[Congressional Record Volume 140, Number 133 (Wednesday, September 21, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: September 21, 1994]



          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. DANFORTH (for himself, Mr. Boren, Mr. Wallop, Mr. Pryor, 
        Mr. Grassley, Mr. Baucus, Mr. Chafee, Mr. Riegle, Mr. Roth, Mr. 
        Daschle, and Mr. Breaux):
  S. 2445. A bill to amend the Internal Revenue Code of 1986 to limit 
the applicability of the generation-skipping transfer tax; to the 
Committee on Finance.


            the generation-skipping transfer tax act of 1994

 Mr. DANFORTH. Mr. President, I am pleased to join with my 
colleagues, Senators Boren, Wallop, Pryor, Grassley, Baucus, Chafee, 
Riegle, Roth, Daschle, and Breaux, to introduce a bill to correct minor 
flaws in the generation-skipping transfer tax [GSTT] law which we 
believe were unintentionally overlooked by Congress at the time of 
enactment and subsequent amendment.
  Every year the need for charitable services seems to increase. Thus, 
it is imperative that the tax law not discourage charitable giving 
unless absolutely necessary to advance other goals of tax policy. 
Unfortunately, a needless disincentive to charitable giving exists in a 
part of the generation-skipping transfer tax law.
  The principle behind the GSTT is to ensure that Federal tax is not 
avoided when property is enjoyed and then transferred from one 
generation to others. Current law provides that GSTT is imposed on 
gifts or bequests from, for example, grandparents to grandchildren. 
However, a grandchild may move-up a generational level if the 
grandchild's parent predeceases the grandchild. Thus, the gift or 
bequest would not be subject to the GSTT. This move-up exception is 
extremely important because the combined application of the GSTT and 
estate or gift tax is severe: an effective tax rate of almost 80 
percent.
  Unfortunately, the exception is not extended to transfers to 
collateral descendants even though there is no tax avoidance purpose. 
Thus, the law discriminates against gifts or bequests to grandnieces 
and grandnephews, even when the grandparent has no living lineal 
descendants.
  In addition, under current law a gift or bequest transferred through 
a trust, that provides income to a charity and then distributes the 
trust property to a grandchild, would be taxable under the GSTT 
provisions. Congress has recognized that such trusts are a desirable 
mechanism to encourage transfers to charities. Thus, the GSTT should 
not produce dramatically different results based upon the manner in 
which the transferor chooses to benefit the charity.
  Our bill focuses on the so-called move-up exception. The changes we 
propose would apply to terminations, distributions and transfers 
occurring after the bill's enactment. These terminations, 
distributions, and transfers are those which would be generation-
skipping transfers and subject to the GSTT except for the application 
of the move-up exception as amended by this legislation.
  First, we propose that the move-up exception include collateral 
descendants, such as grandnieces and grandnephews. Thus, gifts or 
bequests to such descendants would not be subject to the GSTT.
  Second, we propose that the move-up exception include certain 
transfers to trusts. Despite Congress' clear intention in the 1986 GSTT 
amendments to make the application of the law uniform regardless of how 
property is transferred, the move-up exception is limited to direct 
gifts and bequests only, and is not available for transfers through a 
trust. We are particularly concerned that this has the effect of 
strongly discouraging individuals whose direct gifts or bequests would 
otherwise be covered by the move-up exception from establishing a 
charitable trust before distributing property to family members. Such 
trusts are important sources of support for many types of charities.
  In addition to widespread constituent support for our bill, the 
administration stated that the legislation is fully consistent with the 
purpose of the predeceased parent exclusion. Indeed, the provisions of 
this bill were raised during a hearing in the Subcommittee on Select 
Revenue Measures of the Ways and Means Committee. It was one of four 
proposals that the Treasury Department did not oppose and that Members 
seemed to receive favorably.
  Moreover, the changes we propose have been recommended as worthwhile 
technical corrections by members of the real property, probate, and 
trust law section of the American Bar Association.
  Mr. President, I urge my fellow Senators to support this bill. A 
companion bill, H.R. 4326, was introduced in the House of 
Representatives on May 3, 1994, by Congressman Brewster from Oklahoma 
with Congressmen Houghton, Gephardt, Shaw, and Kopetski as well. We 
welcome other Senators as cosponsors of this bill.
                                 ______

      By Mr. FEINGOLD:
  S. 2449. A bill to modify the estate recovery provisions of the 
Medicaid Program to give States the option to recover the costs of home 
and community-based services for individuals over age 55, and for other 
purposes; to the Committee on Finance.


       MEDICAID PROGRAM ESTATE RECOVERY MODIFICATION ACT OF 1994

 Mr. FEINGOLD. Mr. President, I am pleased to introduce 
legislation today to eliminate the current mandate on states to place 
liens on the homes and estates of older Medicaid beneficiaries 
receiving home and community long-term care services, and to provide 
more than adequate funding for that change by establishing a 
certificate of need process to regulate the growth of federally funded 
nursing home beds.
  Altogether, according to the Congressional Budget Office, the measure 
should generate $365 million in savings over the next 5 years.
  As part of last year's Omnibus Budget Reconciliation Act of 1993 
[OBRA 93], language was included relating to States recovering Medicaid 
payments from the estates of beneficiaries, for certain services to 
people over age 55. The Health Care Finance Administration has 
interpreted OBRA 93 to mandate the recovery of, among other things, 
home and community based long-term care services and related hospital 
and prescription drug services. Unless changed, States will have no 
alternative but to implement the mandate.
  In the past, States have had the option of recovering payments for 
those services from the estates of beneficiaries, but in some cases, at 
least, have chosen not to do so.
  Mr. President, in Wisconsin, estate recovery for home and community-
based long-term care services was implemented briefly in 1991, but was 
terminated because of the outcry of caseworkers and consumers. In fact 
the Coalition of Wisconsin Aging Groups documented cases of consumers 
refusing community-based care because of their fear of estate recovery 
or the placement of a lien on their homes.
  As the coalition has pointed out, the resulting lack of long-term 
care could have led to earlier and more costly need for institutional 
care. The State opted to implement estate recovery only on nursing home 
care and related services, where, as a practical matter, the potential 
for estate recovery and liens on homes are much less of a barrier to 
services.
  Indeed, just as we should provide financial incentives to individuals 
to use more cost-effective care, so too should we consider financial 
disincentives for more costly alternatives. A recent study in Wisconsin 
showed that two Medicaid waiver programs saved $17.6 million in 1992 by 
providing home and community-based alternatives to institutional care. 
In that context, including the more expensive institutional care 
alternatives in the estate recovery mandate makes good sense, and my 
legislation would not change that portion of the law.

  Mr. President, the proposed estate recovery for home and community 
care stemming from OBRA 93 is particularly troubling with the prospect 
of a home and community-based long-term care program outside of 
Medicaid--one which will not require liens and other disincentives to 
care. The Clinton plan, or any plan like it, can provide similar home 
and community services, possibly even more flexible and consumer 
oriented services, than the Medicaid alternatives without the need to 
sign one's house away. If the estate recovery language of OBRA 93 is 
not clarified, we could have a dual system of home and community care, 
one providing services without a lien on one's property, the other 
imposing them. In fact, because Medicaid is targeted at those with 
lowest income and assets, it will be the disabled poor who will have 
liens on their homes, while those who are better off, and under the new 
benefit, will not be so restricted.
  The prospect of estate recovery requirements is not a happy one for 
program administrators either. States, counties, and nonprofit 
agencies, administrators of Medicaid services, are ill-equipped to be 
real estate agents. And there were no provisions included in OBRA 93 to 
provide the additional funding necessary to administer such a program.
  Divestment concerns, already a problem, will continue to grow as 
pressure to utilize existing loopholes increases. Worse, as the 
coalition has pointed out, children who feel ``entitled to 
inheritance'' might force transfers, constituting elder abuse in some 
cases.
  Finally, Mr. President, there is a very real question of age 
discrimination with the estate recovery provisions of OBRA 93. Only 
individuals over age 55 are subject to estate recovery. Such age-based 
distinctions border on age discrimination and ought to be minimized.
  All in all, the estate recovery provisions of OBRA 93, as interpreted 
by HCFA, will generate little additional revenue, is likely to produce 
more expensive utilization of Medicaid services, will cause an 
administrative nightmare for State and local government, will aggravate 
the divestment problem, may result in increased elder abuse, and could 
well be age discrimination.
  The proposed legislation modifies the estate recovery provisions of 
OBRA 93 to clarify that States may pursue recovery of the cost of 
Medicaid home and community-based long-term care services from the 
estates of beneficiaries, but that States are not required to do so.
  Though many long-term care experts maintain that mandating estates 
recovery for home and community-based long-term care services will only 
lead to increased utilization of more expensive institutional 
alternatives, and thus increased cost to Federal taxpayers, my proposal 
has been officially scored as a revenue loss of $20 million in the 
first year and $260 million over 5 years.
  Given the continuing need to lower our Federal budget deficit, I feel 
strongly that we should fully fund any proposed major expenditure, and 
to that end, I have included language which will produce more than 
enough savings to offset the change to the Medicaid estate recovery 
provisions.
  That provision regulates the growth in the number of nursing home 
beds eligible for Federal funding through Medicaid, Medicare, or other 
Federal programs by requiring providers to obtain a certificate of need 
[CON] to operate additional beds. For any specified area, States would 
issue a CON only if the ratio of the number of nursing home beds to the 
population that is likely to need them falls below guidelines set by 
the State and subject to Federal approval.
  This approach allows new nursing home beds to operate where there is 
a demonstrated need, while limiting the potential burden on the 
taxpayer where no such need has been established.
  Slowing the growth of nursing home beds is critical to reforming the 
current long-term care system. In Wisconsin, limiting nursing home bed 
growth has been central to the success of the long-term care reforms 
initiated in the early 1980's. While the rest of the country 
experienced a 24 percent increase in Medicaid nursing home bed use 
during the 1980's, Wisconsin saw Medicaid nursing home bed use decline 
by 19 percent.
  The certificate of need provision is far more modest than the 
absolute cap on nursing home beds adopted in Wisconsin, and recognizes 
that there needs to be some flexibility to recognize the differences of 
long-term care services among States. It is also consistent with the 
kind of long-term care reform proposed by President Clinton and others.
  Certainly, our ability to reform long-term care will depend not only 
on establishing a consumer-oriented, consumer-driven home and 
community-based benefit that is available to the severely disabled of 
all ages, but also on establishing a more balanced and cost-effective 
allocation of public support of long-term-care services by eliminating 
the current bias toward institutional care.
  An analysis by the Congressional Budget Office estimated the lost 
revenue from eliminating the State mandate on home- and community-based 
services at $20 million in the first year, and $260 million over 5 
years. However, in their spending and revenue options document for 
1994, CBO estimates that the proposed regulation of nursing home bed 
growth would generate savings of $35 million in the first year, and 
$625 million over 5 years. The combined effect of this proposal, then, 
would be to generate about $15 million in savings in the first year, 
and $365 million over 5 years.
  Mr. President, taken together, the change in the estate recovery 
provisions and the slowing of nursing home bed growth, these two 
provisions will help shift the current distorted Federal long-term-care 
policy away from the institutional bias that currently exists and 
toward a more balanced approach that emphasizes home- and community-
based services.
  This is the direction that we will need to take if we are to achieve 
significant long-term-care reform.
  Mr. President, I ask unanimous consent that the text of the 
legislation as well as a letter from the Coalition of Wisconsin Aging 
Groups be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                S. 2449

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. MEDICAID ESTATE RECOVERIES.

       Section 1917(b)(1)(B) of the Social Security Act (42 U.S.C. 
     1396p(b)(1)(B) is amended by striking ``consisting of--'' and 
     all that follows and inserting the following: ``consisting 
     of--
       ``(i) nursing facility services and related hospital and 
     prescription drug services; and
       ``(ii) at the option of the State, any additional items or 
     services under the State plan.''.

     SEC. 2. REQUIRING STATES TO REGULATE GROWTH IN THE NUMBER OF 
                   NURSING FACILITY BEDS.

       (a) In General.--A nursing facility shall not receive 
     reimbursement under the medicare program under title XVIII of 
     the Social Security Act, the medicaid program under title XIX 
     of such Act, or any other Federal program for services 
     furnished with respect to any beds first operated by such 
     facility on or after the date of the enactment of this Act 
     unless a certificate of need is issued by the State with 
     respect to such beds.
       (b) Issuance of Certificate.--A certificate of need may be 
     issued by a State with respect to a geographic area only if 
     the ratio of the number of nursing facility beds in such area 
     to the total population in such area that is likely to need 
     such beds is below the ratio included in guidelines that are 
     established by the State and approved by the Secretary under 
     subsection (c),.
       (c) Approval of Guidelines.--The Secretary shall promulgate 
     regulations under which States may submit proposed guidelines 
     for the issuance of certificates of need under subsection (b) 
     for review and approval.
                                  ____



                          Coalition of Wisconsin Aging Groups,

                                  Madison, WI, September 20, 1994.
     Hon. Russell Feingold,
     U.S. Senate,
     Washington, DC.
       Dear Senator Feingold: I am writing to indicate our strong 
     support for your bill to permit, rather than mandate, states 
     to implement estate recovery programs for Medicaid services 
     other than nursing facility services and related hospital and 
     prescription drug services.
       As you know we are extremely concerned about the federal 
     law which will require Wisconsin to implement estate recovery 
     for home and community-based long-term care services in 
     April, 1995. Our concern is based on real experience not 
     abstract thinking. Wisconsin implemented estate recovery for 
     home and community-based services and it was a disaster. We 
     documented numerous cases of people refusing needed services 
     because they did not want the state to take a lien on their 
     homes. Refusing needed community services is likely to hasten 
     the need for more expensive nursing home care which will be 
     paid for by state and federal funds under the Medicaid 
     program.
       As a matter of public policy we should be encouraging the 
     use of less expensive, more desirable home and community-
     based care and discouraging the use of more expensive 
     institutional care. Your bill does that by requiring estate 
     recovery for institutional care and requiring states to 
     regulate the number of nursing home beds through a state-
     administered certificate of need process. I believe your bill 
     will encourage more states to do what Wisconsin, Oregon and 
     Washington have done; i.e., reduce nursing home utilization 
     through a policy of controlling institutional growth and 
     expanding the use of home and community-based services. These 
     states have been very successful according to an August, 1994 
     GAO report entitled ``Medicaid Long-Term Care--Successful 
     State Efforts to Expand Home Services While Limiting Costs.''
       Our organization has never opposed Medicaid estate recovery 
     for nursing home services because we believe it does not 
     create a disincentive (i.e., people already have a strong 
     desire to avoid institutionalization), and we understand that 
     public funds alone cannot meet the large and increasing costs 
     of nursing facilities. But requiring estate recovery for home 
     and community-based services may have the unintended 
     consequence of being more expensive as the growing elderly 
     population receives long-term care services in nursing homes 
     instead of their own homes.
       States have been very effective and creative in providing 
     home and community-based services as an alternative to 
     institutional care. Your bill will allow states the 
     flexibility of continuing to be creative in meeting the long-
     term care needs of their elderly populations by requiring 
     estate recovery for institutional care, but giving states the 
     option of implementing estate recovery for other Medicaid 
     services. Some states are likely to pursue estate recovery 
     for other services but, based on our experience in Wisconsin, 
     the Governor and the legislature repealed estate recovery for 
     community-based services as soon as they saw the negative 
     impact. Your bill will allow states the flexibility to make 
     changes when the circumstances indicate a need for change 
     rather than being required to implement a policy even when it 
     is clearly not in the best interest of the state or its 
     citizens.
       We appreciate your efforts to change a law which could have 
     the opposite effect than the one intended.
           Sincerely,
                                                Thomas L. Frazier,

                                       Executive Director.

                                 ______

      By Mr. STEVENS:
  S. 2447. A bill to authorize a certificate of documentation for the 
vessel Lady Hawk; to the Committee on Commerce, Science, and 
Transportation.


             ``ladyhawk'' vessel documentation act of 1994

 Mr. STEVENS. Mr. President, today I am introducing a bill to 
provide a certificate of documentation for the vessel Lady Hawk, U.S. 
Official No. 961095.
  The Lady Hawk is owned by Ms. Joan Dunn of Seldovia, AK.
  The vessel was built in Little Falls, MN, in 1989.
  The first owners of the vessel--a married couple--were thought to be 
U.S. citizens, and a certificate of documentation for the Lady Hawk was 
issued in June 1990.
  In November 1990, Ms. Joan Dunn purchased the Lady Hawk from the 
original owners, with the intent to eventually use it as a charter 
fishing vessel.
  On November 11, 1993, Ms. Dunn received notice from the Coast Guard 
that one of married couple who originally owned the vessel was, in 
fact, a Canadian citizen, and that the certificate of documentation for 
the Lady Hawk was therefore invalid.
  The Coast Guard determined that Ms. Dunn was a bona fide purchaser in 
good faith, and informed her that it was pursuing penalty action 
against the former owner, but that the certificate of documentation for 
the Lady Hawk was nevertheless invalid.
  The bill I am introducing today would grant a Jones Act waiver to Ms. 
Dunn for the vessel Lady Hawk. Ms. Dunn, through no fault of her own, 
cannot use this vessel for fishing charters or other coastwise trade 
without this waiver.
                                 ______

      By Mr. SHELBY (for himself, Mr. Heflin and Mr. Craig):
  S. 2448. A bill to impose a moratorium on immigration by aliens other 
than refugees, certain priority and skilled workers, and immediate 
relatives of U.S. citizens and permanent resident aliens; to the 
Committee on the Judiciary.


                   immigration moratorium act of 1994

 Mr. SHELBY. Mr. President, the United States has long been 
known as a nation of immigrants. It is said that much of our country's 
greatness--its strength, historically--is due to the unique, diverse, 
and rich mix of its social makeup. I couldn't agree more with this 
characterization. And I couldn't agree more about the important impact 
immigration holds for the future welfare of our country.
  But, Mr. President, the time has come for us to separate our 
nostalgia for immigration from today's harsher realities. Today, our 
national interest and the quality of life of many U.S. citizens is 
being undermined by excessive immigration.
  While immigration has helped in the past, times and circumstances 
have changed. Unless we significantly reduce today's excessive levels 
of immigration we will continue to increase the temperature on this 
country's already highly pressurized social and economic condition.
  Mr. President, for a country--for a nation of immigrants--that has 
absorbed wave after wave of immigrants throughout its history, you 
would think that we would have a carefully crafted policy on 
immigration that serves our national interests. In fact, however, we do 
not.
  Instead, we have a hodgepodge of annual limits for legal immigration 
and no effective way of controlling a tide of illegal entrants every 
year. Indeed, our inability to formulate a comprehensive and effective 
policy to deal with illegal immigration only highlights the absolute 
failure of our policy on legal admissions.
  Mr. President, our immigration problems are not limited to simply 
controlling our borders against illegal aliens. It is much broader than 
that. Most people are shocked to learn that illegal immigration is far 
less than the amount of legal immigrants we admit to this country.
  We're concerned about approximately 300,000 people who emigrate here 
illegally when--at the same time--we are voluntarily admitting close to 
1 million every year.
  Mr. President, immigration levels, legal and illegal, are out of 
control and exceed historical numbers. We admit more legal immigrants 
today than we did during the Great Wave from 1880 to 1924. Moreover, 
our legal limits are more like targets than actually restrictions. What 
good are legal limits that are easily waived, paroled, or amnestied and 
an immigration policy so easily held hostage to foreign demands to 
increase the amount of refugees allowed to enter the United States 
legally?
  What do the numbers matter, if every time we are faced with a refugee 
crisis, like Haiti and Cuba, we end up raising or disregarding the 
limits by adopting questionable administrative interpretations of 
existing laws or paroling those who are not entitled to enter legally 
under our current scheme. Mr. President, the refugee threat is a real 
one because the United States is already accepting more immigrants than 
it can absorb each year.
  The United States cannot continue at current immigration levels 
without compromising the quality of life of every American citizen. 
Lower wages, excessive demands on social, medical, and welfare services 
are all products of a failed immigration policy.
  States and local governments can barely keep up with the Federal 
Government's promise of a better life for the million or so immigrants 
that flock here each year. Already States are bringing suit against the 
Federal Government seeking reimbursement for billions of dollars in 
immigration-related costs.
  Mr. President, the demands of our society are growing far apace of 
our ability as a government and an economy to satisfy them. Promising 
better health care and more responsive welfare programs are high on the 
administration's agenda of needed changes.
  But, Mr. President, we must change our immigration policy if we are 
to effectively deal with these greater issues. Reforming health care 
and welfare includes creating entirely new entitlement programs and yet 
we cannot control how many people may be entitled to programs like AFDC 
or Medicaid or proposed health insurance subsidies because we can't 
control our borders.
  How can we accurately gage the cost of these programs and the value 
and success of reforming if we cannot control how many people may be 
entitled to the benefits that they promise?
  A comprehensive solution to our immigration policy problems is 
certainly what we need. Senators Reid and Simpson have introduced bills 
designed to help establish such a framework for reform. I support their 
efforts and hope to work with them in achieving such necessary change.
  In the interim, however, we must act. We must answer the demands 
being placed on our system today. Mr. President, we can do this by 
lowering how many people we allow into this country legally. We can do 
this by establishing a 5-year moratorium on what we definitely can 
control--legal admissions.
  While providing only a temporary response to a long-term problem, a 
5-year moratorium would nonetheless allow existing immigrants to 
assimilate and provide Congress sufficient time to address more 
comprehensive reform.
  Under my moratorium bill, spouses and minor children of U.S. citizens 
would continue to be allowed without limit. In recent years, this 
amount has remained at about 175,000 per year. This would leave about 
150,000 annual admission slots under the moratorium's 325,000 immigrant 
cap.
  These would go to refugees--50,000, highly skilled and priority 
workers--50,000, and to other relatives of U.S. citizens and permanent 
resident aliens on current admissions lists--50,000.
  Mr. President, I believe this is a responsible and effective way to 
deal with a problem that overwhelms us more every day. It is important 
to every American and every person who would like to be an American 
some day to maintain a healthy and prosperous economy and a diverse, 
but harmonious society.
  The reality of the situation is this: A lifeboat can only hold so 
many people before it too becomes a sinking ship. Mr. President, I 
submit our lifeboat--the U.S. lifeboat--is taking on water.
  A moratorium will ease that circumstance and allow us as a nation to 
continue to provide the kind of safe haven that has encouraged 
individuals in the thousands to take to rafts to reach our shores.
  Mr. President, similar proposals have already been introduced in the 
House of Representatives and are supported by close to 100 Members. I 
would encourage my colleagues to give this proposal similar support and 
consideration.
                                 ______

      By Mr. BIDEN (for himself, Mr. Bingaman, Mrs. Boxer, Mr. Bradley, 
        Mr. Bryan, Mr. Chafee, Mr. Coats, Mr. Cochran, Mr. D'Amato, Mr. 
        Danforth, Mr. DeConcini, Mr. Dodd, Mr. Dole, Mr. Domenici, Mr. 
        Dorgan, Mr. Durenberger, Mrs. Feinstein, Mr. Ford, Mr. Glenn, 
        Mr. Grassley, Mr. Hatch, Mr. Heflin, Mr. Helms, Mrs. Hutchison, 
        Mr. Inouye, Mr. Jeffords, Mrs. Kassebaum, Mr. Kennedy, Mr. 
        Kerry, Mr. Lautenberg, Mr. Levin, Mr. Mathews, Mr. Metzenbaum, 
        Ms. Mikulski, Mr. Mitchell, Mr. Moynihan, Mr. Murkowski, Mrs. 
        Murray, Mr. Packwood, Mr. Pell, Mr. Reid, Mr. Riegle, Mr. Robb, 
        Mr. Rockefeller, Mr. Roth, Mr. Sarbanes, Mr. Sasser, Mr. Simon, 
        Mr. Specter, Mr. Thurmond, Mr. Warner, and Mr. Wellstone):
  S.J. Res. 220. A joint resolution to designate October 19, 1994, as 
``National Mammography Day''; to the Committee on the Judiciary.


                        national mammography day

  Mr. BIDEN. Mr. President, I rise today to introduce a joint 
resolution designating October 19, 1994 as ``National Mammography 
Day.''
  Last year, I was pleased to sponsor similar legislation that 
designated October 19, 1993, as a special day to encourage women to get 
mammograms as part of the early detection process in the fight against 
breast cancer. That measure received positive support among cancer and 
women's groups from around the country, and was successful in focusing 
attention on the value of mammography.
  According to the American Cancer Society, national figures on breast 
cancer indicate that, in 1994 alone, 182,000 women will be diagnosed 
with breast cancer. Forty-six thousand women will succumb to this 
disease.
  My home State of Delaware still ranks among the worst in breast 
cancer mortality, with an estimated 600 new breast cancer cases and 150 
breast cancer deaths in 1994.
  While many areas of breast cancer remain unknown, significant 
progress has been made to help unlock the mysteries of the disease. 
Research funding has been greatly increased, along with heightened 
awareness and education.
  For example, last year in my own State of Delaware, a working group--
comprised of my wife Jill, Lieutenant Governor Ruth Ann Minner, County 
Councilwoman Karen Venezky, and a number of breast cancer survivors, 
business and community leaders, and health professionals--was 
established to educate and raise consciousness about the importance of 
early detection throughout the State. Subsequently, this group has 
created a health awareness program that has focused on educating young 
women about breast cancer and mammography. I applaud this group and 
others, in Delaware and across the Nation, who have united for the 
fight against breast cancer.
  Although a cure for breast cancer may be some time away, early 
detection and treatment are crucial to ensure survival. Studies have 
shown and experts agree, that mammography is one of the best methods to 
detect breast cancer in its early stages. Mammograms can reveal the 
presence of small cancers up to 2 years before regular clinical breast 
examinations or breast self-examinations [BSE], saving as many as a 
third more lives of those diagnosed with the disease.
  Mammograms are especially important to older women, with 50 percent 
of the breast cancer cases occurring in women over age 65. In addition, 
no woman can be considered immune from the disease; in fact, 80 percent 
of the women who get breast cancer have no family history of the 
disease.
  Finally, when conducted by professionals, mammograms are a relatively 
quick and safe procedure, and numerous efforts have been made to make 
mammograms more accessible and affordable. For instance, groups such as 
Mammography of Delaware have been operating mobile diagnostic centers, 
with the cost of the mammogram determined by the woman's ability to 
pay. In addition, many of the health care reform proposals before 
Congress include mammograms as part of the standard benefit package.
  Mr. President, the resolution I am introducing today is the result of 
the hard work of a number of organizations. It sets aside one day in 
the midst of National Breast Cancer Awareness Month--which was passed 
by the Senate earlier this year--to encourage women to receive or sign 
up for a mammogram, as well as to bring about greater awareness and 
understanding of one of the key components in fighting this disease.
  The organizations promoting National Mammography Day include: the 
American Cancer Society, the American Academy of Family Physicians, the 
American College of Radiology, the American Medical Women's 
Association, the American Society of Clinical Oncology, Cancer Care 
Inc., Cancer Research Foundation of America, the Centers for Disease 
Control and Prevention, the National Alliance of Breast Cancer 
Organizations, the National Cancer Institute, National Medical 
Association, Oncology Nursing Society, the Susan G. Komen Foundation, 
the American College of Obstetricians and Gynecologists, Y-ME, and the 
Zeneca Pharmaceuticals Group.
  Once again, I am pleased to sponsor this resolution, and ask 
unanimous consent that the full text of this joint resolution be 
printed in the Record.
  There being no objection, the joint resolution was ordered to be 
printed in the Record, as follows:

                             S.J. Res. 220

       Whereas according to the American Cancer Society, 182,000 
     women will be diagnosed with breast cancer in 1994, and 
     46,000 women will die from this disease; and
       Whereas in the decade of the 1990's, it is estimated that 
     about two million women will be diagnosed with breast cancer, 
     resulting in nearly 500,000 deaths; and
       Whereas the risk of breast cancer increases with age, with 
     50 percent of the breast cancer cases occurring in women over 
     age 65; and
       Whereas 80 percent of women who get breast cancer have no 
     family history of the disease; and
       Whereas mammograms, when operated professionally at an 
     accredited facility, can provide a safe and quick diagnosis; 
     and
       Whereas experts agree that mammography is the best method 
     of early detection of breast cancer, and early detection is 
     the key to saving lives; and
       Whereas mammograms can reveal the presence of small cancers 
     up to two years before regular clinical breast examinations 
     or breast self-examinations (BSE), saving as many as a third 
     more lives; Now, therefore, be it
       Resolved by the Senate and the House of Representatives of 
     the United States of America in Congress assembled, That 
     October 19, 1994, be designated as ``National Mammography 
     Day,'' and the President is authorized and requested to issue 
     a proclamation calling upon the people of the United States 
     to observe such day with appropriate programs and activities.

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