever you have, you can keep its, but we know that a lot of people don't have insurance, we know a lot of people go out and look for individual policies and oftentimes and they can't get them because of preconditions for are so expensive or small group plans to better too expensive and have all these discriminatory prices here what we're doing is setting up this exchange with both public and private insurers competing against each other that has eliminated this discriminatory

practices and provides for a portability for several reasons, first of all because now there is a large exchange and the people that are participating in some ways are acting like a large group plan, they bring prices down. then you have the competition between the public auction of and the other private insurers that brings prices down even more, then you have a subsidy for a lot of people that brings prices down even more. so for very lot of reasons the public plan is an important part of it, we really are pretty affordability and eliminating discrimination and the public plan is a very impressive part of that, not the only part so when you are proposing simply isn't necessary. there is no reason to set up this high risk pools and the other things that you're talking about and putting that burden on the state's think as of the exchange accomplishes everything that is yours seeking to accomplish. >> would you yield? >> i yield to the gentlewoman. >> thank you, i've been pretty quiet but i've been taking it all when.

i am a blue dog but i call myself a and blue dog for purposes of health care in the like mr. burton him and many others on this committee and both sides i strongly believe in the ability of markets to deliver the best health care. that is why i support a robust public auction. as mr. villone was saying, it can create pools purchasing power and leverage large prices, multistate a drug purchasing pools. there are examples and then dod of how well this kind of thing can work and the flexibility in the seventh series innovates and competition, the public plant will add the mack's have about 30 million people in eds and many estimates are far smaller so it won't be the dominant exclusive provider of health care. right now we have a market failure. we have one insurance plan in many i think 50 percent of

americans in the united states, 94 percent by able colleagues rex me. that is obviously worse, far worse off than a market mechanism that will be generated and by the public auction. i want to name it something else, i somehow have voiced thoughts that sounds of a scary than that is its name and what it is is a way to drive competition, get prices down and quality up and that's what we're all about in trends report this bill have today. thank you for yielding. >> mr. chairman, mr. burton, the problem is you're such a pessimist, you have this notion of what we have out there is doomed to failure and there for you to set up these high-risk insurance pools. this bill in is of the most optimistic wonderful thing that we can possibly achieve and don't take it down with his pessimistic attitude of this amendment. i yield back. >> the gentleman yield back,

mr. barton for closing on your eminence. >> briefly mr. chairman, the contrary to my friend from new jersey says i'm an optimist, but i look as the cbo scoring on a public auction and the current bill and i see when trillion, that's not all because of a public plan been a big chunk of it is indelicate this alternative and i see approximately 2 billion a year. if we get the same band for the bought except own spin to don't -- $2 billion a year instead of a hundred billion a. seems to me we would want to go with a less expensive alternative. but i'm very optimistic. i think the market transparency, people for the sake and infrastructure, it saves a lot of money in the overhead. with all respect i think that as much preferable to something the public opinion polls less than half the country says they want.

that i yield back. >> the vote now comes on the barton amendment and i believe we will go to a roll-call vote so the clerk will call the roll. >> [roll call] >> [roll call] >> [roll call] >> [roll call]

>> [roll call] >> [roll call] >> [roll call] >> [roll call]

>> [roll call] >> [roll call] >> [roll call]

>> [roll call] >> [roll call] >> [roll call]

>> [roll call] >> [roll call] >> [roll call]

have all members responded to the call of several? this is an opportunity if anyone wishes to change his or her vote to. the clerk will report the votes. >> mr. chairman, on that though there were 22 at the ayes and 35 nos. >> the amendment is not agreed to appear in miss eshoo, you have an amendment at the desk. >> thank you mr. chairman, i have an amendment at the desk. 069 eshoo and egil. >> may we get the division on that amendment, the division is

two? to make it is either a or b, does anybody know? this is being. >> thank you. >> the clerk will report the amendment can recommend to them and in the nature of substituted a check for the 200 offered by necessity mac without objection considered as read commence until i recognize for five minutes to my point of order, mr. chairman to amend the gentleman from louisiana reserves a point of order. >> thank you mr. chairman. my colleagues, this is a clarification of medicaid coverage for the citizens of freely associated states which most of you may not be familiar with. and i will just spend about a

minute and then deal to mr. angles who is also offering this with me. over the years the federal government has made a treaty agreements with micronesia, the marshall islands, and the palau to allow the citizens to free the into the united states without a visa or how the certifications. there are called compaq to my friends. in exchange in the u.s. operates military bases on these islands. the u.s. tested bonds on these islands which had detrimental half of next to the people living there including their children and their children's children. there are allowed to arrive in stay in any of the 50 states and that state was required to pay for them with no federal assistance whatsoever. when the era was passed in 2005, the federal government stopped contributing medicaid dollars toward compaq's migrant health care. so while states are not required to cover a compact by grants,

there are serious public health ramifications for not doing this amendment addresses that gap and i am pleased to offer it. i think it is a worthy amendment to. a really, mr. chairman, i can hardly hear myself spake. i don't think the committee is an order, mr. chairman. >> said until it is correct, the committee will please come to order can i thank you for calling the young lady, i caught that. that is a nice way to set the day. at any rate, hawaii has the highest number of compounds by grants due to its proximity, of course, in that state alone is spending hundred million dollars a year in medicaid dollars alone, obviously it is a huge burden. but i would like to do is deal to mr. angles and i think the chairman for allowing us to offer in this amendment. i think it makes sense, it is practical, it is fair especially given the fact that the united

states entered into this agreement with a silence so that they cannot operate military bases on them. >> i think the young lady to yell to make, will save twice. [laughter] and i am pleased to put forth this amendment with her at the behest of our colleague and friend of mr. abercrombie of hawaii. as ms. eshoo pointed out, these are agreements made by the united states and we talk a lot about unfunded mandates on the states, this is an unfunded mandate if i ever saw one. we have to be agreements with these countries, people come over here to work. the united states government, the federal government signed these agreements and then the states are left to pay for this. this is a right at all, this should be paid for by the federal government. compact migrants are allowed to come to the united states, the

state in which they land that must absorb their costs, that is in right at all said this amendment simply makes compact migrants eligible for medicaid, the federal matching dollars help pay for them. that is something that is very important. now, we have to the agreements with the use islands and the people come over and again as miss eshoo said there are called compacts my friends. we are operating military bases on this island so it does have a national security implications and so it is not simply their people come over here. we are getting something in return, we have bases on these islands and is something important to the united states national security and all we're saying is in the states should not be left holding the bag if this is a federal agreement than the federal government needs to be responsible. so i hope that our colleagues will consider this amendment on a bipartisan basis and if

miss eshoo doesn't have anything else to say will yield back the balance of our time. >> mr. chairman. >> the time has been yielded. >> i want to insist on a mr. sculley is point of order. this amendment has jurisdiction with the interior committee. this bill has not been referred to the interior committee -- in tier committee there for this amendment is not germane for the same reason one of them ammons' last night that we offered is not germane. >> before the share in detains the point of order, without objection why do we check with the interior and set aside in this issue. because we do want to get a definitive ruling. without objection the eshoo angle amendment will be put aside and that the pending matter which is before us is a

point of order and will put that aside as well. we will return to it -- >> mr. chairman, an injection here. i was a clarification. we have indicated a point of order in the mr. byrne has indicated our reason. it is almost identical with to what last night made a decision. >> rather than telling how difficult it is levied find out, the parliamentarian what his view is because we do rely heavily on the parliamentarians. >> but i want to put aside the debate on the issue. >> eshoo seem to be of some of the decision last i pick up quickly, announced a decision of have to put this aside because it is actually identical to we wanted to make sure the members of congress have the same policy healthcare as the rest of americans being put in this plan. we asked for an amendment on a family would not allow the vote because he said it was not

germane because it has to be referred to government administration who made the decision on the spot. this is absolutely identical, why can't you use parallel to make the same decision is not germane? eman yield to me? >> sure. >> last night when that issue came up, we called the parliamentarian to get the ruling. that's the way to operate. we have to follow the rules. >> i understand the rules. but once the rule has been set, then you just follow the rule. i think you established the rule last night. so let's just follow the rule. >> we would like to see if the same rule applies. >> it might be a different rule today. you never know.@@@@@ @ @@

>> mr. chairman, parliamentary inquiry. >> when it. we are not there yet. let's not waste a lot of time. we have a lot of work to do. >> mr. chairman, how long are you going to take on this? will it be half-hour, 10 minutes or a day? >> do you want to stop work while we are inquiring of the parliamentarian? >> not necessarily. it seems so blatantly obvious

that this is not germane. >> further parliamentary inquiry. is the chairman bound by the ruling of the parliamentarian? >> pardon? >> is the chairman bound by the ruling of the parliamentarian? >> is a very strong indication of what the rule. >> where is this part of the tarrying, mr. chairman? where is that person? >> i will recognize you to speak on the point of order. you are obviously doing it. you have your views. we will have some debate and then i will make a ruling based on the parliamentarian's advice. >> i don't want you to get upset. >> i'm not upset but i don't want you to be upset. all i want to do is follow the rules. >> but isn't the parliamentarian right behind you? >> no, we have a house parliamentarian. >> did you consult with that, last night on the -- >> yes. it seems like you've made that decision pretty probably. that decision was made within three or four minutes. and we have already talked three or four minutes. it seems like this is very simple to do.

>> i guess a question for you, mr. chairman, what is the difference between this and last night that you can't rule without the parliamentarian? that would be the key question for you to answer. >> the question is whether i need a parliamentarians and you are not? >> know, the question is based upon the decision last night, why can't you make a similar decision based upon that precedent? why do you need a parliamentarian? >> will the gentleman yield? >> let the chairman have the time to. >> the judge would like you to yield to him. >> mr. stearns, don't you think is under fundamentally unfair to challenge the chair on this committee to get an interpretation of the role from the parliamentarian? is that unreasonable to give him a few minutes to get and interpretations of you can make an informed decision? >> i think it is fundamentally

unfair to allow an amendment to go for that is not germane, and this amendment obviously is not germane. the president has been set, judge, and you know having been a judge when you have a president you follow the president. so in this case they should. >> at the gentleman would yield. and i don't know exactly what you have the time,. [laughter] >> the issue is this. it does depend on what committees of the bill was referred to when it was introduced. >> okay. >> and i want to find out if that rule pertains in this particular case. last night's ruling was a fact that an amendment, which i supported, was not in order under the rules because the bill had -- had not been referred to the committee on house administration, and therefore we would be legislating in that committees of jurisdiction.

now, the inference from that is that had the bill originally been sent to the house administration committee, that it might have been germane. i don't know if this bill had been originally referred to the interior committee, and what the parliamentarians you would be of that matter. if you want to play strictly by the rules, and you don't want us to do anything else about talk about this issue, i will ask the gentle lady to withdraw her amendment and we will come back to it. >> thank you, mr. chairman. just for the record, i think that especially mr. stearns should know that the bill was introduced last year, h.r. 4000, to reinstate these federal benefits here and we went through the story of what happens in the agreements and why we think this is a sensible case to be made.

and it was exactly like this and then it. that legislation. and it did not, it was never sent to or have to go to the interior committee. so i just ask you to consider that. if the chairman thinks that we should withdraw, and this would be -- do you have a ruling? >> mr. chairman. >> do you want to withdraw its? >> what's the ruling? >> mr. chairman? mr. chairman? >> this meeting will come to order. the committee will come to order. i have just now had an interpretation from the parliamentarian. now, then i would request you not withdraw your name and. the amendment is pending. the point of order has been asserted. i want to recognize mr. scalise or mr. barton, if you wish to elaborate on your point of order. if not, i think we know what the issue is in the parliamentarian

has given me an interpretation and i'm ready to roll. >> and we are invoking rule 10. i think i said what i wanted to say. i might ask the gentle lady from california if winterville is introduced as a stand-alone bill, was referred to any other committee than the energy and commerce? last year. >> thank you. that it was not. there was no referral to interior. going to the point that they should. >> we were told it was referred also to the activity last year, which is not the resources committee, the interior committee but was referred to another committee. anyway, we are ready to hear you're going. >> we have been informed by the parliamentarian that this particular amendment does not invoke the jurisdiction of the resources committee or any other committee. that it is within the jurisdiction of this committee. and therefore, the point of order will not be sustained. is there for the debate on the

issue amendment? >> mr. chairman? >> mr. barton. for what purpose do you seek recognition? >> to oppose the issue amendment on policy grounds. >> the gentleman is recognized. >> i want to make one comment on the ruling. based on the ruling you just gave, would it be -- well, i won't ask that now. i will ask that later. we understand what the gentle lady from california and the gentleman from new york are attempting to do. it does call into question this would be an expansion of medicaid. it would also wage certain rules citizens in the united states have to comply with, the five year waiting period and think that this sort. there should be another way to help these folks without an essence is waiting current federal law, and so we would oppose it on policy grounds as well as on procedural grounds.

>> the gentleman opposes the amendment. is there for the debate? >> mr. chairman? >> who seeks recognition? mr. hall. >> i yield my time to chairman stearns. >> i will yield to you if i have the time, mr. chairman. >> i rise in opposition to this. i don't think many members know who paygo is in the specific imminent. it is a very small-company, in the capital has about 600 people in it. it's a huge number of islands that stretch of. in fact, supposedly 17 in the tariffs from gitmo to guantanamo bay are going to be sent there. and we're going to give them $200 million so that they will take these terrorists. now, their whole gdp is about $64 million. so that's going to be a huge surplus to the country of pay to. now, for the united states to step up and say that we are

going to include them in medicaid and allow them to bypass the five year waiting period, under the personal responsibility of work opportunity reconciliation act, just seems a little over the top. i mean, i'm not sure that we need to do that. now, mr. engel mention we have a military base there. the military base is there for their protection also. it goes both ways. it's not just a one way street. so i really think this is a huge amount of money we're giving to these folks, and i just oppose the amendment on the basis of why not let them wait the five years for the waiting period under the law? and so i just think, mr. chairman, that we should defeat the eminent. >> would the gentleman yield? >> yes. >> thank you. right now, these people are getting what they need. it's just paid for by the states

as an unfunded mandate. and i know my friend, because we have talked for many years, as opposed to unfunded mandates. this is not a matter of will these people get the aid. it is a matter of who will pay for it. and the question is, if the united states government entered into an agreement with these people, and we may not like the agreement, but they entered into an agreement, shouldn't the united states federal government pay for it? it doesn't affect my home state of new york. it actually affects five states. it affects polite, california, oregon, washington state and arkansas. so it doesn't affect my home state. but i think it is fair and equitable that the federal government pay for something that they entered into and not put an unfunded mandate on the states. and i thank the gentleman for yielding. >> unfunded mandates across the board here everywhere. and i ensure california with this budget crisis has unfunded mandates also.

so is there any reason, mr. engel, why they couldn't wait dacia why should we allow them to bypass the five year waiting period? >> well, because these agreements have been in effect for many years, and the states are forced to pay for this. so if we wait five years, it's just five more years of the state paying for an unfunded mandate. >> just with the economy here in the united states, so dissembled and we are in such a high unemployment in this country and we are bailing out all of these people. should we go into palu who have such a low gdp and giving them $200 million to take 17 terrorists? isn't there some point were we just follow the law and wait five years and then say we will consider it at the end of five years when the economy is better? >> if the gentleman would yield. >> is one less question. how much will this cost in the united states government? what is the total cost?

>> 's i am told it is $200 billion over 10 years. scored by cbo, but i just want to say that it's the federal government signed the agreement allowing these people to enter the u.s. without visas, and health screenings, we signed that agreement with these people. we may not like the agreement, but it is a federal obligation. >> the gentleman's time has expired. we have consumed five minutes on each side but i would like to ask that we allow the gentle lady from the virgin islands to have two minutes and then we will give anybody else to minutes and then we will go to the vote. >> thank you, mr. chairman. i am in strong support of the eshoo-engle and then enter the people of micronesia and the freely associated states are former residence of trust territories of the united states, in some instances such as the marshall islands. they have been on the receiving

end of many of our nuclear tests and have been remained loyal americans -- loyal to this country throughout. there is a compact agreement between the united states and a decent freely associated states, and i think the fact that they were trust territories of the united states, these are not immigrants from a totally foreign country. they have always -- they historically have been part of this country as president of trust territories, that the compact of being in place that provides assistance to those of freely associated states. these i believe that forms the basis for supporting this amendment, and providing medicaid to the residents of the freely associated states who are allowed to freely migrate to the united states and are placing a really undue burden on the states where they now reside. >> with a with the gentle lady

yield 40 from the question? >> are we saying palu or another? >> palu. >> is an island in the south pacific where it was bypassed already by the general wanted to take it and its 26000 people died there and most of them japanese? is that the same place? >> palu. >> one of the most beautiful island in the pacific. >> yes. >> how can you be over five or 600 people there? >> i think a lot of the people who have migrated, for example, to hawaii and arkansas are not from palu, but they are from the marshall islands. some of the poorest islands in micronesia, and some that have really suffered because of the activities, the nuclear activities that we have done in those islands.

>> the time has expired. >> with the gentle lady yield for 17 seconds? >> we have a lot of amendments before us. >> these people pay taxes in the united states i think that is important to no. >> thank you. all those in favor of the eshoo amendment say aye? opposed a no? the ayes have it. never go to your site. who has an amendment? >> mr. chairman, i have an amendment at the desk. it is shadegg 17 east. >> can i reserve a point of order? >> the gentleman from new jersey preserves a point of order. >> the clerk will report the eminent. >> the eminent author by mr. shattuck. >> without objection daemon that will be considered as red. the gentleman is recognized for five minutes. >> thank you, mr. chairman. this amendment is to a stealth

provision of the bill. is a provision of the bill that no one has talked about in the press and no one has talked about in this room. it's a provision i'm betting that no one here really knows is in the bill or what it does. under current law, if an erisa covered plan, that means a union plant or a governed plan, negligently or even link willfully and in bad faith denies coverage to an employee and that employee is either injured or killed by the denial of coverage, that employee can recover nothing for their injuries. nothing, even if there is a wrongful death. now one would think that is the kind of injustice that congress would want to correct the no one in america should be left to suffer a loss like that from the wrongful denial of coverage and recover nothing. but this bill not only doesn't fix this problem, it literally preserves and extends it.

this injustice is best illustrated by a case called corcoran versus united health care. in that case late in her pregnancy, florence corcoran was ordered hospitalized by her doctor. he told her that if she wasn't hospitalize, either she would die or her baby would die. but united health care refused to cover her hospital stay. they said they would only offer home nursing services. tragically, mrs. corcoran's treating physician was right. at a time when there was no nurse at home at the corcoran's house, mrs. corcoran went into labor and her baby wt into distress and died. i hope my colleagues are listening carefully. even more shocking, whe the corcoran's s united health care, they leard that united health care had hired its own expert to view her records, and united health care's experts had written to united health care saying exactly what her treating physician had said. if she would not issue if she was not hospitalized either she

would die or her baby would die. and nonetheless, united refused to provide coverage. but here's the kicker. even more shocking. the court ruled that notwithstanding -- >> we leave this market as the house energy and commerce committee is resuming work on the bill now following a break for votes on house floor. live coverage on c-span2. >> we freeze a committee to those members in the room at present. [laughter] >> it's a fair fight right now. [inaudible conversations]

>> mr. chairman, i have a colloquy if you want to do that while we are waiting for the other members. >> i heard you. but i don't have the information on the colloquy. if it's a colloquy. i could wing it. let's wait until we have more members here to begin. [inaudible conversations]

[inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations]

[inaudible conversations] [inaudible conversations] >> ms. christianson, you have an amendment on the territories. i would like to recognize you for that. it is christian 21-002 on payments to the characteristic are you ready with the sentiment?

>> i am ready. >> i would like the clerk to report the amendment. >> this is amendment 21? >> yes, sir. >> the amended to the nature of a substitute to h.r. 3200 offered by mrs. christianson of the virgin islands. >> without objection the amendment will be considered as red and the gentleman is recognized for five minutes. >> thank you, mr. chairman. while this amendment is far from the parity or state like treatment of medicaid that we would have wanted and which we want to continue to work with this committee to achieve, we thank you, mr. chairman, and we thank the ranking member for providing a meaningful increase

in medicaid funding to begin to put us on the road to get to where we really want to be. this amendment does three things. one, it keeps the funding provided in the amendment in the nature of a substitute at the same level, but it is distributed by a formula that has been agreed to buy all five territories. to it allows us within the level of funding to adjust our match from a fixed 50/50 to somewhat closer to the way the state is adjusted. third, it provides for a report from the secretary on a process for achieving parity in medicaid for the territories, and fourth, it provides technical assistance to improve the administrative efficiency of the program in the territories. i hope that my colleagues on both sides of the aisle will support this simple but very important amendment for the people of puerto rico, guam, u.s. virgin islands, american samoa and the northern america

is. although we wish that much more could be done to bring the full benefits of health care reform to your fellow americans in those territories, this is a substantial first step, and i ask for everyone's support. >> the gentleman yield to me? >> s. >> i want to express my support for this amendment in which we could do more than miss a minute because people living in our territories are u.s. citizens. and we got to be up to provide them the full health care rights we give to all americans. i want to continue working with you as we try to figure out how to accomplish that goal. this is a major step forward, and i am pleased that we are able to take that step. >> thank you, mr. chairman. yes, it is a very, very big step forward, and we truly appreciate the work of un your staff on this amendment. >> with the gentle lady deal for a question? >> yes, i would be happy to

yield. >> if i heard you correctly, you indicated in your statement in support of the amendment that it didn't have any increased funding, minority staff seems to think that it does increase the funding. and the total -- do you just redistribute funding? >> absolutely. just redistribute it in a way that all of us sat down and figured it out, and it totals the same amount that is in the substitute him in. >> if the gentle lady would permit, i am told we have the wrong amendment before us. so there seems to be some confusion about it. >> we made some revisions working with your staff, especially on the match area. yesterday. >> is your amendment reflect the agreement with our staff? >> yes. the amendment that i have here reflects the agreement with the staff. the only thing that was change

was in the match area. and that has to be worked out so that it still stays within the same amount that's in the mm and the nature -- >> the nascar council, medicaid expert. >> this is a big increase. it says right here. >> have you had a chance to review the amended? is to see a minute that was worked out? do we have the wrong amendment? i think the minute that was distributed might not be the correct amendment that the member intended because it does not reflect -- >> at the gentle lady would withdraw the imminent temporarily. we will get to it. >> reserving the right to object,. >> there is no yield at this i'm. >> but the mm that we haven't says additional increase for fiscal years 2011 through 2009. additional increase. >> mr. ranking member, i believe that that means that the increase does not start until

that time, because in arra were given increases for two years, and so the amount, the total amount that is in the amendment in the nature of eight substitute starts to be used after -- in 2011. >> we just need -- obviously you can offer anything you wish, but if it is just a redistribution we are fine with that, but if you are increasing above the baseline, that is something we would like to know how much. >> we were very, very careful in ensuring that it did not increase above the baseline. >> just pull it back temporarily, if you would, because there shouldn't be any confusion. >> i will pull back temporary until we can clarify. >> mr. kerry, you have been a minute? >> mr. chairman, i have an amendment at the desk. it is as the hbp 003.

>> de klerk will identify the amendment. >> do you have the amendment? >> mr. chairman, can i reserve a point of order? >> the gentleman from new jersey preserves a point of order. does the clerk had the amendment? >> could we hear the number? >> . .

[inaudible conversations] with

[inaudible conversations] the amendment has been located, the clerk will report them and. >> and the nature of substitution of hi3200 and offered by mr. terry. a strike subtitle a nba of title two of division eight and answer the following: subtitle a congressional health care for all. iraqi rating. >> section 201, congressional health care available to all. in general. notwithstanding any other provisions of law beginning with your wine, and the individual who it would be a u.s. citizen in the united states and to is not enrolled in a group health plan and health insurance coverage offered in connection with a group health plan and shelby entitles to enroll in a qualified health benefits plan

having the same terms they cover conditions as the health benefit plan under chapter 89 of thai live in that the states could. >> of this time i ask unanimous consent to waive reading. >> may i begin, mr. chairman? >> without objection, the rating of the amendment will be dispensed with and the gentleman is recognized for a five minutes. >> as a clerk read, this is to provide those without insurance or frankly anyone that needs a certain level of insurance to opt into a system, to enroll into a system exactly what we have as members of congress and all federal employees. the federal employees health benefit plan that is determined by much of the public in many of

our colleagues in the house of representatives has the gold standard for health care. it matches what many of us on both sides of the aisle wish and think is best of the american public. if provides coverage at an affordable rate because of this plane can have as many as 47 million or more people in a group to drive down the costs. and they have joyce. between different plans like we have in the federal employees health benefits -- health benefits were as the market's entity is competing against each other, to get someone to enroll in their plan so we have got competition, we have got affordability. we have that choice. those are all things that i want and i think most of the republicans want for our

constituents of this country, it just so happens that this is private sector not government-run plan. let me read you from a recent floor statement. this is a quote from one of our committee members, the fact of the matter is that some of the republican party don't want these problems fixed and accessibility because they are already doing just fine. they've got choice. they've got that federal plan. that's what i have by the way. the government run plan. well, and the democratic party we are seeing something else, we want the american people to get at least as good as my friends in the republican party have. we wanted least the benefits that we have in congress, a choice of portability, lower costs, and lower taxes for all americans. i cannot agree with you more, that is exactly what we are

doing here today isn't doing what you have asked us and to challenge us to do. i cannot only wish they would be a co-sponsor of this with mr. gingrey and mr. bond and i. this is the right thing to do with the people of americans to divide them into the federal health care plan or they say similar type of system until another committee can have a role on that part but that's not what this bill does, it allows the light to be traded so that a in a. of portability and choice at this time i'd like to yield to mr. bonds. >> i think the gentleman for yielding and deal to mr. gaidar and his seconds. numerous times and the last campaign the senator obama said that the american people should have exactly the same kind of insurance had. he did not point as to whether important things, one was that every single federal employee from the forest ranger to prison guard to postal clerk have the same kind of insurance and he

also did point out it was a plan where you could make lots of choices, some of them at the higher end of the choices cost federal employees quite a bit and some at the how the savings accounts don't cost very much. he also did and point out there was no government-run option. if anybody knows they don't want a government-run health-insurance plan it's a bunch of federal employees who clearly now that the federal government can barely run the government let alone also run health care. there are federal employees in every state. this would be part of our overall plan that we want more choice, more competition, even if you have insurance at work be fine with me if you also have insurance access to this plan but certainly if you don't like to have every american have this as well as every american regardless of pre-existing conditions have access to health coverage, that was of a big part of the problem here that i yield to our other cosponsor, mr. gingrey. >> i think the gentleman, i'm

sure all my colleagues have had experience either on a town hall meeting in or live in town hall meeting, we my democratic friends have experience somebody outrageous lot of opinions in regard to this, but people will say to us why can't we have the same thing you guys have? that they assume they get it for free. obviously we don't, we pay for is, but the federal employee health benefit plan is a good plan. it is a gold standard in that we ought to give in this opportunity to everybody in this country and also led the supplement to supply those who are low and, they should have the same opportunity we do and, of course, of this eminence we get rid of a government-run plan and get rid of exchange -- we don't need that to commend the gentleman's time has expired. >> i strongly recommend this to both sides of the aisle. >> mr. villone. >> mr. chairman, i insist on my point of order that specifically

mentions in the bell the health benefit plans under chapter eight of title five which is under the jurisdiction of the government reform committee. this is outside of our jurisdiction. we do not have jurisdiction. >> mr. chairman, point of order. >> i am sure we have checked this with the parliamentarian and we believe it does me the standard of the committee and we are going to insist on a road two. >> we are going to refer to the chairman to allow us to have a road two. >> let me say to it my friend from azeri and my colleagues we just ran our savages read this amendment to the parliamentarian and of parliamentarians said this is solely within the jurisdiction of the oversight house oversight committee and not within our jurisdiction. >> will do yield? >> we need to call the parliamentarian, mr. chairman because we've drafted this in

conjunction with a parliamentarian. if it was redrafted specifically so it would be germane, specifically. if there is a democrat parliamentarian and a republican parliamentarians are there is one house parliamentarian. this is a germane. now if you and i want to suspend the committee every goes to the parliamentarian in person, let's do it. right now. [applause] >> mr. chairman, mr. barton. >> i think we ought to get your parliamentarian on your side of the aisle, our parliamentarians to this to the house parliamentarian and at like to ask the gentleman from nebraska two temporarily withdraw his amendment so we can get this official decision. >> i have no problems with china as long as i'm not prejudiced iraq not in any way. we will have to get further

information from the house parliamentarian on this matter so that sentiment withdraws his amendment. [inaudible conversations] this doesn't come to have an amendment? >> i do, it is eminence slauson underscore of 39. it is sutton's sarbanes actually appear in [inaudible conversations] the clerk will report the amendment to recommend an opera

by ms. sutton of ohio and that mr. sarbanes of maryland, and a sometime socci of title one. >> without objection will be considered as read and the gentle lady from ohio is recognized for five minutes to that reserve a point of order mr. chairman. >> mr. sculley is reserves a point of order. >> thank you mr. chairman and i am very pleased to offer this amendment in conjunction with my distinguished colleagues from maryland, mr. sarbanes. this amendment deals with pre-existing conditions and as we now they america's affordable health choices and will prohibit pre-existing condition exclusions and insurance markets but this section will not take the bank until 2013. end of the americas with pre-existing conditions cannot wait until 2013. so this is intended to remedy that situation currently uninsured can deny coverage for in the absence of have a pre-existing condition for up to 12 months period in individual

has had a continuous coverage defined as coverage with no lapses 73 days or more, then this 12 month time can be reduced based on the number of months of rebel coverage. in determining whether an individual has a pre-existing condition insurers are able to look back at an individual's medical history for six months with this amendment simply reduces the pre-existing medical condition limitations from time to 12 months to have to three months. this amendment also reduces the look back from six months to 30 days. for group health plans, these changes would apply to plan years beginning six months after enactment. for how their insurance coverage and the individual markets in these changes would apply six months after enactment. this amendment makes these changes to the public health service act which falls of this committee's jurisdiction. my friend and distinguished joe courtney from connecticut

offered a companion amendment during the education and labor committee markup regarding this issue and his eminence made identical changes to private employers provide health care and the employee retirement income security act, his amendment mr. chairman was approved by the education and labor committee by a voice votes obviously widespread support in the mr. chairman is my sincere hope that our commitment to they can also passed by voice vote and at this point i like to yield to my distinguished colleague from maryland, mr. sarbanes for his remarks. >> thank you, i think the gentle lady from ohio. i want to commend her on this amendment, i'm very pleased to join in offering its. i would imagine that there isn't anyone in this drama certainly no one on the committee as they move around their districts who has not heard stories heart wrenching story is told to them

where somebody thought that they would be covered for a particular achievement and then when they went to try to access that treatment they were confronted with this pre-existing condition exclusion from their coverage. is the most debilitating game of gotcha and you can imagine and, of course, it comes at a point in time when at the last thing people need to be worried about is whether coverage is fine to be there. as was indicated, this is designed to further modify the health insurance portability and accountability act which put in place provisions and that would limit this kind of exclusion for pre-existing conditions. and their recognizes that the total elimination of this kind of exclusion is not going to occur at the base spell until

the year to has an 13, but there is such high expectation on the part of the public that this particular issue will be address that we thought it was critical to try to do something during the transition. and as congressman sutton indicated the education labor committee already took action in a unanimous fashion to enter as of this with respect to employer sponsored plans. we do is pick up the rest of the universe and now limit that lookbacks to 30 days instead of six months and reduce an exclusion from 12 months to three months. we think this is of the right thing to do whether many people out there that have borne the burden of this exclusion coverage based on pre-existing conditions and we would hope

that this is noncontroversial and would be supportive by our colleagues on both sides of the aisle. without i yield back. >> the gentle lady yields back, mr. barton. >> mr. chairman, i'm going to oppose the amendment. i offered to read before the break the national pool that covered all pre-existing conditions at the same level. and i believe every member of the majority of those in that. of now we have a proposal where it if i endorse it correctly, you can be diagnosed with some catastrophic condition, wait a month and apply to insurance and i have to cover you. i do say that i totally understand the to the extent i do understand this is a

disincentive to have a health insurance until you know you needed to which would tend to be kind of counter-productive to the whole point of insurance and the others place. >> for the gentleman yield? >> at i'd be happy to command it wouldn't permit this in error you're talking about, the 63 day lapse of coverage provision still applies, in other words, if you have gone more than 63 days or more without being coverage than your not going to get the benefit of what they call this creditable coverage as to carry forth from the time in which you were covered. so it is really address in this situation that they both have some coverage for one reason or another lost are needed to change their job, had elapsed time that was less than 63 days and then when they went together your insurance coverage they're able to carry over creditable

coverage from before. with a means to the is if you have six months of coverage from before under current law if you carry that foreign you is still high exposure because you only get credit of six months against a 12-month time in now because we are reducing the 12 months down to three months, the kerry huron mean you would experience no time of exposure in terms of your coverage so i don't think it is, this does not create an opportunity for people that want to gain the system. it really just tries to enhance and strengthen the portability element that was part of the original hipaa and to energize to adjust during this interim time and leaving at two the implementation. >> with the gentleman yield? >> i have another question for mr. sarbanes, the ranking members bill earlier, we want to cover everybody regardless in

the existing conditions established risk pooling mechanism where insurance companies would have summer to collectively go with patients that charlie had is a generic cost rather than passing those costs onto all of their other customers, i wonder is there anything like that in this bill, which expects to trade them on their own and i guess why weren't we able to get that done earlier since we both have the same goal? high-yield. >> i appreciate that, my reason for voting against the earlier proposal is that i think recently in vesicular there has been too much emphasis on this notion that you can solve these insurance questions by creating these opt out opportunities. the strong this kind of insurance models are the ones that have the most people in the same pool. those who are well, those who are not so well, those who are young and old so that you completely distribute the rest

across the pool. >> reclaiming my time, i thank the gentleman. i think i would tend to agree with that except you are now talking about putting people who are already sick into the pool as opposed to some other way to assure you cover people with pre-existing conditions, that would be my problem and i yield back. >> dr. burgess and then mr. stern's. >> and thank the gentleman for yielding, between these two proposals offered by the ranking member, this proposal mr. chairman is a shame we did not serve from this .4 months ago. there is a broad consensus and would have delivered a product that would have solved a problem for a million which is the real problem they're asking us to solve, they don't want us to turn over 17 percent of the nation's economy to some program they don't trust the they do want us to fix this problem and as you can see from this discussion there are good ideas on both sides to have to get this down. i yield back mr. vartan met

mr. stern's. >> quickly, council appears to me that the offensive did this start six months after enactment but there is a clause on page three special rule for collective bargaining agreements and the question i have reviewed is this of this, the more these collective bargaining agreements and special exemption. the bill starts by six months after enactment of a site into this bill that three years after enactment who are these people collective bargaining agreements are set up for so they get a waiver of three years? >> what entities are we talking about blacks. >> collective bargaining agreements? and its use they usually are? >> why do we have a special exemption for one group -- >> without objection, gentleman from texas will be given additional minutes to complete. >> said the council can ask a question, we don't need

additional time to adjust an answer from the question. >> collective bargaining agreements are usually between unions and employers i believe in giving so in this case the unions get an exemption for three years but all the insurance companies in this bill would apply six months after enactment? >> normally enters contracts are written on a one-year basis so when insurance contract is a review of an individual they can do that changed within a year or as the collective bargaining agreements are multi-year contracts so is about not to serve in the contracts. >> the last question i have for you is six months after enactment of the bill all insurance companies in america must comply with this, is that correct? in other words, the bill as written is 2013 but with this bill passing this pre-existing condition will apply six months after enactment? command that is the way they buy today is written.

>> all time is expired, will now proceed to a vote on the sutton that sarbanes and an income of those in favor will say ayes. opposed nos. the ayes have in the amendment is agreed to. mr. rogers. >> thank you mr. chairman, i have an amendment at the desk. i believe it is a degree 10 on the list. [inaudible conversations] the clerk have the eminence? >> mr. gingrey, but it should be -- >> matheson, gingrey, rogers or

one of those. and. >> scores 00 to appear in at the top ranks. >> yes para [inaudible conversations] i've got it, mr. chairman. command the clerk will report the eminence. >> millman offered by mr. rogers, and at the end of section -- >> without objection the amendment will be considered as read and the gentleman from michigan mr. rogers. >> i hope this would be in the man and the majority would accept. we have worked on it in a bipartisan way and one of the disturbing trends in this particular bill is that there's been a lot of misleading comments that if you like the health plan you have you can keep its. unless we're one of the 11 million seniors on medicare advantage with 8 million americans that have health savings accounts by the way which is growing by about 30% each year.

or the 100 and 14 million people under erisa plan that after five years will lose their plan and be shoved into a government plan, other than those over 100 million people you get to give the plan you like. this is i think a number of amendments to protect something that is driving innovation, the rise catastrophic coverage so those horrible stories about losing your home -- chemical the gentleman yield? >> psr. >> i think hsh eligible high deductible health plans should be treated as health benefits plan. but what i'm concerned about is that we still have all the protections from of discrimination by anybody who are representing planned. would you be willing to work with us to allow people the choice of age as a way but not a plan that exempts them from these issues of consumer

detections? >> if you are saying it has a mirror of a government plan mr. chairman. >> i'm not saying, it has to mirror a planned test. >> mightier reclaim my time is the more difficult to remain these things to be successful the last opportunity people have to participate and one of the reasons these are so successful and growing so quickly is we've made it very easy for people to get involved in this program and employers to get involved in the program, some 30 percent of everybody has on never had health insurance to their employer before so it tells me it's the one thing working, the one innovation as working to get people connected to health care. mr. chairman, my argument would be i went to anything to stop the progress and by the way by the time the exchange of your bills passes this new government and exchange 20 million americans will be on age as a day, why we would want to screw that up is beyond me so i would respectfully dashers by flea decline and hope we would take

to protect the people who have opted to get connected to health insurance through has. >> will the gentleman yield further? your eminence would excuse has high deductible plans, other requirements apply to all other qualified health benefit plans. over example the has eligible health plans that don't cover the benefits such as maternity care or prescription drugs. just like other health insurance policies these high deductible plans will eventually add to the grandfather have to cover all the minimum benefits as drafted in the amendment would also excuse has eligible plans from other requirements for example, a high deductible health plan would deny coverage for pre-existing conditions allowing insurers to charge cancer patients more for insurance and rely on inadequate provided networks will the two have prompted requirements and more.

>> i would hope to give a little i should have two our hopes as you been arguing on our time mr. chairman. here is the point, if you really believe it has all of you have said that you want choice which of this bill by the way does not provide, then let them have the joyce. of the people who have been chosen of savings accounts keep them if they like them. he may find those and i disagree with your assumption that those will happen, i completely disagree with that but was just consider the set of arguments say it was if they wanted to make this choice they will and if that is true believe me it will be a viable option in your new federal government mandate run exchange. so let's all this says is if your employer you should have the right to be able to provide this, if you are an insurance provider you should have the right to be able to sell this and by the way if your individual american up losing choice two have the right to build to buy one. is really all it does and i would feel some time to mr. gingrey. >> mr. chairman, may i ask

unanimous consent for an additional minute? thank you, again going back to the president said, if you like to have you can keep it. until you can't. and when you can't is 2013. and mr. chairman with all due respect i thank you pretty much made a case when you said then that may be held savings accounts with high deductibles low premium insurance policies that young people many of whom are in that 47 million today that don't have health insurance, these other kinds of plans and they would choose and certainly our great fear on this side and i think most people would agree that after 2013 as secretary in her infinite wisdom or whomever the secretary is an hhs could determine that any employer plan not just the high

deductible low premium affiliated with combined age essay, by any standard plan that not meet the requirements was not credible and all of a cent would be disallowed and that's where the 110 million that are now in shared by employers with more of into the government's public auction so-called public auction. clearly we don't want to deny a million people the opportunity to have these plans. we would just be contributing more to the percentage of when members of the uninsured. so this is a straight toward amendment, i would hope that members on both sides of the aisle was supportive and i yield back. >> gentleman yields back his time. of the chair recognizes himself. i made a simple request of the gentleman from michigan -- i wanted to support his idea of the hsa but wanted to be treated like all other insurance plans

competing. and i don't think it ought to have a separate special treatment, i don't want hsa saying they don't have to cover benefits like maternity care, prescription drugs, i don't want hsa to say that they could deny coverage for people with pre-existing medical conditions. were allowed insurers to charge cancer patients more for this insurance. this is a form of insurance by should not be treated as an of insurance that is so special that they can do all the things we're trying to stop insurance companies from doing. now offered to take your eminence if you work with me in new to nine the willingness to even more for me, i can support your amendments. >> the difference between working with us and completely changing the locus of the amendments to man quick changes of this of the amendments. >> i am asking a question, would a change of the lotus of your

amendments to allow hsa plans and not allow them when they compete to be was to discriminate when we are not allowing the other insurance plans to discriminate? >> mr. chairman, if you yield that is not what you're doing. which you say is right but your intent in the language is wrong he has actually the premiums what you've done about 70 percent just by -- >> i have asked you to work with me to make sure we accomplish these goals. >> with the chairman neil? , the gentleman from texas. >> i think we might having on intercepting conversation here. i think both of you are right. i think mr. rogers is right. the intent of the house savings account is to put cash money each month into an account in most cases the build of tax-free and the most of savings accounts have in this forest -- requirement to have a

catastrophic policy. but within the discretionary part you can spend that money on anything, many of the things you are talking about would be covered by cash and the discretionary part of the account. >> levied reclaim my time. let's look at the amendment. says in the case of a health benefits plan offered in conjunction with a health savings account so in the flag to the health benefit plan under the legislation in conjunction with the health savings account would not have to meet these requirements? >> i may be missing something but i would think mr. chairman the joys of it -- if you believe in choice we should allow this to go forward command i don't believe in the choice of insurance companies to exclude people. >> there is an individual choice to be allowed to be part of the government exchange. >> wouldn't the catastrophic part of -- that's what i think you're both right, the cash and other parts of the hsa and have

to read the requirements that chairman waxman is talking about but that cash discretionary part of the account that mr. rogers p.o.t.u.s. -- focused on is available for whatever the patient and that the health care provider wanted to be is the way i would interpret it so you both of which you want. >> and just try to make sure that high deductible plans have the same requirements as in the and the insurance plan. entrée to dictate how the cash would be used rather, it's a high deductible plan we know that. but that ought not to be able to discriminate, on not to be able to ignore all of the things we have in the consumer protections no cost-sharing, no dropping of coverage for seriously ill, no gender discrimination, no annual or lifetime caps on coverage. guaranteed insurance renewal. the gentleman from michigan with

not like to allow that? do rich and those kinds of provisions? >> again it is a trojan horse, mr. chairman. >> i oppose the gentleman's amendment and recommended that other members to some. we will try to work out something on a hsa health savings accounts that require them to be the same as others and not allow this discrimination. are you ready for the question press all those in favor of the rogers and evans say ayes, opposed nos. the nos have a, the amendment is not agreed to a man can we have a [roll call] can we have a roll-call vote, mr. chairman? >> [roll call] >> [roll call]

>> [roll call] >> [roll call] >> [roll call] >> [roll call]

>> [roll call] >> [roll call] >> [roll call]

>> [roll call] >> [roll call] >> [roll call] >> [roll call]

>> [roll call] >> [roll call] >> [roll call]

>> [roll call] have all members respond to the call the roll blacks [inaudible conversations] mr. gordon? to mr. gordon votes now. any member wish to change his or her vote? the clerk will tally the votes

to. >> [inaudible conversations] >> [inaudible conversations] >> [inaudible conversations] the clerk ready to announce a

the? >> mr. chairman, there are 26 ayes and 33 nos. >> the amendment is not agreed to. mr. space, you have an amendment? >> thank you mr. chairman, i do have an amendment at the desk. >> mr. chairman, while we are getting that is the bill of entombment at any point plaques to have not yet but will be sent to mad. c-span: >> you don't have a whole lot of time left. the clerk will report the amendment. >> amendment to the amendment in the nature of the age of 3200 and offered by mr. space of a high of. at the end of some tile h of

title seven of division b add the following concessions 1783. prohibitions on federal to ask that we dispense with reading. >> without objection the amendment will be considered as read and the gentleman from ohio is recognized. >> a point of order, mr. chairman. >> mr. sculley is observes a point of order. >> mr. space command thank you mr. chairman. this amendment is very simple. it ensures that this legislation does nothing to bring people in this country illegally -- medicaid services. reaffirms and provides assurances both to members of congress and the american public's that and removes all doubt frankly that this bill has somehow or another would afford benefits to those who are here

illegally or in an undocumented vashon. i asked and urge my colleagues on both sides of the aisle to adopt this straightforward amendment to the legislation and would yield some of my time to my colleague from california, congressman mack and rene. >> of like to commend my colleague from ohio for his work on this amendment which as a common-sense clarification to the bill to ban medicaid into payments from being made on behalf of illegal immigrants. federal prohibits illegal immigrants from enrolling medicaid in schip, this amendment simply ensures that those prohibitions and maintain. the amendment is a message to maintain the integrity of our laws and ask our colleagues to support it. this i would yield to my colleague from indiana. so i will turn back over to my colleagues from ohio. >> mr. chairman, i would deal

the back. >> with the gentleman from ohio il to lee brice. >> by all means. >> i think the gentleman for yielding cummings says on live forever your eminence, nothing in this title shall change current prohibitions against federal medicaid in payments under the title. what verification system do you have to make sure that these individuals are lawfully present in the united states? document this amendment does not provide any new verification system, is simply applies the existing verification system. >> what is that existing irrigation system? >> i would refer your question to castle. >> search if you refer the question to me, counsel i do ask that question. what is the existing verification? under this h.r. 3200? >> under current law not of the bill before you, and the crown on already in place in the medicare gramm is a citizenship

documentation requirement and that was recently extended to the legislation that passed this year. >> -- counsel for that and in regard to the language in this bill would be the verification blacks meant there is no new verification system in this bill >> there is no verification. >> there is an existing law to this citizenship requirement both and medicated and the chip. there is an existing law verification system call citizenship documentation. >> another question for council. does this require a photo identification verification system drugs under current law to match the amendment before you does not, the bill does not, the current law does. the current law the citizenship documentation requirements

requires documentation of citizenship and identity. an entity requirements include peanuts among other things presentation of the photographic evidence. so that is just current law. this amendment with the bill makes any change in the front of citizenship documentation requirements. you have to prove citizenship and establish identity. mack well, i ask my colleague and from ohio does this amendment included current law verification for the legal presence in the united states by virtue of an indication system but no? >> i think the gentleman from georgia, this legislation. terms existing law and specifically to iraq's nothing in this section of legislation changes to existing law when it comes to determine eligibility

for medicaid and chip provisions. >> if this doesn't change existing law the why are you offering the amendment comics can't because there seems to be some misunderstanding or concern that the legislation at hand will provide some kind of benefits to undocumented aliens. this legislation is being offered to provide assurance those members of congress to question that as well as the general public that it is not and i benefit to those who are undocumented aliens. i think generating this sufficient confidence to the american public in this legislation is a very important step in the process and i think this is one of the steps we should be making. >> who wishes to be recognized? mr. chairman mr. deal, you're recognized for five minutes. >> mr. chairman i like to ask counsel isn't it true that the underlying bill has a provision that says that in certain conditions namely in medicaid

that individuals and family units will be automatically enrolled in the medicaid program and that a state may not put any other interference in front of the automatic and roman? >> the only provision that comes to mind i have to look back at is requirement for automatic enrollment of newborns who do not have any other source of acceptable coverage. >> what about those individuals who are up to the 150 percent of poverty will be automatically enrolled now in medicate? >> the bill requires the coverage of asserting and 2013 of individuals under 133% of the federal poverty level. >> automatically enrolled? >> if they needed the current eligibility requirements to make an automatic enrollment to mad

include the citizenship documentation requirements. >> there is no reference in the automatic alignment to verification of citizenship and is there? >> the bill requires states to cover people under 133% in the medicaid programs and leaves his testing procedures and methods and standards in place. one of the procedures in citizenship documentation. that applies to all people be enrolled under medicaid of these eligibility levels. >> descanso recall when we reauthorize the schip program as to what was done to the language that requires verification amanda that is a reduction act? did not, in fact, in the schip reauthorization made this an option that states could elect not to verify? >> states don't have an option with respect to whether they need the documentation requirements. i have an option as to how they do appear in.

>> right. >> with the gentleman yield? >> is council aware of the situation that existed in this area prior to the death was a reduction in 2005 in which 46 days and the district of columbia and existing laws that mr. space is referring to which says you not allowed illegals to enroll in these programs, 46 days in the district of columbia used self revocation of just signing an affidavit? >> that is not in a proper question to ask of counsel, counsel can tell us with a lot is and what the bill says that the tax r. >> mr. chairman, question for council? >> i will not ask counsel that question, i will tell this body that that's exactly the reason the 2005 provision was put in. now, if you really wanted verification you would have voted for them and that loss by one vote yesterday.

i recognize that this is political cover. but i want to tell you is a spin as a fast machine, it will provide you know cover on this issue and the reason being is that verification is the key to making this provision workable. and you have rejected the provision that was offered yesterday that would have provided very clear language about in the verification requirements that should exist here. >> i yield to my colleague from illinois. >> i think my colleague, this is the debate we had last night, this is a see why a amendment because my colleague is correct, the laws were changed to allow states to make a determination without federal intensification prove. we all know there are states that allow illegal immigrants to get driver's licenses and they can then use those to this day many kids to summer to enroll

and to sign an affidavit that they are citizens. so don't try to cover up for the failure of last night, this bill will allow illegal immigrants access to federal funded in taxpayer dollars and if that is what you want that is fine, but don't hide it. just be up front. and i yield back to my colleagues to read the yield to the gentle lady from tennessee. >> i think the gentleman from georgia. and i think him for his good work on this issue and i do oppose this amendment. i have talked a lot about the experience in tennessee, what we saw with this is with the state verification mechanism drivers license which have been in a properly obtained, they could use a utility bill, they could use a rental receipts, they could use all sorts of mechanisms to enroll in the public option plan, taxpayer funded and we held that the bill

hearing in tennessee on enrollment with illegal immigrants and 10 percent of the growth every year was attributed not by us but by 10 carries off to illegal immigration's coming on to that program. i yield back. >> the chair recognizes himself and i find in this an argument on the other side that is as thin as a gossamer swinton. because we are talking about very different things. and mr. space is arguing is that we ought not to allow people who are undocumented to be able to access the federal medicaid and schip program. now, mr. deal would make the argument that in order to enforce that you ought to have anybody coming with a birth certificate. for some proof of their citizenship. the reason that amendment was rejected is because it hurt more

americans than anybody who tried to skirt the requirements that they be undocumented aliens from of the ones who are being disadvantaged. american citizens are being disadvantaged. now, this amendment would say that new eligibles will be subject to the same citizenship documentation requirements that apply to existing beneficiaries. there will have to document their citizenship for a passport or verse certificate, half that documented their identity to a valid driver's license with a loa id, that is in order to ensure that undocumented aliens and not eligible. this basement makes clear that the current prohibitions against federal medicaid payments for services of undocumented immigrants will be made in place and that this title does nothing to change these prohibitions. so i don't understand this

argument with some of his argument for argument's sake. and i almost think we ought to have a recorded vote to see if republicans want to vote against this amendment. i can't believe that they would any more than bonds to against medicare. which they chose not to do whether it was offered by mr. wiener and speaking of mr. wiener, he asked me to yield to him and i will do so can i briefly mr. chairman i think my colleagues and the other side to some degree inherent in this space eminence think there is a conversation going on that we have to continue in this congress about how we deal with 11 million undocumented people in this country. but we tried real idea, and it was a failure, if you verify we can't seem to figure out a way to get up and running. this is not just in health care. my colleagues are correct, there are problems in figuring out both employers and government and everyone tries to figure out how the undocumented, how we figure out a way to bring them out of the shadows of horse a

lot to get preventing terrorists and i just want to remind all of us, another is almost an irresistible urge to demagogue and it comes to immigration matters. just remind everyone that when you are talking about young children who are sick, who are trying to find care led to the likes of which that might be in your examples here of. those children who are sick have committed no crime. they are too young, they're just children and to some degree we need to have a health care system that figures out how we make people well, how we don't think fred, how we have a system that makes sense. we don't have that now and so with to have his young children being kept on because parents are fearful of bringing them to a doctor. going into hospital emergency rooms and getting care that is not been paid for by the bill berry, it will be by all of us. so i know there is this desire to be to the rostrum about immigration and his courage to use this of language about

people being illegal, the suns i commend to children are what we're talking about and i hope we can keep that in mind that made a mistake i agree with many of my colleagues. how is that we solve these immigration problems and how it is that we saw the idea and identify. >> notwithstanding a powerful argument the amendment before us with proof of its federal medicaid in check payment for undocumented aliens, even given vitamins they think that to be covered are not but the space amendment says that they will not be entitled to those coverage. >> i would ask a question of counsel and i'm a human mr. radanovich, i yield to you. >> repressing council, in the law where it is a required the health care choices commission and to require where they were acquired and all want to apply citizenship of their vacation

under 1903x of the the social security act? >> search in my response before i was referring just to that for the medicaid law and just the the current jupon not speaking to the health choices administration can agree planning my time i yield back and ask for the question, all those in favor of the space amendment say hi. all those opposed say now. the the ayes have it, the amendment is agreed to. kingman mr. chairman, i want to ask unanimous consent to amend the lending greets harry blount eminent. that we withdrew because of question about chimineas. and i want to bring that back up and then i was to ask unanimous consent to strike line 13 on page one whether to on page two.

..

>> i can't argue with you. you are right about my being right, you are right. [laughter] >> if you agree, or if every member will agree to the unanimous consent that we strike that portion that i have identified, then we are told, and i hope you were told, that the remainder is germane. >> the gentleman is correct. however, that doesn't make it without controversy. >> it makes it jermaine. >> but let's bring it before as. without objection, the amendment offered by mr. gingrich, mr. blonde, mr. terry, on congressional health care for all, will be put before the committee again. and by unanimous consent, everything after line 10, -- everything from line 13 through line two on page two will be

stricken. and mr. pallone reserves a point of order in case we can find something else that is not jermaine. >> i believe there is one, mr. pallone. >> and i would yield to the author's -- >> the amendment is now under consideration. the gentleman is recognized. >> we have already spoken on our five minutes. >> mr. terry, do you wish to control the five minutes? >> we say we the proponents have spoken. we would certainly let the opponents have five minutes and then have a vote on the amendment. >> i will recognize myself than in opposition to the amendment. the amendment seeks to require that all citizens may go into a

plan for insurance that would be under the same terms and conditions as a health benefit under chapter 89 of title five, and if so, it is like the -- it strikes the public plan completely. in fact, would substitute something else. and we argue that it would substitute something like that federal employees benefit plan but not that plan but i think that is not what we intended in underlying legislation. we intend a market competition with a public plan, and i would have to oppose this amendment because it strikes the public plan and does not give that as an option to any american who might choose it.

>> mr. chairman? >> i would be happy for further debate. mr. starr bains, and then we will come back. >> thank you, mr. chairman for yielding. i would echo what you just said. the biggest problem with this is that it does strike not just the public plan. it strikes the whole exchange. the purpose of the exchange is to begin to bring innovation and choice into insurance markets all across the country that right now are captive of a handful insurers with predictable consequences for costs and innovation, which means often high-cost and a little innovation. and so i can't understand why the other side would want to remove an opportunity to generate more options and more

choice to explore -- to test the opposition really to add more actors into the mix, choices into the mix that you might get to a better health care system. so my primary concern about the amendment as proposed is the fact that it would completely wipe away what is a prime mechanism in this bill to get to the kind of choice and options and competitiveness and exploration of reducing costs that have to be central to this reform effort. and so for that reason i would urge us to reject the proposed amendment. i yield back my tight. >> mr. pallone? >> mr. chairman, this goes back to what i basically was saying before. we have set up a really great proposal here under this underlying bill, and i think mr.

sarbanes and you describe this to some extent, whereby people now who are in an individual market or small group market or have no insurance can enroll in an exchange that offers them a benefit package, consumer protection, and all kinds of ways of reducing costs, because it is a sort of like a group plan because it has the competition between the public and private insurance because it has subsidies. you know, just assuming that somehow letting people enroll in something like that federal employees plan is somehow going to be better, i think is a false assumption. >> this is not a federal employees health plan. it is something like something like that, or something like something that is like that. it is very vague. and we shouldn't -- >> with the chairman yield on that? >> yes. >> the reason it is like that is for germane purposes. honestly, we couldn't say the

febp plan because that would not have been germane. >> i understand what he did. >> that's what we had to do to make it jermaine. >> it is germane, and now that it is germane to say congressional health care for all. but we don't have congressional health care. we are federal employees. and you make it sound like it's for the same thing as we are getting, but it is no certainty of that at all, and you strike in this amendment an option for a public plan. so we are objecting to it -- we would like to proceed to a vote that we have a lot of amendment. mr. barr says he is willing to vote let's go to the. all of those in favor of the amendment say imac. opposed. let's go to a roll call vote. [roll call]

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[roll call] [roll call] >> have all members and recorded to seek to be recorded? the clerk will give us the tally. >> mr. chairman, on that boat there were 28 ayes and 31 nose. >> and the amendment is defeated.

>> let me announce that from here on in, the amendment -- any amendments to division eight, b., or c. would be in order. we are no longer -- >> mr. chairman? >> i think mr. rush has an amendment first. >> thank you, mr. chairman. mr. chairman, we have three colloquies i would like to offer for the record in the interest of time. these are for amendments, 8001, 4002, and 7001. and i ask for unanimous consent to accept these into the record before offering my amendment. >> the clerk will report the

amendment. amendment. i'm sorry. mr. rush is asking unanimous consent to put the colloquies in the record. >> yes. >> without objection, so order. >> reserve a point of order. >> the point of order has been reserved. my understanding, and let me if i misunderstand, you can correct me. you have some colloquies that you are asking to put in the record and then we will go to your amendment. >> that is correct. >> is there an objection to the colloquy? i ask unanimous consent to have the colloquies put in the record. is there an objection to that? >> yes. >> the colloquies are already

part of the record because the woman is keeping track of whatever you speak about so what does that have to be part of the record? >> he doesn't want to have to read the colloquies, just asking that the colloquies be put in the record. and i would ask that we do that without objection. >> is it possible we could see the colloquies? >> yes, we can share that with you, certainly. why don't we do this, while we are sharing those, why don't we move to your amendment? >> i have an amendment that is -- >> the clerk will report the russian minute. >> unanimous consent that the amendment be considered as read. >> thank you, mr. chairman. mr. chairman, my amendment makes it a violation of the federal food, drug and act for brand name and generic drug firms to enter agreements selling patent

infringement claims, in some certain prescribed instances. this existing regulatory framework established by hatch-waxman created powerful incentives for making generic drugs to challenge brand names companies patents prior to their expiration. because these new generics threaten the patent, protect their profits of brand name companies, branding firms have responded by offering, and i quote, paid for delay celibates to generic firms. in doing so, it is their intention to safeguard their enormous profits and extend new generic versions to enter in the market. which would dramatically drive down the cost of these drugs.

my amendment will curb these eyebrow raising settlements, which makes allies of industry sector members when all other respects behave and should behave as arch competitors. earlier, entry by generics would save consumers billions of dollars. this will result in significant cost reduction and contain those costs associated with the health care reform package that we are now considering. the cbo has scored this amendment as saving for the federal government while protecting celibate agreements for patents infringement claims inconsideration received by the generic industry relates to marketing of new generic drug prior to the expiration of the patent.

this amendment protects against unfair and successive acts in an unfair method of competition under section five of the aft cca. mr. chairman, as requested by the minority and the subcommittee markup, this amendment will require the disclosure of these settlement agreements to the controlling -- comptroller general for purposes of completing gao study. my subcommittee, i held a hearing on the bill and passed it out of subcommittee on june 3 of this year. mr. chairman, i want to thank you and i ask that the committee vote in favor of this amendment and i yield to the vice chair of the subcommittee. >> this jackowski. >> thank you for using, and it thank you, mr. chairman.

the federal trade commission and state attorney general and consumers have raised many concerns about a process called paid to delay, which actually allows brand name drug companies effectively to pay generic drug companies to delay bringing generics to market. now, the cbo scored it, but also the federal trade commission economists think that this amendment will save about $35 billion over 10 years, reducing costs to individuals and families here so here's an example of how we can help consumers save money, and also passed something that is supported by many, many organizations and is a much more efficient way to do business in the pharmaceutical market.

and so i would say that this is really a win-win situation to change in this unfair rule that prevents consumers from getting access to generic drugs. it's a good way i guess for the pharmaceutical companies, both generics and the brand names companies, but while they collude with each other in a way consumers are really get the raw end of the deal. so we can save lots of money for consumers and do the right thing, and i would urge my colleagues to vote for it. >> the gentleman from illinois. >> mr. chairman, i just want to further say that this does, this practice that has been so significant in terms of rising cost of medicine care to all americans, and the passage of this amendment will bring a

screeching halt to this honor is an unhealthy and unwholesome relationship between generics and brand name pharmaceutical companies. mr. chairman, with that i doubt yield back the balance of my time. >> anyone who likes to be recognized on the minority side? >> mr. chairman? >> yes, the gentleman from california. >> i support the goals of trying to promote competition and lower drug prices i can't support the approach of this amendment or it is unprecedented for congress to intervene and litigation rights particularly when the federal regulars had the ability to challenge the settlements and court. also, i don't believe that the amendment will guarantee lower drug prices for consumers and could actually result in fewer patent challenges and less competition in the drug industry. there is no guarantee that the mmo will provide consumers with lower drug prices. in some cases early celibates have benefited consumers greatly

such as a case where barr labs brought a generic version of prozac to the market approximately two and a half years earlier than it would have because it was settled early and involve a cash payment. consumers saved between 1.5 and $2 billion according to a bar. if such settlement opinions were removed, the incentive for the generic companies may be reduced greatly when they are not overly confident of the strength of the patent challenge claim. reducing options will increase the risk to generic drug company of challenging a patent and failing. such an outcome would influence a decision to challenge additional drug patents and reduce the number of generics coming into market. this outcome will not benefit consumers. the ftc has challenged a number of the settlement, but has failed in a number of cases to convince course of their position. and as i stated in the subcommittee market, it is not for congress to did side the terms of litigation settlement when courts review the settlements and they does a problem. for these reasons i respectfully oppose the amendment and urge my

colleagues to vote no and i yield back. >> would you yield to me? >> yes. >> in terms of savings to consumers, the ftc's bureau of economics using conservatives assumptions has estimated that the cost to consumers of these pay for delay deals, the cost or lost savings is anyone from 35 to $70 billion over 10 years, at least 3.5-inch dollars annually. and there is bipartisan support at the federal trade commission, all the commissioners since 2000 have thought that this is a shabby, shoddy, anti-competitive behavior and that we should change it. so i salute mr. rush and all the cosponsors for offering this amendment, and salute the ftc for trying to ban this practice. and i really think we should adopt this amendment, and i appreciate you yielding to me. >> the gentleman from california to. >> mr. chairman, i yield back. >> yields back.

time has expired, so we will call the question. >> one point of order. >> point of order. >> oh, withdrew the point of order. thank you. >> all those in favor of the amendment by the gentleman from illinois. mr. rush, say i go. all those opposed say no. >> the ayes have it in the amendment is carried. let me say that mr. stern has reviewed mr. rush's colloquy, so at this time i would again ask unanimous consent that the colloquies from mr. rush be included in the record. without objection. so ordered. next, mr. stearns has an amended. >> yes, i do, mr. chairman. i think it is amendment one or a i n. s. .de c.

>> the clerk will report the amendment. >> sterns 20. >> it's the government planned bailout amendment 22 desch 001. doesn't help you? thanks. mr. chairman, we should probably give a great laudatory support to this staff who is tracking all this. >> the amendment is being distributed. the clerk report the amendment. >> the amendment to the

amendment offered by mr. stern added at the end of section -- >> unanimous consent that the amendment be considered as read. i would point out that we are willing to accept this amendment. >> good. >> i don't know if you want to think you. >> i will speak for about a minute. >> the gentleman is recognized. >> no bailouts the public health insurance option receive any federal funds for purpose of insolvency in any manner similar to the manner in which energy is received federal funding under the troubled asset relief program of the secretary of treasury. you know, this year medicare will report an $89 trillion unfunded liability and become insolvent in just eight years, in 2017. and if you go through all these federal programs, you can see that they are in financial extranets. so my point is wiped with a new

public policy in the same type of thing. so we should start again with my amendment, which says that public money will not be used to bail out this health care plan, and so i appreciate the majority accepting my amendment. and i think it is good for both parties to make this statement early on, and with that i yield back the balance of i can't. >> the gentleman yield back, and less there is further debate we will call the question. all those in favor say aye ko. all those opposed, they go. the ayes have it and the amendment is adopted. mr. stupak. >> thank you, mr. chairman. i have an amendment at the desk. it is two desch 001. >> the clerk will report the amendment. >> its unanimous consent that the amendment be considered as read. mr. stupak. >> thank you, mr. chairman.

mr. chairman, last night we were debating life issues, mr. pitt and i said we would offer for amendments every action offered in three. i offered one, he offered to. this is the fourth one. and this amendment goes correctly at the caps amendment which was approved by one or two votes here last night. and this really is the heidemann and. this is the hyde amendment being codified because the issue, and i believe that unless abortion is specifically excluded, the health benefits advisory committee and/or the secretary of health and human services, or if not them, then a court through a lawsuit brought by any abortion advocacy group will mandate coverage of abortion as an essential benefit. for example, when the federal medicaid statute was passed, nowhere in the statute did it say that abortion would be covered. by the administrators running the program deemed abortion to be covered. as the sixth circuit court of appeals explained, because abortion fits within many mandatory care categories, including family planning,

health patient services, inpatient services and physician services, medicaid covered medically necessary abortions between 1973 and 1976. as we all know back in 1973 in 1976, congressman jim oberstar and henry hyde put together the hyde language. since that time, since 1976, it has been part of our law, but we have to renew it every year in the appropriation bills. so as we take a look at it, and in the cast language last night, when we amended, we said abortion is neither required nor prohibited. that means the legislation is silent on it, therefore if the administrator isn't going tocomment in the courts can interpret it as we can see from the sixth circuit court of appeals. so the caps amendment, as we have in this bill now, does not include any restriction under use of federal subsidies to pay for health insurance that covers abortion on demand, and because the bill authorizes and appropriates the funding for

these subsidies, there is no need for congress to pass future appropriation riders like the heidemann and. the caps amendment that was approved last night is really an end run on the hyde amendment. we must get the hyde amendment language back into this bill right here and now or we will be looking at massive subsidies for abortion. and that is without even talking about the funding of abortions through medicaid and the public plan. so it is really critical we pass this amendment. and i would yield to mr. pitts. i have two minutes left? >> yes. >> thanks, mr. chairman. this bill will provide massive subsidies for plans that cover abortion, including the public plan. the amendment we don't with last night had to do with mandates. this has to do with subsidies or funny. once again, we need only look to history to give evidence to this fact. under medicaid and federal funding for abortion was mandated by the courts. and as a result, the taxpayers

funded over 300,000 abortions per year between 1973 and 1976 when the hyde amendment was passed. before it was passed. it is for this reason that statutory exclusions have been necessary in programs like schip, and the federal employees health benefits plan, the dod and indian health bills. now some of our colleagues have talked about the status quo. in these plans, the status quo is no federal funding for plans that include abortion. the caps amendment last night repudiates this long-standing federal policy, and instead it established what i would call an accounting gimmick. instead of creating a -- it created a bookkeeping measure to create the illusion of a prohibition of taxpayer support for abortion. this amendment actually prohibits public funds from being used to subsidize plans that cover abortions. the amendment before us will

correct these negative effects of the caps amendment. moreover, the caps amendment is dependent on annual re- approval of the hyde amendment. the health care bill of such massive proportions should have permanent language clarifying that taxpayer dollars will not be used to subsidize abortion. if there is any doubt about intentions to attack annual provisions, like the hyde amendment, my colleagues need only remember the dornan amendment which was just gutted this month in the dc appropriations bill. the amendment will have no impact on the legality or illegality of abortion. it is about what the government chooses to subsidize. so the issue here isn't the. americans should not be forced to have their tax dollars pay for plans that include abortions. and that is 71% of the public, according to the recent polls. 71% of americans do not support public funding for abortion.

and when asked about whether taxpayer funds would go to pay for abortions, the budget director, heater or zag, state i am not appear to rule it out. so this memo would simply protect taxpayers from being forced to finance the distraction of human life against gore will i definitely ruling out taxpayer funding of plans that include abortion. and i urge support. >> the gentleman's time is expired. ms. degette. >> thank you very much, mr. chairman. let me try to say this extremely clearly. this legislation and the caps amendment which we passed last night prohibit the use of any and all public funds for abortions, except as specified in the hyde amendment. what this amendment does is it expands the hyde amendment in ways never contemplated before. it puts the hyde restrictions

into statute for the first time, but more disturbingly, it applies the hyde amendment even to the private plan, even to private funds that are used in the private plans. this has never been done before. and it would in essence restrict health insurance plans, private or public, all around the country from offering a medical procedure which, as of today's date, is a legal medical procedure. under current law, women can use their own private funds to choose private insurance that covers abortion services. and this amendment would completely wipe this out. it would restrict private citizens from using their own private funds to purchase private insurance that covers healthcare services from plans that also accept public funds. >> would you yield on that, please? >> in a moment.

in the capps amendment, weakley said, and this is passed as part of the amendment, no public funds would be used for the abortions. the capps amendment also says that every american will be able to choose a health insurance plan that provides no abortion coverage. so someone is not going to be forced to enroll in an insurance plan that will -- that will cover abortions except as specified by the hyde amendment. and so i think it's a very reasonable -- i would just note as i noted last night, again, we just passed the labor hhs bill which included the hyde amendment again. the president has not issued a veto threat. no one is talking about taking that language out. what we need to do today is preserved the status quo and give a quality health care to every american, not to make this

a debate, about a false issue, about expansion of abortion which is not to. i will yield to mr. caps and then if i have time i will yield to you, mr. stupak. >> and asked it i would like to ask the author of this amendment a question about people today, many in this room who have private health insuranceplans, many of which have abortion services as part of the. under this amendment, those plans -- like insurance policy would be null and void. is this correct? >> no. >> would you explain why? >> no fun to authorize may be used for abortion or to cover any part of cost of any health plan that includes abortion. smack my health plan include abortion. could i ask counsel. >> if you could repeat the question, i'm sorry. >> the question is, my health insurance policy debate or anyone's in this room, private health insurance policy, if it

includes abortion services as a reproductive service that allow for abortion using private funds, will this amendment, if it is part of our bill prevent that? >> as i understand the question you're asking, whether the febp program, which i think all of us are under -- >> remove it from that and. anyone anyone. not just federal employees. >> as i understand it, this amendment would affect the plans in the exchange. >> but my plan may go into the exchange. >> and if that is true, then it would not allow any -- >> what i would would like to reclaim my time, and i would like to ask mr. stupak the question. any plan in the exchange which takes money from the subsidies could not use private funds in that plan, whether the plan is

public or private, to provide abortions. >> if it receives subsidies. is public funds. >> then they could not use private funds to do abortions, correct? yes or no? correct? >> if you take a subsidy, public subsidy? -- >> correct. >> you could not use -- >> council, is that cracked? >> yes, ma'am. >> idea backed. >> i would like us to go to a vote on his. >> mr. chairman, can i ask questions of counsel to follow-up on that? >> the gentleman is recognized. >> we still have five minutes if we want to use a. >> i haven't used any time. >> you have a usual five minutes at all? i'm sorry. please, the gentleman from pennsylvania is recognized. >> i would like to ask counsel, could federal dollars under this legislation subsidized plans that include abortions?

>> as amended by the capps amendment adopted last night, yes. >> question too, is there any existing federal health subsidy that funds plans that include abortion, other than those permitted in the case of a rape, incest, or life of the mother? >> i -- forgive me, i'm trying to go through a quick inventory of federal plans. the febp plan does not. the indian health service does not. the medicaid program, although it does not allow federal funds to be spent for abortion services, allows states to use their funds to pay for abortion services, and i believe at this .17 states do so. >> and what about indian health?

and dod? >> neither febp or indian health currently allows abortion services with federal funds. >> so this is a new policy with regard to federal funding? this would expand federal funding with respect to plans that cover abortions. >> it would -- i'm sorry, sir, the way the question is phrased i have trouble answering it directly. the capps amendment as passed last night allows -- allows plans that pay for abortions, but it does not allow federal funds to be used to pay for those abortions. >> i understand the accounting gimmick. the capps amendment changes the status quo by gutting the current pro-life policy with the scheme which plans that cover abortion may receive taxpayer

funding. i will yield to mr. terry. >> thank you. the issue here is that under the exchange with the private insurance, and of course, with a government run public plan, the people that enter into the exchange, many of them will be eligible for a government subsidy, some up to 100% of the policy costs, others not at 100%, but you cannot deny that those are government funds going into and paying for a plan, of which are then depending mandates within the caps amendment, would go towards the cost of an abortion. you can say that there is a wall between them, but the reality is, money is fungible. you have to admit that if there's public dollars going in there, whether you create a fictitious wall, the fungibility

of the dollars will subsidize the abortions regardless. and that is our concern here, is that we prevent that taxpayer dollars going from in there. so we can't stop what a state does or what an individual does here, but we can't stop the taxpayer dollars from subsidizing the exchange and the public plan. i will yield back to mr. pitts. >> thank you. reclaiming my time. just to respond to what mr. caps said. nothing in the amendment says anything about this allowing voluntary offered coverage or to sedley says the government can't mandate abortion coverage. and if private plans want to cover abortion, the amendment doesn't stop that. what it stops is what we tried to do is stop the mandate to force abortion, every insurance plan in the country. and the question really is whether the secretary or the advisory committee or the

commissioner can at some point mandate the plans cover abortion. and if that's not their intent, this amendment should pass. >> would you yield? >> i will yield to the gentleman. >> mr. pitts. >> thanks for giving. she asked about her plantar coverage, that is a private plan. that is not receiving any subsidy money. this is a heideman and. that is what this amendment is. it says no public funds for abortion. that's really the question that we have before us. therefore, i urge all members to vote in favor of this amendment. >> appear. >> just to thank my colleagues and my colleague and friend from michigan for his stand and i look forward to supporting his amendment. >> mr. chairman? >> ms. harman. >> thank you. >> we have been trying to operate five on each side. we had five on each side so far.

>> this is a critical debate, mr. chairman. >> it is critical so i will recognize you and if you will yield to others. >> i will yield to mr. doyle. just very quickly. i recognize how personal this subject is too everybody sitting here. and most of us are parents and those of us who are mothers and have daughters, have really struggled with this overhears. but here's my point. and i would like to ask us to counsel. the comment though on the other side we are talking about federal dollars subsidizing plans. my understanding is that federal dollars subsidized parts of premiums for individual people, is that correct? >> yes. >> who then purchase plans. >> yes, ma'am. >> so generalizing it to the whole plan i think is somewhat misleading. do you agree?

>> i -- >> well, my personal view is it is somewhat misleading. second, is it true, counsel, that many private plans that many people purchase, including people sitting in this room, include abortion services? is that true? >> it is my understanding that 86% of private plans now. >> eighty-six or send a private plans and they wouldn't include services and less people were interested. and people use their private dollars, or they use dollars from employers for which there is a tax-deductible purchase those plans, is that correct? >> yes, ma'am. >> well, i believe that i will yield to mr. doyle that the intent of the capps amendment, which i thought was very carefully crafted, was to give people a sickly the same options they have no to use private dollars to purchase abortion services, if they choose, in plans that they choose that have abortion services. is that correct? is that the intent of the capps

amendment? >> that is the effect of the capps amendment. >> i will yield to mr. donald. >> thank you. i want to make sure i understand the pitts a minute. if a plan wants to offer abortion services, and that plan accepts one customer that is subsidized, you know, once it takes that first subsidize customer, is that planned in precluded from offering abortion, even if they have private pay customers? or are they just excluding the subsidize people ask if someone comes into a plan and they are not subsidize, it is all their money -- >> if i may, i think they understand the question. i think it goes in reverse. that the plan may not accept any person with a subsidy, if that plan offers abortion services. >> so that they plan wants to offer abortion services, it can accept nobody in the plan that subsidize? >> yes, sir. >> even if that person is tempers and subsidize and 90% of their own money, that person is

precluded from entering that plan because of that plan offers abortion services. >> yes, sir. >> and one last question. again, i just want to say this once more. is there any way possible, in any circumstance, under any loophole, under any condition, that anybody under the capps amendment that was adopted yesterday can use public funds to pay for abortion? >> not legally. no, sir. >> with the gentleman yield? >> i think it is my time. >> thank you very much. this amendment is unnecessary because of the adoption of the capps amendment yesterday. but i'm afraid if this is adopted it will have a very serious consequence of interfering with individuals and families choice of their own insurance coverage, in which medical services that they need. that decision is rightfully left to the individual, or to that

family. now i understand and i respect that some in congress do not agree with the current status of law, that certain women's medical services are legal, but they are legal in america. and because certain medical services are legal, the appropriate course is to trust and leave it up to the individual or to the family to choose their medical care, to choose their doctor, to choose their insurance coverage. it is not appropriate for the members of congress who disagree with the law to intervene. it is important ultimately to ensure consistency and stability and health insurance options, and not restrict access to certain legal medical services because members of congress disagree. we should not disagree with that doctor patient relationship, and a person's choice of insurance coverage. i yield back. >> think of it and i yield back my time, mr. chairman.

>> the gentle lady yields better time. let's proceed to the vote. let's call the roll because i know we will get there. [roll call] [roll call] [roll call] [roll call]

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[roll call] [roll call] >> have all members responded to the call of the roll? mr. gordon? >> any member wish to change his

or her vote? the clerk will tally the vote. >> is the clerk ready to announce the vote? >> mr. chairman? >> yes. >> i would like to change my vote to unknow. nay. >> the clerk will announce the vote. >> the ayes were twice seven and

the nays were 31. >> the amendment is not agree to. mr. chairman? >> mr. radanovich, do you have an amendment? >> yes, sir. my due. amendment number 22 at the desk. . .

offering and to see, a qualified health benefit plan to the health insurance exchange.

one, finance all startup cost to the option by loans secured to non-government, non-governmental lending institutions that any assistance from any other government agency except to the same extent that such financing for assistance from a governmental entity would be available to other kube hpv authoring entities. two, statement of state premium taxes. three, payment of state and local property taxes. for, payment of the market rates for all of building equipment and services that. >> without objection the amendment will be considered and the gentlemanç from californias recognized. >> this amendment will ensure that government plan to compete

on a level playing field with private health plans by making it made the same requirements. according to the independent island group, underç this bill coverage under private insurance would declineç by 83 million people, this is a 40% reduction in the number ofç people with private insurance year despite its supporters' claims it's abundantly clear that the government plan can't compete on a level playing field with a private plans. the private insurance market will be destroyed. americans access to their current health plans will be destroyed along with that, with the inclusion of this government plan the president of rights is promised to americans who want to keep their current health insurance. the government plan will not face a premium and property taxes, will not be subject to lawsuits, will not be forced to abide by state financial stability requirements and not pay market rates to doctors and hospitals for their services. these are just some of the advantages. specifically my amendment

requires the government plan to do the following -- finance all startup costs by loan secured the non-governmental lending institutions without any assistance from other government agency, pay premium taxes, pay market rates for all buildings, equipment and services, receive no access to any special data and other government agencies, it cannot except funds from the u.s. treasury or any other government agency and lost those are available to all private-sector health insurance companies, mostly financed the cause of all employees, pay the u.s. treasury and the states and the state the brady close to what the state of federal corporate taxes would be, the subject to lawsuits, pay market rates to providers, and i can't force doctors and hospitals to sell public plans as a condition for participating in medicare. this amendment is not offered to protect health insurance companies for republicans agree that they need to be held

accountable. instead this amendment is offered to save america's ability to continue to access their current health insurance if they want to do so. our president, our speaker and a distinguished colleagues have repeatedly stated intention of the public plan is to provide competition. if that is to the gold and thus ensure that the planned sale this fair two all competitors. >> the gentleman yield back this time. mr. murphy recognize for five minutes. >> thank you mr. chairman. again to rebut the notion that began option is going to destroy private health care insurance, you have very little of a thing your constituents. if you believe that that a public plan that only gets enrollees by people choosing to

join it, that only gives providers by providers choosing to participate is going to destroy private health care insurance. and the fact is as a have said before over and over cbo has looked at this, has determined that that though there will be a certain number of people who will go into the public plan potentially 910 million people, that it will only represent a smaller share of the overall number of individuals who are receiving coverage and, in fact, -- >> will the gentleman yield? >> let me say, i will be glad to yield, let me finish my thought -- over of a number in private insurance actually increase over the course of the 10 years of this bill. i'd be glad to yield but let me make a specific point to your amendment and that is the requirement that the public plan would place a premium taxes. a i think that provision in particular is particularly wrong

headed because as a nonprofit health care provider which is essentially what we are attempting to create a public plan is two frankly be treated like most other nonprofit health care providers are treated. in 24 states across blue shield don't pay premium taxes, medicare event his plans to dump a premium taxes, nonprofit health care insurance companies in the states are not required to pay premium taxes so by requiring that the public plan has to pay premium taxes to actually sat in on a novel plan to with respect to the major insurers in assays which is blue cross blue shield so on that particular point -- >> if the gentleman will yield. >> i'm just wanted to provide a level playing field between the public and government health care plan and i am assuming that you would agree that there ought to be in a level playing field between the of plans. >> reclaiming my time. >> would you yield?

>> reclaim my time by requiring that this plan. say opinion taxes when other nonprofit health care plans including the biggest -- >> there is a long list of other things required. >> i'm making a specific point in that particular incidence very consciously on level the playing field he met mr. villone. >> i and sustanon went to the authors of this amendment are trying to do take them in good faith and try to level the playing field, i think we all agree that we have to have a level playing field but the problem is you have to be careful about exactly how you do that and mr. murphy is talking pointing out with say premium taxes to go the other way because blue cross and some of the other nonprofits don't have that analysis of the same thing with regard to this provision that says finance all startup costs by the unsecured and food

non-governmental lending institutions without any assistance. some federal funds for startup that they have to be paid back into understand that initially following the private insurance plans which have been around for years and have been operating, the public plan is starting from scratch. and it is going to have to have some startup costs and to say that it has to go out and get these loans that are going to be difficult and can use federal funds even for that, this is going beyond, this is in my opinion an effort to basically announcing intentionally, to cripple the public plan from the beginning and add nothing that's fair. we have a good idea of competition between public and private. we have a level playing field in the bill and this amendment goes beyond and makes it virtually impossible for it to be given started out here, i think that is not fair and as against the basic grain and we should oppose it.

i yield back. >> would you yield to last 30 seconds? >> thank you mr. murphy. two? statements, when we had cdl in front of us i ask them specifically on the chemistry of costs if they captivated any of these things and they said they did not. and i think when we look at whether they are getting the advantage on the administrative costs is important about whether it is a level playing field because there are a lot of insurance companies paying about all of these items listed at least some of them. the issue about the intelligence of our constituents yes we respect that, that is why they are the same project and one is artificially lower cost the same thing they will take a lower cost which is a public auction. >> the gentleman's time is expired, let's proceed to a vote. all those in favor of the radanovich amendment will say ayes. opposed nos.

this nos have a. >> mr. chairman, i ask for a recorded vote. >> the clerk will call the roll. >> [roll call] >> [roll call] >> [roll call] >> [roll call]

>> [roll call] >> [roll call] >> [roll call] >> [roll call]

>> [roll call] >> [roll call] >> [roll call] >> [roll call] >> [roll call]

>> [roll call] >> [roll call] >> [roll call] >> [roll call]

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>> [roll call] [inaudible conversations] all members have responded to the role, nobody wishes to change a vote, the clerk will tally the votes. in announcing its parent. mr. chairman, on that vote there were 23 ayes and 32 nos. >> the amendment is not agreed to. this matsui, you have an amendment?

>> yes mr. chairman, i have amendment at the desk, matsui six -- 002. >> [inaudible conversations] >> the clerk will report the amendment. >> amendment to the amendment in the nature of substitutes a chair 3200 opera by ms. matsui of california. >> without objection of the amendment will be considered as read, the gentle lady from california will be recognized for five minutes. >> mr. chairman, the eminence and offering is one that's critically important to medicaid beneficiaries across our country and medicare managed care plans. since 1991, states have had the federal authority to tax

medicaid managed-care plans in order to generate revenue for the medicaid programs. eight states have realized taxing authority to expand medicaid eligibility to increase medicaid reimbursement rates to providers and strengthen cared for the nation. unfortunately that deficit reduction after the loss of five limited the ability of the states to generate money for the medicaid programs by taxing it managed care organizations. when congress changed the authority to recognize the negative attacks this would have had on medicare beneficiaries and the impact states. as a result, congress delay the advance of this provision for those days until october of this year on a person of october california and several other states with the same thing available dollars jobs by $2.7 million. when congress last active at the body on this issue now one could have predicted that the immense

physical prices which would hit our states. and our home state of california are governor signed a budget this week that cuts more than $1 billion from medicaid. it said t.r. a provision on medicaid managed care is allowed to take a rise in october almost half of the billion additional dollars will be lost in california's medicaid program this year alone. now in georgia $253 million was taken unless we act. in a high of $242 million medicaid dollars are at risk. medicaid beneficiaries in the state's and across our country are already faced with serious service reductions that will lower the cost -- efficiency of health care they receive. chemical the gentle lady yield? >> yes please. >> mine leader who is left us for eminence, and of this is an amendment that very positively impact the state of michigan. in with his absence we are ready

to and willing to accept its. [laughter] >> thank you para i appreciate him i don't tell him i said so but he signed off. >> that's good, thank you, let's do appear in. >> all those in favor of the mets three amendment say i. opposed now period of the eyes have it, the amendment is agreed to. >> who is our next democrat practice [inaudible conversations] mr. boyer, you have an amendment? >> i do. i have a three amendments and i asked that they all be considered in block. one would-be boyer number 142. the other would be -- i think it

is 142b, do have that won? and the other is 002 in the other is 004. [inaudible conversations] >> mr. chairman, can i reserve reports of order. king that the gentleman from new jersey reserves a point of order. >> [inaudible conversations] >> if the gentleman would permit, we are being told by our staff we have another chance to read them yet, and why don't we take them up and reserve the question of unblocking them, but i don't know why i wouldn't, but

let's just don't bother to read what i suspend, put them in and block form and ledger sat take a look at them and i'd be more than happy to speak with them and lead to -- i will suspend the offering of those amendments until i working out with chairman. >> thank you. [inaudible conversations] mr. wiener. [inaudible conversations]

[inaudible conversations] the chair recognizes and eshoo from california, do you have an amendment at the desk? >> i do, the amendments at the desk is members 001 eshoo. >> without objection the amendment will be considered as read and the gentle lady is recognized to explain her amendment can i thank you mr. chairman. i'm very pleased to offer this amendment which is really the

culmination of nearly three years of work to create a regulatory path way before fda approval of by a similar or follow on biologics. i know that this is an issue which you also cared deeply about mr. chairman, and while we have different views on some of the details of our legislative approaches we both share the same goal of bringing new competition and lower prices to the biotechnology sector. along with representatives inslee and the ranking member of this committee mr. barton, early this year we introduced the pathway for by a similar site which now has 142 bipartisan co-sponsors. this bill today mirrors the by a similar legislation introduced as an amendment in the senate's health care bill. the amendment to the overwhelming support of the health committee --

>> with a gentle lady yield? i know our side is prepared to accept this. mcginnis read things along a little bits. >> i think i appreciate that and i am as anxious as you are to take the but. i do think that three years of work where it's at least two minutes of remarks speak as the legislation does have complexity so i would like to do it as quickly as i can. the senate health committee produced a one of the f-16 to seven on the legislation, chairman edward kennedy cast his vote in absentia and have the legislation is scheduled to save $9 billion according to the cbo over 10 years. we have john on the senate health amendment to incorporate provisions related to the

approval process and the issue of that exclusivity. it also included in our amendment that passed a resolution provisions of the bill which we believe will protect the rights of all parties and insure that all patent disputes involving the biosimilars are resolved very importantly my colleagues before the expiration of the data exclusivity. i am going to summarize since members are anxious to take a but. i think that this amendment sets forth is a foreign scientifically based process for expedited approval of biologics base and innovative products already on the market. insures that patients again safe and effective treatments, that there are subjected to thorough scrutiny and testing by the fda, that the bill provides for the promotion of competition and the lowering the price this year, i think that those are more than

were the most. i impanel of the post -- co-sponsors of on a bipartisan basis, to thank everyone and you that have worked on and went to ask my colleagues for their support for this historic pathway and the approval of biosimilars, i'd be happy to yield to this christensen and mr. kinsley and have a minute and a half left. >> on be very brief, it is one to speak in support of this amendment. it is important that there will be in the process established for biosimilars and one that ensures safety for the patients come in is a very complex molecules and evade -- the provisions in your bill ensure that when in the biosimilars and on biologic is a proven that it has gone through is a vision path by and that it is time to lay a similar drug with a

similar impact in the facts on the patience and i thank you for the imminent and am pleased to support it. >> thank you, mr. inslee and then 10 seconds for mr. steve packin mack there are some money, eric lundberg is this grandson of the case, he was better and in doing to that room to an arthritis and then invested about a billion dollars to build a product called embryo, he is now up walking iran is a successful artist and his life has been restored because we have laws that allow investors to put a billion dollar investment that eventually did incredible creativity to save his life. that is the guy i'm thinking of when i'm voting on this that does create to the inappropriate balance of protecting investors and investment and moving forward and i think this is the right balance, thank you. >> remaining two seconds, i want to compliment the gentle lady on this amendment, she's worked

long and hard on it for three years and a mention how to tell people and help people out of artistic. of this is a good amendment and i want to compliment you on your work. >> i think the gentleman he made the chair recognizes himself and i'll yield to others if they wish me to. and other members of this committee supports creation of the biosimilars pass by. and now they believe in will bring competition and reduce the high price of biologics. i endorse that. but i strongly believe that the adoption of this amendment is exactly the wrong way to achieve increased competition and lower prices. down nor will it enhance innovation. this amendment is actually giving a monopoly time, 12 years and then allows those times to be extended indefinitely, the so-called evergreen problem. the evidence is overwhelming that these over in the monopolies will create huge obstacles to competition coming

to those who want competition in the biologics market, i refer people to a letter from the ceos of the 28 major generic drug companies. they say monopolies with this long and unpredictable time will not, they will not even enter the via -- biosimilars market because there's no economic incentive for them to do it. two those who norcross -- lower costs, look to what appears and the patients' group. coalition of consumer groups, unions, businesses and state and private payers promise -- strong oppose this amendment because it will rob us of the opportunity to achieve significant cost savings for patience and pares. two those who think this is fun to bring innovation look at the report from the federal trade