[Congressional Record (Bound Edition), Volume 158 (2012), Part 1]
[Senate]
[Pages 1045-1051]
[From the U.S. Government Publishing Office, www.gpo.gov]




                             WOMEN'S HEALTH

  Ms. MIKULSKI. Madam President, I claim 10 minutes of the Democratic 
majority time. I come to the floor to speak about women's health. I 
come to speak about the issue of prevention, and I want everybody to 
fundamentally remember what we debated and what we did in the health 
care bill.
  For the first time in a long time, our Nation is talking about 
women's health. Am I glad to hear that. It has mostly been happening on 
the morning talk shows and on the front pages of our newspapers. But, 
unfortunately, too much of the conversation isn't about women's health; 
it is politics disguised as women's health.
  What should we be talking about when it comes to women? We should be 
talking about the top killers of women: cancer--that dread ``C'' word--
including breast cancer, cervical cancer, lung cancer. They are the 
highest killers of women: lung cancer, cervical cancer, and breast 
cancer. Then there are the silent killers of women: undetected diabetes 
as well as the consequences of heart and vascular disease. What did we 
talk about in the health care bill to deal with these issues? We talked 
about the fact that we needed preventive services, that we believed in 
early detection, that we believed in screening for early detection so 
we could identify those consequences that would negatively impact women 
in terms of their health care.
  One of the things we know is that many women don't have health 
insurance at all. Seventeen million are uninsured. Women are most 
likely to neglect their treatment because of cost. Women of 
childbearing age are also even more at risk because they are performing 
jobs that tend to be starting out and they don't pay for health 
insurance.
  We tackled a lot of this in the health care bill. I am so proud that 
one of the first things we did was end general discrimination in health 
care--the punitive practices of insurance companies discriminating 
against women by charging more for women of the same age and the same 
health status as men. But we came together, united, and passed it as 
part of the affordable health care act, and we ended gender 
discrimination.
  Then we saw that simply being a woman meant being treated as a 
preexisting condition. I held a hearing about this that was bone-
chilling, when we listened to how women were discriminated against and 
aspects that had happened to them were viewed as a preexisting 
condition. In eight States if a woman was a victim of domestic 
violence, she could not get health insurance.
  In another bone-chilling story, which was breathtaking, a woman 
testified at our hearing that because she had a C-Section, her 
insurance company told her they would drop her from their insurance 
plan unless she got sterilized. That was in the hearing. She had a 
letter from her insurance company. We were aghast on both sides of the 
aisle, regardless of how one feels about some of these reproductive 
issues. Nobody felt that should happen in America. So the people on the 
committee, led by myself, said: We can't have that. So we have ended 
discrimination against women getting health care on the basis of 
preexisting conditions.
  We wanted to go further, and one of the issues we looked at was that 
of prevention. This is a subject of great debate. The very first 
amendment on the Senate floor during the health care debate was one to 
add preventive health care benefits. I offered an amendment, and the 
Senator from Alaska, Ms. Murkowski, offered a counteramendment. Her 
amendment was terrific. She had every preventive service that I would 
have ever loved. CBO, though, scored it at something such as $50 
million. The CBO's score sunk the Murkowski amendment, but the Mikulski 
amendment prevailed, in which we said we will leave it to the Institute 
of Medicine to determine what would be some of these amendments for 
women.
  So guess what we have. In our preventive health amendment, which is 
now the subject of such debate, such controversy and, unfortunately, 
such

[[Page 1046]]

misinformation, our amendment said this: First of all, if a woman is 
over 50, she gets a free yearly mammogram, one of our highest risks. 
Second, if a woman is over 40, she gets an annual well woman preventive 
care visit. This then goes to the screenings that then go to the 
highest risk for the highest diseases we have.
  We have early detection and early screening. For young women who are 
pregnant, we guarantee they can be screened for diabetes, but also in 
our prevention amendment we provided for maternity services. We provide 
for maternity services so these women can get proper prenatal care. 
Working with their doctor, we can ensure the health of the mother and 
survivability and the ability to carry her pregnancy to term. We looked 
out for those maternity benefits.
  IOM also said that as part of prevention we should add contraceptive 
coverage. That was a recommendation not of Senator Barb and not of 
Senator Jeanne Shaheen; this was a recommendation of the Institute of 
Medicine. Why do they say that? First of all, there are over 15 or 20 
percent of women who need to take birth control in order to deal with 
the medical issues associated with their menstrual cycles. This isn't 
the place to go into the biology of being a woman, but for many this is 
where people long before--young women and adolescents who were not 
sexually active were experiencing some significant hormonal problems. 
So it is not always about being sexually active.
  So this whole thing about the preventive amendment being all about 
birth control is so exaggerated, so overblown, so out of context with 
what we wanted to do. I am shocked and--I am just shocked.
  We looked at our bill, in addition to my amendment, and we included 
preventive services for men and women, those services that affect both 
sexes, including colorectal screening for adults over 50. That also 
includes prostate screening for men. We have diabetes and high blood 
pressure screening. There is also the ability to do alcohol misuse 
screening which, in many instances, is an undetected and silent killer 
not only of lives but of families.
  So one of our major thrusts was prevention. We won maternity benefits 
so a mother can be safe and well herself and be able to carry her 
pregnancy to term in a way that ensures the health of both the mother 
and the child, when the child is born. The fact that we had these other 
screenings, including mammograms, prostate cancer, diabetes-- the 
things that are killers of us all--some of these will close the health 
disparity gap because so many African-American men face terrible 
problems with high blood pressure that leads to the terrible 
consequences of stroke. Diabetes is rampant in our country but 
particularly rampant among people of color. So that is what we were 
doing.
  I find it troubling that instead of focusing on our preventive health 
services, we are focusing on birth control. Birth control was never the 
focus of health care reform. It was a recommendation to be included in 
the benefit that came from the Institute of Medicine.
  There is another bit of confusion out there about mandating churches 
to do something against their will. I wish to draw a distinction 
between what the bill does and mandating the provision of service and 
providing insurance coverage. The bill does include insurance coverage. 
But there is no place in the bill that mandates a religious 
organization provide something against their principle in providing a 
service. So if you are St. Mary's Hospital, you do not have to give out 
birth control in your women's health clinic. If you are Notre Dame 
University or Georgetown University or a Catholic women's college, you 
do not have to give out birth control in your student health clinic.
  What the Obama-Sebelius regulations say is that there has to be 
insurance coverage available, particularly to those who are non-
Catholic. For all of us who go to these wonderful institutes and have 
benefited from their services, they are nondiscriminatory. One does not 
have to be Catholic to teach at a Catholic college. One does not have 
to be Catholic to work at a Catholic hospital. One does not have to be 
Catholic. So these institutions hire people of a variety of religious 
preferences.
  I don't want to get into a debate on the first amendment, but I do 
welcome a debate on what the health care bill did and what it intended.
  The health care bill, I felt, was one of the greatest social justice 
initiatives I have participated in in the Senate. It was going to work 
and organize in an effective way to make sure we were on the road that 
every American had access to affordable care. Then we removed the 
barriers that were not only financial but often these discriminatory 
practices, these punitive practices that often were directed against 
women and preexisting conditions or in gender discrimination and the 
way they set their prices.
  The best care is preventive care, and one of the tools well known in 
the public health field is these screenings tests that we worked to 
provide, and we turned to the eminent and distinguished people in 
learned societies, in this case the Institute of Medicine, to tell us 
not based on politics but to tell us based on science what the benefits 
should be, and they added contraceptive coverage.
  That is the history. I hope it clears up the misinformation. But we 
did work to move our citizens to greater health care and remove the 
financial and other societal barriers to getting health care in our 
society, with a fantastic emphasis on prevention. We have gotten off to 
the wrong debate and the wrong discussion. Let's get back to talking 
about how we improve the health care of women and how we can keep 
moving on our preventive aspects that not only help women but help the 
men who so love us and support us, and we want to return the favor by 
making sure they get their screenings too.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Casey). The senior Senator from New 
Hampshire.
  Mrs. SHAHEEN. Mr. President, I am pleased to be able to join my 
colleague from Maryland to try and point out how this issue is being 
manipulated.
  Almost 2 years ago, Congress--this institution--voted to end 
discrimination against women by health insurance plans. We voted to 
make it easier for women to seek referrals to see the health 
specialists they need, and we voted to give women greater access to 
affordable preventive health care services, including contraception.
  These are important historic advances for women's health, and they 
should not fall victim to ideological policies.
  Over the last several weeks, we have seen women all across this 
country stand in huge numbers to support women's health. That 
grassroots support will be needed again and again to stave off 
ideological attacks on women's health care.
  Over the past year, House Republicans have repeatedly attempted to 
both eliminate funding for title X family planning and Planned 
Parenthood. Thankfully, we have been able to block these attempts in 
the Senate.
  Ninety-seven percent of the reproductive health services provided by 
Planned Parenthood in New Hampshire and across the country is 
preventive care. As we all know, preventive health care lowers health 
care costs and saves lives.
  We were reminded of the important role Planned Parenthood plays in 
preventive health when the Susan G. Komen Foundation decided to end its 
contracts with the provider. It is unfair to politicize women's health 
in the way we saw played out in the media last week. Women from across 
the country let their voices be heard. The 750,000 women who received 
breast cancer screenings at Planned Parenthood clinics with support 
from the Komen Foundation deserve better. They did not ask to be thrown 
into the political fire. They merely sought detection and treatment 
against a life-threatening disease.
  I am pleased Komen reversed that decision.
  I also commend the President for standing for women's health and 
reaffirming the recommendation of the Institute of Medicine to protect 
access to affordable birth control for all women. The decision 
requiring health

[[Page 1047]]

care plans to cover contraception with no copays or deductibles will 
improve the lives of millions of women and their families.
  Birth control pills can cost up to $600 a year. It can be a serious 
economic issue for some women. Studies have shown it costs employers as 
much as 17 percent more to exclude contraceptive coverage in employee 
health care plans than to provide such coverage.
  Birth control is also a fundamental health care issue. Doctors and 
public health experts agree that increased access to birth control 
prevents unintended pregnancies. It is directly linked to declines in 
maternal and infant mortality and a reduction in the risk of ovarian 
cancer. It is linked to overall good health outcomes.
  Permanent and temporary contraception is critical for family planning 
purposes, but many women--a full 14 percent--use birth control for 
medical and health reasons, including helping to reduce the risk of 
some cancers, treatment for endometriosis, serious infections, and 
cysts.
  Let's be clear. In talking about the health benefits of birth 
control, I am not telling women they must use it. The decision on 
whether to pursue contraception is an individual choice that each woman 
must make for herself with her family. No part of the affordable care 
act or the President's ruling regarding insurance coverage forces any 
woman to use contraception.
  However, birth control will now be affordable and accessible for any 
woman who, in consultation with her doctor, decides she needs or wants 
to use it. The policy represents one of the greatest advances for 
women's health in decades.
  Sadly, there is an aggressive and misleading campaign to deny this 
benefit to women. A conscience clause exists that exempts religious 
institutions such as churches from having to carry insurance that 
covers contraception. Mr. President, 335,000 churches and their 
employees in this country are exempt. Many have argued that conscience 
clause should be expanded to include religiously affiliated hospitals 
and universities in the name of religious liberty.
  The millions of women who work in a Catholic hospital or university--
from the overnight nurse to the classroom aide or cafeteria worker--who 
choose to use birth control should have the same access as their 
counterparts at other institutions. That is their decision. It is not 
their employer's.
  There are religions that believe divorce is a sin. Should these 
institutions be exempt from our labor laws and be allowed to 
discriminate based on marital status? Of course not, and this is no 
different.
  A recent survey showed that 71 percent of American voters, including 
77 percent of Catholic women voters, support the requirement to make 
birth control available to all. They understand that religious freedom 
means that all women--Catholic or non-Catholic--should have the 
opportunity to make their own decisions when it comes to birth control.
  I applaud the President for his decision and for putting women's 
health above politics.
  We know ideological attacks on women's health care will continue. But 
I thank my colleagues who are here today for speaking out against those 
who want to turn the clock back on women, who want to limit access and 
availability of women's health services. We are watching, and we are 
going to continue to be watching.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Washington.
  Mrs. MURRAY. Mr. President, last week, we saw something amazing 
happening in communities across the country. When the news got out that 
the Susan G. Komen Foundation had cut off funding for breast cancer 
screenings at Planned Parenthood, men and women across this country 
were just outraged. They did not understand the decision, they did not 
agree with it, and they did something about it.
  They picked up their phones, they talked to their friends, they e-
mailed, they tweeted, they called their elected officials, they made 
their voices heard loudly and clearly, and they got results.
  On Friday of last week, Komen did the right thing and announced they 
had reversed their initial decision. I wish to commend them for that 
because their mission and their great work in the fight against breast 
cancer is just too important to get mixed up in partisan politics.
  But although that reversal was a great victory for so many women and 
men across the country, let's be clear: Our fight for women's health 
care did not end there. There are still many who continue to push 
partisan politics ahead of women's health, and we need to make sure the 
grassroots support and energy that successfully came together to right 
this wrong last week continues to stand firm against each and every 
attack that comes our way, because we do know those attacks are coming. 
Republicans in the House of Representatives have been waging a war on 
women's health since the moment they came into power.
  After campaigning across the country a year and a half ago on a 
platform of jobs and the economy, the first three bills they introduced 
were direct attacks on women's health in America.
  The very first one, H.R. 1, would have totally eliminated title X 
funding for family planning and teen pregnancy prevention. It included 
an amendment that would have completely defunded Planned Parenthood and 
cut off support for the millions of women in this country who count on 
it.
  Another one of their opening round of bills would have permanently 
codified the Hyde amendment and the DC abortion ban. The original 
version of their bill did not even include an exception for the health 
of the mother.
  Finally, they introduced a bill right away that would have rolled 
back every single one of the gains we made for women in the health care 
reform bill.
  Their bill would have removed the caps on out-of-pocket expenses that 
protect women from losing their homes or their life savings if they get 
sick.
  It would have ended the ban on lifetime limits on coverage.
  It would have allowed insurance companies to once again discriminate 
against women by charging them higher premiums or even denying women 
care because of the so-called preexisting conditions--such as being 
pregnant.
  It would have rolled back the guarantee that insurance companies 
cover contraceptives, which will save the overwhelming majority of 
women who use them hundreds and hundreds of dollars a year.
  We know ensuring access to effective birth control is directly linked 
to declines in maternal and infant mortality, reduced risk of ovarian 
cancer, better overall health outcomes for women, and far fewer 
unintended pregnancies and abortions, which is a goal we all share.
  Contraceptive coverage should not be a controversial issue. It is 
supported by the vast majority of Americans who understand how 
important it is for women and families.
  I also wish to note that the affordable contraceptive policy we put 
in place preserves the freedoms of conscience and religion for every 
American. Churches and other religious institutions are exempt, and no 
doctor would ever have to dispense contraceptives if that is at odds 
with his or her religious views.
  But it also protects the rights of the millions of Americans who do 
use contraceptives, who believe family planning is the right choice for 
them personally, and who do not deserve to have politics or an extreme 
minority's ideology prevent them from getting the coverage they 
deserve.
  I am very glad, joining with all my colleagues, that we beat back 
that effort by the House Republicans, and I truly wish to commend 
President Obama for moving forward with this sound policy for women 
across America. Because that is what this is truly about. It is what it 
needs to be about: women and their health care needs, not partisan 
politics, not point scoring.
  House Republicans and their allies have demonstrated they will stop 
at nothing to politicize this issue. Last

[[Page 1048]]

year, they even threatened to shut down the Federal Government in a 
failed attempt to defund an organization that provides critical health 
care services for millions of women in this country. Now they are 
trying to cut off contraceptive coverage for women across America.
  They can keep trying to push their extreme agenda, but they should 
know we are going to fight back just as hard in the Senate, as we 
clearly saw this past week, with the voices of millions of people 
across America who feel very strongly that politics should never come 
between a woman and her health care--men and women who will be watching 
what is happening here in DC and who, I am confident, stand ready to 
act again.
  I am proud to be here with my colleagues today. I am proud of the 
victory of last week, and I am determined to remain vigilant and keep 
up the fight for women, for men, and their families.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from California.
  Mrs. BOXER. Mr. President, I am also very proud to be here with my 
colleagues. I think Senator Murray was eloquent, along with Senator 
Shaheen and Senator Mikulski. I am here to put it in my own words; that 
is, here they go again. Sadly, politics has once again entered into 
women's health care. This time we see an attempt to deprive women of a 
critical benefit: access to contraception through their health 
insurance plans.
  Just last week, what did we see? A move to punish women by taking 
away their free breast cancer screenings all because of rightwing 
politics.
  Before that, as Senator Murray eloquently indicated, we saw a 
Republican move to defund family planning because of politics.
  My Republican colleagues almost shut down the government over family 
planning, and now, if they have their way, millions of women could lose 
their contraceptive coverage, which could expose them to declining 
health outcomes and their babies to declining health outcomes and could 
cost them about $600 a year.
  Let's step back and look at where we are.
  Some months ago, the Institute of Medicine, which is comprised of a 
number of leading scientific and health experts, made a decision.
  They advised the Obama administration on what preventative benefits 
should be included for women--specifically for women--in new health 
insurance plans. That is what this whole to-do is all about. This 
organization that has nothing to do with politics and everything to do 
with health care made a very clear recommendation to the Obama 
administration. They said there are a number of preventative benefits 
that should be included for free for the women of this country: 
screening for gestational diabetes, HIV screening, cervical cancer 
prevention, annual well women visits, and access to contraception.
  Now, just as these women, our women of this Nation, are ready for 
these preventative services--services they need, services most of them 
want--my Republican friends, from Presidential candidates Romney to 
Newt Gingrich to the Senate and House Republican leaders--I heard 
Senator McConnell threaten legislation to take away these benefits--to 
Speaker Boehner to individual Republicans in both Houses, they are 
gearing up to repeal one of these benefits: access to birth control--
access to birth control.
  Now, I believe women in this country deserve respect. Some of them do 
not want access to birth control. They have a religion that dictates 
their views, and they have every right to make that decision. Others 
decide that they need to have access to birth control. So the Obama 
administration said to the women of this great Nation that they believe 
there ought to be access. But I think it is very important that the 
Institute of Medicine said: No exception. They think access to 
contraception is so important to women's health, they did not want any 
exception. But the Obama administration made an exception for churches 
and for religious institutions, and under the Obama administration's 
rule, 335,000 religious organizations will not have to offer birth 
control if they have a conscience reason not to do so. That is a 
compromise.
  Remember, the health experts said: No exceptions. The Obama 
administration said: Well, I want to respect the religious institutions 
and so I will allow them, if their mission is religious, and the people 
they serve and the employees they hire are basically of one religion, 
they are a religious institution, they will not have to offer 
contraception in the health care benefits to their employees.
  But guess what. There is another part of this equation. Women. Women. 
They have to have their religious beliefs respected. That is why the 
President also said: If you run an organization that serves a diverse 
number of people from different religions, and so on, and different 
beliefs, let them have the right to make that decision if they want to 
obtain free birth control through their insurance.
  Now, here is the thing. This outcry is astonishing to me since 28 
States already assure access to birth control. I have never heard any 
of my colleagues--maybe they did. Maybe they did come on the Senate 
floor and complain. But more than half of our women--over 28 States, 
more than half of women have similar access to birth control. So this 
is not some new benefit. This is just making sure all women, except 
that very narrow band that work for strictly religious institutions, 
have the right to have access to free birth control.
  The outcry is unbelievable, a political outcry making this a 
political issue when it is a medical issue. The President compromised. 
He said: If you are strictly a religious institution, you do not have 
to do this if you do not want to.
  Now, here is the other thing. All organizations that have any 
religious issue have an extra year to determine if they are going to 
offer this or how they can do it. They may be able to find a way in 
that year to get women access and at the same time not violate their 
consciences. They have an extra year to do that. But, oh, no, we are 
going to see legislation--I can assure you we are going to see 
legislation to overturn this, legislation that even goes further than 
this. And it is going to be a battle on the floor of the Senate, I am 
afraid.
  I am not afraid of the fight; I welcome it because, let's be clear: 
Virtually all women have used birth control at some point in their 
lives. Let me repeat this. Virtually all women have used birth control 
at some point in their lives, including 98 percent of Catholic women. 
That is a fact. And 71 percent of American voters, including 77 percent 
of Catholic women voters, support the administration's policy.
  So if my colleagues decide they are going to take this issue on in 
the face of overwhelming support for this policy by the American 
people, I say we are ready. We are ready to make the case.
  Access to birth control is directly linked to maternal and infant 
health. This is not some theoretical right. It is a right that is 
necessary. Health experts tell us that women with unintended 
pregnancies are less likely to get prenatal care in the first 
trimester, and in some cases they never get it. If there is one thing 
that should unite us, it is healthy babies, healthy outcomes from 
healthy pregnancies. That is what we are talking about.
  I want to talk about something else we do not hear enough of. I want 
to compliment Senator Gillibrand on this because she is the one who 
brought this issue to my attention.
  A full 14 percent of women who use birth control pills--that is 1.5 
million women--use them to treat serious medical conditions, not to 
prevent pregnancies. One of those conditions: Debilitating monthly 
pain, irregular cycles, conditions like endometriosis, serious 
conditions.
  I just learned of a young woman at Georgetown University. Their 
insurance policy did not cover free birth control. Her doctor told her 
she had a serious medical condition and she needed to use birth control 
pills that had nothing to do with pregnancy or

[[Page 1049]]

anything else, or preventing pregnancy. It was a serious medical 
condition. The diagnosis was--I may not say it right--polycystic ovary 
syndrome.
  Now, what happened is, she was told: You must go on birth control 
pills. But we at Georgetown, we will not pay for that benefit. She had 
to go out and get it. It was more than $100 a month. She could not 
afford it. Within months she developed a large ovarian cyst that had to 
be removed surgically. In addition, she lost an ovary.
  So please do not stand here and tell us that women do not need access 
to birth control pills or contraception because we have story after 
story after story.
  Let me tell you something else some folks may not know; that is, on 
many occasions when a woman wants to become pregnant and has irregular 
cycles and cannot, she will be put on birth control pills. A British 
scientific study came out and showed that after 5 years on birth 
control pills, women who wanted to get pregnant had a decreased risk of 
delayed conception--so they were better able to become pregnant and 
become mothers. So this is not some simple pat statement. This is about 
making sure the women of this country--the young women, the middle-aged 
women of child-bearing age and older woman who have other conditions--
get the medicine they need--and, by the way, get them for free because 
$600 a year for many middle-class or working poor women is just out of 
reach.
  So I say to my Republican friends who came to the floor previous to 
our statements, do not punish women again. Do not try to. Under the 
administration's plan, churches are respected and women are respected. 
All sides are respected. No one is forced to use birth control; it is 
up to the women. In 28 States more than 50 percent of the women already 
have this benefit. Why are you bringing politics into this?
  My Republican friends want to turn back the clock on birth control. 
Some of us remember the days when birth control was illegal. Well, I 
have news for them. This is the 21st century. Wake up. Look at your 
calendar. It is the 21st century, and women ought to be respected. 
Women ought to be trusted, and their families ought to be trusted and 
respected. We are not going quietly into the night on this one. We will 
be here. We will fight back. We will fight for women and their families 
and health care, and we will fight to keep politics out of the 
equation.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from New Jersey.
  Mr. LAUTENBERG. Mr. President, I come to the floor now as a father 
and a grandfather. Bonnie and I have five daughters and are 
grandparents of eight granddaughters. Nothing in our family and nothing 
in families across this country have anything more critical on their 
minds than the health of their children and their daughters and our 
families.
  Women in this rich country have a right to expect affordable quality 
health care. But those rights are under attack, and the attack is 
coming from what I call the ``maleogarchy''.
  Several years ago, I initiated the name ``maleogarchy'' right here on 
the Senate floor. A maleogarchy is made up of men in Congress who 
always decide what they want to do for women, even taking away their 
rights.
  These days the maleogarchy has declared war on women's health. We saw 
it when the Republicans in the House tried to defund Planned 
Parenthood. Now we are seeing it again this week in the Republican 
efforts to take away affordable birth control, basic health care for 
women in our country.
  Under a historic provision of the health care reform law, health 
insurance companies will be required to cover contraception with no 
additional copays or fees. This landmark requirement is scheduled to go 
into effect this summer. But as women cheer this new law, the 
maleogarchy is looking to take it away.
  Here in the Senate, there is a Republican bill to get rid of these 
benefits for women. Imagine. This body, principally made up of males, 
wants to take away benefits for women.
  The top Presidential candidate on the Republican side is Mitt Romney. 
He just said one of the first things he will do--I heard it, everybody 
heard it; it was loudly broadcast, it was vividly broadcast on 
television--he will do as the first thing, if elected, is overturn 
these new policies making birth control more affordable. Imagine. That 
is why he wants to be elected. I hope the American public is listening 
carefully to what is being said.
  Affordable birth control shouldn't be controversial. I thought we put 
this question to rest long ago. Back in 1965, the Supreme Court 
overturned the State of Connecticut's ban on contraception. Today, 99 
percent of women either use birth control or have used it at some point 
during their lives. It has become a critical component of health care 
for women in our country. But, as so many women know, birth control is 
also significantly expensive. One-third of all women have struggled to 
pay for it, and even if you have health insurance it is a struggle. 
Copays for birth control can be as much as $50 a month, and $50 a month 
adds up to $600 a year. Yet now the other side wants to take this 
benefit away. President Obama and many of us in Congress believe that 
is fundamentally unfair.
  Mr. President, everyone needs to speak against this attack on women's 
health, just as they did last week when the Komen Foundation--a 
foundation that was named after Susan Komen, a young woman who died of 
breast cancer--allowed a partisan agenda to cancel its mission to fight 
breast cancer. Imagine that--this organization named for a young woman 
who died, and now they want to cut out these examinations for women who 
wish to see whether breast cancer is ahead for them. Komen tried to cut 
funding to Planned Parenthood, a trusted provider of lifesaving breast 
cancer exams for hundreds of thousands of women in our country. Across 
America, women were offended, hurt, and angry, so they spoke up and 
spoke out against Komen's narrowminded decision. People were outraged 
and justifiably so.
  I was proud to bring together more than two dozen of our Senate 
colleagues to join the fight. We persuaded Komen to see the error of 
their ways, and they reversed their decision a few days later. Now the 
Komen organization and Planned Parenthood are getting back to doing 
what they do best--protecting women's health.
  Let's be clear. It would have been wrong to take away resources that 
could save their lives, just as it is wrong to deny women the right to 
affordable contraception. So I call on my Republican colleagues to 
disband the maleogarchy view. Join us and stand up for women in our 
country. Politics don't belong in our doctors' offices, examination 
rooms, or in our medical clinics. Politics should never be used to 
block women's rights to get the care they need for healthier lives. I 
ask my friends on the other side of the aisle to consider what they are 
doing before they vote to take away those rights.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Connecticut.
  Mr. BLUMENTHAL. Mr. President, I am honored to rise today after my 
distinguished colleagues have spoken on this issue so powerfully and 
eloquently, but I do so reluctantly because I rise in the face of a 
continuing assault on women's health care in this country--an assault 
on women's health care that is unworthy of our political system because 
these health care decisions involving women should be made by them. 
They are a matter of their conscience and their choice. Politics has no 
place in health care decisions.
  This assault is waged by a group on the radical right. It is an 
ideologically based attack on personal health care decisions of women 
and their families, and they are wasting taxpayer dollars doing it. 
This ideologically based stand on women's health care over these years 
is nothing less than unconscionable and unbelievable.
  I have only been in this body for a short time, but one of the first 
votes I cast was on H.R. 1, which wasn't about growing jobs or 
strengthening our economy, it was known best for completely eliminating 
the funding for responsible family planning programs.

[[Page 1050]]

The fact is family planning can prevent unintended high-risk 
pregnancies, reduce abortion rates--reduce abortion rates--and they are 
cost-effective. They provide $4 of return for every $1 that is spent on 
family planning, invested in those programs. But there are some on the 
radical right who would rather have the people of our Nation pay $11 
billion a year in unplanned pregnancies rather than receive a nearly 
threefold return on investment for family planning services.
  This debate is about more than dollars and cents, and it is about 
more than cost. It is about protecting the right of every woman to 
receive good-quality preventive care and equal access to preventive 
health care benefits from the provider they trust. And these decisions 
should be made between the provider a woman trusts and herself.
  In 2010, Congress took a great step forward, as my colleague Senator 
Mikulski has described so powerfully. A decision was made to require 
health care plans to cover a core packet of preventive health services, 
moving our country dramatically and historically toward a trend of 
overall lifetime health.
  The Institute of Medicine--an unbiased scientific organization--was 
tasked with evaluating the most important preventive services to 
include in the best health outcomes for women, seeking those best 
health outcomes for every woman in America. This scientific 
organization named birth control as one of those core benefits--birth 
control. Let's be very clear. We are talking about birth control--the 
pill that 99 percent of women use as part of their daily preventive 
health care. At some point in their lives, 99 percent of women use it.
  That very same benefit--coverage for it--is guaranteed by 28 States 
around the Nation. They already require health care plans to cover it. 
And more than half of the women of our Nation live in those States. Now 
the radical right would seek to take away that guarantee--that 
coverage, that basic health care outcome. They would take away that 
right--repeal it, restrict it, remove it as an option for women. That 
is unacceptable.
  Women spend an average of $500 per year for birth control--a cost men 
will never have to incur. That is why the Institute of Medicine 
recommended that birth control be included as part of the package of 
preventive services without copays--because costs should not be a 
barrier to those 99 percent of women in the United States who use birth 
control. Yet the radical right has decided that the politics of taking 
birth control away from women is more important, and they have used 
every tool in their arsenal--creating misunderstandings--to try to take 
this right away from women, including misrepresenting what the 
administration has decided to do. One of these mistruths they are 
spreading is that churches will be required to offer birth control. Not 
so. Another is that institutions affiliated with churches will be 
required to provide those services. Not true. What any institution is 
required to cover is, in fact, the coverage, not necessarily provide 
the service, and that is a key distinction.
  The majority of Americans agree that employers should be required to 
provide their employees with health care plans that cover contraception 
and birth control at no cost. The majority of Americans believe that is 
true. Nearly two-thirds of young Americans of childbearing age agree 
that employer health care coverage should include birth control at no 
cost.
  In short, this decision should be a matter of conscience, a matter of 
choice for individual women. Politicians should not be permitted to 
exploit it, as some are doing now. I stand for women making choices 
about their own health care, and I stand against politicians telling 
them what they should do. This issue before this body and this Nation 
is one of the critical issues of this time, and politics has no place 
in these health care decisions.
  Mrs. FEINSTEIN. Mr. President, I rise to discuss the continued 
attacks on the rights of women to control their own reproductive 
choices.
  Women should have access to comprehensive reproductive care and 
should be able to decide for themselves how to use that care.
  Here is the problem. The politics of women's health care has reached 
an extreme point, most recently with the decision of the Susan G. Komen 
Foundation to stop funding for breast cancer screenings at Planned 
Parenthood.
  Following the outrage of millions of men and women around the 
country, the Foundation reversed its course, at least for this year.
  A year ago, House Republicans passed a budget that would have 
eliminated the Title X Family Planning Program and defunded Planned 
Parenthood.
  Annually, these programs serve almost 8 million Americans nationwide 
providing primary care, cancer screenings, well baby care, 
contraceptive services, education, annual exams, STD and HIV testing, 
and flu vaccines.
  These programs provide critical health care services to many women 
who simply cannot afford to go anywhere else.
  It is ironic to defund these programs because family planning 
education and access to contraception can save money. For example, 
title X supported family planning centers prevented 406,000 abortions 
and saved taxpayers $3.4 billion in 2008 alone.
  The same House-passed budget would have also eliminated the Teen 
Pregnancy Prevention Program. Teen pregnancy costs taxpayers billions 
of dollars annually.
  Recently, the Obama administration announced its final policy on 
contraception coverage as part of the preventive health services 
recommended for women. The policy concluded employers are required to 
provide no-cost contraception or another option to their employees.
  The administration included a very narrow exemption to this 
requirement, and allowed religious organizations, such as churches or 
synagogues that primarily employ people of their own faith, to opt-out.
  This narrow religious exemption, which does not include hospitals, 
universities, or other organizations with religious affiliations, was 
the right decision. It ensures that millions of women of all faiths, 
including nurses, janitors, doctors, and college instructors, will 
access to good health care, including contraception, if they want it.
  A nurse seeking employment should not have to choose between one 
employer who provides contraception coverage and one who doesn't.
  Access to contraception is widely supported. Today, two new polls 
were released that showed the majority of catholic voters support 
coverage for prescription birth control.
  Seventy-one percent of American voters, including 77 percent of 
Catholic women voters, support health plans covering birth control 
without co-pays.
  Moreover, 28 States, including California, already require employer-
provided health plans to include contraception coverage if the plan 
provides prescription drug coverage.
  In 2004, the California Supreme Court held that Catholic Charities 
was no different from any other employer and therefore required to 
provide contraception coverage for their employees.
  I agree.
  Access to contraception can reduce rates of unintended pregnancy, 
help with certain health problems, and reduce the risks of some 
cancers. Expanding the exemption would have caused unacceptable harm to 
women.
  The administration should keep this exemption narrow.
  House Republicans insisted on including a ban on local funding for 
abortions in the District of Columbia in the fiscal year 2012 
appropriations bill.
  They have introduced and passed numerous bills that would 
significantly restrict a women's right to choose. This past October, 
the House passed a bill that would prohibit Federal funds from being 
used for any health plan that offers abortion coverage.
  This would mean that any women receiving Federal subsidies to help 
them afford health insurance would effectively be prohibited from 
purchasing coverage that included abortion services.

[[Page 1051]]

  Last May, the House passed a bill that falsely claimed to end public 
funding for abortion. There are already stringent Federal protections 
that prohibit Federal dollars from being used for abortions; this bill 
was not about that.
  Instead this bill was an attempt to reopen a contentious debate and 
to impose unprecedented limitations on women using their own money for 
abortion services.
  Even worse, this bill would have allowed hospitals to refuse to 
provide abortion care or refer a patient to a hospital that would 
provide it, even when a woman's life is in critical danger.
  This attack on women's health must be defeated. All women deserve 
access to quality comprehensive health care, regardless of their income 
level or place of employment.
  There is a balance between respecting America's democratic values and 
increasing access to important health services for women. In addition 
to being a health concern, for many women it is an economic concern as 
well.
  Better health policies for women help them save on out of pockets 
costs. When women are healthy, communities are healthy. I will continue 
to stand for women's health and fight for equal access to care.
  Mr. President, I yield the floor, and I suggest the absence of a 
quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. CASEY. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Reed). Without objection, it is so 
ordered.

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