Michael Bilirakis

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in support of H.R. 540, the Nursing Home Resident Protection Amendments of 1999. This measure will protect the health and dignity of nursing home residents who rely on Medicaid. In a hearing of my Subcommittee on Health and Environment on February 11, Mr. Nelson Mongiovi described the trauma that his mother suffered when she was targeted for eviction by her nursing home in Tampa, Florida. That facility attempted to evict over 50 Medicaid residents last year under the guise of remodeling their wing. In fact, those residents were targeted for eviction solely, solely because they relied on Medicaid. Although a court halted the evictions in Tampa, this was not an isolated incident. Discrimination against Medicaid residents has also been reported in other States. HCFA estimates that an average of 58 nursing homes voluntarily withdraw from the Medicaid program each year. In an informal survey of 47 States' ombudsmen, 15 cited transfer and discharge violations as highly problematic. To stop this outrageous practice, the gentleman from Florida (Mr. Jim Davis) and I worked on a bipartisan basis to draft H.R. 540. Our bill adopts a simple and fair approach. It protects current nursing home residents from eviction when their facility withdraws from Medicaid. It does not, and I repeat, it does not force nursing homes to remain in the Medicaid program, and facilities may continue to decide which residents to admit in the future. If a facility, however, withdraws from the program, H.R. 540 requires the home to provide clear notice to future residents that it does not accept Medicaid payments. This safeguard will prevent new residents from assuming that they can remain in a facility once they exhaust their assets and become Medicaid-eligible. This legislation, Mr. Speaker, is necessary to close a loophole that exists under current law. In testimony before my subcommittee, Mike Hash, Deputy Administrator of HCFA, stated clearly, and I quote him, ``We do not have the authority to prevent evictions of Medicaid patients if nursing homes leave the Medicaid program.'' I represent a district, Mr. Speaker, with one of the highest concentrations of senior citizens in the country. I am committed to reforming our Nation's long-term care system. The bill before us is part of a larger effort to remedy these problems. It addresses one serious concern by guaranteeing that nursing home residents and their families will not have to live with a fear of eviction. H.R. 540 is a responsible measure supported by a broad range of seniors' advocates, including AARP, the Seniors Coalition, and the 60 Plus Association. In addition, the nursing home industry and the administration have endorsed the bill. It is the product of our bipartisan effort to improve safeguards for vulnerable residents of nursing homes. I am proud to bring H.R. 540 to the floor as the first measure approved by my subcommittee in this Congress. Passage of this bill sends a clear message that we put patients ahead of profits. I urge all Members to vote in favor of H.R. 540. Before I sign off, Mr. Speaker, I would like to express my gratitude to the gentleman from Virginia (Chairman Bliley), to the gentleman from Michigan (Mr. Dingell) and the gentleman from Ohio (Mr. Brown), and of course to the staffs, Todd Tuten of my personal staff, and Mr. Mark Wheat and Mr. Tom Giles of the committee staff, and of course, Mr. John Ford, the head of the minority staff. Mr. Speaker, I reserve the balance of my time.

Mr. BILIRAKIS. Mr. Speaker, I reserve the balance of my time.

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Chairman, I rise today to support H.R. 707, the Disaster Mitigation and Cost Reduction Act of 1999. Florida occupies a unique position in our nation's landscape. Unfortunately, natural disasters often threaten my state's magnificent environment. In the past year alone, Florida has been devastated by floods, fires, and tornadoes. Nationwide, the cost of responding to such catastrophes has skyrocketed over the past decade. According to the National Oceanic and Atmospheric Administration, twenty-five major weather-related incidents occurred from 1988 through 1997, resulting in total damages of approximately $140 billion. The most costly insured catastrophe in U.S. history was Hurricane Andrew, which hit South Florida in August 1992. It caused more than $25 billion in damages and resulted in fifty-eight deaths. In the aftermath of this hurricane, many insurance companies no longer provide coverage in Florida. As a result, my constituents are concerned about the availability and affordability of residential property insurance. I have cosponsored legislation to guarantee that homeowners have access to affordable disaster insurance. I have been working with the Florida delegation to enact this important measure. Prevention is critical to reducing the economic costs and loss of life when severe weather strikes. To that end, I held a workshop in my district last year on Project Impact, an initiative sponsored by the Federal Emergency Management Agency (FEMA). Project Impact helps communities prepare for natural disasters by establishing a partnership between citizens, businesses and government. It also encourages communities to act now to reduce the threat of future calamities. Congress must take a more pro-active approach to disaster mitigation. H.R. 707, sponsored by Congresswoman Fowler and Congressman Traficant, achieves this goal. Through this bill, states will be able to accurately assess the risks of natural disasters and reduce the resulting damages. I commend my colleagues for working on a bipartisan basis to develop this common-sense measure. Mr. Chairman, H.R. 707 represents a critical step forward in disaster mitigation efforts. I urge my colleagues to support the bill. Ms. MILLENDER-McDONALD, Mr. Chairman, I would like to thank the Chair and Ranking Member of the Subcommittee on Oversight, and the Chair and the Ranking Member of the Full Committee on Transportation & Infrastructure for their attentiveness to the needs and concerns of California's municipal and county governments by including ``Due Process'' language in the Committee's Manager's Amendment. This language has the bi-partisan support of the California Delegation, the California State Association of Counties, and the California League of Cities. The fiscal burden that California's county and municipal governments have had to bear as a result of natural disasters has grown dramatically over the last few years. The increased number and magnitude of natural disasters is one of the major factors contributing to this fiscal burden. While the Federal government plays a key role in disaster recovery, it is state and local governments that are ultimately charged with responding to the immediate needs of citizens and businesses in the aftermath of a natural disaster. Since state and local governments must carry this burden, they should have a voice in the rulemaking process. FEMA often provides for public participation in the rulemaking process regarding its programs and functions, including matters that relate to public property, even though notices and public comment for rulemaking were not required by law. That such due process measures are not required by law is a mistake that can have major financial repercussions. The result of failing to require public due process, including the proper notification of policy modifications, has obviously had an overwhelming fiscal impact on California's state and local governments. In the aftermath of the 1995 winter storms, California's localities were not informed of FEMA's 1996 flood control policy which listed the federal agencies responsible for funding flood control projects. As a result of this failure to disseminate vital information, California local governments were denied millions of dollars in funding from federal agencies for damaged incurred during the 1995 winter storms. As the former Mayor Pro-tempore of the City of Carson and the former Chair of the California Assembly's Committee on Insurance, I am all too familiar with these problems and understand the need for due process requirements and public comment in the rulemaking process. The language included in this Manager's Amendment requires FEMA to provide public comment before adopting any new or modified policy that would have a ``nontrivial'' impact on the amount of disaster assistance that may be provided to a state and local government. The language further prohibits FEMA from adopting any new or modified policy that would retroactively reduce the amount of assistance provided to state and local governments in the wake of a natural disaster. Again, I would like to thank my California Colleagues, Representatives Steve Horn, Ellen Tauscher, Buck McKeon, Bob Filner, Jerry Lewis, Gary Miller, Steve Kuykendall, and John Doolittle for their work together to protect the interests of the State of California. Mr. Chairman, thank you again for responding to our concerns on this issue.

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, I would like to share a poem with my colleagues that was written by one of my constituents, Stanley Karczeuski. Stanley wrote this poem while he was serving aboard the SS John Ainsworth during World War II. Home to Stay I won't rejoice or boast or brag, On that eventful day, I'll just thank God I'm still alive, And going home to stay. I've counted days and months and years, Since I have been away, But now my counting days are done, I'm going home to stay. They wanted us to do a job, Which was all work, no play, And now the job is done, and I Am going home to stay. There'll be parades for heroes all, And services to pray, For both those men returning home, And those who had to stay. It's these thoughts while homeward bound, Upon my mind do prey, While those who fought and died remain, I'm going home to stay. So let us all in silence kneel, And to our God we pray, For lasting peace to those who fell, While we go home to stay.

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, I rise today with a heavy heart, but with a solemn sense of duty, and that is to support all four articles of impeachment against the President of the United States. I want to believe my president. I cannot. I hoped he would keep his promise to have the most ethical administration in history. He did not. I want to accept his explanation that he did not lie under oath, commit perjury, obstruction of justice, or abuse the power of his office. However, his actions and comments over the past 11 months have shaken my confidence in his ability to distinguish truth from fiction. If you can't convince them, confuse them, President Harry Truman once quipped. Like many Americans, I have been confused by the President's denials, admissions, declarations, and apologies over the past year. I have no doubt, however, that the President has engaged in a clear and calculated pattern of deception. The integrity of the presidency, Mr. Speaker, must always take priority over the self-interest of the current occupant of that office. Mr. Speaker, failing to hold the President accountable for his actions would create a dangerous double standard. To borrow a phrase from George Orwell's Animal Farm, we would be establishing a principle that some Americans are more equal than others. Mr. Speaker, I rise today with a heavy heart--but with a solemn sense of duty--to support all four articles of impeachment against the President of the United States. Like most Americans, I have closely followed the Judiciary Committee's proceedings in recent weeks. Over the past few days, I have carefully studied the Committee's findings and again reviewed the available evidence. After serious consideration of these issues, I am convinced that the President committed perjury, obstructed justice, and abused the power of his office. The Constitution of the United States empowers the House of Representatives to impeach public officials who engage in ``treason, bribery, or other high crimes and misdemeanors.'' Impeachment is not a punishment. It is a process established by the Constitution to protect our democracy and preserve the rule of law. Historical writings on impeachment clearly define its role as a democratic safeguard. In Federalist Paper Number Sixty-Five, Alexander Hamilton wrote that a President may be impeached for ``offenses which proceed from the misconduct of public men, or in other words, from the abuse of violation of some public trust.'' James Madison explained the impeachment power at the 1787 Constitutional Convention by stating that ``some provision should be made for defending the community against the incapacity, negligence, or perfidy of the chief magistrate.'' Our government is founded on the simple premise that ``all men are created equal.'' Equal justice under the law is more than a slogan. It is the bedrock principle that supports our democracy. It is too important to set aside simply to avoid unpleasant or inconvenient consequences. Our President violated the public trust. His offenses arose from reckless personal misconduct, but they were very clearly public in nature. Perjury, obstruction of justice, and abuse of power can hardly be described as ``private conduct.'' We do not have the option of simply ``forgiving'' the President's unlawful behavior. Failure to hold the President accountable for his actions would seriously undermine the rule of law. Under these circumstances, the Constitution compels us to follow the impeachment process to its conclusion. I want to believe my President. I cannot. I hoped he would keep his promises to have ``the most ethical administration in history.'' He did not. I want to accept his explanation that he did not lie under oath, commit perjury, obstruct justice, or abuse the power of his office. However, his actions and comments over the past eleven months have shaken my confidence in his ability to distinguish truth from fiction. ``If you can't convince them, confuse them,'' President Harry Truman once quipped. Like many Americans, I have been confused by the President's denials, admissions, declarations, and ``apologies'' over the past year. I have no doubt, however, that the President has engaged in a clear and calculated pattern of deception. On January twenty-sixth, the President wagged his finger at the American people and said: ``I did not have sexual relations with that woman, Ms. Lewinsky.'' On August seventeeth, the President stared us in the eye and said: ``I did have a relationship with Ms. Lewinsky that was not appropriate.'' Last weekend, the President again took to the airwaives to state that he ``could not admit to doing something that I am quite sure I did not do.'' He said all he can do now is ``the work of the American people.'' I disagree. He can tell ``the truth, the whole truth, and nothing but the truth.'' He swore to do so in the Paula Jones civil deposition and in his federal grand jury testimony. The evidence demonstrates, however, that he knowingly lied under oath. While President Clinton claims to be remorseful, he continues to ignore the evidence and to deny his unlawful actions. His reliance on legalisms and abrsurd grammatical constructions is an insult to the common sense of the American people. The President's defense was similarly unconvincing. Instead of refuting the Independent Counsel's charges, the President's lawyers claimed that his transgressions do not rise to the level of impeachable offenses. I believe they do, and the Constitution directs Congress to make that determination. The President's lawyers argued that his conduct, even if admitted, would never result in criminal prosecution. However, constitutional scholar Bruce Fein summarized studies of impeachment by concluding that ``impeachable offenses were envisioned as political crimes against the nation, which might or might not be indictable under the criminal code.'' I believe the weight of the evidence is overwhelming. It leads me to conclude that the President committed perjury, obstructed justice, and abused the power of his office. He committed impeachable offenses by breaking the very laws he twice swore to ``preserve, protect, and defend.'' He knowingly subverted the judicial process and intentionally deceived the courts, federal officials, his friends and family, and the American people. As our nation's senior law enforcement official, the President must be held responsible for his actions. Perjury undermines the rule of law. It cannot be overlooked or ignored. Over one hundred people are currently incarcerated in federal prisons for committing perjury in civil cases. How can we demand responsibility from them while judging the President by a different standard? The answer, of course, is that we cannot. The integrity of the presidency must always take priority over the self-interests of the current occupant of that office. Former Supreme Court Justice Felix Frankfurter wrote in 1946 that ``If one man can be allowed to determine for himself what is law, every man can. That means first chaos, then tyranny. Legal process is an essential part of the democratic process.'' Mr. Speaker, failing to hold the President accountable for his actions would create a dangerous double standard. To borrow a phrase from George Orwell's novel Animal Farm, we would be establishing the principle that some Americans are ``more equal than others.'' This is one of the most difficult decisions I have ever made, or will ever make. Throughout this process, my constituents made impassioned arguments both for and against impeachment. I spoke with many local residents who offered their heartfelt opinions on how to resolve this matter. In the final analysis, however, I alone must make this momentous decision. After carefully reviewing all of the available evidence and legal precedents, and after much soul-searching, I have decided to support the constitutionally prescribed remedy of impeachment. Webster's Dictionary defines the term ``impeach'' as follows: ``to bring an accusation against; to charge with a crime or misdemeanor; and to charge . . . with misconduct in office.'' The evidence demonstrates that the President must be charged with perjury, obstruction of justice, and abusing the power of his office. He has exhibited gross misconduct in office. He should now be held accountable for his actions and stand before the Senate in judgment. When I was sworn in as a member of the House of Representatives, I took a solemn oath to ``support and defend the Constitution of the United States against all enemies, foreign and domestic . . .'' I am confident that history will judge my vote to impeach the President as one borne not from malice, but out of love for my country, and in defense of my sworn oath.

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, I would like to provide additional background information on Congress' intent and understanding regarding section IX of the Labor, Health and Human Services, and Education provisions which may be cited as the ``Women's Health and Cancer Rights Act of 1998.'' Title IX of this legislation contains the ``Women's Health and Cancer Rights Act of 1998.'' This legislation, which requires coverage for reconstructive surgery following mastectomies, creates two new Sections in the Public Health Service Act--section 2706 which applies the requirement to health insurance issuers providing insurance coverage in connection with group health plans; and section 2752 which applies the same requirement to health insurance coverage offered by a health insurance issuer in the individual market. Section 2706 requires a health insurance insurer providing health insurance coverage in connection with a group health plan, that provides medical and surgical benefits with respect to a mastectomy to include in their scope of coverage: (1) all stages of reconstruction of the breast on which the mastectomy has been performed; (2) surgery and reconstruction of the breast to produce a symmetrical appearance; and (3) prostheses and physical complication of mastectomy, including lymphedemas, in a manner determined under the terms of the plan or health insurance coverage in consultation with the attending physician and patient. Section 2752 requires a health insurance insurer in the individual market that provides medical and surgical benefits with respect to a mastectomy to include in their scope of coverage: (1) all stages of reconstruction of the breast on which the mastectomy has been performed; (2) surgery and reconstruction of the breast to produce a symmetrical appearance; and (3) prostheses and physical complications of mastectomy, including lymphedemas, in a manner determined under the terms of the plan or health insurance coverage in consultation with the attending physician and patient. Additionally, since the act is effective with respect to plan years beginning on or after the date of enactment, it is expected that the Departments administering the act shall follow procedures under which no enforcement action will be taken with respect to a violation of a requirement imposed by the act on a plan or health insurance issuer before the date of issuance of final regulations, if the plan or health insurance insurers has sought to comply with the act in good faith. It is also the congressional intent that the agencies involved in issuing regulations will follow the same procedures under HIPPA as found in section 104 of the act.

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, I thank the gentleman for yielding to me and for those kind remarks. Mr. Speaker, Congress had a tremendous opportunity this year to expand health care access to the uninsured as well as to the insured and, at the same time, provide better protections for the patients of managed care providers. Earlier this year the House completed its job and passed health care, health reform legislation. Unfortunately, the Senate was not able to debate and approve a similar bill. I am deeply disappointed by the fact that the Congress was unable to work in a bipartisan fashion and reach agreement in this very important issue, and I honestly feel let down because many days and hours, early and late, would have gone for naught because many needed patient protection reforms would not be available for patients. This situation, Mr. Speaker, we are in today is similar to what we went through in 1994. At that time we had the Rowland-Bilirakis health bill sidetracked by the then Democratic majority leadership because the large number of cosponsors from both parties meant sure passage, sure passage if the bill had been allowed to come to the floor. A couple of years later, many of the same provisions, I would say most of the same provisions, were contained in the Kassebaum-Kennedy bill which was enacted into law, but the American people would have had those reforms available to them 2 years earlier under the aforementioned Rowland- Bilirakis bill. As our task force worked on the Patient Protection Act, I believed it was necessary to include provisions on health access to the uninsured as well as those who are insured. After all, we have to ask ourselves what good is insurance if one does not have access to basic medical care? Both expanded care for the uninsured and increased patient protections were accomplished, as others have already said I think, in the Patient Protection Act without, without imposing burdensome government mandates. One principle way our bill expanded health access was by broadening the role of community health centers. Currently there are 42 million uninsured individuals in the United States. Our bill made it easier for community health centers to offer health care to those in medically underserved areas. H.R. 4250 would have saved money because patients would have used more efficient forms of care. The bill also created community health organizations which are managed care plans controlled by community health centers. H.R. 4250 eliminated state requirements preventing community health organizations from participating in the health market. H.R. 4250 also encouraged more competition in order to lower prices for health consumers. Community health centers would have had more money because they would have had more private paying patients using their facilities, and, as a result, these health centers would have provided care to even more uninsured people. In addition, the Patient Protection Act also created important new safeguards which have been mentioned previously and gave patients greater access to high quality health care. The bill included a provision that enabled employers to pull together in health marts, a voluntary choice market where small employers could have obtained low cost and high quality coverage through the fully insured market. Of course the Patient Protection Act also included, as we have already said so many times, important new patient protections. For months people across the country told Congress that they wanted to choose their own doctors. Well, we listened to our constituents. In fact, through our bill patients were guaranteed their choice of medical providers. We also made it easier for patients to determine what their health plans covered. People would have actually understood their health care policies because descriptions would have been written in plain English. Mr. Speaker, again Congress had a great opportunity to follow through with its commitment to reform health care in our country, and I challenge those that support patient rights to put people ahead of politics and agree to work with us instead of against us. Next year we must continue our fight for the uninsured. They deserve access to health insurance, and we will not stop until we achieve this goal, and in addition we must help those who want to choose their own doctors instead of allowing their insurance companies to choose their doctors for them. People want their personal health evaluated by someone who they can trust, and I feel it is our responsibility as Members of Congress to move forward in order to make this goal a reality for all Americans. And finally, Mr. Speaker, I want to personally thank both you and Congressman Denny Hastert and of course all of the members of the task force with whom it was such a pleasure to work for their leadership in this issue. Both of you, both the Speaker and Mr. Hastert, have done a tremendous job in bringing health reform before the House of Representatives this year. I will continue to be supportive of your efforts during the 106th Congress.

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, this important legislation will improve the supply and distribution of health professionals nationwide. It also focuses, as has been so ably explained already, much needed attention on the training of caregivers for our Nation's underserved communities. For three decades the Public Health Service Act has played an important role in funding the training of America's health professionals. As chairman of the Subcommittee on Health and Environment of the Committee on Commerce, I am proud of our bipartisan efforts in support of these very critical education programs. The challenge we face today is ensuring that the providers we train are prepared to meet the diverse needs of America's many different communities, and that is why this act replaces line items with clusters, as the gentleman from Virginia (Mr. Bliley) has already explained, to better match resources with needs. This has not been an easy outcome to achieve. I would like to take a moment to thank all of those who have dedicated their time and energy to help us get here today. In particular I would like to commend the members of America's nursing community. After bringing concerns they had, and, God knows they did have concerns, with the Senate-passed bill to our attention, the community as a whole worked together to help us reach consensus. S. 1754, as amended, represents that consensus, Mr. Speaker, and, again, I am grateful for their efforts and, of course, those of the gentleman from Virginia (Chairman Bliley), the gentleman from Michigan (Mr. Dingell) and the gentleman from Ohio (Mr. Brown), and I also want to acknowledge, as the gentleman from Ohio (Mr. Brown) was so very kind to do, the hard work of our committee staffs on both sides of the aisle working in a bipartisan basis. They were able to draft language that enjoys the support of the entire public health community. I urge passage of S. 1754, as amended.

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, I reserve the balance of my time.

Mr. BILIRAKIS. Mr. Speaker, how much time do we have remaining?

Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may consume. I would like to close strongly recommending an aye vote on this legislation. It is really the result of a work in progress over a period of time. We have recognized other Members who have introduced pieces of legislation which we have incorporated in so many words into this piece of legislation. And certainly my gratitude to Senator Frist was mentioned. He has been very, very cooperative. We have worked with him for quite some time on this. His staff, the gentleman from Virginia (Mr. Bliley), the majority committee staff, the gentleman from Michigan (Mr. Dingell) and the gentleman from Ohio (Mr. Brown) and their fine staff over there. We were able to show what can be done, another illustration of what can be done when Members are willing to sit around the table and work in a bipartisan fashion.

Mr. BILIRAKIS. Mr. Speaker, I would say that not only talking about the scientific community, but certainly the gentleman's knowledge on these areas certainly greatly exceeds that of ours, and I have no reason to dispute what the gentleman says. I have already indicated that what we try to do with this legislation was try to work it out with the other body, with the other side, so that we could have a piece of legislation which would be a good piece of legislation, but certainly far from perfect. So having said all of that, I assure the gentleman that we will address those issues in the next Congress.

Mr. BILIRAKIS. Mr. Speaker, will the gentleman yield?

Mr. BILIRAKIS. Mr. Speaker, I yield 3 minutes to the gentleman from Pennsylvania (Mr. Fox).

Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in strong support of S. 1722, the Women's Health Research and Prevention Amendments of 1998. This legislation will revise and extend a number of important women's health research and prevention programs at the National Institutes of Health and the Centers for Disease Control and Prevention. Earlier this month, Mr. Speaker, I introduced the House companion measure, H.R. 4683, with the gentleman from Virginia (Chairman Bliley), the chairman of the Committee on Commerce. Both S. 1722 and the House bill enjoy strong bipartisan support, including members of the leadership and the chairman and ranking members of the committees of jurisdiction. The American Cancer Society and the American Heart Association have also endorsed this legislation. In a recent letter, the Secretary of Health and Human Resources expressed the administration's support for passage of the bill. Secretary Shalala stated, ``The research, prevention and health promotion activities that would be reauthorized are critical to the health and well-being of the Nation's women.'' While noting that the bill does not include some of the administration's legislative proposals on women's health, the Secretary concluded that ``extension of the vital efforts that are addressed in the bill should not be delayed.'' Mr. Speaker, both the NIH and the CDC play critical roles in efforts to improve women's health through research, screening, prevention, treatment, education and data collection. S. 1722 reauthorizes programs at the NIH for vital research into the causes, prevention and treatment of some of the major diseases affecting women, including osteoporosis, breast and ovarian cancer and for research into the aging processes of women. In addition, the bill authorizes a new research program at the National Heart, Lung and Blood Institute to target heart attacks, strokes and other cardiovascular diseases in women, and this program will advance research into cardiovascular disease, which is the leading cause of death in women. In fact, one in ten American women between the ages of 45 and 64 has some form of heart disease, and this increases to one in five women over 65. According to the American Heart Association, more than 500,000 American women die of cardiovascular diseases each year. NIH data indicates that 1.6 million women have had a stroke and 90,000 women die of strokes each year. In the past, the medical community has focused on men in research, treatment and counseling for heart disease and stroke. Clearly we need to do more to prevent and treat these diseases in women. S. 1722 also reauthorizes several major programs at the CDC for prevention and education activities in women's health issues. These include the National Center for Health Statistics, the National Program of Cancer Registries, the National Breast and Cervical Cancer Early Detection Program, and the Centers for Research and Demonstration of Health Promotion and Disease Prevention. It is particularly important that we reauthorize these programs this year, Mr. Speaker. While funding is currently available, the CDC relies on its statutory authorization for certain critical activities. For example, the National Center on Health Statistics relies on its legal authority to ensure complete privacy of the data collected. Without this authority, the center's ability to collect the data is threatened. The Congressional Budget Office has issued a preliminary estimate of the bill's cost, which totals $5.1 billion over five years. However, and it is important to realize this, all of the spending authorized in this bill is discretionary, subject to appropriation. The bill reauthorizes programs that are already funded, already funded, with the exception of the new cardiovascular disease program. However, NIH is currently conducting research in this area and the new cardiovascular research program will expand and coordinate those efforts. Mr. Speaker, we have worked very, very hard to develop legislation that enjoys strong bipartisan support. The bill does not purport to address every woman's health concern, and there is clearly more work ahead for our committee. To avoid unnecessary controversy and to speed reauthorization of these important programs, however, it was necessary to maintain a consensus-based approach in developing the bill. The legislation also represents the work product of several Members. Mr. Speaker, I want to take a moment to acknowledge their contributions. Section 101, which establishes a national education and research program regarding the drug DES, is modeled on legislation introduced by the gentlewoman from New York (Ms. Slaughter). Section 104, which promotes research related to cardiovascular diseases in women, is similar to provisions of H.R. 2130 introduced by the gentlewoman from California (Ms. Waters). I also want to recognize the efforts of the gentleman from New York (Mr. Lazio) to promote access to treatment for patients screened under the CDC's National Breast and Cervical Cancer Early Detection Program. At the urging of the gentleman from New York (Mr. Lazio) and the American Cancer Society, provisions were added to section 203 of the bill to emphasize the importance of case management services. This language recognizes the critical role of case managers in assisting breast cancer patients in obtaining access to treatment. Mr. Speaker, I believe the Congress must play an active role in promoting women's health research and prevention efforts. I am particularly proud of the Committee on Commerce's role this year in reauthorizing the Mammography Quality Standards Act, which ensures safe and accurate mammography services for women. The measure before us today reauthorizes a number of other critical women's health programs, and I urge all Members to join me in supporting passage of this important legislation. Mr. Speaker, I reserve the balance of my time.

Mr. BILIRAKIS. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and include extraneous material on S. 1722.

Mr. BILIRAKIS. Mr. Speaker, I move to suspend the rules and pass the Senate bill (S. 1722) to amend the Public Health Service Act to revise and extend certain program with respect to women's health research and prevention activities at the National Institutes of Health and the Centers for Disease Control and Prevention.

Mr. BILIRAKIS. Mr. Speaker, I yield 4 minutes to the gentlewoman from Maryland (Mrs. Morella).

Mr. BILIRAKIS. Mr. Speaker, I yield 4 minutes to the gentleman from Oklahoma (Mr. Coburn).

Mr. BILIRAKIS. Mr. Speaker, on that I demand the yeas and nays.

Mr. BILIRAKIS. Mr. Speaker, I yield back the balance of my time.

Mr. BILIRAKIS. Mr. Speaker, I yield 2 minutes to the gentleman from Pennsylvania (Mr. Fox).

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, today the House of Representatives approved H. Res. 565, a resolution emphasizing the importance of mammograms and biopsies in the fight against breast cancer. Since October is ``National Breast Cancer Awareness Month,'' it is particularly appropriate that the House passed this resolution before adjournment. Last month, I was proud to work with Chairman Bliley to secure approval by the House of Representatives of H.R. 4382, legislation to reauthorize the Mammography Quality Standards Act. This important law was enacted in 1992 to improve the quality of breast cancer screening exams by establishing national standards for mammography facilities. Without question, it has been an overwhelming success. Screening mammography is currently the most effective technique for early detection of breast cancer. This procedure can identify small tumors and breast abnormalities up to two years before they can be detected by touch. More than 90 percent of these early stage cancers can be cured, according to the Food and Drug Administration. The use of screening mammography provides a ray of hope in the fight against breast cancer. Early detection of breast cancer through accurate and reliable mammograms can spare women from undergoing radical surgery--and often save their lives. Enactment of H.R. 4382 will help reduce the threat of breast cancer by providing women the tools they need to detect this terrible disease in its early stages. As chairman of the Health and Environment Subcommittee, however, I believe the federal government can and should do more to support cancer research. Specifically, I support an increased financial commitment to fund the biomedical research necessary to find a cure for breast cancer. To that end, I have endorsed a proposal to double Federal funding for the National Institutes of Health over the next five years. I have also authored legislation to allow taxpayers to designate a portion of any income tax refund to support NIH research efforts. For the hundreds of thousands of patients, families, caregivers and friends whose lives have been touched by breast cancer, we must renew and strengthen our commitment to ending this terrible disease. H. Res. 565 places appropriate emphasis on the importance of mammograms and biopsies in the fight against breast cancer, and I urge Members to support this resolution.

Mr. BILIRAKIS

Mr. BILIRAKIS. Mr. Speaker, I yield 2 minutes to the gentleman from Oklahoma (Mr. Coburn).

Mr. BILIRAKIS. Mr. Speaker, I yield 1 minute to the gentleman from New York (Mr. Lazio), another member of the subcommittee.