Barbara Mikulski

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, my amendment, I believe, is far superior to the amendment the Senate just adopted. It is a simple, straightforward amendment. It exempts from the bill all cases related to those committed by the despicable predators John Malvo and John Muhammad. This is a very specific, very limited exemption. I urge the Senators to consider it. If we really want to honor the victims of the sniper cases, please give them the opportunity to pursue their cases in court. We have a substantial legal opinion from an eminent scholar such as Lloyd Cutler, who says if this bill passes, and passes with Frist-Craig, the victims' cases will be thrown out of court absolutely or, at the very least, be left in great ambiguity. Please, let us do justice to the victims and at least give them the opportunity to seek justice.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I oppose S. 2061, the Healthy Mothers and Healthy Babies Access to Care Act. It should be called the ``Insurance Companies First Act.'' This is extreme legislation that puts the interests of the insurance industry ahead of the interests of women, their families and their doctors. It applies only to women seeking obstetrics and gynecological services--that's it. Every other patient can recover full damages. But under this bill only women will be limited in what they can recover for a doctor's medical error. This bill penalizes patients, while doing nothing to prevent doctors from being gouged by insurance companies. This bill is legislative malpractice. First of all, the procedure for considering this bill is seriously flawed. The bill was brought to the full Senate without hearings, without consideration by the Judiciary Committee. There was no chance for patients, doctors or others affected by this bill to testify. There was no Committee Report to analyze the effects of the extremely complex and controversial legislation. The result is a bill that targets some of the most serious cases of medical error, restricts the rights of women and infants, while doing too little to protect doctors from the high cost of insurance. It is the same broad brush legislation that we defeated in July, only this time they limit it to obstetrical and gynecological services and by design only restrict the rights of women patients. Proponents of the bill say they wanted to streamline the bill, to address the area of medicine with one of the highest premium rates and they claim that the beneficiaries will be women who will have improved access to health care. But since when has limiting one's rights improved anything? And how does restricting a woman's right to full recovery and only her rights provide her a benefit? The real beneficiaries of this bill are the insurance companies. They get to see their profits soar while mothers who take care of infants who suffer because of medical error will face unfair caps in the remedies they receive. These are often stay at home mothers who need resources to care for their families and their infants who may need constant care, but the cap on non-economic damages will prevent them from getting those resources. It's unfair to penalize these women because they can't recover economic damages. I think the Senate can do better. I oppose this legislation for three reasons: As a Senator from Maryland, I cannot support legislation that gives Marylanders a worse deal. This legislation would override the Maryland law and place a $250,000 cap on non-economic damages. Maryland law strikes an important balance, providing a much higher cap on non- economic damages. The cap increases each year to offset inflation. It started at $500,000 and is now $635,000. It also has no caps on punitive damages. The Maryland law is supported by both physicians and patient advocates. Yet the Republican bill would preempt Maryland law. It would put women and infants in Maryland at a disadvantage. It would severely limit their ability to get relief for the death, physical impairment or disfigurement that they suffer as a result of serious medical error. This legislation shuts the court house door. It denies justice to women and women only. It denies justice to those who must care for a mentally disabled child for his or her whole life because of a doctor's mistake during prenatal or post-natal care. It denies justice to women who needlessly lost a child during delivery because of a serious medical error. It does this by imposing arbitrary caps instead of enabling juries to determine damages. I have faith in juries made up of members of the community to reach a fair verdict. Who would be hurt by this legislation? Someone like the mother from Baltimore whose newborn baby suffered brain damage because an emergency c-section was not performed in time. His mother had gone to the hospital reporting that there was decreased fetal movement. She knew something was wrong. Tests were performed. Yet the doctor misdiagnosed the problem. After several days, an emergency c-section was performed. It was too late. The baby suffered severe brain damage. He died 13 months later. It is impossible to put a price on the loss of a child. Imagine if that death is the result of carelessness. Parents who suffer the unbearable pain of losing a child deserve the right to use the courts to seek full accountability. Instead of penalizing patients, we need legislation to help doctors who are facing skyrocketing insurance costs. A doctor's number one priority is the care of his or her patients. We should make sure that it is easy for them to do so, knocking down the roadblocks to practice that excessive insurance premiums create. S. 2061 won't do that. It won't provide doctors with real relief today. That's why the Senate should consider alternatives such as that proposed by Senator Durbin, which focuses on solving the problems where they start. Senator Durbin addresses the root of the problem, creating greater accountability for doctors through a voluntary error reporting database, economic help for those who face growing premiums, punishment for frivolous lawsuits, grants to provide physicians in areas where malpractice insurance has led to a shortage of doctors, and critically, an end to the immunity that insurance companies face from anti-trust regulations. Yet instead of helping patients and doctors, the Senate is again caught up in a political game. It doesn't have to be this way. We have worked together in the past to pass legislation that helps victims and lowers insurance costs. The terrorism insurance legislation is a prime example. We passed it because there was a national will and the urgency to do something that provided real solutions. Today, we are faced with the same national will. And I urge my colleagues to work toward a sensible compromise. One that does not unfairly target women and their infants. One that addresses all forms of medical error, not just those affecting women and puts the rights of all patients first. The public is demanding that we do something, as more Americans are suffering from serious medical mistakes and more doctors are unable to treat patients because of rising premiums. We now need the political will to help doctors without harming patients. I urge my colleagues to vote no on cloture. We need to send this bill back to the Judiciary Committee for full consideration of the issue of medical liability as well as the impact of limiting women's rights to recovery on their health and well-being and that of their new born infants.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, today I rise to introduce legislation which will help America's families who are fighting to drive drugs and violence out of their communities. The Dawson Family Community Protection Act of 2004 asks the Federal Government to do its fair share by devoting some of its drug fighting resources to communities with high intensity drug trafficking and severe safety concerns. That means dedicating much needed resources to help communities fight the infiltration of drugs and the drug dealers that plague their communities and threaten the safety of their children. This bill is named in memory of a heroic Baltimore family--the Dawsons--whose active role in trying to rid their neighborhood of drugs and violence cost them their lives. Carnell and Angela Dawson lived in the community of Oliver in East Baltimore and raised five children there. Every day Angela, known as ``Angel,'' walked her children to school, she made sure that they only rode their bikes on the sidewalk so they would be safe. Her husband, Carnell, worked hard as a construction worker to provide for his family. Both parents were devoted to their children and wanted to make a better life for them. The house they lived in on the corner of N. Eden Street made Angel nervous. It had too many windows and she was scared that a stray bullet would come in and harm one of her children. The street also worried Angel. There were lots of young teens dealing drugs. She wanted the drugs out of her neighborhood, away from her children and away from all the neighbors' children. She fought every day to make that happen, calling the police when she saw dealers, or violence on her block. She was persistent and the neighbors knew it. They called her a great mother--``someone who stood up for what she believed in.'' Sadly, that persistence and those beliefs cost her and her family their lives. Angel had repeatedly called the police in September of 2002 to report drug activity. Then on October 3--someone threw two Molotov cocktails through the kitchen window of their house--causing a fire but no injuries. They were sending a message. Two weeks later that message was unmistakable as someone broke through their front door and poured gasoline throughout the first floor of their house and lit a match. Within minutes the house was in flames and it was impossible to escape. Although fire fighters arrived almost immediately--they could not save the family. Angel and five of her children had perished and her husband Carnell had jumped from the second story with burns all over his body-- he survived only a week in the hospital. Many in the neighborhood thought it was the final message. The Dawsons are the kind of neighbors we all would want. They cared about the community and wanted to make it better and safer. They represent brave families all over America who are trying to take back their neighborhoods, who have worked with law enforcement and their neighbors to make their communities safer. Too many of these families have had to face threats and retaliation and sadly even murder in their attempt to help their loved ones and neighbors. They work hard, send their kids to school to get an education and play by the rules--yet they live in communities that are unsafe because they are infested with drugs and drug dealers. We need to get assistance to these communities, as they are working hard to make life better, they need the resources of law enforcement and government to make that a reality. We have to help communities that are trying to help themselves, communities that are trying get rid of drugs, rehabilitate and educate drug dealers and most importantly end violence and protect their neighborhood children. That is why today, I join with my colleagues, Senator Sarbanes, Hatch and Biden in introducing this legislation that provides $5 million to high intensity drug traffic areas with severe safety and illegal drug distribution problems--to support communities that are affected by drug trafficking and to encourage their cooperation with local, State and Federal law enforcement officials. These funds also help to protect families that cooperate, families that report crimes and drugs and families that seek to make a difference in their communities. These resources help law enforcement provide witness protection and address safety issues in these communities. The funding only goes to neighborhoods--like the East Baltimore neighborhood that the Dawson's lived in--with severe neighborhood safety and illegal drug distribution problems. For these communities it's time for the Federal Government to step up and do more, especially when average citizens put their lives on the line every day trying to stop the violence and crime that comes when the illegal drug trade invades their neighborhoods. This bill will give citizens and law enforcement the tools they need to make sure the community is safe and those doing the reporting are protected. In honor of the Dawson family, I ask my colleagues to support this important legislation. I ask unanimous consent that the text of the bill be printed in the Record.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, today I rise to introduce legislation which will help America's families who are fighting to drive drugs and violence out of their communities. The Dawson Family Community Protection Act of 2004 asks the Federal Government to do its fair share by devoting some of its drug fighting resources to communities with high intensity drug trafficking and severe safety concerns. That means dedicating much needed resources to help communities fight the infiltration of drugs and the drug dealers that plague their communities and threaten the safety of their children. This bill is named in memory of a heroic Baltimore family--the Dawsons--whose active role in trying to rid their neighborhood of drugs and violence cost them their lives. Carnell and Angela Dawson lived in the community of Oliver in East Baltimore and raised five children there. Every day Angela, known as ``Angel,'' walked her children to school, she made sure that they only rode their bikes on the sidewalk so they would be safe. Her husband, Carnell, worked hard as a construction worker to provide for his family. Both parents were devoted to their children and wanted to make a better life for them. The house they lived in on the corner of N. Eden Street made Angel nervous. It had too many windows and she was scared that a stray bullet would come in and harm one of her children. The street also worried Angel. There were lots of young teens dealing drugs. She wanted the drugs out of her neighborhood, away from her children and away from all the neighbors' children. She fought every day to make that happen, calling the police when she saw dealers, or violence on her block. She was persistent and the neighbors knew it. They called her a great mother--``someone who stood up for what she believed in.'' Sadly, that persistence and those beliefs cost her and her family their lives. Angel had repeatedly called the police in September of 2002 to report drug activity. Then on October 3--someone threw two Molotov cocktails through the kitchen window of their house--causing a fire but no injuries. They were sending a message. Two weeks later that message was unmistakable as someone broke through their front door and poured gasoline throughout the first floor of their house and lit a match. Within minutes the house was in flames and it was impossible to escape. Although fire fighters arrived almost immediately--they could not save the family. Angel and five of her children had perished and her husband Carnell had jumped from the second story with burns all over his body-- he survived only a week in the hospital. Many in the neighborhood thought it was the final message. The Dawsons are the kind of neighbors we all would want. They cared about the community and wanted to make it better and safer. They represent brave families all over America who are trying to take back their neighborhoods, who have worked with law enforcement and their neighbors to make their communities safer. Too many of these families have had to face threats and retaliation and sadly even murder in their attempt to help their loved ones and neighbors. They work hard, send their kids to school to get an education and play by the rules--yet they live in communities that are unsafe because they are infested with drugs and drug dealers. We need to get assistance to these communities, as they are working hard to make life better, they need the resources of law enforcement and government to make that a reality. We have to help communities that are trying to help themselves, communities that are trying get rid of drugs, rehabilitate and educate drug dealers and most importantly end violence and protect their neighborhood children. That is why today, I join with my colleagues, Senator Sarbanes, Hatch and Biden in introducing this legislation that provides $5 million to high intensity drug traffic areas with severe safety and illegal drug distribution problems--to support communities that are affected by drug trafficking and to encourage their cooperation with local, State and Federal law enforcement officials. These funds also help to protect families that cooperate, families that report crimes and drugs and families that seek to make a difference in their communities. These resources help law enforcement provide witness protection and address safety issues in these communities. The funding only goes to neighborhoods--like the East Baltimore neighborhood that the Dawson's lived in--with severe neighborhood safety and illegal drug distribution problems. For these communities it's time for the Federal Government to step up and do more, especially when average citizens put their lives on the line every day trying to stop the violence and crime that comes when the illegal drug trade invades their neighborhoods. This bill will give citizens and law enforcement the tools they need to make sure the community is safe and those doing the reporting are protected. In honor of the Dawson family, I ask my colleagues to support this important legislation. I ask unanimous consent that the text of the bill be printed in the Record.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I am pleased that today the Senate will pass the Mammography Quality Standards Reauthorization Act of 2003, S. 1879. I am pleased to be sponsoring this bill with Senator Ensign and our bipartisan cosponsors. This important bill is about saving lives. That's what the Mammography Quality Standards Act (MQSA) does. Accurate mammograms detect breast cancer early, so women can get treatment and be survivors. Mammography is not perfect, but it is the best screening tool we have now. I authored MQSA over 10 years ago to improve the quality of mammograms so that they are safe and accurate. Before MQSA became law, there was an uneven and conflicting patchwork of standards for mammography in this country. There were no national quality standards for personnel or equipment. Image quality of mammograms and patient exposure to radiation levels varied widely. The quality of mammography equipment was poor. Physicians and technologists were poorly trained. Inspections were lacking. MQSA set Federal safety and quality assurance standards for mammography facilities for: personnel, including doctors who interpret mammograms; equipment; and operating procedures. By creating national standards, Congress helped make mammograms a more reliable tool for detecting breast cancer. In 1998, Congress improved MQSA by giving information on test results directly to the women being tested, so no woman falls through the cracks because she never learns about a suspicious finding on her mammogram. Now it is time to renew MQSA and lay the foundation to strengthen it even further. The bill passed by the Senate today will extend MQSA for 2-years. This 2-year reauthorization of MQSA is important. It will give Congress an opportunity to consider in the next reauthorization expert recommendations from an Institute of Medicine, IOM, study and a General Accounting Office, GAO, report on several issues related to MQSA. I have been working with the Labor, Health and Human Services, HHS, and Education Appropriations Subcommittee to get these studies underway. The IOM study was included in the fiscal year 2004 omnibus appropriations bill. The HELP Committee also heard testimony in support of a 2 year reauthorization at its hearing last year on MQSA. This legislation is also supported by groups including the American Cancer Society, the Susan G. Komen Breast Cancer Foundation, the National Alliance of Breast Cancer Organizations, Y-ME National Breast Cancer Organization, and the American College of Radiology Association. I thank Senators Gregg and Kennedy for their support and help in moving this legislation through the Senate. I hope that the House will move quickly to pass this important bill. It is estimated that over 217,400 new cases of breast cancer will be diagnosed and over 40,500 breast cancer deaths will occur in the United States this year. Early detection and treatment are important to reducing breast cancer deaths. Congress should pass this bill to reauthorize MQSA and extend this valuable program that helps save the lives of women and men with breast cancer.

Ms. MIKULSKI

Ms. MIKULSKI. I thank the Senator, who, like me, is a strong supporter of the International Fund for Ireland. As the Senator from Vermont knows, peace and reconciliation efforts in Northern Ireland, under the Good Friday Agreement, will be assisted by efforts to build community institutions that promote tolerance and cooperation at the local level. I very much appreciate IFI's investment in these types of programs in Northern Ireland and the border counties of Ireland. I want to particularly commend IFI for the grant awarded to the Community Foundation for Northern Ireland, formerly the Northern Ireland Voluntary Trust. I would urge IFI, where appropriate, to increase its investment in these community-building efforts, as they are an important complement to IFI's economic development efforts.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I voted to continue debate on the Omnibus because I believe we need to explore alternatives. Let me be clear: I want this bill to pass. I am proud of the work we did on the VA-HUD subcommittee to help our veterans, protect our environment, rebuild our communities, but I believe we need to pause. We need to take a break and problem solve. There should be an alternative between passing an Omnibus that contains terrible provisions and a one year continuing resolution that would underfund so many of our priorities. There must be a way to compromise and go back to the original seven appropriations bills, negotiated on a bipartisan basis, before provisions were added in the dead of night, outside the usual and customary conference procedures. The Omnibus includes critical funding for our Nation's veterans. Working on a bipartisan basis, Senator Kit Bond and I increased funding for VA health care by $1.5 billion over the President's request. We said no to the administration's proposal to charge our veterans a $250 membership fee for their healthcare. We said no to higher deductibles and co-payments. With record numbers of veterans seeking medical care through VA, with soldiers returning from Iraq and Afghanistan, we have a duty and responsibility to care for them. Promises made must be promises kept. The Omnibus funding bill allows us to keep our promise. The Omnibus also includes increased funding for AmeriCorps--$444 million--an increase of $170 million over last year the highest funding level ever. With this funding, more volunteers will serve our communities teaching in our schools, tutoring and mentoring our children, rebuilding neighborhoods, restoring parks, all while earning money to help pay for college, and learning the habits of the heart that make a difference for America. The Omnibus adds $500 million for the Clean Water revolving loan fund, and another $6 million to improve water and sewer infrastructure that directly helps clean up the Chesapeake Bay. Let me tell my colleagues what this means in my State of Maryland. The Chesapeake Bay is part of our heritage. It also source of jobs from the watermen to the restaurant owner. Yet the President's budget cut funds for this critical infrastructure program. That's why I fought to provide $1.35 billion for water and sewer construction. This funding means a cleaner Chesapeake Bay and new jobs right away-- high paying construction jobs that will put people back to work clean our environment and prevent cost shifting to our local communities. We have a chronic shortage of nurses in America. This bill contains a $30 million increase for the Nurse Reinvestment Act--legislation I wrote that provides scholarships to nursing students in exchange for 2- years of service in areas that need nurses most. The Omnibus increases funding for special education by $1.2 billion. This is an important step toward the Federal Government fulfilling its obligations. When IDEA first became law, the federal government promised to pay 40 percent of the cost. But Federal funding has never topped 17 percent that means local districts must make up the difference by skimping on special ed, by cutting from other education programs, or by raising taxes. I do not want to force States and local school districts to forage for funds, cut back on teacher training, or delay school repairs. We need to make up the difference and help relieve a crushing financial burden on local school districts. I fought hard to improve this bill to meet the day to day needs of Marylanders and the long range needs of our Nation. So why do I want to pause--before we pass it? Because we can do better. I want time to discuss and explore alternatives to provisions that were added in the dead of night and that cause real problems. I believe the best social program is a job. You should be paid if you work. You should be paid overtime if you work overtime. Yet the Omnibus allows the administration to gut overtime protections for 8 million American workers. The Bush proposal means workers will have to work long hours for less money. It hurts nurses, police officers, fire fighters who are already stretched to the limit. This provision hurts working families struggling to make ends meet. The Senate voted to block this provision. The House supported our efforts. But then, in the dead of night, the administration strong-armed conferees to strip our protections out of the bill. The administration should not be able to overturn the will of Congress without debate and without a vote. The administration did the same thing to federal employees--twisting arms and going outside the usual and customary process to push an anti-worker agenda. The White House has a plan to contract out as many federal jobs as possible. It is a political agenda, masquerading as management reform. The Administration's plan for privatization costs money, costs morale, and costs the integrity of the civil service. They have changed the rules to favor their contractor cronies, and now they have violated the democratic process. They know they do not have support in Congress or from the American public for their privatization agenda. So they are using bully boy tactics and back room politics to bypass Congress and overturn a bipartisan compromise. Let me tell my colleagues, what happened. During an appropriations conference, the House and Senate agreed to a bipartisan compromise that fixed some of the problems with OMB's new unfair contracting out rules but still recognized the importance of competition. The compromise did not fix every problem. And it did not stop contracting out. But I supported it because it was fair, and I thought it was a good start. My Republican colleagues supported it. And the White House supported it as well. Yet now, the White House has gone back on the deal. They slipped a provision into the Omnibus spending bill that guts the bipartisan compromise and leaves us with meaningless ``improvements'' This is disgraceful. The contracting out provisions in the Omnibus roll back workers' rights--the right to appeal a contracting out decision, the right to competitively bid on their own jobs. It even rolls back the requirement that contractors have to save money. That is not what we agreed to in a bipartisan, bicameral compromise. We had an agreement that these three things were important. But OMB did not like it, because it would have given workers a fair shot. Our country faces a new threat--the threat that mad cow disease will contaminate our food supply. But, instead of taking this seriously, and doing everything possible to keep our food supply safe, the administration pushed to delay the country-of-origin labeling for meat products, overriding the will of the Senate. Labeling of meat and meat products was supposed to go into effect this year, based on provisions in the 2002 Farm Bill. With this labeling, consumers could make an informed decision about what they purchased and what to feed their families. Even with the first case of mad cow in the United States, administration will not back down from protecting its special interests friends. They made sure the Omnibus kept language delaying implementation of labeling for 2 years. The Omnibus also rolls back existing gun laws and ties the hands of law enforcement. The Brady law requires that gun records be held for 90 days, yet this bill allows Government to destroy records after only 24 hours. These records are kept for a reason--to help law enforcement track down weapons used in a crime, and to keep law breakers from buying guns. The rollback provision also blocks the public from seeing critical information, even if they were the victim of a gun crime. If these rollbacks were in place last year, families of the DC sniper victims would not be allowed to know where the sniper got his gun and the questionable practices of the gun shop. Without this information, they would effectively be denied their day in court. These provisions were not raised in the Senate. They should not be forced through in an omnibus. I voted against cloture so the Senate has more time to discuss these important issues and explore the alternatives. The American people deserve our best effort, not an omnibus rushed through in a single day. There are serious problems with this bill--problems largely created by an administration that runs rough-shod over the democratic process and the will of Congress. I am volcanic about how the final version of this bill was written. As a member of the Appropriation Committee, I know first-hand the hard work and honest effort at bipartsanship went into the 7 appropriations bills. All that went out the window once the administration forced itself into the room. The underlying bill is a good bill that does a lot of good things. We need to find a way to get back to those things and move forward for the good of America.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise to pay tribute to the life and legacy of Julie Ellis LeMoult, an extraordinary young woman from Bethesda, MD. This past spring, Julie Ellis LeMoult, loyal, compassionate, understanding and forgiving friend passed away far too early at the age of 28. Her death has dimmed the light of all who knew her: her husband, Chris LeMoult; her parents, Bruce and Donna Ellis; her sisters, Sheri DeLorenzo, Andrea Lynch and Christiane Ellis, and her many, many friends in Bethesda and all across the country. Julie is irreplaceable. She dedicated her short life to maintaining and exalting humankind by paying tribute to each person's individual gifts. Above all, Julie was always selfless and strived to draw on and draw out the best in everyone she met. The third of four children and the daughter of an entrepreneur who catered to kings, queens, presidents, diplomats, charitable causes and private social functions, Julie was raised in Bethesda, MD and attend Georgetown Visitation Preparatory School. In December 1996, Julie graduated from Ohio Wesleyan University where she received a business degree in 3\1/2\ years while playing lacrosse. She excelled in her academics through fortitude and perseverance, overcoming a childhood struggle with dyslexia. Her self-esteem remained intact because of her athletic abilities, providing her swimming, diving, basketball, softball and lacrosse teams with the highest excellence of leadership and sportsmanship. Julie's stride and form as a runner exhibited her most memorable style of athletic grace. In 1997, Julie worked for Hambrecht and Quist in San Francisco before returning to Maryland to join Discovery Communications where she was an invaluable member of its corporate affairs and communications department. As an adult, Julie became a knowledgeable resource for many people experiencing panic and anxiety disorders and was able to recommend The Ross Center of Washington, DC, and the Midwest Center for Anxiety, Stress and Depression to those who sought her counsel. Julie Katherine Ellis married Christopher M. LeMoult of Cape Code, MA, in September 2001. She delivered their baby boy, Logan Donnelly, in April 2003. Her life as a mother allowed her to be with her son for only 8 hours before unknown complications took her life. In addition to her beautiful smile and peaceful nature, Julie's greatest legacies are her son Logan and her ability to open up her heart unconditionally to family, friends, acquaintances and strangers alike in the hope of making their lives better while expecting nothing in return. The sorrow over Julie's loss is accompanied by the abundance of joy that exists in the memories her family and friends share, her life that they celebrate and her love that will live on. At Thanksgiving and always, Julie's parents, sisters, husband, son, family, friends and colleagues are grateful for the brilliance of her life. Julie Ellis LeMoult will never be forgotten.

Ms. MIKULSKI

Ms. MIKULSKI. Good morning, Mr. President. I ask unanimous consent to use such time as necessary to complete my statement.

Ms. MIKULSKI. Mr. President, this was a day I had always looked forward to, a day where the Senate would be voting on a prescription drug benefit. I have devoted my life to the advocacy of senior citizens and to standing up for ordinary people to make sure they could make sure that government was on their side when they needed it, when they were at risk. But today I come to this vote with indeed a heavy heart. The bill the Senate is voting on today is a hollow promise for a prescription drug benefit for seniors. This bill talks big but delivers small. It promises prescription drugs to seniors yet it will create a skimpy benefit for the middle class, cause 2.7 million seniors who already have drug coverage from their employer to lose their coverage, set up the stage to force seniors into HMOs which means seniors could lose the doctors of their own choosing, provides lavish subsidies to insurance companies, creates tax dodges for those making over $250,000, while doing absolutely nothing to stop the soaring cost of prescription drugs. When I voted for a bill in June, it was a modest but genuine bipartisan effort. I believed it was a start. For years Congress had talked about Medicare. But talk, talk, talk; when all was said and done, more got said than got done. And you can't talk your way out of diabetes; you need insulin. You can't talk your way out of high cholesterol; you need Lipitor. So I thought Congress should move on. But when I voted for the bill, I said that was as far as I would go. I said when the plan came back, if it helped the insurance companies instead of seniors, goodbye to my vote. I said if it increases costs for seniors, say goodbye to my vote. And if it limits benefits, say goodbye to my vote. On all three of these points, this bill falls and fails. I am going to say that people who say this is a first step--well, it is a step in the wrong direction. If you take the wrong step, you can fall flat on your face. Some believe it is the best we can do. I don't believe that. I believe we can do better, we can do better now, and we can do better next week. We are 45 weeks away from adjourning from this Congress. We have 45 weeks to do a bill that will benefit seniors, protect seniors, protect the integrity of the Federal budget and be able to get the job done. Seniors don't do better under this bill. It is skimpy. You have a premium of $420 a year, a deductible of $250. You pay $670 a year. When I sat and figured it out, you have to spend $1,000 to get $1,000 worth of drugs. Let me tell you what bothers me also. When you spend up to a drug cost of $2,250, then the Government says the gap between $2,250 and $5,100--your Government says we cannot afford to help you. That is a $2,850 coverage gap. This is while you are going to continue to pay your premiums. You keep on buying your drugs. Your Government says it cannot help you. While you are paying that premium and paying for your drugs, the Government will keep paying those HMOs. This bill leaves too many seniors in the coverage gap. In my home State, 200,000 people will fall in this coverage gap. Some call it a donut. I call it a poison pill. I have looked at what it means for those who already have prescription drug benefits. I truly believe that 400,000 Marylanders will be at risk from losing their private plans--whether it is from a Government employer or a private sector employer. I am talking about factory workers and teachers. I am talking about secretaries and firefighters. This bill could dilute or even destroy these benefits over a lifetime. Often, workers took these benefits instead of pay raises. They chose the promise of a secure health retirement instead of increased pay. I am very concerned that they could lose their benefit. Employers are already being crushed under the weight of health care costs. In 1998, 48 percent had prescription drug benefits, and now only 28 percent have those employer-sponsored health care coverage. Now, why is this a problem also? The other very troubling provision in this bill is it has an absolute prohibition on allowing the Government to use its buying power to negotiate lower prices. This bill does nothing to save money on drug costs. In fact, it does the opposite. This bill prohibits the Government from negotiating lower prices. Page 54 of this bill--read it. But, we already do it. I am the ranking member on the VA-HUD Appropriations Committee. I know what the VA does. The VA uses its buying power to negotiate with drug companies for lower prices. That means we get a 25-percent reduction. It is not price control. It doesn't shackle innovation. It is good management. By the VA negotiating those prices, it is good for the VA to be able to afford to provide drugs, and it is good for the veteran to be able to afford to buy their drugs. Why can't we do this everywhere? I will tell you, while we give these subsidies, while we have the skimpy benefit, it provides lavish benefits to insurance companies and HMOs; $12 billion in subsidies to private insurance plans to subsidize their participation, forcing them into HMOs in the future--$12 billion. What is the consequence? It means if you are forced into an HMO, you are going to lose your doctor. You will get the doctor that a bureaucrat tells you you should have rather than the doctor you want to have. It also creates tax dodges for those making over $250,000, the so- called health savings account--another $6 billion, which they should be paying taxes on. But oh, no, it is one more gimmick, a tax dodge. If you take that $12 billion plus the $6 billion, it would give us $18 billion to close the coverage gap. Instead, we have tax dodges and bonuses to insurance companies rather than a better benefit for the seniors. I know what some seniors are asking: Barb, why are you going to vote against this bill? I need help now. I need a prescription drug coverage now. Senior citizens in Maryland have told me that they don't even buy green bananas. They don't want to wait. I want to ease your worry about prescription drug costs. I want to give you something real. For the next 2 years, all you are going to get is a 15-percent discount card, while insurance companies and HMOs are going to get $12 billion from the Government, and there will be this tax dodge for those making over $250,000. To the seniors of Maryland, I am going to vote against this bill. I am not voting against you. I am voting for you so that you have the benefit that you need. We have an affordable program for the U.S. Government. We can hold our heads up high, but know that when my name is called, I am going to vote no on this bill and, yes, that we can do it better, and we can do it better tomorrow.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise to pay tribute to the life and legacy of Delegate Pete Rawlings. He was a big man with a big heart--who leaves an indelible mark on the people of Maryland. The Baltimore Sun said Delegate Rawlings had ``the passion of a civil rights activist and the analytical mind of a mathematician combined with the savvy of a backroom pol.'' I think that captures him perfectly. Delegate Rawlings used America's unique opportunity structure to build a life of accomplishment and of service. But more importantly, he expanded that opportunity structure for thousands of others. In over a quarter century in the House of Delegates, Pete Rawlings was known as a man of principle who put his principles into action. Mathematician and politician, educator and leader, Pete Rawlings may be best remembered for his untiring advocacy to improve education for all. He was an unfailing advocate for education. He used his power and influence to provide an unprecedented State commitment to education, a $1.3 billion commitment that the State recognized it would be constitutionally bound to fulfill. Maryland's schools are better today because of Delegate Rawlings. The passing of Delegate Rawlings is a tragedy, but his life was a triumph. His wife, Dr. Nina Cole, and his children, Wendall Rawlings, Lisa Rawlings, and Councilwoman Stephanie C. Rawlings Black are in my thoughts and prayers. I ask that an editorial from the Baltimore Sun be printed in the Congressional Record. The editorial follows: [From the Baltimore Sun, Nov. 16, 2003] Pete He'd thunder and preach, he'd deplore and beseech, he'd count pennies and votes and usually come out on the money. With the death Friday of Del. Howard P. ``Pete'' Rawlings, Maryland lost an extraordinarily gifted leader and one of the most accomplished politicians of his era--known for both a tight fist and a caring heart. Mr. Rawlings' intellectual grasp of policy detail and instinct for mastering the levers of power propelled him to a top post in the General Assembly. His greatest contributions arose, however, from his willingness to take on the unpopular yet critical tasks of fiscal management. He never forgot his West Baltimore constituents, yet he had the rare courage to sometimes tell them no. Such was the force of his conviction that he managed not only to survive such battles but to prosper. His remarkable legacy includes a new generation of political leaders he mentored along the way. As a freshman delegate, part of a tiny minority of black lawmakers, Mr. Rawlings claimed his seat on the House Appropriations Committee in 1979 and immediately started breaking the rules. He publicly questioned every spending item, including those dear to the hearts of his committee mates, wanting to know what good the money would do for ``his people.'' Colleagues rolled their eyes. Who was this guy? They were used to machine-backed black legislators who were reliable votes, and to the ``screamers'' who would grandstand in protest of the system but never get anything done. In Mr. Rawlings, they found the passion of a civil rights activist and the analytical mind of a mathematician combined with the savvy of a backroom pol. He was quickly tagged as a ``comer,'' was named to a subcommittee chairmanship and by 1992 was awarded the gavel of Appropriations Committee chairman. Running Appropriations in Annapolis isn't like in Congress, where the bounty flows seemingly without limit. In Maryland, the budget has to balance. Mr. Rawlings made it his business to try to ensure the taxpayers' money was being spent wisely. He battled with Baltimore mayors and officials of Morgan State University. He authored reforms in education, housing and health care. He brought home the bacon as he saw fit. The strongest testimony to his style may be his endorsement of Martin O'Malley in the 1999 mayoral race against black competitors, thus awarding the job of running a majority- black city to a white politician Mr. Rawlings thought better qualified. Much of Mr. Rawlings' success stemmed from the sense that he was not interested in power for its own sake, but for what he could accomplish. That, and a deep bass voice that boomed with such moral authority it seemed to come from the heavens. His passing robs Baltimore of its most effective and empathetic advocate. All of Maryland, though, is poorer for his loss.

Ms. MIKULSKI

Ms. MIKULSKI. I move to lay that motion on the table. The motion to lay on the table was agreed to.

Ms. MIKULSKI. I further say to my unflagging colleague from Minnesota, this $500,000 will not come out of other Minnesota projects. OK? The memorial to Senator Wellstone is a national project of national impact and, therefore, will not impact upon the Minnesota projects which are also so important and needed.

Ms. MIKULSKI. First, we acknowledge the very able Senator from Minnesota has offered an amendment for the full funding of the Wellstone Memorial in this year's appropriation. We acknowledge the vigorous advocacy of Senator Dayton for not only Minnesota but for his dear and beloved colleague, Senator Wellstone, of happy memory. We all remember with great melancholy that terrible day when Senator Wellstone lost his life. We promised we wanted to have a permanent memorial to the legacy of truly an extraordinary American. I assure the Senator from Minnesota and all the people of Minnesota, we have the will to help complete this memorial. We are a little tight on the wallet. I wonder if the Senator would accept essentially a 2-year funding promise, that we fund this this year at $500,000 and that next year we complete it with $700,000. This way it keeps the money in the pipeline so the memorial can be sure it can meet its bottom line, and that we can continue to stay the course on creating this most appropriate memorial to our beloved colleague. Would the Senator accept that as a way of keeping the process moving forward but understanding that we are a bit tight this year? I know, because the Wellstone legacy was in championing veterans, I say to my colleague from Minnesota, we have been able to add $1.3 billion, and if I know our colleague, that is what he would be happy about. But we are not going to abandon the memorial, either. Does this sound like a reasonable, rational, and acceptable approach?

Ms. MIKULSKI. I move to lay that motion on the table. The motion to lay on the table was agreed to. Amendment No. 2193

Ms. MIKULSKI. I move to lay that motion on the table. The motion to lay on the table was agreed to. Amendment No. 2200 to Amendment No. 2150

Ms. MIKULSKI

Ms. MIKULSKI. I move to lay that motion on the table. The motion to lay on the table was agreed to.

Ms. MIKULSKI. Mr. President, we have fully funded the VA including a $1.5 billion increase over the President's request for VA medical care. We have provided $28.5 billion for medical care, a 12 percent increase over last year's level. with no deductibles, no co-pays, and no membership fees for veterans. Promises made to our veterans must be promises kept and we have kept our promises to veterans in this bill. In the area of housing and community development, we continue our commitment to core housing programs, including Community Development Block Grants, HOME, HOPE VI, and Section 8. These programs provide flexible funding for local communities for a range of activities, such as new rental housing, rehabilitation of dilapidated properties, and child care centers. Last year, CDBG funds created or retained over 100,000 jobs nationwide. We also keep our commitment to the environment helping local communities protect their citizens' health and their environment. EPA helps communities by cleaning up Brownfields, improving air quality, and fixing water and sewer systems. We provide $8.2 billion to the EPA, $105 million above last year, and $500 million above the President's budget request. In water and sewer needs, communities all across the country are faced with aging water and sewer systems. The costs of fixing and maintaining these aging systems continue to increase. That is why Senator Bond and I worked together to restore the administration's $500 million cut to the Clean Water State Revolving Loan Fund. We have also fully funded environmental cops on the beat so that we catch polluters who threaten public health and the environment. We have provided a record amount for Americorps, $340 million, so that Americorps can enroll more volunteers to serve in our communities. In NASA, we provided the full amount for the Space Shuttle--$3.9 billion. Senator Bond and I have always made the Space Shuttle safety a priority. The bill also funded all major programs in space science, earth science, and aeronautics. In order to keep our manufacturing jobs here, we increase our investment in the National Science Foundation. We win the Nobel Prizes, and they win the markets. That is why we provide NSF with the largest budget in its history. We have increased funding for education to attract and train more scientists, engineers and teachers of science. Again, I joined this Subcommittee to meet the needs of our veterans, empower communities, and create new jobs. This bill has accomplished all three goals. I support this bill, and I urge my colleagues to support it. Mr. President, I thank Senator Bond for the wonderful job he has done on this bill on the part of representing the Democratic side. I thank him for all the courtesies and collegiality. Most of all, I thank him for really not playing politics with veterans health care, as I did not. As we approached this bill, when it came to looking out for veterans health care, we weren't the Republican Party; we weren't the Democratic Party; we were the red, white, and blue party. Therefore, we could raise the funding for veterans medical care by 12 percent with no deductibles, with no new deductibles, no new copayments, and no membership fees. That was due in large part to our mutual advocacy and the wonderful cooperation of Senator Stevens and Senator Byrd. I joined this subcommittee for two reasons: To meet the day-to-day needs of my constituents--our veterans--housing, the environment; and the long-range investments needed for our country in science and technology. I believe we have accomplished both. I also thank the staff who enabled us to do this: On my own side, Paul Carliner, Gabrielle Batkin, Alexa Sewell, and Jennifer Storipan; and the staff of the distinguished Senator from Missouri: Jon Karmarck, Cheh Kim, Allan Cutler, and Rebecca Benn. I also thank the floor staff of both the majority and the minority who helped us expedite the bill. No kinder words could be said by me than to express my gratitude to Senator Harry Reid, the whip on our side, who really also helped bring this bill to closure. This is why we come to the Senate, to try to use the taxpayers' money in a wise way. It keeps promises made to our U.S. veterans, but adds value to our country, whether through empowering neighborhoods, protecting the environment, or investing in science and technology so we not only win the Nobel Prizes but we win the markets. I yield the floor.

Ms. MIKULSKI. Mr. President, if I might say to the wonderful distinguished whip and my colleague from Missouri, at 2:30 the Senator from Maryland, along with the distinguished Senator from Utah, Mr. Hatch, are receiving a national award. It will occur in Statuary Hall. It is really important, if the Senator from Arizona could come next, we could finish this bill. It will be very awkward to try to do the bill at 2:30. I will be here. I will give up the reception of this award. It is really awkward when we are ready to go. I respect the impeccable credentials of the Senator from Arizona on national security. We know what he wants to offer. We could deal with this now and have him present his arguments and our rebuttal, and perhaps do this before the luncheon recess. We would like to get this done before the Senate recesses for the year.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise to introduce the Mammography Quality Standards Reauthorization Act of 2003. I am pleased to be joined in introducing this bill by Senator Ensign and our bipartisan cosponsors. This important bipartisan bill is about saving lives. That's what the Mammography Quality Standards Act (MQSA) does. Accurate mammograms detect breast cancer early, so women can get treatment and be survivors. Mammography is not perfect, but it is the best screening tool we have now. I authored MQSA over ten years ago to improve the quality of mammograms so that they are safe and accurate. Before MQSA became law, there was an uneven and conflicting patchwork of standards for mammography in this country. There were no national quality standards for personnel or equipment. Image quality of mammograms and patient exposure to radiation levels varied widely. The quality of mammography equipment was poor. Physicians and technologists were poorly trained. Inspections were lacking. MQSA set federal safety and quality assurance standards for mammography facilities for: personnel, including doctors who interpret mammograms; equipment; and operating procedures. By creating national standards, Congress helped make mammograms a more reliable tool for detecting breast cancer. In 1998, Congress improved MQSA by giving information on test results directly to the women being tested, so no woman falls through the cracks because she never learns about a suspicious finding on her mammogram. Now it is time to renew MQSA and lay the foundation to strengthen it even further. The bill that I am introducing with Senator Ensign today is a bipartisan agreement to extent MQSA for two years while making two additional changes to certificates that facilities are required to have to perform mammograms. First, the bill allows the Secretary of Health and Human Services to issue a temporary renewal certificate for up to 45 days to a facility seeking reaccreditation, if the accreditation body has issued an accreditation extension and other criteria are met. This will help ensure that a facility is not forced to close its doors to women seeking mammograms, while it is completing its reaccreditation and the quality of mammography is not compromised. Second, the bill allows the Secretary, at the request of an accreditation body, to issue a limited provisional certificate to a facility to enable a facility to conduct examinations for educational purposes while an onsite visit from an accreditation body is in progress. This certificate would only be valid during the time the site visit team from the accreditation body is physically in the facility and would not be valid longer than 72 hours. The two year reauthorization of MQSA is important. It will give Congress an opportunity to consider in the next reauthorization expert recommendations from an Institute of Medicine (IOM) study and a General Accounting Office (GAO) report on several issues related to MQSA. I have been working with the Labor, Health and Human Services (HHS), and Education Appropriations Subcommittee to get these studies going since I included them in the Senate fiscal year 2004 Labor/HHS Appropriations bill. The HELP Committee also heard testimony in support of a two year reauthorization at the HELP Committee's April hearing on MQSA. As I talked to advocacy groups about ways to improve MQSA, the need to improve the skills of doctors reading mammograms was brought to my attention. One study found that a woman has a 50 percent chance of getting a ``false positive'' reading from her mammogram over 10 years. I'm gravely concerned about reports that doctors miss about 15 percent of breast cancers on mammograms. I was also disturbed by a New York Times investigation last year. It found that some radiologists were missing alarming numbers of breast cancers because they lacked the experience or training they needed for the difficult task of interpreting the X-ray. These are reasons why I requested the hearing that the HELP Committee held in April on this issue. While I am disappointed that the HELP Committee was not able to reach agreement this year on a continuing medical education provision to address this issue, I look forward to Congress reexamining this issue once the IOM and GAO studies are completed. The IOM and GAO will look at several important issues such as: ways to improve physicians' interpretation of mammograms; possible changes to MQSA regulatory requirements; ways to ensure the recruitment and retention of sufficient numbers of adequately trained personnel to provide quality mammography; how data currently collected under MQSA could be better used; and factors that led to the closing of mammography facilities since 2001. I look forward to working with my colleagues in Congress to examine the recommendations from these studies in 2005 and to consider further improvements to MQSA in its next reauthorization. The HELP Committee will mark up this bill tomorrow. This legislation is supported by groups including the American Cancer Society, the Susan G. Komen Breast Cancer Foundation, the national Alliance of Breast Cancer Organizations, and the American College of Radiology Association. I strongly urge Committee passage and swift Senate passage of the bill later this week. I hope that the House will also expeditiously pass this bill. There are an estimated 212,600 new cases of breast cancer and an estimated 40,200 breast cancer deaths in the United States this year. Early detection and treatment are essential to reducing breast cancer deaths. Congress should pass this bill this year to reauthorize MQSA and extend this valuable program that helps save the lives of women and men with breast cancer. I ask unanimous consent that letters of support be printed in the Record. American Cancer Society, November 18, 2003. Hon. Barbara Mikulski, U.S. Senate, Washington, DC. Dear Senator Mikulski: On behalf of the American Cancer Society and its more than 28 million supporters, I would like to thank you, along with Senator Ensign, for your continued leadership in sponsoring the ``Mammography Quality Standards Act of 2003.'' As the largest national, community-based organization dedicated to eliminating the incidence and burden of cancer and improving cancer care, the Society strongly supports the reauthorization of the Mammography Quality standards Act of 1992 (MQSA) in the remaining days of this session. In addition, we believe a two year reauthorization is appropriate at this time, as we continue to examine methods for mammography quality improvement. Currently, funding has been included in the LHHS Appropriation bill for the Institute of Medicine and General Accounting Office to study and recommend concrete improvement to MQSA. When the results of these studies are released, we look forward to again working with the Congress to further improve MQSA and ensure that women's access to high quality mammography continues. The American Cancer Society, along with other professional societies and advocacy groups, was actively involved in the development of the 1992 MQSA law and its reauthorization in 1997, in an effort to further reduce deaths and disability from breast cancer. Mammography screening has led to earlier detection of breast cancer when it is in its most treatable stages, thereby providing a greater chance for life-saving treatments and a greater range of treatment options. Increasing utilization of mammography has been a major factor in the reduction of breast cancer deaths in the U.S. over the last decade. Based upon ongoing scientific evidence and improvements in technology, high-quality mammography continues to be the best available tool for the early detection of breast cancer. Therefore, the Society is honored to again lend our support to Congress in its commitment to ensure that women have access to high-quality mammograms. The Society would like to commend you again for your leadership on this critical public health issue, and we look forward to continuing to work closely with you and the other cosponsors to ensure the enactment of this important legislation this year. If you or your staff have any questions, please contact Kelly Green Kahn, Manager of Federal Government Relations (202-661-5718). Sincerely, Daniel E. Smith, National Vice President, Federal & State Government Relations. Wendy K.D. Selig, Vice President, Legislative Affairs.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise to introduce the Mammography Quality Standards Reauthorization Act of 2003. I am pleased to be joined in introducing this bill by Senator Ensign and our bipartisan cosponsors. This important bipartisan bill is about saving lives. That's what the Mammography Quality Standards Act (MQSA) does. Accurate mammograms detect breast cancer early, so women can get treatment and be survivors. Mammography is not perfect, but it is the best screening tool we have now. I authored MQSA over ten years ago to improve the quality of mammograms so that they are safe and accurate. Before MQSA became law, there was an uneven and conflicting patchwork of standards for mammography in this country. There were no national quality standards for personnel or equipment. Image quality of mammograms and patient exposure to radiation levels varied widely. The quality of mammography equipment was poor. Physicians and technologists were poorly trained. Inspections were lacking. MQSA set federal safety and quality assurance standards for mammography facilities for: personnel, including doctors who interpret mammograms; equipment; and operating procedures. By creating national standards, Congress helped make mammograms a more reliable tool for detecting breast cancer. In 1998, Congress improved MQSA by giving information on test results directly to the women being tested, so no woman falls through the cracks because she never learns about a suspicious finding on her mammogram. Now it is time to renew MQSA and lay the foundation to strengthen it even further. The bill that I am introducing with Senator Ensign today is a bipartisan agreement to extent MQSA for two years while making two additional changes to certificates that facilities are required to have to perform mammograms. First, the bill allows the Secretary of Health and Human Services to issue a temporary renewal certificate for up to 45 days to a facility seeking reaccreditation, if the accreditation body has issued an accreditation extension and other criteria are met. This will help ensure that a facility is not forced to close its doors to women seeking mammograms, while it is completing its reaccreditation and the quality of mammography is not compromised. Second, the bill allows the Secretary, at the request of an accreditation body, to issue a limited provisional certificate to a facility to enable a facility to conduct examinations for educational purposes while an onsite visit from an accreditation body is in progress. This certificate would only be valid during the time the site visit team from the accreditation body is physically in the facility and would not be valid longer than 72 hours. The two year reauthorization of MQSA is important. It will give Congress an opportunity to consider in the next reauthorization expert recommendations from an Institute of Medicine (IOM) study and a General Accounting Office (GAO) report on several issues related to MQSA. I have been working with the Labor, Health and Human Services (HHS), and Education Appropriations Subcommittee to get these studies going since I included them in the Senate fiscal year 2004 Labor/HHS Appropriations bill. The HELP Committee also heard testimony in support of a two year reauthorization at the HELP Committee's April hearing on MQSA. As I talked to advocacy groups about ways to improve MQSA, the need to improve the skills of doctors reading mammograms was brought to my attention. One study found that a woman has a 50 percent chance of getting a ``false positive'' reading from her mammogram over 10 years. I'm gravely concerned about reports that doctors miss about 15 percent of breast cancers on mammograms. I was also disturbed by a New York Times investigation last year. It found that some radiologists were missing alarming numbers of breast cancers because they lacked the experience or training they needed for the difficult task of interpreting the X-ray. These are reasons why I requested the hearing that the HELP Committee held in April on this issue. While I am disappointed that the HELP Committee was not able to reach agreement this year on a continuing medical education provision to address this issue, I look forward to Congress reexamining this issue once the IOM and GAO studies are completed. The IOM and GAO will look at several important issues such as: ways to improve physicians' interpretation of mammograms; possible changes to MQSA regulatory requirements; ways to ensure the recruitment and retention of sufficient numbers of adequately trained personnel to provide quality mammography; how data currently collected under MQSA could be better used; and factors that led to the closing of mammography facilities since 2001. I look forward to working with my colleagues in Congress to examine the recommendations from these studies in 2005 and to consider further improvements to MQSA in its next reauthorization. The HELP Committee will mark up this bill tomorrow. This legislation is supported by groups including the American Cancer Society, the Susan G. Komen Breast Cancer Foundation, the national Alliance of Breast Cancer Organizations, and the American College of Radiology Association. I strongly urge Committee passage and swift Senate passage of the bill later this week. I hope that the House will also expeditiously pass this bill. There are an estimated 212,600 new cases of breast cancer and an estimated 40,200 breast cancer deaths in the United States this year. Early detection and treatment are essential to reducing breast cancer deaths. Congress should pass this bill this year to reauthorize MQSA and extend this valuable program that helps save the lives of women and men with breast cancer. I ask unanimous consent that letters of support be printed in the Record. American Cancer Society, November 18, 2003. Hon. Barbara Mikulski, U.S. Senate, Washington, DC. Dear Senator Mikulski: On behalf of the American Cancer Society and its more than 28 million supporters, I would like to thank you, along with Senator Ensign, for your continued leadership in sponsoring the ``Mammography Quality Standards Act of 2003.'' As the largest national, community-based organization dedicated to eliminating the incidence and burden of cancer and improving cancer care, the Society strongly supports the reauthorization of the Mammography Quality standards Act of 1992 (MQSA) in the remaining days of this session. In addition, we believe a two year reauthorization is appropriate at this time, as we continue to examine methods for mammography quality improvement. Currently, funding has been included in the LHHS Appropriation bill for the Institute of Medicine and General Accounting Office to study and recommend concrete improvement to MQSA. When the results of these studies are released, we look forward to again working with the Congress to further improve MQSA and ensure that women's access to high quality mammography continues. The American Cancer Society, along with other professional societies and advocacy groups, was actively involved in the development of the 1992 MQSA law and its reauthorization in 1997, in an effort to further reduce deaths and disability from breast cancer. Mammography screening has led to earlier detection of breast cancer when it is in its most treatable stages, thereby providing a greater chance for life-saving treatments and a greater range of treatment options. Increasing utilization of mammography has been a major factor in the reduction of breast cancer deaths in the U.S. over the last decade. Based upon ongoing scientific evidence and improvements in technology, high-quality mammography continues to be the best available tool for the early detection of breast cancer. Therefore, the Society is honored to again lend our support to Congress in its commitment to ensure that women have access to high-quality mammograms. The Society would like to commend you again for your leadership on this critical public health issue, and we look forward to continuing to work closely with you and the other cosponsors to ensure the enactment of this important legislation this year. If you or your staff have any questions, please contact Kelly Green Kahn, Manager of Federal Government Relations (202-661-5718). Sincerely, Daniel E. Smith, National Vice President, Federal & State Government Relations. Wendy K.D. Selig, Vice President, Legislative Affairs.

Ms. MIKULSKI

Ms. MIKULSKI. I acknowledge the validity of my colleagues' concerns and look forward to working with them to try to address these concerns in conference and with Secretary Principi.

Ms. MIKULSKI. I move to lay that motion on the table. The motion to lay on the table was agreed to.

Ms. MIKULSKI. No objection.

Ms. MIKULSKI

Ms. MIKULSKI. I move to lay that motion on the table. The motion to lay on the table was agreed to.