[Congressional Record Volume 149, Number 85 (Wednesday, June 11, 2003)]
[Senate]
[Pages S7728-S7729]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. LINCOLN (for herself, Mrs. Murray, Ms. Landrieu, and Ms. 
        Cantwell):
  S. 1238. A bill to amend titles XVIII, XIX, and XXI of the Social 
Security Act to improve women's health, and for other purposes; to the 
Committee on Finance.
  Mrs. LINCOLN. Mr. President, I am pleased to introduce the Improving 
Women's Health Act of 2003, which seeks to make Medicare, Medicaid, and 
S-CHIP better programs for women. I am pleased to be joined in this 
effort today by my friends Senators Murray, Landrieu, and Cantwell.
  Women are the majority of Medicare recipients, and, at age 85, women 
make up 71 percent of the Medicare population. By adding several modern 
treatments to the list of Medicare benefits, we will begin to address 
some of the most prominent, underlying risk factors for illness that 
face women Medicare beneficiaries today. These new benefits represent 
the highest recommendations for Medicare beneficiaries in the U.S. 
Preventive Services Task Force and the Institute of Medicine. These 
benefits can help reduce Medicare beneficiaries' risk for health 
problems such as diabetes, stroke, cancer, osteoporosis, and heart 
disease.
  This bill would also eliminate all cost-sharing for these and 
existing preventive health benefits to encourage women to get screened 
for diseases such as osteoporosis and breast cancer. We need to get rid 
of all barriers to preventative services. Studies have

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shown that cost-sharing deters beneficiaries, especially those with 
low-incomes, from getting screened.
  Because heart disease is the number one killer of women, this bill 
would add new preventive services to Medicare, such as cholesterol 
screening, medical nutrition therapy services for beneficiaries with 
cardiovascular disease, counseling for cessation of tobacco use, and 
diabetes screening.
  In addition, this bill provides for coverage of annual pap smear and 
pelvic exams and boosts the payment amount for screening mammography 
under Medicare. Numerous reports in the media have indicated that 
screening mammography is not adequately reimbursed and, as a result, 
facilities are closing or ending their service. Facilities are saying 
that they are losing money on every patient that comes through the 
door, and patient load is rising.
  Recognizing the role women play as caregivers for aging family 
members, this bill provides Medicare beneficiaries with a new option of 
receiving home health services in an adult day care setting. Adult day 
centers enable family caregivers to continue working or simply take a 
break from their caregiving duties. Most importantly, adult day care 
patients benefit from social interaction, therapeutic activities, 
nutrition, health monitoring, and medication management.
  More than 22 million families nationwide, or nearly 1 in 4 families, 
serve as caregivers for aging seniors, providing close to 80 percent of 
the care of to individuals requiring long-term care. Nearly 75 percent 
of people providing care for aging family members are women who also 
maintain other responsibilities, such as working outside of the home 
and raising young children. The average loss of income to these 
caregivers has been shown to be over $650,000 in wages, pension, and 
Social Security benefits. The loss of productivity in U.S. businesses 
ranges from $11 to $29 billion a year. The services offered in adult 
day care facilities provide continuity of care and an important sense 
of community for both the senior and the caregiver. This important 
provision will benefit women of all ages.
  Finally, this legislation provides States with the flexibility and 
Federal resources to improve and expand prenatal care for low-income 
pregnant women. It gives States new options to cover pregnant women 
under their State Children's Health Insurance Program, S-CHIP, to cover 
low-income legal immigrant pregnant women and children under Medicaid 
and S-CHIP, and to cover tobacco cessation counseling services for 
pregnant women under the Medicaid program. The bill also gives States 
the option to provide family planning services and supplies to low-
income women. In recent years, a number of States, including Arkansas, 
have sought and received Federal permission in the form of waivers to 
provide Medicaid-financed family planning services and supplies to 
lower income, uninsured residents whose incomes are above the state's 
regular Medicaid eligibility ceilings. Under this section, States would 
no longer have to seek a waiver to extend Medicaid coverage for family 
planning services; instead they could establish these programs at their 
option.
  I encourage my colleagues to join me by supporting this important 
legislation that will make Medicare, Medicaid, and S-CHIP better 
programs for all women.
                                 ______