Ciro Rodriguez

Mr. RODRIGUEZ

Mr. RODRIGUEZ. Mr. Speaker, I thank the gentleman for allowing me to be here. I also had a chance to listen to the dialogue that was coming, and I have the hour after yours regarding border health, but I needed to come up here because, in all honesty, there was a sense of frustration and some anger. Because, as the gentleman well knows, for the last two or 3 years we have been talking about making sure we pass a Patients' Bill of Rights. We know that people are, throughout the country, having those difficulties. Not only do they have to fight their illness when they get sick, but they have to fight their HMO and their managed care system, and that is unfortunate. One of the good things about it is, if nothing else, now they are talking about it. Now they have brought up the issue. Now they realize that it is something that is serious and so they need to at least begin to give it lip service. But we are hoping that they do more than just lip service, because I know that they can do that and then decide not to do what they are supposed to be doing. Mr. Speaker, I cannot help but recall an incident back when I was in the State legislature when we talked about access to rural health care. One of the first things we talked about was how can we get access to rural Texas. At that time, when I was in the Texas legislature. I remember that a person with any logic, any sense of wanting to really respond to the problem, would start thinking, well, let us see how we can get a doctor down there. Let us see how we can get a mobile unit down there. Let us see how we can get some nurses down there. Well, the response from what actually occurred after all that, because I was real naive to the political process, was they decided to draft legislation that was tort reform. So here we stand and what I hear is the lawyers are going to get it. I am not a lawyer. I do not care about attorneys. The only thing I do care about is to make sure that those people have access to health care. Yes, in some of those critical situations, if HMOs are not responsive, they should have access to the judicial courts. No one who is sick would want to go to the courts. No one who has been hurting and is tired enough of having to fight their HMO wants to go see an attorney. I know I would not want to do that. But one has to be able to leave that as a last option, no matter what. I will share an example. I have a friend who was working in the garage, cut his finger, his finger fell off completely, and he got scared, grabbed it, and he went to the hospital. He went into the emergency room. This happened prior to the legislation. First, they had some trouble getting the doctor that he should have been seeing, and then the specialist, they had trouble getting the specialist. Well, the insurance company, the bottom line was, told him, number one, we are not going to pay for that specialist because we did not okay it. So here he is, losing a finger, and he has to try to get an okay as to whether this specialist should put it on or not. Well, he lost his finger. He does not have the finger now. They are still unwilling to pay, approximately, a little less than $3,000. What does he do? What does he do? So one of the things that this particular legislation does is it allows an opportunity for the person to choose the doctor of their choice, and that is so important. Not only is that critical, but it also allows that physician to determine whether one needs a specialist or not. Those are the ones that are supposed to be making the decisions, not the accountant, not the insurance based on how much profits they are going to be making or not making if they make certain decisions. It should be made on the needs of that person. Secondly, the bill covers all Americans, and that is so important, whether one works for small businesses or not. There are company doctors that are out there that we need to be concerned about. A lot of times the company doctors will choose to make decisions based on the needs of the company and not the particular patient. So that becomes real important. Thirdly, it ensures that all external reviews of medical decisions are conducted by independent, qualified physicians, and that is so important. We want to make sure, if you are there, if your mother is there or if a loved one is there, you want qualified people making those decisions. You do not want them to be made because they are going to save a few hundred dollars or a few thousand dollars in choosing not to do certain procedures. The other thing is that doctors right now, and the gentleman mentioned this, are gagged by the gag rule. They are actually being told that they cannot provide certain options where they can tell the patient, look, you have this disease, these are the options. You can do this, this, or this other option and then decide. The cost varies. They are not even allowed to do that. We ought to be ashamed of ourselves. We have passed this piece of legislation several times already, and the Republican-dominated Congress continues to kill it in conference. Now, they get up here, and now they are talking about it. Well, let us see if it does not turn into a situation where the rules will allow a lot of other amendments to come in and then, very similar to what happened in campaign finance, where they allowed so much junk out there so that they were going to pile it up so that not even the author would want to be able to vote for that piece of legislation. So I am hoping that, as we move forward now, that at least we got them to a point that they are at least talking about it, and that we can go forward in making sure that we do the right thing when it comes to the Patients' Bill of Rights, when it comes to our patients throughout this country. I want to thank the gentleman for his hard work that he has done, because he has been at the frontline. We need to keep hitting on this issue. It is something that is right, and it is something that we need to do. I just want to remind the gentleman that President Bush, then Governor Bush, initially vetoed the first Patients' Bill of Rights in Texas. The second time, and that was in 1998 when it came back, then at that point he allowed it to go through, although he had the same arguments then of that bill that he has now. That is, his arguments against the bill were that it would increase costs and increase the number of lawsuits against doctors. That has not occurred. That has not happened. He also mentioned that other health providers would also be hurt by it. That has not occurred. It has been a good piece of legislation. It still has some holes that need to be worked out, but I think that we could do this, and it would go a long way throughout this country to providing those people who have insurance right now and who get sick at least that leverage to be able to fight the disease and not have to fight the managed care system, so that the managed care system becomes more accountable to our constituency throughout this country.

Mr. RODRIGUEZ

Mr. RODRIGUEZ. Mr. Speaker, on Friday, July 13, 2001, after 85 years the flag will be brought down for the final time at Kelly Air Force Base in San Antonio, Texas. In recognition of this momentous occasion I offer the following tribute of Kelly AFB and its lasting legacy to the United States Air Force, the nation, and the San Antonio community. Seventy-four years after Travis, Crockett and Bowie manned the battlements at the Alamo, a different kind of warrior made his appearance over the South Texas City of San Antonio. He rode on wings of wood and fabric. In January 1910, on orders from Major General James Allen, Chief of the Army Signal Corps, Lieutenant Benjamin Foulois established a flying field at Fort Sam Houston, Texas. Foulois arrived at the Fort with a Wright flyer, the only airplane in the air service. In April 1911, three young Army officers joined Foulois fresh from Glenn Curtiss' Flying School at San Diego. Among them was a thirty- year-old lieutenant from London, England, George Edward Maurice Kelly. Kelly immigrated to America, enlisted in the United States Army and eventually received his citizenship and gained a commission. Volunteering for duty in the Air Service, he trained briefly with Curtis and then joined Foulois at San Antonio. Lieutenant Kelly's aviation career would be short lived. On May 10, 1911, he crashed his Curtis Type-4 Pusher into the brush near Fort Sam Houston's Drill Field. Lieutenant Kelly became the first American military aviator to die in the crash of a military aircraft. Six years later, one of the nation's premier flying fields would bear the name of this brave young aviator. Lieutenant Kelly's death caused the Commander at Fort Sam Houston to call a halt to flying at the Post. Aviation didn't return to the Alamo City until November 1915, when the First Aero Squadron arrived from Fort Sill, Oklahoma. It did not stay long. In March 1916, the Mexican Revolutionary leader, Pancho Villa, attacked Columbus, New Mexico, and the First Aero Squadron, commanded by Foulois, joined a punitive expedition commanded by General John J. Pershing. Within months all its few aircraft were grounded. With World War I raging in Europe, it was clear With the acquisition of more land west of Frio City Road in 1917, Kelly Field was divided into two areas, Kelly Number I and Kelly Number 2. While Kelly Number 2 was busy turning out dashing aviators, Kelly Number 1, renamed Duncan Field in 1925, was engaged in a less glamorous task of aviation supply and maintenance. This humble stepchild spawned out of necessity would eventually thrive and go on to become an Air Force logistical giant. By 1935, most world powers were struggling to free themselves from the grip of worldwide depression. In Germany, Adolph Hitler had seized the reigns of power. On the other side of the globe, Japan was running rampid through Manchuria. The clouds of depression were clearing, but clouds of war were rapidly taking their place. Aircrew training at Kelly was stepped up; courses were conducted in nearly every form of military aviation including attack, pursuit, observation and bombardment. Paved runways and In the early '50s, propeller whine was replaced by jet roar. Boeing B-47s, first operational all jet strategic bombers, began to line Kelly ramps awaiting their turn to pass through the overhaul and modification lines in building 375, at that time the world's largest hangar. They would be followed by a succession of aerial armament including the B-58 Hustler, the F-102 Delta Dagger, and now the venerable B-52 Stratofortress. For over forty-five years the B-52 filled the role of manned strategic bombers; and for thirty-six of those years, the San Antonio Air Materiel Area and its successor, the San Antonio Air Logistics Center, strengthened its airframe and modified its offensive and defensive capabilities. In January 1970, a cavern with wings shared the maintenance area with the camouflaged B-52s. It is the world's largest aircraft, the Lockheed C-5. This enormous cargo and troop carrier, longer than the area covered by the Wright brothers' first flight, was the most ambitious workload ever assumed by this or any other Air Logistics Center. From the tip of its liftable nose, to the top of its five-story tail, the C-5 was a Kelly management responsibility for over 35 years. Less visible was the vital support given to other aircraft and weapon systems. Kelly personnel managed over half of the Air Force engine inventory, repairing and managing the C-5's TF39 engine and the F100 engine, which powers the F-15 and F-16 aircraft. Kelly personnel also managed engines for the T-37 and T-38 trainers, the A-10 Attack aircraft and C-130 transport. Other members of the Kelly team manage all the fuel used by the Air Force and NASA and monitor all Air Force nuclear weaponry. Although the Berlin Wall came down in 1989, Kelly AFB remained a vital part of American defense of freedom. During Operation JUST CAUSE in December 1989, Kelly was a staging area for troops on their way to Panama and was a reception point for wounded Americans. Less than a year later Kelly's people worked 24-hour days in support of American and Allied efforts to drive Iraqi invaders from Kuwait in Operations DESERT SHIELD/DESERT STORM. By March 1991, Kelly had sent nine million pounds of munitions to the theatre of operations along with 7,400 tons of other supplies and 4,700 passengers. In April 1999, Kelly employees again were called upon to perform their ``logistical magic.'' Engines were surged to support NATO's efforts to end brutal ethnic cleansing in Kosovo. Even before the end of the Cold War, America's military services saw their budgets grow smaller, and by the early 1990s, people expected to see a ``peace dividend'' to help reduce the budget deficit and pay for soaring costs of social services. Continuing efforts to cut defense spending by relocating some missions and closing some bases put Kelly and the San Antonio Air Logistics The center had the maximum of six years to relocate its missions and turn over a going concern to the city's redevelopment authority. Center officials used three guiding principles in its planning: the first was continued support to maintain Air Force readiness; the second was taking care of the Kelly work force; and finally, minimizing the impact on the San Antonio Community. Both the city and the Air Logistics Center were determined to make this transition a success. Kelly created the Privatization and Realignment Directorate, headed by Tommy Jordan, to handle the Air Force side of the operation. The city created the Greater Kelly Development Corporation (later Authority) to carry out the strategies and plans to redevelop the base. The group went right to work, signing its first lease for a portion of East Kelly to Rail Car Texas for a rail car repair facility. Less than a month later, aircraft engine giant Pratt & Whitney signed a lease to perform upgrades on the F100 engines. And in November 1997, Ryder International Logistics, Inc. signed a lease for warehouse space. However, the dream to keep all of the Center's workload at Kelly never materialized. The Air Force ran public-private competitions for Kelly's workload. The first went to another ALC. In September 1997, the Air Force announced that Warner Robins ALC won the C-5 depot maintenance contract. Only 200 Kelly workers moved to the Georgia base, but thousands upon thousands of pounds of equipment necessary for C-5 maintenance were loaded on 18-wheelers for the trek to south Georgia. Over the next year, as workers finished maintenance on the C-5s, Kelly's giant aircraft hangar got emptier and emptier. On 15 September 1998, the last C-5 to undergo PDM at Kelly lifted off the runway, ending nearly eight decades of aircraft depot maintenance. But building 375 didn't remain empty for long. On 20 February 1998, representatives from Boeing, GKDC, and the city of San Antonio signed letters of intent for the lease of five buildings. Workloads at the new Boeing Aerospace Support Center included C-17s, KC-10s and KC-135s for Kelly's other large workload, the Propulsion Business Area, went on the bidding block in March 1998. In February 1999, the Air Force announced that Oklahoma City ALC and its bidding partner Lockheed Martin had won the contract. The news for Kelly and San Antonio was not all bad, however. Early on, Oklahoma City ALC announced it was only interested in Kelly's F100 workload, which left in December 1999. Work on the TF39 and T56 engines, and about 1,400 former Kelly federal workers, would stay at Kelly in building 360 under contract with Lockheed. The rest of Kelly's depot maintenance workload, automatic test equipment, gas turbine engines, and ICBM reentry vehicles for example, moved to the other ALCs between 1997 and 2000. The remaining three ALCs picked up Kelly's materiel management responsibilities beginning with ICBM reentry vehicle items in August 1997 and ending with secondary power systems in June 2001. In the intervening four years, millions of pounds of equipment needed to perform Kelly's various missions left the base for their new homes across the country. Kelly's remaining base operating support transitioned to Lackland AFB, beginning with the 76th Medical Group in October 1999. The final realignment of base support and Kelly's major tenant units to Lackland was completed by April 2001. Meanwhile, the GKDA's vision of a ``new Kelly'' had taken off. The city-appointed authority renamed the base KellyUSA as a way to convey the nonmilitary focus of the burgeoning 2,000-acre industrial and commercial park. By 2000, GKDA was already well on its way to its goal of replacing the civil service jobs lost at Kelly. Although the flag came down on the San Antonio Air Logistics Center on July 13, 2001, it was not the end of Kelly's story. Kelly's legacy will live on for generations. Kelly was a place where people from all backgrounds came together to roll up their sleeves and work for a united cause--our country's freedom. For 85 years Kelly AFB made major contributions to the military strength of the United States and the prosperity of San Antonio. Kelly was the largest single employer in San Antonio and South Texas for over 50 years, and year-after-year Kelly was the largest contributor to the Combined Federal Campaign within the city. Kelly was a place where the workers prospered, purchased better homes, and provided family members the resources to pursue more education and more opportunities. Kelly Field provided tens of thousands of civil service jobs, and was the birth and backbone of the Hispanic middle class in the Alamo City. Generations of Hispanic families were employed at Kelly throughout its history, and, today many of the city business leaders and even congressional members have their roots as Kelly families. For decades the men and women of Kelly AFB dedicated their hearts and lives to the service of their country. From its beginnings as a farmer's cotton field in 1916, Kelly became the largest recruit and aviation training camp in the United States during World War I. In the interwar years, Kelly served as the Alma Mata of the Air Corps while its neighbor Duncan Field provided repair and supply support for America's small air arm. Following World War I, Kelly became one of the country's largest logistical supermarkets, supporting the Air Force around the globe. During the most recent conflicts of JUST CAUSE, DESERT SHIELD/DESERT STORM, and Kosovo, the Kelly employees had the greatest logistical support of all the ALCS, shipping more components, more engines, and more munitions. From the beginning of Kelly Field to the end of the San Antonio Air Logistics Center, the logistical impact and support of Kelly and its employees were vital for the United States to be successful in completing the mission. Today, Kelly transitions again, becoming KellyUSA, an industrial, commercial park for the 21st century. But, throughout this tradition of service remains and will continue to be--Kelly Forever!

Mr. RODRIGUEZ

Mr. RODRIGUEZ. Mr. Chairman, I rise in support of the amendment offered by my colleagues earlier that we were not allowed to have an opportunity to dialogue on. I represent 13 counties in south Texas, two of which are along the Texas-Mexican border and part of the commercial zone already accessible to Mexican trucks. A number of the other counties contain I-35, a principal trade corridor for truck traffic from Mexico. I recognize the importance and value of expanding trade with Mexico. We need to build upon the trade relationships with Mexico and Canada. I also recognize that the dramatic growth in truck traffic comes with a price. I know from my constituents that that price is often paid on the ground in those counties as we move forward. The issue is not whether we should have more trade, rather, the challenge is how to protect the public while increasing trade. One should not be pitted against the other. We should just use our common sense. Road maintenance, border infrastructure improvements and border inspection in general have been the responsibility of the counties along the border, some of which are the poorest counties in the Nation. Increased truck traffic without increased inspections is a recipe for disaster. Creating a special 18-month exemption for Mexican trucks in south Texas and San Antonio is not the appropriate way to go and is not the way that we should be doing business. It is a price we should not be asked to pay, it is a risk that we need not take, if we adopt a sensible inspection policy and then pay for it. We need to make sure that those trucks are inspected just like any other truck. Nearly 70 percent of Mexican truck freight traffic enters the United States through Texas, which experienced 2.8 million truck crossings last year. The volume of truck is expected to increase by 85 percent. As of now, we do not have the ability to inspect and regulate these trucks. A total of 1 percent of the trucks that are crossing into Texas are now being inspected. Of those inspected, the out-of-service rate is 40 percent, nearly twice the national average for U.S. trucks. We will make the problem worse if we do not insist on inspections for Mexican trucks. We must insist that Mexican trucks and companies meet the same safety and inspection requirements as U.S. trucks. We are not asking for anything special. We want to make sure that they also be able to go through the same guidelines. We are not anticompetitive, and we are not anti-Mexican. What we want to make sure is that those trucks get treated in the same way. They should be inspected in the same manner. All we are asking is that Mexican carriers be subject to on-site inspections prior to being granted operating authority and permitted to travel throughout the United States. Why should we have to wait 18 months for that? When it comes to public safety, should we not be more sure? Mexico, which has no standard apparatus in place, cannot now certify the safety of its trucks, especially its long-haul fleet, or enforce a border safety inspection program of its own. We have made modest progress in harmonizing motor carrier safety processes between our two countries. Nevertheless, the Department of Transportation's inspector general recently confirmed that serious discrepancies persist. Mexican trucks tend to be older, heavier and more likely to transport unmarked toxic or hazardous material. Mexico has not yet developed hours of service requirements for commercial drivers. Mexico does not have a laboratory certified to U.S. standards to perform drug testing. Mexico does not have a roadside inspection program. On our side, in Texas alone, I sent a letter to then Governor Bush when he was there almost 4 years ago. At that time we had 17 workers part time doing the inspections. Now we have 37 part-time people, yet we have 70 percent of the traffic. Texas was supposed to hire 171 new commercial vehicle inspectors. They did not. They did not get the resources. The bottom line is in the existing situation, the State of Texas has not put the resources where they should be. According to the State legislative officials that we just talked to a couple of days ago, they received no additional money for this purpose because of budgetary shortfalls that the past Governor put the whole State into. I ask Members to really look at this seriously and to make sure that we treat Mexican trucks in the same way that we treat our U.S. trucks.

Mr. RODRIGUEZ

Mr. RODRIGUEZ. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks on the subject of my special order tonight.

Mr. RODRIGUEZ. Mr. Speaker, this special order tonight is to highlight some injustices, an injustice that is not only unfair, but unwise. Tens of thousands of women and children in this country are denied vital medical and food benefits because of their immigration status. What does this policy say about our country, the richest in the world, especially now in these times of surplus? What kind of country are we building for our children when we say some are eligible and some are not, even though they have played by the rules? These are people that are legal immigrants that have played by the rules. Today hundreds of thousands of women and children are left outside without assistance in times of need. These are people who are here legally. They have followed the guidelines. They have paid taxes. They work. They are individuals that are out there baby-sitting our children, that pick up our trash. These people have been working hard, and they are strong Americans. But in 1996, Congress decided that it was not the American benefit to provide safety net services to the communities that contribute so much. Last week we observed the first International French Citizen Day. It is only fitting that we recognize the contributions of this community and restore their access to the food and medical assistance that they need. I strongly believe that we need to look at this as a national public health issue. When children go sick because their families cannot afford care, it is a public health issue. When pregnant women cannot get prenatal care, it is a public health issue. When pregnant women and young children do not have essential nutrition that they need, it is a public health issue. Ultimately it impacts on more than just our health, it hurts our educational system and economic possibilities. Children who go to school hungry will not perform to the best of their abilities. Nor will they achieve the full potential that they have. We all lose when we do not provide them access to good quality care and good nutrition. As I need to remind my colleagues, this is a Nation of immigrants, a Nation whose strength has come from hard work, of those who have fled persecution, from those who have left other countries to find better futures in our country, and who have left with their families and have come here. None of us would be here if it were not for immigration. Our country would have not had the academic, scientific, nor the industrial strength it does today without the contribution of our immigrants. So why do we choose to raise obstacles in the way that we have? It is wrong. We should change our misguided policy as soon as possible. Numerous bills are pending in the House under the banner of health solutions for hardworking American families that offer solutions for correcting this problem. The Legal Immigrant Children's Health Improvement Act, H.R. 1143, introduced by the gentleman from Florida (Mr. Diaz-Balart) and the gentleman from California (Mr. Waxman), the Nutrition Assistance for Working Families and Seniors Act, which is H.R. 2142, introduced by the gentleman from New York (Mr. Walsh), and the Women Immigrants Safe Harbor Act, H.R. 2258, introduced by the gentleman from Michigan (Mr. Levin), the gentlewoman from California (Ms. Pelosi), the gentlewoman from Maryland (Mrs. Morella) and others. These three bills help to basically address one of the problems that we have encountered. Should we deny health care and nutrition to this baby? The answer should be no. This baby should have access to good nutrition. We need to understand that these people are here legally and they have gone through the process. But because of our laws that we passed in 1996, we excluded them from participating in access to Medicare and the CHIP program that helps youngsters to be able to have access to insurance coverage; and in addition, we have excluded them from food stamps that are very critical, and in some cases we will find different families that have one that was born here, one that has come abroad, some that qualify, some that do not. So we have in our laws things that need to be corrected. Hopefully, we will have an opportunity to do this in this session. In addition, the Women Immigrants Safe Harbor Act, which is the third piece of legislation that is important, we have a lot of women that are abused. They do not have the opportunity to be able to get the services that they need. It is important. The third piece of legislation that we are going to be talking about tonight is the Women Immigrants Safe Harbor Act. I want to take this opportunity to also thank my fellow colleague who is here from Texas, Congressman Gene Green from Houston, who has been in the forefront on a variety of issues. He just spent some time talking about the Patients' Bill of Rights. I know he is up here tonight to talk about these issues. I thank him for being here with us.

Mr. RODRIGUEZ. I want to thank the gentleman from Texas (Mr. Green) as he so eloquently indicated was the fact that we are talking about legal immigrants. We are not talking about individuals that are here illegally. These are people that went by the rules and played by the rules and abide by all the laws that we have. They have not become citizens as of yet and find themselves in this situation. At this time to make the system fair for everyone, I urge my colleagues to cosponsor these important pieces of legislation that I have mentioned. Once again, it is the Legal Immigrant Children's Health Improvement Act, H.R. 1143 and S. 582; number two is the Nutrition Assistance for Working Families and Seniors Act, which is H.R. 2142; and the third is the Women Immigrants Safe Harbor Act. These are three important pieces of legislation that I feel will correct some of the injustices that exist out there and try to correct the situation where these individuals will be able to apply. As the Congressman has also indicated, when we look at those two pieces of legislation, first the Legal Immigrant Children's Health Improvement Act, it is one about making sure that people get included into Medicaid. The legislation does not require any State to cover these immigrant children and pregnant women. It merely allows the State to draw down Federal moneys to be able to provide the care. And so if States choose to do that, they can; but it is not mandatory. Secondly, the Nutrition Assistance for Working Families, once again it allows the State the option of creating a fixed 6-month transitional food stamp benefit for those moving from welfare to work in addition to providing them access to those food stamps that are critical. I want to take this opportunity to look at the specific problem that we have encountered with the existing piece of legislation. Current law bars legal immigrants, including pregnant women and children who arrive after August 22, 1996, for 5 years from receiving health benefits under Medicaid or under the CHIP program. Remember the CHIP program is that program of those youngsters, those families that are working hard and making money but yet do not have access to any kind of coverage. They are not poor enough to qualify for Medicaid, but they are finding themselves that they could qualify for CHIP; but because of the fact that they are in this status that they arrived here after August 22, 1996, they have to wait 5 years. Children and pregnant women who are denied coverage through the CHIP and Medicaid 5-year ban usually can get other vital health care coverages. We all know and recognize that preventive care minimizes emergency room visits, a costly and inefficient way of providing health care. More alarming is a recent Kaiser study that was done which reports that even though noncitizens are more likely to be without usual sources of care, they are less likely to go to emergency rooms than citizens. This particular study finds that if you are a noncitizen but here legally, you are less likely to have access to health care. This means that noncitizens are less likely to be able to have those opportunities, to be able to have preventive care, to be able to get to the emergency care when it is needed. The second piece of legislation, the Legal Immigrant Children's Health Improvement Act, gives States the option to allow low-income legal immigrants, children and pregnant women to have access not only to Medicaid and CHIP, but it also looks in terms of access to additional services. When we look at the health of children in immigrant families, it is important that now the States are having a crisis in this particular situation. Certain States are burdened, in addition, more than others. Some have more noncitizens than others. So we see the disparity that exists. According to a recent Urban Institute study, children of immigrants are three times as likely as children of natives to lack the usual sources of health care and more than twice as likely to be as fair or poor in health. For pregnant women and their children, regular prenatal care and early intervention saves lives and dollars as we all know. Children who have routine office visits and immunizations grow to be healthier adults with less medical complications. Children monitored by pediatricians are less likely to be victimized by chronic and communicable diseases. The 5-year ban on providing Medicaid and CHIP coverage has been the greatest barrier to health care for legal immigrants. As a matter of decency and as a matter of economics and as a matter of public health, legal immigrant children and pregnant women deserve the same access to essential health care coverage offered to citizens. We are talking about people who also pay their taxes, and we are talking about individuals that are here legally. This group has been singled out, and they are forbidden from accessing the very programs their tax dollars support. Studies show that each year, immigrants pay approximately $1,800 more in taxes than they use in services. This is according to the National Academy of Science. I would like to point out that the vast majority of immigrant families are mixed-status families that include at least one U.S. citizen and typically a child. The mixed status makes it impossible to have continued good continuity of services for the family. For instance, one foreign-born child may rely on emergency room care while a U.S.-born sibling might qualify for Medicaid. And so you find those situations in particular households where you have the parents that are here legally, then have children and now find themselves that the children might qualify, but they do not or the other children do not. The same complications are true for accessing other services such as food stamps. The Second Harvest National Food Bank Network study that was recently done found nearly 38 percent of emergency food assistance for clients that were children. That is, 38 percent of emergency food assistance clients were children. So we find a situation where children are lacking good nutrition. The food stamp program has played a vital role in helping low income working families, the elderly and the disabled make ends meet. It is a crucial support for hard-working families trying to make ends meet. For families who are in mixed immigrant status and that is where they have some kids that are citizens and some that are in the process of becoming citizens, it is the child that is hurt the most. Children who are U.S. citizens may not receive food stamps because their parents have immigrant status. Participation in the food stamp program among citizen children with legal permanent resident status declined 70 percent from 1994 to 1998. So we have actually had a decline in the participation from 1.35 million to 350,000. Twice the overall rate of participation declined in the food stamp program. I think that a lot of this is attributed to the piece of legislation that we have now and we will hopefully be able to correct that. I find this appalling, especially when you consider the reports that document hunger among children in America. This year the Urban Institute reported that nationwide 37 percent of all children immigrants lived in families worried about encountering difficulties with purchasing food. Should we deny food and nutrition services to children that are babies and would you deny this particular baby the right to have access to good quality nutrition and to good care? I think it is important for us that we be responsive and treat everyone in an equitable manner. So you have thousands of children throughout this country that find themselves in this particular loophole that I feel that needs to be corrected and these three pieces of legislation helped do that. So as we move forward, I urge my colleagues to cosponsor the Nutrition Assistance for Working Families and Seniors Act, which would restore food stamp benefits to qualified immigrants and primarily affecting families with children. I also want to say a few words about a bill recently introduced by the gentleman from Michigan (Mr. Levin) on Women Immigrants Safe Harbor Act, which is H.R. 2258. This particular legislation allows legal immigrants, who are victims of domestic violence, to be eligible for public benefits such as food stamps and Medicare and SSI for the period of time long enough to allow them to escape from their abusers. I will say that time and time again we need to care for the most vulnerable in our communities. Individuals fleeing domestic violence certainly need our help. It is time to talk about compassion, about fairness, about keeping our community healthy. Now is the time to give legal immigrants a chance to escape their abusive relationships. Under the present situation, they cannot. Now is the time to restore both the medicaid and the CHIPS benefits to lawfully presenting in any event women and children. Now is the time also to restore the food stamp benefits to working families and children and the seniors who rely on the assistance in time of need. I urge my colleagues to support the healthy solutions of American hard working families. This is the right thing to do for the immigrants, for the children and for all Americans. I want to take this final opportunity, Mr. Speaker, to just indicate that it is three pieces of legislation that will help correct the problems that we see now. Once again, it is the Legal Immigrant Children's Health Improvement Act that talks about only people that are legally in this country. I am not talking about illegal. These are people once again that went by the rules, played by the rules and now they find themselves in that 5-year gap. I ask for assistance and for people to sign up. Secondly, when it comes to nutrition and food stamps, we want to make sure that the Nutrition Assistance for Working Families and Seniors Act also is passed so they will have access to food stamps if they are in need. Finally, the Women Immigrants Safe Harbor Act allows women that are being abused the opportunity to qualify for these programs as they flee from those situations that are not healthy. General Leave

Mr. RODRIGUEZ

Mr. RODRIGUEZ. Mr. Speaker, first of all, I want to congratulate the gentleman for being here tonight. I know it is kind of late, and it is difficult to be home during the weekend and then coming here and spending some late hours at night talking about an issue that is so important to all Americans, including Texans. Let me just say that the Patients' Bill of Rights is very straightforward. It allows the opportunity, first of all, to see the doctor of one's choice. It makes all the sense in the world. One of the basic principles is that one wants to be able to see the doctor of one's choice, and that is important. Secondly, what it also does is it allows an opportunity, especially in those cases, and I had some particular constituents of mine who had some difficulties with lupus and some of the serious illnesses that they needed to see specialists for, so that when one has a very serious problem and requires specialists, one does not have to find that they are not only fighting the disease, but also fighting the HMO because they are not being responsive. So it becomes really important that we allow that opportunity, that a physician should have the right to be able to determine whether one should see a specialist or not. We all recognize that they are the ones that are the most qualified to be able to do that, and that we should not depend on someone who is doing the accounting or some insurance company to make their decision based on economics, but it should be based on what is the best thing for that particular patient in terms of seeing a specialist. In addition, we also talk about the importance of independent review. The gentleman explained it pretty clearly. A lot of times we have a situation, and now, this is one of the areas that we need to correct back at home, where we have a decision that is made by a company that has their own doctor, and the company decides that they are not going to allow that particular doctor to refer or do certain things, and then it is detrimental to the patient, and then that patient has the right to sue. The guidelines right now in Texas are that if they choose not to go based on the independent review organization recommendations, and something drastically happens that is wrong and bad, then they should have that right to sue. But as the gentleman indicated, and I have seen some statistics, I just saw an article that showed only 10 lawsuits. There is one other that showed 17.

Mr. RODRIGUEZ. Mr. Speaker, as the gentleman indicated, also one of the things that we still have to do that we did not do in Texas, and that is with the businesses. We have a lot of businesses that have their own insurance where they have their own company doctor, and where they might have some other obligations besides the fact of what they are supposed to be doing in terms of access to health care where we need to make sure we hold them accountable. So this is a very straightforward piece of legislation that allows one to see the doctor of one's choice; that allows one to see a specialist if it is so determined by the physician, and not by an accountant or for financial reasons, and it allows for an external review group that is independent and makes the decision and decides whether one should have access to specialists or not, or whether one should have additional treatment or not. That is important. I think that it is funny to see right now the amount of money that is being expended by the insurance companies on ads that say that the cost is going to go up. That has not occurred in Texas. In fact, in California they just passed a similar piece of legislation in January; they have not seen any lawsuits as of yet. I think that with this piece of legislation, and I am really proud that we were able to pass it in a bipartisan effort in the House last year, and we have been able to do that, but it was killed in conference committee. So we are hoping that we can get that bipartisan effort, both in the Senate and the House, and get it out so that the President will sign it. I know that he did not sign our piece of legislation, although he talked about it very proudly in a debate that he had with Al Gore when he talked about the fact that he had done this in Texas, and so that because of that, I think if it is sent to him, I feel very optimistic that he will do the right thing and sign it and allow it to become law, because it is the right thing to do. It is something that has worked in Texas, and it is something that makes all the sense in the world. Mr. Speaker, once again I want to thank the gentleman from Texas (Mr. Green) for his hard work, not only in this area, but in other areas that help out all Texans and other Americans.

Mr. RODRIGUEZ

Mr. RODRIGUEZ. Mr. Speaker, I move that the House do now adjourn.

Mr. RODRIGUEZ

Mr. RODRIGUEZ. Mr. Speaker, let me thank the gentleman first of all for bringing this up tonight. I think it is so important. I think we forget that we are all involved in agriculture when it comes to the issue of eating. I represent a district that runs from San Antonio north to south, all the way to the Mexican border, and I take pride that I am the seventh producer of peanuts in the Nation. But I also do not take pride in the fact that we are having a rough time, as the gentleman has indicated. Nature determines a lot of times what happens to our farmers. It is something where they basically put all their money into that crop. I had one year, in 1998, where I had a major flood that destroyed a lot of the crops that we had. Previously, we had about 5 years straight where droughts hit and devastated a lot of our farmers. Those kind of things we forget. One of the things that I think the gentleman mentioned, and that I think is important, is that we continue to mention the importance of our national security when it comes to agriculture and food. We cannot depend on foreign food when it comes to our national security. We have got to make sure that we continue to grow that food in this country. Because I think that is also important, as mentioned earlier in the discussions, the fact that a lot of our farmers now are senior citizens. The young are choosing not to go into it because it is very difficult, and a lot of times there are not the profits, and the risks are just tremendous. So we as a Congress and as a people need to make sure that we protect our farmers, and we need to do everything we can to make that happen. We talk about the minimum wage and the prevailing wage, but we very seldom talk about a prevailing price for that product that those farmers have. I think it is important that we do that. There is no doubt there is no way we can compete with Europe when they get subsidized. There is no way we can compete with Latin America, when they almost do not get paid for anything. The bottom line is, for our national security, we have to make sure we have our farmers. And I want to thank the gentleman for being out here tonight talking about the ag bill and what we need to do. We need to make sure that that food continues to be on the tables.

Mr. RODRIGUEZ

Mr. RODRIGUEZ. Madam Speaker, I rise this evening to offer my full support of funding for the National 4-H Program Centennial Initiative. 4-H is the youth education branch of the Cooperative Extension Service, which is also a program of the United States Department of Agriculture. The 4-H program is one of the nation's largest youth development organizations operating in over 3,000 counties throughout each of the fifty states. Texas has one of the largest memberships which includes more than 1.1 million children and teenagers. In and around the district I am privileged to represent, the 28th District of Texas, more than 72,000 young people are enrolled in the 4-H program. In anticipation of its centennial in 2002, the National 4-H Council has proposed the creation of a public-private partnership to develop new strategies for youth development that will reflect the fast- changing realities of life in the 21st Century. Among other things, 4-H hopes to examine the impact of expanding globalization and the role of emerging high technology businesses. The National 4-H Program Centennial Initiative will promote program discussions on the national, state, and local levels. These programs, whether meetings, seminars, or listening sessions, will promote new strategies for youth development and education. This legislation will provide grants up to $5 million to the National 4-H Council to federal share of program costs. Funding for these planning strategies will help address the issues facing millions of youth all across America. During these sessions, which will begin at the county level, interested young people will be able to raise issues or questions that face them and their future, such as how the 4-H program can best use emerging technologies to meet tomorrow's challenges. The results of these county sessions will form the foundation of a national strategic plan to implement changes and better prepare for the future. The diverse backgrounds and needs of Texas' counties will be reflected in these reports, helping 4-H members all across the nation understand and adapt to our changing world. Funding for this program will greatly benefit America's future by helping today's youth. We always say that our children are our future. Let's give them the chance to speak out and address the concerns of our changing world.

Mr. RODRIGUEZ

Mr. RODRIGUEZ. Madam Speaker, today marks an important date in our Nation's history. Today, the bells of freedom ring in our consciousness and our hearts as we celebrate Juneteenth, the oldest known celebration of the ending of slavery. On June 19th, 1865, two years following the Emancipation Proclamation issued by President Abraham Lincoln, Major General Gordon Granger of the Union Army read General Order #3 in Galveston, Texas. This order began most significantly with: The people of Texas are informed that in accordance with a Proclamation from the Executive of the United States, all slaves are free. This involves an absolute equality of rights and rights of property between former masters and slaves, and the connection heretofore existing between them becomes that between employer and free laborer. This profound news inspired immediate jubilation and happiness. African-Americans, previously bonded to their owners in slavery, were now united in their freedom and liberty. Juneteenth, celebrated every June 19th, commemorates this day of emancipation in Texas. Since 1865, Juneteenth celebrations have taken place throughout the United States. Large celebrations on June 19, 1866 marked the first anniversary of African-American independence day. Many of these events mirrored Fourth of July festivities. In these early days, the celebration included a prayer service, speakers with inspirational messages, reading of the Emancipation Proclamation and stories from former slaves. Juneteenth festivals spread from Texas to neighboring states as freed African-Americans migrated in search of work and to re-unite families separated by the slave trade. Celebration of Juneteenth revived in 1950 at the Texas State Fair Grounds in Dallas. Legislation passed in the 66th Texas legislature declared June 19 Emancipation Day in Texas, beginning January 1, 1980. Since that time, the celebration of Juneteenth continues across the state of Texas. Laws can set the stage for change, but actual progress can be slow. As Juneteenth takes on a more national and global perspective, the events in 1865 in Texas cannot be forgotten, for on this fertile soil the inalienable rights of life, liberty and the pursuit of happiness which Jefferson so eloquently crafted and championed in the Declaration of Independence were ultimately made possible--in law though not always in fact--for the former slaves. Today, Juneteenth celebrates African- American freedom while encouraging self-development and respect for all cultures. As we continue to move forward as a nation, we must continue to strive for equality. As Dr. Martin Luther King Jr. states on August 28, 1963 on the steps of the Lincoln memorial: This will be the day when all of God's children will be able to sing with a new meaning, ``My country, 'tis of thee, sweet land of liberty, of thee I sing. Land where my fathers died, land of the pilgrim's pride, from every mountainside, let freedom ring.'' And if America is to be a great nation, this must become true. And so today, let us continue to ring the bell of freedom and renew our commitment to the principles of equality and freedom--in fact not just in law--for all.

Mr. RODRIGUEZ

Mr. RODRIGUEZ. Madam Speaker, it is with great pleasure that we honor the continued commitment of the Army National Guard in supporting peacekeeping operations in Bosnia, as well as recognize the sacrifices made by these brave men and women who so valiantly serve our country. H. Con. Res. 154 commends the gallantry and dedication of these soldiers who have not only restored peace to the Balkans but have facilitated the recent democratization of the former Yugolslavia. With such distinguished units as the 49th Armored Division, Texas Army National Guard, and the other National Guard combat units deployed to Bosnia in support of the NATO peacekeeping mission, we have met our obligation to our European allies while serving our national interest in maintaining calm and promoting democracy in this part of the world. We must continue our commitment to providing the necessary resources to ensure the continued readiness of the National Guard and Reserve in the future. The National Guard and Reserve personnel at home and abroad play an instrumental role in the national security of the United States. I am honored to commemorate their efforts with this resolution.

Mr. RODRIGUEZ

Mr. RODRIGUEZ. I thank the gentleman from New Mexico for joining us tonight. I thank him for coming out. I know it is kind of late. We are also joined tonight by the gentlewoman from California (Ms. Sanchez). I want to thank her for coming out here tonight. I know it is kind of late. She was also working on an issue today on the House floor. I thank her for coming back and joining me.

Mr. RODRIGUEZ. Mr. Speaker, I rise tonight to highlight the health care needs of our communities throughout this country. I am deeply concerned with the lack of attention that the House leadership and the administration has paid, not just to managed-care reform, but to health care as a whole. Every day, millions of Americans suffer from diseases that we could prevent, diseases we could treat, diseases that we could cure. But we have not made the commitment to take care of that. We must not let them down. In this Special Order tonight, we look at the Patients' Bill of Rights, as well as the issue of health care. It is time for us to also consider the fact that there are a lot of individuals out there who are sick and that need our assistance, and we must not forget them. We hear so much about values, and the greatest value I know is helping those who need the assistance. And who needs the assistance more than those afflicted with the diseases of the body and of the mind? There is no doubt that this particular issue is an issue that continues to haunt us and is an issue that as a country we need to come to grips with. The Patients' Bill of Rights is an important piece of legislation. Not only does it make sense, but it also is the right thing to do. The Ganske-Dingell bill accomplishes the critical goals of managed- care reform. First, one of the things that it does, it gives every American the right to choose their own doctor. That makes every sense in the world. That is the fact that each one of us should have, the right to choose our own doctor. Secondly, the bill covers all Americans with employer-based health insurance, as well as other bills that, remarkably, exclude individuals such as firefighters, church employees, and teachers. Thirdly, this bill ensures that we extend external reviews of medical decisions that are conducted by independent and qualified physicians. We should not be allowing insurance accountants and people who are going to be looking at the all-mighty dollar when deciding the decisions of health care of those people that are ensured. Fourthly, it holds a plan accountable when the plan makes a bad decision that harms and kills someone. If the insurance and managed- care system decides not to provide access to care to someone, then we need to look at that seriously; and that is occurring throughout the country. Finally, it guarantees that health care decisions are made based on the medical, not the financial, considerations. Managed-care companies must put health care first, and the Patients' Bill of Rights creates the incentives to make sure that that occurs. Tonight, I am also joined here with the gentleman from Texas (Mr. Lampson). I am glad that he is here. Mr. Speaker, I yield to the gentleman from Texas (Mr. Lampson)

Mr. RODRIGUEZ. Mr. Speaker, I know that when the gentleman talked about that specific story, we all have stories; and we all have had calls and letters that we have received. Mr. Speaker, I had a family that recently sent me a letter complaining about the fact that she had Lupus and had received some contact from the particular company, and it is unfortunate in terms of the difficulty that some of these people are having. There is no doubt that when you are healthy and young, they are willing to have you onboard. As soon as you get sick and serious, then you begin to have some problems with those managed-care systems.

Mr. RODRIGUEZ. I also want to thank the gentleman. The gentleman mentioned the disparities that exist in the area of access to health care. We know that one of the biggest disparities that exists is the number of uninsured. The gentleman talked about Hispanics. We have some data to show that in Texas it is over 33 percent; but throughout the country, we continue to have almost 25 percent, that lack access to healthcare insurance. I want to share that with my colleagues a little bit, in terms of the discussion, a particular call that I had from one of my constituents. I recently received a letter from this constituent, who is not only battling Lupus, but also battling her managed-care company. Lupus is a chronic disease that causes the immune system to attack the body's own tissue. Patients often need access to several specialists because the disease can affect many different organ systems. When individuals need those several specialists, they find difficulty in dealing with the managed care system and difficulty in them responding. I want to quote from a letter that a person received. It says, ``People with lupus enrolled in managed care health plans should have immediate access to specialists and the specialty care they need even if those specialties are outside of the provider network. Because lupus can quickly become life-threatening, people with lupus should be able to seek emergency care when they reasonably believe that their health is in danger. They should not have to go through the lengthy complicated appeals process for receiving special care.'' Mr. Speaker, this story speaks well to the importance of a strong patient bill of rights. It is important to ensure that those who have private health coverage also have meaningful health care coverage that they can depend on when they are in need. I am a strong supporter of this, and I think it is important for us to continue to be supportive of this effort that when an individual is ill they have to be able to have access to those specialists, especially in specific cases such as lupus and many others. Unfortunately, people that find themselves in this bind also are having to battle the managed care systems throughout our country. I also want to mention that it is unfortunate that both administratively and legislatively recently we decided to look at the tax cut as the number one priority before we begin to look at the issues that confront us. It was unfortunate that we went forward on this tax cut without looking at the resources that were going to be needed, not only in all aspects of health care but all the other issues that confront us. It leaves too many Americans with diminished hopes in the area of health care. We are following the wrong path. We should first meet our needs and our priorities, which must include access to health care, before helping those individuals on the tax cuts. We face two great health care obstacles before us. First, too many Americans do not have the basic health care coverage that is needed. Secondly, even those who do often find themselves subject to a bureaucracy that they can neither understand nor navigate, a bureaucracy that is not responsive, a bureaucracy that needs to be pushed into doing the right thing. I am not referring to government, I am referring to the private sector and the managed care systems. We can no longer put off addressing these two great health care issues, the issue of access and managed care reform. The problem of access to care is not a small problem. More than 42 million persons, and the number is growing in this United States, lack access to good health care insurance. The burden falls disproportionately on a lot of the poor and minorities throughout this country. So many places of employment do not provide coverage. And let me add that those working in a small company, if it is not a major corporation, probably do not have access to insurance. Those not working for government, whether it be local government or Federal Government, probably do not have access to health insurance. So people find themselves in a real serious problem. Individuals not over 65 do not have Medicare; individuals who are not indigent, they do not have Medicaid. So here we have working Americans finding themselves in a real bind. In America, the rural populations face special challenges to access care. For example, nearly one-fourth, or 25 percent, of the uninsured in the United States are Hispanic, as indicated earlier. That is twice the proportion based on population. So we can see the disproportionate numbers. In addition, African Americans also lack insurance, 25 percent of them, when they only represent half of that amount of the population. So we can see the disparity in these communities. The rest are people that are poor and that do not have access to insurance but who are out there working trying to make ends meet. Roughly 20 percent of the uninsured live in rural areas. I have the distinction of having both not only an urban area in San Antonio but also 13 other counties of rural Texas, and I find myself that a lot of the rural counties have a great amount of difficulty with managed care systems, partly because of the reimbursement rates, partly because of the problem that a lot of the managed care systems choose not to go into rural America, and also because of the difficulties in terms of providing access to the ones that are really in need. According to recent studies by the Kaiser Family Foundation, the rural populations tend to be older, they tend to be poorer and they tend to be less healthy compared to the people living in urban areas. So here we find ourselves with a very vulnerable population and a real need for us to reach out. When we look at the statistics of the uninsured, our children, the numbers are staggering. Nearly 11 million children under 19 do not have access to insurance. We have tried some efforts in that area, but a lot more needs to occur and we hopefully will continue to move forward in those directions. In places like my hometown of San Antonio I am ashamed to say one- third, or 33 percent, of our children do not have coverage for health insurance. The burden falls not only on the children and not only on the families but also on the local governments. The reason why that is, for example, in the State of Texas we hold each county obligated up to 10 percent of their budgets to make sure they provide for the health care of their constituency. Yet those rural counties in south Texas, along the border, are expending up to 30 percent of their budgets for the poor. The rich counties have less poor and so do not have to expend as much, but a poor county, where individuals are paying property taxes, and in some cases in Texas for the hospital districts they are having to pay more to take care of these individuals, because the children's access to care is at the most expensive point, the emergency room. We need to make every effort to make sure that we take care of those kids before the emergency room; that we take care of those people before the emergency room. The cost rises as local governments are forced to raise taxes. So it is important for us to look at health care as a major issue that confronts this country and an issue that we have been unwilling to deal with not only as elected officials but as a community as a whole. Everyone pays and everyone pays too much because we do not offer the proper care up front. We need to look at the preventive care that is so very critical and very important and that can help prevent a lot of the diseases. The beauty of it now is that we can tell when youngsters are prone to have diabetes, type 2 diabetes, but what do we do with that information? Unless we do something to help prevent that diabetes as that youngster grows up, then we are defeating ourselves. My colleagues will also hear me speak time and time again on the need for improving access for the uninsured, especially with regard to the health status of the most underserved population, the poor, the rural population, the children, and minority of this country. The current debate on patients' rights illustrates the access to service that does not necessarily guarantee quality of service. We tend to associate barriers to care only with the uninsured, but even the insured in this country have a barrier to service. Those who have health insurance also, as my colleagues well know, face those barriers, and we need to make sure that those people at least have access. After all, they have been paying for that insurance, and when they get sick, it should be there for them. Let me be clear. Managed care companies provide a valuable service for millions of Americans. Health care must be affordable and it must be available. HMOs do work hard to reach those goals, but there are excesses. There are situations where individuals lose out and there are situations where HMOs have not been responsive. For many, health care coverage has not been there when it is needed. I recall a story that was told of LBJ, when he looked at establishing Medicare and Medicaid in this country back in the 1960s, and the story is that when he was having difficulty with the insurance companies who continued to bring obstacles on Medicare and Medicaid, he brought them into a room and he basically told them, and it is a very similar situation that we find ourselves in now, where he said, look, we all know that you are willing to take care of individuals when they are young and healthy, but as soon as they get old and sick, you are unwilling to expend what needs to be expended. As the story goes, LBJ got those people there into that room that were part of the insurance companies of this country and he told them, look, I am willing to help you by taking and being able to support and establish a Medicare and taking care of the senior citizens. After all, the statistics and the data showed that a lot of the companies were basically dumping our seniors after they got sick, very similar to what we find now in a lot of areas. So LBJ was able to convince them to support him on establishing Medicare for our seniors because, after all, those are the ones that are the most ill, those are the ones where the private sector is less likely to make a profit from, and they knew that they needed some help in that area. For the same reason, for the indigent, who did not have the resources to buy the insurance, he asked them to allow him the opportunity to establish Medicaid for the indigent so that these people that do not have those resources to buy insurance that they can be able to have access. So now we find a dilemma that in this country we somewhat take care of our seniors with Medicare and somewhat take care of our indigent with Medicaid, but in middle America we find people who are working hard, who are trying to make ends meet, in a bind, and yet not having access to good quality care. In fact, we have the largest number of uninsured in this country, over 42 million and growing. So many of us have experienced the frustration of having also changed doctors because they are no longer a part of our plan. The patient bill of rights addresses this issue, where individuals should have the right to see the doctor of their choice. It does not make any sense for them to force an individual to see someone that they do not want to see, especially if they have their own doctor. It also is troubling not being referred to specialists when a doctor says a person needs to see a specialist. That opportunity needs to be there and that opportunity is not there now with the private sector, some HMOs, who are giving individuals a rough time and giving those people who do pay their monthly premiums and should be able to have access to good quality care and to the specialists that they need. Such is the case with my constituent with lupus who had difficulty getting access to good care. We continue to hear these stories throughout the country. The passage of a Patient's Bill of Rights is important for all Americans and for members of the various communities that make up this Nation. As chair of the Congressional Hispanic Caucus, on the Task Force on Health Care, I would also like to highlight briefly how a Patient's Bill of Rights would help the Hispanic community in particular. The needs of managed care reform is especially important for Hispanics. Fully two-thirds of privately insured Hispanics are enrolled in managed care while only about one-half of privately insured whites are in managed care. This is based on a study done by a medical expenditures panel survey. In addition, the health care system is complicated enough, but for Hispanics and populations with limited English proficiency, the task of dealing with managed care is even more difficult. We need access to good culturally competent, linguistically sensitive providers that serve our communities. I want to share an example when we talk about culturally competent. This was a story that I continue to tell because it is a true story, a devastating story, of a woman who was told that she was positive for AIDS. In Spanish when you say positive, just like in English, it is ``positivo.'' If you do not explain what that means, the lady when she was told she was positive, she felt everything was great, not realizing that she was positive for AIDS, and she had a child that contracted AIDS. So the issue of cultural competency and linguistic understanding is very important. Hispanics, because they are more likely to be in managed care, are also more likely to have limited providers' options and limited treatment options. By having the right to choose doctors, patients can seek a doctor who speaks the same language. Managed care may be less likely to provide treatment and diagnosis that most affect these populations. Mr. Speaker, I am joined tonight by my colleague, the gentlewoman from Texas (Ms. Jackson-Lee).

Mr. RODRIGUEZ. Mr. Speaker, I thank the gentlewoman for her participation. I know the gentlewoman mentioned specifically about the fact that there are people making decisions, and as we well know, sometimes it is the accountant making a decision whether the patient should have a specialist or not. The ones making the decision should be the physicians. They are the ones that know best. They should be deciding whether a patient should have access to a specialist or not, and it should not be based upon economics. As the gentlewoman knows, this bill will make sure that occurs. As the gentlewoman stated, we want to see the doctors of our choice. It is a basic right that a patient should see a doctor that they want to see and that just makes all of the sense in the world. We want to make sure the patient feels comfortable. The gentlewoman mentioned the importance in terms of making sure that the language barriers and the competency is there. Nothing is worse than a patient being sent to someone that they do not feel comfortable with, that they do not feel secure with. That the patient feels maybe they are not making the right decisions. Maybe a patient has someone that they have been seeing all this time that they want to continue to see. I have always had my own doctor, and I have continued to see him despite the fact that my insurance does not cover those visits, but I continue to see him because I want to see him.

Mr. RODRIGUEZ. Mr. Speaker, the gentlewoman has hit the nail right on the head. That is one issue that all Americans agree we need to push for. The Patient Bill of Rights allows us to have the doctor of our choice. When we look at that and when we look at lawsuits, we have not seen that many lawsuits, but I will attest that if an accountant makes a decision whether you should see a specialist or not and that person dies, and that decision was made not for a medical reason but in terms of financing, then they have every right to be sued for malpractice. It is unfortunate that that is occurring in this country. We need to put a stop to that. I thank the gentlewoman for being here with us. Mr. Speaker, I want to take this opportunity to stress a little more in terms of the language barriers that exist, both to services and to health care that we encounter. The experiences that a lot of people have, if they do not speak the language, it becomes very difficult. We need to continue to move forward on that. Mr. Speaker, tonight I am joined by the gentleman from New Mexico (Mr. Udall). I know the gentleman has been active on health care and has serious concerns about access to health care, and I thank the gentleman for joining me tonight.

Mr. RODRIGUEZ. I thank the gentlewoman for joining me tonight. She has worked hard in the caucus on various task forces. I know she is interested in health also, and I know she is very interested in the Patients' Bill of Rights. We have talked tonight about the importance of seeing the doctor of our choice, the importance of making sure that physicians make the decisions and not accountants, the importance of making sure that we hold the managed-care system accountable when that person needs a specialist and the physician says that they need a specialist, then that person should be allotted that specialist. We have a variety of cases that have been brought, I know, to her office. The gentlewoman has had letters from people who have had difficulty with managed-care systems. I shared with the public a particular person who had had lupus, a disease that required a variety of specialists and had not only had to fight with her illness but also had to fight with our managed-care system.

Mr. RODRIGUEZ. I want to thank the gentleman from New Mexico (Mr. Udall) for his service. I know he has been working real hard in this area, too. He mentioned the lawsuits. He is right and correct in the fact that we have not seen those lawsuits in Texas. It just gives that right. They know that the decision should be made by the medical profession and not by the accountants. In addition, he also represents a State that has a lot of rural community, a lot of Hispanics also that are uninsured. I know he has worked hard in representing them. I want to thank him for what he has done in that area. And also the fact that rural America, such as rural New Mexico and Texas, find themselves without access to health care. A lot of the managed-care systems are not operating in rural America. We have a great deal of difficulty in getting access to managed care in those areas. It has created a lot of problems for us. I want to thank the gentleman personally for what he has done on behalf of New Mexico and everyone in New Mexico including the Hispanics there.

Mr. RODRIGUEZ. Mr. Speaker, I thank the gentlewoman from California (Mrs. Napolitano) for her comments. The Ganske-Dingell piece of legislation allows this opportunity. By the way, this particular bill has been passed by the House and we will have an opportunity to pass it again and hopefully pass it through both Houses and be able to make it through. Once again, I want to thank all the Members that have come out today to provide their testimony of the importance of the Patients' Bill of Rights and the importance of passing this to be able to see the doctor of one's choice.

Mr. RODRIGUEZ

Mr. RODRIGUEZ. Mr. Speaker, the House has taken a major step in supporting the federal government's role in education with the passage of H.R. 1, the No Child Left Behind Act, which re-authorizes the Elementary and Secondary Education Act (ESEA). Through this legislation, we have made a $22.8 billion commitment for elementary and secondary education programs--a $5 billion increase over last year. Specifically, this comprehensive measure authorizes $11.5 billion for Title I grants, which assist school districts serving economically disadvantaged students; requires states and school districts to issue report cards on aspects of student performance and teacher qualifications; requires all teachers to achieve state certification by 2005; and allocates $1.3 billion for afterschool programs, including the 21st Century Learning Centers and the Safe and Drug-Free Schools. I am also pleased that amendments calling for the implementation of block grants and private school vouchers were soundly defeated during floor consideration of H.R. 1. While H.R. 1 consolidates thirteen programmatic titles under ESEA into six, the current funding structure remains intact. Federal dollars will continue to go directly to the local school districts rather than be needlessly funneled through a state's bureaucracy. Furthermore, although the Act provides public school choice as well as private tutorial services to Title I students in consistently failing schools, it does not create a private school voucher program. I have consistently opposed any private voucher proposal because it would undermine public financing for public schools and provide no guarantee that low-income students would have any meaningful choice. The House's rejection of these provisions reaffirms Congress' bi-partisan support of public education. Despite these many achievements during consideration of the No Child Left Behind Act, there remain several shortcomings which I hope are addressed during the House-Senate conference. In particular, I am disappointed with the House's failure to authorize funds for class size reduction and school renovation and construction. We have again missed the opportunity to bring older schools into the new century and ensure that our children learn in safe facilities with the most modern amenities and technology. Unfortunately, the primary focus of ``reform'' has been on testing. In the name of accountability, more testing will be mandated with little financial support from the federal government. Given that many states have failed to comply with current law calling on states to Moreover, I, along with my colleagues in the Congressional Hispanic Caucus (CHC), have concerns with H.R. 1's treatment of the Limited English Proficient (LEP) student population. The National Assessment of Educational Progress (NAEP), a diagnostic tool to be used to audit the results of state assessments, does not administer a Spanish language reading test. Additionally, H.R. 1 unwisely consolidates immigrant, bilingual, and foreign language education into a single formula grant program. It would also require parents to opt-in to Title I LEP services and bilingual education and would subject bilingual education programs to a 3-year limit. In their March 3, 2001 letter to President Bush, Congressman Reyes, Chair of the CHC, and Congressman Hinojosa, Chair of the CHC Education Task Force, voiced the CHC's opposition to the above provisions. First, tests provided in only English could result in inaccurate assessments of student performance for LEP students. Second, because LEP children have diverse needs and skills, a one-size fits-all approach is impractical. Establishing an arbitrary three year instructional time limit is short-sighted and contrary to the objectives of bilingual education, which is the academic achievement of LEP students in addition to English proficiency. Finally, opt-in provisions will place cumbersome procedural requirements on school districts and potentially dissuade them from providing educational instruction to LEP students. LEP students should be automatically enrolled in bilingual education programs and allowed to opt out of them if their parents so choose. The conference version of the ESEA's re-authorization should incorporate language that provides better funding, requires no time limits, contains no opt-in provisions, and maintains immigrant, bilingual, and foreign language education as three separate programs. As an educator and supporter of public schools, I will continue to seek the resources our schools need to succeed. We have an obligation to provide fair and equal access to quality education for our children so that truly no child is left behind. Until we are truly ready to commit ourselves to educating all our children with the best we can offer, we cannot honestly say we have left no child behind.

Mr. RODRIGUEZ

Mr. RODRIGUEZ. Madam Speaker, today I rise because we have a major bill before us, H.R. 1291, that will talk about the Montgomery GI bill; but I want to take this opportunity to discuss the process. Madam Speaker, I am concerned that as people learn about the political process and how it is supposed to operate, here is a bill on the House floor today that is very important, yet it never saw the light in terms of subcommittee. It never had the opportunity of being heard in full committee. It never had the opportunity so that we could provide some amendments. In fact, I presumed that when the leadership heard we had some amendments to try to improve the bill, they chose to bring it on the House floor without the process that this body has allowed through the ages to allow an opportunity for us to be able to influence. It is unfortunate. It is a good bill; yet we need to understand that we need to improve this bill. Madam Speaker, tuition rates throughout this country have risen. The studies show that even the fees in a lot of universities are higher. We need to make sure that our veterans get what they deserve, not only a process but a service.

Mr. RODRIGUEZ

Mr. RODRIGUEZ. Madam Speaker, I am proud to be here today and be a cosponsor of H.R. 1291, the 21st Century GI Bill Enhancement Act. At a time when drastic tax cuts have overshadowed our Nation's priorities, it is refreshing that the House should take up the legislation that takes a major step towards restoring purchasing power for the GI Bill. Educational benefits are the military's best recruiting tool. The Montgomery GI Bill must be modernized to meet today's demands. H.R. 1291 moves toward this goal of expanding access to higher education by increasing the current monthly benefits from $650 to $800 by the year 2002, and ultimately to $1,100 by 2004. Clearly, today's legislation provides a stronger education package to the men and women who choose to serve our country. However, while I support this measure, I regret that I did not have the opportunity to vote for the bill in full committee because of the manner in which H.R. 1291 was brought to the House floor. More importantly, I am disappointed that the gentleman from Illinois (Mr. Evans), the ranking member, was not permitted to offer his amendment during the subcommittee markup on H.R. 1291, which was abruptly canceled. H.R. 320, the amendment offered by the gentleman from Illinois (Mr. Evans), the Montgomery GI Bill Improvements Act, would have provided additional resources for tuition, would have provided additional resources for fees, would have provided additional resources for books and supplies, as well as provided assistance and allowances for these people that would have enlisted for 4 additional years in service. As drafted and presented today on the House floor, H.R. 1291 only provides modest assistance in covering this cost. Yes, we are happy that this is here. We would have had a great opportunity to make some things happen, and it is unfortunate we did not have the opportunity to make that happen. My understanding is, based on the rules that we operate under, Rule 4(c)(1), the committee rule states that each subcommittee is authorized to meet and report to the full committee on all matters under its jurisdiction. These committees were not allowed to practice the way we should, and it is something that we also need to recognize, that this is not a way of handling our issues that come before the House. As we look in terms of the resources that we have now and the costs of higher education, recent reports show that fees alone are higher than tuition in most universities around the country, so there is a real need for us to look at this seriously. We can stand here today and be proud of this piece of legislation, but we can also not feel proud of the way it was handled. Why, why, did this particular piece of legislation not have an opportunity to have a vote?