[Congressional Record Volume 141, Number 123 (Thursday, July 27, 1995)]
[Senate]
[Pages S10747-S10754]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  RYAN WHITE CARE REAUTHORIZATION ACT

  The PRESIDENT pro tempore. The clerk will report the bill.
  The assistant legislative clerk read as follows:

       A bill (S. 641) to reauthorize the Ryan White CARE Act of 
     1990, and for other purposes.

  The Senate resumed consideration of the bill.

       Pending:
       Helms amendment No. 1854, to prohibit the use of amounts 
     made available under this act for the promotion or 
     encouragement of homosexuality or intravenous drug use.
       Helms amendment No. 1855, to limit amounts appropriated for 
     each of fiscal years 1996 through 2000 under title XXVI of 
     the Public Health Service Act to the level of such 
     appropriations in fiscal year 1995.
       Helms amendment No. 1856, to ensure that Federal employees 
     will not be require to attend or participate in AIDS or HIV 
     training programs.
       Helms amendment No. 1857, to limit amounts appropriated for 
     AIDS or HIV activities from exceeding amounts appropriated 
     for cancer.
       Kassebaum amendment No. 1858, to prohibit the use of funds 
     to fund AIDS programs designed to promote or encourage 
     intravenous drug use or sexual activity.

  The PRESIDENT pro tempore. Under the previous order, the able Senator 
from Nevada is recognized.
  Mr. REID. Mr. President, under the order that has previously been 
entered, how much time does the Senator from Nevada have?
  The PRESIDENT pro tempore. Fifteen minutes.
  Mr. REID. Mr. President, my oldest child, my only daughter, married a 
young man from North Carolina, a fine young man, someone that our whole 
family has accepted. He has been great to my daughter and to the whole 
family. We are very proud of both of them.
  We have learned that when your child marries, other people 
automatically come into the family. As a result of my son-in-law coming 
into our family, his parents came into our family as well, a wonderful 
couple, Melvin and Mattie.
  Mr. President, we got to love and appreciate both of them, and all 
the time that we knew Mattie, my daughter's mother-in-law, she was very 
ill. She was dying of cancer, and had been suffering for a long period 
of time.
  Finally, Mattie passed away. Melvin and Mattie had been married 40-
plus years. Then, after a few years had passed, Melvin and a woman that 
he had known his entire life--she was a widow, he was a widower--
married.
  This relatively elderly couple on their honeymoon recognized that 
Beulah, the new wife, was ill. She did not know what was wrong, but she 
was very sick. And after having a significant number of medical tests, 
it was learned that his new wife had AIDS. It was determined she had 
contracted the disease from her former husband. He had had open-heart 
surgery and was given tainted blood. So this angelic man, Melvin, who 
had spent many, many years caring for his very sick wife dying of 
cancer, now faced another tragic situation--his new wife was dying of 
AIDS. You see, Mr. President, anyone that gets AIDS dies. It is a 
terminal disease. It is only a question of how long. Beulah suffered 
significantly, and recently passed away.
  Mr. President, the reason I relate this story to my colleagues here 
in the Senate is that AIDS affects everyone. It does not affect a 
specific community. It does not affect a specific ethnic group. It does 
not affect just young men. It does not affect only young women. It has 
some effect on all of us. Really, Mr. President, that is what the Ryan 
White legislation is all about. It recognizes that AIDS is an epidemic 
that is sweeping the country. It recognizes that victims with AIDS need 
special help as a result of the disease. 

[[Page S 10748]]

  Ryan White, the young man whose name is affixed to this legislation, 
had a disease called hemophilia. As we know, this is a disease where 
the human body is unable to stop bleeding. These young people who have 
this disease need large amounts of blood in the form of transfusions. 
Ryan White, as a boy, was given tainted blood and wound up with the 
AIDS virus and ultimately full-blown AIDS. He suffered tremendously, as 
anyone who has this disease does.
  Mr. President, Ryan White lived to be 18 years of age. To add to this 
sad story, Ryan White also suffered significant, severe discrimination. 
Why? Because he had this disease--AIDS. He struggled merely to attend 
public schools. Eventually, he succeeded in getting a court order which 
allowed him into the school, but he was then ostracized by his peers. 
People lied about him. They claimed he spit on people and bit people. 
There were even accusations that he was a homosexual, with all of the 
connotations relating to that, and many other hateful and spiteful 
things that this young man had to endure.
  His mother fought hard for her boy. She wanted him to have a normal 
childhood. Through her perseverance and her constant fighting to bring 
this disease to the forefront, we passed the Ryan White bill.
  This CARE Act is a cornerstone of Federal funding for AIDS-specific 
care. There is bipartisan support, as there should be, for this 
reauthorization. We do not know exactly how many Americans are infected 
with the HIV virus. We do know it is over a million. There is not a 
place you can go in the United States that does not have a story to 
tell about AIDS.
  A recent poll was taken that shows more than 70 percent of Americans 
believe that funding should either be increased or remain the same for 
AIDS-related causes. There has been some talk, Mr. President, on the 
Senate floor that too much money is being spent on people with AIDS. I 
have a number of answers to anyone who would make such a statement. 
First, any medical research that is done, whether it is for AIDS, 
cancer, diabetes, lupus, any disease you want to mention, helps us all, 
because it is through medical research that breakthroughs come that 
help us in understanding disease generally.
  For example, Mr. President, the billions of dollars spent on star 
wars has not resulted in a defense to stop incoming missiles, however, 
significant scientific advancements were made as a result of doing work 
on that project. Laser technology has advanced a thousandfold as a 
result of that research. The same applies, in my estimation, to 
research on AIDS-related diseases. If we better understand the cause of 
AIDS, if we better understand and reach some conclusion as to better 
ways to treat AIDS, and perhaps someday cure AIDS, there would be all 
kinds of side effects, positive in nature, as a result of the research 
done on AIDS. I do not believe, Mr. President, that we are spending too 
much money on this disease.
  The CARE Act is a model of local control, planning authority and 
funding decisions rest with State and local governments. The CARE Act 
programs provide health care and support services to more than 300,000 
people with the HIV virus. The Ryan White CARE Act, enacted in 1990, 
has, in effect, disaster relief to help America's hardest hit cities 
with AIDS.
  This act provides for Federal resources to States and localities to 
assess their needs and design effective strategies to meet them.
  There are four titles to the CARE Act. Title I provides for primary 
care. Another title deals with a consortia of local providers, with 
prescription drugs, and insurance continuation. Title III provides for 
early intervention, and categorical grants to private and nonprofit 
entities already providing primary care. Title IV provides for 
coordinated comprehensive care for children, and families among other 
things.
  This legislation, Mr. President, is an important step to relieve 
people and their immediate families and neighbors from the problems 
that relate to people who are suffering from HIV/AIDS. Having people 
with HIV involved with the CARE Act reduces further transmission of 
this disease.
  Having said that, we save money as a result of people being treated 
properly that have AIDS. It also reduces inappropriate use of emergency 
rooms and inpatient hospitalization.
  I believe that prevention is the best way to save money. With the 
Ryan White Act, we are spending money now in order to save money in the 
future. So we should not be shortsighted in our actions. The programs 
we have already established have reduced inpatient care costs, 
increased access to care for undeserved populations and improved 
quality of life for those infected by the epidemic.
  The AIDS epidemic is getting worse. It was originally centered in 
large urban areas. Now it is truly national. It affects rural America.
  Without funding through this act, the AIDS epidemic in some 
communities will simply become unmanageable.
  Mr. President, Reno, NV, a relatively small community, has a real 
problem with treating people with this disease. Like all communities, 
we do not know exactly how many people have this disease, but at our 
early intervention clinic we have a caseload of about 275 people--
again, Mr. President this is at an early intervention clinic.
  The reason this clinic is important, Mr. President, and there are a 
number of reasons, but one reason is that it saves Nevada money. At 
this facility, people can come and receive advice, counsel, and 
treatment, therefore, avoiding unnecessary hospitalization. Through 
avoiding emergency visits alone, we save thousands and thousands of 
dollars.
  The success of this early intervention clinic was so impressive that 
two Reno hospitals made grants of $50,000 each to the clinic in 1993 to 
support HIV and related direct patient care. It would save the hospital 
money in the long run to keep the clinics open.
  Mr. President, Nevada has the 11th highest per capita reported HIV 
cases in the Nation. The overwhelming majority of HIV-infected Nevadans 
live in the Las Vegas area. Las Vegas is in region 9, which ranked 
fifth in the number of HIV cases. The majority of these infected 
individuals receive their medical care at the University Medical Center 
in Las Vegas. UMC spends millions of dollars each year of taxpayers' 
money on AIDS treatment.
  The Ryan White legislation, Mr. President, will save the people of 
the State of Nevada money as a result of early intervention.
  The Ryan White legislation, Mr. President, is something that we 
should all support. It is important legislation.
  This disease affects almost every American. It has affected this 
Senator. It has affected many other people who work in these Chambers. 
I think it is important that we understand that when we help people who 
are sick, no matter what disease they have or why they have it, helping 
them is the right thing to do. It is the right thing from a moralistic 
standpoint, as well as the right thing to do from an economic 
standpoint. We save the taxpayers of this country money by providing 
appropriate and proper care. I yield the floor.
  The PRESIDING OFFICER (Mr. Ashcroft). The Senator from New Hampshire.
  Mr. GREGG. Mr. President, it is my understanding under the unanimous-
consent agreement, at this time I was allocated an hour to bring forth 
an amendment. I do not intend to bring that amendment forward.
  I have been discussing this with the chairman of the subcommittee and 
ranking member of the committee and also with other cosponsors of this 
amendment, which deals with the export activity, drug, pharmaceutical, 
and device companies, and would address what I think is an absolutely 
essential need to reform our export activities so that our drug, our 
biological, and device companies are not put at the significant 
disadvantage relative to the international marketplace, and so they are 
not shipping abroad jobs, technology, and research which is what is 
occurring today.
  This amendment, which would correct that problem and make our 
pharmaceutical, biologic, and device companies more competitive and 
give them the opportunity to produce goods here, sell them abroad in a 
reasonable manner, and to do their research here, rather than shipping 
them abroad, is a critical amendment. 

[[Page S 10749]]

  I have received a commitment, and I am very appreciative of this from 
the chairman and ranking member of the committee, that this matter will 
be taken up at a markup in committee next Wednesday, as I understand 
it. That is very satisfactory to me.
  I think that will give Members a chance to have a full airing at the 
committee level and, hopefully, bring legislation to the floor which 
will address this issue, which I do feel needs to be addressed in the 
short term rather than the long term.
  With that background, I will not be offering my amendment. I yield 
back my time.
  Mr. KENNEDY. Mr. President, I express appreciation to the Senator 
from New Hampshire for proceeding this way. It will permit the Human 
Resources Committee to have an opportunity to consider an extremely 
important and significant change in terms of our export policy, in 
terms of medical devices, and other pharmacological products.
  It is a very, very important issue. At the present time, for example, 
we are able to export to the 21 countries that have the technological 
and scientific basis. If those countries have approved those particular 
products, we can export to those. But this would open up export to a 
wide range of different countries that do not have that kind of 
scientific basis.
  We have to take note that we have Americans that will be living in 
those countries, that will be traveling in those countries, that will 
be perhaps consuming these various products. I think we want to make 
very, very sure that the type of product that will be exported from the 
United States is going to be safe and efficacious. We have seen too 
many instances in the past, even when products have been utilized in 
foreign countries and found to provide a very substantial and 
significant health hazard, they have still been exported to other 
countries and endangered the health and the well-being of children, 
expectant mothers, and others.
  We want to be very, very sure that we are going to be part of a world 
system in terms of competitiveness, but also that if the products are 
going to be exported from the United States, that they are going to 
need, I think, some minimal standards either established here or 
established in other countries that have the scientific capability and 
capacity.
  As I mentioned, 21 countries do have that. To even provide the degree 
of flexibility to the FDA, if they make a judgment that they believe 
other countries have that kind of expertise and they feel it is 
warranted and justified, to be able to export those, I think we ought 
to be able to consider that.
  There are some very, very important public policy issues involving 
not only the economic issues in terms of export market, but also health 
issues in terms of products that are made here in the United States.
  I am grateful to the Senator from New Hampshire. This will give 
Members an opportunity in the period of time in the next several days 
to see if we cannot find some common ground. There are some ideas and 
suggestions that we have that I think can move us very substantially 
toward the goal of the Senator from New Hampshire. It would do it in a 
somewhat different way.
  I welcome the opportunities to explore those over the period of these 
next several days and see if we cannot have the discussion of those and 
consideration of those in the committee next week, and then move that 
whole process through in a timely way.
  I appreciate the willingness to proceed in this way. I think we will 
get a better product and, hopefully, one that can have the broad 
support of the Members.
  Mrs. KASSEBAUM. Mr. President, I, too, am appreciative of being able 
to work this out. We will put this legislation on the committee markup 
calendar for next week.
  I am a cosponsor of the legislation that has been introduced by the 
Senator from New Hampshire. I know that Senator Gregg has some very 
strong and very constructive views on FDA reform, as many Members do. 
We are working toward a comprehensive approach including the specifics 
of the export policy. I think this is a very positive direction for 
Members to go.
  I appreciate all parties concerned, including Senator Kennedy and the 
other members of the Labor Committee, for being willing to put, this 
legislation on the markup calendar.
  Mr. President, we are trying to confirm that all Members are notified 
that the vote schedule will probably be a bit earlier than we had 
anticipated, since the FDA amendment has been worked out. I think we 
are trying to arrange for 10 o'clock, but this has not yet been 
finalized.
  Mrs. MURRAY. Mr. President, I rise today in strong support of S. 641, 
the Ryan White CARE Reauthorization Act of 1995. I am proud to join 63 
of my colleagues from both sides of the aisle in cosponsoring this 
bill, and I thank our distinguished majority leader, Senator Dole, for 
bringing the measure to the floor.
  The AIDS epidemic is one of the most serious public health crises the 
world has ever faced. AIDS is now the leading cause of death of 
Americans between the ages of 25 to 44. Even more startling to me, AIDS 
is the second highest cause of death among women across our country. In 
addition, AIDS cases among people of color are on the rise and rural 
populations are witnessing sharp increases of reported AIDS cases.
  We all know that AIDS has devastated the gay and hemophiliac 
communities. Yet, surveillance data from the Centers for Disease 
Control show the rates of increases in AIDS cases are highest among 
women, adolescents, and persons infected through heterosexual contact. 
In my home State of Washington, 37 of our 39 counties have reported 
cases of AIDS.
  The National Center for Health Statistics projects that deaths due to 
AIDS will increase 100 percent over the next 5 years. Clearly, the 
epidemic is not abating.
  Mr. President, I believe the Federal Government has an important role 
to play in combating the AIDS epidemic. But I also believe we--as 
parents, neighbors, and human beings--have an obligation to care for 
those living with HIV/AIDS. As more adolescents, our Nation's children, 
become infected with the AIDS virus, we must ensure they have access to 
adequate HIV-related treatment and services.
  When I see that adolescents are one of the fastest growing 
populations of people with HIV/AIDS, I get particularly concerned. I am 
the mother of two teenagers. I know AIDS is an issue they are very 
worried about. I want to do all I can to assure them that as a nation 
we are facing up to this crisis, and that perhaps one day they can 
raise their kids in a world that is no longer threatened by AIDS.
  One of the first trips I took as a U.S. Senator was to the pediatric 
AIDS ward at the National Institutes of Health. I was both heartened by 
the progress made by the researchers, and heartbroken by the 
unimaginable loss of life that is inevitable in the coming decade.
  I still have vivid memories of that trip to NIH.
  I remember the face of a young boy, barely in his teens, although 
physically he was the size of a 6-year old. His whole young life and 
that of his family's were consumed with trying to outwit this terrible 
disease. Tragically, he died a short time later, but I am determined to 
ensure that we do all we can and not turn our backs on our children. 
They are our future and they deserve better.
  The Ryan White CARE Act is one of the best programs to care for 
people living with HIV-infection. Our constituents have told us how 
much they have come to rely on the services funded through the Ryan 
White CARE Act.
  Maybe we need to reflect for a moment on what these services mean to 
a person living with AIDS. Because of the lifesaving resources the Ryan 
White Act provides, people living with HIV/AIDS have access to mental 
health counseling, transportation to medical appointments, companion 
care, and the delivery of a nutritional meal. In other words, the Ryan 
White CARE Act gives people with AIDS a most precious gift--a little 
peace of mind.
  I am proud of the people who are fighting on the frontlines of this 
epidemic in my State. Without Ryan White funding, organizations like 
the Northwest AIDS Foundation and the Chicken Soup Brigade would not be 
able to continue their life-sustaining work.
  Let me repeat that. Without funding from the Ryan White Act, people 
who 

[[Page S 10750]]
are too sick to leave their homes could not count on a home-delivered 
meal, nor would they have access to HIV-related counseling and 
treatment services. It seems to me that ensuring the value of dignity 
in someone's last days is not too much to ask for in this greatest of 
countries on Earth.
  And, let us not forget, the Ryan White CARE Act saves us money. Ryan 
White-supported volunteer programs and case management programs are 
cost-effective alternatives to hospitalization and institutional care. 
Early intervention care services keep people living with HIV healthy 
and working far longer. And Ryan White services help prevent the spread 
of HIV by increasing people's awareness and understanding of the 
disease.
  Sooner or later, every Member of this Chamber will be personally 
touched by the shadow of AIDS.
  I already know what it feels like to have a good friend call and 
sadly confirm he has been diagnosed with HIV. My very good friend and 
former colleague in the Washington State Senate, Cal Anderson, has been 
living with AIDS for several months. I served with Cal before coming to 
this body, and I feel honored to be able to call him my friend. Cal is 
one of the most determined, respected, and strongest people I know. He 
has not let his health get in the way of his drive and commitment to 
serving the people of our State, and I want to let him know how much I 
admire his courage and his wisdom.
  This is a disease that affects us all, Mr. President. Finger-pointing 
and moralizing have no place in this debate. The AIDS virus does not 
choose its victims, and it does not seek to punish them either. None of 
us shall tolerate the suggestion that people who get AIDS are 
disgusting and reprehensible. All I know is that people with AIDS are 
sick--and they need our help and our compassion.
  Mr. President, the time to act is now. I urge all of my colleagues to 
support swift and final passage of the reauthorization of the Ryan 
White CARE Act.
  Mr. KERRY. Mr. President, The Ryan White CARE Act is about people. It 
is about community and caring and, fundamentally, it is about our 
response to a public health crisis, and the fairness with which we deal 
with such crises. It is about community and what we stand for as a 
nation. It is about adequate education and the prevention of a deadly 
disease. It is about Government's rightful role in protecting the 
health of Americans. And it is about life and hope, health and caring.
  It is the function of this body to debate issues on principle, and 
there will always be issues that will philosophically divide us, but 
illness and human suffering is not a wedge issue; and it should not be 
debated based on our fears and our anxieties. I sincerely hope that, in 
discussing AIDS education, prevention, and funding we do not engage in 
a debate about cultural differences or lifestyles, but about illness, 
disease, and the devastating impact of the HIV virus on our fellow 
citizens.
  I would hope that the fight against AIDS, like the fight against 
cancer or heart disease would unite us, and strengthen our resolve as a 
community, because HIV knows no cultural bounds, and spares no gender, 
color, creed, or national origin. I wish that this Senate could 
unanimously support legislation--without divisive amendments--that 
addresses, a devastating disease with tragic consequences that has torn 
families and friends apart.
  Mr. President, in this debate let us not drift too far afield from 
what this legislation would do. We are simply talking about outpatient 
medical care to those who suffer the HIV virus. We are talking about 
supporting services to families and individuals living with the HIV 
virus and AIDS. We are talking about education and prevention. We are 
talking about altering funding formulas to reflect the geographic and 
demographic reality of where the problem is and who needs the help.
  We are simply talking about fairness, about doing all we can to help 
victims and families who have struggled with HIV. We should not divert 
our attention from intolerance of the suffering HIV causes to 
intolerance of those who suffer.
  In conclusion, beyond the specifics of this important legislation, I 
see the Ryan White CARE Act as a test of our leadership in the U.S. 
Senate, and as a symbol of our commitment to the fundamental concept of 
community that holds us together as a diverse nation, strengthened by 
our differences.
  I yield the floor.
  Mr. DODD. Mr. President, I rise in strong support of the Ryan White 
Reauthorization Act of 1995. I would like to thank the chair of the 
Labor and Human Resources Committee, Senator Kassebaum, and the ranking 
member, Senator Kennedy, for all the hard work that they have put into 
this bill.
  AIDS continues to be a serious public health problem in this country. 
It has become the leading killer of U.S. adults between the ages of 25 
to 44. Since it was first identified in the early eighties, nearly 
500,000 cases of AIDS have been reported. More than 40 percent have 
been diagnosed in the last 2 years. Clearly, the situation is getting 
worse, not better. And as much as we would all like to see this crisis 
just go away, it will not. AIDS is rippling through every one of our 
States--from rural hamlets to major cities. It is a national problem 
that requires a national response.
  The disease strikes and kills Americans in the prime of life--the 
most productive members of our society. The median age at time of 
infection is 25 years of age.
  The spread of HIV and AIDS among young adults is particularly 
alarming. According to the Centers for Disease Control, young adults 
from 20 to 29 years of age account for almost 20 percent of diagnosed 
AIDS cases. Given the typical lengthy period between HIV-infection and 
diagnosis with AIDS, it is likely that these young people became 
infected as adolescents. And in 1993, the largest increases in reported 
AIDS cases occurred among young people between the ages of 13 to 19 and 
20 to 24. Additionally, the number of pregnant women and children born 
with the disease continues to grow with the epidemic.
  My State of Connecticut is hard hit by the epidemic, where the 
problem continues to grow. More than one-sixth of our total AIDS cases 
were reported in 1994 alone.
  The epidemic has hit my State's poorest cities the hardest. Ninety 
percent of the AIDS cases in Connecticut are concentrated in the New 
Haven and Bridgeport metropolitan areas and in Hartford County. In 
Hartford, AIDS is the leading cause of death among youth. Pediatric 
AIDS cases are twice the national average. Female AIDS cases are also 
twice the national average. Hartford will receive title I funds in the 
coming year to help it cope with this crisis.
  In New Haven, 3,355 cases had been diagnosed through December 1994, 
and an estimated 8,039 were infected with HIV. In Bridgeport, there are 
between 3,400 and 4,000 cases of HIV infection, 16 percent in the age 
group 15 to 24.
  The Ryan White CARE Act provides vital funds to help States, cities, 
individuals, and families cope with the epidemic's impact. Title I of 
the act provides dollars to metropolitan areas disproportionately 
affected by the epidemic. The funds go to health care and support 
services to prevent hospitalization and improve the lives of 
individuals living with HIV infection and AIDS. Title II provides funds 
to States for the delivery of health care and services, the development 
of community-based consortia, and services such as health insurance 
continuation and HIV medication reimbursements. Title III B supports 
early intervention services on an outpatient basis. Title IV provides 
grants for services for women and children.
  The strength of the Ryan White Program is made clear by the broad 
bipartisan support for the bill. It was initially passed in 1990 with 
the sponsorship of Senators Kennedy and Hatch and signed into law by 
President Bush. It now enjoys the support of more than 60 Members from 
both sides of the aisle.
  The services paid for under this act are desperately needed by the 
health care providers and institutions that work on the frontlines of 
this illness and by the individuals and families that live with the 
disease. I urge my colleagues to support this reauthorization bill.
  Mr. HARKIN. Mr. President, I rise to share my strong support for S. 
641, the Ryan White CARE Reauthorization Act of 1995. The AIDS 
emergency is far from over. In fact, it is only getting 

[[Page S 10751]]
worse. Now more than ever, we need the Ryan White CARE Act.
  The Ryan White Act is a vital source of health services for people 
with AIDS. Often, it is the only source of help available. AIDS victims 
commonly suffer from discrimination and social isolation, leaving them 
with no one to turn to when they get sick.
  Also, they often lose their health care coverage, so they must rely 
on public assistance for care. That is where the Ryan White Act comes 
in. It is there to lend a hand in times of crisis when there is nowhere 
else to turn to.
  For those who think that AIDS is no longer a major crisis in the 
United States, I have a wake-up call for you: the AIDS epidemic is at 
its height. According to the Centers for Disease Control and 
Prevention, AIDS has now grown to become the No. 1 killer among 
American males aged 25-44. In 1992, there were approximately 48,000 new 
AIDS cases in the United States. Last year, that number grew to more 
than 80,000. We should all be alarmed.
  Some would like us to believe that AIDS is a disease that affects 
only homosexuals and drug-users. Some people still refer to AIDS as a 
``gay disease.''
  But, Mr. President, that invective which we hear is also a virus. It 
is the virus of ignorance, the virus of indifference, the virus of 
intolerance spreading a dangerous message. And we have to put a stop to 
that virus, too.
  AIDS is not a ``them'' disease. It is an ``us'' disease. Every 
American--regardless of color, creed, gender, or sexual orientation--is 
at risk for AIDS.
  Recently, in some parts of the country, the rate of AIDS incidence 
has shown signs of leveling off in the homosexual population. 
Unfortunately, at the same time, the heterosexual AIDS epidemic is 
rising at an alarming rate. Growing numbers of women are contracting 
AIDS. Also, teenagers in the United States now have one of the fastest 
growing rates of infection.
  While AIDS continues to have a disproportionate impact on urban 
areas, it is cropping up in our suburban and rural areas as well. Iowa 
has reported over 650 cases since the epidemic began. You don't have to 
travel far to run up against this deadly disease--it's right in our own 
backyard.
  In Iowa, we have four Ryan White CARE consortias in operation around 
the State. They receive no funding from the State, nor do they get city 
or county funds for program costs or direct services. Without the Ryan 
White Act, these organizations would be unable to function, and many 
Iowans with AIDS would be left out in the cold.
  I recently received a letter from Kirk Bragg, director of the AIDS 
Project of central Iowa. In his letter, he gives an excellent example 
of the kind of care Ryan White provides in our State. Let me share it 
with you:

       Five months ago we received a call for help. Bob R. has 
     AIDS and HIV-related dementia. His parents attempted to care 
     for him at home, but could not cope with the demands of his 
     illness and his confused mental condition. In desperation, 
     they drove to Des Moines and left Bob at the front entrance 
     of Broadlawns Medical Center.
       Bob's parents, we found, were not bad people--they simply 
     had reached the end of their emotional and financial rope.
       A social worker from Broadlawns called our agency, and we 
     picked Bob up and took him to our office. In less than 24 
     hours, we found Bob a place to live, purchased vitally needed 
     medications, connected him with volunteer support, and 
     provided ongoing case management that continues to help Bob 
     avoid harmful decisions.
       Today, five months later, Bob's condition has stabilized.
       He has re-established his relationship with his parents, 
     and he has the medications, care, and counseling he requires. 
     His life is not easy, and his disease is not cured, but one 
     more human life was pulled from the abyss.
       The Ryan White CARE Act made this all possible.

  In closing, Kirk had one final note to share that I would like to 
pass on to my colleagues. He says:

       Tell the Senators who oppose this legislation that we who 
     are working in the fields have come to believe that AIDS 
     poses a moral question that must be answered--how our society 
     cares for the sick and despised is, in reality, a test of our 
     national character and our national will. If Americans truly 
     care for each other, we care for all our people.

  Kirk is right--this legislation is a test of our national will and 
our national character. Unfortunately, time is running out. The longer 
we wait on this bill, the more dangerous the situation becomes.
  On September 30, the Ryan White CARE Act will expire unless we move 
forward with reauthorization. Also, the appropriations process is well 
underway in both Houses, which means that we need move quickly to 
ensure that the new act is firmly in place so that it gets full and 
fair consideration for funding.
  On behalf of the thousands of Americans who suffer from AIDS and 
their families, I strongly urge my colleagues to support passage of S. 
641.
  This act is a life-line for those with AIDS. Let us act now before it 
is too late.


                dental provisions of the ryan white case

  Mr. HATCH. I am pleased to see the consolidation of most all of the 
Federal AIDS programs under the Ryan White AIDS CARE Act, as I believe 
that this will enhance the coordination of the services that we 
provide. I am concerned, however, that S. 641 fails to include a very 
important education and service program--the HIV/AIDS dental program.
  Mrs. KASSEBAUM. The Senator is correct.
  Mr. HATCH. As the Senator knows, dental care is consistently 
identified as one of the unmet needs of most AIDS patents. In fact, the 
need for dental care has been used to illustrate the importance of 
reauthorizing the Ryan White CARE Act.
  Mrs. KASSEBAUM. That is correct. Health officials in Kansas tell me 
that the dental needs of persons with HIV disease differ from those of 
people without chronic diseases--while many Americans visit the dentist 
primarily for preventive care, I understand that some patients with 
AIDS experience mouth lesions and pain so devastating that they see 
their dentist more often than their physician.
  Mr. HATCH. Receiving treatment for oral diseases is often difficult 
for HIV/AIDS patients because many are uninsured and, in addition, most 
dental services are not reimbursed under Medicare and are seldom 
covered by Medicaid. As a result, dental schools and hospitals provide 
a safety net for many of these uninsured patients, but risk serious 
financial problems in doing so.
  In fiscal year 1995, over 73,000 patients nationwide were cared for 
through this program; over $14 million in unreimbursed dental care was 
provided, for which the Federal Government reimbursed approximately 49 
percent.
  It is my understanding that the House Commerce Committee included 
this program in its Ryan White reauthorization bill, and that the House 
Appropriations Committee has continued funding for the program in its 
fiscal year 1996 bill. I do not want to hold up the progress of this 
bill, so I am not offering an amendment today, but I hope that we can 
find a way to reauthorize the AIDS dental program in the Ryan White 
CARE Act as it moves forward in conference with the House.
  Mrs. KASSEBAUM. I certainly appreciate the comments of the 
distinguished Senator.
  As you know, in the health professions bill which cleared the 
Committee on Labor and Human Resources earlier this year, we 
consolidated this program with others. This would allow the Secretary 
to determine if AIDS dental training programs are really needed. I 
understand the Senator from Utah's concerns, but, this is an issue 
which I will reexamine in the context of the health professions bill.
  Mr. HATCH. Mr. President, I rise to comment on an agreement reached 
earlier among my colleague from New Hampshire, Senator Gregg and the 
distinguished floor managers for this bill, Senator Kassebaum and 
Senator Kennedy. Senator Gregg agreed to withdraw his amendment this 
morning and the measure will be considered at a markup at the Labor 
Committee next Wednesday. I am very pleased by this outcome and wish to 
express my appreciation to Senator Gregg for his leadership on this 
issue.
  The Gregg amendment closely parallels S. 593--the FDA Export Reform 
and Enhancement Act of 1995. The amendment allows the free export of 
drugs and medical devices not approved by the FDA for use in the United 
States to member countries of the World Trade Organization, if certain 
safeguards are satisfied.

[[Page S 10752]]

  Before this markup takes place, I plan to work closely with Senator 
Gregg and other Members to make sure we have a bill which is acceptable 
to the committee.
  This amendment builds upon the bipartisan 1986 legislation that I 
sponsored to allow export of pharmaceuticals to certain specified 
countries. It is clear to me that this list is too rigid and outdated.
  The 1986 law identifies 21 countries, but some of the countries 
omitted from the list may surprise my colleagues. For example, absent 
from the list are Israel, Greece, Brazil, and Russia. It strikes me a 
little ironic that in the conduct of foreign affairs we are always 
cautioned about meddling in the internal affairs of other countries 
such as Israel and Russia, but the law, the relatively pedestrian 
Federal Food, Drug, and Cosmetic Act, in effect deems these nations as 
incapable of managing their own affairs.
  As Dr. Michael King, vice president for science and technology at 
Merck, said at the recent Aging Subcommittee hearing on my bill:

     * * * the drug export laws have tilted the playing field 
     against locating manufacturing jobs in the Untied States.

  At the July 13 hearing, medical device manufacturers took the same 
view. Mr. Arthur Collins, chief operating officer of Medtronic, the 
world's largest manufacturer of medical devices, headquartered in 
Minneapolis, said:

     * * * every week that the current policy continues to be 
     implemented, more American jobs are lost through the 
     relocation of manufacturing overseas and the loss of market 
     share to foreign competitors. The jobs being lost are 
     technologically oriented, and in addition to being highly 
     paid, they represent high levels of skills and education that 
     will produce further innovation in the future. Action must be 
     taken quickly to stem this decline.

  I plan to continue to work hard on this legislation since it means 
jobs for Americans and can help us maintain our leadership in medical 
technology. This will result in improvement to the public health both 
here in America and abroad. This is good legislation and I believe that 
we can and should work together to address any legitimate concerns that 
are raised and adopt this measure.
  On one final point, I knew that there are some in this body who have 
concerns about the possibility of this legislation resulting in dumping 
of unsafe products in the Third World and about the potential for less 
than scrupulous behavior under the bill.
  I commend my colleagues' attention to the comments provided to the 
Labor and Human Resources Committee by the Massachusetts biotech 
company Genetics Institute, Inc., official, Dr. John Petricciani. I 
should note that before joining the private sector, Dr. Petricciani 
spent over 20 years as a commissioned officer in the United States 
Public Health Service. He was Director of the FDA Center for Biologics 
and also was head of the World Health Organization's biologicals unit 
for several years. He completed his career within the Public Health 
Service as the Deputy Director of the National AIDS Program Office.
  Permit me to read a few excerpts from Dr. Petricciani's comments:

       The real issue here is one of benefit and risk. Do the 
     benefits to foreign countries in the current law outweigh the 
     risks imposed on the U.S. in terms of draining jobs and 
     capital investment in research, development, and 
     manufacturing? As has been pointed out by others, one of the 
     results of that drain is the earlier availability of products 
     in Europe and elsewhere than in the U.S. If we were 
     discussing electronics or automobiles, I would not be as 
     concerned because the American people are not being placed at 
     a meaningful disadvantage by such delays.
       However, the issue here is medical products that can make a 
     very big difference in the health of the American people. The 
     current law is resulting in new products being introduced 
     first in foreign countries, where U.S. firms are forced to 
     manufacture them. I believe that we are paying far too high a 
     price in terms of delayed availability of new products in the 
     U.S. for the theoretical benefit being provided to developing 
     countries.
       I would also like to point out that if a U.S. company 
     really wanted to export a product that would be unacceptable 
     in the U.S., all they would have to do is manufacture it 
     outside the U.S. and export it to a developing country.

  I think that Dr. Petricciani says it very well. This legislation is 
sound trade policy and is consistent with the public health. So while I 
recognize the concerns of those who might criticize this legislation, I 
hope that they will consider this perspective before they decide their 
position on this bill.
  Mr. D'AMATO. Mr. President, I rise to support the swift approval of 
S. 641, the Ryan White CARE Act reauthorization.
  The Ryan White program is a key element of the safety net for persons 
with HIV-AIDS--funding critical medical care, support services, and 
prescription drug assistance to prolong and improve the lives of those 
living with this disease.
  This program is particularly important to New York, which, 
unfortunately, continues to be the epicenter of this deadly epidemic. 
Of the 442,000 AIDS cases reported to the U.S. Centers for Disease 
Control as of December 1994, 83,000--or almost 19 percent--occurred in 
New York State, and 72,000--about 16 percent--occurred in the New York 
City metropolitan area. In New York City alone, an estimated 200,000 
individuals are thought to be infected with HIV. Tragically, since 
1988, AIDS has been and continues to be the leading cause of death for 
men and women aged 25-34.
  Ryan White has provided critical support to help mitigate the 
horrible impact of this epidemic in my State. The following are just a 
few of the positive effects resulting from the first 3 years of Ryan 
White funding in New York State, according to an analysis by the New 
York State AIDS Institute:
  First, the proportion of hospital admissions for patients in early 
stages of HIV disease were significantly reduced compared to control 
hospitals not receiving Ryan White funds. On average the proportion of 
early stage patients at Ryan White funded sites was 24 percent lower 
than at control sites at hospitals with primary care funded by Ryan 
White.
  Second, as a result of reduced utilization of inpatient services at 
the 19 hospitals funded by Ryan White to provide primary care, 
estimated gross savings were achieved in excess of $25 million a year.
  Finally, it has been estimated that without CARE Act-funded programs, 
HIV-related Medicaid expenditures in New York would have been 71 
percent higher. This represents a cost-savings of over $300 million. 
According to New York's AIDS Institute, the CARE Act-funded 
reimbursement pools for primary care and home care saved approximately 
$3 for every $1 invested.
  It is critical to remember that, by helping people with HIV to remain 
healthy and productive for as long as possible, the Ryan White CARE Act 
is helping us save both lives and money.
  The Ryan White CARE Act has proven effective in meeting the needs of 
States and communities affected by the HIV epidemic, and it deserves to 
be reauthorized without delay.
  Mr. HATFIELD. Mr. President, since its original passage in 1990, I 
have been a strong supporter of the Ryan White CARE Act. In the early 
1980's as we saw the rapid spread of AIDS throughout our Nation, it 
became apparent that HIV and AIDS treatment and care services were 
lacking. This bill has made a significant difference in building an 
infrastructure of critical care services for those suffering from this 
horrible disease.
  We all know the chilling facts--AIDS is now the leading cause of 
death of young Americans ages 25 to 44. The prevalence of the disease 
among women is rising dramatically. In my own State of Oregon, we have 
seen more than 2,900 AIDS cases since 1981. Nearly 1,000 of these cases 
were reported in 1993 and 1994. In addition, there are currently an 
estimated 6,000 to 10,000 Oregonians infected with HIV. We can now say 
that nearly every Oregon county is affected.
  As chairman of the Appropriations Committee in the early 1980's, I 
was able to play a role in providing the first Federal AIDS funding. We 
were able to take these first steps in the absence of an AIDS 
authorization bill until the 100th Congress, when the first 
authorization bill was passed. Despite the dim fiscal realities we face 
this year in the Appropriations Committee, I remain committed to 
assuring that funding for health care programs and medical research, 
including the important HIV and AIDS programs authorized under this 
bill, are funded to the greatest extent possible.
  Mrs. KASSEBAUM. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll. 

[[Page S 10753]]

  The assistant legislative clerk proceeded to call the roll.
  Mrs. KASSEBAUM. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mrs. KASSEBAUM. Mr. President, I ask unanimous consent that the 
Senator from Florida, Senator Mack, be added as an original cosponsor 
of amendment numbered 1859 to S. 641, and that he also be added as a 
cosponsor to S. 641, the Ryan White CARE Act.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mrs. KASSEBAUM. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. COATS. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. COATS. Mr. President, I ask unanimous consent that I be allowed 
to speak as if in morning business for 5 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Indiana is recognized.
  Mr. COATS. I thank the Chair.
  (The remarks of Mr. Coats pertaining to the introduction of S. 1079 
are located in today's Record under ``Statements on Introduced Bills 
and Joint Resolutions.'')
  Mr. COATS. I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. JEFFORDS. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Inhofe). Without objection, it is so 
ordered.
  Mr. JEFFORDS. Mr. President, I will be very brief because I know we 
are about ready to vote. I did not want to let this time go by without 
expressing my strong support for the Ryan White Act, and I am proud to 
be an original cosponsor.
  As many of my colleagues have already pointed out, we need to pass 
this bill as written with an authorization for adequate funding. The 
statistics are clear. AIDS has become one of the most difficult and 
complicated public health threats in recent memory. The incidence of 
AIDS and the need for the Ryan White CARE, far from abating, are 
increasing. Some today have asked: Why AIDS? Why the Ryan White CARE 
Act? What is so important about this program?
  Well, it has already been said but it bears repeating, that AIDS is 
now the leading killer of men and women ages 25 to 44. This virus is 
challenging our health care system in ways it has not been challenged 
before as it moves through the population with terrifying speed and 
deadliness.
  It is estimated that over 1 million Americans are currently infected 
with HIV. A quarter of a million Americans have already died from this 
disease. Far from going away, this virus is spreading through 
geographic and demographic regions that we might previously have 
considered unaffected.
  When the Ryan White CARE Act was first passed with wide bipartisan 
support 5 years ago, we clearly recognized the need for addressing this 
emerging epidemic through a national health program. This bill is not 
about homosexuality. This bill is not about abstinence. This bill is 
about judgment. This bill is about providing health care to people who 
are suffering from a disease.
  We designed the CARE Act to do equally two important things: to 
provide help and health services to those already living with AIDS, as 
well as to take the pressure off our critical care units and emergency 
rooms by utilizing early intervention techniques with AIDS and HIV 
patients. It is cost effective. The Ryan White CARE Act funds 
community-based organizations to provide needed outpatient care at the 
local level in the most cost-effective and efficient ways possible for 
the populations that need help the most.
  One study even indicated that a person receiving outpatient managed 
care spends 8 fewer days in a hospital than a person not receiving such 
care. This would indicate a cost savings of over $22,000 per person.
  I think it is important to outline what these funds do and do not do. 
Dollars from the CARE Act go to increasing the availability of critical 
outpatient primary care services, providing support services and 
improving the quality of life of those living with HIV. In Vermont the 
CARE Act money is primarily used to provide pharmaceuticals to people 
with HIV and AIDS who need drugs but cannot afford them.
  Successful outpatient care keeps people out of the hospital, 
improving their quality of life, while saving the system money. When 
early interventions and primary care are used successfully, the health 
care system saves untold dollars in unused emergency health care 
services. From a purely fiscal perspective, we cannot afford not to 
fund these programs.
  The funding these community based organizations receive goes to care 
and services. It does not go to advertisements in the Washington Blade. 
It does not go to brochures about prevention. The dollars that we 
authorize in this bill help sick people, people from all walks of life, 
all demographic groups, to get the health care and other services that 
they need to live with this deadly disease.
  During our committee consideration it became clear that the AIDS 
epidemic is spreading. It is no longer confined to certain populations 
or certain geographic locations, but is now clearly affecting rural as 
well as urban areas, women and children as well as men.
  Any of us who previously felt confident and untouched by HIV because 
AIDS affected other people must now reexamine those assumptions. Soon 
we will all have friends whose lives have been touched by this disease. 
I had the honor of hosting one of my friends, David Curtis, at a Labor 
Committee hearing on this bill.
  David Curtis and I have known each other for over 30 years. David is 
a lawyer, around my age, in fact we clerked together. He's from a 
similar background to my own, and I would venture to guess, similar to 
that of many of my colleagues. David Curtis has AIDS.
  As a person living with AIDS he told our committee of the 
debilitation of this disease, how he can no longer drive over half an 
hour without stopping to rest, how he has been forced to sharply 
curtail his practice of law. As former chair of the largest AIDS 
service organization in Vermont he also told of the difficulties of 
providing services to people who live tens and sometimes hundreds of 
miles apart and how CARE Act funding helps make it possible for people 
to get access to health care, services, counseling, and pharmaceuticals 
that otherwise would not be available.
  The Ryan White CARE Act helps people like David, people living with 
HIV and AIDS, not only in Vermont, but all over the country, to get the 
help they need. The face of AIDS is changing, it is affecting the 
people I know and the people we all know. We must all remember during 
this debate that the disease could easily affect us or someone we care 
about.
  If we and our loved ones are affected, I know we will want adequate 
resources to be available to help with prescription drugs, health care, 
and support services. The Ryan White CARE Act is an assurance that help 
will be available. So for my friend, David Curtis and the millions of 
other Americans affected by HIV, I hope my colleagues will join me in 
supporting the Ryan White CARE Act as reported out of the Labor 
Committee.
  Mr. President, I yield the floor.
  Mrs. KASSEBAUM. Mr. President, I appreciate the statement and the 
cosponsorship of the Ryan White CARE Act. Senator Jeffords, a member of 
the Labor and Human Resources Committee, has been a thoughtful 
contributor to the Committe in crafting this legislation.


                           Amendment No. 1860

  (Purpose: To limit amounts expended for AIDS or HIV activities from 
                 exceeding amounts expended for cancer)

  Mrs. KASSEBAUM. Mr. President, I ask that amendment No. 1860 be 
called up, and I ask for the yeas and nays for that amendment as well 
as amendment No. 1858 in the proper ordering of the listing of 
amendments. 

[[Page S 10754]]

  The PRESIDING OFFICER. The clerk will report the amendment.
  The legislative clerk read as follows:

       The Senator from Kansas [Mrs. Kassebaum] proposes an 
     amendment numbered 1860.

  Mrs. KASSEBAUM. Mr. President, I ask unanimous consent that further 
reading of the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:

       At the appropriate place, insert the following new section:

     SEC.   . LIMITATION ON APPROPRIATIONS.

       Notwithstanding any other provision of law, the total 
     amounts of federal funds expended in any fiscal year for AIDS 
     and HIV activities may not exceed the total amounts expended 
     in such fiscal year for activities related to cancer.

  Mrs. KASSEBAUM. I ask for the yeas and nays on both amendment No. 
1860 and amendment No. 1858 when they fall in the proper order of our 
voting this morning.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Is there a sufficient second? There appears to be a sufficient 
second.
  The yeas and nays were ordered.
  Mrs. KASSEBAUM. Mr. President, it is my understanding that we are 
prepared to begin the voting on the amendments. And as was agreed to 
last night in the consent agreement, we will take them in the order as 
we listed them last night. The first will be an amendment of Senator 
Helms, No. 1854. This amendment prohibits the use of funds under the 
act for the direct or indirect promotion of homosexuality or 
intravenous drug use. The yeas and nays were ordered.
  The PRESIDING OFFICER. The Senator is correct.


                       Vote on Amendment No. 1854

  The PRESIDING OFFICER. The question is now on agreeing to the 
amendment No. 1854 to S. 641.
  The yeas and nays are ordered.
  The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. LOTT. I announce that the Senator from Utah [Mr. Bennett] is 
necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 54, nays 45, as follows:

                      [Rollcall Vote No. 333 Leg.]

                                YEAS--54

     Abraham
     Ashcroft
     Baucus
     Bond
     Breaux
     Brown
     Bumpers
     Burns
     Byrd
     Coats
     Cochran
     Conrad
     Coverdell
     Craig
     DeWine
     Dole
     Domenici
     Dorgan
     Exon
     Faircloth
     Ford
     Frist
     Glenn
     Gramm
     Grams
     Grassley
     Gregg
     Hatch
     Heflin
     Helms
     Hollings
     Hutchison
     Inhofe
     Johnston
     Kempthorne
     Kyl
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Murkowski
     Nickles
     Pressler
     Pryor
     Rockefeller
     Roth
     Santorum
     Shelby
     Smith
     Stevens
     Thompson
     Thurmond
     Warner

                                NAYS--45

     Akaka
     Biden
     Bingaman
     Boxer
     Bradley
     Bryan
     Campbell
     Chafee
     Cohen
     D'Amato
     Daschle
     Dodd
     Feingold
     Feinstein
     Gorton
     Graham
     Harkin
     Hatfield
     Inouye
     Jeffords
     Kassebaum
     Kennedy
     Kerrey
     Kerry
     Kohl
     Lautenberg
     Leahy
     Levin
     Lieberman
     Mikulski
     Moseley-Braun
     Moynihan
     Murray
     Nunn
     Packwood
     Pell
     Reid
     Robb
     Sarbanes
     Simon
     Simpson
     Snowe
     Specter
     Thomas
     Wellstone

                             NOT VOTING--1

       
     Bennett
       
  So the amendment (No. 1854) was agreed to.
  Mr. HELMS. Mr. President, I move to reconsider the vote.
  Mrs. KASSEBAUM. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  Mrs. KASSEBAUM. Mr. President, I ask unanimous consent that all 
remaining votes in the voting sequence be limited to 10 minutes in 
length.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                       Vote on Amendment No. 1855

  The PRESIDING OFFICER. The question is on agreeing to the amendment 
numbered 1855. The yeas and nays have been ordered. The clerk will call 
the roll.
  The bill clerk called the roll.
  Mr. LOTT. I announce that the Senator from Utah [Mr. Bennett] is 
necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 32, nays 67, as follows:

                      [Rollcall Vote No. 334 Leg.]

                                YEAS--32

     Ashcroft
     Bond
     Brown
     Burns
     Coats
     Cochran
     Craig
     Dole
     Faircloth
     Frist
     Gramm
     Grams
     Grassley
     Gregg
     Helms
     Hollings
     Hutchison
     Inhofe
     Kempthorne
     Kyl
     Lott
     McCain
     McConnell
     Nickles
     Pressler
     Roth
     Santorum
     Shelby
     Simpson
     Smith
     Thomas
     Thompson

                                NAYS--67

     Abraham
     Akaka
     Baucus
     Biden
     Bingaman
     Boxer
     Bradley
     Breaux
     Bryan
     Bumpers
     Byrd
     Campbell
     Chafee
     Cohen
     Conrad
     Coverdell
     D'Amato
     Daschle
     DeWine
     Dodd
     Domenici
     Dorgan
     Exon
     Feingold
     Feinstein
     Ford
     Glenn
     Gorton
     Graham
     Harkin
     Hatch
     Hatfield
     Heflin
     Inouye
     Jeffords
     Johnston
     Kassebaum
     Kennedy
     Kerrey
     Kerry
     Kohl
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lugar
     Mack
     Mikulski
     Moseley-Braun
     Moynihan
     Murkowski
     Murray
     Nunn
     Packwood
     Pell
     Pryor
     Reid
     Robb
     Rockefeller
     Sarbanes
     Simon
     Snowe
     Specter
     Stevens
     Thurmond
     Warner
     Wellstone

                             NOT VOTING--1

       
     Bennett
       
  So the amendment (No. 1855) was rejected.
  Mr. KENNEDY. Mr. President, I move to reconsider the vote.
  Mr. EXON. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                       Vote On Amendment No. 1856

  The PRESIDING OFFICER. The question is on agreeing to amendment No. 
1856. The yeas and nays have been ordered.
  The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. LOTT. I announce that the Senator from Utah [Mr. Bennett] is 
necessarily absent.
  The result was announced--yeas 99, nays 0, as follows:

                      [Rollcall Vote No. 335 Leg.]

                                YEAS--99

     Abraham
     Akaka
     Ashcroft
     Baucus
     Biden
     Bingaman
     Bond
     Boxer
     Bradley
     Breaux
     Brown
     Bryan
     Bumpers
     Burns
     Byrd
     Campbell
     Chafee
     Coats
     Cochran
     Cohen
     Conrad
     Coverdell
     Craig
     D'Amato
     Daschle
     DeWine
     Dodd
     Dole
     Domenici
     Dorgan
     Exon
     Faircloth
     Feingold
     Feinstein
     Ford
     Frist
     Glenn
     Gorton
     Graham
     Gramm
     Grams
     Grassley
     Gregg
     Harkin
     Hatch
     Hatfield
     Heflin
     Helms
     Hollings
     Hutchison
     Inhofe
     Inouye
     Jeffords
     Johnston
     Kassebaum
     Kempthorne
     Kennedy
     Kerrey
     Kerry
     Kohl
     Kyl
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Mikulski
     Moseley-Braun
     Moynihan
     Murkowski
     Murray
     Nickles
     Nunn
     Packwood
     Pell
     Pressler
     Pryor
     Reid
     Robb
     Rockefeller
     Roth
     Santorum
     Sarbanes
     Shelby
     Simon
     Simpson
     Smith
     Snowe
     Specter
     Stevens
     Thomas
     Thompson
     Thurmond
     Warner
     Wellstone

                             NOT VOTING--1

       
     Bennett
       
  So the amendment (No. 1856) was agreed to.
  Mr. DASCHLE addressed the Chair.
  The PRESIDING OFFICER (Mr. SANTORUM). The distinguished minority 
leader is recognized.

                          ____________________