[Congressional Record Volume 147, Number 34 (Wednesday, March 14, 2001)]
[Senate]
[Pages S2318-S2319]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BINGAMAN (for himself, Mr. McCain, Mr. Daschle, Mr. 
        Baucus, Mrs. Clinton, Mr. Domenici, Mr. Feingold, Mr. Kennedy, 
        Mr. Johnson, Mrs. Murray, Ms. Stabenow, and Mr. Wellstone):
  S. 535. A bill to amend title XIX of the Social Security Act to 
clarify that Indian women with breast or cervical cancer who are 
eligible for health services provided under a medical care program of 
the Indian Health Service or of a tribal organization are included in 
the optional medicaid eligibility category of breast or cervical cancer 
patients added by the Breast and Cervical Cancer Prevention and 
Treatment Act of 2000; to the Committee on Indian Affairs.
  Mr. BINGAMAN. Mr. President, I rise today to introduce legislation 
with 11 original cosponsors, including Senators McCain and Daschle, 
entitled the ``Native American Breast and Cervical Cancer Treatment 
Technical Amendment Act of 2001.'' The legislation makes a simple, yet 
important, technical change to the ``Breast and Cervical Cancer 
Treatment and Prevention Act'' by correcting a provision of last year's 
bill to ensure the coverage of breast and cervical cancer treatment for 
Native American women.
  The National Breast and Cervical Cancer Early Detection Program, 
funded through the Centers for Disease Control and Prevention, CDC, 
supports screening activities in all 50 states and through 15 American 
Indian/Alaska Native organizations. However, the CDC program provides 
funding only for screening services and not for treatment.
  Last year's bill, which passed the Senate by unanimous consent and 
had 76 cosponsors, gives states the option to extend Medicaid treatment 
coverage to certain women who have been screened by programs operated 
under the National Breast and Cervical Cancer Early Detection Program 
and diagnosed as having breast or cervical cancer. Through passage of 
the ``Breast and Cervical Cancer Treatment and Prevention Act,'' for 
those women not otherwise eligible for Medicaid, States may elect to 
expand their Medicaid programs to provide breast and cervical cancer 
treatment as an optional benefit and receive an enhanced federal match 
to encourage participation.
  Last year's legislation restricts Medicaid treatment coverage to 
those who have no ``creditable coverage'' or treatment options. 
Unfortunately, the term ``creditable coverage'' is defined under

[[Page S2319]]

the Act to include the Indian Health Service, IHS. In short, the 
reference to IHS in the law effectively excludes Indian women from 
receiving Medicaid breast and cervical cancer treatment, as provided 
for under last year's bill, regardless of whether a State chooses to 
provide that coverage. Not only does the definition deny coverage to 
Native American women, but the provision runs counter to the general 
Medicaid rule treating IHS facilities as full Medicaid providers. My 
legislation corrects these issues.
  During 2001, almost 50,000 women are expected to die from breast or 
cervical cancer in the United States despite the fact that early 
detection and treatment of these diseases could substantially decrease 
this mortality. While passage of last year's bill makes significant 
strides to address this problem, it fails to do so for Native American 
women and that must be changed as soon as possible.
  In support of Native American women across this country that are 
being diagnosed through CDC screening activities as having breast or 
cervical cancer, my legislation would assure that they can also access 
much needed treatment through the Medicaid program. I urge its 
immediate adoption.
  I request unanimous consent that the text of the bill be printed in 
the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 535

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Native American Breast and 
     Cervical Cancer Treatment Technical Amendment Act of 2001''.

     SEC. 2. CLARIFICATION OF INCLUSION OF INDIAN WOMEN WITH 
                   BREAST OR CERVICAL CANCER IN OPTIONAL MEDICAID 
                   ELIGIBILITY CATEGORY.

       (a) Technical Amendment.--The subsection (aa) of section 
     1902 of the Social Security Act (42 U.S.C. 1396a) added by 
     section 2(a)(2) of the Breast and Cervical Cancer Prevention 
     and Treatment Act of 2000 (Public Law 106-354; 114 Stat. 
     1381) is amended in paragraph (4) by inserting ``, but 
     applied without regard to paragraph (1)(F) of such section'' 
     before the period at the end.
       (b) BIPA Technical Amendments.--
       (1) Section 1902 of the Social Security Act (42 U.S.C. 
     1396a), as amended by section 702(b) of the Medicare, 
     Medicaid, and SCHIP Benefits Improvement and Protection Act 
     of 2000 (as enacted into law by section 1(a)(6) of Public Law 
     106-554), is amended by redesignating the subsection (aa) 
     added by such section as subsection (bb).
       (2) Section 1902(a)(15) of the Social Security Act (42 
     U.S.C. 1396a(a)(15)), as added by section 702(a)(2) of the 
     Medicare, Medicaid, and SCHIP Benefits Improvement and 
     Protection Act of 2000 (as so enacted into law), is amended 
     by striking ``subsection (aa)'' and inserting ``subsection 
     (bb)''.
       (3) Section 1915(b) of the Social Security Act (42 U.S.C. 
     1396n(b)), as amended by section 702(c)(2) of the Medicare, 
     Medicaid, and SCHIP Benefits Improvement and Protection Act 
     of 2000 (as so enacted into law), is amended by striking 
     ``1902(aa)'' and inserting ``1902(bb)''.
       (c) Effective Dates.--
       (1) BCCPTA technical amendment.--The amendment made by 
     subsection (a) shall take effect as if included in the 
     enactment of the Breast and Cervical Cancer Prevention and 
     Treatment Act of 2000 (Public Law 106-354; 114 Stat. 1381).
       (2) BIPA technical amendments.--The amendments made by 
     subsection (b) shall take effect as if included in the 
     enactment of section 702 of the Medicare, Medicaid, and SCHIP 
     Benefits Improvement and Protection Act of 2000 (as enacted 
     into law by section 1(a)(6) of Public Law 106-554).
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