[Congressional Record Volume 149, Number 78 (Friday, May 23, 2003)]
[Senate]
[Pages S7158-S7159]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BINGAMAN (for himself, Mr. Daschle, Mrs. Boxer, and Mrs. 
        Lincoln):
  S. 1159. A bill to provide for programs and activities to improve the 
health of Hispanic individuals, and for other purposes; to the 
Committee on Finance.
  Mr. BINGAMAN. Mr. President, today, I am introducing a bill with 
Senators Daschle, Boxer, and Lincoln that will be jointly introduced by 
Representatives Ciro Rodriguez, Hilda Solis, and others in the House of 
Representatives entitled the ``Hispanic Health Improvement Act of 
2003.'' This bill addresses the tremendous health disparities that 
confront the Hispanic community in our Nation.
  Even if you know the statistics, they remain shocking. Over one-
third, a 35 percent of Hispanic adults lack health insurance. Despite 
that passage of the Children's Health Insurance Program, 27 percent of 
Latino children remain uninsured, which is sharp comparison to 9 
percent of white, 18 percent of black and 17 percent of Asian/Pacific 
Islander children.
  In testimony before the Senate Health, Education, Labor and Pensions 
Committee on September 23, 2002, on Hispanic health issues, Dr. Glenn 
Flores, chair of the Latin Consortium of the American Academy of 
Pediatrics Center for Child Health Research, added: ``Among uninsured 
poor children in the U.S., Latinos outnumber all other racial/ethnic 
groups, including whites: there are 1 million poor, uninsured Latino 
children, compared with 766,000 white, and 533,000 African-American 
poor, uninsured children. Although 1999 marked the first time in many 
years that the proportion of uninsured Latino children actually 
decreased (from 30 percent to 27 percent), recent national data suggest 
that outreach efforts to enroll Latino children have largely been 
unsuccessful. A Kaiser Commission report found that only 26 percent of 
parents of eligible uninsured children said that they had ever talked 
to someone or received information about Medicaid enrollment, and 46 
percent of Spanish-speaking parents were unsuccessful at enrolling 
their uninsured children in Medicaid because materials were unavailable 
in Spanish.''
  In order to address the lack of health care coverage, the legislation 
would expand CHIP to cover pregnant women and parents of children 
enrolled in CHIP. The legislation provides $50 million in grants to 
community-based groups to improve outreach and enrollment of children 
in Medicaid and CHIP with the grants targeted to Hispanic communities.
  In addition, the bill eliminates a number of enrollment barriers 
within Medicaid.
  And finally, it provides States the option to enroll legal immigrant 
pregnant women and children in Medicaid or CHIP. This comes from 
legislation introduced by Senator Graham earlier in this Congress.
  In addition to poor coverage rates, according to the Centers for 
Disease Control and Prevention, or CDC, the Hispanic population has 
morbidity and mortality rates that more often than not exceed that of 
any other ethnic groups. For example, age-adjusted mortality rates for 
diabetes are over 50 percent higher among Hispanic persons than non-
Hispanic whites. HIV infection rates are over 3 times those of non-
Hispanic whites. Tuberculosis rates among Latino children are 13 times 
that of whites.
  The legislation addresses these problems in a number of ways. In the 
area

[[Page S7159]]

of access and affordability, our bill requires an annual report to 
Congress on how federal programs are responding to improve the health 
status of Hispanic individuals with respect to diabetes, cancer, 
asthma, HIV infection, AIDS, substance abuse, and mental health. The 
bill provides $100 million for targeted diabetes prevention, education, 
school-based programs, and screening activities in the Hispanic 
community.
  In addition, the legislation specifically addresses the problems 
facing communities along the U.S.-Mexico border, a 2,000-mile stretch 
of land that contains 11 million people, 5 of the 7 poorest 
metropolitan statistical areas in the country, and disease rates in 
some areas that are extraordinary. If the region were a state, the 
border would rank 1st in the number of uninsured, last in terms of per 
capita income, and 1st in a number of diseases.
  As Dr. Francisco Cigarroa, president of the University of Texas 
Health Sciences Center at San Antonio, noted in testimony at the 
hearing last year on Hispanic health, ``Germs respect no INS 
regulations. We truly must work with our neighbors to the South if we 
are to avoid a major influx of new conditions and diseases. It can be 
seen so clearly on a map. Just as there are `rivers of commerce' there 
are `rivers of infectious disease' and though they may start at the 
Border, they are eventually seen all the way to the northern Border 
that we share with Canada.''
  In response, the bill provides $200 million to border communities to 
improve health services and infrastructure along the U.S.-Mexico 
border.
  The numbers I have cited thus far indicate what we do know. Almost as 
much of a concern is what we do not know with respect to the status of 
Hispanic health in this Nation. According to one study, only 22 percent 
of all articles published in major medical journals included non-
English-speaking patients.
  The bill provides funding to do additional research and work on 
reducing health disparities in this Nation. The various provisions 
include efforts to improve the recruitment and retention of Hispanic 
health professionals and programs that support training health 
professionals who can provide culturally competent and linguistically 
appropriate care. With respect to training more minority health 
professionals, Dr. Cigarroa said at last year's hearing, ``We should do 
this because it is the smart thing to do. If we fail to take steps to 
address the gap between the health of the majority population and the 
health of the Nation's rapidly growing minority populations, we are on 
a court leading to a collision. We are far too great a nation to allow 
this to happen.''
  Representative Ciro Rodriguez, chairman of the Congressional Hispanic 
Caucus, and I, have worked together on this legislation to respond to 
the challenge before us with regard to coverage, access, and health 
disparities in the last Congress and have reintroduced the bill with 
the hope to move it forward this year.
  Before closing, it should be noted that while the legislation puts 
forth a number of initiatives to address what are disproportionately 
Hispanic problems, each section of the bill, including those to reduce 
the number of uninsured and to improve access to care, would improve 
the overall health of our entire Nation regardless of race or 
ethnicity.
  I ask 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:
  (The bill was not available at time of printing.)

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