[Congressional Record Volume 150, Number 43 (Wednesday, March 31, 2004)]
[Senate]
[Pages S3457-S3461]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. BINGAMAN (for himself, Mr. Inhofe, Ms. Landrieu, and Mr. 
        Lugar):
  S. 2262. A bill to provide for the establishment of campaign medals 
to be awarded to members of the Armed Forces who participate in 
Operation Enduring Freedom or Operation Iraqi Freedom; to the Committee 
on Armed Services.
  Mr. BINGAMAN. Mr. President, I rise today with my colleagues, 
Senators Inhofe, Landrieu, Lugar, and Lott, to introduce a bill to 
honor our service men and women in Iraq and Afghanistan who have served 
and continue to serve their country by working for a free, independent, 
and stable Iraq and a new Afghanistan. These missions have been 
difficult and the cost has been high; nearly 600 Americans have been 
killed and almost 3,000 Americans have been injured in Iraq, while more 
than 500 Americans have been injured and more than 100 U.S. service men 
and women have been lost in Afghanistan.
  More than a year after the initial invasion, nearly 110,000 troops 
are still stationed in Iraq, working to build a new, stable beacon of 
freedom in the region. My fellow Senators, the liberation of Iraq is 
turning out to be the most significant military occupation and 
reconstruction effort since the end of World War II. We cannot 
understate the importance of the work being done there today.
  The administration's focus on Iraq leaves the mission in Afghanistan 
incomplete. Despite constant progress there, the fighting is still not 
over. Recent assassinations of government officials, car bombings, and 
the lingering presence of terrorist forces and former Taliban fighters 
force thousands of our troops to stay in-country.
  For there courageous efforts, the Department of Defense has decided 
to award our brave young men and women with the Global War on Terrorism 
Expeditionary Medal, GWOT, and no other medal. This is despite the fact 
the GWOT medal is meant for any individual who has served overseas 
during the war on terror and may have come within a few hundred miles 
of a combat zone. The dangers of serving in Iraq and Afghanistan are 
greater; therefore, along with my colleagues, Senators Lott, Landrieu, 
Inhofe, and Lugar, I propose to correct this mistake by passing 
legislation authorizing the Iraq and Afghanistan Liberation Medals in 
addition to the Global War on Terrorism Expeditionary Medal.
  While some of us in this body have not shared the administration's 
view on this war, we are united when it comes to supporting our troops. 
These young men and women from Active Duty, National Guard, and 
Reserves are all volunteers and exemplify the very essence of what it 
means to be a patriot. We believe that what they are doing in Iraq and 
Afghanistan today differs from military expeditionary activities such 
as peacekeeping operations or no-fly-zone enforcement.
  They continue to serve, even though they do not know when they will 
return home to family and friends. They continue to serve despite the 
constant threat to their lives and the tremendous hardships they face.
  There is a difference between an expeditionary medal and a campaign 
medal. We only need to look at an excerpt from U.S. Army Qualifications 
for the Armed Forces Expeditionary Medal and Kosovo Campaign Medal. In 
order to receive the Armed Forces Expeditionary Medal, you don't need 
to go to war. You only need to be ``placed in such a position that in 
the opinion of the Joint Chief of Staff, hostile action by foreign 
armed forces was imminent even though it does not materialize.''
  To earn the Kosovo Campaign Medal, the standard is higher. A military 
member must:
  Be engaged in actual combat, or duty that is equally hazardous as 
combat duty, during the Operation with armed opposition regardless of 
time in the Area of Engagement. Or while participating in the 
Operation, regardless of time, [the service member] is wounded or 
injured and required medical evacuation from the Area of Engagement.
  Many within the military agree that there is a difference. According 
to the Army Times, ``Campaign medals help establish an immediate 
rapport with individuals checking into a unit.'' An expeditionary medal 
like the GWOT does not necessarily denote combat. A campaign medal is 
designed to recognize military personnel who have risked their lives in 
combat.

  Campaign medals matter. ``When a Marine shows up at a new duty 
station, commanders look first at his decorations and his physical 
fitness score--the first to see where he's been, the second to see if 
he can hang. They show what you've done and how serious you are,'' said 
GySgt James Cuneo. ``If you're a good Marine, people are going to award 
you when it comes time. . . .''
  My fellow colleagues, it is time. We must recognize the sacrifice of 
our young men and women who liberated Iraq, including great Americans 
like Army SPC Joseph Hudson from Alamogordo, NM, who was held as a 
prisoner of war. The Nation was captivated as we watched Specialist 
Hudson being interrogated by the enemy. Asked to divulge his military 
occupation, Specialist Hudson stared defiantly into the camera and 
said, ``I follow orders.'' Those of us with sons and daughters were 
united in worry with Specialist Hudson's family. The entire Nation 
rejoiced when he was liberated.
  We have also asked much from our Reserve and National Guard Forces.

[[Page S3458]]

The reconstruction of Iraq would not be possible without the commitment 
and sacrifice of the 170,000 guardsmen and reservists currently on 
active duty.
  My colleagues, Senators Lott, Landrieu, Inhofe, Lugar, and I are 
committed to honoring our over 200,000 heroes who liberated Iraq and 
Afghanistan. We believe that current administration policy does a 
disservice to our fighting men and women. Therefore we propose, in 
addition to the GWOT medal, new decorations that characterize the real 
missions in Iraq and Afghanistan, two that are distinctive and honor 
their sacrifice, the Iraq and Afghanistan Liberation Medals.
  What we do today is not without precedent; Congress has been 
responsible for recognizing the sacrifice and courage of our military 
forces throughout history. Congress has had a significant and 
historically central role in authorizing military decoration. Our 
Nation's highest military decorations were authorized by Congress, 
including: the Medal of Honor, the Air Force Cross, the Navy Cross, the 
Army's Distinctive Service Cross, the Silver Star, and the 
Distinguished Flying Cross.
  We have also authorized campaign and liberation medals similar to 
what we hope to accomplish with this legislation. A partial list 
includes the Spanish War Service Medal, the Army Occupation of Germany 
Medal, the World War II Victory Medal, the Berlin Airlift Medal, the 
Korean Service Medal, and the Prisoner of War Medal.
  The list goes on and on. The great men and women of our military 
forces are doing their jobs every day in Iraq and Afghanistan. It is 
time to do our job and honor them with an award that truly stands for 
their heroic service, the Iraq and Afghanistan Liberation Medals.
  I ask unanimous consent that an article from the Army Times and the 
text of the bill be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                  [From the Army Times, Mar. 15, 2004]

           Hill Set To Challenge Pentagon on Terror-War Medal

                             (By Rick Maze)

       The Pentagon's determination to award a single campaign 
     medal for the entire global war on terrorism will come under 
     fire Wednesday when the House Armed Services Committee is 
     expected to pass a bill ordering creation of separate 
     campaign medals for combat operations in Iraq and 
     Afghanistan. This is a bipartisan bill, first introduced in 
     September, with 84 cosponsors. It is expected to pass the 
     committee Wednesday with little or no discussion, but the 
     next step is unclear, House aides said. The Defense 
     Department has stood firm in the face of complaints about 
     having a single Global War on Terrorism Expeditionary Medal 
     instead of separate campaign medals, and is likely to lean on 
     House Republican leaders to prevent passage of the bill, 
     aides said. ``Passing the committee isn't a problem. Getting 
     the bill scheduled for a vote in the House of Representatives 
     could be a lot tougher,'' said one Republican aide. Exactly 
     who would get the campaign medals would be left to the 
     Pentagon to determine. The bill, HR 3104, only orders the 
     medals to be established and leaves eligibility rules to the 
     military. Passage by the full House still wouldn't ensure the 
     separate medals would ever be issued. The Senate debated the 
     issue last year and by a 48-47 vote ended up siding with the 
     Pentagon. Defense officials have argued that a single medal 
     treats all deployments for the war on terrorism equally, 
     whether the operations are in Iraq, Afghanistan, Africa, 
     Colombia or the Philippines. The chief cosponsors of the 
     House bill are all Vietnam veterans who serve on the armed 
     services committee: Vic Snyder, D-Ark., a former Marine, and 
     Army veterans Rob Simmons, R-Conn., and Silvestre Reyes, D-
     Texas. Snyder, the chief sponsor, said his combat experience 
     is part of the reason why he is pushing for separate 
     campaign medals. ``I know the incredible pride and sense 
     of accomplishment our military personnel feel about how 
     well they have done in our most recent wars,'' he said. 
     ``In past wars, millions of soldiers, sailors, airmen, and 
     Marines have received combat medals that have held intense 
     meaning for them,'' Reyes added. ``Soldiers who fought and 
     are fighting in Iraq and Afghanistan deserve a medal of 
     equal significance.'' ``As a Vietnam veteran and 
     reservist, I am proud of the sacrifices made by our 
     military men and women,'' said Simmons, who remained in 
     the Army Reserve after his combat experience and retired 
     from the military in 2000. ``Whatever one thinks about the 
     war on terror, our service men and women did what their 
     country asked of them and did it very well. Congress 
     should recognize these accomplishments.'' In addition to 
     the campaign medal bill, the House Armed Services 
     Committee is scheduled to take up three other measures on 
     Wednesday. One bill would order the reimbursement of 
     travel expenses for service members who used the Central 
     Command's rest and recuperative leave program in its early 
     stages last fall, a measure passed by the Senate last 
     week. Also planned are votes on a bill attempting to 
     expand access for military recruiters to college campuses 
     and a non-binding resolution asking the Defense 
     Department, banks and credit unions and the Federal Trade 
     commission to all work to reduce the financial hardships 
     of mobilized reservists. The planned markup is unusual 
     because the House Armed Services Committee normally would 
     wrap such bills into the larger defense authorization bill 
     it approves each year. Aides who spoke on the condition of 
     not being identified said there are two reasons for 
     breaking with tradition to pass separate bills. One is 
     that lawmakers want to move quickly on some issues, like 
     R&R travel reimbursement, which have already been 
     completed. The second reason is that House Republican 
     leaders have been pleading with committees to have some 
     bills ready for debate and passage on the House floor. The 
     legislative calendar already is light because of the 
     upcoming elections, aides said. Delays in House floor 
     debate on the 2005 budget resolution, due to problems 
     getting a consensus among Republicans about budget 
     priorities, has left a big hole in the legislative 
     schedule that House leaders would like to fill, aides 
     said.

                                S. 2262

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

     SECTION 1. MILITARY CAMPAIGN MEDALS TO RECOGNIZE SERVICE IN 
                   OPERATION ENDURING FREEDOM AND OPERATION IRAQI 
                   FREEDOM.

       (a) Requirement.--The President shall establish a campaign 
     medal specifically to recognize service by members of the 
     Armed Forces in Operation Enduring Freedom and a separate 
     campaign medal specifically to recognize service by members 
     of the Armed Forces in Operation Iraqi Freedom.
       (b) Eligibility.--Subject to such limitations as may be 
     prescribed by the President, eligibility for a campaign medal 
     established pursuant to subsection (a) shall be set forth in 
     uniform regulations to be prescribed by the Secretaries of 
     the military departments and approved by the Secretary of 
     Defense or in regulations to be prescribed by the Secretary 
     of Homeland Security with respect to the Coast Guard when it 
     is not operating as a service in the Navy.
                                 ______
                                 
      By Mr. FEINGOLD (for himself and Mr. Alexander):
  S. 2264. A bill to require a report on the conflict in Uganda, and 
for other purposes; to the Committee on Foreign Relations.
  Mr. FEINGOLD. Mr. President, today I am very pleased to be joined by 
my colleague, Senator Alexander, in introducing legislation to draw 
attention to the horrifying situation in northern and eastern Uganda.
  When most of my colleagues think of Uganda, they probably think, 
quite rightly, of Uganda's inspiring example of how a concerted effort 
on the part of government and civil society can save lives in the fight 
against HIV/AIDS. Or perhaps they recall the brutal history of the Amin 
era, and reflect on the extraordinary progress that the Ugandan people 
have made in closing that chapter of their history and rebuilding their 
country. Today, so much of Uganda is vibrant and exciting. A lively 
debate about the pace and depth of democratization has been underway 
for years. Ugandan leaders, including civil society leaders, work to 
fight against the insidious influence of corruption, just as leaders 
here in our country do. Ugandan officials devote time and energy to 
fostering a climate the encourages enterprise and increased trade and 
investment so that the next generation of Ugandans might know even more 
progress. And importantly Uganda is a strong partner in cooperating 
with the United States and with the rest of the vast global coalition 
committed to fighting international terrorist networks.
  It is in part because there is so much that is positive and promising 
about Uganda and about our relationship with Uganda that the situation 
in northern and eastern Uganda is so very shocking. For more than 17 
years, a conflict has raged between the Lord's Resistance Army and the 
Government of Uganda. All conflict comes with costs, but this one has 
been particularly atrocious. The LRA's campaign has been characterized 
by the forced abduction of thousands of Ugandan children--possibly over 
25,000 children. These children have been terrorized, tortured, forced 
to participate in extraordinarily brutal acts, pressed into service as 
soldiers and used as cannon fodder, and forced into sexual servitude. 
Throughout the region, about 1.4 million people are displaced, often

[[Page S3459]]

forced into camps by the government. They cannot plant their crops, 
they cannot support themselves, and insecurity makes it difficult to 
get humanitarian assistance to these populations. Acute malnutrition is 
widespread, sanitary conditions often do not meet even minimal 
standards.
  Worse, often these camps have insufficient protection, and the LRA 
has targeted these civilian communities of the displaced. Just last 
month, a displaced persons camp was attacked by the LRA, and in a 3-
hour period, some 200 unarmed civilians were hacked, shot, and burned 
to death. Many fear that targeting of civilians will only increase with 
the government's efforts to arm and train local defense forces, and 
local leaders warn of the potential for these forces to take the form 
of ethnic militias, harkening back to some of the worst days of 
Uganda's history.
  Reputable human rights organizations have reported disturbing abuses 
committed by Ugandan security forces in the region, and an absence of 
reliable mechanisms for holding those responsible to account. The 
recent history of Ugandan military adventures in the Democratic 
Republic of the Congo, particularly in Ituri, does not inspire 
confidence. Thankfully, Uganda has withdrawn from the DRC. But 
lingering questions about the military's commitment to basic human 
rights standards remain. I believe that the Ugandan military and the 
Ugandan government want to answer those questions definitively, and to 
reaffirm their commitment to developing professional and responsible 
forces. But pretending that these questions and concerns do not exist 
is not in the interest of Ugandans, it is not in the interest of 
Americans, and it is not in the interest of the kind of solid, frank, 
genuine partnership that I believe we all wish to cultivate with 
Uganda.
  The Women's Commission for Refugee Women and Children reports that at 
least 50,000 people--the majority of them children an adolescents--flee 
their homes nightly in search of secure places to stay until dawn. Dusk 
brings seemingly endless lines of children walking into town centers 
from homes that are often miles away, sleeping en masse in makeshift 
shelters if they are very lucky, sleeping on the streets where they are 
extremely vulnerable to exploitation if they are not. This is not 
something that happens occasionally. This has become a nightly ritual, 
a way of life, for the civilians caught up in this nightmare. Children, 
some of whom have been abducted and have escaped only to be abducted 
again, know much about fear. But they know little about school. They 
know little about safety. They know very little about the promise of a 
better future. And the entire structure of their community has been 
shattered.
  The human tragedy is devastating and the implications are quite 
serious. If Sudan is continuing to support the LRA, I am concerned 
about what this tells us about the nature of the Sudanese regime. I am 
troubled by the prospect that some will, for their own purposes, cast 
the conflict in northern and eastern Uganda in purely ethnic terms, 
lumping civilians who have been victimized in with the LRA forces 
responsible for their suffering. I worry about the potential for 
regional fractures when one part of the country lives in such a 
different world from the rest, enjoying none of the stability and 
development that we all so admire. I want Uganda to succeed. I want the 
volume of positive news to increase. And that means that we must 
address this serious issue frankly today.
  This legislation asks the administration to report to Congress on a 
number of issues relating to the situation in northern and eastern 
Uganda. I ask for these reports because I certainly do not have all of 
the answers. But I know enough about the problem to know that these 
reports will help the Congress to make informed decisions about how to 
proceed in our relationship with Sudan and about how to most 
effectively help the people of northern and eastern Uganda.
  Once again, I thank my colleague from Tennessee for joining me in 
this effort. I urge my colleagues to support this legislation.
                                 ______
                                 
      By Mr. ROBERTS (for himself and Mr. Kennedy):
  S. 2265. A bill to require group and individual health plans to 
provide coverage for colorectal cancer screenings; to the Committee on 
Health, Education, Labor, and Pensions.
  Mr. ROBERTS. Mr. President, I ask unanimous consent that the 
following bill, the Eliminate Colorectal Cancer Act, be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2265

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

     SECTION 1. SHORT TITLE; FINDINGS.

       (a) Short Title.--This Act may be cited as the ``Eliminate 
     Colorectal Cancer Act of 2004''.
       (b) Findings.--The Congress finds the following:
       (1) Colorectal cancer is the second leading cause of cancer 
     deaths in the United States for men and women combined.
       (2) It is estimated that in 2004, 146,940 new cases of 
     colorectal cancer will be diagnosed in men and women in the 
     United States.
       (3) Colorectal cancer is expected to kill 56,730 
     individuals in the United States in 2004.
       (4) When colorectal cancer is diagnosed early, at a 
     localized stage, more than 90 percent of patients survive for 
     5 years or more. Once the disease has metastasized, 92 
     percent of patients die within 5 years. Yet, only 37 percent 
     of colorectal cancer cases are diagnosed while the disease is 
     still in the localized stage.
       (5) If all men and women age 50 and over practiced regular 
     colorectal cancer screening, without any new scientific 
     discoveries, the United States could see up to a 50 to 90 
     percent reduction in deaths from this disease.
       (6) Currently, many private insurance health plans are not 
     providing coverage for the full range of colorectal cancer 
     screening tests. Lack of insurance coverage can act as a 
     barrier to care.
       (7) Assuring coverage for the full range of colorectal 
     cancer tests is an important step in increasing screening 
     rates for these life saving tests.

     SEC. 2. COVERAGE FOR COLORECTAL CANCER SCREENING.

       (a) Group Health Plans.--
       (1) Public health service act amendments.--The Public 
     Health Service Act (42 U.S.C. 201 et seq.) is amended by 
     adding at the end the following:

              ``TITLE XXIX--MISCELLANEOUS HEALTH COVERAGE

     ``SEC. 2901. COVERAGE FOR COLORECTAL CANCER SCREENING.

       ``(a) Coverage for Colorectal Cancer Screening.--
       ``(1) In general.--A group health plan, and a health 
     insurance issuer offering group health insurance coverage, 
     shall provide coverage for colorectal cancer screening 
     consistent with this subsection to--
       ``(A) any participant or beneficiary age 50 or over; and
       ``(B) any participant or beneficiary under the age of 50 
     who is at a high risk for colorectal cancer.
       ``(2) Definition of high risk.--For purposes of subsection 
     (a)(1)(B), the term `high risk for colorectal cancer' has the 
     meaning given such term in section 1861(pp)(2) of the Social 
     Security Act (42 U.S.C. 1395x(pp)(2)).
       ``(3) Requirement for screening.--The group health plan or 
     health insurance issuer shall cover methods of colorectal 
     cancer screening that--
       ``(A) are deemed appropriate by a physician (as defined in 
     section 1861(r) of the Social Security Act (42 U.S.C. 
     1395x(r))) treating the participant or beneficiary, in 
     consultation with the participant or beneficiary;
       ``(B) are--
       ``(i) described in section 1861(pp)(1) of the Social 
     Security Act (42 U.S.C. 1395x(pp)(1)) or section 410.37 of 
     title 42, Code of Federal Regulations; or
       ``(ii) specified by the Secretary, based upon the 
     recommendations of appropriate organizations with special 
     expertise in the field of colorectal cancer; and
       ``(C) are performed at a frequency not greater than that--
       ``(i) described for such method in section 1834(d) of the 
     Social Security Act (42 U.S.C. 1395m(d)) or section 410.37 of 
     title 42, Code of Federal Regulations; or
       ``(ii) specified by the Secretary for such method, if the 
     Secretary finds, based upon new scientific knowledge and 
     consistent with the recommendations of appropriate 
     organizations with special expertise in the field of 
     colorectal cancer, that a different frequency would not 
     adversely affect the effectiveness of such screening.
       ``(b) Notice.--A group health plan under this section shall 
     comply with the notice requirement under section 714(b) of 
     the Employee Retirement Income Security Act of 1974 with 
     respect to the requirements of this section as if such 
     section applied to such plan.
       ``(c) Non-Preemption of More Protective State Law With 
     Respect to Health Insurance Issuers.--This section shall not 
     be construed to supersede any provision of State law which 
     establishes, implements, or continues in effect any standard 
     or requirement solely relating to health insurance issuers in 
     connection with group health insurance coverage that provides 
     greater protections to participants and beneficiaries than 
     the protections provided under this section.

[[Page S3460]]

       ``(d) Definitions and Enforcement.--The definitions and 
     enforcement provisions of title XXVII shall apply for 
     purposes of this section.''.
       (2) ERISA amendments.--
       (A) In general.--Subpart B of part 7 of subtitle B of title 
     I of the Employee Retirement Income Security Act of 1974 (29 
     U.S.C. 1185 et seq.) is amended by adding at the end the 
     following new section:

     ``SEC. 714. COVERAGE FOR COLORECTAL CANCER SCREENING.

       ``(a) Coverage for Colorectal Cancer Screening.--
       ``(1) In general.--A group health plan, and a health 
     insurance issuer offering group health insurance coverage, 
     shall provide coverage for colorectal cancer screening 
     consistent with this subsection to--
       ``(A) any participant or beneficiary age 50 or over; and
       ``(B) any participant or beneficiary under the age of 50 
     who is at a high risk for colorectal cancer.
       ``(2) Definition of high risk.--For purposes of subsection 
     (a)(1)(B), the term `high risk for colorectal cancer' has the 
     meaning given such term in section 1861(pp)(2) of the Social 
     Security Act (42 U.S.C. 1395x(pp)(2)).
       ``(3) Requirement for screening.--The group health plan or 
     health insurance issuer shall cover methods of colorectal 
     cancer screening that--
       ``(A) are deemed appropriate by a physician (as defined in 
     section 1861(r) of the Social Security Act (42 U.S.C. 
     1395x(r))) treating the participant or beneficiary, in 
     consultation with the participant or beneficiary;
       ``(B) are--
       ``(i) described in section 1861(pp)(1) of the Social 
     Security Act (42 U.S.C. 1395x(pp)(1)) or section 410.37 of 
     title 42, Code of Federal Regulations; or
       ``(ii) specified by the Secretary, based upon the 
     recommendations of appropriate organizations with special 
     expertise in the field of colorectal cancer; and
       ``(C) are performed at a frequency not greater than that--
       ``(i) described for such method in section 1834(d) of the 
     Social Security Act (42 U.S.C. 1395m(d)) or section 410.37 of 
     title 42, Code of Federal Regulations; or
       ``(ii) specified by the Secretary for such method, if the 
     Secretary finds, based upon new scientific knowledge and 
     consistent with the recommendations of appropriate 
     organizations with special expertise in the field of 
     colorectal cancer, that a different frequency would not 
     adversely affect the effectiveness of such screening.
       ``(b) Notice Under Group Health Plan.--The imposition of 
     the requirements of this section shall be treated as a 
     material modification in the terms of the plan described in 
     section 102(a), for purposes of assuring notice of such 
     requirements under the plan; except that the summary 
     description required to be provided under the third to last 
     sentence of section 104(b)(1) with respect to such 
     modification shall be provided by not later than 60 days 
     after the first day of the first plan year in which such 
     requirements apply.''.
       (B) Technical and conforming amendments.--
       (i) Section 731(c) of the Employee Retirement Income 
     Security Act of 1974 (29 U.S.C. 1191(c)) is amended by 
     striking ``section 711'' and inserting ``sections 711 and 
     714''.
       (ii) Section 732(a) of the Employee Retirement Income 
     Security Act of 1974 (29 U.S.C. 1191a(a)) is amended by 
     striking ``section 711'' and inserting ``sections 711 and 
     714''.
       (iii) The table of contents in section 1 of the Employee 
     Retirement Income Security Act of 1974 is amended by 
     inserting after the item relating to section 713 the 
     following new item:

``Sec. 714. Coverage for colorectal cancer screening.''.

       (b) Individual Health Insurance.--
       (1) In general.--Part B of title XXVII of the Public Health 
     Service Act (42 U.S.C. 300gg-41 et seq.) is amended by 
     inserting after section 2752 the following new section:

     ``SEC. 2753. COVERAGE FOR COLORECTAL CANCER SCREENING.

       ``(a) In General.--The provisions of section 2901(a) shall 
     apply to health insurance coverage offered by a health 
     insurance issuer in the individual market in the same manner 
     as it applies to health insurance coverage offered by a 
     health insurance issuer in connection with a group health 
     plan in the small or large group market.
       ``(b) Notice.--A health insurance issuer under this part 
     shall comply with the notice requirement under section 714(b) 
     of the Employee Retirement Income Security Act of 1974 with 
     respect to the requirements referred to in subsection (a) as 
     if such section applied to such issuer and such issuer were a 
     group health plan.''.
       (2) Technical amendment.--Section 2762(b)(2) of the Public 
     Health Service Act (42 U.S.C. 300gg-62(b)(2)) is amended by 
     striking ``section 2751'' and inserting ``sections 2751 and 
     2753''.
       (c) Effective Dates.--
       (1) Group health plans.--The amendments made by subsection 
     (a) shall apply with respect to group health plans for plan 
     years beginning on or after January 1, 2005.
       (2) Individual health insurance.--The amendments made by 
     subsection (b) shall apply with respect to health insurance 
     coverage offered, sold, issued, renewed, in effect, or 
     operated in the individual market on or after January 1, 
     2005.
       (d) Coordinated Regulations.--The Secretary of Labor and 
     the Secretary of Health and Human Services shall ensure, 
     through the execution of an interagency memorandum of 
     understanding among such Secretaries, that--
       (1) regulations, rulings, and interpretations issued by 
     such Secretaries relating to the same matter over which both 
     Secretaries have responsibility under the provisions of this 
     section (and the amendments made thereby) are administered so 
     as to have the same effect at all times; and
       (2) coordination of policies relating to enforcing the same 
     requirements through such Secretaries in order to have a 
     coordinated enforcement strategy that avoids duplication of 
     enforcement efforts and assigns priorities in enforcement.

  Mr. KENNEDY. Mr. President, it is a privilege to join my colleagues 
in introducing the Eliminate Colorectal Cancer Act of 2004. I 
especially commend Senator Roberts for his leadership, assistance, and 
support on this important legislation. This bipartisan bill is being 
introduced on the final day of National Colorectal Cancer Awareness 
Month, as a sign of our intention to do all we can to see that more 
effective action is taken as soon as possible to combat this deadly 
disease. Our goal in this is to give every American with health 
insurance the right to access a full range of screening tests for 
colorectal cancer.
  The statistics are staggering. Colorectal cancer is the second 
leading cause of cancer deaths among men and women in America. Last 
year, 148,000 people were diagnosed with colorectal cancer, and 56,000 
mothers, fathers, daughters, and sons died from the disease. Tragically 
these deaths are taking place despite the fact that this form of cancer 
is curable 90 percent of the time if detected early.
  We know that screening can discover this cancer early, in fact, so 
early that growths can be identified and removed before they become 
cancerous. For no other disease are the guidelines for screening better 
defined and nationally recognized as the best way to prevent deaths 
from this cancer.
  Screening for colorectal cancer will save lives, and it will also 
avoid thousands of dollars in later treatment costs for each patient. 
The Institute of Medicine estimated that such screenings cost less than 
1 percent of later treatment for this cancer. Screening for colorectal 
cancer is obviously the right thing to do, and it is also the cost-
effective thing to do.
  The real tragedy is that fewer than half of those who fit the 
guidelines for screening are actually screened within the right 
timeframes, if at all. As a result, only 37 percent of colorectal 
cancers are diagnosed at the early, most curable stages.
  Many citizens are aware, at least vaguely, that they should probably 
be screened, but they can't afford it, because it is not covered by 
their health insurance. In our view, no American should be denied 
access to these lifesaving screening procedures simply because their 
health insurance company will not pay for it.
  Every American with insurance should have access to screening 
procedures that will prevent cancer. By requiring insurers to cover 
colorectal cancer screening, we will save thousands of lives each year, 
and save money too.
  Some argue that it is wrong to require insurers to cover a test for a 
specific disease. Yet the evidence is clear that screening makes 
colorectal cancer preventable, treatable, and beatable.
  National Colorectal Cancer Awareness Month has brought new attention 
to the fact we can eliminate a disease that causes immeasurable 
suffering and sadness in the lives of millions of Americans. With this 
legislation, we can save hundreds of thousands of lives over the next 5 
years.
  The need is clear and so is the solution. As National Colorectal 
Cancer Awareness Month comes to a close, let us do the right thing and 
work together to approve the Eliminate Colorectal Cancer Act of 2004.
                                 ______
                                 
      By Mr. DASCHLE (for Mr. Kerry (for himself, Ms. Cantwell, Mr. 
        Harkin, Mr. Bayh, Mr. Pryor, Ms. Landrieu, Mr. Bingaman, and 
        Mr. Levin)):
  S. 2266. A bill to amend the Small Business Act to provide adequate 
funding for Women's Business Centers; to the Committee on Small 
Business and Entrepreneurship.
  (At the request of Mr. Daschle, the following statement was ordered 
to be printed in the Record.)

[[Page S3461]]

 Mr. KERRY. Mr. President, today as ranking member of the 
Committee on Small Business and Entrepreneurship, I offer the Women's 
Business Center Safeguard Act, legislation to fix a funding gap that 
exists for the most experienced meritorious women's business centers.
  I would first like to express my sincere disappointment that the 
Republican majority refused to include the bipartisan women's business 
center compromise that was agreed to by Chair Snowe and the bipartisan 
leadership of the House Small Business Committee, and, in the best 
interest of women business owners across the country, I urge them to 
reconsider.
  I also want to comment on the Bush administration's proposals to 
eliminate experienced, efficient, and effective women's business 
centers in favor of new, untested, and inexperienced centers. Moving 
forward with the administration's proposal and failing to correct this 
funding gap immediately would jeopardize women's business centers in 39 
States and eliminate assistance for thousands of women in business. 
While, as my bill demonstrates, I support opening new centers to help 
women entrepreneurs who do not currently have access to this important 
assistance, this should only occur when the existing centers, whether 
in their initial or a later funding period, are fully funded. The 
administration's policy to sacrifice successful, experienced centers in 
the interest of opening new centers is unwarranted and unwise. Women 
entrepreneurs and their businesses are critically important to our 
economy and to U.S. job creation, and women's business centers help 
them succeed. I intend to continue to advocate on their behalf.
  This legislation contains a small adjustment to the Women's Business 
Center program that updates an outdated funding formula, without added 
cost to the Treasury. The adjustment changes the portion of funding 
allowed for women's business centers in the sustainability part of the 
program to keep up with the increasing number of centers that will need 
funding this fiscal year. In short, this change directs the SBA to 
reserve 54 percent of the appropriated funds for the sustainability 
centers, instead of 30 percent, which will allow for full funding of 
the most experienced centers, while still allowing for new centers and 
protecting existing ones.
  Currently there are 88 women's business centers. Of these, 35 are in 
the initial grant program and 53 will have graduated to the 
sustainability part of the program in this funding cycle. These 
sustainability centers make up more than half of the total women's 
business centers, but under the current funding formula are only 
allotted 30 percent of the funds. Without the change to 54 percent, all 
grants to sustainability centers could be cut in half--or worse, 23 
experienced centers could lose funding completely. Cutting funding for 
these, our most efficient and successful centers, would not only be 
detrimental to the centers themselves, but also to the women they 
serve, to their local communities, to their States, and to the national 
economy.
  As the author of the Women's Business Centers Sustainability Act of 
1999, I can tell you that when the bill was signed into law, it was 
Congress's intent to protect the established and successful 
infrastructure of worthy, performing centers. The law was designed to 
allow all graduating Women's Business Centers that meet certain 
performance standards to receive continued funding under sustainability 
grants. This approach allows for new centers to be established--but not 
by penalizing those that have already demonstrated their worth. It was 
our intention to continue helping the most productive and well-equipped 
women's business centers, knowing that demand for such services was 
rapidly growing.
  Today, with women-owned businesses opening at one-and-a-half times 
the rate of all privately held firms, the demand and need for women's 
business centers is even greater. Until Congress makes permanent the 
Women's Business Center Sustainability Pilot Program, as intended in 
Senate-passed legislation, an extension of authority and increase in 
sustainability funds is vital--not only to the centers themselves, but 
to the women's business community and to the millions of workers 
employed by women-owned businesses around the country.
  This bill is necessary to continue the good work of SBA's Women's 
Business Center network, and I urge all of my colleagues to support it 
and its inclusion as part of any extension of SBA programs. I ask that 
the full text of this bill be printed in the Record.
  The bill follows.

                                S. 2266

       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 ``Women's Business Center 
     Safeguard Act''.

     SEC. 2. WOMEN'S BUSINESS CENTERS.

       (a) In General.--Section 29(k) of the Small Business Act 
     (15 U.S.C. 656(k)) is amended--
       (1) in paragraph (2), by adding at the end the following:
       ``(C) Funding priority.--Subject to available funds, and 
     reservation of funds, the Administration shall, for each 
     fiscal year, allocate--
       ``(i) $150,000 for each women's business center established 
     under subsection (b), except for any center that requests a 
     lesser amount;
       ``(ii) from the remaining funds, not more than $125,000, in 
     equal amounts, to each women's business center established 
     under subsection (l), to the extent such funds are reserved 
     under subsection (k)(4)(A), except for any center that 
     requests a lesser amount; and
       ``(iii) any funds remaining after allocations are made 
     under clauses (i) and (ii) to new eligible women's business 
     centers and eligible women's business centers that did not 
     receive funding in the prior fiscal year under subsection 
     (b). ''; and
       (2) in paragraph (4)(A), by adding at the end the 
     following:
       ``(v) For fiscal year 2004, 54 percent.''.
       (b) Sunset Date.--The amendments made by this section are 
     repealed on October 1, 2004.
                                 ______
                                 
      By Ms. SNOWE (for herself, Mr. Domenici, and Mr. Chafee):
  S. 2267. A bill to amend section 29(k) of the Small Business Act to 
establish funding priorities for women's business centers; to the 
Committee on Small Business and Entreprenuership.
  Ms. SNOWE. Mr. President, I ask unanimous consent that the bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2267

       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 ``Women's Sustainability 
     Recovery Act of 2004''.

     SEC. 2. WOMEN'S BUSINESS CENTERS.

       (a) In General.--Section 29(k) of the Small Business Act 
     (15 U.S.C. 656(k)) is amended--
       (1) in paragraph (2), by adding at the end the following:
       ``(C) Funding priority.--Subject to available funds, and 
     reservation of funds, the Administration shall, for fiscal 
     year 2004, allocate--
       ``(i) $150,000 for each eligible women's business center 
     established under subsection (b), except for centers that 
     request a lesser amount;
       ``(ii) from the funds reserved under subsection (k)(4)(A), 
     not more than $125,000, in equal amounts, to each eligible 
     women's business center established under subsection (l), 
     except for centers that request a lesser amount; and
       ``(iii) any funds remaining after allocations are made 
     under clauses (i) and (ii) to new eligible women's business 
     centers and eligible women's business centers that did not 
     receive funding in the prior fiscal year under subsection 
     (b).''; and
       (2) in paragraph (4)(A), by adding at the end the 
     following:
       ``(v) For fiscal year 2004, 48 percent.''.
       (b) Sunset Date.--The amendments made by subsection (a) are 
     repealed on October 1, 2004.

                          ____________________