Daniel Akaka

Mr. AKAKA

Mr. AKAKA. Mr. President, I would like to announce that the Committee on Indian Affairs will meet during the session of the Senate on July 26, 2012, in room SD-628 of the Dirksen Senate Office Building, at 2:15 p.m., to conduct a hearing entitled ``Regulation of Tribal Gaming: From Brick & Mortar to the Internet.'' Those wishing additional information may contact the Indian Affairs Committee at (202) 224-2251. Committee on Energy and Natural Resources

Mr. AKAKA

Mr. AKAKA. Mr. President, I rise today to speak in strong support of S. 3369, the Democracy Is Strengthened by Casting Light On Spending in Elections, DISCLOSE, Act. I am proud to join 39 of my colleagues in sponsoring this measure and urge the Senate to act now to pass this transparent, commonsense piece of legislation. Free, fair, and open elections, as well as an informed electorate, are fundamental to ensuring that our government reflects the highest principles of democracy, which is the foundation of this country. What is at stake today is nothing short of our electoral system. We must reinforce the right of Americans to make fully informed decisions about the political candidates and parties that seek to represent them in government. More than 2 years ago, the Supreme Court's 5-to-4 decision in Citizens United set the stage for the emergence of super political action committees, PACs, primarily underwritten by wealthy individuals to finance unregulated and often anonymous attack political campaign advertising. This decision effectively puts our elected positions up for sale to moneyed interests. The DISCLOSE Act would address problems caused by the Citizens United decision by restoring accountability and transparency to our electoral system. It would simply require labor unions, traditional PACs, super PACs, and other covered organizations that spend $10,000 or more on political campaigns to identify themselves by filing a timely report with the Federal Elections Commission. Opponents of the DISCLOSE Act claim that this bill would impede free speech and discourage political involvement. I cannot disagree more. To the contrary, the DISCLOSE Act preserves the right to express one's opinions and ideas through contributions to political campaigns; it only forces large contributors to identify themselves when making influential contributions. Furthermore, it promotes civic involvement by empowering voters to effectively participate in the electoral process and make informed choices about their leaders. We are all here to represent the voters in our States and districts who have entrusted us to represent them. In our system of checks and balances, elected officials remain beholden to their constituents through elections; however, to allow this system to work, voters need to have all of the essential information that could influence their decision: who we are, who our supporters are, and how much support we have received from various sources. No democracy, including this one, can remain fair, successful, and viable if wealthy individuals are allowed to spend unchecked sums of money to anonymously influence the outcomes of its elections. I urge my colleagues to do what is right for all Americans today and pass this important bill. I yield the floor.

Mr. AKAKA

Mr. AKAKA. Mr. President, I would like to announce that the Committee on Indian Affairs will meet during the session of the Senate on July 19, 2012, in room SD-628 of the Dirksen Senate Office Building, at 2:15 p.m., to conduct a hearing entitled ``Impacts of Environmental Changes on Treaty Rights, Traditional Lifestyles, and Tribal Homelands.'' Those wishing additional information may contact the Indian Affairs Committee at (202) 224-2251.

Mr. AKAKA

Mr. AKAKA. Mr. President, I would like to announce that the Committee on Indian Affairs will meet during the session of the Senate on July 12, 2012, in room SD-628 of the Dirksen Senate Office Building, at 2:15 p.m., to conduct a hearing entitled ``Federal Recognition: Political and Legal Relationship between Governments.'' Those wishing additional information may contact the Indian Affairs Committee at (202) 224-2251.

Mr. AKAKA

Mr. AKAKA. Mr. President, I rise today to introduce legislation to reauthorize the National Dam Safety Program managed by the Federal Emergency Management Agency, FEMA. I thank Senators Boozman, Whitehouse, and Crapo for joining me in sponsoring this bill that will help promote public safety and prevent the destruction caused by dam failures. This fiscally responsible legislation will help states do more to protect communities and avoid costly dam incidents without increasing funding above the most recent authorization level. With more than 84,000 dams listed in the National Inventory of Dams, dams are a critical and ubiquitous part of our nation's infrastructure. In Hawaii, 142 State-regulated dams are located across our islands from Kekaha on Kauai to Paauilo on Hawaii Island. These dams are owned by non-profit organizations, private companies, individuals, and Federal, State, and local governments. While they go largely unseen, dams benefit our lives every day. They provide drinking water, hydroelectric power, irrigation water, flood control, and recreational opportunities. However, dams also pose a significant risk to public safety, local economies, and the environment. Our nation's dams received a grade of ``D'' from the American Society of Civil Engineers 2009 Report Card for America's Infrastructure, which cited more than 4,000 deficient dams, including more than 1,800 that would result in loss of life if they failed. Unfortunately, we know that this risk is not just hypothetical. In 2006, the Ka Loko Dam on Kauai collapsed killing seven people, and dozens of other dam failures have occurred across the nation since that time. While we cannot avoid all dam incidents, this legislation will help prevent dam disasters and better prepare Americans for when they do happen. The National Dam Safety Program is the foundation of prevention efforts nationally. The program helps states to check for deteriorating conditions at dams. This is important so that repairs can be made in order to safeguard against incidents that result in loss of life and property. The program also helps ensure that states have the technical assistance, training, and procedures needed to prevent dams from reaching a condition that puts communities in danger. I very much appreciate the involvement of experts in dam safety, including FEMA, the Army Corps of Engineers, Hawaii Department of Land and Natural Resources, the American Society of Civil Engineers, and the Association of State Dam Safety Officials, in developing this legislation. I urge my colleagues to support his measure. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. AKAKA

Mr. AKAKA. Mr. President, I would like to announce that the Committee on Indian Affairs will meet during the session of the Senate on June 28, 2012, in room SD-628 of the Dirksen Senate Office Building, at 2:15 p.m., to conduct a business meeting to consider the following: H.R. 443, To provide for the conveyance of certain property from the United States to the Maniilaq Association located in Kotzebue, Alaska; H.R. 1560, To amend the Ysleta del Sur Pueblo and Alabama and Coushatta Indian Tribes of Texas Restoration Act to allow the Ysleta del Sur Pueblo Tribe to determine blood quantum requirement for membership in that tribe; H.R. 1272, To provide for the use and distribution of the funds awarded to the Minnesota Chippewa Tribe, et al, by the United States Court of Federal Claims in Docket Numbers 19 and 188, and for other purposes; S. 134, A bill to authorize the Mescalero Apache Tribe to lease adjudicated water rights; S. 1065, A bill to settle land claims within the Fort Hall Reservation; S. 2389, A bill to deem the submission of certain claims to an Indian Health Service contracting officer as timely; and S. 3193, A bill to make technical corrections to the legal description of certain land to be held in trust for the Barona Band of Mission Indians, and for other purposes. Those wishing additional information may contact the Indian Affairs Committee at (202) 224-2251.

Mr. AKAKA

Mr. AKAKA. I ask unanimous consent that further reading of the amendment be dispensed with.

Mr. AKAKA. I rise today to speak in favor of amendment No. 2396, a bipartisan amendment Senator Thune and I are offering to the farm bill. This amendment would make permanent the Office of Tribal Relations at the USDA. This office was created to ensure that the USDA upholds Federal Indian policy and maintains its government-to-government relationship with tribes. Permanently establishing this office will ensure that tribal governments can develop their programs in parity with their neighbors in rural America. It will ensure that the USDA consults with tribal governments and that tribes can participate in programs related to agricultural, infrastructure, and economic development opportunities. I encourage all my colleagues to support this bipartisan amendment to the farm bill. I thank the Chair, I yield back the remainder of my time, and I call up amendment No. 2396.

Mr. AKAKA. Mr. President, I call up my amendment and speak in favor of amendment No. 2396, a bipartisan amendment Senator Thune and I are offering to the farm bill.

Mr. AKAKA. Mr. President, I rise today to speak in favor of amendment No. 2440 to the farm bill. This amendment would improve implementation of an existing program at USDA which provides loans to purchasers of highly fractionated Indian lands. One unfortunate legacy of policies of the late 1800s is that many Indian lands are highly fractionated. This means that one parcel of land might have hundreds or even thousands of owners. Highly fractionated parcels make putting these Indian lands to viable use virtually impossible. This goes against any well-established Federal Indian policies encouraging the productive use of Indian lands. As chair of the Committee on Indian Affairs, I have worked with the USDA and stakeholders to craft this amendment to improve agricultural land use for tribal governments and individual Indians. I urge my colleagues to support this amendment.

Mr. AKAKA

Mr. AKAKA. Mr. President, I would like to announce that the Committee on Indian Affairs will meet during the session of the Senate on June 14, 2012, in room SD 628 of the Dirksen Senate Office Building, at 2:15 p.m., to conduct a hearing entitled ``New Tax Burdens on Tribal Self- Determination.'' Those wishing additional information may contact the Indian Affairs Committee at (202) 224 2251.

Mr. AKAKA

Mr. AKAKA. Mr. President, I would like to announce that the Committee on Indian Affairs will meet during the session of the Senate on June 7, 2012, in room SD 628 of the Dirksen Senate Office Building, at 2:15 p.m., to conduct a hearing entitled ``Universal Service Fund Reform: Ensuring a Sustainable and Connected Future for Native Communities.'' Those wishing additional information may contact the Indian Affairs Committee at (202) 224 2251. Committee on Energy and Natural Resources

Mr. AKAKA

Mr. AKAKA. Mr. President, I would like to announce that the Committee on Indian Affairs will meet on May 24, 2012, in room SD 628 of the Dirksen Senate Office Building, at 12:45 p.m., to conduct a hearing entitled ``Programs and Services for Native Veterans.'' Those wishing additional information may contact the Indian Affairs Committee at (202) 224 2251.

Mr. AKAKA

Mr. AKAKA. Mr. President, I would like to announce that the Committee on Indian Affairs will meet on May 24, 2012, in room SD 628 of the Dirksen Senate Office Building, at 2:15 p.m., to conduct a hearing entitled ``Programs and Services for Native Veterans.'' Those wishing additional information may contact the Indian Affairs Committee at (202) 224 2251.

Mr. AKAKA

Mr. AKAKA. Mr. President, I rise today to introduce the Save More Tomorrow Act of 2012. This act seeks to make a modest, commonsense modification to the Thrift Savings Plan, or TSP, which is the tax- deferred, defined contribution plan for Federal employees, similar to private sector 401(k) plans. The Save More Tomorrow Act would build on the Thrift Savings Plan Enhancement Act of 2009, which was enacted with support from large, bipartisan majorities in Congress. Under the Thrift Savings Plan Enhancement Act, new Federal employees are automatically enrolled in the TSP unless they opt out, with a default employee contribution rate of 3 percent of basic pay. This legislation would adjust the TSP's automatic enrollment mechanism to allow it to automatically increase employee contributions, unless the employee chooses a different contribution rate. To accomplish this, the bill authorizes the Federal Retirement Thrift Investment Board, the agency that administers the TSP, to pair the current auto enrollment at 3 percent with automatic escalation of 1 percent per year, for at least 2 consecutive years following the first year of enrollment. This promotes a goal of the Federal Employees' Retirement System Act of 1986, often referred to as FERSA, which was designed to encourage Federal employees to save at least 5 percent of their pay in the TSP. This ``three plus one plus one'' model closely mirrors the model Congress prescribed for the private sector in the Pension Protection Act of 2006, which Mr. Boehner of Ohio introduced, the House and Senate passed with significant bipartisan support, and President George W. Bush signed into law. In enacting the Pension Protection Act, Congress endorsed pairing automatic enrollment with automatic escalation, by incentivizing companies to automatically enroll employees in 401(k) plans at no less than a 3 percent savings rate, and automatically escalate that rate by at least 1 percent for at least 3 years. This act is informed by rigorous oversight I have conducted as Chairman of the Subcommittee on Oversight of Government Management, the Federal Workforce, and the District of Columbia. For example, at a recent Subcommittee hearing, Dr. Brigitte Madrian, a Harvard Kennedy School professor and leading expert on employer-sponsored retirement savings plans, stated, ``the evidence from the private sector is that automatic escalation is, in fact, extremely effective at increasing employee savings rates. And you asked specifically is this [automatic escalation] something that should be considered for the Thrift Savings Plan, and I would say absolutely.'' To preempt any possible misconceptions or misunderstandings that may arise regarding this act, I want to be clear from the outset about which employees the Save More Tomorrow Act applies to, and the voluntary nature of the bill. Since this act builds on the statutory framework established by the Thrift Savings Enhancement Act, it only applies to newly hired Federal employees who are eligible to participate in the TSP's automatic enrollment feature. Additionally, just like the TSP's auto enrollment feature, auto escalation authorized by this act would be voluntary, and allow participants to terminate default contributions, or change contribution rates, at any time. This bill has a limited, targeted scope. It would increase the savings only of the small percentage of new employees who enroll in the TSP, but do not raise their contribution rate enough to reach the goal Congress established with FERSA of having most Federal employees contributing at least 5 percent of basic pay. Under the Thrift Savings Plan Enhancement Act, an impressive 97.2 percent of new Federal employees are enrolling in the TSP--82,632 Federal employees have been automatically enrolled in the TSP since the practice began in August 2010. Most of those employees increase their contributions far above the default rate of 3 percent. These enrollees boast an average TSP savings rate of 12.1 percent. Currently, only about 9 percent of employees in the Federal Employee Retirement System enrolled in the TSP contribute less than 5 percent. Of course, one must not confuse this act's limited scope with the potential benefits. From the most recent survey of TSP participants, we know that just like in the private sector, low-income workers who can least afford to forgo matching contributions are the most likely to do so. Lower-income Federal employees are more than twice as likely as higher-income employees to cite automatic enrollment as the reason they are contributing to the TSP. Many employees who contribute less than 5 percent are not even aware of the benefits of increasing the amount they save--18 percent of this group reported they did not contribute 5 percent because they were unaware agencies matched contributions dollar-for-dollar on the first 3 percent of basic pay, and 50 cents on the dollar for the next 2 percent. Today's Federal workers must plan carefully to ensure their retirement security. Fortunately, the vast majority of the Federal employees are responsibly saving for retirement, exhibiting average savings rates that are far greater than the private sector. However, I am concerned that the most financially vulnerable Federal employees, individuals earning less than $25,000 a year, are saving at a lower rate that will hinder their ability to retire with dignity. We should build on the success of the Thrift Savings Plan Enhancement Act by making it as easy as possible for employees to increase their contributions. The Save More Tomorrow Act is a limited, yet effective legislative response to do just this. Informed by rigorous data from real world experiences in the private sector, this act represents the best in serious, evidence-based policymaking. The modest authorities provided by the Save More Tomorrow Act will enhance the Federal Retirement Thrift Investment Board's ability to meet FERSA's goal of encouraging TSP contributions of 5 percent of pay. I strongly urge my colleagues to support this important legislation. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. AKAKA

Mr. AKAKA. Mr. President, I rise today to introduce the Save More Tomorrow Act of 2012. This act seeks to make a modest, commonsense modification to the Thrift Savings Plan, or TSP, which is the tax- deferred, defined contribution plan for Federal employees, similar to private sector 401(k) plans. The Save More Tomorrow Act would build on the Thrift Savings Plan Enhancement Act of 2009, which was enacted with support from large, bipartisan majorities in Congress. Under the Thrift Savings Plan Enhancement Act, new Federal employees are automatically enrolled in the TSP unless they opt out, with a default employee contribution rate of 3 percent of basic pay. This legislation would adjust the TSP's automatic enrollment mechanism to allow it to automatically increase employee contributions, unless the employee chooses a different contribution rate. To accomplish this, the bill authorizes the Federal Retirement Thrift Investment Board, the agency that administers the TSP, to pair the current auto enrollment at 3 percent with automatic escalation of 1 percent per year, for at least 2 consecutive years following the first year of enrollment. This promotes a goal of the Federal Employees' Retirement System Act of 1986, often referred to as FERSA, which was designed to encourage Federal employees to save at least 5 percent of their pay in the TSP. This ``three plus one plus one'' model closely mirrors the model Congress prescribed for the private sector in the Pension Protection Act of 2006, which Mr. Boehner of Ohio introduced, the House and Senate passed with significant bipartisan support, and President George W. Bush signed into law. In enacting the Pension Protection Act, Congress endorsed pairing automatic enrollment with automatic escalation, by incentivizing companies to automatically enroll employees in 401(k) plans at no less than a 3 percent savings rate, and automatically escalate that rate by at least 1 percent for at least 3 years. This act is informed by rigorous oversight I have conducted as Chairman of the Subcommittee on Oversight of Government Management, the Federal Workforce, and the District of Columbia. For example, at a recent Subcommittee hearing, Dr. Brigitte Madrian, a Harvard Kennedy School professor and leading expert on employer-sponsored retirement savings plans, stated, ``the evidence from the private sector is that automatic escalation is, in fact, extremely effective at increasing employee savings rates. And you asked specifically is this [automatic escalation] something that should be considered for the Thrift Savings Plan, and I would say absolutely.'' To preempt any possible misconceptions or misunderstandings that may arise regarding this act, I want to be clear from the outset about which employees the Save More Tomorrow Act applies to, and the voluntary nature of the bill. Since this act builds on the statutory framework established by the Thrift Savings Enhancement Act, it only applies to newly hired Federal employees who are eligible to participate in the TSP's automatic enrollment feature. Additionally, just like the TSP's auto enrollment feature, auto escalation authorized by this act would be voluntary, and allow participants to terminate default contributions, or change contribution rates, at any time. This bill has a limited, targeted scope. It would increase the savings only of the small percentage of new employees who enroll in the TSP, but do not raise their contribution rate enough to reach the goal Congress established with FERSA of having most Federal employees contributing at least 5 percent of basic pay. Under the Thrift Savings Plan Enhancement Act, an impressive 97.2 percent of new Federal employees are enrolling in the TSP--82,632 Federal employees have been automatically enrolled in the TSP since the practice began in August 2010. Most of those employees increase their contributions far above the default rate of 3 percent. These enrollees boast an average TSP savings rate of 12.1 percent. Currently, only about 9 percent of employees in the Federal Employee Retirement System enrolled in the TSP contribute less than 5 percent. Of course, one must not confuse this act's limited scope with the potential benefits. From the most recent survey of TSP participants, we know that just like in the private sector, low-income workers who can least afford to forgo matching contributions are the most likely to do so. Lower-income Federal employees are more than twice as likely as higher-income employees to cite automatic enrollment as the reason they are contributing to the TSP. Many employees who contribute less than 5 percent are not even aware of the benefits of increasing the amount they save--18 percent of this group reported they did not contribute 5 percent because they were unaware agencies matched contributions dollar-for-dollar on the first 3 percent of basic pay, and 50 cents on the dollar for the next 2 percent. Today's Federal workers must plan carefully to ensure their retirement security. Fortunately, the vast majority of the Federal employees are responsibly saving for retirement, exhibiting average savings rates that are far greater than the private sector. However, I am concerned that the most financially vulnerable Federal employees, individuals earning less than $25,000 a year, are saving at a lower rate that will hinder their ability to retire with dignity. We should build on the success of the Thrift Savings Plan Enhancement Act by making it as easy as possible for employees to increase their contributions. The Save More Tomorrow Act is a limited, yet effective legislative response to do just this. Informed by rigorous data from real world experiences in the private sector, this act represents the best in serious, evidence-based policymaking. The modest authorities provided by the Save More Tomorrow Act will enhance the Federal Retirement Thrift Investment Board's ability to meet FERSA's goal of encouraging TSP contributions of 5 percent of pay. I strongly urge my colleagues to support this important legislation. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. AKAKA

Mr. AKAKA. Mr. President, I would like to announce that the Committee on Indian Affairs will meet on May 17, 2012 in room SD 628 of the Dirksen Senate Office Building at 2:15 p.m. to conduct a hearing entitled ``Fulfilling the Federal Trust Responsibility: The Foundation of the Government-to-Government Relationship.'' Those wishing additional information may contact the Indian Affairs Committee at (202) 224 2251.

Mr. AKAKA

Mr. AKAKA. Mr. President, I am proud to once again introduce legislation addressing the health care disparities in racial and ethnic minority communities, the Health Equity and Accountability Act of 2012. I would like to thank my cosponsor, Senator Inouye, along with a number of our colleagues in the House of Representatives, for all their support and contributions to this important legislation, and for raising awareness of this widespread problem. While there are glaring health disparities based on racial and ethnic identity alone, they are further exacerbated by factors such as socioeconomics, geography, and sexual orientation and identity. Although the exact causes for the current state of health disparities in our country may be debatable, it is undeniable that ethnic, racial, geographic, and other minorities across the United States are plagued by disproportionately high rates of disease and experience a diminished quality of health care. Statistics paint a disturbing picture of minority health, consistently showing higher rates of illness and death for members of minority and marginalized groups. For instance, HIV/AIDS has had a devastating impact on minorities in the U.S. In 2009, ethnic minorities accounted for over 70 percent of newly diagnosed cases of HIV. That year, nine out of ten babies born with HIV belonged to minority groups. The Office of Minority Health reported that, compared to Caucasians, Hispanic individuals are 3 times more likely to be diagnosed with AIDS; Native Americans are 1.4 times more likely; and Native Hawaiians and Pacific Islanders are 2.4 times more likely to be diagnosed with AIDS. Cancer is the number one killer of Asian American Pacific Islanders and the second leading cause of death for most other racial and ethnic minorities in the United States. Cancer also affects African Americans at particularly alarming rates and has a disproportionate prevalence in the population of Hispanic women, who are 1.6 times more likely to be diagnosed with cervical cancer than non-Hispanic women. In addition, Native Americans are twice as likely as non-Hispanic whites to develop stomach or liver cancer. The infant mortality rates for African Americans are one-and-a-half to 3 times higher than the rates for infants born to women of other races and ethnicities. Hispanic individuals are three times more likely to be diagnosed with AIDS than Caucasian individuals. As our nation continues to struggle with obesity, trends show increasingly high rates of obesity in minority groups, with young Mexican-American men under the age of 20 experiencing obesity at a rate of 25 percent of the population, while white men of the same age have a rate of just 15 percent. Circulatory diseases are a growing problem in the Pacific region. These diseases not only lower patients' quality of life, but they are also very costly. Data from the Agency for Healthcare Research and Quality shows that eliminating preventable hospitalizations that are associated with lower incomes would save $6.7 billion in health care costs each year. However, the numbers alone do not capture the full extent of health disparities since there are additional issues with data collection and multiple factors often contribute to deaths. In 2005, I introduced a similar piece of legislation, S. 1580, because many of the indigenous and ethnic minority communities across the United States and its territories lacked essential access to health care and suffered from certain key diseases at disproportionately high rates. The bill I am introducing today addresses many of the same issues and also takes into account the strong advances made by the Patient Protection and Affordable Care Act. In 2008, the landmark health care reform legislation laid the foundation to start reducing some of those health disparities. Senator Inouye and I are introducing this legislation today to build on the work of the Affordable Care Act, and to advance the national discussion on how we can better achieve health equity. While the Affordable Care Act expanded care in diverse communities across the country, such as Asian Americans, Native Hawaiians, and Pacific Islanders, it is important that we take further steps to ensure that all Americans, regardless of racial, ethnic, socioeconomic, physical, and geographic circumstances, have affordable access to high- quality health care. Because the causes of health care disparities are wide-ranging, the scope of this bill must be equally encompassing. Therefore, my bill focuses on two main strategies: first, encouraging research on diseases and conditions that disproportionately impact minority individuals; and second, improving access to effective care for minority communities. We must make it easier to identify existing disparities through comprehensive data collection, ensure workforce diversity, target diseases that disproportionately affect minorities, and make culturally and linguistically appropriate health care services available to all. We need more comprehensive data on the most significant health care problems experienced by minority individuals and the factors that play a role in how these diseases affect different communities. The more we know about the way populations are affected by disease, the better prepared health care professionals will be to create strategies to both treat and prevent each high-impact disease in specific communities. My bill will help to accomplish this by strengthening both data collection and the reporting of health data. To complement our efforts in data collection, we must also target disease awareness education and effective preventative services towards communities with large populations of ethnic and racial minorities at high risk for certain diseases. Community-based programs as well as comprehensive disease-specific programs already in place are helping to ensure that the health needs of minority communities are being met. My legislation would revitalize efforts in community health and preventive services, which are the most cost-effective ways of providing care. This bill builds upon the Affordable Care Act's historic investment in prevention and calls for resources to target communities striving to overcome negative social factors. This bill encourages these investments and focuses on preventing fatal diseases, which could save thousands of lives each year and lower health care costs. Although prevention plays a critical role in finding ways to close disparities, we also have to invest in research to develop better treatment plans for diseases that disproportionately affect indigenous, racial, and ethnic minorities, and to ensure that currently underserved communities have access to care. My bill proposes focused approaches to combat a variety of diseases and conditions, including heart disease, cancer, diabetes, and HIV/ AIDS, which have a disparate impact on racial and ethnic minorities. This legislation also helps to provide affordable and culturally appropriate access to care in several ways. My bill, the Health Equity and Accountability Act of 2012, includes proposals to remove significant barriers to health care coverage and access and maximize the positive impact of federal investments in health care in minority communities. For example, it would re-establish Medicaid eligibility for citizens of the Compact of Free Association nations living in the United States. This would greatly ease the financial burden on States like Hawaii and Arkansas, which have been forced to absorb the costs of providing health and social services, education, and public safety for Compact migrants in accordance with unfunded Federal mandates since 1996. My bill would also make health care more affordable and improve access by providing a 100 percent Federal Medicaid Assistance Percentage, FMAP, for Native Hawaiians who receive health care from Federally Qualified Health Centers or the Native Hawaiian Health Care System. The increased FMAP will ensure that Native Hawaiians have access to the essential health services provided by community health centers and the Native Hawaiian Health Care System. These provisions would provide treatment for Native Hawaiians that is similar to that already provided to Native Alaskans through the Indian Health Service or tribal organizations. This legislation will make it easier for minorities with cultural and language barriers to improve their health outcomes by enhancing language access services, making health literacy a priority in patient care, and making sure there is culturally competent care in the health care delivery system. My bill will support professionals who are well- equipped to provide quality health care that is culturally and linguistically appropriate. As a part of this effort, this legislation creates training opportunities for willing and competent minority candidates to enter the health care workforce. The Health Equity and Accountability Act also seeks to ensure that communities of color benefit from the rapid advances in health information technology, or health IT. It also encourages new investments in health IT infrastructure, which will serve as the foundation for improving the quality, effectiveness, and efficiency for all Americans in our future health care system. Improvements in health IT and health IT infrastructure will also make it possible for rural communities to access mobile health services and other treatment and diagnostics that were previously unavailable. Another vital service that my bill seeks to make more accessible is mental health care. The Affordable Care Act fundamentally improved services for individuals with mental health and addiction disorders. Despite the improvements, mental health treatment remains underutilized, especially by minorities, due to social stigma and cultural resistance. To develop access and encourage treatment, my bill incorporates culturally competent strategies to address mental and behavioral health problems affecting minority communities and authorizes investment in researching and treating these serious conditions. However, we cannot simply put these provisions in place and believe that they will eliminate all health disparities. We must have accountability and regular evaluation of these programs to ensure they are being carried out as they were intended, and that they are meeting their goals. To that end, my bill strengthens oversight by the Department of Health and Human Services, requiring the Department to make regular scheduled reports to Congress on the impact of these initiatives to ensure that they are continuing to reduce health disparities. April is National Minority Health Month, and as we work diligently to transform health care in America, it is essential that we strive to eliminate the health disparities that affect our minority groups. This bill would significantly improve the quality of life for indigenous people, ethnic and racial minorities, as well as other marginalized groups. I encourage my colleagues to support this legislation, and begin an open dialogue on how we can close the gap in health care across the country.

Mr. AKAKA

Mr. AKAKA. Mr. President, I am proud to once again introduce legislation addressing the health care disparities in racial and ethnic minority communities, the Health Equity and Accountability Act of 2012. I would like to thank my cosponsor, Senator Inouye, along with a number of our colleagues in the House of Representatives, for all their support and contributions to this important legislation, and for raising awareness of this widespread problem. While there are glaring health disparities based on racial and ethnic identity alone, they are further exacerbated by factors such as socioeconomics, geography, and sexual orientation and identity. Although the exact causes for the current state of health disparities in our country may be debatable, it is undeniable that ethnic, racial, geographic, and other minorities across the United States are plagued by disproportionately high rates of disease and experience a diminished quality of health care. Statistics paint a disturbing picture of minority health, consistently showing higher rates of illness and death for members of minority and marginalized groups. For instance, HIV/AIDS has had a devastating impact on minorities in the U.S. In 2009, ethnic minorities accounted for over 70 percent of newly diagnosed cases of HIV. That year, nine out of ten babies born with HIV belonged to minority groups. The Office of Minority Health reported that, compared to Caucasians, Hispanic individuals are 3 times more likely to be diagnosed with AIDS; Native Americans are 1.4 times more likely; and Native Hawaiians and Pacific Islanders are 2.4 times more likely to be diagnosed with AIDS. Cancer is the number one killer of Asian American Pacific Islanders and the second leading cause of death for most other racial and ethnic minorities in the United States. Cancer also affects African Americans at particularly alarming rates and has a disproportionate prevalence in the population of Hispanic women, who are 1.6 times more likely to be diagnosed with cervical cancer than non-Hispanic women. In addition, Native Americans are twice as likely as non-Hispanic whites to develop stomach or liver cancer. The infant mortality rates for African Americans are one-and-a-half to 3 times higher than the rates for infants born to women of other races and ethnicities. Hispanic individuals are three times more likely to be diagnosed with AIDS than Caucasian individuals. As our nation continues to struggle with obesity, trends show increasingly high rates of obesity in minority groups, with young Mexican-American men under the age of 20 experiencing obesity at a rate of 25 percent of the population, while white men of the same age have a rate of just 15 percent. Circulatory diseases are a growing problem in the Pacific region. These diseases not only lower patients' quality of life, but they are also very costly. Data from the Agency for Healthcare Research and Quality shows that eliminating preventable hospitalizations that are associated with lower incomes would save $6.7 billion in health care costs each year. However, the numbers alone do not capture the full extent of health disparities since there are additional issues with data collection and multiple factors often contribute to deaths. In 2005, I introduced a similar piece of legislation, S. 1580, because many of the indigenous and ethnic minority communities across the United States and its territories lacked essential access to health care and suffered from certain key diseases at disproportionately high rates. The bill I am introducing today addresses many of the same issues and also takes into account the strong advances made by the Patient Protection and Affordable Care Act. In 2008, the landmark health care reform legislation laid the foundation to start reducing some of those health disparities. Senator Inouye and I are introducing this legislation today to build on the work of the Affordable Care Act, and to advance the national discussion on how we can better achieve health equity. While the Affordable Care Act expanded care in diverse communities across the country, such as Asian Americans, Native Hawaiians, and Pacific Islanders, it is important that we take further steps to ensure that all Americans, regardless of racial, ethnic, socioeconomic, physical, and geographic circumstances, have affordable access to high- quality health care. Because the causes of health care disparities are wide-ranging, the scope of this bill must be equally encompassing. Therefore, my bill focuses on two main strategies: first, encouraging research on diseases and conditions that disproportionately impact minority individuals; and second, improving access to effective care for minority communities. We must make it easier to identify existing disparities through comprehensive data collection, ensure workforce diversity, target diseases that disproportionately affect minorities, and make culturally and linguistically appropriate health care services available to all. We need more comprehensive data on the most significant health care problems experienced by minority individuals and the factors that play a role in how these diseases affect different communities. The more we know about the way populations are affected by disease, the better prepared health care professionals will be to create strategies to both treat and prevent each high-impact disease in specific communities. My bill will help to accomplish this by strengthening both data collection and the reporting of health data. To complement our efforts in data collection, we must also target disease awareness education and effective preventative services towards communities with large populations of ethnic and racial minorities at high risk for certain diseases. Community-based programs as well as comprehensive disease-specific programs already in place are helping to ensure that the health needs of minority communities are being met. My legislation would revitalize efforts in community health and preventive services, which are the most cost-effective ways of providing care. This bill builds upon the Affordable Care Act's historic investment in prevention and calls for resources to target communities striving to overcome negative social factors. This bill encourages these investments and focuses on preventing fatal diseases, which could save thousands of lives each year and lower health care costs. Although prevention plays a critical role in finding ways to close disparities, we also have to invest in research to develop better treatment plans for diseases that disproportionately affect indigenous, racial, and ethnic minorities, and to ensure that currently underserved communities have access to care. My bill proposes focused approaches to combat a variety of diseases and conditions, including heart disease, cancer, diabetes, and HIV/ AIDS, which have a disparate impact on racial and ethnic minorities. This legislation also helps to provide affordable and culturally appropriate access to care in several ways. My bill, the Health Equity and Accountability Act of 2012, includes proposals to remove significant barriers to health care coverage and access and maximize the positive impact of federal investments in health care in minority communities. For example, it would re-establish Medicaid eligibility for citizens of the Compact of Free Association nations living in the United States. This would greatly ease the financial burden on States like Hawaii and Arkansas, which have been forced to absorb the costs of providing health and social services, education, and public safety for Compact migrants in accordance with unfunded Federal mandates since 1996. My bill would also make health care more affordable and improve access by providing a 100 percent Federal Medicaid Assistance Percentage, FMAP, for Native Hawaiians who receive health care from Federally Qualified Health Centers or the Native Hawaiian Health Care System. The increased FMAP will ensure that Native Hawaiians have access to the essential health services provided by community health centers and the Native Hawaiian Health Care System. These provisions would provide treatment for Native Hawaiians that is similar to that already provided to Native Alaskans through the Indian Health Service or tribal organizations. This legislation will make it easier for minorities with cultural and language barriers to improve their health outcomes by enhancing language access services, making health literacy a priority in patient care, and making sure there is culturally competent care in the health care delivery system. My bill will support professionals who are well- equipped to provide quality health care that is culturally and linguistically appropriate. As a part of this effort, this legislation creates training opportunities for willing and competent minority candidates to enter the health care workforce. The Health Equity and Accountability Act also seeks to ensure that communities of color benefit from the rapid advances in health information technology, or health IT. It also encourages new investments in health IT infrastructure, which will serve as the foundation for improving the quality, effectiveness, and efficiency for all Americans in our future health care system. Improvements in health IT and health IT infrastructure will also make it possible for rural communities to access mobile health services and other treatment and diagnostics that were previously unavailable. Another vital service that my bill seeks to make more accessible is mental health care. The Affordable Care Act fundamentally improved services for individuals with mental health and addiction disorders. Despite the improvements, mental health treatment remains underutilized, especially by minorities, due to social stigma and cultural resistance. To develop access and encourage treatment, my bill incorporates culturally competent strategies to address mental and behavioral health problems affecting minority communities and authorizes investment in researching and treating these serious conditions. However, we cannot simply put these provisions in place and believe that they will eliminate all health disparities. We must have accountability and regular evaluation of these programs to ensure they are being carried out as they were intended, and that they are meeting their goals. To that end, my bill strengthens oversight by the Department of Health and Human Services, requiring the Department to make regular scheduled reports to Congress on the impact of these initiatives to ensure that they are continuing to reduce health disparities. April is National Minority Health Month, and as we work diligently to transform health care in America, it is essential that we strive to eliminate the health disparities that affect our minority groups. This bill would significantly improve the quality of life for indigenous people, ethnic and racial minorities, as well as other marginalized groups. I encourage my colleagues to support this legislation, and begin an open dialogue on how we can close the gap in health care across the country.

Mr. AKAKA

Mr. AKAKA. Madam President, I rise today in support of S. 1925, the Violence Against Women Act reauthorization of 2011. Since its enactment in 1994, VAWA has enhanced the investigation and prosecution of incidents of domestic and sexual violence and provided critical services to victims and their advocates in court. It has truly been a lifeline for women across the country, regardless of location, race, or socioeconomic status. For these reasons, VAWA's two prior reauthorizations were overwhelmingly bipartisan. This year, however, a number of my colleagues are opposing the Violence Against Women Act reauthorization because they object to, among other things, the authority that it restores to Native American tribes to prosecute those who commit violent crimes against Native women. This bill's tribal provisions address the epidemic rates of violence against Native women by enabling VAWA programs to more directly and promptly respond to their concerns and needs. These tribal provisions are critical to the lives of Native women and doubly important to me as chairman of the Senate Committee on Indian Affairs and a Native Hawaiian. Native women are 2\1/2\ times more likely than other U.S. women to be battered or raped. These are extremely disturbing statistics: 34 percent of Native women will be raped in their lifetimes and 39 percent will suffer domestic violence. That is more than one out of every three Native women. We must come together to put a stop to this. Last summer I chaired an oversight hearing entitled ``Native Women-- Protecting, Shielding, and Safeguarding Our Sisters, Mothers, and Daughters.'' I heard the heartbreaking stories that lie behind the grim and troubling statistics on violence against American Indian, Alaska Native, and Native Hawaiian women. My committee heard from the chief of the Catawba Nation, who gave a moving account of his experience growing up with domestic violence and the impact it had on the women and children in his community. He also spoke of the importance of reauthorizing VAWA. We heard from officials who described how existing laws are failing Native women. We heard, for example, that women in tribal communities live in a confusing and dangerous jurisdictional maze, in which the absence of clear lines of authority often leads to offenders, many of whom are non-Native men, escaping investigation and prosecution, to say nothing of punishment. This outrageous and unacceptable situation has led to repeated offenses against Native women that too often spiral into violence with tragic consequences for the women, their children, and their communities. My committee also heard that Native women are being increasingly targeted by the sex-trafficking industry and that many have, according to police reports in tribal communities across the country, simply vanished into this terrible underworld. The draft bill to address violence against Native women was circulated to a wide range of stakeholders for feedback. This led to strengthened provisions in the draft bill which I introduced as S. 1763, the Stand Against Violence and Empower Native Women Act. The Senate Committee on Indian Affairs held a legislative hearing on my bill the following month and then reported it out of the committee in December. Since then, I have worked closely with my good friend and colleague Senator Leahy, chairman of the Judiciary Committee, as we developed S. 1925, which now includes the SAVE Native American Women Act. S. 1925's tribal provisions empower tribal courts to prosecute crimes of domestic violence, dating violence, or violations of protection orders regardless of the race of the alleged abuser. This bill also strengthens research and programs to address sex trafficking. Since VAWA was enacted 18 years ago and reauthorized twice since then, a hallmark of the law is that it has expanded its protections to classes of once neglected victims. Accordingly, S. 1925's tribal provisions are consistent with VAWA's history as well as its intent and purpose, which past Congresses have embraced. Last week 50 law professors from leading institutions across the country sent a letter to Congress expressing their ``full confidence in the constitutionality of the legislation and in its necessity to protect the safety of Native women.'' Just this week the White House released a Statement of Administration Policy stating that it strongly supports these provisions, which will ``bring justice to Native American victims.'' I commend Chairman Leahy for his dedicated leadership in developing this bill. He has truly worked in the spirit of aloha by partnering with the Indian Affairs Committee and other offices to craft a VAWA reauthorization bill that reasserts VAWA's intent, purpose, and history. I would also like to say mahalo--thank you--to each of this bill's other bipartisan cosponsors. As we all know, domestic and sexual violence continues to occur, and far too many women across the country are victims of these horrible acts. We have heard from victims, from service providers, and from law enforcement that these crimes can leave victims with lasting emotional and physical scars, while endangering their security, their families, and their lives. This bill will strengthen the Violence Against Women Act and extend its protections to include Native women who are underserved in the current system. This is not an issue that should divide us along partisan lines. On the contrary, it should unite us to take a stand against these awful crimes. So I urge you to join me and the rest of S. 1925's cosponsors to protect our sisters, mothers, and daughters and pass this bill. I yield the floor.

Mr. AKAKA

Mr. AKAKA. I ask for a voice vote.

Mr. AKAKA. Mr. President, current law provides postmasters and post office supervisors with the opportunity to consult over pay and benefits. This is not collective bargaining and does not result in a contract. Unfortunately, the Postal Service tries to modify, reduce or eliminate supervisors' benefits outside the normal consultation process, arguing that Congress intended this consultation for the creation but not elimination of benefit programs. This amendment simply clarifies existing law that the consultation requirement applies to any changes to pay or benefits. I urge my colleagues to support this amendment.

Mr. AKAKA. I ask unanimous consent that the reading of the amendment be dispensed with.

Mr. AKAKA. Mr. President, I call up my amendment No. 2049.

Mr. AKAKA. Mr. President, I ask for the yeas and nays.