mr. speaker , i thank the gentleman from new jersey for his leadership on this . 
this is a bad bill , mr. speaker , for many reasons . 
i want to focus on one of them , which is that this bill will strip away the consumer protections and the patient protections that exist under state law for our constituents today . 
i understand that we have 50 states , and in those 50 states many of them have different mandates for what has to be covered and what does not have to be covered , and there is some sense when you are talking about organizations operating across state lines that you would streamline that effort . 
that is exactly what the gentleman from massachusetts ( mr. tierney ) xz4004070 and i tried to do when we took an amendment the other day to the rules committee . 
we said , let us look at six patients ' rights that have been agreed to on a bipartisan basis by this congress in previous legislation and which are overwhelmingly agreed to in our states , and let us say with respect to those six rights , you ca n't take that right away from one of our constituents , one of our patients , one of our consumers if you are an associated health plan . 
what happened to that amendment ? 
we did not even get to hear it or vote on it in this house . 
what are we afraid of ? 
what were those six provisions that we wanted to make sure all our constituents , all our consumers , were protected by ? 
the right to an independent external review of coverage decisions . 
forty-three states have this rule already . 
it says if you disagree with your insurance company as to whether or not you are covered , let us not ask the insurance company who is right and who is wrong , let us have an independent individual who can make that decision . 
does that make sense ? 
most of our constituents think they will have that right . 
if you pass this legislation and if you are in an ahp , you are not going to get it . 
second , direct access to obstetric , gynecological , or pediatric services . 
you do not have to wait in line before you take your child to see the pediatrician . 
third , imposition of prudent layperson decision-making standards . 
if you show up at the hospital , and you have a good faith reason for thinking you are sick , and it turns out you did not have a heart attack , but you went thinking you had one and you had good reason to think so , your insurance company can not deny you coverage for that visit . 
you do not have to be the doctor . 
that is why we have doctors . 
use of drug formularies , access to hospital emergency room treatment , 42 states have this requirement ; and making sure that we do not restrict the ability of our doctors to give us their opinions , to make sure that those states where they say you can not have a gag rule , where your physician can tell you , the patient , what he or she thinks is in your best medical interest , they can not be punished by the insurance company for telling you the truth . 
these are common-sense provisions , six common-sense provisions . 
that is what our amendment would have done . 
it would have made this piece of legislation stronger and protected our constituents . 
what happened ? 
we did not even allow a vote on that . 
i would just like to quote from 42 state attorneys general , republicans and democrats , who say , `` consumers rightfully expect their states to protect them from fraud and abuse . 
elimination of the state role and replacement with weak federal oversight is a bad deal for small businesses and for consumers. '' those are state attorneys general , republican and democrat , who , like us , are trying to look out for the consumer interest . 
do not pass this bill . 
if you do , you are going to have a lot of explaining to do to your constituents when they are denied by their insurance companies coverage that they thought they rightfully had . 
