Barbara Mikulski

Ms. MIKULSKI

Ms. MIKULSKI. How much time do I have left?

Ms. MIKULSKI. Mr. President, I yield 5 minutes to the Senator from Vermont.

Ms. MIKULSKI. I would like to clarify the situation, as well as the innuendo that I am blocking this comity of adding rape and incest. Mr. President, early yesterday I entered into a unanimous-consent time agreement that is pending before the U.S. Senate today as the framework for debate. I negotiated that agreement in good faith with the Republican leader and his staff. The UC that I agreed to, which is the framework under which we are operating, I was told is what the Senator from Oklahoma wanted. I had a lot of my own amendments, but I recognized the fact that the Republican leader and the Democratic leader wanted to move this bill. So I agreed to a 3-hour debate, up or down or on a motion to table, on the House language which is limited to the life of the mother. That was my understanding. At 10 after 10 last night the Senator from Oklahoma approached me and said, ``That is not what I thought the agreement was.'' That was, I was told, the Senator from Oklahoma's desire to have that UC. So then to say I am not the one having comity, that is what happened to me at 10 last night. So, Mr. President, I feel that my reputation and my sense of senatorial courtesy is being impugned in a very unfair and unfactual kind of way. Now, I am prepared to move ahead with the conclusion of this debate, to vote under the UC, as we have agreed upon. And then the Senator from Oklahoma can offer his amendments. And quite frankly, I have two or three of my own. But that is the situation. That is how the situation was agreed upon. I believe that my history in the Senate has been one of comity and senatorial courtesy on these agreements. And having said that, now I yield whatever time to the Senator from Massachusetts.

Ms. MIKULSKI. How much time remains?

Ms. MIKULSKI. I object.

Ms. MIKULSKI. I object.

Ms. MIKULSKI. Mr. President, I believe I have how much time?

Ms. MIKULSKI. Mr. President, I yield myself 10 minutes. I rise to support the committee amendment and oppose any motion to table, and would like to thank the Senators--both the chairman of the subcommittee and the ranking member--for their wise position on this, which is essentially for the committee amendment to be silent on the issue of the nature of health care services. To deny women who work for the Government access to abortion or reproductive services through their health care plan is inconceivable to me and it is inconceivable to the Federal employees. First, abortion is legal in this country. This motion to table, if adopted, denies women access to medical services that are not only legal in the United States of America, but are protected under the Constitution. We are all familiar that the Supreme Court has held for the past 20 years that it is a woman's fundamental right to decide whether to terminate a pregnancy. And that is left to a physician and to the pregnant woman. Currently Federal employees, like workers in the private sector, are permitted to chose a health care plan that covers a full range of reproductive health services, including abortion. Now let me give you an analysis from the National Women's Law Center on this issue. First, the Federal employees health benefit plan does not generally dictate what benefits must be offered. So there is no health plan that determines the medical procedures. The Federal employees health benefit coverage, which takes care of 9 million Federal employees, allows them to choose between 345 different health insurance packages branching from fee-for-service plans to HMO's. By and large, Federal law is nondirective about the scope of benefits which must be provided, leaving it to the individual plans to decide what benefits are offered to employees to determine what packages best suit their health needs. That is the way it is, and that is the way it should be. And that is the way it should continue to be. In the fee-for-service plans, they have very general and nonspecific requirements. They must provide benefits for cost, associated with the care and general hospital and other health services of a catastrophic nature. They may provide hospitals, surgical, medical, ambulatory, prescription drugs, and so on. So there are a lot of ``mays'' in the fee for service. In the HMO's, the requirements are more specific. Certain benefit categories must be covered: physician and outpatient, inpatient, x ray and emergency, and some mental health and substance abuse services. Preventive health services are allowed, like family planning, child care, and immunization. Under the Federal employee benefit package, abortion is treated like any other health benefit. Plans are allowed but not required to provide abortion services. That means if you wish to have a plan that does not cover abortion, you may chose that plan. If you wish to have a plan that does cover abortion, you can have that plan. That is the way the law is, and that is the way we would hope it would continue to be. Under current law, the FEHBP permits health insurance plans to treat abortion services as they do any other health benefit. They may, but are not required, to provide health insurance coverage. Plans, not Federal policymakers, determine the specific benefit package. A ban on abortion coverage under FEHBP is inconsistent with the treatment of other health services which, under most health plans, are included or excluded according to the decision made by the plan and what you want. So that it is not the Congress that decides; it is the plan and the employees who decide. I think we ought to leave it like that. I do not think Congress should treat abortion different than any other medical service that is medically necessary or medically appropriate. In 1993, I worked hard to ensure that the Federal employees health benefit package would permit, but not require, coverage for abortion. Barring abortion coverage for women working for the Federal Government and their families denies these individuals a health benefit that would be provided through the private sector. Over two-thirds of private health insurance plans and 70 percent of the HMO's readily cover abortion services. Restricting a Federal employee's health plan is an arbitrary taking of a Federal earned benefit package. Like wages, health benefits are compensation for Federal workers. Abortion restriction effectively reduces the compensation package and treats it differently than any other health issue. The legislative history shows that the supporters of abortion restriction have as their goal the elimination of the right to reproductive choice for all women. This is a turning back of the clock of reproductive health and women's fundamental right to reproductive choice. We have been here before. Previous debates on abortion and FEHBP reveal that the ultimate goal of the proponents of the abortion ban is to extinguish the legal right to abortion altogether. I urge my colleagues to defeat the motion to table, and I will work, as the day proceeds, to ensure that. Mr. President, how much time do I have left?

Ms. MIKULSKI. I believe the distinguished Senator from Nebraska has designated me as the controller of time on this amendment.

Ms. MIKULSKI. I yield 5 minutes to the Senator from Maine, Senator Snowe, a colleague from the House. We welcome her on this.

Ms. MIKULSKI. I yield 5 minutes to the Senator from California, Senator Boxer.

Ms. MIKULSKI. Mr. President, how much time is remaining?

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I yield myself such time as I may consume. Now, where we are on the Nickles amendment is that, essentially, this is yet another version of a restriction. We just defeated an amendment that was a restriction, and each side articulated that position, I think, in a very clear way. I do not want any restrictions on Federal employees health benefits. Therefore, I oppose the Nickles amendment. Under the legislation pending, the committee amendment, if someone is a victim of rape, they can have an abortion. If someone is a victim of the most horrendous assault on a person, incest, they can have an abortion. This is not about allowing rape or incest; this amendment limits it only to the life of the mother, rape, and incest. So, we will be clear, this is not about being a knight in shining armor that says we will provide at least some flexibility in harsh, punitive, restrictive, and repressive legislation. No. The legislation that is pending before the Senate through the committee amendment has no restrictions on Federal health employee benefits. That is the current law. Now, the issue is not what is decided. The issue is, who decides? I believe the U.S. Congress should not interject itself into the physician's office. I believe the Congress should stay out of that and focus on what it is supposed to be doing, which is broad policy objectives for the Nation. It is not to intervene, interject, detour, derail, or micromanage what goes on in a physician's office when a Federal employee or a dependent in a Federal employee's family seeks medical help. That is why we oppose it. We did not want restrictions. We believe in doctors' autonomy, in doctors' judgment. That is why we say the issue is not what is decided, but who decides. Now, we also believe that there is a war going on against American women; that there is a war going on in the home; that there is a war going on through the terrible violence of domestic violence. We believe there is a war against women in terms of street crime, particularly rape. We believe there is a war against women going on in the workplace through sexual harassment. That there is even a war against women going on in the U.S. Senate, and we cannot even get a public hearing on this. We also believe that there should be no cutting of health care. What we see is that there is a war against women. It is not only about abortion and Federal employees; we are also cutting medically necessary services in other areas of health care. Look what we are doing to the elderly on Medicare. Look what we are doing to children on Medicaid, under the guise of welfare reform, when children will lose their health benefits. Look what we are doing to the elderly, in terms of long-term care, by cutting Medicaid. That is why we say there is a war against women going on in the United States of America. We want our colleagues to defeat the Nickles amendment, restricting women's options in health care, to only be able to have an abortion if their life was at stake or if it is rape or incest. Now, every single Member of the U.S. Senate will view rape and incest as the most repugnant, the most horrible, the most atrocious thing that can be done to a human being. Of course, if you are a victim of rape and incest, we would want you to be able to have that abortion. We want you to have an abortion if it is medically necessary and medically appropriate. We believe in freedom of choice, self-determination. We believe in the United States of America, we believe it in foreign policy, and we believe it in the physician's offices where Federal employees or their dependents seek advice, counsel, and clinical judgment. This is why we oppose this restriction. This is why we want to defeat the Nickles amendment. Later on, we want to defeat the cuts in Medicare. Later on, we want to defeat the cuts in Medicaid that take away medical services for the elderly and for children. We will also want to defeat the other horrendous cuts that are going on where women are victims of violence and abuse, whether it is in the home, whether it is in the streets, or in the neighborhoods. I hope that we would defeat the Nickles amendment, support the committee amendment, currently, which leaves the decisionmaking to the pregnant woman and to the physician. How much time did I consume?

Ms. MIKULSKI. I yield 5 minutes to the Senator from California.

Ms. MIKULSKI. I yield the Senator 30 additional seconds.

Ms. MIKULSKI. Mr. President, how much time do I have?

Ms. MIKULSKI. Mr. President, I am going to yield 5 minutes to the Senator from Illinois, and then, after that, I will yield 10 minutes to the Senator from Pennsylvania.

Ms. MIKULSKI. I thank the Senator from Illinois. She has been a marvelously strong advocate. It is a blessing to have her here. I yield a maximum of 10 minutes to the Senator from Pennsylvania.

Ms. MIKULSKI. Mr. President, how much time do I have remaining?

Ms. MIKULSKI. That is it?

Ms. MIKULSKI. I yield 3 minutes to the Senator from the State of Washington.

Ms. MIKULSKI. I yield whatever time I have remaining to the Senator from California.

Ms. MIKULSKI. Mr. President, I know Senator Feinstein wishes to speak. I yield myself 1 minute. I wish to make very clear that this legislation is, No. 1, a restriction. No matter how it is improved, it is still a restriction. Also, many people continue to bring out the issue of taxpayers' funds. Federal employees contribute to the health insurance plan. This is their contribution. They have a right as Federal employees to be able to seek medically necessary services. This is not like Medicaid funding on abortion which is 100 percent taxpayers' funds. I am sure we are going to be debating it extensively later on in the year. I also want to bring to everyone's attention that right now no Federal plan restricts any type of medical procedure. The Federal Employees Benefit Program generally does not dictate what benefits are offered. Therefore, it goes counter to everything to then single out one medical procedure--abortion--for restriction. We hope that the Nickles amendment is defeated. Excuse me. Was the Presiding Officer tapping me down?

Ms. MIKULSKI. Mr. President, I send an amendment to the desk and ask for its consideration, and while the clerk is reporting the amendment, I would like the courtesy of the Senate to be in order. Mr. President, the Senate is not in order, and I would really ask as a courtesy to me that all Senators take their seats.

Ms. MIKULSKI. Mr. President, the amendment that I am offering will guarantee that there will be coverage for women. This is a serious issue, and I do not want to raise it and I do not want to shout. I understand the desire to come to a closure. Mr. President, the amendment I am offering will guarantee that there will be coverage for women under the Federal employees health benefit plan for abortion services that are medically necessary. What is ``medically necessary''? When a doctor decides using his or her trained professional judgment, in consultation with the patient, what will best protect the woman's health, this judgment is made based on the totality of the circumstances presented by the patient's situation. We, the Senate, are not doctors. It is not our role to substitute our judgment for the judgment of trained medical professionals. With one exception, we do not have medical degrees. We do not have medical training. The Senate cannot write prescriptions. The Senate cannot elaborate on lab results. The Senate cannot conduct physical exams. The Senate cannot perform surgery. This body should allow doctors to do what they are trained to do. We should not second guess these judgments. There are medical conditions which, when presented, increase risk to a woman's health during pregnancy. Cancer, diabetes, high blood pressure, kidney disease, cardiovascular disease, AIDS--these and other conditions are known to increase a woman's health risk. If she carries her pregnancy to term and her doctor concludes that an abortion is medically necessary to protect her health, should we, the Senate, make these judgments? Should we then substitute our judgment for that of a physician? Abortion is a complex, personal decision. It must be made by a woman in consultation with her physician. This amendment will ensure that Congress does not intrude into that personal decision of what the woman and her physician believe to be medically necessary for her. Reproductive health care, including abortion, is essential for women's health and well-being. Providing access to safe, legal abortions protects women's health. The American Medical Association concluded that as access to safe, early, legal abortions becomes increasingly restricted, there is a likelihood there will be a small but measurable increase in mortality and morbidity among women in the United States. That is what the AMA said. They are the doctors. That is what the doctors say. They say to deny access to abortion will harm the health of American women. With the last vote the Senate already carved out exceptions to an absolute prohibition on abortion. We should, therefore, allow one more exemption, and that is where it is medically necessary. That is what I am proposing. Congress should not substitute its political judgment for the judgment of health professionals. Just keep this in mind. Unless the Mikulski amendment passes, if a woman is told by her doctor that she will be paralyzed for life if she carries the fetus to term, she will be unable to obtain an abortion. Mr. President, I yield 3 minutes to the Senator from Pennsylvania. Mr. SPECTER addressed the Chair.