[Congressional Record Volume 144, Number 140 (Thursday, October 8, 1998)]
[House]
[Pages H10137-H10148]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATIONS ACT, 1999
The CHAIRMAN. Pursuant to House Resolution 564 and rule XXIII, the
Chair declares the House in the Committee of the Whole House on the
State of the Union for the consideration of the bill, H.R. 4274.
{time} 1952
In The Committee Of The Whole
Accordingly, the House resolved itself into the Committee of the
Whole House on the State of the Union for the consideration of the bill
(H.R. 4274) making appropriations for the Departments of Labor, Health
and Human Services, and Education, and related agencies, for the fiscal
year ending September 30, 1999, and for other purposes, with Mr.
Bereuter in the chair.
The Clerk read the title of the bill.
The CHAIRMAN. Pursuant to House Resolution 564, the bill is
considered as having been read the first time.
Pursuant to House Resolution 584, the gentleman from Illinois (Mr.
Porter) and the gentleman from Wisconsin (Mr. Obey) each will control
30 minutes.
Mr. ENGEL. Mr. Chairman, today we take a vote on the future of our
children. Day in and day out the Members of the 105th Congress come to
the floor and express their concerns for ensuring opportunities for the
next generation. H.R. 4274, ``the Labor-HHS-Education Appropriations
bill,'' is one piece of legislation that goes to the heart of our
collective concerns. However, despite our desire to assist our children
we instead embark on a bill that politicizes their future. Instead of
providing opportunities, this bill guts national education funding for
short term political gain. This bill eliminates funding for technology
in the classroom in low-income school districts, it eliminates funding
for teacher training, and it even eliminates funding to ensure that our
children can read before the end of the third grade.
However, to just discuss the inadequacies of this bill on our
elementary school aged children would not be a fair summarization of
the destructive nature of this piece of legislation. This
appropriations bill attempts at its very essence, to provide budget
cuts off the backs of the poor, the immigrant and the laborer. H.R.
4274 if passed would eliminate federal subsidized funding for 4.4
million of the poorest households to pay for their heat during the
winter months; this bill if passed would cut federal funding for
bilingual education by $25 million which would reduce funding for
adequate teacher training; this bill if passed would even cut OSHA
workplace safety enforcement by $12 million which would result in 4,000
fewer workplace safety inspections in 1999.
The role of government is debated each day on the floor of this
House, in our committee rooms, and in our districts but we all can
agree that our mandate is to serve the people. It is paramount that as
a national body we focus not on partisan political goals but rather on
what is in the best interest of our constituents. Members would then
understand that this appropriation bill is too unfair, too detrimental
to our national educational policy and too damaging to the poor. I urge
my colleagues on both sides of the aisle to join me in opposing H.R.
4274 and vote no on this bill.
Mr. PORTER. Mr. Chairman, Mr. Greenwood's amendment protects a good
program, a program that Members should support.
One of our priorities in this bill is public health programs that
help expand access to care for the underserved. Title X--as George Bush
and Richard Nixon recognized--is such a program.
1. It supports a broad range of reproductive services to women--
including assistance for women who are having trouble conceiving
children--as well as screening for breast and cervical cancer, sexually
transmitted infections and hypertension. These are life saving, life
giving, life enhancing services.
2. In 1996, 4.3 million clients were served--83 percent with incomes
below 150 percent of the federal poverty level. Everyone above the
poverty line pays something for their care on a sliding scale. For many
working poor, Title X provides their only access to the health care
system.
3. The law has always barred Title X from paying for any abortion
under any circumstances. This is not an abortion issue.
Title X is really an anti-abortion program: roughly half of all
unintended pregnancies end in abortion. It is estimated that, in 1994,
one million unintended pregnancies were averted as a result of services
received at Title X projects. Title X prevents the unintended
pregnancies that lead to abortions and that lead to low-birthweight
babies.
Title X improves maternal and child health, it lowers the incidence
of unintended pregnancy and abortion and it lowers rates of STDs.
It is a good program, it is a wise investment, and we should be very
careful about adopting amendments that undermine the program's
effectiveness.
I urge all Members to support Mr. Greenwood's amendment and oppose
Mr. Istook's substitute.
Mr. STARK. Mr. Chairman, I oppose the Labor, Health and Human
Services and Education Appropriations (Labor--HHS) Bill considered in
the House today.
education suffers under this bill
This bill would have devastating effects on students and our
education system and I strongly urge my colleagues to reject this bill.
My colleagues on the other side of the aisle have been busy with
their education agenda this year. We've debated a Constitutional
Amendment to allow for prayer in schools and we've tried to eliminate
affirmative action programs for minority students. We've also tried to
provide public dollars for private schools--not once, but twice, and to
eliminate public dollars to be used for the purposes of educating our
bilingual students. Lucky for our students, parents and teachers,
Democrats have an education agenda, too.
The Democratic plan will improve public education. We want to reduce
the average class size in the early grades by helping local school
districts hire 100,000 new qualified teachers. We want to provide
federal tax credits to pay the interest on $22 billion in bonds for the
modernization and construction of more than 5,000 schools. We want to
make sure that schoolchildren have somewhere to go after school instead
of hanging out on the streets. We are promoting after school learning
opportunities for students. We support expanding resources for
educational technology in order to ensure that every classroom and
school library is connected to the Internet by 2001.
The Democratic ideas will work; they will provide more opportunities
for out kids. Nobody denies that public education is in bad shape. But
the majority's solution is to cut funding and eliminate programs and to
determine what choices are made available to school districts and
teachers. This does not make good sense or good policy.
This Education Appropriations bill fails to fund a single one of the
Administration's initiatives to modernize schools and build new
schools. it is no secret that schools are overcrowded. Schoolteachers
in my district are conducting classes in portables, school lunchrooms
and even in hallways. The majority, by not addressing this problem in
their bill, are putting a bag over their head and hoping the problem
goes away.
This Education Appropriations bill does not fund the President's
Literacy Initiatives and eliminates funding for the America Reads
Challenge. Furthermore, the bill cuts funding for the Safe and Drug
Free Schools initiative, and does not fund the President's plan to
target funds to districts and schools with the largest drug and
violence programs.
This bill also incorporates the text of a bill that was defeated by
the House earlier this year and with regard to bilingual education.
This bill would limit the amount of bilingual education a student could
receive to a maximum of two years. Reputable research proves that
children take between four to seven years to master academic English
necessary for higher education success. This bill provides no academic
safety net for students who fail to master English in two years. It
does not make sense to shove children arbitrarily from an environment
where they are learning to one where they are predetemined to fail.
The House has already soundly defeated this idea. Why does this bill
pander to an extreme minority who has already lost this fight?
This bill also prevents students from achieving success in the new
millennium by cutting funds for GOALS 2000 by 50%. How does cutting
funding for this program help students? I would ask the majority
leadership to answer this question.
This bill also prevents any funds from being spent to adopt a
national testing standard for our kids. These tests have nothing to do
with content and would test fourth graders for reading comprehensive
and eighth graders for math ability. I support national testing
standards. These voluntary tests will have no effect on home schooling
or parochial education interests. Testing gives states, local
communities and parents one more tool to measure how well their
curriculum prepares students in basic reading and math skills. If we
are to spend taxpayer money on public schools, we must know that we are
getting measurable results.
It is clear that my colleagues on the other side of the aisle do not
think the same way about education as we do. Their attacks on our basic
fundamental obligation to provide a
[[Page H10138]]
public education for every child in America will have a devastating
effect on schoolchildren and our Country's future.
A real stand for education is a vote against this terrible bill.
Cuts Hurt the Most Vulnerable
H.R. 4274 is a confrontational bill--the product of a majority
leadership decision to cave to demands from the right wing of its own
conference. It does nothing to heal the economic and social divisions
within our society. Instead it resembles a blueprint for the reelection
of the House Republican leadership.
H.R. 4274 is the direct result of the majority's decision to kill
tobacco legislation. Instead of using tobacco company revenues to fund
a set of fairly balanced domestic priorities, the majority has decided
to offset their spending priorities by cutting the programs that
benefit the most vulnerable members of our society.
H.R. 4274 eliminates funding for LIHEAP. I oppose this provision.
There is no programmatic or economic rationale to justify eliminating a
program that helps 4.4 million low-income households pay their heating
and cooling bills. About 1.5 million of these households have elderly
members, 1.3 million have disabled members, and 2.1 million have
children in poverty. Two-thirds of LIHEAP recipients earn less than
$8,000 per year. Energy prices constitute a significant expense for
poorer households whose incomes have not kept up with inflation.
I also strongly oppose the bill's prohibitions on Title X funding.
Title X family planning clinics offer a wide range of critical services
including contraception, screening and treatment for sexually
transmitted diseases, HIV screening, routine gynecological exams, and
breast and cervical cancer screening. If minors are required to comply
with parental consent or notification laws for contraceptive services,
not only will they avoid seeking family planning services, they will
avoid seeking any of the services at a Title X clinic. Without these
services, the authors of this bill can soon take credit for an increase
in abortions and sexually transmitted diseases. I oppose this bill for
its blatant disregard for the reproductive health, safety, and
constitutional rights of America's women.
Supporters argue that H.R. 4274 eliminates excessive and burdensome
federal regulation and provide enhanced discretion to state and local
officials. Yet, the bill prohibits the use of Title X funds by any
entity unless it certifies that it encourages family participation in
the decision of minors to seek family planning services. It also
prohibits a state or locality's contribution of Medicaid matching funds
to pay for any abortion or to pay for health benefits coverage offered
by a managed care provider that includes coverage of abortion.
This Bill Plays Politics With Organ Donations
Every day 10 people die in this country waiting for an organ
transplant. There is no disagreement about the problem--there aren't
enough organs to meet the needs of patients.
In March, the Department of Health and Human Services issued proposed
regulations to equalize large discrepancies in waiting times for
transplant patients around the country and help guide the transplant
community to create a fairer transplant system.
Now the House Labor-HHS bill includes two riders, which would
prohibit the implementation of these regulations and prevent the HHS
Secretary from working to increase the number of available organs.
The first rider would prevent the Secretary from requiring hospitals
to report patient deaths to regional Organ Procurement Organizations.
This simple requirement is in effect in Maryland and Pennsylvania and
both states report additional organ donations as a direct result.
Preventing this regulation from going forward will make more patients
die waiting for other organs. This is a matter of life and death and
this rider should be removed from the bill.
The second rider puts a moratorium on the Secretary's organ
allocation plan to make the distribution of organs more fair for
patients. The Secretary's organ allocation plan is urgently needed by
patients across the country. Patients in the Bay Area wait an average
of over 300 days for a transplant, while patients in Tennessee wait 21
days. This isn't fair.
The Secretary has proposed to let medical people make medical
decisions about the best way to allocate the limited number of donated
organs. The Appropriations Committee should allow these regulations to
be implemented without further delay.
This rider is being pushed by a group of Louisiana transplant
surgeons who believe that organs should be hoarded for their own state
use. Over 30% of Louisianans needing a transplant leave the state to
find better care in other hospitals or because they have been turned
down for transplants in Louisiana. The state has recently passed an
``organ hoarding'' law to prevent organs that are made available for
transplant in Louisiana from leaving the state. The state has also
filed a lawsuit against the Secretary for issuing national regulations,
despite the fact that the National Organ Transplant Act specifically
requires that the Secretary do so.
Fairness is half of this fight; Quality is the other part. There is a
lot of money to be made in organ transplants. Too many centers have
been opened to increase the prestige and the profits of a local
hospital--and not because they do a good job. In fact, in general the
lower volume small transplant centers have poorer outcomes than the
high volume transplant centers. The fact is that having a transplant
center has become the equivalent of health pork. Many of these centers
are like the excess projects in the recently-passed highway bill:
centers without a justification. But unlike highway pork, these centers
sometimes end up killing patients because they do not do as good a job
as the high volume centers. I really think it is immoral for centers
that have a lower success rate than the high volume centers to be
fighting the Department's regulation. Their actions are a disgrace to
the Hippocratic Oath.
The proliferation of poor quality transplant centers not only wastes
lives, it wastes money. The United States has 289 hospitals doing
tranplants--and that is an enormous commitment of capital. I have read
that a hospital has to invest about $10 million to be able to do heart
transplants.
These proliferating costs are part of what drives health inflation in
the United States and part of what places such huge budget pressures on
Medicare. Concentrating transplants in fewer, high-quality, life-saving
centers would allow us to save hundreds of millions of dollars in the
years to come. The Department's regulation gives us the potential to
focus on Centers of Excellence where we not only save lives, but can
obtain economies of scale necessary to preserve the Medicare program.
If my colleagues are serious about putting patients first, what is so
onerous about a system that proposes to base transplant decisions on
common medical criteria on a medical need list--not geography, not
income, not even levels of insurance coverage--just pure professional
medical opinion and medical need.
This issue is about putting patients first--not putting transplant
bureaucracies first. I can think of no better way to put patients first
than to make the system fair for all. I urge my colleagues to support
the Department's regulations and to vote against the Labor-HHS bill.
The Bill is Bad for Working Families
This bill would have devastating effects on working families and I
strongly urge my colleagues to reject this bill.
America's working families deserve a break. After a few years of
record profits for Wall Street and the Fortune 500 companies, it is
time to help out the working men and women responsible for this
productivity. Instead, some of my colleagues, in their quest to please
corporate shareholders, have launched an assault upon the basic
protections that working families count on and enjoy.
I've heard from numerous young people in my district about the
importance of the Summer Youth Employment Training Program (SYETP).
They tell me that they have learned the value of a dollar and the
importance of being accountable and responsible because of their summer
jobs. I've heard from Mayors and School Districts about the need for
this program. The Castro Valley Unified School District wrote to me to
tell me that ``SYETP is one of those programs that addresses the needs
of a segment of our student population and does so with a high degree
of success.'' I've included this letter for the Congressional Record to
accompany my statement.
What has the Majority done in response to this support for the Summer
Youth Employment Training Program? They have eliminated all of the
funding for it.
The Summer Youth Employment Training Program works. It give young
people the tools, skills and experience they need to succeed in the
workplace after they are finished with school. Eliminating this program
is not an investment in our future.
This Labor-HHS bill cuts funding for Job Training Partnership Act by
$1.5 billion from the President's request. The bill also cuts School-
to-work programs by 62 percent from last year's appropriation. The
message to young workers is clear: if you stuck in a low paying job or
lack a graduate degree, the government will not help you obtain the
skills you need to provide for your family. This is the wrong direction
for our country to be going.
One of the largest roles for government to protect working families
is through the Occupational Safety and Health Administration (OSHA).
OSHA offers guidelines for employers to provide employees with safe
workplaces and enforces safety standards to ensure that the likelihood
of injury or death on the job is reduced. OSHA is the safety cop on the
beat for working families, and deserves our support.
[[Page H10139]]
This Labor-HHS bill cuts OSHA funding by $18 million from the
Administration's request. Furthermore, the bill includes provisions to
require peer-review of the scientific data on which OSHA standards are
based. The bill specifically permits a person with a financial interest
in the outcome of the standard to set on the pear review panel. I
question how many true labor protection standards will make it out of
the regulatory process with employers and financial backers making the
final decisions about what workers safety standards are really needed.
The majority's labor record is clear. Working families should take a
back seat to corporate interests and employer decisions. I don't share
this view.
I believe that working families deserve strong protections at the
workplace, should be able to organize and advocate for their common
interests and should not have to work in an environment of indentured
servitude to guarantee a paycheck.
If my colleagues were serious about help out working men and women,
they would work to pass a real minimum wage increase and link it to a
cost of living adjustment to provide a real working wage for working
families. Making investments in people is the highest priority for me.
Cutting funding out of programs to provide job skills and job security
does not lead to an economically stable society.
I urge my colleagues to vote for working families and for worker
protections and to vote against this bill.
Board of Education, Castro Valley Unified School District
Castro Valley, CA, September 14, 1998.
Hon. Fortney ``Pete'' Stark,
Fremont, CA.
Dear Representative Stark: The purpose of this letter is to
urge you to support the continuation of the Summer Youth
Employment Training Program (SYETP). This program has been a
valuable one over the years over the Castro Valley Unified
School District as it has provided opportunities for students
from low income families to be successful in a work
experience environment.
Our responsibility as educators is to provide programs and
strategies that are diverse in nature in order to address the
diversity within our student population. SYETP is one of
those programs that addresses the needs of a segment of our
student population and does so with a high degree of success.
There is no doubt that the elimination of this program will
be a major loss for us in the district and the Regional
Occupational Program in general. Judging by the information
that I have received, the elimination of SYETP nationally
would result in approximately 400,000 young people not having
an opportunity for work and educational assistance in 1999.
This is staggering and unacceptable! We cannot afford to
ignore the needs of any of our students and specifically with
regard to SYETP, the needs of students who have potential to
be productive members of our society when they reach
adulthood.
Thank you in advance for your support and assistance.
Sincerely,
George Granger,
President.
Ms. JACKSON-LEE of Texas. Mr. Chairman, thank you for the opportunity
to speak on this bill tonight, and this amendment, the Istook/Barcia/
Manzullo Amendment to the Labor HHS bill. Mr. Chairman, for the first
time EVER, the House Appropriations Committee voted to impose a
restrictive provision in this bill which will require that minors
require five business days' parental notice or parental consent before
a minor can obtain contraceptive services at a Title X clinic.
I have consistently opposed mandatory parental consent requirements
for young people seeking family planning services, and I am not alone.
The American Medical Association, the American Academy of Pediatrics,
the American Academy of Physicians, and the American Medical Women's
Association are just a number of the organizations that also oppose
this restriction. The reason is because such restrictions are dangerous
to our country's young people.
There is no question that recent declines in the teen pregnancy and
teen abortion rates have been attributed to increased use of birth
control. The vast majority of young people who seek contraceptive and
family planning services are already sexually active. In one recent
study of over 1,200 teenagers in 31 family planning clinics, only 14
percent of the teens came in for family planning services prior to
initiating sexual activity. In fact, over \1/3\ of these teens (36
percent) sought services ONLY because they suspected they were
pregnant. This legislation will only make it worse. In general, teens
are sexually active for 11.5 months prior to seeking clinic services!
This provision will not persuade our young people to have sex, it will
ensure that the rates of unintended pregnancies, abortion and STDs
including HIV increase! Currently 78 percent of teen pregnancies are
unintended, half of which end in abortion. Approximately 3 million
teenagers acquire an STD each year! I am sure that no Member of
Congress wants these numbers to increase, yet making it more difficult
for teenagers to seek reproductive health services will do just this.
Title X counselors are already required to encourage family
participation for teen clients. However, Congress, despite, its wishes
cannot mandate open family communication. Title X clinics encourage
their teenage clients to discuss their needs with parents or family
members they can trust. Confidential access to family planning is
crucial in helping teenagers obtain timely medical advice and
appropriate medical care.
Our children are our most important resource. We must do whatever we
can to make sure that our children remain safe and healthy. I am voting
against this amendment because I want our children to have a childhood
and to keep our teenagers from becoming parents.
Mr. CASTLE. Mr. Speaker, as you know, Title X of the Public Health
Service Act, the National Family Planning Program, sponsored by then-
Congressman George Bush, was enacted in 1970. It was signed into law by
President Nixon. The program provides grants to public and private non-
profit agencies to support projects which provide a broad range of
family planning and reproductive services, as well as screening for
breast and cervical cancer, sexually-transmitted infections and high
blood pressure. Title X also supports training providers, an
information and education program, and a research program that focuses
on family planning service delivery improvements. The Title X program
has provided services to millions of American women, many of whom have
no other access to health care services. By law, none of the funds
provided may be used for abortions.
Today, we are considering a bill that includes a provision requiring
parental consent or advanced notification in order for a minor to
receive contraceptive drugs or devices. Ideally, we would like all
teens to abstain from pre-mature sexual relationships. Ideally, we
would like to think that all teenagers have a wonderful relationship
with a loving parent. Unfortunately, the reality is that for many, many
teens neither is the case. There are young people who are scared to
death of their parents. There are young people who do not have parents.
And, the unfortunate reality is that there are young people who would
rush out and have unprotected sex if they knew practicing safe sex
would come at the price of having their parents find out. This is what
the mandatory parental consent and advanced parental notification
provision does.
In many cases such a provision would actually increase the chances of
teenagers engaging in unprotected, nondiscriminatory or unsafe sex,
thereby increasing the rates of pregnancy, sexually-transmitted
diseases, and abortions. 56% of women and 73% of men are sexually
active before the age of 18. 86% of teenagers using or seeking Title X
services for the first time were already sexually active for nearly a
year. In addition, studies show that about 55% of adolescents already
inform parents of their use of reproductive health services. For those
who do not or cannot discuss family planning with their parents,
mandatory parental consent and advanced parental notification are not
likely to convince them otherwise. In fact, an overwhelming number of
teens who do not involve their parents in such decisions reported that
they would not seek clinic care if their parents had to be notified.
Let me repeat--they would not seek clinic care. This means that they
are left to make decisions on their own, and those decisions will most
likely lead to unprotected sex, higher rates of pregnancy and higher
rates of abortion.
Let me give you an example. In my home state, as scary as this is,
there are kids who have reported that they cannot tell their parents
about the use of family planning services because they are afraid they
will be hurt physically. We also had a case where parents of a 15 year
old girl refused to bring her to get family planning services until she
was 16 years old and had her drivers license. Well, she turned 16, she
got her drivers license and she was already pregnant. If she had the
services a year before, she wouldn't be in this predicament. Now, I'm
not saying this is the norm. What I am saying is that we need to take
situations like this into consideration before we start mandating
policies as far reaching as this one. If parents and guardians are
unable to help these teenagers, for whatever reason. I believe health
professionals should help.
I also want to note that the Greenwood/Castle amendment does not in
anyway discourage parental involvement. It simply strikes the mandatory
parental notification clause and inserts strong language requiring
Title X providers to take a strong stand on abstinence, by expressly
informing all minors that abstinence is the only certain way to avoid
pregnancy, sexually transmitted diseases, and HIV. Our language ensures
that all Title X counselors receive training on how to help minors
abstain from sexual activity, avoid coercive relationships, and involve
their parents in the decision to receive family planning services.
We support family involvement, and if we believe that mandating
parental consent or notification was in the best interest of teens,
than we would support that as well. But, we do not. There are too many
facts that demonstrate that mandating parental consent will hurt teens
considerably more than it could ever help them.
Congressmen Istook and Manzullo will offer a second degree amendment
to our amendment inserting the parental consent or notification
language back into the bill. I urge my colleagues to vote against their
amendment and for the Greenwood/Castle amendment. Mandated parental
consent or notification would scare teens into doing something
[[Page H10140]]
stupid--like having unprotected sex in secret rather than having their
parents find out that they wanted to be safe and responsible.
Mr. PAUL. Mr. Chairman, I am sorry that under the rule my amendment
to the Labor-HHS-Education Appropriations bill is not permitted. This
simple amendment forbids the Department of Health and Human Services
from spending any funds to implement those sections of the Health
Insurance Portability and Accountability Act of 1996 authorizing the
establishment of a ``standard unique health care identifier'' for all
Americans. This identifier would then be used to create a national
database containing the medical history of all Americans. Establishment
of such an identifier would allow federal bureaucrats to track every
citizen's medical history from cradle to grave. Furthermore, it is
possible that every medical professional, hospital, and Health
Maintenance Organization (HMO) in the country would be able to access
an individual citizen's record simply by entering the patient's
identifier into the national database.
My amendment was drafted to ensure that the administration cannot
take any steps toward developing or implementing a medical ID. This
approach is necessary because if the administration is allowed to work
on developing a medical ID it is likely to attempt to implement the ID
on at least a ``trial'' basis. I would remind my colleagues of our
experience with national testing. In 1997 Congress forbade the
Department of Education from implementing a national test, however it
allowed work toward developing national tests. The administration has
used this ``development loophole'' to defy congressional intent by
taking steps toward implementation of a national test. It seems clear
that only a complete ban forbidding any work on health identifiers will
stop all work toward implementation.
Allowing the federal government to establish a National Health ID not
only threatens privacy but also will undermine effective health care.
As an OB/GYN with more than 30 years experience in private practice, I
know better than most the importance of preserving the sanctity of the
physician-patient relationship. Oftentimes, effective treatment depends
on a patient's ability to place absolute trust in his or her doctor.
What will happen to that trust when patients know that any and all
information given their doctor will be placed in a data base accessible
by anyone who knows the patient's ``unique personal identifier?''
I ask my colleagues, how comfortable would you be confiding any
emotional problem, or even an embarrassing physical problem like
impotence, to your doctor if you knew that this information could be
easily accessed by friend, foe, possible employers, coworkers, HMOs,
and government agents?
Mr. Chairman, the Clinton administration has even come out in favor
of allowing law enforcement officials access to health care
information, in complete disregard of the fifth amendment. It is
bitterly ironic that the same administration that has proven so
inventive at protecting its privacy has so little respect for
physician-patient confidentiality.
My amendment forbids the federal government from creating federal IDs
for doctors and employers as well as for individuals. Contrary to the
claims of some, federal-ID numbers for doctors and employers threaten
American liberty every bit as much as individual medical IDs.
The National Provider ID will force physicians who use technologies
such as e-mail in their practices to record all health care
transactions with the government. This will allow the government to
track and monitor the treatment of all patients under that doctor's
care. Government agents may pull up the medical records of a patient
with no more justification than a suspicion the provider is involved in
fraudulent activity unrelated to that patient's care!
The National Standard Employer Identifier will require employers to
record employees' private health transactions in a database. This will
allow coworkers, hackers, government agents and other unscrupulous
persons to access the health transactions of every employee in a
company simply by typing the company's identifier into their PC!
Many of my colleagues admit that the American people have good reason
to fear a government-mandated health ID card, but they will claim such
problems can be ``fixed'' by additional legislation restricting the use
of the identifier and forbidding all but certain designated persons to
access those records.
This argument has two flaws. First of all, history has shown that
attempts to protect the privacy of information collected by, or at the
command, of the government are ineffective at protecting citizens from
the prying eyes of government officials. I ask my colleagues to think
of the numerous cases of IRS abuses that were brought to our attention
in the past few months, the history of abuse of FBI files, and the case
of a Medicaid clerk in Maryland who accessed a computerized database
and sold patient names to an HMO. These are just some of many examples
that show that the only effective way to protect privacy is to forbid
the government from assigning a unique number to any citizen.
Even the process by which the National Identifier is being developed
shows disdain for the rights of the American people. The National
Committee on Vital and Health Statistics, which is developing the
national identifier, attempted to keep important documents hidden from
the public in violation of federal law. In fact, one of the members of
the NCVHS panel working on the medical ID chastised his colleagues for
developing the medical ID ``in an aura of secrecy.''
Last September, NCVHS proposed guidelines for the development of the
medical ID. Those guidelines required that all pre-decisional documents
``should be kept in strict confidence and not be shared or discussed,''
This is a direct violation of the Federal Advisory Committee Act, which
requires all working documents to be made public. Although NCVHS,
succumbing to public pressure and possible legal action against it,
recently indicated it will make its pre-decisional documents available
in compliance with federal law, I hope my colleagues on the Rules
Committee agree that the NCVHS attempt to evade the will of Congress
and keep its work secret does not bode well for any future attempts to
protect the medical ID from abuse by government officials.
The most important reason, legislation ``protecting'' the unique
health identifier is insufficient is that the federal government lacks
any constitutional authority to force citizens to adopt a universal
health identifier, regardless of any attached ``privacy protections.''
Any federal action that oversteps constitutional limitations violates
liberty for it ratifies the principle that the federal government, not
the Constitution, is the ultimate arbitrator of its own jurisdiction
over the people. The only effective protection of the rights of
citizens is for Congress and the American people to follow Thomas
Jefferson's advice and ``bind (the federal government) down with the
chains of the Constitution.''
For those who claim that this amendment would interfere with the
plans to ``simplify'' and ``streamline'' the health care system, under
the Constitution, the rights of people should never take a backseat to
the convenience of the government or politically powerful industries
like HMOs.
Mr. Chairman, all I ask is that Congress by given the change to
correct the mistake made in 1996 when they authorized the National
Health ID as part of the Kennedy-Kasebaum bill. The federal government
has no authority to endanger the privacy of personal medical
information by forcing all citizens to adopt a uniform health
identifier for use in a national data base. A uniform health ID
endangers the constitutional liberties, threatens the doctor-patient
relationships, and could allow federal officials access to deeply
personal medical information. There can be no justification for risking
the rights of private citizens. I therefore urge the Rules Committee to
take the first step toward protecting Americans from a medical ID by
ruling my amendment to the Labor-HHS-Education Appropriations bill in
order.
Mrs. CLAYTON. The Labor-HHS-Education Appropriations Bill is one
about priorities. Cutting successful and extremely important education
and labor programs is not a priority for me.
Mr. Chairman, I am very disturbed about the number of programs that
have been left out of this bill.
Strong employment and training programs for youth and adults would
help mitigate problems arising from people who do not have the skills
or the intent to be good employees. Yet, this Labor HHS and Education
Appropriations bill decimates funding for these very programs. This
bill eliminates funding for effective programs such as School-to-Work,
Summer Jobs, and Job Corps.
By eliminating the Summer Jobs program, the bill denies jobs to a
half-million of our most disadvantaged youth. Without these funds, \3/
4\ of the young people currently participating in this program would be
without a job next year. Are these not the same youth who concern us
because of their potential for gang affiliation, violence and crime?
The bill, in its original form, eliminated the Low-Income Home Energy
Assistance Program (LIHEAP)--a program that helps 4.4 million low-
income households pay their heating and cooling bills. However, the
manager's amendment may appropriate money for LIHEAP, but it will only
be a fraction of the 1.1 billion appropriated in advance last year for
use in FY 1999. 1.5 million of the 4.4 million households have elderly
members. 1.3 million have disabled members. And 2.1 million have
children in poverty. Who, out of the 4.4 million households, will
receive the benefit of this insufficient amount of money?
This bill also cuts funding for the Goals 2000 education reform
program by 50% below current levels. And, it cuts OSHA workplace safety
enforcement by 9% below the administration's request. It's ironic. How
can you eliminate so many programs and claim to improve
[[Page H10141]]
and support opportunities for employment, and the good health and
education of the people of our country?
We must restore these programs and remain committed to initiatives
that allow the disadvantaged to survive. We must remain devoted to
programs that educate our youth and dedicated to providing our youth
with opportunities that prepare them for the world of work.
Mr. Speaker, this is a bill about priorities. This is a bill about
values. It is not my priority to eliminate necessary programs. And it
definitely is not a priority for the disadvantaged individuals in our
society.
However, it is my priority to ensure that our youth and those who are
disadvantaged are treated fairly and are given the opportunity to be
productive citizens. So I ask you . . . honestly is this your priority?
If it is, then vote no to the Labor-HHS-Education Appropriations Bill.
Mr. PORTER. Mr. Chairman, I rise in opposition to the Istook
substitute.
The Istook amendment is unwise and should be opposed.
A. First, because it overturns the considered judgment of many
states.
1. Virtually all states have laws providing for some degree of
confidentiality in the provision of such services to minors.
2. In Illinois, statute provides that physicians may give birth
control services and information to minors under a number of
circumstances--including when the minor is already married, is already
a parent, or when failure to do so would create a serious health
hazard.
3. This amendment would overturn the considered judgment of the state
of Illinois in enacting these provisions--and you might find that it
poses similar problems in your state. And I do not recommend abrogating
a law that empowers physicians to act to address serious health
hazards.
4. In fact, there are presently twenty-three states that explicitly
ensure minors' access to confidential family planning services. The
amendment directly contravenes these state's judgments.
5. If we are going to set up this Congress as a super State
Legislature, it seems to me that, at a bare minimum, we should look at
these state laws carefully and incorporate the learning of the states
on this subject?
B. Second, the Istook amendment is premised on the false logic that,
if minors had to tell their parents they were getting contraceptive
services, they would abstain from sexual activity. That sounds good,
but unfortunately its wrong.
1. The truth is that most minors who go to Title X projects have
already been sexually active for about a year. They go to a Title X
project when they fear they have contracted a disease, become pregnant,
or they decide they need contraceptives.
2. When they enter the door, they receive counseling by professionals
who attempt to ascertain the nature of the relationship, including
potential sexual abuse, encourage the minor to consider abstinence and
to involve their parents in their decision making, and educate them on
how to resist coercive sexual activity.
3. If these minors who are already sexually active know that they
will not be able to receive contraceptives, they will not go to the
project. They will not receive abstinence counseling or other
protective assistance. They will continue to have sex, contract STDs,
become pregnant and, statistics tell us, over half will have abortions.
4. And minors from dysfunctional families who may suffer abuse at
home and be surrounded by drug and alcohol abuse and crime may have
many valid reasons for wishing to not involve their parents.
Categorically mandating that involvement, in the absence of a court
order is neither wise nor realistic.
5. This is why so many states expressly protect confidential services
for minors.
6. And this is why medical organizations--the provider organizations
that know the realities better than anyone in this room--support
confidential services.
a. As the American Medical Association has told us, AMA policy
opposes mandatory parental notification when prescription
contraceptives are provided to minors through federally funded programs
since it creates a breach of confidentiality in the physician-patient
relationship.
b. The American Public Health Association and American Nurses
Association are similarly opposed.
We should heed this judgment and support the substitute.
Mr. CLAY. Mr. Chairman, I rise in opposition to the H.R. 4274, the
Labor/HHS Appropriations bill, because through it the House Republicans
propose to make drastic cuts in many programs that are vitally
important to all Americans, but especially to those most in need whose
very survival and growth depends upon the assistance they receive from
their government. Fortunately, however, this destructive bill is going
nowhere and every Member of this body knows it for the sham that it is.
The Republican leadership recognizes they don't have the votes to pass
it and are negotiating to include another version of this measure in
the Omnibus spending bill.
The funding levels in the bill, as reported, fall $2 billion short of
what democrats believe is needed to improve our schools and prepare our
children for the 21st Century. There are no funds for America Reads,
which helps endure that all children can read well when they complete
the third grade. There are no funds to help communities hire 100,000
new teachers and reduce class size so that students can have a better
chance to learn. There are no funds to help communities modernize and
build schools that provide safe and appropriate learning environments.
Clearly, there is nothing in this bill that reflects any investment in
the future of public education. In fact, this bill grossly underfunds
existing and proven educational programs upon which we have long
relied.
Later today, this body will consider a bipartisan conference report
reauthorizing the Head Start program, yet this appropriations bill
would provide $160 million less than what the President has requested
to run Head Start next year. A second bipartisan conference report to
be taken up today extending child nutrition programs, would authorize
new funds for meal supplements to induce greater participation in
after-school programs. This appropriations bill, however, would provide
$140 million less than what the President requested to operate these
very same after-school programs. I can't imagine how any Member who
would vote today to reauthorize our Head Start and nutrition programs
could, in good conscience, support these devastating cuts.
Regrettably, Mr. Speaker, the cuts don't stop here, there are many
many more. For example, funding for Title I, bilingual education, Safe
and Drug Free Schools, Work-Study, and School to Work are all cut.
Without the assistance there programs, provide, thousands of
disadvantaged students will be deprived of both the educational and
career opportunities they need to succeed in life.
Our nation's labor force also suffers under this appropriations bill.
It cuts funding for critical worker protection programs run by the
Occupational Safety and Health Administration, and the Mine Safety and
Health Administration. Several regulatory riders are attached that
compromise these agencies' effectiveness. In addition, the bill
undermines efforts to help our youth enter the workforce by completely
defunding the Summer Jobs Program and the President's Youth Opportunity
Areas Initiative.
Finally, Mr. Chairman, this bill eliminates funding for the Low
Income Energy Assistance Program which provides heating and cooling
assistance for over 5.5 million low and fixed-income households. With
winter approaching, many of those who have relied on this program may
soon be forced to choose between heating their homes and feeding their
families. That should be totally unacceptable in a nation as prosperous
as ours. But rather than meet this urgent need, Republicans would
rather squander available dollars on tax cuts for the wealthy.
Mr. Chairman, this is a bad bill that hurts students, working
families, and our most neediest families. I strongly urge Members to
oppose it.
Thank you Mr. Chairman.
The Chair recognizes the gentleman from Illinois (Mr. Porter).
Mr. PORTER. Mr. Chairman, I yield back the balance of my time.
Mr. OBEY. Mr. Chairman, because I think this is a colossal waste of
time, I, too, yield back the balance of my time.
The CHAIRMAN. All time for general debate has expired.
Pursuant to the House Resolution 564, the bill shall be considered
for amendment under the 5-minute rule.
Pursuant to that resolution, Amendment No. 1 printed in House Report
105-762 may be offered only at the appropriate point in the reading of
the bill. Pursuant to House Resolution 584, Amendments No. 2 and 3
shall be in order before the consideration of any other amendment.
The Amendments No. 2 and 3 printed in the report may be offered only
by a Member designated in the report, shall be considered read, shall
be debatable for the time specified in the order of the House today,
equally divided and controlled by the gentleman from Pennsylvania (Mr.
Greenwood) for 8 minutes, the gentleman from Oklahoma (Mr. Coburn) for
8 minutes, the gentleman from Oklahoma (Mr. Istook) for 8 minutes, and
the gentleman from Ohio (Mr. Stokes) for 8 minutes, shall not be
subject to amendment except as specified in the report, and shall not
be subject to a demand for division of the question.
The Clerk will read.
[[Page H10142]]
The Clerk read as follows:
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled, That the
following sums are appropriated, out of any money in the
Treasury not otherwise appropriated, for the Departments of
Labor, Health and Human Services, and Education, and related
agencies for the fiscal year ending September 30, 1999, and
for other purposes, namely:
Amendment No. 2 Offered By Mr. Greenwood
Mr. GREENWOOD. Mr. Chairman, I offer an amendment.
(The portion of the bill to which the amendment relates is as
follows:)
Sec. 220. (a) Notwithstanding any other provision of law,
no provider of services under title X of the Public Health
Service Act shall be exempt from any State law requiring
notification or the reporting of child abuse, child
molestation, sexual abuse, rape, or incest.
(b) None of the funds appropriated in this or any other Act
for any fiscal year for carrying out title X of the Public
Health Service Act may be made available to any family
planning project under section 1001 of such title if any
provider of services in the project knowingly provides
contraceptive drugs or devices to a minor, unless--
(1) the minor is emancipated under applicable State law;
(2) the minor has the written consent of a custodial parent
or custodial legal guardian to receive the drugs or devices;
(3) a court of competent jurisdiction has directed that the
minor may receive the drugs or devices; or
(4) such provider of services has given actual written
notice to a custodial parent or custodial legal guardian of
the minor, notifying the parent or legal guardian of the
intent to provide the drugs or devices, at least five
business days before providing the drugs or devices.
(c) Each provider of services under title X of the Public
Health Service Act shall each year certify to the Secretary
of Health and Human Services compliance with this section.
Such Secretary shall prescribe such regulations as may be
necessary to effectuate this section.
This title may be cited as the ``Department of Health and
Human Services Appropriations Act, 1999''.
The CHAIRMAN. The Clerk will designate the amendment.
The text of the amendment is as follows:
Amendment No. 2 printed in the House Report Number 105-762
offered by Mr. Greenwood:
Page 52, strike line 8 and all that follows through page
53, line 8, and insert the following:
(b)(1) The Secretary of Health and Human Services (in this
section referred to as the ``Secretary'') shall require that
each family planning project under section 1001 of title X of
the Public Health Service Act--
(A) expressly inform all minors who seek the services of
the project that abstinence is the only certain way to avoid
pregnancy, sexually transmitted diseases, and infection with
the human immunodeficiency virus; and
(B) ensure that all individuals who provide counseling
services to minors through the project are trained to provide
to minors counseling that encourages the minors--
(i) to abstain from sexual activity;
(ii) to avoid being coerced into engaging in sexual
activities; and
(iii) to involve their parents in the decision to seek
family planning services.
(2) The Secretary, acting through the Deputy Assistant
Secretary for Population Affairs, shall carry out the
following with respect to family planning projects referred
to in paragraph (1):
(A) The Secretary shall develop and disseminate to the
projects protocols for providing the counseling described in
paragraph (1)(B), including protocols for training
individuals to provide the counseling.
(B) The Secretary shall ensure that such protocols include
protocols specific to younger adolescents.
(C) In developing protocols under subparagraphs (A) and
(B), the Secretary shall consider the results of research
under title XX of the Public Health Service Act.
__________
3. A Substitute Amendment Offered by Representative Istook of Oklahoma
or His Designee to the Amendment Numbered 2 Offered by Representative
Greenwood of Pennsylvania or His Designee
Strike section 220 (page 52, line 3, and all that follows
through page 53, line 8) and insert the following:
Sec. 220. (a) Notwithstanding any other provision of law,
no provider of services under title X of the Public Health
Service Act shall be exempt from any State law requiring
notification or the reporting of child abuse, child
molestation, sexual abuse, rape, or incest.
(b) None of the funds appropriated in this or any other Act
for any fiscal year for carrying out title X of the Public
Health Service Act may be made available to any family
planning project under section 1001 of such title if any
provider of services in the project knowingly provides
contraceptive drugs or devices to a minor, unless--
(1) such provider of services has given actual written
notice to a custodial parent or custodial legal guardian of
the minor, notifying the parent or legal guardian of the
intent to provide the drugs or devices, at least five
business days before providing the drugs or devices; or
(2) the minor has the written consent of a custodial parent
or custodial legal guardian to receive the drugs or devices;
or
(3) the minor is emancipated under applicable State law; or
(4) a court of competent jurisdiction has directed that the
minor may receive the drugs or devices.
(c)(1) The Secretary of Health and Human Services (in this
section referred to as the ``Secretary'') shall require that
each family planning project under section 1001 of title X of
the Public Health Service Act--
(A) expressly inform all minors who seek the services of
the project that abstinence is the only certain way to avoid
pregnancy, sexually transmitted diseases, and infection with
the human immunodeficiency virus; and
(B) ensure that all individuals who provide counseling
services to minors through the project are trained to provide
to minors counseling that encourages the minors--
(i) to abstain from sexual activity;
(ii) to avoid being coerced into engaging in sexual
activities; and
(iii) to involve their parents in the decision to seek
family planning services.
(2) The Secretary, acting through the Deputy Assistant
Secretary for Population Affairs, shall carry out the
following with respect to family planning projects referred
to in paragraph (1):
(A) The Secretary shall develop and disseminate to the
projects protocols for providing the counseling described in
paragraph (1)(B), including protocols for training
individuals to provide the counseling.
(B) The Secretary shall ensure that such protocols include
protocols specific to younger adolescents.
(C) In developing protocols under subparagraphs (A) and
(B), the Secretary shall consider the results of research
under title XX of the Public Health Service Act.
The CHAIRMAN. Pursuant to the order of the House today, the gentleman
from Pennsylvania (Mr. Greenwood) and a Member opposed, the gentleman
from Oklahoma (Mr. Coburn) each will control 8 minutes.
Amendment No. 3 Offered By Mr. Istook As A Substitute For The Amendment
Offered By Mr. Greenwood
Mr. ISTOOK. Mr. Chairman, I offer an amendment as a substitute for
the amendment.
The CHAIRMAN. The Clerk will designate the amendment offered as a
substitute for the amendment.
The text of the amendment offered as a substitute for the amendment
is as follows:
Amendment No. 3 printed in House Report 105-762 offered by
Mr. Istook as a substitute for the Amendment No. 2 offered by
Mr. Greenwood:
Strike section 220 (page 52, line 3, and all that follows
through page 53, line 8) and insert the following:
Sec. 220. (a) Notwithstanding any other provision of law,
no provider of services under title X of the Public Health
Service Act shall be exempt from any State law requiring
notification or the reporting of child abuse, child
molestation, sexual abuse, rape, or incest.
(b) None of the funds appropriated in this or any other Act
for any fiscal year for carrying out title X of the Public
Health Service Act may be made available to any family
planning project under section 1001 of such title if any
provider of services in the project knowingly provides
contraceptive drugs or devices to a minor, unless--
(1) such provider of services has given actual written
notice to a custodial parent or custodial legal guardian of
the minor, notifying the parent or legal guardian of the
intent to provide the drugs or devices, at least five
business days before providing the drugs or devices; or
(2) the minor has the written consent of a custodial parent
or custodial legal guardian to receive the drugs or devices;
or
(3) the minor is emancipated under applicable State law; or
(4) a court of competent jurisdiction has directed that the
minor may receive the drugs or devices.
(c)(1) The Secretary of Health and Human Services (in this
section referred to as the ``Secretary'') shall require that
each family planning project under section 1001 of title X of
the Public Health Service Act--
(A) expressly inform all minors who seek the services of
the project that abstinence is the only certain way to avoid
pregnancy, sexually transmitted diseases, and infection with
the human immunodeficiency virus; and
(B) ensure that all individuals who provide counseling
services to minors through the project are trained to provide
to minors counseling that encourages the minors--
(i) to abstain from sexual activity;
(ii) to avoid being coerced into engaging in sexual
activities; and
(iii) to involve their parents in the decision to seek
family planning services.
(2) The Secretary, acting through the Deputy Assistant
Secretary for Population Affairs, shall carry out the
following with respect to family planning projects referred
to in paragraph (1):
(A) The Secretary shall develop and disseminate to the
projects protocols for providing the counseling described in
paragraph
[[Page H10143]]
(1)(B), including protocols for training individuals to
provide the counseling.
(B) The Secretary shall ensure that such protocols include
protocols specific to younger adolescents.
(C) In developing protocols under subparagraphs (A) and
(B), the Secretary shall consider the results of research
under title XX of the Public Health Service Act.
(d) Each provider of services under section 1001 of title X
of the Public Health Service Act shall each year certify to
the Secretary of Health and Human Services compliance with
this section. Such Secretary shall prescribe such regulations
as may be necessary to effectuate this section.
The CHAIRMAN. Pursuant to the order of the House today, the gentleman
from Oklahoma (Mr. Istook) and a Member opposed, the gentleman from
Ohio (Mr. Stokes) each will control 8 minutes.
The Chair recognizes the gentleman from Pennsylvania (Mr. Greenwood).
Mr. GREENWOOD. Mr. Chairman, I yield myself 2 minutes.
Mr. Chairman, this is a virtual reality debate as we know. This bill
is not going to go anywhere. This is a debate that should have occurred
months ago, and the opponents of free debate on the floor held us up
for months, but now we will have the debate. I think we can and should
do it in a civilized way.
This is the issue. The gentleman from Oklahoma (Mr. Istook) in the
Committee on Appropriations inserted language into the title 10
program, the program that provides family planning services to
Americans, to lower income Americans, so that they can avoid pregnancy
and provide services so that they can avoid sexually transmitted
diseases.
The language of the gentleman from Oklahoma (Mr. Istook) says that,
when a minor, a 17-year-old teenager who has been sexually active for a
long time, as is usually the case, comes into a clinic. The clinic
counselor must send a letter to the parents and the child. The minor
cannot receive services for 5 additional days.
I understand the gentleman's intent. I am a parent. But it is wrong-
headed. The result of that language, the result of that policy is that
if young people do not go into centers and clinics, they do not get the
services they need, they become pregnant, and they get diseases.
Our language makes it clear that every family counselor, every family
planning counselor has to encourage family involvement in the decision
of minors to seek family planning services and provide counseling to
minors on how to resist coercive sexual relations.
It requires them to expressly inform all minors that abstinence is
the only certain way to avoid pregnancy, sexually transmitted diseases,
including HIV.
It requires further that every counselor have state of the art
training to encourage, to learn how, and teach kids to involve their
parents with these decisions and to abstain from sexual activity.
I urge a ``no'' vote on the Istook amendment and a ``yes'' vote on
the underlying Greenwood amendment.
Mr. ISTOOK. Mr. Chairman, I yield myself 1 minute and 15 seconds.
Mr. Chairman, the Committee on Appropriations has sought to reform a
Federal program that has not been revised or reviewed by the Congress
in a great number of years, that being Federal Family Planning.
It is not a matter of 17 years olds, it is a matter of children of
any age whatsoever, Mr. Chairman. It is not a matter of just low income
persons because the effect of not having parental notice is to say that
any child is considered to be a child of poverty and, therefore, at
taxpayers' expense, can receive, among other things, taxpayer financed
contraceptives, condoms, birth control pills, IUDs, diaphragms, with
neither the knowledge or consent of their parents.
Now, Mr. Chairman, if the government were enabling children to be
involved with drugs or alcohol or were aware that they were involved,
parents would be notified. There is no other circumstance like this
where parents are cut out.
The issue is to vote that parents have a right to know, to be
involved with the morals and the life and the activities of their
children. That is simply why we encourage a vote for the Istook
substitute to provide for parental notice, which is sadly lacking
today.
{time} 1900
Mr. GREENWOOD. Mr. Chairman, I yield 4 minutes to the gentleman from
Ohio (Mr. Stokes) for purposes of control.
The CHAIRMAN. Without objection, the gentleman from Ohio (Mr. Stokes)
will control 4 minutes.
There was no objection.
Mr. STOKES. Mr. Chairman, I thank the gentleman for yielding to me.
Mr. Chairman, I yield the 4 minutes to the distinguished gentlewoman
from New York (Mrs. Lowey).
Mrs. LOWEY. Mr. Chairman, I thank my distinguished good friend and
ranking minority member, the gentleman from Ohio, (Mr. Stokes).
My colleagues, the Istook provision represents the latest attack by
family planning opponents against our Nation's flagship program. Three
years ago, family planning opponents tried to zero out funds for the
Title X program. They failed. Two years ago, family planning opponents
led by the gentleman from Oklahoma (Mr. Istook) offered a parental
consent amendment, and it failed. Last year the gentleman from Oklahoma
(Mr. Istook) offered language nearly identical to that which he is
offering today. That amendment also failed.
These attacks on the Title X program have failed because a majority
of Members in this body, pro-life and pro-choice, understand that
denying teens access to family planning does not promote abstinence. I
only wish it were that simple.
Contrary to what we will hear today, the Istook language does not
promote family values or protect the authority of parents over their
teenagers. As a mother of 3 and a grandmother of 2, I can vouch for
that. And instead, cutting off family planning services to teens simply
increases STDs and HIV infections, unintended pregnancies and
abortions.
The Istook provision would deny contraception to minors unless they
have the consent of their parents or waited 5 days after their parents
were notified before obtaining contraception. Some of my colleagues are
making a distinction between notification and consent, but who is
kidding who? The 5-day waiting period before contraception can be
obtained is no different than parental consent. The AMA, the American
Academy of Pediatricians, Child Welfare League, Public Health
Association, Social Workers and Nurses Association all oppose the
mandatory parental notification restrictions in the Istook amendment.
Of course, we would prefer that all teens consult with their parents
about important life decisions such as using contraception. We would
prefer that teens abstain from having sex altogether. But
unfortunately, we know that teens will not change their behavior just
because Congress passes a law. Instead, teens will forego contraception
rather than facing their parents.
In fact, studies show that over 80 percent of teens seeking family
planning services have already been sexually active for nearly a year.
By denying contraceptive services to tens of thousands of teens, the
Istook language will simply result in higher rates of STDs, more
unintended pregnancies and more abortions. If teens are required to
obtain parental consent for contraceptive services, they will also
avoid STD and HIV screening and routine gynecological exams.
Our Nation already leads the western world in teen pregnancies.
Millions of teens have some kind of STD, and the incident of AIDS among
teens is, frankly, alarming.
Mr. Chairman, we need to address these problems, but not by making
Title X services more difficult to obtain. My colleagues, we have a
teen pregnancy crisis in the country, and the Istook provision, in my
judgment, will only make it worse. By contrast, the Greenwood-Castle
substitute before us today promotes sensible policies for teens. It
promotes the values we all share: abstinence for teens and parental
involvement. However, it does not threaten the health of teens by
withdrawing contraceptive services from our most vulnerable teens who
simply have nowhere else to turn.
Please, I say to my colleagues, think carefully. Let us protect the
health and well-being of our teenagers, reduce the teen pregnancies
which lead to abortion, support the Greenwood-Castle substitute, and
oppose the Istook second degree amendment.
[[Page H10144]]
Mr. ISTOOK. Mr. Chairman, we have 3 cosponsors of the amendment:
myself, the gentleman from Michigan (Mr. Barcia), and the gentleman
from Illinois (Mr. Manzullo).
Mr. Chairman, I yield 2 minutes to the gentleman from Illinois (Mr.
Manzullo).
Mr. MANZULLO. Mr. Chairman, the reason for the Istook-Barcia-Manzullo
amendment is simple. In McHenry County, Illinois, which I represent, a
37-year-old teacher was raping a 13-year-old student of his over and
over and over again. He took her to the Title X-funded McHenry Tri-
County Health Clinic. She was injected on 3 different occasions with
Depo-Provera, which is a harsh chemical. In fact, the chemical of
choice for chemical castration by convicts.
Her parents had no idea that she was getting these shots. In America
today, children as young as 12 years old are being injected, implanted,
and given prescriptive medication without their parents even knowing.
Our bill does something very simple. It adopts the language of the
gentleman from Oklahoma (Mr. Istook) that Title X health care providers
are required to counsel all minors regarding abstinence. It adopts the
gentlewoman from New York (Mrs. Lowey's) problem with this bill that
says that children are getting STDs because our bill still allows them
to get STDs. In fact, the clinic is still open. Kids can get all the
information they want.
What we are simply saying here is this: Allow the parents in this
Nation to be put in charge of the sexuality of their children. It is
just that simple. We talk about 17 year olds, the gentleman from
Pennsylvania (Mr. Greenwood) talks about. I wonder at what age he would
allow young women to get these injections. In Winnebago County, we
understand it is 12 years old. Winnebago County, Illinois.
So vote for the Istook-Barcia amendment that does 3 things. Parents
are given actual notice that their children are about to receive
prescriptive drugs. It provides for judicial bypass. The amendment does
not require parental notification for a minor to receive information,
counseling and treatment of STDs. A very modest request.
JAMA, Journal of American Medical Association, in a study done in
September of 1997 would agree with this position.
Mr. GREENWOOD. Mr. Chairman, I yield myself 15 seconds.
In response to the previous speaker, one cannot conduct this debate
by using the most exaggerated, extreme cases. In the real world, it is
16- and 17-year-old kids who have no parent at home to talk to, who
will have no counseling unless the Greenwood amendment is adopted.
Mr. Chairman, I yield 1 minute to the gentleman from Delaware (Mr.
Castle).
Mr. CASTLE. Mr. Chairman, I rise in support of the Greenwood
amendment and in opposition to the Istook amendment.
I would like to explain to everybody, this is not pro-life and pro-
choice. We need to understand what is going on. Mr. Chairman, 55
percent of all teenagers consult with their parents before they do
anything. Eighty-six percent of the teenagers that go into these
clinics looking for contraceptive devices or other help are already
sexually active.
In a perfect world we would have no sexual activity among teenagers,
but we do. And when they come in there, they are looking for help, and
the help they are getting hopefully will help them prevent STD or
pregnancy and abortion. It is my personal view that if we are able to
give them the help, even though we may not prefer that they be involved
with a sexual activity, but if we give them that help that they are
going to in that way be able to prevent getting sexual diseases,
prevent pregnancy, and therefore, prevent the abortion.
I love the idea of mandatory parental notification. That is the
difference between our bills, because everything else is provided for
in the Greenwood-Castle bill, except for the mandatory parental
notification, but if we do that, we are not going to have these kids go
in and get the help they need. Please support the Greenwood bill.
Mr. ISTOOK. Mr. Chairman, I yield myself 15 seconds.
Mr. Chairman, I think it is crucial to understand that we are not
talking about the past when a child goes into a Title X clinic, we are
talking about the future. We are talking about enabling the future
conduct with a program that spends $200 million of taxpayers' money a
year and gives these to 1\1/2\ million teenagers without the knowledge
of their parents.
Mr. COBURN. Mr. Chairman, I yield 1 minute and 15 seconds to the
gentlewoman from Idaho (Mrs. Chenoweth).
Mrs. CHENOWETH. Mr. Chairman, I thank the gentleman for yielding me
this time.
I just simply wanted to say that I rise in great support of the
Istook amendment.
Mr. Chairman, the tendency in these days is to interfere with that
very precious relationship between parents and children, and yes,
children are going to do what young people do. But nevertheless, the
parents are still primarily responsible for their children, and we as
lawmakers must do all that we can to make sure that relationship stays
strong and the parents remain responsible.
In a recent Gallup poll of over 500 teenagers between the ages of 15
and 17, fully 66 percent of those polled said that they believed that
parental consent, which is a stronger standard than we are asking for
in the Istook amendment, parental consent should be required. This is
what teenagers said.
Also, in another recent poll it also said that 47 percent of all
unintended pregnancies in the U.S. occur when women are on
contraceptives. We need more than just contraceptives. We need good
parental relationships, and we need to encourage that.
Mr. GREENWOOD. Mr. Chairman, I yield myself 15 seconds.
Mr. Chairman, the gentlewoman who just spoke said that we need more
than contraceptives. That is why the Greenwood language is so focused
on abstinence, abstinence counseling. That is why we are so focused on
getting the families in. The problem is that not every kid has the
right parent to do that.
Mr. Chairman, I yield 2 minutes to the gentlewoman from Maryland
(Mrs. Morella).
Mrs. MORELLA. Mr. Chairman, I rise in very strong support of the
Greenwood-Castle amendment and in opposition to the Istook amendment.
This current language in the bill requiring parental consent or
notification would really do great harm to our efforts to lower the
number of unintended pregnancies and abortions, and to our efforts to
reduce the incidence of sexually transmitted diseases, including HIV
and AIDS.
On the face of it it sounds very reasonable, but it really ignores
the realities of the young people who seek care at these clinics. The
vast majority of them are already sexually active, have been for almost
a year or more, and many of them seek these services because they are
afraid they may be pregnant or they have a sexually transmitted
disease.
Mr. Chairman, if teens are required to obtain parental consent for
any of the Title X services, many of them will avoid the program
entirely. It is important to remember that some contraceptives provide
protection from STDs. And the opportunity to provide accurate,
potentially life-saving education on the transmission of HIV and other
STDs could also be lost if teens avoid these services because of
parental consent requirements.
I think the Greenwood-Castle amendment offers all kinds of counseling
that would be necessary.
I just want to point out the medical community is overwhelmingly
opposed to parental consent notification requirements for minors, and I
hope that this Congress will support the Greenwood-Castle amendment and
oppose the Istook amendment.
The CHAIRMAN. The Chair will seek a clarification of the gentleman
from Pennsylvania. Did the gentleman yield 4 of his 8 minutes to the
gentleman from Ohio (Mr. Stokes)?
Mr. GREENWOOD. Mr. Chairman, I believe I yielded 4 minutes, and I
would be delighted to yield another 4 minutes.
The CHAIRMAN. The gentleman has exhausted the balance of his time
through yielding it to the gentlewoman from New York (Mrs. Lowey).
Mr. GREENWOOD. Mr. Chairman, is it the case then that the time is not
entirely fungible, but that there will be
[[Page H10145]]
another 8 minutes yielded on the Greenwood underlying amendment? Is
that correct?
The CHAIRMAN. The time was allocated at the outset for both
propositions.
Mr. ISTOOK. Mr. Chairman, if I may inquire as to the time remaining
and the different allocations.
The CHAIRMAN. The Chair asks indulgence for 1 minute. The Chair
understands the time as fungible.
Under the unanimous consent, each of the following Members were
recognized for 8 minutes:
The gentleman from Oklahoma (Mr. Istook); the gentleman from Oklahoma
(Mr. Coburn); the gentleman from Ohio (Mr. Stokes); the gentleman from
Pennsylvania (Mr. Greenwood), and that is on both amendments, in
combination, total time.
So the gentleman from Pennsylvania (Mr. Greenwood), perhaps under a
misunderstanding, has yielded 4 of his 8 minutes to the gentleman from
Ohio (Mr. Stokes), who used that time. The gentleman from Ohio (Mr.
Stokes) may, in turn, choose to yield 4 minutes of his time back to the
gentleman from Pennsylvania.
Mr. STOKES. Mr. Chairman, I am pleased to yield 4 minutes to the
gentleman from Pennsylvania (Mr. Greenwood)
{time} 1915
The CHAIRMAN. The gentleman from Ohio (Mr. Stokes) yields to the
gentleman from Pennsylvania (Mr. Greenwood) for his management of 4
minutes of time.
Mr. COBURN. Mr. Chairman, I yield 1 minute to the gentleman from
Michigan (Mr. Barcia).
Mr. BARCIA. Mr. Chairman, I rise in support of the Istook amendment
to allow parental notification of minors seeking contraceptives in
Title X clinics.
In a recent Gallop survey of 500 teens age 13 through 17, 66 percent
indicated that they believed that parental consent should be required
before minors received birth control, and believed in fact that
parental support and involvement would be beneficial to them.
I would like to also point out, current law requires minors to
receive parental consent to have their ears pierced, or even, in cases
of an allergy sufferer, to receive an allergy shot. Yet these children
can gain access to hormones or other contraceptive drugs that can in
fact pose a serious danger to the health of that child. In effect, this
issue begs the question of what role should parents have in helping to
determine their children's health care needs.
I want to say that while I respectfully disagree with my
distinguished colleagues, I commend them for their concern and their
focus on abstinence, also, as a key method of preventing unwanted
pregnancies.
The CHAIRMAN. The Chair will advise the four Members controlling
time, for purposes of the debate that the decision is that the
gentleman from Oklahoma (Mr. Istook) as a member of the committee will
have the right to close, and the gentleman from Ohio (Mr. Stokes) as a
member of the committee will be next to last in closing.
In order to balance the other two, the gentleman from Oklahoma (Mr.
Coburn) and the gentleman from Pennsylvania (Mr. Greenwood), it is in
the Chair's discretion to decide. In order to alternate pro and con on
this issue overall, the gentleman from Pennsylvania (Mr. Greenwood)
will go first in the final use of time, the gentleman from Oklahoma
(Mr. Coburn) will go second, the gentleman from Ohio (Mr. Stokes)
third, and the gentleman from Oklahoma (Mr. Istook) fourth.
Mr. COBURN. Mr. Chairman, I yield 2 minutes to the gentleman from
Florida (Mr. Weldon).
Mr. WELDON of Florida. Mr. Chairman, I thank the gentleman for
yielding time to me.
Mr. Chairman, I rise in strong support of the Istook-Barcia-Manzullo
amendment. I encourage all of my colleagues to vote for it, and vote
against the Greenwood amendment.
As many know, I practiced medicine prior to coming to the Congress,
including working in emergency rooms. When I work in the emergency
room, one of the things we always fear is the possibility that a minor
child can come in with a serious illness and the parents will not be
with them, and we will not be able to get parental consent.
The reason why that is a very, very serious concern is if we stitch
up a wound or give a drug and that child has a reaction to that drug,
we can actually be prosecuted for assault. Indeed, a minor child cannot
get an aspirin from a school nurse, nor, as was stated previously on
the other side of the aisle, their ears pierced without parental
consent in the United States. But there is one place in the United
States today where a minor child can get medical care without parental
consent, and that is in the Title X family planning clinics.
It has been proposed or expounded that these clinics are somehow
cutting down on the incidence of AIDS, unwanted pregnancies, or HIV. I
would assert that all the research data indicates that since this
program began that the incidence of all of those things has gotten
consistently worse, not better.
Indeed, I would assert that this policy established by this Congress
has been a tremendous assault on the integrity of the family, and has
played a role in the explosion of sexual activity.
In closing, I would just like to say one additional thing. The data
that has actually come out of the Alan Gutmacher Institute indicates
that up to as many as 50 percent of these kids under the age of 18 are
having sexual relations with a man over the age of 18, and in the vast
majority of the States that is statutory rape. Indeed, in the case
cited by the gentleman from Illinois (Mr. Manzullo), it involved a
teacher of 37 years having relations with a 13-year-old child.
So I would encourage all of my colleagues to vote with the gentleman
from Oklahoma (Mr. Istook) on his amendment. It is the right thing to
do for the family, it is morally right, and the arguments being put
forward by the opponents of the gentleman from Oklahoma (Mr. Istook)
are incorrect.
Mr. GREENWOOD. Mr. Chairman, I yield 2 minutes to the gentlewoman
from Connecticut (Mrs. Johnson).
Mrs. JOHNSON of Connecticut. Mr. Chairman, in the real world it is
not hard for kids to get condoms. We may not like it, but it is true.
Would Members not rather that they got the advice that came from
someone who said to them, you ought to talk to your mom and dad about
that; that it was someone skilled enough that they would know how to
tell that kid how to talk to their mom and dad? A lot of kids do not
talk to their mom and dad about this stuff because they actually do not
know how to approach it.
They would sit them down and say, look, this is how you do it, then
back them up, and say, come back to me and talk to me about it. A lot
of kids need to be coached to talk to their parents, because their
parents do not talk to them. Their parents do not talk to them, not
just about sex, but also not about school, not about friendships, not
about intimacy, not about love.
If Members want to mandate, mandate that everyone has to get anything
they want to use from a Title X clinic or any health clinic that meets
these standards. Then every kid, including the kid that the gentleman
from Illinois (Mr. Manzullo) was so concerned about, she would have
come someplace that was skilled in explaining to her, you do not have
to participate in coercive sexual relationships.
My point is that we do not tell kids this is coercive sex, we do not
tell them they do not have to do this. We do not get them someplace
where there are skilled people who can help them build their
relationships with their family, help them resist the kind of pressures
that are on them, help them understand that abstinence is the only real
protection. Furthermore, it gives them a chance to develop their
personal power as a young woman.
If Members want to mandate, mandate that they get whatever it is that
they want to get from skilled counselors, from a facility that can give
them the advice and guidance they need to go to the right people, their
families. Remember, States are a lot closer to these problems.
Connecticut has a very good law. I ask Members, please do not override
our good law with their mandate.
Mr. COBURN. Mr. Chairman, I yield 15 seconds to the gentleman from
Illinois (Mr. Manzullo).
Mr. MANZULLO. Mr. Chairman, in the case in Illinois, under Illinois
law,
[[Page H10146]]
the 13-year-old did receive abstinence counseling.
Mr. COBURN. Mr. Chairman, I am happy to yield 45 seconds to the
gentlewoman from North Carolina (Mrs. Myrick).
Mrs. MYRICK. Mr. Chairman, the Istook amendment does protect our
children, and it does provide counseling for children during the time
that they are going through emotional problems in their lives. But it
does protect a parent's right to know. It simply requires that a parent
be notified before their child is given contraception. As parents, we
do want to know that. We want to know if they smoke, drink, or do
drugs. I do not really see why this is any different.
One thing we have not talked about is that all birth control is not
safe, because it has been documented that birth control can be very
damaging to young girls going through puberty. It can cause blood
clotting, bone deterioration, blindness, among a long list of possible
side effects, and even death in girls with heart conditions. It has
been a cause of brainstem stroke in teenagers. So I urge Members to
support the Istook amendment.
Mr. STOKES. Mr. Chairman, I yield 1\1/2\ minutes to the gentlewoman
from Texas (Ms. Sheila Jackson-Lee).
(Ms. JACKSON-LEE of Texas asked and was given permission to revise
and extend her remarks.)
Ms. JACKSON-LEE of Texas. Mr. Chairman, I thank the gentleman from
Ohio for yielding time to me.
Mr. Chairman, this is a difficult time. Let me share a fact in our
community. A young woman living with a stepfather and her mother, a
young woman having her future before her, her stepfather sexually
abused her. There obviously was not enough communication in that home.
The child wound up pregnant.
I support the Greenwood-Castle substitute, for any other approach to
that would go against what 23 States have done. This now will require
Title X counselors to expressly inform all minors that abstinence is
the only certain way to avoid pregnancy, sexually transmitted
infections, and HIV, but it adds counseling to this process. It makes
clear that Title X providers must abide by State laws in the reporting
of contribution, child molestation, sexual abuse, rape, and incest.
Now we are talking more to these young women who may come for these
kinds of prescriptions, but then also share and burden those who are
counseling them, what is going on in their home, and maybe this tragedy
in Houston would not have occurred.
The Greenwood-Castle substitute ensures that all Title X counselors
receive state-of-the-art training on how to help minors abstain from
sexual activity, avoid coercive sexual relationships, and involve their
parents in the decision to receive family planning.
Mr. Chairman, if the Istook amendment is passed, we will see more of
those victims, impregnated young girls, losing the future of their
lives. I would ask that we vote for the Greenwood-Castle substitute
only.
Mr. COBURN. Mr. Chairman, I yield 2 minutes to the gentleman from
Pennsylvania (Mr. Pitts).
Mr. PITTS. Mr. Chairman, I rise in strong support of the Istook-
Barcia-Manzullo parental notification amendment. Parents should have
the right to know what the Federal Government is doing to their
children. It absolutely amazes me that the opponents of this provision
do not have a problem with having to write a note for their daughters
to receive an aspirin at school or permission to have their ears
pierced. Yet, when it comes to young girls being given serious birth
control prescription by strangers, opponents do not believe that
parents should even be told, that they even have the right to know.
President Clinton has said, parents quite simply have a right to
know. Unfortunately, he was not referring to parents having the right
to know about their children being given DepoProvera, he was referring
to the importance of parents knowing which companies are most
responsible for the problem of teen smoking.
If parents quite simply have the right to know about teen smoking,
then surely they have the right to know if their minor daughter is
receiving potentially dangerous contraceptive prescriptions. The Istook
amendment is the only amendment that requires parental notification for
prescription contraceptives. The Greenwood amendment would gut this
provision.
I urge Members to vote for the Istook-Barcia-Manzullo amendment, to
give parents the right to protect their minor daughters.
Mr. STOKES. Mr. Chairman, I yield 1 minute to the gentlewoman from
New York (Mrs. Maloney).
Mrs. MALONEY of New York. Mr. Chairman, in my State alone over
300,000 women and teens rely on Title X for their only reproductive
health care. Studies show that 80 percent of teens who currently seek
family planning advice at clinics would stop going if they had to tell
their parents. The Istook language will cause many teens to delay or,
even worse, avoid seeking essential health care services, placing their
health at risk.
How can we claim to be protecting the health of our young women if we
pass legislation that damages their health by restricting access to the
care they need? I agree that ideally teens should be encouraged to talk
to their parents about their health care decisions, but we do not live
in an ideal world, and millions of teens do not live in ideal families.
{time} 1930
The Greenwood-Castle substitute is the correct approach. It provides
teens with the message that abstinence is the only way to avoid
pregnancy, STDs and HIV infection without restricting their access to
needed health care.
Mr. COBURN. Mr. Chairman, I reserve the balance of my time.
The CHAIRMAN. The Chair would inquire of the gentleman from Oklahoma
(Mr. Coburn) how many speakers he has remaining for his 1\1/2\ minutes.
Mr. COBURN. Just one, Mr. Chairman.
The CHAIRMAN. And how many speakers does the gentleman from
Pennsylvania (Mr. Greenwood) have remaining for his 2 minutes?
Mr. GREENWOOD. One, Mr. Chairman.
The CHAIRMAN. The gentleman from Ohio (Mr. Stokes) has 30 seconds
remaining. In that case, I think it would be appropriate that all the
rest of the time be used for closing statements.
So then it is appropriate under the previous direction of the Chair
that the gentleman from Pennsylvania (Mr. Greenwood) is recognized to
close with 2 minutes.
Mr. GREENWOOD. Mr. Chairman, I yield myself the balance of my time.
Mr. Chairman, this is one of those debates where real good friends
look at each other and say, ``How can you think this way? How can we
come to such different conclusions?"
Mr. Chairman, these are my two pretty little girls and I love them
and I want to make sure that nothing ever happens to them. And they are
so lucky. They are so lucky because their mother and I talk to them,
and we are going to talk to them about their health and their sexuality
and their personalities and the strength of their character. And when
they come to this decision, they will have us.
But walk out the door of this building. Walk out the door of this
building and tell me how many minutes it takes to find the first
teenage girl whose parents could care less about her; if they knew
where she was, if she knew where they were. Tell us what value it is
that we are accomplishing when we send a letter into that home, we send
a letter into that home from an agency.
Do my colleagues know what happens? The girl says, Do not send that
letter there. I do not want this service, if that is what it means. And
so where does she live? She lives in a world in which she has
predators. She could be 15 or 16, and there are guys in those
neighborhoods all over America, all kinds of neighborhoods, preying on
her, putting her at risk of pregnancy, putting her at risk of abortion,
putting her at risk of HIV.
She has got nobody. She does not have a parent. She does not have, if
the Istook language prevails, a counselor. She has got nobody to teach
her what is right. And if we want these values taught to these poor
kids, just like we want them taught to our kids, vote for the Greenwood
amendment and please vote ``no'' on the Istook amendment.
Mr. COBURN. Mr. Chairman, I yield 1\1/2\ minutes to the gentleman
from Oklahoma (Mr. Istook).
[[Page H10147]]
Mr. ISTOOK. Mr. Chairman, this program provides birth control pills
and other contraceptives to kids. Not just those who are 17, but it
freely gives them to those who are 15, to those who are 13, to those
who are 12, to those who are 11, to those who are 11, 10, with no
limit, totally ignoring the State laws on the books about age of
consent.
Without the language, the Istook language in the bill, we do not even
have a requirement to turn in people who are taking advantage of kids,
and then taking them to these clinics for birth control, who are
breaking the law that is designed to protect minors and our kids.
The issue is should $200 million a year of taxpayers' money go to
provide contraceptives to 1.5 million kids each year without their
parents knowing it? This is not emergency care. We do not say they have
to have notice if they need treatment, if they have already contracted
some disease. It is only if they are giving out contraceptives for
future sexual activity.
And birth control pills, yes, they have side effects. They have
interactions. Parents need to know about their children's health, as
well as about their children's morals, if they are going to be involved
in being able to give parental guidance.
The Istook language has counseling on abstinence. It has a
requirement that State laws are to be followed in reporting sexual
predators. For goodness sakes, Mr. Chairman, let the parents know.
Mr. STOKES. Mr. Chairman, I yield 1\1/2\ minutes to the gentleman
from Texas (Mr. Edwards) for the purpose of closing.
Mr. EDWARDS. Mr. Chairman, this debate is certainly not about
statutory rape, nor is it about taking aspirin. What this debate is
about is the real world consequences of the Istook amendment,
regardless of the intentions.
I often hear my Republican friends and colleagues talking about
taking responsibility for one's actions. They are right, and I agree.
And what taking responsibility means on the Istook amendment is that
the supporters of this amendment must honestly face the real world
consequences of the actions of this amendment and the result of this
amendment, if it were to pass into law.
According to the expert opinion of the American Medical Association,
the American College of Obstetricians and Gynecologists, and even the
American Family Physicians, is that this type of amendment could cause
several things to happen. First, more unplanned pregnancies. Because of
that, more abortions.
It could also cause in the real world a lot of young teenagers to
have serious health problems that otherwise could have been prevented,
including lifelong infertility for young women who would love to some
day have a family of their own, like many of us are blessed to have our
own family.
I do not question the intentions of the gentleman from Oklahoma (Mr.
Istook) or his supporters but I do ask them to face not the ideal world
in which we would like to live but the real world and the real world
consequences that we actually do live in.
I will finish. To suggest that there is anything in the Greenwood
language that would come between families and teenagers and parents is
absolutely simply not true.
Mr. ISTOOK. Mr. Chairman, I yield the balance of the time to the
gentleman from Oklahoma (Mr. Coburn), a family doctor who practices in
this area, to close the debate.
The CHAIRMAN. The gentleman from Oklahoma (Mr. Coburn) is yielded the
remaining 4 minutes.
Mr. COBURN. Mr. Chairman, first of all, let me thank the gentleman
from Illinois (Mr. Porter) for the way he worked with us this year. He
has my utmost respect. I also want to say that the gentleman from
Pennsylvania (Mr. Greenwood) and I have become good friends through
this because we have both learned something from one another.
I do not doubt anybody's motives here, but I definitely doubt the
gentleman's knowledge of the facts. I am in the real world every day
dealing with teenagers who are pregnant and have a sexually transmitted
disease. Do you know what? Two-thirds of them have already been to the
Title X clinic. We enabled them to fail.
At the time we have this debate today, 32,000 Americans will get a
new sexually transmitted disease, and of that, 17,000 have already been
to a Title X clinic.
So the question is, what are the real facts? I agree, if we put in
the Istook language, some additional young women will get pregnant;
some will get a sexually transmitted disease. But what about all those
children now who are going to a Title X clinic or using birth control
pills and do not use them right because it is not talked to by their
parents? They do not even brush their teeth at night, let alone
remember to take a pill.
Here is the science on oral contraceptives. This is married couples
taking the pill, here is what we can expect: 12 to 16 percent of them
get pregnant in the first year. Why would we think a 12 or a 16 or 18
year old would not? That does not have anything to do with sexually
transmitted diseases, of which human papilloma virus is growing like
gangbusters, and herpes, now 40 percent of our population has herpes.
Oral contraceptives do not protect; a condom does not protect. What
are we going to give our children for the two greatest sexually
transmitted diseases that we have today? The only thing that we can
give them is the knowledge of involving their parents back with them in
this decision.
I agree, there will be young women who will choose not to go but
there will be hundreds of thousands of young women who do have an
opportunity to have a relationship with their parents renewed and
discuss this issue. If they choose to continue to take oral
contraceptives, they will have a parent there saying be sure and take
your pill; be sure and do not be indiscriminate; let us teach you how
to do it.
The idea of the gentleman from Pennsylvania (Mr. Greenwood) on
counseling, I agree.
Title X, for those under 18 years of age, in my opinion, is one of
the biggest causes of failure of our children. It is not a help. The
facts do not show that it is a help. We like to say it is a help
because of all of the problems we see.
I give teenage girls oral contraceptives. I practice in this area.
But before they walk out of my office, after I have tried to talk them
out of it, I make sure they know everything about it, everything about
it. The real world is, is there are some wonderful Planned Parenthood
clinics that do a good job but the real world on Title X clinics is
they do not. They hand them a book of pills and a piece of paper and
say, go. They never say the first thing about they are not going to be
protected against a sexually transmitted disease.
Finally, my colleagues need to know about the NIH study. Ninety
thousand teenagers, 1993, we sponsored the study, here is what it says:
The number one way to keep teenagers from getting pregnant or getting a
sexually transmitted disease is to connect the parent to the teenager.
It is called parental connectedness.
Why would we not want to have a government policy that follows the
largest study ever done in our country on this issue?
It is an easy, simple thing. We all want the same thing. We do not
want our kids to get pregnant. We do not want them to get a sexually
transmitted disease. The difference is, there is a base of knowledge
and if we will really look at it we will all go to the same point. We
are not 100 percent right or 100 percent wrong.
The CHAIRMAN. The question is on the amendment offered by the
gentleman from Oklahoma (Mr. Istook), as a substitute for the amendment
offered by the gentleman from Pennsylvania (Mr. Greenwood).
The question was taken; and the Chairman announced that the ayes
appeared to have it.
Recorded Vote
Mr. STOKES. Mr. Chairman, I demand a recorded vote.
A recorded vote was ordered.
The CHAIRMAN. Pursuant to clause 2(c) of rule XXIII, the Chair
announces that he may reduce to not less than 5 minutes any recorded
vote on the underlying Greenwood amendment.
The vote was taken by electronic device, and there were--ayes 224,
noes 200, not voting 10, as follows:
[[Page H10148]]
[Roll No. 504]
AYES--224
Aderholt
Archer
Armey
Bachus
Baker
Ballenger
Barcia
Barr
Barrett (NE)
Bartlett
Barton
Bateman
Bereuter
Bilirakis
Bishop
Bliley
Blunt
Boehner
Bonilla
Bono
Brady (TX)
Bryant
Bunning
Burr
Burton
Callahan
Calvert
Camp
Canady
Cannon
Chabot
Chambliss
Chenoweth
Christensen
Coble
Coburn
Collins
Combest
Cooksey
Costello
Cox
Cramer
Crane
Crapo
Cubin
Cunningham
Danner
Deal
DeLay
Diaz-Balart
Dickey
Doolittle
Doyle
Dreier
Duncan
Dunn
Ehlers
Emerson
English
Ensign
Everett
Ewing
Forbes
Fossella
Fowler
Fox
Gallegly
Gekas
Gibbons
Gillmor
Goode
Goodlatte
Goodling
Gordon
Goss
Graham
Granger
Gutknecht
Hall (OH)
Hall (TX)
Hamilton
Hansen
Hastert
Hastings (WA)
Hayworth
Hefley
Herger
Hill
Hilleary
Hoekstra
Holden
Hostettler
Hulshof
Hunter
Hutchinson
Hyde
Inglis
Istook
Jenkins
John
Johnson, Sam
Jones
Kanjorski
Kasich
Kildee
Kim
King (NY)
Kingston
Knollenberg
LaFalce
LaHood
Largent
Latham
Lewis (CA)
Lewis (KY)
Linder
Lipinski
Livingston
LoBiondo
Lucas
Manzullo
Mascara
McCollum
McCrery
McHugh
McIntosh
McIntyre
McKeon
Metcalf
Mica
Miller (FL)
Mollohan
Moran (KS)
Murtha
Myrick
Nethercutt
Neumann
Ney
Northup
Norwood
Nussle
Ortiz
Oxley
Packard
Pappas
Parker
Paul
Paxon
Pease
Peterson (MN)
Petri
Pickering
Pitts
Pombo
Portman
Quinn
Radanovich
Rahall
Redmond
Regula
Riggs
Riley
Roemer
Rogan
Rogers
Rohrabacher
Ros-Lehtinen
Roukema
Royce
Ryun
Salmon
Sandlin
Sanford
Saxton
Scarborough
Schaefer, Dan
Schaffer, Bob
Sensenbrenner
Sessions
Shadegg
Shaw
Shimkus
Shuster
Skeen
Skelton
Smith (MI)
Smith (NJ)
Smith (OR)
Smith (TX)
Smith, Linda
Snowbarger
Solomon
Souder
Spence
Stearns
Stenholm
Stump
Stupak
Sununu
Talent
Tanner
Tauzin
Taylor (MS)
Taylor (NC)
Thornberry
Thune
Tiahrt
Traficant
Turner
Visclosky
Walsh
Wamp
Watkins
Watts (OK)
Weldon (FL)
Weldon (PA)
Weller
White
Whitfield
Wicker
Wilson
Wolf
Young (AK)
Young (FL)
NOES--200
Abercrombie
Ackerman
Allen
Andrews
Baesler
Baldacci
Barrett (WI)
Bass
Becerra
Bentsen
Berman
Berry
Bilbray
Blagojevich
Blumenauer
Boehlert
Bonior
Borski
Boswell
Boucher
Boyd
Brady (PA)
Brown (CA)
Brown (FL)
Brown (OH)
Campbell
Capps
Cardin
Carson
Castle
Clay
Clayton
Clement
Clyburn
Condit
Conyers
Cook
Coyne
Cummings
Davis (FL)
Davis (IL)
Davis (VA)
DeFazio
DeGette
Delahunt
DeLauro
Deutsch
Dicks
Dingell
Dixon
Doggett
Dooley
Edwards
Ehrlich
Engel
Eshoo
Etheridge
Evans
Farr
Fattah
Fawell
Filner
Foley
Ford
Frank (MA)
Franks (NJ)
Frelinghuysen
Frost
Furse
Ganske
Gejdenson
Gephardt
Gilchrest
Gilman
Gonzalez
Green
Greenwood
Gutierrez
Harman
Hastings (FL)
Hefner
Hilliard
Hinchey
Hinojosa
Hobson
Hooley
Horn
Houghton
Hoyer
Jackson (IL)
Jackson-Lee (TX)
Jefferson
Johnson (CT)
Johnson (WI)
Johnson, E. B.
Kaptur
Kelly
Kennedy (MA)
Kennedy (RI)
Kilpatrick
Kind (WI)
Kleczka
Klink
Klug
Kolbe
Kucinich
Lampson
Lantos
LaTourette
Lazio
Leach
Lee
Levin
Lewis (GA)
Lofgren
Lowey
Luther
Maloney (CT)
Maloney (NY)
Manton
Markey
Matsui
McCarthy (MO)
McCarthy (NY)
McDermott
McGovern
McHale
McInnis
McKinney
McNulty
Meehan
Meek (FL)
Meeks (NY)
Menendez
Millender-McDonald
Miller (CA)
Minge
Mink
Moran (VA)
Morella
Nadler
Neal
Oberstar
Obey
Olver
Owens
Pallone
Pascrell
Pastor
Payne
Pelosi
Pickett
Pomeroy
Porter
Price (NC)
Ramstad
Rangel
Reyes
Rivers
Rodriguez
Rothman
Roybal-Allard
Rush
Sabo
Sanchez
Sanders
Sawyer
Schumer
Scott
Serrano
Shays
Sherman
Sisisky
Skaggs
Slaughter
Smith, Adam
Snyder
Spratt
Stabenow
Stark
Stokes
Strickland
Tauscher
Thomas
Thompson
Thurman
Tierney
Torres
Towns
Upton
Velazquez
Vento
Waters
Watt (NC)
Waxman
Wexler
Weygand
Wise
Woolsey
Wynn
NOT VOTING--10
Buyer
Fazio
Kennelly
Martinez
McDade
Moakley
Peterson (PA)
Poshard
Pryce (OH)
Yates
{time} 2001
Ms. HOOLEY of Oregon changed her vote from ``aye" to ``no.''
Mr. STUPAK and Mr. NEY changed their vote from ``no'' to ``aye.''
So the amendment offered as a substitute for the amendment was agreed
to.
The result of the vote was announced as above recorded.
The CHAIRMAN. The question is on the amendment offered by the
gentleman from Pennsylvania (Mr. Greenwood), as amended.
The amendment, as amended, was agreed to.
Mr. PORTER. Mr. Chairman, I move that the Committee do now rise.
The motion was agreed to.
Accordingly, the Committee rose; and the Speaker pro tempore (Mr.
Shimkus) having assumed the chair, Mr. Bereuter, Chairman of the
Committee of the Whole House on the State of the Union, reported that
that Committee, having had under consideration the bill (H.R. 4274)
making appropriations for the Departments of Labor, Health and Human
Services, and Education, and related agencies, for the fiscal year
ending September 30, 1999, and for other purposes, had come to no
resolution thereon.
____________________