[Congressional Record (Bound Edition), Volume 146 (2000), Part 5]
[House]
[Pages 7296-7307]
[From the U.S. Government Publishing Office, www.gpo.gov]



    BREAST AND CERVICAL CANCER PREVENTION AND TREATMENT ACT OF 2000

  Mr. LAZIO. Mr. Speaker, I move to suspend the rules and pass the bill 
(H.R. 4386) to amend title XIX of the Social Security Act to provide 
medical assistance for certain women screened and found to have breast 
or cervical cancer under a federally funded screening program, to amend 
the Public Health Service Act and the Federal Food, Drug, and Cosmetic 
Act with respect to surveillance and information concerning the 
relationship between cervical cancer and the human papillomavirus 
(HPV), and for other purposes, as amended.
  The Clerk read as follows:

                               H.R. 4386

       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 ``Breast and Cervical Cancer 
     Prevention and Treatment Act of 2000''.

     SEC. 2. OPTIONAL MEDICAID COVERAGE OF CERTAIN BREAST OR 
                   CERVICAL CANCER PATIENTS.

       (a) Coverage as Optional Categorically Needy Group.--
       (1) In general.--Section 1902(a)(10)(A)(ii) of the Social 
     Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended--
       (A) in subclause (XVI), by striking ``or'' at the end;
       (B) in subclause (XVII), by adding ``or'' at the end; and
       (C) by adding at the end the following:

       ``(XVIII) who are described in subsection (aa) (relating to 
     certain breast or cervical cancer patients);''.

       (2) Group described.--Section 1902 of the Social Security 
     Act (42 U.S.C. 1396a) is amended by adding at the end the 
     following:
       ``(aa) Individuals described in this paragraph are 
     individuals who--
       ``(1) are not described in subsection (a)(10)(A)(i);
       ``(2) have not attained age 65;
       ``(3) have been screened for breast and cervical cancer 
     under the Centers for Disease

[[Page 7297]]

     Control and Prevention breast and cervical cancer early 
     detection program established under title XV of the Public 
     Health Service Act (42 U.S.C. 300k et seq.) in accordance 
     with the requirements of section 1504 of that Act (42 U.S.C. 
     300n) and need treatment for breast or cervical cancer; and
       ``(4) are not otherwise covered under creditable coverage, 
     as defined in section 2701(c) of the Public Health Service 
     Act (45 U.S.C. 300gg(c)).''.
       (3) Limitation on Benefits.--Section 1902(a)(10) of the 
     Social Security Act (42 U.S.C. 1396a(a)(10)) is amended in 
     the matter following subparagraph (G)--
       (A) by striking ``and (XIII)'' and inserting ``(XIII)''; 
     and
       (B) by inserting ``, and (XIV) the medical assistance made 
     available to an individual described in subsection (aa) who 
     is eligible for medical assistance only because of 
     subparagraph (A)(10)(ii)(XVIII) shall be limited to medical 
     assistance provided during the period in which such an 
     individual requires treatment for breast or cervical cancer'' 
     before the semicolon.
       (4) Conforming amendments.--Section 1905(a) of the Social 
     Security Act (42 U.S.C. 1396d(a)) is amended in the matter 
     preceding paragraph (1)--
       (A) in clause (xi), by striking ``or'' at the end;
       (B) in clause (xii), by adding ``or'' at the end; and
       (C) by inserting after clause (xii) the following:
       ``(xiii) individuals described in section 1902(aa),''.
       (b) Presumptive Eligibility.--
       (1) In general.--Title XIX of the Social Security Act (42 
     U.S.C. 1396 et seq.) is amended by inserting after section 
     1920A the following:


    ``presumptive eligibility for certain breast or cervical cancer 
                                patients

       ``Sec. 1920B. (a) State Option.--A State plan approved 
     under section 1902 may provide for making medical assistance 
     available to an individual described in section 1902(aa) 
     (relating to certain breast or cervical cancer patients) 
     during a presumptive eligibility period.
       ``(b) Definitions.--For purposes of this section:
       ``(1) Presumptive eligibility period.--The term 
     `presumptive eligibility period' means, with respect to an 
     individual described in subsection (a), the period that--
       ``(A) begins with the date on which a qualified entity 
     determines, on the basis of preliminary information, that the 
     individual is described in section 1902(aa); and
       ``(B) ends with (and includes) the earlier of--
       ``(i) the day on which a determination is made with respect 
     to the eligibility of such individual for services under the 
     State plan; or
       ``(ii) in the case of such an individual who does not file 
     an application by the last day of the month following the 
     month during which the entity makes the determination 
     referred to in subparagraph (A), such last day.
       ``(2) Qualified entity.--
       ``(A) In general.--Subject to subparagraph (B), the term 
     `qualified entity' means any entity that--
       ``(i) is eligible for payments under a State plan approved 
     under this title; and
       ``(ii) is determined by the State agency to be capable of 
     making determinations of the type described in paragraph 
     (1)(A).
       ``(B) Regulations.--The Secretary may issue regulations 
     further limiting those entities that may become qualified 
     entities in order to prevent fraud and abuse and for other 
     reasons.
       ``(C) Rule of construction.--Nothing in this paragraph 
     shall be construed as preventing a State from limiting the 
     classes of entities that may become qualified entities, 
     consistent with any limitations imposed under subparagraph 
     (B).
       ``(c) Administration.--
       ``(1) In general.--The State agency shall provide qualified 
     entities with--
       ``(A) such forms as are necessary for an application to be 
     made by an individual described in subsection (a) for medical 
     assistance under the State plan; and
       ``(B) information on how to assist such individuals in 
     completing and filing such forms.
       ``(2) Notification requirements.--A qualified entity that 
     determines under subsection (b)(1)(A) that an individual 
     described in subsection (a) is presumptively eligible for 
     medical assistance under a State plan shall--
       ``(A) notify the State agency of the determination within 5 
     working days after the date on which determination is made; 
     and
       ``(B) inform such individual at the time the determination 
     is made that an application for medical assistance under the 
     State plan is required to be made by not later than the last 
     day of the month following the month during which the 
     determination is made.
       ``(3) Application for medical assistance.--In the case of 
     an individual described in subsection (a) who is determined 
     by a qualified entity to be presumptively eligible for 
     medical assistance under a State plan, the individual shall 
     apply for medical assistance under such plan by not later 
     than the last day of the month following the month during 
     which the determination is made.
       ``(d) Payment.--Notwithstanding any other provision of this 
     title, medical assistance that--
       ``(1) is furnished to an individual described in subsection 
     (a)--
       ``(A) during a presumptive eligibility period;
       ``(B) by a entity that is eligible for payments under the 
     State plan; and
       ``(2) is included in the care and services covered by the 
     State plan;

     shall be treated as medical assistance provided by such plan 
     for purposes of section 1903(a)(5).''.
       (2) Conforming amendments.--
       (A) Section 1902(a)(47) of the Social Security Act (42 
     U.S.C. 1396a(a)(47)) is amended by inserting before the 
     semicolon at the end the following: ``and provide for making 
     medical assistance available to individuals described in 
     subsection (a) of section 1920B during a presumptive 
     eligibility period in accordance with such section''.
       (B) Section 1903(u)(1)(D)(v) of such Act (42 U.S.C. 
     1396b(u)(1)(D)(v)) is amended--
       (i) by striking ``or for'' and inserting ``, for''; and
       (ii) by inserting before the period the following: ``, or 
     for medical assistance provided to an individual described in 
     subsection (a) of section 1920B during a presumptive 
     eligibility period under such section''.
       (c) Enhanced Match.--The first sentence of section 1905(b) 
     of the Social Security Act (42 U.S.C. 1396d(b)) is amended--
       (1) by striking ``and'' before ``(3)''; and
       (2) by inserting before the period at the end the 
     following: ``, and (4) the Federal medical assistance 
     percentage shall not be less than 75 percent with respect to 
     medical assistance provided to individuals who are eligible 
     for such assistance only on the basis of section 
     1902(a)(10)(A)(ii)(XVIII)''.
       (d) Effective Date.--The amendments made by this section 
     apply to medical assistance for items and services furnished 
     on or after October 1, 2001, without regard to whether final 
     regulations to carry out such amendments have been 
     promulgated by such date.
       (e) Sense of Congress.--It is the sense of Congress that 
     the amendments made by this section, as enacted into law, 
     should conform to the levels of new budget authority and 
     budget outlays of the most recently adopted concurrent 
     resolution on the budget for the fiscal years that are 
     subject to such resolution, and to the extent that those 
     amendments result in estimated expenditures for the five-
     fiscal-year period beginning with fiscal year 2001 in excess 
     of such levels, that excess for such period should be fully 
     offset before this section is enacted by both houses of 
     Congress.

     SEC. 3. HUMAN PAPILLOMAVIRUS; ACTIVITIES OF CENTERS FOR 
                   DISEASE CONTROL AND PREVENTION.

       Part B of title III of the Public Health Service Act (42 
     U.S.C. 243 et seq.) is amended by inserting after section 
     317G the following section:


                         ``human papillomavirus

       ``Sec. 317H. (a) Surveillance.--
       ``(1) In general.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     shall--
       ``(A) enter into cooperative agreements with States and 
     other entities to conduct sentinel surveillance or other 
     special studies that would determine the prevalence in 
     various age groups and populations of specific types of human 
     papillomavirus (referred to in this section as `HPV') in 
     different sites in various regions of the United States, 
     through collection of special specimens for HPV using a 
     variety of laboratory-based testing and diagnostic tools; and
       ``(B) develop and analyze data from the HPV sentinel 
     surveillance system described in subparagraph (A).
       ``(2) Report.--The Secretary shall make a progress report 
     to the Congress with respect to paragraph (1) not later than 
     one year after the effective date of this section.
       ``(b) Prevention Activities; Education Program.--
       ``(1) In general.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     shall conduct prevention research on HPV, including--
       ``(A) behavioral and other research on the impact of HPV-
     related diagnoses on individuals;
       ``(B) formative research to assist with the development of 
     educational messages and information for the public, for 
     patients, and for their partners about HPV;
       ``(C) surveys of physician and public knowledge, attitudes, 
     and practices about genital HPV infection; and
       ``(D) upon the completion of and based on the findings 
     under subparagraphs (A) through (C), develop and disseminate 
     educational materials for the public and health care 
     providers regarding HPV and its impact and prevention.
       ``(2) Report; final proposal.--The Secretary shall make a 
     progress report to the Congress with respect to paragraph (1) 
     not later than one year after the effective date of this 
     section, and shall develop a final proposal not later than 
     two years after such effective date, including a detailed 
     summary of the significant findings and problems. The report 
     shall outline the further steps needed to make HPV a 
     reportable disease and the best strategies to prevent future 
     infections.

[[Page 7298]]

       ``(c) Condom Effectiveness; Education.--The Secretary shall 
     require that the Department of Health and Human Services and 
     all contractors, grantees, and subgrantees of such Department 
     specifically state the effectiveness or lack of effectiveness 
     of condoms in preventing the transmission of HPV, herpes, and 
     other sexually transmitted diseases in all informational 
     materials related to condoms or sexually transmitted diseases 
     that are made available to the public. The Secretary shall 
     assure that such information is made available to relevant 
     operating divisions and offices of the Department of Health 
     and Human Services. This subsection shall be effective within 
     6 months of the date of its enactment.''.

     SEC. 4. LABELING OF CONDOMS WITH RESPECT TO HUMAN 
                   PAPILLOMAVIRUS.

       (a) In General.--Section 502 of the Federal Food, Drug, and 
     Cosmetic Act (21 U.S.C. 352) is amended by adding at the end 
     the following:
       ``(u) If it is a condom, unless its label and labeling bear 
     information providing that condoms do not effectively prevent 
     the transmission of the human papillomavirus and that such 
     virus can cause cervical cancer.''.
       (b) Applicability.--The amendment made by subsection (a) 
     applies to condoms manufactured on or after the expiration of 
     the 180-day period beginning on the date of the enactment of 
     this Act.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
York (Mr. Lazio) and the gentleman from Ohio (Mr. Brown) each will 
control 20 minutes.
  The Chair recognizes the gentleman from New York (Mr. Lazio).


                             General Leave

  Mr. LAZIO. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days within which to revise and extend their remarks 
and include extraneous material on this legislation.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New York?
  There was no objection.
  Mr. LAZIO. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, today Mother's Day comes a few days early in this House 
because of the hard work in a bipartisan fashion of a number of 
different leaders in the House of Representatives, beginning with the 
Speaker of the House, the gentleman from Illinois (Mr. Hastert). 
Without his support and his commitment to this legislation, we simply 
would not be here right now.
  Mr. Speaker, the gentleman from Virginia (Mr. Bliley), chairman of 
the Committee on Commerce, deserves our respect and our appreciation 
for having addressed the merits of this bill in hearings and then 
supported it throughout the process.
  I also commend the gentlewoman from Florida (Ms. Ros-Lehtinen), the 
gentlewoman from Florida (Mrs. Fowler) and the gentlewoman from Ohio 
(Ms. Pryce), my colleagues, for their considerable influence with the 
leadership and with the membership to help move this along.
  Finally, I want to thank the gentlewoman from North Carolina (Mrs. 
Myrick), who for her entire tenure in the House has been focused on 
issues involving those people who are in struggles and need to build 
better partnerships. She has been an incredible advocate for women who 
face breast and cervical cancer and as the lead sponsor on this bill, I 
express my deep appreciation.

                              {time}  1315

  Mr. Speaker, I want to tell my colleagues a story. It is a true 
story. It is a story about one of my constituents, but she can just as 
well have been born or lived somewhere else in America. It is about a 
woman named Judy Lewis.
  See, Judy is a woman of modest means. She is an honest woman. She 
works as a waitress. Her employer, like a lot of employers throughout 
America, cannot afford to give his employees health insurance. On a 
waitress' salary, Judy cannot afford to purchase a policy either.
  So imagine Judy's delight when she heard of a Federal program that 
would provide breast and cervical cancer screenings free of charge. So 
Judy went out and had herself screened, just as the Federal Government 
has encouraged her to do.
  Mr. Speaker, one can imagine how Judy's delight turned to devastation 
when she received the diagnosis of breast cancer. One can imagine how 
her devastation turned to utter despondency when she was told that this 
Federal program was limited solely to cancer screening and that there 
was no treatment to be had.
  Mr. Speaker, Judy Lewis found herself facing hard, hard options that 
I would not wish on anyone. She was forced to spend her life savings, 
to reduce herself to penury, in order to qualify for the Medicaid 
program that might just save her life.
  Mr. Speaker, there are thousands of Judy Lewises out there. Thousands 
of women who are forced to face a Hobsons choice between a flatline or 
the bread line, between chemotherapy or the homeless shelter.
  Mr. Speaker, it is about time that Congress acted, and it is about 
time that we filled in this deadly crack in our medical system that is 
consuming thousands of women like Judy Lewis each and every year.
  Mr. Speaker, this is a good bill. This is a just bill. Let us work to 
make sure that no American woman would needlessly die of these deadly 
yet treatable diseases.
  I want to conclude by emphasizing once again, Mr. Speaker, the 
bipartisan nature of this bill. I want to thank the gentleman from Ohio 
(Mr. Brown), and I want to thank the gentlewoman from California (Mrs. 
Capps), and I would like to thank the gentlewoman from California (Ms. 
Eshoo) for their work on this as well.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I want to commend the gentlewoman from California (Ms. 
Eshoo) and the gentleman from New York (Mr. Lazio) for their hard work 
on behalf of women screened under the CDC National Breast and Cervical 
Cancer screening program. H.R. 1070 has tremendous support with 315 
cosponsors.
  In 1990, Congress passed a Breast and Cervical Cancer Mortality 
Prevention Act authorizing funding for a national breast and cervical 
cancer screening program, focusing on uninsured and under-insured 
women. The program is federally funded and locally operated, and it 
works.
  My home State of Ohio set up 12 local screening sites providing 
coverage for all of Ohio's 88 counties. Since its inception, some 
16,000 women in my State have been screened for cervical and breast 
cancer, and cancer has been detected in more than 200 women.
  Early detection alters the odds of successful treatment dramatically, 
restoring precious years otherwise lost to these devastating cancers. 
But there is a catch. Early detention is a futile and ultimately cruel 
exercise if the cancer diagnosis does not trigger appropriate 
treatment. They go hand in hand.
  The 1990 bill authorizes funding for screening but not for treatment. 
Screening alone surely cannot reduce cancer mortality. Thankfully, only 
a small percentage of women screened under the CDC program were 
actually diagnosed with cancer.
  Imagine if one of these women was your sister, your mother, your 
wife, your daughter. Maybe she works for a company that does not offer 
health insurance. Maybe she is out of a job. Maybe you are.
  With our encouragement, she participates in the CDC cancer screening 
program and learned she has life threatening cancer. What is next? If 
we pass this bill, she will face cancer with doctors and in a setting 
that makes sense. If we do not, she will be relegated to charity care. 
It is as simple as that.
  The Nation can make a small investment and, in so doing, reduce 
cancer mortality, promote cost-effective early detection and prevention 
of cancer, and spare seriously ill women the added trauma of cobbled 
together often-ineffective care. Or we can look the other way.
  There is only one right answer, Mr. Speaker. We need to pass this 
bill.
  Mr. Speaker, I reserve the balance of my time.
  Mr. LAZIO. Mr. Speaker, it is now my pleasure to yield 2 minutes to 
the

[[Page 7299]]

gentlewoman from North Carolina (Mrs. Myrick), the primary sponsor of 
this legislation.
  Mrs. MYRICK. Mr. Speaker, I thank the gentleman from New York 
(Chairman Lazio) for yielding me this time.
  I am so pleased to be able to be here today and support this bill 
because it is a great day for American women. Today we can actually 
pass a bill that is going to ensure that low-income working women can 
get treatment for their breast or cervical cancer.
  This is a bill that covers women who are not eligible for Medicaid 
and too young for Medicare, but are caught in that crack of not having 
insurance coverage for a lot of reasons. Some, their employer does not 
provide it. Other times, they just flat cannot afford it.
  So this program is a follow-up to something Congress has been doing 
for the last 10 years. We have been providing screening for breast and 
cervical cancer. But then if the woman is told that she has cancer, the 
critical aspect of treatment is not there. A lot of them are sent home 
with no treatment options.
  By establishing this service, they are going to have that peace of 
mind that they will receive the care that they need. If we care enough 
to screen the women, we certainly should care enough to be able to 
provide the treatment.
  I am very fortunate. I am currently undergoing treatment for breast 
cancer, but I have insurance. It is paying my thousands and thousands 
of dollars of medical bills. But the women that we are talking about 
today do not have that luxury. I cannot imagine anything more 
devastating than being told one has cancer, but I am sorry, there is no 
way one can get treated. I mean, one goes through enough emotional 
turmoil when one has to deal with this disease alone, let alone knowing 
that there is no hope there for one as a human being to continue to 
lead the rest of one's life, live the rest of one's life in a healthy 
manner.
  So this is not only a great day for American women, it is a great 
Mother's Day gift for American women because, yes, Sunday is Mother's 
Day.
  I would like so much to thank the gentleman from New York (Mr. Lazio) 
and the gentlewoman from California (Ms. Eshoo) who have taken the lead 
on this bill. I thank Speaker Hastert for his willingness to bring it 
to the floor.
  I urge all of my colleagues to support the bill.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 3\1/2\ minutes to the 
gentlewoman from California (Ms. Eshoo) who has done yeoman's work in 
pushing this bill to the House floor.
  Ms. ESHOO. Mr. Speaker, I thank the gentleman from Ohio, the ranking 
member, for yielding me this time.
  Mr. Speaker, I rise in support of the legislation that is here on the 
floor under suspension, which, to the American people, what that means 
is that there are so many people that support this that we do not have 
to worry about its passage.
  On March 11, 1999, we held a press conference. The gentleman from New 
York (Mr. Lazio) and myself brought about this bill, and I am very 
proud to be the chief Democratic sponsor of it.
  On that day, I issued a challenge, our challenge to ourselves and the 
women around the country, that we would lobby the Congress and all of 
its Members so that, by Mother's Day of last year, we would have more 
than a simple majority to pass the bill. I did not realize what a fight 
we had on our hands.
  We are here today for a bill that today, as brought to the floor, has 
three cosponsors. Why did it go from 315 to 3? Because last Friday the 
bill was gutted, plain and simple.
  Now, this bill is not about my work. This bill is really not about 
the work of the gentleman from New York (Mr. Lazio). This bill is about 
a need of women to have treatment for breast and cervical cancer. That 
is why I brought everything that I could to it.
  The reason the bill was reconstituted with money in it, make no 
mistake about it, is because of the National Breast Cancer Coalition 
and its brave and courageous members. They were the ones that put in 
the telephone calls to the Speaker's office and to the leadership and 
said, unless you retain money in the bill, the Congress might as well 
send a greeting card to the families of America who have been 
victimized by either breast or cervical cancer, and said we are 
thinking about you on Mother's Day.
  So I rejoice for them and their courageous advocacy, because, were it 
not for the National Breast Cancer Coalition, Mr. Speaker, we would not 
be here today with the reconstituted bill, because it was gutted and 
thrown by the side of the road last week.
  This is a need in our Nation. Imagine women being victimized, not 
once, but twice, first by the breast or cervical cancer and then by a 
lack of insurance coverage. These are the waitresses, these are the 
uninsured or the under-insured women of our Nation.
  So we do noble work for them today by passing this and saying to them 
that America is a better country, that she can, indeed, step up to and 
fund and advocate for and recognize where there is a weak link, where 
something is broken in our society.
  I want to salute everyone in the House that was a cosponsor of H.R. 
1070. That was the legislation that really allowed this to happen 
today. I want to thank all of my colleagues for having done that. It 
was a very important bipartisan effort. No major legislation in this 
House, no meaningful legislation can ever pass the Congress unless it 
is bipartisan.
  So as we used to say when we were kids, sticks and stones may break 
my bones, but no one is going to break the spirit of those that need 
the most of what they need; and those of us in this House are going to 
insist that it be done the way it should be done in order to make it 
happen for them.
  So God bless the women. Happy Mother's Day. They deserve it. They 
earned it. I thank the National Breast Cancer Coalition.
  Mr. LAZIO. Mr. Speaker, I include for the Record the letter of 
glowing support of H.R. 4386 from the National Breast Cancer Coalition, 
as follows:

                             National Breast Cancer Coalition,

                                                      May 9, 2000.
       Dear Congressperson: On behalf of the National Breast 
     Cancer Coalition (NBCC) and the 2.6 million American women 
     living with breast cancer. I urge you to support H.R. 4386, 
     the substitute for H.R. 1070, the Breast and Cervical Cancer 
     Treatment Act, when it comes to the House floor for a vote 
     today. H.R. 4386 is bi-partisan legislation offered by 
     Representatives Myrick (R-NC), Danner (D-MO), and Lazio (R-
     NY). This legislation is very similar to H.R. 1070, the 
     Breast and Cervical Cancer Treatment Act, offered by 
     Representatives Lazio (R-NY), Eschoo (D-CA), Ros-Lehtinen (R-
     FL) and Capps (D-CA), one of NBCC's priority issues for the 
     106th Congress.
       H.R. 4386 would give states the option of providing 
     Medicaid coverage to low-income women who are screened and 
     diagnosed with breast and cervical cancer through the Centers 
     for Disease Control and Prevention's (CDC) National Breast 
     and Cervical Cancer Early Detection Program. While the CDC 
     Early Detection Program currently provides screening for 
     breast and cervical cancer for low-income, uninsured and 
     underinsured women, if lacks a critical aspect--funding for 
     treatment for women diagnosed with these cancers. These women 
     are often working mothers who are too young for Medicare and 
     whose incomes are too high for Medicaid, but who do not have 
     health insurance. Screening must be coupled with treatment to 
     reduce mortality.
       H.R. 4386, like H.R. 1070, also includes the enhanced match 
     of 75% Federal-25% State dollars for treatment, instead of 
     the basic 60% Federal-40% State dollars. This enhanced match 
     is a major incentive for governors to enroll their states in 
     the program once the bill is signed into law so that these 
     women can be created for their cancers. Many governors, 
     including George W. Bush, have endorsed this legislation.
       Congress provided funding for H.R. 4386 in the FY 01 Budget 
     Resolution. President Clinton also included funding for this 
     program in his FY 01 budget. H.R. 1070, which contains almost 
     all of the same provisions as H.R. 4385, has 315 co-sponsors. 
     The Breast and Cervical Cancer Treatment Act passed 
     unanimously out of the House Commerce Committee.
       Please vote ``yes'' on H.R. 4386. NBCC will record Members' 
     votes on this legislation in our 2000 Voting Record, which 
     will come out prior to the November elections.
       With all of this support, we must pass H.R. 4386. Let's 
     give all the mothers in this country the best gift we can 
     this Mothers Day week--peace of mind that we are one step 
     closer to assurance that if they are diagnosed with breast or 
     cervical cancer they

[[Page 7300]]

     will receive the life-saving treatment they need.
           Sincerely,
                                                       Fran Visco,
                                                        President.

  Mr. LAZIO. Mr. Speaker, I yield 2\1/2\ minutes to the distinguished 
gentlewoman from Florida (Ms. Ros-Lehtinen) who has been just an 
amazing advocate for this bill and for women who struggle with breast 
and cervical cancer.
  Ms. ROS-LEHTINEN. Mr. Speaker, I congratulate the gentleman from New 
York (Mr. Lazio) for his tireless leadership efforts on this bill 
because today marks a significant day in women's history as we will 
help decide the fate of scores of women throughout our country.
  The bill before us, the Breast and Cervical Cancer Treatment Act, is 
a bill that has long been awaited by our Nation's mothers and daughters 
whose lives have been touched by breast or cervical cancer.
  Women's cancers are sweeping the Nation at high speeds. While 
researchers continue to look for cures and effective treatments, many 
women will never be able to see the benefits of such research because 
they simply are not able to afford it.
  The bill before us will enable many low-income women to receive the 
necessary life treatment, life saving treatment through a State-
optional Medicaid benefit which will help provide coverage for 
treatment for women who are screened and diagnosed through the Federal 
CDC Early Detection Program.
  Today, if we pass our bill, our Nation's women will finally be given 
a fighting chance at beating a life-threatening disease. Today if we 
pass the bill of the gentleman from New York (Mr. Lazio), low-income 
women everywhere will have peace of mind that, should she ever be 
diagnosed with breast or cervical cancer, life-saving treatment will be 
made available to them.
  Despite education on preventative measures and early detection, the 
rate of cancer among women continues to increase at an alarming rate. 
Every 64 minutes, a woman is diagnosed with a reproductive tract 
cancer; and just today, one in eight women will be diagnosed with 
breast cancer.
  The gentlewoman from North Carolina (Mrs. Myrick), our own colleague, 
shared with us how her life has been directly touched by breast cancer. 
Fortunately for the gentlewoman, she is among the fortunate ones who 
can afford life-saving treatment after diagnosis, but many women 
unfortunately are not as lucky.
  As cancer eats away at their spirits, many women are left to scramble 
and search for funding. They are forced to hold bake sales and car 
washes just to be able to afford the necessary life-saving treatment 
they so desperately need.
  As role models and community leaders, we encourage all mothers and 
daughters to have mammogram screenings and take early detection 
measures. Today, Congress can make a difference and give mothers all 
over the country the best gift this coming Mother's Day by giving them 
life.
  By passing the bill of the gentleman from New York, (Mr. Lazio), the 
Breast and Cervical Cancer Treatment Act, we can give women a fighting 
chance at beating cancer. It is the very least that all of us in 
Congress can do for mothers and women everywhere.
  I thank our colleagues for their extraordinary leadership, especially 
the gentleman from New York (Mr. Lazio). I also thank the gentlewoman 
from North Carolina (Mrs. Myrick) whose perseverance in the battle to 
eradicate breast cancer has been a strong inspiration for all of us.
  When battling a fierce and treacherous disease such as cancer, every 
minute counts. Mr. Speaker, many of our Nation's mothers and daughters 
cannot wait any longer. I urge my colleagues to vote for passage of 
H.R. 4386, to extend to them the gift of life.

                              {time}  1330

  Mr. BROWN of Ohio. Mr. Speaker, I yield 3 minutes to the gentleman 
from California (Mr. Waxman).
  Mr. WAXMAN. Mr. Speaker, I rise in support of H.R. 4386, the Breast 
and Cervical Cancer Treatment Act of 2000. This bill is a variation of 
legislation originally introduced by the gentlewoman from California 
(Ms. Eshoo) and the gentleman from New York (Mr. Lazio) as H.R. 1070. 
Because of the untiring efforts of both of these sponsors, that 
legislation was finally considered by the Committee on Commerce and 
passed by a vote last October.
  The gentlewoman from California (Ms. Eshoo) has continued to work to 
see that this legislation would receive consideration by the full 
House. She has been a driving force for this legislation. In view of 
those efforts, I find it disturbing that her name appears nowhere on 
the legislation before us today. Instead, we have a new bill and new 
Republican lead sponsors.
  The bipartisan way this bill has been approached from the beginning 
is now paid lip service at best. Well, that will not fool the many 
groups who have long fought for this bill and who know the dedication 
of the gentlewoman from California (Ms. Eshoo) and many other Democrats 
who have fought for this effort as well. It will not fool the women of 
America.
  I think it reflects poorly on the Republican leadership for trying to 
take sole partisan credit for a bill that has been bipartisan from the 
very beginning and is bipartisan in support of this legislation today. 
The Republicans are trying to take partisan credit for this bill, and 
by the time we are finished, they will take partisan credit for 
Mother's Day.
  I regret also that the bill that is before us is not going to even be 
put into effect until the year 2001. This bill should have been 
effective immediately. It should have been brought up last year. 
Instead, what we have is a bill that will not be effective until 2001 
but is called the Breast and Cervical Cancer Treatment Act of 2000.
  Notwithstanding these last-minute changes, this bill will provide 
crucial treatment and follow-up services under Medicaid for women 
screened under the Breast and Cervical Cancer Screening Program who are 
found to have cancer.
  Mr. Speaker, I was chairman of the Subcommittee on Health and the 
Environment when we originally passed the Breast and Cervical Cancer 
Screening Program into law. It was an important step forward. We did it 
on a bipartisan basis. It has proved to be a real success story in 
helping women. It remains a law that I am proud of. But when we have no 
services available for women who find that they have breast cancer, it, 
one, discourages many from even going in to be screened, and it is 
inhumane not to have those services available.
  However, there is one part of this bill that was added in committee 
that is of great concern to me, and I want to point that out. I believe 
the mandate concerning human papilloma virus, HPV, was a well-intended 
but deeply misguided provision. From a public health point of view, 
this provision will not achieve a meaningful improvement in health or 
in the prevention of HPV. On the contrary, it threatens to discourage 
the use of condoms in preventing other sexually transmitted diseases, 
including HIV and AIDS.
  I urge my colleagues to support the bill because of its important 
contributions to the treatment and care of American women with breast 
and cervical cancer.
  Mr. Speaker, I rise in support of H.R. 4365, ``The Children's Health 
Research and Prevention Amendments of 2000.'' This bill includes many 
important provisions which will advance the treatment, cure and 
prevention of many childhood diseases and disorders.


           Important Titles on Asthma and Autoimmune Diseases

  I am very pleased that H.R. 4365 includes two titles which I have 
authored. Both titles promise to make significant advances in the 
treatment and prevention of childhood asthma and of autoimmune 
diseases, like multiple sclerosis, juvenile diabetes and lupus: Title V 
of this bill consists of H.R. 2840, ``The Children's Asthma Relief Act 
of 1999,'' introduced by Congressman Fred Upton and myself; and title 
XIX is based on H.R. 2573, ``The NIH Office of Autoimmune Diseases Act 
of 1999,'' which was authored by Congresswoman Connie Morella and 
myself.


                      Children's Asthma Relief Act

  Today, more than 5 million American children have asthma, one of the 
most significant

[[Page 7301]]

and prevalent chronic diseases in America. Surgeon General David 
Satcher recently concluded that the United States is ``moving in the 
wrong direction, especially among minority children in the urban 
communities.''
  That is why the Children's Asthma Relief Act provides new funding for 
pediatric asthma prevention and treatment programs, allowing States and 
local communities to target and improve the health of low-income 
children suffering from asthma. The act would also increase the 
enrollment of these children into Medicaid and State Children's Health 
Insurance Programs, (CHIP), such as California's Healthy Families.
  I am particularly pleased that title V of H.R. 4365 includes mobile 
``breathmobiles'' among the community-based programs eligible for 
funding. These school-based mobile clinics were developed by the 
southern California chapter of the Asthma and Allergy Foundation of 
America, in conjunction with Los Angeles County, Los Angeles Unified 
School District, and the University of Southern California.
  Finally, this title reflects the leadership and work of Senators Dick 
Durbin and Mike DeWine. It also has the strong support of leading child 
health and asthma organizations, including the American Lung 
Association, the American Academy of Pediatrics, Association of 
Maternal and Child Health Programs, the National Association of 
Children's Hospitals, the American Academy of Chest Physicians, and the 
Children's Health Fund.


                 NIH Initiative on Autoimmune Diseases

  I am also pleased that H.R. 4365 establishes a new initiative at NIH 
to ``expand, intensify and coordinate'' research and education on 
autoimmune diseases.
  Last year, Congresswoman Morella and I introduced ``The NIH Office of 
Autoimmune Diseases Act of 1999.'' This legislation created an office 
in the NIH Office of the Director to ensure the Federal funding of 
autoimmune disease research is used optimally and that clinical 
treatments are developed as rapidly as possible.
  There are more than 80 autoimmune diseases--including multiple 
sclerosis, lupus, and rheumatoid arthritis--in which the body's immune 
system mistakenly attacks healthy tissues. These diseases affect more 
than 13.5 million Americans and are major causes of disability. Most 
striking of all, three-quarters of those afflicted with an autoimmune 
disease are women.
  Research on autoimmune diseases is spread through many institutes of 
the National Institutes of Health (NIH), just as treatments involve 
many clinical specialties. Increasingly, however, scientists are 
identifying the common risk factors and symptoms of autoimmune 
diseases. This is why greater coordination and additional resources are 
needed in our Nation's autoimmune research effort.
  Title XIX of H.R. 4365 adopts our office, transferring its activities 
and mission to an Autoimmune Diseases Coordinating Committee. Composed 
of NIH institute directors and permanently staffed with scientists and 
health professionals, the coordinating committee would be advised by a 
public advisory council.
  Most significantly, the coordinating committee, in close consultation 
with the advisory council, will develop a plan for research and 
education on autoimmune diseases. The plan will establish NIH 
priorities and the Director of NIH will ensure the plan is fully and 
appropriately funded. The strategic plan would create crucial new 
funding opportunities for autoimmune research, based on the 
professional and scientific judgments of researchers, patients, and 
clinicians.
  Finally, the committee would report to Congress on implementation of 
the plan, including the actual amounts dedicated by NIH to autoimmune 
disease research. The committee will also prospectively identify areas 
and projects of great promise which Congress should support.
  I cannot overstate the importance of these activities. In conjunction 
with the strategic plan, these reports will provide an objective, 
scientifically sound roadmap to Congress and NIH to follow in the 
pursuit of new treatments and cures for autoimmune diseases.


         controversy concerning title xii on adoption awareness

  However, I do have serious concerns over one section of this bill--
title XII's adoption awareness provisions. This title was the subject 
of great controversy and debate. The original language raised many 
serious objections concerning adoption policy as well as abortion 
policy.
  These objections were made by Members, including myself, and 
important public health organizations including the American College of 
Obstetricians and Gynecologists, the National Association of Community 
Health Centers, and the National Abortion and Reproductive Rights 
Action League.
  I recognize the sincerity of Chairman Bliley's concern on the issue 
of adoption. And he has clearly made significant efforts to achieve a 
compromise and to remove the more troubling provisions from this title.
  But while I support the passage of H.R. 4365, I join many colleagues 
in calling for careful scrutiny of this title when the legislation is 
in conference with the Senate. We must assure that its provisions do no 
harm to the provision of federally funded reproductive health services 
or to sensible adoption policy across the country.
  Again, I urge passage of this bill's important provisions for 
children's health, and ask every Member to join me in voting for H.R. 
4365.
  Mr. LAZIO. Mr. Speaker, I yield myself 30 seconds just to respond, if 
I can, to the remarks of the gentleman from California.
  First of all, I want to say it has been 10 years now since the 
Federal Government developed the screening program for low-income women 
who have breast and cervical cancer, and I am proud of the leadership 
in allowing us to bring this to the floor to finally address this. That 
is number one.
  Number two, we are going to work very hard to try to ensure that we 
will move the effective date up to October of 2000 in conference. We 
are trying to make adjustments. Because of budgetary constraints and 
the budget resolution, we cannot move it any further until then.
  Finally, let me just note that the gentlewoman from Missouri (Ms. 
Danner), the last time I checked, was on the other side of the aisle 
and is a cosponsor of this bill. It is a bipartisan bill and I did try 
to pay tribute, in fact, to the gentlewoman from California (Ms. 
Eshoo), who has played an important role in moving this bill forward.
  Mr. Speaker, I yield 2\1/2\ minutes to the gentleman from Oklahoma 
(Mr. Coburn).
  Mr. COBURN. Mr. Speaker, first of all, I would like to pay tribute to 
the gentlewoman from California (Ms. Eshoo) and to the gentleman from 
New York (Mr. Lazio) for their work on this bill. I do not think it 
would have come about without their efforts.
  And I do not believe this has anything to do with partisan politics, 
and I am sorry that that has been raised as a part of this. The human 
papilloma virus, breast cancer, does not care what one's political 
affiliation is. It just is coming after us.
  I also want to make clear the statements by the gentleman from 
California are erroneous. The number one sexually transmitted disease 
in this country today, that claims 15,000 lives, more lives than AIDS, 
is human papilloma virus. And for the American College of Obstetricians 
and Gynecologists to stick their head in the sands and say they do not 
really care about women because they do not want them educated about 
the number one risk factor for them developing cervical cancer.
  It is true that 15,000 women will be diagnosed with cervical cancer 
this year. Fifteen thousand women will die. But hundreds of thousands 
of women will be treated for precancer dysplasia because we, as a 
government and health policy, have decided we are not going to let 
everybody know about the most dangerous sexually transmitted disease 
out there. This bill moves a long way toward that, of informing women 
of the actual method of transmission and the fact that prophylactic use 
of condoms will not prevent this disease.
  ACOG did not dispute the facts. They just said they did not want the 
public to know. I think it is highly ironic in this day and time of 
advances in health care that those that control the power over the 
medical institutions have chosen to go against knowledge, against 
informing women. If they were to apply the same logic to breast cancer, 
they would not tell women about annual screening with mammograms, they 
would not tell women about how important it is for them to get a report 
back on their mammogram or to have a follow-up doctor visit or to do 
annual self-breast exams.
  So I find it very ironic that, number one, this bill can be claimed 
to be partisan. It is not. The gentlewoman from Missouri (Ms. Danner), 
the gentlewoman from California (Ms. Eshoo), and many others in this 
Chamber have worked hard to see that this bill came

[[Page 7302]]

to fruition, including the ranking minority member of this 
subcommittee. Let us not let it be partisan.
  Number two, let us not deny scientific truth. Let us let people know 
what they are at risk for. That is all this is about, to inform the 
public of the risks that are out there in terms of a disease that 
causes more deaths than AIDS in this country, and it is preventable.
  And, Mr. Speaker, I am providing for insertion into the Record a 
letter from the Medical Institute on Human Papilloma Virus.

                                        The Medical Institute,

                                          Austin, TX, May 9, 2000.

                             Press Release


 house to decide whether americans should be told the truth about the 
              most common std, human papilloma virus (hpv)

       Austin, Texas (May 9, 2000).--Today the House of 
     Representatives will consider the Breast and Cervical 
     Treatment Act legislation (H.R. 4386). This important 
     legislation has the potential to dramatically decrease the 
     number of lives shortened each year by cervical cancer, which 
     results from the most common STD, human papilloma virus 
     (HPV).
       H.R. 4386 would make HPV and cervical cancer prevention a 
     new public health priority. The bill directs the CDC to 
     determine the prevalence of HPV, and to develop and 
     disseminate educational materials for the public and for 
     health care providers regarding the impact and prevention of 
     HPV. In addition, condom labels and government sponsored 
     informational materials would be required to state that 
     condoms do not prevent the transmission of HPV and that HPV 
     can cause cervical cancer.
       This bill is particularly significant in that it would make 
     HPV a reportable disease to the Centers for Disease Control 
     and Prevention. This action would make it possible to 
     accurately assess how many individuals are hurt by the 
     disease each year. Current estimates suggest that 75 percent 
     of all sexually active adults currently have, or previously 
     had, an HPV infection--that's over 80 million Americans 
     between the ages of 15 and 49.
       Current labeling on condom packages suggests that condoms 
     protect users from HIV and other sexually transmitted 
     diseases, including HPV. This bill would require condom 
     packaging and public health messages to warn the public that 
     condoms do not provide adequate protection for HPV 
     transmission, which can lead to cervical cancer.
       Most Americans--including American health care 
     professionals--are currently unaware of HPV's dramatic 
     prevalence.
       HPV is the most common viral STD in the United States. 
     Current estimates suggest that 5.5 million Americans acquire 
     the infection each year.
       HPV is the virus present in over 93 percent of all cervical 
     cancers (according to a 1995 study in the Journal of the 
     National Cancer Institute).
       More women die from cervical cancer than die from AIDS each 
     year in the U.S.
       In addition to cervical cancer, HPV can lead to vaginal, 
     vulvar, penile, anal and oral cancer. According to the 
     National Cancer Institute, the evidence that condoms do not 
     protect against HPV is so definitive that ``additional 
     research efforts by NCI on the effectiveness of condoms in 
     preventing HPV transmission is not warranted.''
       Dr. Richard Klausner of the National Cancer Institute has 
     stated, ``condoms are ineffective against HPV because the 
     virus is prevalent not only in mucosal tissue, but also on 
     dry skin of the surrounding abdomen and groin, and can 
     migrate from those areas into the vagina and cervix.''
       Despite these findings, The American College of 
     Obstetricians and Gynecologists (ACOG) does not support this 
     legislation. In a letter sent to the members of the House, 
     the College states, ``We believe that the HPV language 
     included in H.R. 4386 is not medically appropriate. Indeed, 
     we feel the language, if passed, would discourage condom use 
     although condoms are effective in preventing other serious 
     STDs such as HIV/AIDS.''
       This statement indicates that ACOG has abandoned its 
     responsibility to inform the American public about the truth: 
     condoms don't protect against the transmission of the most 
     common STD--HPV. It's worth noting that ACOG is not 
     questioning the medical accuracy of the legislation. They are 
     simply fearful that the data might discourage condom usage 
     (although there is no scientific or anecdotal evidence to 
     support this conclusion).
       H.R. 4386 must be passed to protect the future health of 
     Americans. Americans have a right to know the truth about 
     human papilloma virus (HPV). It is only when individuals know 
     the facts that they can make informed decisions that impact 
     their personal health and future happiness. The Medical 
     Institute applauds the House for addressing this important 
     issue.
       The Medical Institute is a nonprofit medical organization 
     founded in 1992 to confront the worldwide epidemics of 
     nonmartial pregnancy and sexually transmitted infection with 
     incisive health care data.

  Mr. BROWN of Ohio. Mr. Speaker, how much time is remaining for each 
side?
  The SPEAKER pro tempore (Mr. LaTourette). The gentleman from Ohio 
(Mr. Brown) has 11\1/2\ minutes remaining, and the gentleman from New 
York (Mr. Lazio) has 9 minutes remaining.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the gentlewoman 
from Missouri (Ms. Danner).
  Ms. DANNER. Mr. Speaker, during the break between the first and 
second session of the 106th Congress the gentlewoman from North 
Carolina (Mrs. Myrick) and I had similar schedules to many of our 
compatriots here on the floor; cutting ribbons, going to civic affairs, 
meeting with our constituents in general. However, she and I differed 
from other Members in a very significant way. We each began our 
personal battle against breast cancer.
  Fortunately, we were diagnosed very early. And since each of us have 
routine physical checkups and mammograms, our diagnoses were followed 
immediately by treatment because we both had insurance to cover us. And 
I might mention that we do pay premiums for that insurance. Some people 
wonder about that.
  Unfortunately, there are many women who do not have the ability to 
pay for treatment after being diagnosed with breast or cervical cancer. 
This is a most tragic situation that this legislation seeks to address.
  Because of my early diagnosis and subsequent treatment, along with 
millions of other women in America, I am a survivor. The early 
detection of my cancer has strengthened my belief in the vital role of 
having a regular mammogram and an annual physical checkup. I attribute 
my favorable and fortunate outcome to this diligence, and I encourage 
all women to take similar action for themselves, their families and 
their loved ones.
  There is no denying that this short examination each year can be 
rather unnerving, rather trying, but I promise it may be a life-
changing and, indeed, it may be a lifesaving experience for any woman 
and her family.
  I urge all Members of this body to adopt this legislation, Mr. 
Speaker.
  Mr. LAZIO. Mr. Speaker, I yield 2 minutes to the gentleman from 
Florida (Mr. Bilirakis), the chairman of the Subcommittee on Health and 
Environment of the Committee on Commerce, and a true advocate for all 
people suffering with cancer.
  Mr. BILIRAKIS. Mr. Speaker, I thank the gentleman for yielding me 
this time, and I rise in support of H.R. 4386, this bipartisan bill, 
and I emphasize bipartisan bill, which was introduced by our colleagues 
the gentleman from New York (Mr. Lazio), the gentlewoman from North 
Carolina (Mrs. Myrick), and the gentlewoman from Missouri (Ms. Danner).
  This bill would allow States to expand coverage under the Medicaid 
program to breast and cervical cancer patients who have been screened 
through the National Breast and Cervical Cancer Early Detection 
Program. I was pleased to secure passage of similar legislation through 
my Subcommittee on Health and Environment last year, and that 
legislation was clearly ramrodded by the gentlewoman from California 
(Ms. Eshoo), and we must really credit her for starting the ball 
rolling in this regard.
  The screening program is administered by the Centers for Disease 
Control and Prevention. I had the opportunity to learn more about the 
agency's important work in this area during a trip which I took with 
the gentleman from Ohio (Mr. Brown) to its Atlanta headquarters last 
year, and I was also proud to sponsor women's health legislation which 
was enacted into law in 1998 to reauthorize the screening program.
  H.R. 4386 will close the gap, as others have already said, left open 
when the screening program was first created, and it represents an 
important step forward in the battle against breast and cervical 
cancer. I urge my colleagues to support passage of this critical 
measure which will give new hope to breast and cervical cancer patients 
in need as we continue the fight to find a cure for these terrible, 
terrible diseases.

[[Page 7303]]


  Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the gentlewoman 
from Connecticut (Ms. DeLauro).
  Ms. DeLAURO. Mr. Speaker, in the past decade, over 2 million women 
were diagnosed with breast or cervical cancer. One quarter of these 
women, America's mothers, daughters, sisters, and wives, will be taken 
from their loved ones by the disease.
  As a cancer survivor, I recognize the importance of cancer research 
and I am committed to increasing funding for research. Today, over 8 
million people are alive as a result of the progress of cancer 
research. It has increased the cancer survival rate. With early 
detection, there is hope. I am living proof of that. I survived ovarian 
cancer because it was caught early. It gave me a fighting chance.
  Congress made a commitment to early detection when it passed the 
Breast and Cervical Cancer Mortality Prevention Act, providing low-
income women with access to a mammogram or a Pap smear through the 
Centers for Disease Control's Breast and Cervical Cancer Screening. An 
important step. Early detection can make all the difference. As a 
result of this program, over three-quarters of a million women receive 
breast and cervical cancer screenings.
  Because it helped detect their cancers early, many of these women 
were easily treated and cured. In too many cases, women who are 
screened receive the awful news that they are facing cancer. They are 
without treatment because they are without insurance. This is wrong 
and, thankfully, today, we can do something about it. By passing the 
Breast and Cervical Cancer Treatment Act, we can ensure that these 
women are not left to battle cancer alone. The legislation will make 
these women eligible for Medicaid so that they can get the care and the 
treatment that they need.
  Being told that one has cancer is frightening enough; a million fears 
run through the mind all at once: Will I survive? What will happen to 
my family? The fear can be crippling. It takes the help of loved ones 
to build up strength to battle back. But love alone will not battle and 
defeat cancer. Access to treatment is critical. This legislation 
ensures that these women are given a fighting chance. I urge my 
colleagues to give it their full support.
  Mr. LAZIO. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from 
Florida (Mr. Foley), a member of the Committee on Ways and Means.
  Mr. FOLEY. Mr. Speaker, I want to thank the gentleman for yielding me 
this time, and I strongly support passage of H.R. 4386.
  Breast cancer is a disease that can strike almost anyone, no matter 
how young or how healthy, no matter how rich or how poor. One of my 
friends was recently diagnosed with breast cancer. When she got her 
diagnosis, she was able to get the best care money could buy. She was 
soon on a plane to Sloan-Kettering to be treated by one of the foremost 
cancer doctors in the country. Once there, she received quick treatment 
and top quality reconstructive surgery. Then she was able to return to 
the comfort of her own home for a long recovery.

                              {time}  1345

  Tricia was also fortunate that she had a loving and supportive family 
to help her cope with this disease. Even though she was fortunate 
enough to have these benefits, she has still suffered great emotional 
and physical pain from the breast cancer, painful surgery, the sickness 
of chemotherapy, the loss of hair, and the terrible uncertainty of 
whether the cancer would spread or be eliminated completely.
  I think of someone in Tricia's situation, and then I try to imagine 
what breast or cervical cancer would mean to someone with no health 
insurance, no good medical care, and no support network.
  These women not only face the fear of having this disease, they must 
also cope with the costs associated with their medical treatment, they 
have to worry about how to pay for their treatment, about whether they 
will be fired from their job, if their recovery period is too long, and 
about who will take care of their children while they recover.
  These fears also lead to denial and to a delay in diagnosis and 
treatment. This delay is one of the leading factors in breast and 
cervical cancer morbidity and mortality.
  The passage of this bill will help eliminate these fears and give 
uninsured women the hope and help that they need to get treated quickly 
and, God willing, to get back their lives.
  Saving someone's life should not be determined by how much money or 
health insurance someone has. Let us give those who do not have wealth 
or good insurance the same chance at life the rest of us enjoy.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 1\1/2\ minutes to the 
gentlewoman from New York (Mrs. Lowey).
  Mrs. LOWEY. Mr. Speaker, I rise in support of H.R. 4386, the Breast 
and Cervical Cancer Treatment Act, which has the potential to save the 
lives of thousands of American women.
  Right now, with limited resources, only 15 percent of eligible women 
are being screened. But even if we could screen all eligible women, 
early detection is not enough. If we are serious about eradicating the 
scourge of breast and cervical cancer, all women diagnosed must have 
access to medical treatment.
  The screening program was not designed to do that, and States have 
found themselves haphazardly and frantically cobbling together whatever 
resources they can. That is why this bill is so important.
  I am truly delighted that this leadership brought the bill to the 
floor today. Yet, while I strongly support the overall bill, I do want 
to express my disappointment about the provisions dealing with human 
papillomavirus, which would make HPV a reportable disease and allow 
condoms to be labeled with a disclaimer that they do not effectively 
protect against HPV. I think it is critical that we get more research 
done and more education done with regard to HPV.
  While there is a relationship between HPV and cervical cancer, the 
overwhelming majority of HPV cases do not result in cancer, and it is 
entirely too early to make HPV a reportable disease.
  We also do not yet fully understand how condom use affects the 
transmission of HPV, and that is why again we must bolster the funding 
for HPV-related research and prevention programs. But it is imperative 
that we provide accurate information about HPV.
  So I hope as the bill moves through the Senate we can work with our 
colleagues to address this issue, protect the health and safety of 
American women. Again, I want to reiterate my strong support for this 
bill.
  Mr. LAZIO. Mr. Speaker, I now have the pleasure of yielding 2 minutes 
to the distinguished gentlewoman from Ohio (Ms. Pryce) a member of the 
House leadership.
  Ms. PRYCE of Ohio. Mr. Speaker, let me first congratulate my good 
friend the gentleman from New York (Mr. Lazio) for his dedication to 
this cause and for his hard work in the battle against cancer on every 
front.
  I also want to recognize the courage of my colleague the gentlewoman 
from North Carolina (Mrs. Myrick). Her own personal fight against 
cancer is truly inspiring. The battle she is waging is not just for her 
own survival but also to promote awareness so that other women may 
prevail against this dreaded and all too familiar disease.
  The public education that promotes early detection is absolutely 
crucial for cancer patients. And in the case of breast cancer, 
education is no small task, since one in eight American women will 
develop breast cancer in her lifetime.
  After breast cancer, cervical cancer is the second most commonly 
diagnosed malignancy in women, 15,000 each year. This cancer often has 
no symptoms, and regular pap smears are our best defense.
  This legislation builds on efforts Congress has already taken to 
encourage early detection of these cancers among low-income women. 
While these services are absolutely critical, their value is 
significantly diminished if these

[[Page 7304]]

women find out they have cancer but do not have the resources to access 
treatment.
  Imagine coping with the fear of being diagnosed with cancer 
compounded by the prospect of having no way to pay for the treatment 
that could save your life.
  This bill helps these vulnerable women by encouraging States to 
provide Medicaid coverage to those diagnosed. And, in my mind, if it is 
a good public policy to use tax dollars to help these women detect 
their disease, then certainly it is worth every penny we spend to help 
them fight it.
  I urge all of my colleagues to join with me in giving these women 
hope by voting for the Breast and Cervical Cancer Treatment Act.
  I congratulate the gentleman from New York (Mr. Lazio) and the 
gentlewoman from North Carolina (Mrs. Myrick).
  Mr. BROWN of Ohio. Mr. Speaker, I yield 1\1/2\ minutes to my friend, 
the gentleman from Texas (Mr. Bentsen).
  Mr. BENTSEN. Mr. Speaker, if this Congress does anything this year, 
this might be the bill to pass and get signed into law. This bill 
underscores the whole issue of the uninsured in this country.
  When women are diagnosed with breast cancer or cervical cancer and do 
not have the means to get the treatment, it is effectively giving them 
a death sentence. This bill will, at least, start the process of trying 
to help these women and help them beat this disease, which they can.
  Now, I want to give my colleagues a story about somebody in my 
district, a woman named Barbara Mitchell, who was recently diagnosed 
with Stage 3 breast cancer at the Rose Center at Pasadena, Texas. The 
Rose in my district does free examinations.
  The problem is, once they you examined, if they cannot get treatment, 
they are pretty much out of luck.
  Ms. Mitchell is 35 years old and cannot afford the treatment for her 
breast cancer. She fought her first battle with cancer in 1988. 
Although uninsured at the time, Ms. Mitchell beat her cervical cancer 
and she managed to pay for her services. But because of her previous 
cancer history, she cannot afford to buy prohibitively expensive health 
insurance.
  At 32, when she discovered a lump in her breast and was treated for 
breast cancer through the public health system, because she owns a 
dance studio, she is considered to have assets and, thus, has to pay 
$26,000 and probably will have to sell her only business, her only 
asset.
  Now, this is counterproductive to what Democrats and Republicans 
would want to see Americans do. We want to see them create more jobs, 
create small businesses, and beat this terrible disease. This bill will 
allow it to happen, and I think we ought to pass it and get it signed 
into law.
  Mr. LAZIO. Mr. Speaker, may I inquire as to the remaining time.
  The SPEAKER pro tempore (Mr. LaTourette). The gentleman from New York 
(Mr. Lazio) has 4 minutes remaining, and the gentleman from Ohio (Mr. 
Brown) has 4\1/2\ minutes remaining.
  Mr. LAZIO. Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman 
from Maryland (Mrs. Morella).
  Mrs. MORELLA. Mr. Speaker, I thank the gentleman for yielding me the 
time.
  Mr. Speaker, to honor Mother's Day on May 14, with passage of this 
bill, H.R. 4386, the Breast and Cervical Cancer Act, we will celebrate 
another step forward to stop the violence of cancer against women.
  I want to congratulate the gentleman from New York (Mr. Lazio), the 
gentlewoman from California (Ms. Eshoo), certainly the gentlewoman from 
North Carolina (Mrs. Myrick), and the gentlewoman from Missouri (Ms. 
Danner) who have indicated their own personal experiences have shown 
the need for this bill.
  The legislation will provide treatment for low-income, uninsured 
working women who are diagnosed with breast or cervical cancer. Today 
the program provides screening for breast or cervical cancer but does 
not provide treatment. This must change. This bill will do it.
  However, Mr. Speaker, while I strongly support this overall bill and 
its potential for saving lives, I am troubled with the provision on HPV 
and concerned that the proposed language could be problematic from a 
public health perspective. I hope the provision will be dropped in 
conference.
  I do understand that there will be a meeting of some medical experts 
to discuss this issue and that meeting will be forthcoming. I look 
forward to that meeting to help to ameliorate this problem.
  H.R. 4386 deserves to be passed unanimously by this body. Because, 
indeed, if we offer screening, we must offer treatment. Congress must 
and should pass the Breast and Cervical Cancer Treatment Act.
  I again applaud the cosponsors and those who worked so hard, 
including the leadership, to help bring it to the floor now.
  The proposed language on HPV and condom labeling could discourage 
condom use, thereby exposing men and women to the risks of HPV and 
other STDs, including HIV/AIDS.
  The language of HPV belies the fact that condoms are highly effective 
in reducing the risk of contracting HPV and other STDs, including HIV/
AIDS.
  Mr. Speaker, there are over 100 strains of the HPV virus, and very 
few of these have the potential to lead to cervical cancer. It is 
misleading to have a label that does not clarify this point.
  The HPV provision also suggests working to make HPV a reportable 
disease. Over 80 percent of the population has been found to carry one 
of the 100's of HPV strains. Reporting 80 percent of the population 
would not only be costly, but it is unrealistic.
  Mr. Speaker, our goal should be to educate Americans about how to 
best prevent all STDs.
  I support this H.R. 4386, it will save lives. This legislation will 
provide treatment for low-income, uninsured working women who are 
diagnosed with breast or cervical cancer.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 1\1/2\ minutes to the 
gentlewoman from New York (Mrs. Maloney).
  Mrs. MALONEY of New York. Mr. Speaker, I thank the gentleman for 
yielding me the time.
  Mr. Speaker, as co-chair of the Congressional Caucus for Women's 
Issues, I rise in strong support of this bill and congratulate my 
colleagues who have been leaders on this issue on both sides of the 
aisle, the gentleman from New York (Mr. Lazio), the gentlewoman from 
California (Ms. Eshoo), the gentlewoman from California (Mrs. Capps), 
the gentlewoman from Missouri (Ms. Danner), the gentlewoman from North 
Carolina (Mrs. Myrick) and the gentlewoman from Connecticut (Ms. 
DeLauro).
  Some of them have come to the floor today and shared their personal 
experiences that have highlighted the important need for this bill. 
This particular bill is one of the top priorities of the Women's 
Caucus, and we urge its passage.
  The Center for Disease Control's National Breast and Cervical Cancer 
Early Detection Program provides screening services for low-income 
people who have little or no health insurance. But for many women who 
find that they have cancer from this important screening program, there 
is no guarantee of complete and comprehensive treatment.
  This bill underscores the need for the uninsured and it underscores 
the fact that many, many women and, actually, many men cannot afford 
treatment. It is clear that much more needs to be done to provide 
coverage.
  The bill, H.R. 4386, the Breast and Cervical Cancer Treatment Act, 
will help low-income women find resources to combat and, hopefully, 
cure cancer. I am a proud cosponsor of this legislation, and I 
encourage its swift enactment. It will save thousands and thousands of 
lives.
  Mr. LAZIO. Mr. Speaker, it is now my pleasure to yield 1\1/2\ minutes 
to the distinguished gentlemen from Kentucky (Mr. Fletcher), a fine 
Member of the House and a physician in his own right.
  Mr. FLETCHER. Mr. Speaker, I stand before the House today to express 
my strong support for the Breast and Cancer Prevention Treatment Act.

[[Page 7305]]

  Back a few weeks ago during the budget debate, myself, along with a 
number of colleagues, worked very hard to set aside what ended up being 
$250 million to provide treatment for those women that were identified 
to have breast and cervical cancer to make sure that they got Medicaid, 
that they got treatment if they were uninsured. So this certainly is a 
very important issue.
  Also, in the State of Kentucky, we were able to get last year and 
worked very hard to get a CDC Cancer Prevention Center at the 
University of Kentucky. Because we have in Kentucky the highest rates 
of cervical cancer in the Nation. And, so, this bill is very important.
  We also have a degree, unfortunately, levels of poverty and uninsured 
in Kentucky. This bill will be very important to make sure we address 
those needs, that those individuals first get detected early and, 
second, so that they can get the kind of treatment.
  When we look at medical studies, we find that an individual that is 
hospitalized without insurance or coverage and matched demographically 
with others is three times more likely to die if they have no insurance 
versus having insurance.
  So this bill is substantially, I believe, going to reduce morbidity 
and mortality to our women across the Nation and especially help at the 
University of Kentucky and in central Kentucky as we work to screen 
more individuals for breast and cervical cancer.
  Let me talk briefly about HPV. Its unequivocally associated with 
cervical cancer. No question from a medical standpoint that it is 
associated. I think it is time for us to be honest to make sure that we 
report this and reduce the number of deaths.
  I rise to support this bill.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 1 minute to the gentlewoman 
from Colorado (Ms. DeGette) who has done excellent work on this bill.
  Ms. DeGETTE. Mr. Speaker, I want to thank everybody who has worked on 
this legislation, most particularly my colleague the gentlewoman from 
California (Mrs. Eshoo) and my colleague the gentleman from New York 
(Mr. Lazio).
  In general, it is a good piece of legislation. However, I am deeply 
concerned about the provision included on human papilloma virus, or 
HPV, because I think from a public health perspective it is misguided.
  I agree with the American College of Obstetrics and Gynecology that 
the condom labeling requirement may very well have the unintended 
consequence of discouraging condom use, which, as we all know, is very 
effective in preventing other diseases, including HIV/AIDS.
  Taking steps to make HPV a reportable disease also does not make 
sense, since most all of these cases do resolve on their own and only a 
very small percentage lead to cervical cancer.
  We should not be trying to instill panic here. Rather, we should be 
trying to encourage every American woman to have regular pap smear 
examinations, which are still the state of the art; and then we should 
finish researching all of these other issues.

                              {time}  1400

  The SPEAKER pro tempore (Mr. Barrett of Nebraska). The Chair advises 
that the gentleman from New York (Mr. Lazio) has 1 minute remaining; 
the gentleman from Ohio (Mr. Brown) has 2 minutes remaining.
  Mr. LAZIO. Mr. Speaker, I want to reserve the right to close. I have 
no other additional speakers.
  Mr. BROWN of Ohio. Mr. Speaker, I have one additional speaker, and 
then I will close on our side.
  Mr. Speaker, I yield 1 minute to the gentlewoman from New York (Ms. 
Slaughter).
  Ms. SLAUGHTER. Mr. Speaker, I rise to express some serious concerns 
about a section of the bill that has gone largely unnoticed, that 
dealing with human papillomavirus virus, or HVP.
  First and foremost, I would like to express my strong support for the 
underlying bill. I am proud to be an original cosponsor on which this 
legislation is based. Our consideration of this measure is long 
overdue, and I commend my friend, the gentlewoman from California (Ms. 
Eshoo), for her hard work and perseverance in advancing it.
  My colleagues should be aware, however, of a troublesome provision 
that was added to H.R. 4386 in committee dealing with HPV issues. HPV 
is a group of viruses composed of over a 100 strains, of which 
approximately 30 are sexually transmitted. Recent research has shown 
that a few select strains appears to have precursors to cervical 
cancer. Promising research is being done on preventing and treating HPV 
as a method of reducing cervical cancer rates.
  Mr. Speaker, unfortunately, this bill could damage our efforts to 
reduce HPV transmission and, by extension, cases of cervical cancer. 
During a markup, the language was added to the bill that directs the 
Department of Health and Human Services to outline further steps toward 
making HPV a reportable disease.
  Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I ask House support for H.R. 4386. When women are 
diagnosed under a Federal program that has been in existence for about 
a decade with breast cancer, some women clearly have nowhere to turn, 
they must cobble together various kind of charitable care and any 
health services that they can get.
  I would hope this legislation, Mr. Speaker, will change that and take 
care of those women once they are diagnosed with breast cancer. I hope 
that H.R. 4386 will set the tone in this House and set the direction in 
this House for universal coverage for all Americans.
  Mr. Speaker, I yield back the balance of my time.
  Mr. LAZIO. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, let me thank the 310-plus Members of this House who have 
been cosponsors of H.R. 1070, and let me thank the two lead sponsors of 
H.R. 4386, the gentlewoman from North Carolina (Mrs. Myrick) and the 
gentlewoman from Missouri (Ms. Danner), one a Republican and one a 
Democrat, both Members of this House, and both breast cancer survivors. 
How could we have better advocates for this bill than those two?
  Mr. Speaker, de Tocqueville said ``America is a great Nation because 
America is a good Nation, and the moment that America ceases to be 
good, she will cease to be great.''
  Mr. Speaker, what greater test of goodness can there be to our 
willingness to take care of our own who are in need? Mr. Speaker, let 
us pass this bill. Let us give thousands of American women the gift of 
life. The cost is nominal. The benefit is enormous. It is the only fair 
and decent thing to do.
  Mr. Speaker, I urge my colleagues to vote aye.
  Mr. KLECZKA. Mr. Speaker, I would like to add my comments to those of 
my colleagues who have taken the floor in support of the Breast and 
Cervical Cancer Treatment Act.
  Every year more than 4,400 American women die of cervical cancer. 
Breast cancer, the leading cause of death among women between 40 and 
45, kills more than 46,000 women a year. This year it is estimated that 
in Wisconsin alone over 800 women will die of breast or cervical 
cancer. In many cases, early detection and treatment would have 
prevented these deaths. Nine years ago, Congress enacted the Breast and 
Cervical Cancer Mortality Prevention Act of 1990, authorizing the 
Centers for Disease Control to offer a breast and cervical cancer-
screening program for low-income, uninsured, or underinsured women.
  Unfortunately, the screening program lacks a critical aspect: 
treatment services for women diagnosed with breast cancer. Under 
current law, cancer therapy for Medicaid-eligible women is provided 
through an ad hoc patchwork of providers, volunteers, and local 
programs and often results in unpredictable, delayed, or incomplete 
treatment. Women are often forced to rely on charity care, donated 
services by physicians, or funds from bake sales and quilting bees. The 
Breast and Cervical Cancer Treatment Act would solve this problem by 
allowing States to establish an optional State Medicaid benefit for the 
treatment of low-income women diagnosed under the 1990 law.
  I am pleased to see that the Breast and Cervical Cancer Treatment Act 
is supported by a bipartisan majority of the House. I salute

[[Page 7306]]

the efforts of the advocacy groups, including the Wisconsin Breast 
Cancer Coalition to make this day possible.
  Mr. WATTS of Oklahoma. Mr. Speaker, today I urge my colleagues to 
provide relief for low-income women who are screened and diagnosed with 
breast and cervical cancer. As you know, breast and cervical cancer is 
killing too many of our wives, mothers, sisters and daughters. 
Currently, the early detection screening program does not provide 
treatment for women who discover they have cancer as a result of that 
screening. This screening must be coupled with treatment in order to 
save lives.
  Cancer is often fatal and the women who are tested can't afford 
critical treatment without help. These women face numerous difficulties 
in trying to obtain and pay for treatment for cancer. Resources are 
limited and yet the numbers of women being diagnosed are increasing.
  Today, we have an opportunity to do something about this devastating 
disease by allowing states to expand Medicaid coverage to these women. 
Follow-up and treatment are the key to saving lives.
  The fight against cancer transcends party lines and partisan 
bickering. So today, I urge all of my colleagues to join me in the 
fight against breast and cervical cancer. We must act now.
  Mrs. KELLY. Mr. Speaker, I am in support of H.R. 4386, the Breast and 
Cervical Cancer Treatment Act. This legislation will give the States 
the ability to provide a reliable method of treatment for uninsured and 
underinsured women battling breast or cervical cancer.
  The program currently provides screening for cancer, but it provides 
no treatment options for these women. If they are diagnosed with 
cancer, they have no options for their cure, which is a harsh problem. 
Giving States the option of providing Medicaid coverage for women will 
help save thousands of lives.
  The present CDC program is a tremendous first step in identifying 
this disease early enough to make a difference in the lives of these 
women, but we need to help cover the cost of treatment when necessary. 
Being diagnosed with cancer is terrifying. Women shouldn't have the 
pain of knowing they have cancer, compounded with the despair of not 
being able to do anything about it.
  The Breast and Cervical Cancer Treatment Act will allow women to 
focus their efforts on getting well instead of worrying about how they 
or their family will pay for their treatment. This legislation is a 
very important step in the process of getting treatment to women who 
need it. With Mother's Day just around the corner, it is critical that 
we pass this legislation in time to give our mothers, our sisters, our 
daughters the most important gift of all, the gift of life.
  Mr. WELDON of Florida. Mr. Speaker, I am in strong support of H.R. 
4386, the Breast and Cervical Cancer Treatment Act. This measure amends 
title XIX of the Social Security Act to provide medical assistance for 
certain women under 65 who have been screened and found to have breast 
or cervical cancer by the Center for Disease Control and Prevention 
[CDC] early detection program.
  In the United States, one out of eight women will develop breast 
cancer at some point in her lifetime. It is the second most common form 
of cancer in the country, afflicting three million women--including one 
million women who do not know they have breast cancer. Cervical cancer 
kills 4,400 women a year, and is increasingly becoming a nationwide 
concern due to a lack of proper education and research.
  The Breast and Cervical Cancer Treatment Act will protect women who 
are diagnosed with breast and cervical cancer but do not have insurance 
to pay for treatment. Currently, the National Breast and Cervical 
Cancer Early Detection Program provides screening services for low-
income women who have little or no health insurance. Treatment, 
however, is not provided through the program. Women who earn too much 
to be on federal assistance, but do not earn enough to afford private 
insurance are left without resources to cover the treatment they need 
to fight this dreaded disease. This bill will provide that much needed 
treatment.
  As a physician I have treated hundreds of cancer patients and the key 
to providing a successful remedy to their life-threatening illness is, 
when possible, prevention, otherwise early detection, followed by 
immediate treatment. This bill will offer much needed assistance to 
thousands of American women who need these vital medical resources.
  I am also very pleased with the provisions in this bill relating to 
the human papillomavirus [HPV] which affects at least 24 million 
Americans and is the principal cause of cervical cancer. H.R. 4386 
makes cervical cancer prevention a priority. This bill requires the CDC 
to develop educational materials for health care providers and the 
public regarding HPV. And, it requires condom packages to include 
information stating that HPV is a cause of cervical cancer and that 
condoms do not prevent HPV transmission.
  Many sexually active Americans have been mislead to believe a condom 
will protect them; however, this is not the case with HPV. In fact, the 
American Cancer Society has stated ``research shows that condoms cannot 
protect against infection with HPV.'' Our young people need to know 
this and H.R. 4386 takes a big step toward informing them.
  This is a good bill and I urge all of my colleagues to support its 
passage.
  Mr. TOWNS. Mr. Speaker, I am pleased that we will have an opportunity 
to vote on this important health bill before this weekend's celebration 
of Mother's Day. Certainly, no action is more important than the 
preventive breast and cervical cancer health screenings which will be 
authorized by this bill. As an advocate for retaining mammography 
screenings at age 40, I am pleased that H.R. 4386 will afford us the 
opportunity to provide breast and cervical cancer screenings for early 
detection and treatment.
  For the grandmothers, mothers and aunts who are too young for 
Medicare and whose incomes are too high for Medicaid, but who still do 
not have health insurance, this bill can literally be the difference 
between life and death. H.R. 4386 includes the enhanced match of 75 
percent Federal to 25 percent state dollars for treatment, instead of 
the basic 60 percent Federal to 40 percent State dollars. Hopefully, 
this enhanced match will be a major incentive for Governors to enroll 
their States in the program once the bill is signed into law so that 
these women can receive the treatment they need. I remain hopeful that 
our Senate colleagues will soon join us in passing this important 
initiative.
  Mr. CROWLEY. Mr. Speaker, this year more than 200,000 American women 
will be diagnosed with breast and cervical cancer. These women are our 
mothers, our sisters, our friends, and our colleagues.
  I am proud to be a cosponsor of the bipartisan Breast and Cervical 
Treatment Act that will enable low-income, uninsured women diagnosed 
with breast or cervical cancer in the National Breast and Cervical 
Cancer early detection program [NBCCEDP] to obtain treatment. 
Currently, the CDC detection programs provide eligible women with 
screening, but if cancer is detected, there are no funds to provide 
much-needed treatment. Instead, these women have to find other funds 
for treatment. No woman should have to worry about funding her 
treatment.
  H.R. 4386 is bipartisan legislation that would add the life-saving 
treatment component to the NBCCEDP. The Breast and Cervical Cancer 
Treatment Act has overwhelming support and was passed unanimously by 
the Commerce Committee. I support this critical legislation and urge 
every member to vote for passage.
  It is simply unfair that low-income, uninsured women are not given 
every treatment available to save their lives because they cannot 
afford costly medication and treatments.
  Passage of this legislation is the best Mother's Day gift we can give 
our mothers, wives, sisters, and daughters. All women and their 
families in this country deserve the peace of mind that if diagnosed 
with one of these terrible illnesses, they will have access to the 
treatment they deserve.
  While I strongly support the overall bill, I am deeply concerned 
about the provision included on human papillomavirus [HPV] and believe 
it is misguided from a public health perspective. The condom labeling 
requirement may have the unintended effect to discouraging condom use, 
which, as we all know, is effective in preventing other serious STDs, 
including HIV/AIDS. HPV is a serious public health issue, which 
deserves Federal funding and a coordinated response to educate men and 
women on its causes, effects, and treatment. I urge my colleagues to 
provide that by supporting more funding for title X, and other programs 
that work in a comprehensive and holistic way to improve women's 
health.
  We should be advocating for public health policy that encourages 
women to be screened through Pap smear examinations to prevent the 
potential for cervical cancer, not discouraging condom use. I urge my 
colleagues to reexamine this issue.
  Mr. QUINN. Mr. Speaker, I am in support of H.R. 4386, to provide 
financial assistance to women for the treatment of breast and cervical 
cancer.
  Breast and cervical cancer together claim the lives of approximately 
50,000 women each year. As Americans we must continue to address this 
crisis which today constitutes the number one cause of death among 
women aged 40-45. In 1990 we took a critical step in fighting this 
battle by passing the Breast and

[[Page 7307]]

Cervical Cancer Mortality Prevention Act. This act authorized a 
screening program for low-income, uninsured or underinsured women. This 
was an important step since detection is the first step in fighting 
breast and cervical cancer. Indeed, more widespread use of regular 
screening mammography has been a major contributor to recent 
improvements in the breast cancer survival rate.
  Providing financial assistance for screening and testing for women in 
financial need has been a major accomplishment in the fight against 
breast and cervical cancer. If detected early, breast cancer can be 
treated effectively with surgery that preserves the breast, followed by 
radiation therapy. However, screening and early detection are 
meaningless without following through with cancer treatment. For many 
women however, the costs of treatment are prohibitive and merely 
knowing that their cancer has been detected is inadequate when they are 
unable to seek treatment. The time has come for us to comprehensively 
confront these cancers and provide women with the power to conquer 
these odds. I urge the support of this bill critical to protecting 
women's health.
  Mr. BEREUTER. Mr. Speaker, this Member is in support of H.R. 4386, 
the Breast and Cervical Cancer Prevention and Treatment Act of 2000.
  The American Cancer Society estimates that within his home state of 
Nebraska, approximately 1,000 women will be diagnosed with breast 
cancer this year and nearly 300 will die as a result of breast cancer. 
We must provide this enhanced Medicaid matching funds to our states to 
continue to promote early detection and prevention of breast and 
cervical cancer.
  The five-year survival rate is over 95 percent if breast cancer can 
be detected early. Because only 5-10 percent of breast cancers are due 
to heredity, early detection must be made available to all women.
  Mr. Speaker, this Member encourages his colleagues to continue to 
support the early detection and prevention of breast and cervical 
cancer and support H.R. 4386.
  Mr. GILMAN. Mr. Speaker, I am in support of H.R. 4368, the Breast and 
Cervical Cancer Treatment Act. I am an original cosponsor of the 
legislation on which this bill is based, H.R. 1070 and I commend the 
gentleman from New York Mr. Lazio, the gentlewoman from Missouri, Ms. 
Danner and the gentlewoman from North Carolina Mrs. Myrick for their 
commitment to fighting breast and cervical cancers and for helping to 
bring this legislation before us today.
  This legislation will provide medical assistance for certain women 
under 65 who have been screened and found to have breast or cervical 
cancer by the Center for Disease Control and Prevention (CDC) Early 
Detection Program. Many women simply cannot afford to undergo 
prevention screenings and especially medical treatments. By providing 
screenings for breast and cervical cancer for the uninsured, many will 
benefit from early detection and by following up a screening with 
medical treatment, fewer women will succumb to these devastating 
diseases.
  Mr. Speaker, this issue is especially important to me and to my 
constituents, especially those in Rockland county. Recent studies have 
found that Rockland county has the highest rate of breast cancer in New 
York State and according to some studies, in the Nation. This 
legislation will help many of my constituents during a very difficult 
time in their lives. Providing medical treatment to those women who 
have been screened by the CDC will vastly improve their chances of 
survival and reduce the rate of mortality due to these cancers. I 
strongly support this legislation.
  Accordingly, I urge my colleagues to support this important measure.
  Mr. DINGELL. Mr. Speaker, I am in support of a bill that will make a 
big difference in the lives of low-income women with cancer, H.R. 4386, 
the Breast and Cervical Cancer Treatment Act.
  Two individuals have campaigned tirelessly for this bill and the 
rights of low-income women. First, I commend Representative Anna Eshoo. 
Were it not for the energy and attention that Ms. Eshoo brought to this 
issue, this bill would not be on the floor today. Secondly, I would 
like to remember Senator John Chafee, the original cosponsor of the 
companion bill in the Senate. The late Senator Chafee's advocacy for 
women, children, the poor, and the disabled will continue with the 
passage of this bill.
  We all know that early detection and treatment are the key to 
surviving cancer. This is the reason why the Centers for Disease 
Control (CDC) uses Federal funds to provide free diagnostic tests for 
breast and cervical cancer for low-income uninsured women, many of whom 
are minorities.
  With this bill, the Federal Government will complete its commitment 
to the low-income women who are diagnosed with cancer through the CDC's 
screening program. No longer will women diagnosed through the program 
have to scramble to find state funds, rely on charity care, or incur 
enormous debts in order to pay for radiation or chemotherapy. H.R. 4386 
will allow women to enroll in the Medicaid program for the duration of 
their cancer treatment, so that they can focus their energies on 
fighting cancer instead of the health care system.
  I hope that my colleagues will join me in voting for H.R. 4386. 
Advocates of this bill have waited a long time for this day. Let's not 
make women with breast and cervical cancer wait any longer.
  Mr. BLILEY. Mr. Speaker, I commend the gentlelady from North 
Carolina, Mrs. Myrick, for her personal courage in the face of breast 
cancer and for her many hours of work in persuading the House 
Leadership to bring this important bill to the floor today.
  I also wish to recognize one of the original cosponsors of H.R. 4386, 
Mr. Lazio of New York for his many months of hard work on the Commerce 
Committee persuading members and forging alliances with the American 
Cancer Society, the National Women's Health Network, the National 
Cervical Cancer Coalition, the National Breast Cancer Coalition, the 
Cancer Research Foundation of America, and so many others to make this 
day possible.
  Like so many women with whom I have met over the last few years 
advocating for this legislation, my own wife is a breast cancer 
survivor. I know firsthand the fears that families face when they first 
hear that word. It is with those memories in my mind that I work in 
Congress to help find new ways that we can help more women from falling 
victim to cancer.
  In the closing days of the last session, the Committee I chair 
reported out H.R. 1070, the Lazio ``Breast and Cervical Cancer 
Prevention and Treatment Act of 1999.'' I am very pleased that we are 
now on the floor debating a bill based on the Committee's work, which 
addresses both breast cancer, the leading cause of cancer deaths among 
women, and cervical cancer, a form of cancer caused by a viral 
infection that kills more women in America than AIDS.
  Again, I thank Congresswoman Myrick, my Commerce Committee 
colleagues, and many other Members who have contributed to bringing 
this legislation to the floor today.
  Mr. LAZIO. Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from New York (Mr. Lazio) that the House suspend the rules 
and pass the bill, H.R. 4386, as amended.
  The question was taken.
  Mr. LAZIO. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

                          ____________________