[Congressional Record Volume 144, Number 24 (Tuesday, March 10, 1998)]
[House]
[Pages H920-H925]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  BIRTH DEFECTS PREVENTION ACT OF 1997

  Mr. BILIRAKIS. Mr. Speaker, I move to suspend the rules and pass the 
Senate bill (S. 419) to provide surveillance, research, and services 
aimed at prevention of birth defects, and for other purposes.

[[Page H921]]

  The Clerk read as follows:

                                 S. 419

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

     SECTION 1. SHORT TITLE; FINDINGS.

       (a) Short Title.--This Act may be cited as the ``Birth 
     Defects Prevention Act of 1997''.
       (b) Findings.--Congress makes the following findings:
       (1) Birth defects are the leading cause of infant 
     mortality, directly responsible for one out of every five 
     infant deaths.
       (2) Thousands of the 150,000 infants born with a serious 
     birth defect annually face a lifetime of chronic disability 
     and illness.
       (3) Birth defects threaten the lives of infants of all 
     racial and ethnic backgrounds. However, some conditions pose 
     excess risks for certain populations. For example, compared 
     to all infants born in the United States, Hispanic-American 
     infants are more likely to be born with anencephaly spina 
     bifida and other neural tube defects and African-American 
     infants are more likely to be born with sickle-cell anemia.
       (4) Birth defects can be caused by exposure to 
     environmental hazards, adverse health conditions during 
     pregnancy, or genetic mutations. Prevention efforts are 
     slowed by lack of information about the number and causes of 
     birth defects. Outbreaks of birth defects may go undetected 
     because surveillance and research efforts are underdeveloped 
     and poorly coordinated.
       (5) Public awareness strategies, such as programs using 
     folic acid vitamin supplements to prevent spina bifida and 
     alcohol avoidance programs to prevent Fetal Alcohol Syndrome, 
     are essential to prevent the heartache and costs associated 
     with birth defects.

     SEC. 2. PROGRAMS REGARDING BIRTH DEFECTS.

       Section 317C of the Public Health Service Act (42 U.S.C. 
     247b-4) is amended to read as follows:


                   ``programs regarding birth defects

       ``Sec. 317C. (a) In General.--The Secretary, acting through 
     the Director of the Centers for Disease Control and 
     Prevention, shall carry out programs--
       ``(1) to collect, analyze, and make available data on birth 
     defects (in a manner that facilitates compliance with 
     subsection (d)(2)), including data on the causes of such 
     defects and on the incidence and prevalence of such defects;
       ``(2) to operate regional centers for the conduct of 
     applied epidemiological research on the prevention of such 
     defects; and
       ``(3) to provide information and education to the public on 
     the prevention of such defects.
       ``(b) Additional Provisions Regarding Collection of Data.--
       ``(1) In general.--In carrying out subsection (a)(1), the 
     Secretary--
       ``(A) shall collect and analyze data by gender and by 
     racial and ethnic group, including Hispanics, non-Hispanic 
     whites, Blacks, Native Americans, Asian Americans, and 
     Pacific Islanders;
       ``(B) shall collect data under subparagraph (A) from birth 
     certificates, death certificates, hospital records, and such 
     other sources as the Secretary determines to be appropriate; 
     and
       ``(C) shall encourage States to establish or improve 
     programs for the collection and analysis of epidemiological 
     data on birth defects, and to make the data available.
       ``(2) National clearinghouse.--In carrying out subsection 
     (a)(1), the Secretary shall establish and maintain a National 
     Information Clearinghouse on Birth Defects to collect and 
     disseminate to health professionals and the general public 
     information on birth defects, including the prevention of 
     such defects.
       ``(c) Grants and Contracts.--
       ``(1) In general.--In carrying out subsection (a), the 
     Secretary may make grants to and enter into contracts with 
     public and nonprofit private entities.
       ``(2) Supplies and services in lieu of award funds.--
       ``(A) Upon the request of a recipient of an award of a 
     grant or contract under paragraph (1), the Secretary may, 
     subject to subparagraph (B), provide supplies, equipment, and 
     services for the purpose of aiding the recipient in carrying 
     out the purposes for which the award is made and, for such 
     purposes, may detail to the recipient any officer or employee 
     of the Department of Health and Human Services.
       ``(B) With respect to a request described in subparagraph 
     (A), the Secretary shall reduce the amount of payments under 
     the award involved by an amount equal to the costs of 
     detailing personnel and the fair market value of any 
     supplies, equipment, or services provided by the Secretary. 
     The Secretary shall, for the payment of expenses incurred in 
     complying with such request, expend the amounts withheld.
       ``(3) Application for award.--The Secretary may make an 
     award of a grant or contract under paragraph (1) only if an 
     application for the award is submitted to the Secretary and 
     the application is in such form, is made in such manner, and 
     contains such agreements, assurances, and information as the 
     Secretary determines to be necessary to carry out the 
     purposes for which the award is to be made.
       ``(d) Biennial Report.--Not later than February 1 of fiscal 
     year 1998 and of every second such year thereafter, the 
     Secretary shall submit to the Committee on Commerce of the 
     House of Representatives, and the Committee on Labor and 
     Human Resources of the Senate, a report that, with respect to 
     the preceding 2 fiscal years--
       ``(1) contains information regarding the incidence and 
     prevalence of birth defects and the extent to which birth 
     defects have contributed to the incidence and prevalence of 
     infant mortality;
       ``(2) contains information under paragraph (1) that is 
     specific to various racial and ethnic groups (including 
     Hispanics, non-Hispanic whites, Blacks, Native Americans, and 
     Asian Americans);
       ``(3) contains an assessment of the extent to which various 
     approaches of preventing birth defects have been effective;
       ``(4) describes the activities carried out under this 
     section; and
       ``(5) contains any recommendations of the Secretary 
     regarding this section.
       ``(e) Applicability of Privacy Laws.--The provisions of 
     this section shall be subject to the requirements of section 
     552a of title 5, United States Code. All Federal laws 
     relating to the privacy of information shall apply to the 
     data and information that is collected under this section.
       ``(f) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $30,000,000 for fiscal year 1998, $40,000,000 
     for fiscal year 1999, and such sums as may be necessary for 
     each of the fiscal years 2000 and 2001.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Florida (Mr. Bilirakis) and the gentleman from Ohio (Mr. Brown) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Florida (Mr. Bilirakis).
  Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may 
consume.
  (Mr. Bilirakis asked and was given permission to revise and extend 
his remarks.)
  Mr. BILIRAKIS. Mr. Speaker, S. 419, introduced by Senator Bond of 
Missouri, calls for a national strategy to prevent birth defects. This 
legislation has a history of bipartisan support with key provisions 
having passed both the House and Senate previously.
  It passed the Senate by voice vote on June 12, 1997. The bill was 
cosponsored by 34 Senators, including both the majority leader, Senator 
Lott, and the minority leader, Senator Daschle. The companion House 
bill, H.R. 1114, was introduced by the gentleman from Texas (Mr. Ortiz) 
and the gentleman from Texas (Mr. Bonilla) and has 162 cosponsors.
  The Birth Defects Prevention Act was first introduced by the 
gentleman from Texas (Mr. Ortiz) in 1992 in response to a tragedy that 
occurred in south Texas where a cluster of devastating birth defects 
escaped detection for several years. I want to particularly, Mr. 
Speaker, commend the gentleman from Texas (Mr. Ortiz) for his 
commitment to preventing birth defects and for his leadership on this 
legislation; and to best exemplify that commitment, I would share with 
my colleagues the fact that when I called him as a matter of courtesy 
with a plan to offer Senator Bond's bill, rather than his, because the 
Bond bill was already passed by the Senate unanimously, he without 
hesitating said, ``Mike, I don't care about credit. The important thing 
is to get the bill passed.''
  Mr. Speaker, each year 150,000 infants are born with serious birth 
defects according to the Centers for Disease Control and Prevention. 
Many more children are found to have such disorders later in life. 
According to the March of Dimes, birth defects have been the leading 
cause of infant mortality for more than 20 years. Birth defects cause 
one out of every 5 infant deaths and they are responsible for about 30 
percent of all pediatric admissions to hospitals. Among the babies born 
with birth defects who survive, a large number develop serious 
disabilities with high emotional and social costs.
  Families from all racial, ethnic and economic groups share the risk 
of having a child with a serious birth defect. S. 419 authorizes a 
national plan to prevent birth defects. These efforts would be 
coordinated by the CDC as a partnership between the Federal and State 
governments, as well as health and education groups involved in birth 
defects prevention.

                              {time}  1630

  The strategy has three components: surveillance, research, and 
prevention.
  First, surveillance is necessary to track the incidents of birth 
defects and identify communities and populations at higher risk. 
Currently, 31 States

[[Page H922]]

have some surveillance program. In my own State of Florida, a 
surveillance system was approved and funded in 1997 and will become 
operational in 1998. According to the Florida Department of Health, 21 
percent of infant deaths in Florida are related to birth defects. 
Florida's Secretary of Health, Dr. James T. Howell, has expressed 
strong support for the measure under consideration today.
  S. 419 directs the CDC to carry out through the States a program to 
collect, analyze and report statistics on birth defects. Over the past 
several years the CDC has received additional Federal support to 
provide this technical assistance and to fund cooperative agreements to 
help States establish or improve the State-based surveillance programs. 
Additional funds were included in the fiscal year 1998 budget which 
will provide assistance to additional States this year.
  The second component of the bill relates to CDC research activities. 
The causes of 75 to 80 percent of birth defects and developmental 
disabilities are unknown. Until the causes are known, prevention 
strategies cannot be developed. S. 419 authorizes at least 5 regional 
centers to conduct and apply epidemiological research on the prevention 
of birth defects.
  As of October 1, 1997, 8 centers for birth defects research and 
prevention are already in operation, and these are located in 
Massachusetts, Iowa, California, New York, Texas, Arkansas, New Jersey 
and Georgia. These centers contribute cases into an ongoing 
collaborative study to determine causes of birth defects. The National 
Birth Defect Prevention Study is one of the largest case control 
studies of birth defects ever conducted, Mr. Speaker. The study also 
provides a mechanism for collaboration among the most prominent 
national researchers into the causes of birth defects.
  In addition, each center will expand and approve their State birth 
defects surveillance systems and will conduct additional studies of 
potential genetic and environmental causes of birth defects. The 
research conducted by these centers will dramatically increase our 
understanding of the causes of birth defects and will provide 
information for developing effective programs to prevent the tragedy of 
birth defects.
  Finally, prevention activities also include professional and public 
education about birth defects as called for in the bill. The CDC has 
helped to establish a new organization called the National Birth 
Defects Prevention Network. This network provides technical assistance 
to States in the development and implementation of programs, publishes 
a newsletter, conducts special projects, and holds workshops for 
members. The network will play a major role in improving the quality of 
data collected about birth defects.
  The goal of birth defects surveillance and research is to develop 
intervention strategies to integrate into our public health and medical 
care systems. Preventing those defects will reduce costs for medical 
care and other services for affected families and society.
  S. 419 is supported by many groups representing families of children 
with birth defects, researchers working to find the causes, and health 
officials trying to prevent birth defects. Passage of the bill is also 
the top Federal legislative priority of the March of Dimes. This 
organization's mission is to prevent birth defects and infant 
mortality. The March of Dimes has 99 chapters around the country and 3 
million volunteers.
  Last September over 500 March of Dimes volunteers and staff came to 
Capitol Hill to urge passage of the bill. I was impressed by the 
commitment of the volunteers from my district, John and Suzie Haden and 
their daughter, Lindsey, who live at Palm Harbor, Florida.
  Mr. Speaker, 1998 marks the 60th anniversary of the March of Dimes 
and I believe that passage of this bill is a fitting way to commemorate 
this important anniversary. Passage of S. 419 today will underscore 
this Congress's strong commitment to the most vulnerable in our 
society, our children, and particularly those with special health care 
needs.
  Again, Mr. Speaker, I thank my colleagues, the gentleman from Texas 
(Mr. Ortiz) and the gentleman from Texas (Mr. Bonilla), for their 
leadership in sponsoring this legislation. And I certainly thank the 
gentleman from Michigan (Mr. Dingell) and the gentleman from Ohio (Mr. 
Brown) for their willingness to basically waive the rules and bring 
this to the floor, and I urge all of my colleagues to support passage 
of S. 419.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, 150,000 children in the United States are born each year 
with a serious birth defect. Depending on the severity of the defect, 
many of these children die at a young age. Almost 1 out of every 5 
infant deaths can be attributed to birth defects, according to recent 
data from the National Center for Health Statistics. Those who grow up 
to be adults oftentimes develop serious mental, emotional and physical 
disabilities.
  Compounding these human costs are the staggering financial burdens 
facing the families whose children suffer from birth defects.
  Fortunately, there are reasons to hope that the future is brighter 
for individuals suffering from birth defects and that we will 
ultimately be successful in our efforts to prevent more infants from 
suffering from these horrible illnesses in the future.
  As the ranking Democrat on the Subcommittee on Health of the 
Committee on Commerce, I am pleased to join the gentleman from Florida 
(Mr. Bilirakis) and the gentleman from Michigan (Mr. Dingell) in 
bringing legislation to the floor today to address this serious public 
health problem.
  I would also like to say a special thanks to the gentleman from Texas 
(Mr. Ortiz) who has worked so hard on this issue. He has dedicated many 
years to passing legislation to provide CDC with the tools to reduce 
the number of children born with birth defects and reduce the economic 
costs associated with this national tragedy. The gentleman from Texas 
has been a tireless champion in the fight against birth defects, and 
without him and his efforts, we probably would not be here today 
considering this bill.
  Many birth defects are preventable, and with integrated systems in 
place to help health care providers evaluate needs and deliver services 
and implement effective prevention strategies, we can win the fight 
against birth defects. Just as we have eradicated life threatening and 
crippling diseases like smallpox and polio, we can similarly win the 
battle against birth defects. I urge my colleagues to support this 
legislation which will ensure that millions of children have an 
opportunity to grow up healthy and strong, free of debilitating and 
life-threatening birth defects.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BILIRAKIS. Mr. Speaker, I yield 1 minute to the gentleman from 
Missouri (Mr. Blunt).
  Mr. BLUNT. Mr. Speaker, I want to encourage my colleagues to support 
this legislation. I certainly want to thank Senator Bond for the 
leadership role he has played in the Senate, and the gentleman from 
Texas (Mr. Ortiz) here in the House for addressing this problem that is 
really the number one cause of infant death.
  As the gentleman from Florida (Mr. Bilirakis) has already said, 
150,000 births every year are affected with serious birth defects, but 
about 3 percent of all births have birth defects. Three out of 100 
families with new babies deal with birth defects.
  This bill will put a system in place where we can begin for the first 
time to collect and share that information. It also puts a system in 
place where for the first time we can begin on a project basis to look 
and see if we cannot solve these specific problems that lead to these 
results, and eliminate this problem.
  This is an incredible challenge, not only important to the families 
and individuals involved, but it is a challenge in our society that we 
should not let continue to be a challenge for our society. We can solve 
it. This bill does solve it. I urge my colleagues to support this 
legislation.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 8 minutes to the gentleman 
from Texas (Mr. Ortiz).
  Mr. ORTIZ. Mr. Speaker, I thank the gentleman for yielding me this 
time.
  I am extremely pleased to see this legislation come to the floor of 
the

[[Page H923]]

House. This has been a bipartisan effort from the very, very beginning.
  Mr. Speaker, there are many people to whom this effort means so much, 
and I want to thank them. They include the gentleman from Florida (Mr. 
Bilirakis), the subcommittee chairman, the gentleman from Ohio (Mr. 
Brown), the ranking member of the subcommittee, and their staffs; along 
with Committee on Commerce chairman, the gentleman from Virginia (Mr. 
Bliley), and the gentleman from Michigan (Mr. Dingell), the ranking 
member, and their staffs; the March of Dimes, for their undying 
support; Senator Christopher Bond, who moved the companion legislation 
in the Senate; and my colleague from Texas, (Mr. Bonilla), who as lead 
cosponsor of this bill worked hard to push this legislation. Lastly, I 
would like to thank all of the 163 cosponsors who have joined to 
champion the cause of reducing the rate of birth defects in our 
country.
  This legislation was first introduced in 1992, in response to the 
tragedy that occurred in part of my district of Cameron County, Texas, 
where a cluster of devastating birth defects escaped detection for 
several years. In March of 1991, a nurse helped deliver 2 babies in a 
36-hour period. Both babies had anencephaly, a lethal birth defect in 
which the baby either has only a partial brain or is born with no brain 
at all. This pattern triggered this very competent nurse to review 
recent hospital birth records where she found a pattern of six babies 
born with anencephaly in the previous month.
  These incidents caused unbelievable anguish and misery in my south 
Texas community. However, I want my colleagues to understand that 
anencephaly and other birth defects are not only prevalent in south 
Texas but all over the United States. I was told that there are no 
means to detect such birth clusters around our Nation, so I introduced 
this bill to establish a surveillance system.
  This bill creates regional birth defects centers to study the 
information about birth defects. It creates a clearinghouse for the 
Centers for Disease Control so information on birth defects is 
centralized. Families all over the Nation, from all racial, ethnic and 
economic groups, share the risk of having a child with a birth defect.
  Birth defects are preventable. This bill will provide an important 
first step in helping our country's next generation to be healthy and 
active members of our communities.
  Birth defects research is a wise investment. The children and the 
families of Cameron County sounded this alarm, and I am proud that 
today Congress answers the call for investigation. Nothing is more 
important than our kids.
  Mr. Speaker, at this time I would like to engage the distinguished 
gentleman from Florida (Mr. Bilirakis), the chairman of the 
Subcommittee on Health and the Environment, in a colloquy for a few 
moments, if I may.
  Some of my constituents, Mr. Speaker, wrote to me raising a concern 
about whether the Birth Defects Prevention Act will impose a burden on 
their religious practices. It is not my intent that this bill 
detrimentally affect religious practices or religious freedom.
  Let me ask a question. Nothing in this act is designed to preempt 
existing State religious accommodation laws which allow those with 
religious objections to decline to have personal health information 
about themselves, or their minor children, included in birth defects 
information collection, analysis and reporting; is that correct?
  Mr. BILIRAKIS. Mr. Speaker, will the gentleman yield?
  Mr. ORTIZ. I yield to the gentleman from Florida.
  Mr. BILIRAKIS. Mr. Speaker, the gentleman from Texas is very 
certainly correct. States have historically provided accommodations in 
their laws for individuals whose religious beliefs and practices would 
be burdened by certain governmental programs. This act does not preempt 
those existing State religious accommodation laws. Moreover, this bill 
does not limit a State's authority to enact religious accommodation 
laws in the future.
  Mr. ORTIZ. Mr. Speaker, I thank the gentleman and the ranking member 
for their support because without that help, this would not be on the 
House floor today, and I thank my colleagues for their support.
  Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may consume 
to say that the gentleman from Texas (Mr. Ortiz) has thanked me and 
others, but all of us as well as the little children out there should 
be grateful to him, because he has worked awfully hard on this 
particular issue. The only reason we brought up Senator Bond's bill is 
because it has already been taken care of in the Senate and it would 
just expedite the process.
  Mr. Speaker, I yield 5 minutes to the gentlewoman from Missouri (Mrs. 
Emerson).
  Mrs. EMERSON. Mr. Speaker, there is nothing in the world that can 
possibly console a family when they learn that their newborn child has 
been victimized by a preventable birth defect. Sometimes there is 
nothing in our universe of knowledge that can explain to proud new 
parents why their child has been born with a debilitating condition 
that he or she will carry for the rest of their life. Still worse, 
because birth defects are the leading cause of infant mortality, that 
debilitating condition will often lead to tragic death. We can and must 
take prudent actions to respond to this public health tragedy, which is 
why this bill before us today, the Birth Defects Prevention Act, is of 
such importance.

                              {time}  1530

  As a mother, I can tell my colleagues that Bill and I were blessed 
with happy and healthy children. There is not a day that goes by that I 
do not thank the good Lord and say many prayers for that wonderful 
blessing.
  But some people are not so fortunate. In fact, the district that I 
represent in southern Missouri is home to the highest rate of birth 
defects in the State. Scientists cannot yet tell us what causes all 
birth defects, but we know from the brilliance of modern science that 
many birth defects can be prevented.
  The March of Dimes, which is leading America's battle against this 
national tragedy, informs us that if American women consumed just 400 
milligrams of the B vitamin folic acid each day, 50 to 75 percent of 
all cases of spina bifida and anencephaly would be prevented. The 
discovery that the use of this simple, widely available vitamin is 
proven in the prevention of neural tube defects is one of most exciting 
medical findings of the last part of this century.
  According to Dr. Godfrey Oakley, director of the Centers for Disease 
Control's Division of Birth Defects and Developmental Disabilities, 
``Not since the rubella vaccine became available 30 years ago have we 
had a comparable opportunity for primary prevention of such common and 
serious birth defects.''
  Mr. Speaker, I am especially excited about the outreach efforts 
called for under this bill. I know from my own experience that 
expectant mothers need all of the information they can get about what 
it takes to raise a healthy child. The strategy called for under this 
bill to track regional incidences of birth defects also will help 
public health officials identify opportunities to prevent future 
occurrences of birth defects.
  In closing, I want to thank the gentlemen from Texas (Mr. Ortiz) and 
(Mr. Bonilla) for taking an early lead here in the House by sponsoring 
the Birth Defects Prevention Act. I also want to extend my great 
appreciation to the gentleman from Florida (Mr. Bilirakis), the 
gentleman from Virginia (Mr. Bliley) and the gentleman from Michigan 
(Mr. Dingell) for their efforts to pass this bill, as well as the 
gentleman from Ohio (Mr. Brown).
  Certainly, not the least, my State's senior Senator, Kit Bond, who is 
sitting with me here in the House Chamber right now, seized the 
initiative by writing this bill and guiding it through the other body 
by a firm unanimous vote. He has been a true leader in this endeavor to 
help promote the public health by taking common-sense steps to prevent 
birth defects.
  Mr. Speaker, I want to encourage all of my colleagues to join in 
supporting the Birth Defects Prevention Act. With Mother's Day fast 
approaching, I can think of few better responsive actions we can take 
to help promote the health of America's children.
  Mr. BROWN of Ohio. Mr. Speaker, I reserve the balance of my time.
  Mr. DINGELL. Mr. Speaker, I do not want to take up too much of this 
body's valuable time so I will be brief.

[[Page H924]]

  I am pleased to join my distinguished colleagues Mr. Bilirakis, Mr. 
Brown, and particularly Mr. Ortiz, in support of the enactment of S. 
419, the Birth Defects Prevention Act. This important public health 
measure should provide significant dividends by reducing preventable 
birth defects. I am disappointed to think how much more good this bill 
would have done had it been enacted when first proposed by my good 
friend and distinguished colleague, Mr. Ortiz. He should take 
justifiable pride in his work on this bill.
  Thousands of healthy babies will be born in the future whose lives 
would have been far different if not for my colleague's efforts. When 
these babies grow up they will not know to thank him, nor should they. 
Such is the nature sometimes of the work we do here.
  Although a regrettable situation in Texas involving children born 
with spina bifida demonstrated the need for this legislation, the Birth 
Defects Prevention Act will have powerful and positive benefits 
everywhere in America. The heart wrenching statistics on birth defects 
have been vividly set forth by my colleague, Mr. Ortiz, and by my other 
colleagues who have spoken in favor of this bill. The collection of 
surveillance data and epidemiological research to study the incidence 
of birth defects and their causes will lead directly to the design and 
implementation of prevention programs. Two leading causes of 
preventable birth defects, spina bifida and fetal alcohol syndrome, 
will be among those targeted for public and professional information 
and education programs.
  Mr. Speaker, this bill is a fitting capstone to the strong leadership 
and sustained effort on this issue by the gentleman from Texas and 
others. I commend him and my other colleagues here and in the other 
body for their superb efforts and I am delighted to join with Mr. Ortiz 
and the rest of my colleagues in support of this important legislation.
  Mr. BLILEY. Mr. Speaker, I am pleased to rise in support of this 
bill. As you know, the Committee on Commerce has a long and proud 
tradition of promoting and improving the health of America's children.
  That is why the committee discharged S. 419--to make today's vote 
possible.
  Mr. Speaker, birth defects are one of the most serious and compelling 
health problems in the United States today.
  Ironically, they are also one of the most overlooked.
  Birth defects affect over 3 percent of all births in America, and 
they are the leading cause of infant deaths.
  S. 419 addresses this problem in a number of important ways:
  It broadens public and professional awareness of birth defects and 
new prevention strategies. It is our intention that this effort will 
expand the practice of pre-natal surgery--a remarkable step forward 
that can prevent birth defects and save countless lives.
  This bill also establishes a national clearinghouse for data on birth 
defects.
  Finally, it puts in place a meaningful State surveillance effort.
  In response to concerns raised by some, I think it important to 
clearly state what this bill does not do: S. 419 does not make any 
funds available for abortion or euthanasia. Instead, these funds are 
for the prevention of birth defects--and it is the unanimous intent of 
the Congress that this goal not be met through the use of these funds 
for abortion or euthanasia.
  In closing, Mr. Speaker, I would like to note that this bill is 
strongly supported by the March of Dimes Birth Defects Foundation, 
which has worked very hard on this critical issue. I hope all my 
colleagues will join me in adding our support to it, as well.
  Mr. PAUL. Mr. Speaker, I rise in opposition to S. 419, yet another 
circumvention of the enumerated powers clause and tenth amendment by 
this 105th Congress in its continued obliteration of what remains of 
our national government of limited powers.
  For most of the past thirty years, I have worked as physician 
specializing in obstetrics. In so doing, I delivered more than 4,000 
infants. Despite what I believe to be a somewhat unique insight on the 
topic of birth defect prevention, today, I address the house as a 
Congressman rather than as a physician.
  As a Congressman, I have repeatedly come to the house floor to 
denounce the further expansion of the federal government into areas 
ranging from ``toilet-tank-size mandates'' to ``public housing pet 
size;'' areas, that is, where no enumerated power exists and the tenth 
amendment reserves to state governments and private citizens the 
exclusive jurisdiction over such matters. My visits to the floor have 
not gone uncontested--proponents of an enlarged federal government and 
more government spending have justified their pet spending and 
expansionist projects by distorting the meaning of the ``necessary and 
proper'' and ``common defense and general welfare'' clauses to 
encompass the constitutionally illegitimate activities they advocate. 
Even the Export-Import Bank and Overseas Private Investment Corporation 
during Foreign Operations Appropriations debate were constitutionally 
``justified'' by the express power to ``coin money and regulate the 
value thereof''? In other words, where money exists, credit exists--
where credit exists, loans exist--where loans exist, defaulters exist--
and from this, the federal government has a duty to bail-out (at 
taxpayer expense) politically connected corporations who make bad loans 
in political-risk-laden venues?
  In the Federalist Papers, Madison and Hamilton strongly denied such 
views with respect to the necessary and proper clause. Madison was 
similarly emphatic that the ``defense and welfare'' clause did not 
expand the enumerated powers granted to Congress. To the extent these 
clauses encompass the enumerated powers (rather than merely serve as 
their preamble), one must ask why then the federal powers were, in 
fact, enumerated in Article One, Section 8.
  Chiefly to resolve ambiguities about the national powers, the tenth 
amendment, proposed as part of the Bill of Rights by the Federalist-
controlled first Congress, was added, declaring that the ``powers not 
delegated to the United States by the constitution, nor prohibited by 
it to the States, are reserved to the States respectively, or to the 
people.'' According to constitutional scholar Bernard Siegan, 
University of San Diego College of Law, the Constitution might never 
have been ratified had the Federalists' representations in this regard 
not been accepted by a portion of the public. Siegan also reminds us 
that the Framers rejected the notion of empowering the national 
government to grant charters of incorporation; establish seminaries for 
the promotion of agriculture, commerce, trades, and manufactures; 
regulate stages on post roads; establish universities; encourage by 
premiums and provisions, the advancement of useful knowledge; and 
opening and establishing canals. Each notion was introduced during the 
convention and voted down or died in committee.

  Jefferson, in one of his most famous remarks, when addressing the 
issue of whether to grant a federal charter to a mining business, 
recognized below the slippery slope of a lax interpretation of the 
``necessary and proper'' clause:

       Congress are [sic] authorized to defend the nation. Ships 
     are necessary for defense, copper is necessary for ships; 
     mines, necessary for copper; a company necessary to work the 
     mines; and who can doubt this reasoning who has ever played 
     at ``This is the House that Jack Built''? under such a 
     process of filiation of the necessities the sweeping clause 
     makes clean work. [1 c. Warren, The Supreme Court United 
     States History 501 (Rev. ed. 1926]

  Cleary, while engaging in such congressional activism makes ``clean 
work,'' it also makes for an oppressive national government involved in 
every aspect of its citizens' lives. Remember that in engaging in such 
activism, the next liberty upon which the Congress infringes, may be 
your own.
  I, for one, am uninterested in further catapulting this country down 
this ``road to serfdom'' albeit a road paved with the good intentions 
of, in this case, ``preventing birth defects''. If this matter is so 
vital that it can only be done via the power of the federal government, 
then I suggest that members of the House convince their constituents of 
this and amend the constitution accordingly. I, despite my extensive 
work as an obstetrician, remain unconvinced. A volunteer group, private 
charity, hospital trade association, or university could certainly, in 
this age of advanced computer technology, maintain a database necessary 
to adequately address the information needs of those hoping to advance 
the cause of birth defect reduction. This, I believe would be a 
solution compatible with the framer's notion of a national government 
of limited powers.
  For these reasons I oppose S. 419, the Birth Defects Prevention Act 
of 1997.
  Mr. BONILLA. Mr. Speaker, I rise today in support of S. 419, The 
Birth Defects Prevention Act. This bill is aimed at curbing a very 
serious problem that hits over 150,000 American families each year, 
birth defects.
  Birth defects strike over three percent of all births in America and 
are the leading cause of infant death. The real tragedy is that many of 
these birth defects and deaths could be prevented.
  The horrifying impact of birth defects touched my home state of Texas 
just a few years ago. In the early 1990's health officials noted 
extremely high numbers of children born with neural tube defects in 
Cameron County, in my colleague Solomon Ortiz's district.
  Unfortunately, the tragedy did not stop there. During a short four 
month period of 1995, six infants were born without brains or with only 
partial brains in Eagle Pass, Texas, a city in my congressional 
district. Despite a massive investigation by medical researchers, the 
cause of these outbreaks were never discovered. Nightmares like these 
must never happen again.
  That's why I was proud to join my colleague, Solomon Ortiz in 
introducing the Birth Defects Prevention Act. This bill will link

[[Page H925]]

the researchers and health care providers to the important information 
they need to curb birth defects and prevent other tragedies like the 
ones along the Texas/Mexico border.
  Biomedical researchers are making progress in preventing birth 
defects. Recently, scientists discovered the crucial role of the 
vitamin folic acid in preventing birth defects. Despite discoveries 
like this, the fact remains that researchers and health care 
professionals just don't know what causes most birth defects.
  That's why this bill is so important. The bill establishes a National 
Information Clearinghouse on Birth Defects. This national, state-based, 
tracking system will count the number of babies born with birth 
defects, identify the causes and start community prevention programs. 
By learning all the facts surrounding birth defects, we have a chance 
to get ahead in the fight against them.
  Education and research are key to fighting birth defects. With the 
programs established in the Birth Defects Prevention Act, hopefully 
fewer American families and children will be forced to live with the 
tragedy of birth defects.
  I would like to conclude by recognizing the dedication of the March 
of Dimes in the fight against birth defects. Their hard work in trying 
to eradicate the number one killer of American babies is truly 
outstanding.
  Mr. BRADY. Mr. Speaker, today I rise in support of S. 419, the Birth 
Defects Prevention Act, and am pleased to be a cosponsor of its 
companion bill in the House of Representatives, H.R. 1114, which was 
introduced by two of my colleagues from the Texas delegation. As you 
know, this legislation was first introduced in the 102nd Congress in 
response to the tragedy that occurred in South Texas where a cluster of 
devastating birth defects escaped detection for several years.
  S. 419 builds on legislation I introduced in the Texas House of 
Representatives in 1993 and that was signed into law. Anne Andis, from 
The Woodlands, Texas, was told when she was 10 weeks pregnant that her 
baby would be born with anencephaly, the same birth defect plaguing 
women and infants in South Texas. Her physician advised an induced 
delivery immediately. However, after agonizing over this decision with 
her husband and their two young daughters, they decided to have the 
child. Emma was born in February 1992 and lived for five days.
  After Emma's death, Anne became involved in lobbying efforts to 
establish a birth defects registry in Texas after learning of the 
tragic situation in South Texas where an unexplained cluster of babies 
were being born with partial brains. Anne is a heroine because she 
agreed to make a very private tragedy public and was the motivator of 
Texas' efforts.
  As you know, S. 419 calls for the establishment of a National 
Information Clearinghouse on Birth Defects to collect and disseminate 
to health professionals and he public information on birth defects, 
including prevention measures. It also directs the Centers for Disease 
Control to carry out, through the states, a program to collect, analyze 
and report statistics on birth defects.
  Mr. Speaker, 150,000 infants are born each year with a serious birth 
defect. Many more children are found to have such disorders later in 
life. Families from all racial, ethnic and economic groups share the 
risk of having a child with a serious birth defect. Furthermore, for 
more than 20 years, birth defects have been the leading cause of infant 
mortality. Surveillance is necessary to track the incidence of birth 
defects and reduces their impact of public health. Again, I am proud to 
be a cosponsor of this legislation. We can not begin to stop birth 
defects until we know when and where they are occurring. For families 
across our Nation like the Andis family, we must pass this legislation.


                             General Leave

  Mr. BILIRAKIS. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days within which to revise and extend their 
remarks and to include extraneous material on S. 419, the Senate bill 
presently under consideration.
  The SPEAKER pro tempore (Mr. Shimkus). Is there objection to the 
request of the gentleman from Florida?
  There was no objection.
  Mr. BILIRAKIS. Mr. Speaker, we have Senator Bond here, who I know 
must be chomping at the bit to get up and talk about this. We are 
certainly very grateful to him for his leadership in the Senate. I 
guess our rules do not allow that.
  Mr. Speaker, I have no further requests for time, and I yield back 
the balance of my time.
  Mr. BROWN of Ohio. Mr. Speaker, I have no further requests for time, 
and I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Florida (Mr. Bilirakis) that the House suspend the rules 
and pass the Senate bill, S. 419.
  The question was taken.
  Mr. BILIRAKIS. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 5 of rule I and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

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