Olympia Snowe

Ms. SNOWE

Ms. SNOWE. Mr. President I rise today to introduce the Child Protection/Alcohol and Drug Partnership Act, and I am pleased to be joined by my good friends, Senators Rockefeller, DeWine, Dodd, collins, and Lincoln. Mr. President this bill is an enormously important piece of legislation. It provides the means for states to support some of our most vulnerable families, families who are struggling with alcohol and drug abuse, and the children who are being raised in these homes. It is obvious, both anecdotally and statistically, that child welfare is significantly impacted by parental substance abuse. And it makes a lot of sense to fund state programs to address these two issues in tandem. The real question in designing and supporting child welfare programs is how can we, public policy makers, government officials, welfare agencies, honestly expect to improve child welfare without appropriately and adequately addressing the root problems affecting these children's lives? We know that substance abuse is the primary ingredient in child abuse and neglect. Most studies find that between one-third and two-thirds, and some say as high as 80 percent to 90 percent, of children in the child welfare system come from families where parental substance abuse is a contributing factor. The Child Protection/Alcohol and Drug Partnership Act creates a new five-year $1.9 billion state block grant program to address the connection between substance abuse and child welfare. Payments would be made to promote joint activities among federal, state, and local public child welfare and alcohol and drug prevention and treatment agencies. Our underlying belief, and the point of this bill, is to encourage existing agencies to work together to keep children safe. HHS will award grants to States and Indian tribes to encourage programs for families who are known to the child welfare system and have alcohol and drug abuse problems. These grants will forge new and necessary partnerships between the child protection agencies and the alcohol and drug prevention and treatment agencies so they can work together to provide services fort this population. The program is designed to increase the capacity of both the child welfare and alcohol and drug systems to comprehensively address the needs of these families to improve child safety, family stability, and permanence, and to promote recovery from alcohol and drug problems. Statistics paint an unhappy picture for children of substance abusing parents: a 1998 report by the National Committee to Prevent Child Abuse found that 36 states reported that parental substance abuse and poverty are the top two problems exhibited by families reported for child maltreatment. And a 1997 survey conducted by the Child Welfare League of America found that at least 52 percent of placements into out-of- home care were due in part to parental substance abuse. Children whose parents abuse alcohol and drugs are almost three times likelier to be abused and more than four times likelier to be neglected than children of parents who are not substance abusers. Children in alcohol-abusing families were nearly four times more likely to be maltreated overall, almost five times more likely to be physically neglected, and 10 times more likely to be emotionally neglected than children in families without alcohol problems. A 1994 study published in the American Journal of Public Health fund that children prenatally exposed to substances have been found to be two to three times more likely to be abused than non-exposed children. And as many as 80 percent of prenatally drug exposed infants will come to the attention of child welfare before their first birthday. Abused and neglected children under age six face the risk of more severe damage than older children because their brains and neurological systems are still developing. Unfortunately, child welfare agencies estimate that only a third of the 67 percent of the parents who need drug or alcohol prevention and treatment services actually get help today. This bill is about preventing problems. My colleagues and I know that what is most important here is the safety and well-being of America's children. We expect much of our youth because they are the future of our nation. In turn, we must be willing to give them the support they need to learn and grow, so that they can lead healthy and productive lives. In 1997 Congress passed the Adoption and Safe Families Act, ASFA, authored by the late Senator John Chafee. ASFA promotes safety, stability, and permanence for all abused and neglected children and requires timely decision-making in all proceedings to determine whether children can safely return home, or whether they should be moved to permanent, adoptive homes. Specifically, the law requires a State to ensure that services are provided to the families of children who are at risk, so that children can remain safely with their families or return home after being in foster care. The bill we are introducing today identifies a very specific area in which families and children need services, substance abuse. And it will ensure that states have the funding necessary to provide services as required under the Adoption and Safe Families Act. On March 23, 2000, Kristine Ragaglia, Commissioner of the Connecticut Department of Children and Families, testified before the House Subcommittee on Human Resources on this issue. She said simply that ``If substance abuse issues are left unaddressed, many of the system's efforts to protect children and to promote positive change in families will be wasted.'' This legislation aims to address this very gap in our nation's child protection system. I am pleased that this legislation has been endorsed by the American Academy of Child & Adolescent Psychiatry; the American Academy of Pediatrics; the American Prosecutors Research Institute; the American Psychological Association; the American Public Human Services Association; the Child Welfare League of America; the Children's Defense Fund; Fight Crime: Invest in Kids; the Maine Association of Prevention Programs; the Maine Association of Substance Abuse Programs; the Maine Children's Trust; Mainely Parents; the Massachusetts Society for the Prevention of Cruelty to Children; the National Conference of State Legislators; the New York State Office of Alcoholism and Substance Abuse Services; and Prevent Child Abuse America. I encourage my colleagues to take a look at our bill, to think seriously about the future for kids in their states, and to work with us in passing this very important piece of legislation. I ask unanimous consent that a fact sheet and section-by-section description of the bill be printed in the Record.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to reintroduce legislation I first introduced in the 105th Congress to address a serious health concern for veterans specifically the health threat posed by the Hepatitis C virus. The legislation I am introducing today would make Hepatitis C a service-connected condition so that veterans suffering from this virus can be treated by the VA. The bill will establish a presumption of service connection for veterans with Hepatitis C, meaning that the Department of Veterans Affairs will assume that this condition was incurred or aggravated in military service, provided that certain conditions are met. Under this legislation, veterans who received a transfusion of blood during a period of service before December 31, 1992; veterans who were exposed to blood during a period of service; veterans who underwent hemodyalisis during a period of service; veterans diagnosed with unexplained liver disease during a period of service; veterans with an unexplained liver dysfunction value or test; or veterans working in a health care occupation during service, will be eligible for treatment for this condition at VA facilities. I have reviewed medical research that suggests many veterans were exposed to Hepatitis C in service and are now suffering from liver and other diseases caused by exposure to the virus. I am troubled that many ``Hepatitis C veterans'' are not being treated by the VA because they can't prove the virus was service connected, despite the fact that hepatitis C was little known and could not be tested for until recently. We are learning that those who served in Vietnam and other conflicts, tend to have higher than average rates of Hepatitis C. In fact, VA data shows that about 20 percent of its inpatient population is infected with the Hepatitis C virus, and some studies have found that 10 percent of otherwise healthy Vietnam, Veterans are Hepatitis C positive. Hepatitis C was not isolated until 1989, and the test for the virus has only been available since 1990. Hepatitis C is a hidden infection with few symptoms. However, most of those infected with the virus will develop serious liver disease 10 to 30 years after contracting it. For many of those infected, Hepatitis C can lead to liver failure, transplants, liver cancer, and death. And yet, most people who have Hepatitis C don't even know it--and often do not get treatment until it's too late. Only five percent of the estimated four million Americans with hepatitis C know they have it; yet with new treatments, some estimates indicate that 50 percent may have the virus eradicated. Vietnam Veterans in particular are just now starting to learn that they have liver disease likely caused by Hepatitis C. Early detection and treatment may help head off serious liver disease for many of them. However, many veterans with Hepatitis C will not be treated by the VA because they must meet a standard that is virtually impossible to meet in order to establish a service connection for their condition--this in spite of the fact that we now know that many Vietnam-era and other veterans got this disease serving their country. Many of my colleagues may be interested to know how veterans were likely exposed to this virus. Many veterans received blood transfusions while in Vietnam. This is one of the most common ways Hepatitis C is transmitted. Medical transmission of the virus through needles and other medical equipment is also possible in combat. Medical care providers in the services were likely at increased risk as well, and may have, in turn, posed a risk to the service members they treated. Researchers have discovered that Hepatitis C was widespread in Southeast Asia during the Vietnam war, and that some blood sent from the U.S. was also infected with the virus. Researchers and veterans organizations, including the Vietnam Veterans of America, with whom I worked closely to prepare this legislation, believe that many veterans were infected after being injured in combat and getting a transfusion or from working as a medic around combat injuries. I believe we will actually save money in the long run by testing and treating this infection early on. The alternative is much more costly treatment of end-stage liver disease and the associated complications, or other disorders. Some will argue that further epidemiologic data is needed to resolve or prove the issue of service connection. I agree that we have our work cut out for us, and further study should be done. However, there is already a substantial body of research on the relationship between Hepatitis C and military service. While further research is being conducted, we should not ask those who have already sacrificed so much for this country to wait--perhaps for years--for the treatment they deserve. Former Surgeon General C. Everett Koop, well respected both within and outside of the medical profession, has said, ``In some studies of veterans entering the Department of Veterans Affairs health facilities, half of the veterans have tested positive for HCV. Some of these veterans may have left the military with HCV infection, while others may have developed it after their military service. In any event, we need to detect the treat HCV infection if we are to head off very high rates of liver disease and liver transplant in VA facilities over the next decade. I believe this effort should include HCV testing as part of the discharge physical in the military, and entrance screening for veterans entering the VA health system.'' Veterans have already fought their share of battles--these men and women who sacrificed in war so that others could live in peace shouldn't have to fight again for the benefits and respect they have earned. We still have a long way to go before we know how best to confront this deadly virus. A comprehensive policy to confront such a monumental challenge can not be established overnight. It will require the long- term commitment of Congress and the Administration to a serious effort to address their health concern. I hope this legislation will be a constructive step in this effort, and I look forward to working with the Veterans Affairs Committee, the VA-HUD appropriators, Vietnam Veterans of America and other veterans groups to meet this emerging challenge.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to reintroduce legislation I first introduced in the 105th Congress to address a serious health concern for veterans specifically the health threat posed by the Hepatitis C virus. The legislation I am introducing today would make Hepatitis C a service-connected condition so that veterans suffering from this virus can be treated by the VA. The bill will establish a presumption of service connection for veterans with Hepatitis C, meaning that the Department of Veterans Affairs will assume that this condition was incurred or aggravated in military service, provided that certain conditions are met. Under this legislation, veterans who received a transfusion of blood during a period of service before December 31, 1992; veterans who were exposed to blood during a period of service; veterans who underwent hemodyalisis during a period of service; veterans diagnosed with unexplained liver disease during a period of service; veterans with an unexplained liver dysfunction value or test; or veterans working in a health care occupation during service, will be eligible for treatment for this condition at VA facilities. I have reviewed medical research that suggests many veterans were exposed to Hepatitis C in service and are now suffering from liver and other diseases caused by exposure to the virus. I am troubled that many ``Hepatitis C veterans'' are not being treated by the VA because they can't prove the virus was service connected, despite the fact that hepatitis C was little known and could not be tested for until recently. We are learning that those who served in Vietnam and other conflicts, tend to have higher than average rates of Hepatitis C. In fact, VA data shows that about 20 percent of its inpatient population is infected with the Hepatitis C virus, and some studies have found that 10 percent of otherwise healthy Vietnam, Veterans are Hepatitis C positive. Hepatitis C was not isolated until 1989, and the test for the virus has only been available since 1990. Hepatitis C is a hidden infection with few symptoms. However, most of those infected with the virus will develop serious liver disease 10 to 30 years after contracting it. For many of those infected, Hepatitis C can lead to liver failure, transplants, liver cancer, and death. And yet, most people who have Hepatitis C don't even know it--and often do not get treatment until it's too late. Only five percent of the estimated four million Americans with hepatitis C know they have it; yet with new treatments, some estimates indicate that 50 percent may have the virus eradicated. Vietnam Veterans in particular are just now starting to learn that they have liver disease likely caused by Hepatitis C. Early detection and treatment may help head off serious liver disease for many of them. However, many veterans with Hepatitis C will not be treated by the VA because they must meet a standard that is virtually impossible to meet in order to establish a service connection for their condition--this in spite of the fact that we now know that many Vietnam-era and other veterans got this disease serving their country. Many of my colleagues may be interested to know how veterans were likely exposed to this virus. Many veterans received blood transfusions while in Vietnam. This is one of the most common ways Hepatitis C is transmitted. Medical transmission of the virus through needles and other medical equipment is also possible in combat. Medical care providers in the services were likely at increased risk as well, and may have, in turn, posed a risk to the service members they treated. Researchers have discovered that Hepatitis C was widespread in Southeast Asia during the Vietnam war, and that some blood sent from the U.S. was also infected with the virus. Researchers and veterans organizations, including the Vietnam Veterans of America, with whom I worked closely to prepare this legislation, believe that many veterans were infected after being injured in combat and getting a transfusion or from working as a medic around combat injuries. I believe we will actually save money in the long run by testing and treating this infection early on. The alternative is much more costly treatment of end-stage liver disease and the associated complications, or other disorders. Some will argue that further epidemiologic data is needed to resolve or prove the issue of service connection. I agree that we have our work cut out for us, and further study should be done. However, there is already a substantial body of research on the relationship between Hepatitis C and military service. While further research is being conducted, we should not ask those who have already sacrificed so much for this country to wait--perhaps for years--for the treatment they deserve. Former Surgeon General C. Everett Koop, well respected both within and outside of the medical profession, has said, ``In some studies of veterans entering the Department of Veterans Affairs health facilities, half of the veterans have tested positive for HCV. Some of these veterans may have left the military with HCV infection, while others may have developed it after their military service. In any event, we need to detect the treat HCV infection if we are to head off very high rates of liver disease and liver transplant in VA facilities over the next decade. I believe this effort should include HCV testing as part of the discharge physical in the military, and entrance screening for veterans entering the VA health system.'' Veterans have already fought their share of battles--these men and women who sacrificed in war so that others could live in peace shouldn't have to fight again for the benefits and respect they have earned. We still have a long way to go before we know how best to confront this deadly virus. A comprehensive policy to confront such a monumental challenge can not be established overnight. It will require the long- term commitment of Congress and the Administration to a serious effort to address their health concern. I hope this legislation will be a constructive step in this effort, and I look forward to working with the Veterans Affairs Committee, the VA-HUD appropriators, Vietnam Veterans of America and other veterans groups to meet this emerging challenge.

Ms. SNOWE. Mr. President, I rise today to introduce the Veterans Health Care Quality Assurance Act of 2001. This legislation contains a number of proposals designed to ensure that access to high quality medical services for our veterans is not compromised as the Department of Veterans Affairs, the VA, strives to increase efficiency in its nationwide network of veterans hospitals. The VA administers the largest health care network in the U.S., including 172 hospitals, 73 home care programs, over 800 community- based outpatient clinics, and numerous other specialized care facilities. Moreover, there are approximately 25 million veterans in the U.S., including approximately 19.3 million wartime veterans, and the number of veterans seeking medical care in VA hospitals is increasing. The FY2000 VA medical caseload was projected to total approximately 3.8 million, an increase of 185,000 over FY1999. This level is expected to increase to 3.9 million during FY2001. Furthermore, in FY2001, outpatient visits to VA facilities are expected to increase by 2.6 million to 40.4 million. The average age of veterans is increasing as well, and this is expected to result in additional demands for health care services, including more frequent and long-term health needs. The VA is attempting to meet this unprecedented demand for health care services without substantial increases in funding, largely through efforts to increase efficiency. Not surprisingly, these seemingly competing objectives are generating serious concerns about the possibility that quality of care and/or patient satisfaction are being sacrificed. Many VA regional networks and medical center directors report that timely access to high quality health care is being jeopardized, and that is why I am introducing the Veterans Health Care Quality Assurance Act, legislation which seeks to ensure that no veterans' hospital is targeted unfairly for cuts, and that efforts to ``streamline'' and increase efficiency are not followed by the unintended consequence of undermining quality of care or patient satisfaction. I believe that all veterans hospitals should be held to the same equitable VA-wide standards, and that quality and satisfaction must be guaranteed. Toward that end, the Veterans Health Care Quality Assurance Act calls for audits of every VA hospital every three years. This will ensure that each facility is subject to an outside, independent review of its operations on a regular basis, and each audit will include findings on how to improve services to our veterans. The legislation will also establish an Office of Quality Assurance within the VA to ensure that steps taken to increase efficiency in VA medical programs do not undermine quality or patient satisfaction. This office will collect and disseminate information on efforts that have proven to successfully increase efficiency and resource utilization without undermining quality or patient satisfaction. The director of this new Office of Quality Assurance should be an advocate for veterans and would be placed in the appropriate position in the VA command structure to ensure that he or she is consulted by the VA Secretary and Under Secretary for Veterans Health on matters that impact quality or satisfaction. The bill would require an initial report to Congress within six months of enactment, which would include a survey of each VA regional network and a report on each network's efforts to increase efficiency, as well as an assessment of the extent to which each network and VA hospital is or is not implementing the same uniform, VA-wide policies to increase efficiency. Under the bill's reporting requirement, the VA would also be required to publish, annually, an overview of VA-wide efficiency goals and quality/satisfaction standards that each veterans facility should be held to. Further, the VA would be required to report to Congress on each hospital's standing in relation to efficiency, quality, and satisfaction criteria, and how each facility compares to the VA-wide average. In an effort to encourage innovation in efforts to increase efficiency within the agency, the bill would encourage the dissemination and sharing of information throughout the VA in order to facilitate implementation of uniform, equitable efficiency standards. Finally the bill includes provisions calling for sharing of information on efforts to maximize resources and increase efficiency without compromising quality of care and patient satisfaction; exchange and mentoring initiatives among and between networks in order to facilitate sharing of such information; incentives for networks to increase efficiency and meet uniform quality/patient satisfaction targets; and formal oversight by the VA to ensure that all networks are meeting uniform efficiency criteria and that efforts to increase efficiency are equitable between networks and medical facilities. Keeping our promise to our veterans is also an on-going duty. The debt of gratitude we owe to our veterans can never be fully repaid. What we can and must do for our veterans is repay the financial debt we owe to them. Central to that solemn duty is ensuring that the benefits we promised our veterans when they enlisted are there for them when they need them. I consider it a great honor to represent veterans. So many of them continue to make contributions in our communities upon their transition from military to civilian life, through youth activities and scholarships programs, homeless assistance initiatives, efforts to reach out to fellow veterans in need, and national leadership on issues of importance to veterans and all Americans. The least we can do is make good on our promises, such as the promise of access to high quality health care. I have nothing but the utmost respect for those who have served their country, and this legislation is but a small tribute to the men and women and their families who have served this country with courage, honor and distinction. They answered the call to duty when their country needed them, and this is a component of my on-going effort to ensure that we, as elected officials, answer their call when they need us. I urge my colleagues to join me in supporting this legislation.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to introduce the Veterans Health Care Quality Assurance Act of 2001. This legislation contains a number of proposals designed to ensure that access to high quality medical services for our veterans is not compromised as the Department of Veterans Affairs, the VA, strives to increase efficiency in its nationwide network of veterans hospitals. The VA administers the largest health care network in the U.S., including 172 hospitals, 73 home care programs, over 800 community- based outpatient clinics, and numerous other specialized care facilities. Moreover, there are approximately 25 million veterans in the U.S., including approximately 19.3 million wartime veterans, and the number of veterans seeking medical care in VA hospitals is increasing. The FY2000 VA medical caseload was projected to total approximately 3.8 million, an increase of 185,000 over FY1999. This level is expected to increase to 3.9 million during FY2001. Furthermore, in FY2001, outpatient visits to VA facilities are expected to increase by 2.6 million to 40.4 million. The average age of veterans is increasing as well, and this is expected to result in additional demands for health care services, including more frequent and long-term health needs. The VA is attempting to meet this unprecedented demand for health care services without substantial increases in funding, largely through efforts to increase efficiency. Not surprisingly, these seemingly competing objectives are generating serious concerns about the possibility that quality of care and/or patient satisfaction are being sacrificed. Many VA regional networks and medical center directors report that timely access to high quality health care is being jeopardized, and that is why I am introducing the Veterans Health Care Quality Assurance Act, legislation which seeks to ensure that no veterans' hospital is targeted unfairly for cuts, and that efforts to ``streamline'' and increase efficiency are not followed by the unintended consequence of undermining quality of care or patient satisfaction. I believe that all veterans hospitals should be held to the same equitable VA-wide standards, and that quality and satisfaction must be guaranteed. Toward that end, the Veterans Health Care Quality Assurance Act calls for audits of every VA hospital every three years. This will ensure that each facility is subject to an outside, independent review of its operations on a regular basis, and each audit will include findings on how to improve services to our veterans. The legislation will also establish an Office of Quality Assurance within the VA to ensure that steps taken to increase efficiency in VA medical programs do not undermine quality or patient satisfaction. This office will collect and disseminate information on efforts that have proven to successfully increase efficiency and resource utilization without undermining quality or patient satisfaction. The director of this new Office of Quality Assurance should be an advocate for veterans and would be placed in the appropriate position in the VA command structure to ensure that he or she is consulted by the VA Secretary and Under Secretary for Veterans Health on matters that impact quality or satisfaction. The bill would require an initial report to Congress within six months of enactment, which would include a survey of each VA regional network and a report on each network's efforts to increase efficiency, as well as an assessment of the extent to which each network and VA hospital is or is not implementing the same uniform, VA-wide policies to increase efficiency. Under the bill's reporting requirement, the VA would also be required to publish, annually, an overview of VA-wide efficiency goals and quality/satisfaction standards that each veterans facility should be held to. Further, the VA would be required to report to Congress on each hospital's standing in relation to efficiency, quality, and satisfaction criteria, and how each facility compares to the VA-wide average. In an effort to encourage innovation in efforts to increase efficiency within the agency, the bill would encourage the dissemination and sharing of information throughout the VA in order to facilitate implementation of uniform, equitable efficiency standards. Finally the bill includes provisions calling for sharing of information on efforts to maximize resources and increase efficiency without compromising quality of care and patient satisfaction; exchange and mentoring initiatives among and between networks in order to facilitate sharing of such information; incentives for networks to increase efficiency and meet uniform quality/patient satisfaction targets; and formal oversight by the VA to ensure that all networks are meeting uniform efficiency criteria and that efforts to increase efficiency are equitable between networks and medical facilities. Keeping our promise to our veterans is also an on-going duty. The debt of gratitude we owe to our veterans can never be fully repaid. What we can and must do for our veterans is repay the financial debt we owe to them. Central to that solemn duty is ensuring that the benefits we promised our veterans when they enlisted are there for them when they need them. I consider it a great honor to represent veterans. So many of them continue to make contributions in our communities upon their transition from military to civilian life, through youth activities and scholarships programs, homeless assistance initiatives, efforts to reach out to fellow veterans in need, and national leadership on issues of importance to veterans and all Americans. The least we can do is make good on our promises, such as the promise of access to high quality health care. I have nothing but the utmost respect for those who have served their country, and this legislation is but a small tribute to the men and women and their families who have served this country with courage, honor and distinction. They answered the call to duty when their country needed them, and this is a component of my on-going effort to ensure that we, as elected officials, answer their call when they need us. I urge my colleagues to join me in supporting this legislation.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to introduce the Genetic Information Nondiscrimination in Health Insurance Act. I am delighted to be joined by Senators Frist, Jeffords, Collins, DeWine, and Enzi as original cosponsors of this bill, which provides strong protection to all Americans against the unfair and improper use of genetic information for insurance purposes. Similar language passed the Senate in the last Congress as part of the Patients' Bill of Rights, and as an amendment to the FY2001 Labor- HHS-Education appropriations bill by a vote of 58 to 40. The only substantive difference between this year's legislation and last year's is the inclusion of a safe harbor provision to prevent conflict with the new HHS medical confidentiality regulations. This bill ensures that people cannot be denied insurance coverage on the basis of genetic information, cannot be dropped from coverage on the basis of genetic information, cannot be charged exorbitant premiums based on genetic information, and cannot be discriminated against for requesting or receiving genetic services. The bill also ensures that insurance companies cannot release a person's genetic information without their prior consent, and cannot carve out covered services because of an inherited genetic disorder. Finally, we included safe harbor language to prevent conflict with the new privacy regulations published in December by the Department of Health and Human Services. Scientists are finding genetic links to a whole host of diseases such as breast cancer and Huntington's disease--in fact, there are now tests for over 450 disorders including Alzheimer's, cystic fibrosis, Parkinson's, glaucoma, and kidney and colon cancer. Last June America learned that scientists have completed their mapping of the human gene. This was a remarkable and historic event that opens the door to new scientific breakthroughs that may well help lead us one day to the cause and cure for many of these diseases. Unfortunately, this remarkable news has the potential to become a dangerous tool. As the old adage goes, ``knowledge is power'' and an insurance company could use genetic information to deny insurance to an individual because they know that the person is predisposed to a particular disease or health problem. Today in America, we know that an estimated 15 million people are affected by over 4,000 currently known genetic disorders. And while we cannot yet prevent the diseases that genetic testing can help us find, we can give carriers of these mutated genes the information they need to take extra precautions to protect their health and that of their loved ones. It is important to remember that while genetic testing is helpful as an informational tool, it still remains an inexact science. Prediction does not mean certainty--in the case of the Alzheimer's gene, for example, there is less than a 35 percent chance that a patient who tests positive for the mutated gene will actually develop the disease. And yet, that person should not have to worry about their health insurance coverage? For instance, when it comes to breast cancer, we know that early detection can often mean the difference between life and death. We also know that women who inherit mutated forms of either of two genes related to breast cancer--BRCA1 or BRCA2 have an 85 percent risk of developing the disease. So, should a woman test positive, she is more likely to take measures such as regular mammograms and self- examinations that can detect cancer early--thereby giving herself a fighting chance. But at the end of the day, all of this means nothing if people are afraid to take advantage of genetic testing. And people are afraid that the trade-off for gaining an edge in the battle against disease could be losing health insurance--or higher premiums. That's just plain wrong. We need every advantage we can get when it comes to breast cancer and other diseases, and that's why we need this bill. The bill we are offering will address these concerns and will allow our health care system to catch up to the tremendous health care advances of the past few years. It makes no sense to be on the cutting edge of medicine but remain in the dark ages when it comes to genetic discrimination. Anyone who has heard me speak on this issue before has heard me tell of the story of Bonnie Lee Tucker, a constituent whose situation is so compelling that it bears repeating. Indeed, Bonnie Lee puts a face and a name to the very problem I am trying to address here with this bill. Nine women in Bonnie Lee's immediate family have been diagnosed with breast cancer. And Bonnie Lee herself is a breast cancer survivor. So you can imagine that Bonnie Lee is very worried about her daughter, and would like more than anything to have the BRCA test for breast cancer. But she hasn't because she is frightened that having this test could ruin her daughter's chances of ever obtaining insurance in the future. Bonnie Lee Tucker is not alone. Across this country there are mothers and fathers who are caught in a grip of fear for their children--fear that they may have passed along a disease that, without early detection and treatment could kill their child and fear that if a genetic test detects a mutated gene they will have ruined their children's chance of obtaining insurance further down the line. This bill will put an end to discriminatory insurance practices based on genetic testing and allow patients the freedom to access vital information about their health--and I hope my colleagues will join us in supporting it.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to introduce the Genetic Information Nondiscrimination in Health Insurance Act. I am delighted to be joined by Senators Frist, Jeffords, Collins, DeWine, and Enzi as original cosponsors of this bill, which provides strong protection to all Americans against the unfair and improper use of genetic information for insurance purposes. Similar language passed the Senate in the last Congress as part of the Patients' Bill of Rights, and as an amendment to the FY2001 Labor- HHS-Education appropriations bill by a vote of 58 to 40. The only substantive difference between this year's legislation and last year's is the inclusion of a safe harbor provision to prevent conflict with the new HHS medical confidentiality regulations. This bill ensures that people cannot be denied insurance coverage on the basis of genetic information, cannot be dropped from coverage on the basis of genetic information, cannot be charged exorbitant premiums based on genetic information, and cannot be discriminated against for requesting or receiving genetic services. The bill also ensures that insurance companies cannot release a person's genetic information without their prior consent, and cannot carve out covered services because of an inherited genetic disorder. Finally, we included safe harbor language to prevent conflict with the new privacy regulations published in December by the Department of Health and Human Services. Scientists are finding genetic links to a whole host of diseases such as breast cancer and Huntington's disease--in fact, there are now tests for over 450 disorders including Alzheimer's, cystic fibrosis, Parkinson's, glaucoma, and kidney and colon cancer. Last June America learned that scientists have completed their mapping of the human gene. This was a remarkable and historic event that opens the door to new scientific breakthroughs that may well help lead us one day to the cause and cure for many of these diseases. Unfortunately, this remarkable news has the potential to become a dangerous tool. As the old adage goes, ``knowledge is power'' and an insurance company could use genetic information to deny insurance to an individual because they know that the person is predisposed to a particular disease or health problem. Today in America, we know that an estimated 15 million people are affected by over 4,000 currently known genetic disorders. And while we cannot yet prevent the diseases that genetic testing can help us find, we can give carriers of these mutated genes the information they need to take extra precautions to protect their health and that of their loved ones. It is important to remember that while genetic testing is helpful as an informational tool, it still remains an inexact science. Prediction does not mean certainty--in the case of the Alzheimer's gene, for example, there is less than a 35 percent chance that a patient who tests positive for the mutated gene will actually develop the disease. And yet, that person should not have to worry about their health insurance coverage? For instance, when it comes to breast cancer, we know that early detection can often mean the difference between life and death. We also know that women who inherit mutated forms of either of two genes related to breast cancer--BRCA1 or BRCA2 have an 85 percent risk of developing the disease. So, should a woman test positive, she is more likely to take measures such as regular mammograms and self- examinations that can detect cancer early--thereby giving herself a fighting chance. But at the end of the day, all of this means nothing if people are afraid to take advantage of genetic testing. And people are afraid that the trade-off for gaining an edge in the battle against disease could be losing health insurance--or higher premiums. That's just plain wrong. We need every advantage we can get when it comes to breast cancer and other diseases, and that's why we need this bill. The bill we are offering will address these concerns and will allow our health care system to catch up to the tremendous health care advances of the past few years. It makes no sense to be on the cutting edge of medicine but remain in the dark ages when it comes to genetic discrimination. Anyone who has heard me speak on this issue before has heard me tell of the story of Bonnie Lee Tucker, a constituent whose situation is so compelling that it bears repeating. Indeed, Bonnie Lee puts a face and a name to the very problem I am trying to address here with this bill. Nine women in Bonnie Lee's immediate family have been diagnosed with breast cancer. And Bonnie Lee herself is a breast cancer survivor. So you can imagine that Bonnie Lee is very worried about her daughter, and would like more than anything to have the BRCA test for breast cancer. But she hasn't because she is frightened that having this test could ruin her daughter's chances of ever obtaining insurance in the future. Bonnie Lee Tucker is not alone. Across this country there are mothers and fathers who are caught in a grip of fear for their children--fear that they may have passed along a disease that, without early detection and treatment could kill their child and fear that if a genetic test detects a mutated gene they will have ruined their children's chance of obtaining insurance further down the line. This bill will put an end to discriminatory insurance practices based on genetic testing and allow patients the freedom to access vital information about their health--and I hope my colleagues will join us in supporting it.

Ms. SNOWE. Mr. President, long-term care is an issue that continues to tug at Congress and this country. In 1997 close to $117 billion was spent on long-term care--almost 12 percent of total U.S. health care expenditures. And it is estimated that those in need of long-term care will double by 2025, up from the 9 million using these vital services today. The appropriate care for an individual should be an issue that is made by that individual and their loved ones. For many people, remaining at home is their choice. It allows them to remain with their loved ones in familiar surroundings. But we all know the truth is that in many cases it comes down to the financial realities of the family. We need to do more to assist these people and their families so that they really do have a choice. Toward that end I am introducing a bill that provides a tax credit for families caring for a relative who suffers from Alzheimer's disease. When I first came to Congress over 20 years ago, not a single piece of legislation devoted to Alzheimer's disease had even been introduced. We have come a long way since then, as today ``Alzheimer's'' is a household word. It is also the most expensive uninsured illness in America. Alzheimer's treatment is estimated to cost $100 billion each year. And according to the Alzheimer's Association it costs businesses in this country more than $33 billion a year due to caregiver absenteeism. Sadly, the number of those affected by this disease is rising and will continue to rise dramatically, from 4 million today to over 14 million by the middle of the century. As staggering as these numbers are, they pale in comparison to the emotional costs this disease places on the family. The first bill I am introducing today would allow families to deduct the cost of home care and adult day and respite care provided to a dependent suffering from Alzheimer's disease. This bill is important because we need to, as a country, help lessen the financial and emotional cost of Alzheimer's by providing some relief to Alzheimer's patients and their families. The second bill I am introducing today will strengthen the dependent care tax credit and restore Congress' original intent to provide the greatest benefit of the tax credit to low-income taxpayers. This bill expands the dependent care tax credit, makes it applicable respite care expenses, and makes it refundable. In 1976, the dependent care tax credit was created to help low- and moderate-income families alleviate the burden of employment-related dependent care. We have changed the DCTC since it was created 25 years ago and in fact, in the 1985 Tax Reform Act we indexed all the basic provision of the tax code that determine tax liability except for DCTC. We need to make the credit relevant by updating it to reflect today's world. As more and more women enter the workforce combined with the aging of our population, we are continuing to see an increased need for both child and elder care. Expenses incurred for this care can place a large burden on a family's finances. The cost of full time child care can range from $4,000 to $10,000. The cost of nursing home care is more than of $40,000 a year. Managing these costs is difficult for many families, but it is exceptionally burdensome for those in lower income brackets. My legislation will do that by indexing the credit to inflation and making it refundable so that those who do not reach the tax thresholds will still receive assistance. It also raises the DCTC sliding scale from 30 to 50 percent of work-related dependent care expenditures for families earing $15,000 or less. The scale would then be reduced by 1 percentage point for each additional $1,000 more of income, down to a credit of 20 percent for person earning $45,000 or more. In order to assist those who care for loved ones at home, the bill also expands the definition of dependent care to include respite care, thereby offering relief from this additional expense. A respite care credit would be allowed for up to $1,200 for one qualifying dependent care and $2,400 for two qualifying dependents. I hope my colleagues will join me in supporting these two bills that will provide assistance to families that wish to provide long term care to their loved ones at home.

Ms. SNOWE

Ms. SNOWE. Mr. President, long-term care is an issue that continues to tug at Congress and this country. In 1997 close to $117 billion was spent on long-term care--almost 12 percent of total U.S. health care expenditures. And it is estimated that those in need of long-term care will double by 2025, up from the 9 million using these vital services today. The appropriate care for an individual should be an issue that is made by that individual and their loved ones. For many people, remaining at home is their choice. It allows them to remain with their loved ones in familiar surroundings. But we all know the truth is that in many cases it comes down to the financial realities of the family. We need to do more to assist these people and their families so that they really do have a choice. Toward that end I am introducing a bill that provides a tax credit for families caring for a relative who suffers from Alzheimer's disease. When I first came to Congress over 20 years ago, not a single piece of legislation devoted to Alzheimer's disease had even been introduced. We have come a long way since then, as today ``Alzheimer's'' is a household word. It is also the most expensive uninsured illness in America. Alzheimer's treatment is estimated to cost $100 billion each year. And according to the Alzheimer's Association it costs businesses in this country more than $33 billion a year due to caregiver absenteeism. Sadly, the number of those affected by this disease is rising and will continue to rise dramatically, from 4 million today to over 14 million by the middle of the century. As staggering as these numbers are, they pale in comparison to the emotional costs this disease places on the family. The first bill I am introducing today would allow families to deduct the cost of home care and adult day and respite care provided to a dependent suffering from Alzheimer's disease. This bill is important because we need to, as a country, help lessen the financial and emotional cost of Alzheimer's by providing some relief to Alzheimer's patients and their families. The second bill I am introducing today will strengthen the dependent care tax credit and restore Congress' original intent to provide the greatest benefit of the tax credit to low-income taxpayers. This bill expands the dependent care tax credit, makes it applicable respite care expenses, and makes it refundable. In 1976, the dependent care tax credit was created to help low- and moderate-income families alleviate the burden of employment-related dependent care. We have changed the DCTC since it was created 25 years ago and in fact, in the 1985 Tax Reform Act we indexed all the basic provision of the tax code that determine tax liability except for DCTC. We need to make the credit relevant by updating it to reflect today's world. As more and more women enter the workforce combined with the aging of our population, we are continuing to see an increased need for both child and elder care. Expenses incurred for this care can place a large burden on a family's finances. The cost of full time child care can range from $4,000 to $10,000. The cost of nursing home care is more than of $40,000 a year. Managing these costs is difficult for many families, but it is exceptionally burdensome for those in lower income brackets. My legislation will do that by indexing the credit to inflation and making it refundable so that those who do not reach the tax thresholds will still receive assistance. It also raises the DCTC sliding scale from 30 to 50 percent of work-related dependent care expenditures for families earing $15,000 or less. The scale would then be reduced by 1 percentage point for each additional $1,000 more of income, down to a credit of 20 percent for person earning $45,000 or more. In order to assist those who care for loved ones at home, the bill also expands the definition of dependent care to include respite care, thereby offering relief from this additional expense. A respite care credit would be allowed for up to $1,200 for one qualifying dependent care and $2,400 for two qualifying dependents. I hope my colleagues will join me in supporting these two bills that will provide assistance to families that wish to provide long term care to their loved ones at home.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to introduce a Senate concurrent resolution that urges the administration to realize that an immediate trade priority should be to address the problem of subsidized Canadian softwood lumber imports. I am pleased to be joined in this effort by Senators Lott, Lincoln, Cochran, Hutchinson, Thurmond, Crapo, and Craig. The U.S.-Canada Softwood Lumber Agreement of 1996 will expire on March 31, 2001--just 53 short days from now--and there are no government-to-government negotiations taking place. We do not know just what will happen if the Agreement is allowed to expire with no alternative solution in place, but without restrictions, the subsidized lumber from Canada will flood over the border further impacting our U.S. sawmills. This to me is unacceptable. It is safe to say that we who represent our respective states here in the Senate share the same goals for our constituents--economic growth and prosperity through secure businesses and jobs, a healthy environment, including the ability to purchase reasonably priced homes and lumber with which to remodel. I cannot stand by, however, and watch someone's dream become another's nightmare. The United States has over four million forest landowners, with approximately 20,000 logging facilities, sawmills and planing mills, which employ over 700,000 employees. In the past year, lumber prices in the United States have plummeted by 33 percent while Canadian imports have grown to record levels. Approximately 3,500 mills have already closed, and I have heard from those with sawmills in Maine that are still open that they are close to laying off their hard-working employees and using their lumber to board up their businesses. Their message, as is mine, is for free trade that is also fair trade. I would like to note that, the problem of the subsidized lumber is not coming from Maine's good neighbors to the North--those small sawmills of the Canadian Maritimes--as they do not have vast amounts of crown, or government-owned, forest, but also get their wood from private forests, and they do not fall under the current quotas of the Agreement. There are only four provinces that actually fall under the quota system, Quebec, Ontario, Alberta and British Columbia, and the large integrated sawmills--those that have both pulp and sawmill operations, are doing very well. On the other hand, the small sawmills in the Maritimes are hurting just as much as our sawmills in the United States. This is a trade problem that we must negotiate with Canada in the interests of the United States while they also work to solve their own inequities. The U.S. timber prices for lumber are set by the market for both public and private forests, while the Canadian Government sets the price of timber from Quebec to British Columbia at a level that is one half to one-quarter the actual market value of timber. Some of the Canadian provinces with vast crown forests use government timber to subsidize lumber production and employment by providing timber to Canadian lumber companies through noncompetitive, administered pricing arrangements for a fraction of the timber's market value. These unfair subsidy practices have fueled shipments to the United States to the point that subsidized Canadian imports are at record levels and now control over one-third of the U.S. softwood lumber market. The highly subsidized Canadian lumber imports have gained sales volume from U.S. lumber companies, depressed U.S. timber values, and jeopardized thousands of U.S. jobs, and contributed to a collapse in lumber prices. Canadian lumber subsidy practices have been identified by a variety of independent analyses. U.S. Government officials in the Reagan, Bush and Clinton administrations, the U.S. industry and timberland owners, and labor unions all have called for an end to the subsidies and for fair trade. We are calling upon the President, the Office of the U.S. Trade Representative, and the Secretary of Commerce to take every possible action to end Canadian lumber subsidy practices through open and competitive sales of timber and logs in Canada for fair market value, or if Canada will not agree to end the subsidies immediately, the subsidies must be offset pending some sort of reform. In addition, if Canada will not reach an agreement to vigorously, promptly, and fully enforce the trade laws against subsidized and dumped imports and explore all options to stop unfairly traded imports, and to limit injury to the U.S. industry pending further action, the administration should be prepared to vigorously and fully enforce the trade laws against subsidized and dumped imports from Canada. I hope that these efforts today will jump start the administration as soon as tomorrow to start working towards negotiations with Canada. There are no surprises here, as the issue has been around since the 1930s. There have been years of investigations, assessments, petitions, rulings, imposed duties, and a 1986 Memorandum of Understanding to address the inequities. As a matter of fact, a major reason for bringing Canada to the negotiating table for the 1996 Agreement, along with a lawsuit by the Coalition for Fair Lumber Imports, was the implementing legislation for the GATT Uruguay Round Agreements. Congress approved the President's ``statement of administrative action'' that stated that lumber imports from Canada could be subject to countervailing duties under the Uruguay Round. Every possible action must be taken immediately, to end Canadian lumber subsidy practices through open and competitive sales of timber and logs in Canada at fair market value. This trade must be both free and fair. I thank the Chair.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to introduce two bills which build on progress made in the last few years in the difficult and challenging fight against osteoporosis. I am pleased to be joined by my friend, Senator Torricelli of New Jersey, as an original cosponsor of these bills. Osteoporosis is a major public health problem affecting 28 million Americans, who either have the disease or are at risk due to low bone mass. Osteoporosis causes 1.5 million fractures annually at a cost of $13.8 billion--$38 million per day--in direct medical expenses. In their lifetime, one in two women and one in eight men over the age of 50 will fracture a bone due to osteoporosis. Amazingly, a woman's risk of a hip fracture is equal to her combined risk of contracting breast, uterine, and ovarian cancer. Osteoporosis is largely preventable and thousands of fractures could be avoided if low bone mass were detected early and treated. Though we now have drugs that promise to reduce fractures by 50 percent and new drugs have been proven to actually rebuild bone mass, a bone mass measurement is needed to diagnose osteoporosis and determine one's risk for future fractures. And we have learned that there are some prominent risk factors: age, gender, race, a family history of bone fractures, early menopause, risky health behaviors such as smoking and excessive alcohol consumption, and some medications all have been identified as contributing factors to bone loss. But identification of risk factors alone cannot predict how much bone a person has and how strong bone is. Congress passed the Balanced Budget Act 3\1/2\ years ago. In doing so, we dramatically expanded coverage of osteoporosis screening through bone mass measurements for Medicare beneficiaries. Since we passed this law, we have learned that under the current Medicare law, it is very difficult for a man to be reimbursed for a bone mass measurement test. Each year, men suffer one-third of all the hip fractures that occur, and one-third of these men will not survive more than one year. In addition to hip fracture, men also experience painful and debilitating fractures of the spine, wrist, and other bones due to osteoporosis. The first bill we are introducing today, the Medicare Osteoporosis Measurement Act, would help all individuals enrolled in Medicare to receive the necessary tests if they are at risk for osteoporosis. Currently, Medicare guidelines allow for testing in five categories of individuals--and most ``at risk'' men do not fall into any of them. The first category in the guidelines is for ``an estrogen-deficient woman at clinical risk for osteoporosis.'' The Medicare Osteoporosis Measurement Act changes this guideline to say that ``an individual, including an estrogen-deficient woman, at clinical risk for osteoporosis'' will be eligible for bone mass measurement. This change--of just a few words--will vastly increase the opportunities for men to be covered for the important test. The second bill Senator Torricelli and I are introducing today is similar to the Medicare bone mass measurement benefit. The Osteoporosis Federal Employee Health Benefits Standardization Act guarantees the same uniformity of coverage to Federal employees and retirees as Congress provided to Medicare beneficiaries in 1997. Unfortunately, coverage of bone density tests under the Federal Employee Health Benefit Program, FEHBP, is inconsistent. Instead of a comprehensive national coverage policy, FEHBP leaves it to each of the almost 300 participating plans to decide who is eligible to receive a bone mass measurement and what constitutes medical necessity. Many plans have no specific rules to guide reimbursement and cover the tests on a case-by-case basis. Some plans refuse to provide consumers with information indicating when the plan covers the test and when it does not and some plans cover the test only for people who already have osteoporosis. Mr. President, we know that osteoporosis is highly preventable, but only if it is discovered in time. There is simply no substitute for early detection. These bills will ensure that all Medicare beneficiaries at risk for osteoporosis will be able to be tested for this disease, and will standardize coverage for bone mass measurement under the FEHBP. I hope that our colleagues will join Senator Torricelli and me in supporting these bills.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to introduce a bill that is very important to working women and their families--the Pregnancy Discrimination Act Amendments of 2001. This bill would clarify that the Pregnancy Discrimination Act protects breastfeeding under civil rights law, requiring that a woman cannot be fired or discriminated against in the workplace for expressing breast milk during her own lunch time or break time. According to the U.S. Department of Labor, women with infants and toddlers are the fastest growing segment of today's labor force. At least 50 percent of women who are employed when they become pregnant return to the labor force by the time their children are three months old. Although the Pregnancy Discrimination Act was enacted in 1978 and prohibits workplace discrimination on the basis of pregnancy, childbirth, or related medical conditions, courts have not interpreted the Act to include breastfeeding. Some employers deny women the opportunity to express milk . . . some women have been discharged for requesting to express milk during lunch and other regular breaks . . . some women have been harassed or discriminated against; some women have had their pay withheld or been taken off of shift work for saying that they wanted to pump milk. On the other hand, many employers have seen positive results from facilitating lactation programs in the workplace, including low absenteeism, high productivity, improved company loyalty, high employee morale, and lower health care costs. Parental absenteeism due to infant illness is three times greater among the parents of formula-fed children than those that are breastfed. Worksite programs that aim to improve infant health may also bring about a reduction in parental absenteeism and health insurance costs. There is no doubt as to the health benefit breastfeeding brings to both mothers and children. Breastmilk is easily digested and assimilated, and contains all the vitamins, minerals, and nutrients they require in their first five to six months of life. Furthermore, important antibodies, proteins, immune cells, and growth factors that can only be found in breast milk. Breastmilk is the first line of immunization defense and enhances the effectiveness of vaccines given to infants. Research studies show that children who are not breastfed have higher rates of mortality, meningitis, some types of cancers, asthma and other respiratory illnesses, bacterial and viral infections, diarrhoeal diseases, ear infections, allergies, and obesity. Other research studies have shown that breastmilk and breastfeeding have protective effects against the development of a number of chronic diseases, including juvenile diabetes, lymphomas, Crohn's disease, celiac disease, some chronic liver diseases, and ulcerative colitis. A number of studies have shown that breastfed children have higher IQs at all ages. This is a simple bill--it simply inserts the word ``breastfeeding'' in the Pregnancy Discrimination Act. It will change the law to read that employment discrimination ``because of or on the basis of pregnancy, childbirth, breastfeeding, or related medication conditions'' is not permitted. I believe that it is absolutely critical to support mothers in across the country--they are, of course, raising the very future of our country. And we should ensure that the Pregnancy Discrimination Act covers this basic fundamental part of mothering. I urge my colleagues to join me in supporting this bill.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to introduce the Providing Annual Pap Tests to Save Women's Lives Act of 2001. I am pleased to be joined by my friend, Senator Lincoln of Arkansas, as an original cosponsor of this bill. According to the American Cancer Society cervical cancer is one of the most successfully treatable cancers when detected at an early stage. In fact, 88 percent of cervical cancer patients survive one year after diagnosis, and 70 percent survive five years. In the 52 years since use of the pap test became widespread, the cervical cancer mortality rate has declined by an astonishing 70 percent. There is no question that this test is the most effective cancer screening tool yet developed. The Pap smear can detect abnormalities before they develop into cancer. Having an annual Pap smear is one of the most important things a woman can do to help prevent cervical cancer. Congress has recognized the incomparable contribution of the Pap smear in preventing cervical cancer and nine years ago directed Medicare to begin covering preventive Pap smears. Under this law Medicare beneficiaries were eligible for one test every three years, although a more frequent interval is allowed for women at high risk of developing cervical cancer. And through the Balanced Budget Act of 1997, Congress expanded the Pap smear benefit to also include a screening pelvic exam once every three years. Last year as a part of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act, P.L. 106-544, we brought the screening down to once every other year. However, the American Cancer Society screening guidelines recommend that all women who are or have been sexually active or who are 18 and older should have an annual Pap test and pelvic examination. After three or more consecutive satisfactory examinations with normal findings, the Pap test may be performed less frequently at the physician's discretion. Unfortunately, Medicare guidelines do not reflect this recommendation. Women understand the usefulness and life-saving benefit of the Pap smear. The U.S. Centers for Disease Control and Prevention reported that 88.3 percent of women between the ages of 18 and 44 have received a pap test within the preceding three years. However, this rate dropped, for women age 65 and over--only 72.3 percent have received a pap test within the preceding three years. The bill Senator Lincoln and I are introducing today will bring Medicare guidelines in line with the American Cancer recommendations, and it will encourage Medicare beneficiaries to utilize this screening benefit more regularly. The Pap test has contributed immeasurably to the fight against cervical cancer. We cannot risk erasing our advancements in this fight because of an inadequate Medicare screening benefit.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to introduce the Improved Patient Access to Clinical Studies Act. This bill builds on progress made in the last several years in the difficult and challenging fight against life-threatening diseases. This bill will prohibit insurance companies from denying coverage for services provided to individuals participating in clinical trials, if those services would otherwise be covered by the plan. This bill would also prevent health plans from discriminating against enrollees who choose to participate in clinical trials. This bill has a two-fold purpose. First, it will ensure that many patients who could benefit from these potentially life-saving experimental treatments, but currently do not have access to them because their insurance will not cover the associated costs. Second, without reimbursement for these services, our researchers' ability to conduct important research is impeded as it reduces the number of patients who seek to participate in clinical trials. According to a report published by the General Accounting Office in September 1999, ``given the uncertainty about [health insurance] approval and payment levels, patients and physicians can be discouraged from seeking prior approval from insurers'' and therefore, will not attempt to enroll in what could possibly be the patients' last hope. When faced with a life-threatening disease, such as cancer, it is absolutely paramount that individuals be given every opportunity, every possibly imaginable, to fight their illness. What patients should not be faced with is the certainty of a health insurance fight. I hope my colleagues will join me in supporting this bill which will help those suffering from life-threatening diseases and their families.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to reintroduce the Women's Health and Cancer Rights Act. I am pleased to be joined by my friends, Senator Murray of Washington and Senator Johnson of South Dakota, as original cosponsors of this bill. This bill has a two-fold purpose. First, it will ensure that appropriate medical care determines how long a woman stays in the hospital after undergoing a mastectomy. This provision says that inpatient coverage with respect to the treatment of mastectomy-- regardless of whether the patient's plan is regulated by ERISA or State regulations--will be provided for a period of time as is determined by the attending physician, in consultation with the patient, to be medically necessary and appropriate. Second, this bill allows any person facing a cancer diagnosis of any type to get a second opinion on their course of treatment. A diagnosis of breast cancer is something that every woman dreads. But for an estimated 192,200 American women, this is the year their worst fears will be realized. One thousand new cases of breast cancer will be diagnosed among the women in Maine, and 200 women in my home State will die from this tragic disease. The fact is, one in nine women will develop breast cancer during their lifetime, and for women between the ages of 35 and 54, there is no other disease which will claim more lives. It's not hard to understand why the words ``you have breast cancer'' are some of the most frightening words in the English language. For the woman who hears them, everything changes from that moment forward. No wonder, then, that it is a diagnosis not only accompanied by fear, but also by uncertainty. What will become of me? What will they have to do to me? What will I have to endure? What's the next step? For many woman, the answer to that last question is a mastectomy or lumpectomy. Despite the medical and scientific advances that have been made, despite the advances in early detection technology that more and more often negate the need for radical surgery, it still remains a fact of life at the beginning of the 21st century these procedures can be the most prudent option in attacking and eradicating cancer found in a woman's breast. These are the kind of decisions that come with a breast cancer diagnosis. These are the kind of questions women must answer, and they must do so under some of the most stressful and frightening circumstances imaginable. The last question a woman should have to worry about at a time like this is whether or not their health insurance plan will pay for appropriate care after a mastectomy. A woman diagnosed with breast cancer in many ways already feels as though she has lost control of her life. She should not feel as though she has also lost control of her course of treatment. The evidence for the need for this bill--especially when it comes to so-called ``drive through mastectomies'', is more than just allegorical. Indeed, the facts speak for themselves--between 1986 and 1995, the average length of stay for a mastectomy dropped from about six days to about 2 to 3 days. Thousands of women across the country are undergoing radical mastectomies on an outpatient basis and are being forced out of the hospital before either they or their doctor think it's reasonable or prudent. This decision must be returned to physicians and their patients, and all Americans who face the possibility of a cancer diagnosis must be able to make informed decisions about appropriate and necessary medical care. I urge my colleagues to join me in supporting this bill and work towards passing it this year.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to introduce two bills which build on progress made in the last few years in the difficult and challenging fight against osteoporosis. I am pleased to be joined by my friend, Senator Torricelli of New Jersey, as an original cosponsor of these bills. Osteoporosis is a major public health problem affecting 28 million Americans, who either have the disease or are at risk due to low bone mass. Osteoporosis causes 1.5 million fractures annually at a cost of $13.8 billion--$38 million per day--in direct medical expenses. In their lifetime, one in two women and one in eight men over the age of 50 will fracture a bone due to osteoporosis. Amazingly, a woman's risk of a hip fracture is equal to her combined risk of contracting breast, uterine, and ovarian cancer. Osteoporosis is largely preventable and thousands of fractures could be avoided if low bone mass were detected early and treated. Though we now have drugs that promise to reduce fractures by 50 percent and new drugs have been proven to actually rebuild bone mass, a bone mass measurement is needed to diagnose osteoporosis and determine one's risk for future fractures. And we have learned that there are some prominent risk factors: age, gender, race, a family history of bone fractures, early menopause, risky health behaviors such as smoking and excessive alcohol consumption, and some medications all have been identified as contributing factors to bone loss. But identification of risk factors alone cannot predict how much bone a person has and how strong bone is. Congress passed the Balanced Budget Act 3\1/2\ years ago. In doing so, we dramatically expanded coverage of osteoporosis screening through bone mass measurements for Medicare beneficiaries. Since we passed this law, we have learned that under the current Medicare law, it is very difficult for a man to be reimbursed for a bone mass measurement test. Each year, men suffer one-third of all the hip fractures that occur, and one-third of these men will not survive more than one year. In addition to hip fracture, men also experience painful and debilitating fractures of the spine, wrist, and other bones due to osteoporosis. The first bill we are introducing today, the Medicare Osteoporosis Measurement Act, would help all individuals enrolled in Medicare to receive the necessary tests if they are at risk for osteoporosis. Currently, Medicare guidelines allow for testing in five categories of individuals--and most ``at risk'' men do not fall into any of them. The first category in the guidelines is for ``an estrogen-deficient woman at clinical risk for osteoporosis.'' The Medicare Osteoporosis Measurement Act changes this guideline to say that ``an individual, including an estrogen-deficient woman, at clinical risk for osteoporosis'' will be eligible for bone mass measurement. This change--of just a few words--will vastly increase the opportunities for men to be covered for the important test. The second bill Senator Torricelli and I are introducing today is similar to the Medicare bone mass measurement benefit. The Osteoporosis Federal Employee Health Benefits Standardization Act guarantees the same uniformity of coverage to Federal employees and retirees as Congress provided to Medicare beneficiaries in 1997. Unfortunately, coverage of bone density tests under the Federal Employee Health Benefit Program, FEHBP, is inconsistent. Instead of a comprehensive national coverage policy, FEHBP leaves it to each of the almost 300 participating plans to decide who is eligible to receive a bone mass measurement and what constitutes medical necessity. Many plans have no specific rules to guide reimbursement and cover the tests on a case-by-case basis. Some plans refuse to provide consumers with information indicating when the plan covers the test and when it does not and some plans cover the test only for people who already have osteoporosis. Mr. President, we know that osteoporosis is highly preventable, but only if it is discovered in time. There is simply no substitute for early detection. These bills will ensure that all Medicare beneficiaries at risk for osteoporosis will be able to be tested for this disease, and will standardize coverage for bone mass measurement under the FEHBP. I hope that our colleagues will join Senator Torricelli and me in supporting these bills.

Ms. SNOWE. Mr. President, I rise today to reintroduce a bill which builds on progress made in the last few years in the difficult and challenging fight against breast cancer. Our challenge was summed up by one breast cancer advocate when she stated, simply and eloquently, ``We must make our voices heard, because it is our lives.'' A diagnosis of breast cancer is something that every woman dreads. Over 192,000 American women, and 1,000 in my home state of Maine--will face a diagnosis of breast cancer this year. Over 40,000 women across the country will die from this tragic disease. The fact is, one in nine women will develop breast cancer during their lifetime, and for women between the ages of 35 and 54, there is no other disease which will claim more lives. This bill will give breast cancer advocates a voice in the National Institutes of Health's, NIH's research decision-making. The Consumer Involvement in Breast Cancer Research Act urges NIH to follow the Department Of Defense's lead and include lay breast cancer advocates in breast cancer research decision-making. The involvement of these breast cancer advocates at DOD has helped foster new and innovative breast cancer research funding designs and research projects. While maintaining the higher level of quality assurance through peer review, breast cancer advocates have helped to ensure that all breast cancer research reflects the experiences and wisdom of the individuals who have lived with the disease, as well as the scientific community. I hope that my colleagues will join me in supporting this bill.

Ms. SNOWE. Mr. President, I rise today to introduce the Providing Annual Pap Tests to Save Women's Lives Act of 2001. I am pleased to be joined by my friend, Senator Lincoln of Arkansas, as an original cosponsor of this bill. According to the American Cancer Society cervical cancer is one of the most successfully treatable cancers when detected at an early stage. In fact, 88 percent of cervical cancer patients survive one year after diagnosis, and 70 percent survive five years. In the 52 years since use of the pap test became widespread, the cervical cancer mortality rate has declined by an astonishing 70 percent. There is no question that this test is the most effective cancer screening tool yet developed. The Pap smear can detect abnormalities before they develop into cancer. Having an annual Pap smear is one of the most important things a woman can do to help prevent cervical cancer. Congress has recognized the incomparable contribution of the Pap smear in preventing cervical cancer and nine years ago directed Medicare to begin covering preventive Pap smears. Under this law Medicare beneficiaries were eligible for one test every three years, although a more frequent interval is allowed for women at high risk of developing cervical cancer. And through the Balanced Budget Act of 1997, Congress expanded the Pap smear benefit to also include a screening pelvic exam once every three years. Last year as a part of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act, P.L. 106-544, we brought the screening down to once every other year. However, the American Cancer Society screening guidelines recommend that all women who are or have been sexually active or who are 18 and older should have an annual Pap test and pelvic examination. After three or more consecutive satisfactory examinations with normal findings, the Pap test may be performed less frequently at the physician's discretion. Unfortunately, Medicare guidelines do not reflect this recommendation. Women understand the usefulness and life-saving benefit of the Pap smear. The U.S. Centers for Disease Control and Prevention reported that 88.3 percent of women between the ages of 18 and 44 have received a pap test within the preceding three years. However, this rate dropped, for women age 65 and over--only 72.3 percent have received a pap test within the preceding three years. The bill Senator Lincoln and I are introducing today will bring Medicare guidelines in line with the American Cancer recommendations, and it will encourage Medicare beneficiaries to utilize this screening benefit more regularly. The Pap test has contributed immeasurably to the fight against cervical cancer. We cannot risk erasing our advancements in this fight because of an inadequate Medicare screening benefit.

Ms. SNOWE. Mr. President, I rise today to introduce the Improved Patient Access to Clinical Studies Act. This bill builds on progress made in the last several years in the difficult and challenging fight against life-threatening diseases. This bill will prohibit insurance companies from denying coverage for services provided to individuals participating in clinical trials, if those services would otherwise be covered by the plan. This bill would also prevent health plans from discriminating against enrollees who choose to participate in clinical trials. This bill has a two-fold purpose. First, it will ensure that many patients who could benefit from these potentially life-saving experimental treatments, but currently do not have access to them because their insurance will not cover the associated costs. Second, without reimbursement for these services, our researchers' ability to conduct important research is impeded as it reduces the number of patients who seek to participate in clinical trials. According to a report published by the General Accounting Office in September 1999, ``given the uncertainty about [health insurance] approval and payment levels, patients and physicians can be discouraged from seeking prior approval from insurers'' and therefore, will not attempt to enroll in what could possibly be the patients' last hope. When faced with a life-threatening disease, such as cancer, it is absolutely paramount that individuals be given every opportunity, every possibly imaginable, to fight their illness. What patients should not be faced with is the certainty of a health insurance fight. I hope my colleagues will join me in supporting this bill which will help those suffering from life-threatening diseases and their families.

Ms. SNOWE. Mr. President, I rise today to reintroduce the Women's Health and Cancer Rights Act. I am pleased to be joined by my friends, Senator Murray of Washington and Senator Johnson of South Dakota, as original cosponsors of this bill. This bill has a two-fold purpose. First, it will ensure that appropriate medical care determines how long a woman stays in the hospital after undergoing a mastectomy. This provision says that inpatient coverage with respect to the treatment of mastectomy-- regardless of whether the patient's plan is regulated by ERISA or State regulations--will be provided for a period of time as is determined by the attending physician, in consultation with the patient, to be medically necessary and appropriate. Second, this bill allows any person facing a cancer diagnosis of any type to get a second opinion on their course of treatment. A diagnosis of breast cancer is something that every woman dreads. But for an estimated 192,200 American women, this is the year their worst fears will be realized. One thousand new cases of breast cancer will be diagnosed among the women in Maine, and 200 women in my home State will die from this tragic disease. The fact is, one in nine women will develop breast cancer during their lifetime, and for women between the ages of 35 and 54, there is no other disease which will claim more lives. It's not hard to understand why the words ``you have breast cancer'' are some of the most frightening words in the English language. For the woman who hears them, everything changes from that moment forward. No wonder, then, that it is a diagnosis not only accompanied by fear, but also by uncertainty. What will become of me? What will they have to do to me? What will I have to endure? What's the next step? For many woman, the answer to that last question is a mastectomy or lumpectomy. Despite the medical and scientific advances that have been made, despite the advances in early detection technology that more and more often negate the need for radical surgery, it still remains a fact of life at the beginning of the 21st century these procedures can be the most prudent option in attacking and eradicating cancer found in a woman's breast. These are the kind of decisions that come with a breast cancer diagnosis. These are the kind of questions women must answer, and they must do so under some of the most stressful and frightening circumstances imaginable. The last question a woman should have to worry about at a time like this is whether or not their health insurance plan will pay for appropriate care after a mastectomy. A woman diagnosed with breast cancer in many ways already feels as though she has lost control of her life. She should not feel as though she has also lost control of her course of treatment. The evidence for the need for this bill--especially when it comes to so-called ``drive through mastectomies'', is more than just allegorical. Indeed, the facts speak for themselves--between 1986 and 1995, the average length of stay for a mastectomy dropped from about six days to about 2 to 3 days. Thousands of women across the country are undergoing radical mastectomies on an outpatient basis and are being forced out of the hospital before either they or their doctor think it's reasonable or prudent. This decision must be returned to physicians and their patients, and all Americans who face the possibility of a cancer diagnosis must be able to make informed decisions about appropriate and necessary medical care. I urge my colleagues to join me in supporting this bill and work towards passing it this year.

Ms. SNOWE. Mr. President, I rise today to introduce a bill that is very important to working women and their families--the Pregnancy Discrimination Act Amendments of 2001. This bill would clarify that the Pregnancy Discrimination Act protects breastfeeding under civil rights law, requiring that a woman cannot be fired or discriminated against in the workplace for expressing breast milk during her own lunch time or break time. According to the U.S. Department of Labor, women with infants and toddlers are the fastest growing segment of today's labor force. At least 50 percent of women who are employed when they become pregnant return to the labor force by the time their children are three months old. Although the Pregnancy Discrimination Act was enacted in 1978 and prohibits workplace discrimination on the basis of pregnancy, childbirth, or related medical conditions, courts have not interpreted the Act to include breastfeeding. Some employers deny women the opportunity to express milk . . . some women have been discharged for requesting to express milk during lunch and other regular breaks . . . some women have been harassed or discriminated against; some women have had their pay withheld or been taken off of shift work for saying that they wanted to pump milk. On the other hand, many employers have seen positive results from facilitating lactation programs in the workplace, including low absenteeism, high productivity, improved company loyalty, high employee morale, and lower health care costs. Parental absenteeism due to infant illness is three times greater among the parents of formula-fed children than those that are breastfed. Worksite programs that aim to improve infant health may also bring about a reduction in parental absenteeism and health insurance costs. There is no doubt as to the health benefit breastfeeding brings to both mothers and children. Breastmilk is easily digested and assimilated, and contains all the vitamins, minerals, and nutrients they require in their first five to six months of life. Furthermore, important antibodies, proteins, immune cells, and growth factors that can only be found in breast milk. Breastmilk is the first line of immunization defense and enhances the effectiveness of vaccines given to infants. Research studies show that children who are not breastfed have higher rates of mortality, meningitis, some types of cancers, asthma and other respiratory illnesses, bacterial and viral infections, diarrhoeal diseases, ear infections, allergies, and obesity. Other research studies have shown that breastmilk and breastfeeding have protective effects against the development of a number of chronic diseases, including juvenile diabetes, lymphomas, Crohn's disease, celiac disease, some chronic liver diseases, and ulcerative colitis. A number of studies have shown that breastfed children have higher IQs at all ages. This is a simple bill--it simply inserts the word ``breastfeeding'' in the Pregnancy Discrimination Act. It will change the law to read that employment discrimination ``because of or on the basis of pregnancy, childbirth, breastfeeding, or related medication conditions'' is not permitted. I believe that it is absolutely critical to support mothers in across the country--they are, of course, raising the very future of our country. And we should ensure that the Pregnancy Discrimination Act covers this basic fundamental part of mothering. I urge my colleagues to join me in supporting this bill.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise today to reintroduce a bill which builds on progress made in the last few years in the difficult and challenging fight against breast cancer. Our challenge was summed up by one breast cancer advocate when she stated, simply and eloquently, ``We must make our voices heard, because it is our lives.'' A diagnosis of breast cancer is something that every woman dreads. Over 192,000 American women, and 1,000 in my home state of Maine--will face a diagnosis of breast cancer this year. Over 40,000 women across the country will die from this tragic disease. The fact is, one in nine women will develop breast cancer during their lifetime, and for women between the ages of 35 and 54, there is no other disease which will claim more lives. This bill will give breast cancer advocates a voice in the National Institutes of Health's, NIH's research decision-making. The Consumer Involvement in Breast Cancer Research Act urges NIH to follow the Department Of Defense's lead and include lay breast cancer advocates in breast cancer research decision-making. The involvement of these breast cancer advocates at DOD has helped foster new and innovative breast cancer research funding designs and research projects. While maintaining the higher level of quality assurance through peer review, breast cancer advocates have helped to ensure that all breast cancer research reflects the experiences and wisdom of the individuals who have lived with the disease, as well as the scientific community. I hope that my colleagues will join me in supporting this bill.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise to support the confirmation of President Bush's nominee for Attorney General of the United States, former Senator John Ashcroft. After serving in this body with John Ashcroft for the last six years, I know him as a man of integrity and compassion. That is not to say we always agree--we have sparred passionately on issues--not the least of which was abortion rights. Clearly, though, John is a well-qualified nominee, as evidenced by the fact that of the 67 persons who have served as United States Attorney General in our history, only John Ashcroft has served as state attorney general, governor, and U.S. Senator serving on the Judiciary Committee. In fact, John Ashcroft was State Attorney General and Governor for two terms each. He was the head of the National Association of Attorneys General and head of the National Governors' Association. In these roles, John has a solid record of working with and protecting the rights of all people. That John and I hold differing views is certainly not unusual in this body of one hundred individuals--all with strongly held beliefs, all with disparate backgrounds, and all representing different constituencies with distinct concerns and varying priorities. I respected his right to hold his beliefs, just as he has always respected my right to the beliefs that I have often expressed in this very chamber. That is the nature of our representative democracy, and certainly the nature of the Senate as the embodiment of the union of states. Likewise, President Bush, as the duly-elected Chief Executive of the United States, is accorded the privilege of nominating those men and women he deems most fit to administer the policies and duties with which he has been entrusted by the people of this Nation. I did not agree with all of the personal viewpoints of President Clinton's various nominees--far from it. Instead, I attempted to judge the fitness of each nominee based on their individual record, experience, testimony, and integrity. Recognizing that President Clinton's nominees would not surprisingly hold different beliefs than my own in some instances, I asked myself whether or not those beliefs would, in and of themselves, preclude the nominee from executing his or her duties to the extent that they would be unfit to serve. That is the same question I ask myself concerning the nomination of Senator Ashcroft, keeping in mind that I do not believe that a nominee's ideological philosophy should be a determining factor in their ability to serve. As the Portland Press Herald noted in their January 17 editorial ``Senators have the power of ``advice and consent'' over such nominees, and they have the power to make judgments based on whatever criteria they choose. Still, failing to pass an ideological litmus test is not a sufficient reason to decline to nominate someone to an appointive post, barring hard evidence of unsuitability or criminal misconduct. . .'' And what about the power of ``advice and consent'' given to the Senate under Article II, Section 2 of the Constitution? Alexander Hamilton in summing up this power noted ``To what purpose then require the co-operation of the Senate? I answer, that the necessity of their concurrence would have a powerful, though, in general, a silent operation. It would be an excellent check upon a spirit of favoritism in the President, and would tend greatly to prevent the appointment of unfit characters from State prejudice, from family connection, from personal attachment, or from a view to popularity.'' And if you review history you will find that this ``check'' as it were has been used judiciously. The fact is that since 1789--212 years--only 19 cabinet nominees have failed to be confirmed. Clearly the Senate must have differed with the President on his nominees more than 19 times over the past 212 years, yet with very few exceptions has deferred to the President, who will ultimately be held responsible for his choice. In short, our use of the ``advice and consent'' power must achieve a careful balance between our responsibility to check presidential abuse at one end of the scale, and a respect for the president's constitutional prerogative on the other. It is a question of degrees and a matter of judgement left to us to weigh with due diligence and care. In the case of John Ashcroft's nomination to be Attorney General, I would argue that John Ashcroft deserves to be taken at his word with regard to what he has said at his confirmation hearings. He has said, clearly and unequivocally, that he will uphold the laws of the United States of America. During the confirmation hearings, John Ashcroft was characteristically straightforward when he said, ``I understand that being attorney general means enforcing the laws as they are written, not enforcing my personal preferences. It means advancing the national interest, not advocating my personal interest.'' During a private meeting in my office, John echoed that pledge and personally assured me that he would carry out this and other laws on behalf of every American. That includes Roe v. Wade. That includes ensuring access to abortion clinics. And I take John Ashcroft at his word. He also stated during the hearings that, ``The attorney general must recognize this: The language of justice is not the reality of justice for all Americans . . . No American should have the door to employment or educational opportunity slammed shut because of gender or race. No American should fear being threatened or coerced in seeking constitutionally protected health services.'' I commend him for this sentiment and, again, I take John Ashcroft at his word. Importantly, John has carried himself with distinction in carrying out the laws in other elected positions, notably during his terms as governor and Attorney General of Missouri. As he told the Judiciary Committee, ``I take pride in my record of having vigorously enforced the civil rights laws as attorney general and governor,'' and I take John Ashcroft at his word. Moreover, not only John's words but his deeds support his strong commitment to civil rights. As Governor, John signed Missouri's first hate crimes statute and legislation creating the Martin Luther King Holiday. He established Missouri's first and only historic site honoring an African-American, and led the fight to save an independent Lincoln University, founded by African-American soldiers. Last year, he convened the only Senate hearing on the subject of racial profiling, and opened the hearing by unequivocally condemning racial profiling, calling it ``an unconstitutional practice.'' As Missouri Attorney General, John Ashcroft enforced laws that differed from his own beliefs in a number of areas, including abortion and, more specifically, the confidentiality of hospital records on the number of abortions performed; and church and state issues, such as the availability of funds for private and religious schools and the distribution of religious materials in public schools. As Governor, John was presented on nine occasions with three- candidate panels for judicial appointments that contained one or more minority candidates. As he told the Committee in his nomination hearing, ``I took special care to expand racial and gender diversity in Missouri's courts,'' and the facts bear that out. In every instance, he either appointed a minority to the post or appointed the minority candidates on the panel to judicial positions at a later date. He appointed more African-American judges to the bench than any governor in Missouri history. He appointed the first African-American on the Western District Court of Appeals. He appointed the first African-American woman to the St. Louis County Circuit Court. He appointed the first two women to the Missouri Courts of Appeals. And he appointed the first woman to the Missouri Supreme Court--the only woman ever to have been appointed to that court. Similarly, in the Senate, John supported every single African American judicial nominee confirmed by the Senate--26 separate nominations in all. But despite this overwhelming record of supporting minority judicial candidates, he has been attacked for opposing the nomination of one African American Judge, Ronnie White--a nominee who was opposed by 54 members of the Senate, including me. Judge White's nomination was rejected by the Senate not because of his race, but because of his opinions in some death penalty cases. It bears noting that not only was Judge White vigorously opposed by the National Sheriffs' Association, the Missouri Federation of Police Chiefs, and numerous other Missouri and national law enforcement groups, but he also stood as the lone dissenter in a death penalty case involving the brutal slaying of three law enforcement officers in Missouri and the wife of a sheriff who was killed after she was shot five times, in the family's own home, as she was holding a church function. It is critical to note that in 1998, using similar criteria, I opposed the nomination of Judge Ann Aiken to the federal bench because of her decision to give probation instead of jail time to a man who raped a five-year-old child. And what has Judge White said about John Ashcroft's motivations? He has said, and I quote, ``. . . let me say, I don't think Senator Ashcroft is a racist, and I wouldn't attempt to comment on what's in his mind or what's in his heart.'' Finally, I want to emphasize that there were a number of critical policy areas on which Senator Ashcroft and I did agree during our tenure together in the Senate. They deserve mention considering the criticism that has been leveled against this nominee, and the relevance of the issues to the post of Attorney General. John co-sponsored the benchmark Violence Against Women Act, and helped author the provisions to prevent Internet stalking included in the legislation. He supported minimum hospital stays for women who give birth, and a measure to permit breast and cervical cancer coverage by Medicaid for low-income women. He supported a provision urging that the ``Attorney General should fully enforce the law and protect persons seeking to provide or obtain, or assist in providing or obtaining, reproductive health services from violent attack,'' and voted to make civil judgments for those who commit violent acts at abortion clinics non-dischargeable in bankruptcy--an amendment that I cosponsored. This is the John Ashcroft I know--a man of ability, remarkable experience in public service, proven integrity, and unimpeachable professionalism. As Attorney General, he will be charged not with writing new laws--as he ably did as a Senator--or interpreting laws--as a judge would do. Instead, he will be given responsibility as our nation's top law enforcement official for executing the laws of the United States on behalf of President Bush and the American people. I am confident he will enforce the laws to protect all Americans equally, regardless of his personal views, and I will vote to confirm John Ashcroft as Attorney General of the United States.

Ms. SNOWE

Ms. SNOWE. Mr. President, I rise to introduce legislation designed to promote growth in the domestic cruise ship industry and at the same time enable U.S. shipyards to compete for cruise ship orders. The legislation would provide tax incentives for U.S. cruise ship construction and operation. Current law prohibits non-U.S. vessels from carrying passengers between U.S. ports. As such, today's domestic cruise market is very limited. The cruise industry consists predominantly of foreign vessels which must sail to and from foreign ports. The vast majority of cruise passengers are Americans, but most of the revenues now go to foreign destinations. That is because the high cost of building and operating U.S.-flag cruise ships and competition from modern, foreign-flag cruise ships have deterred growth in the domestic cruise ship trade. By some estimates, a single port call by a cruise vessel generates between $300,000 and $500,000 in economic benefits. This is a very lucrative market, and I would like to see U.S. companies and American workers benefit from this untapped potential. However, domestic ship builders and cruise operations face a very difficult, up-hill battle against unfair competition from foreign cruise lines and foreign shipyards. Foreign cruise lines, for example, pay no corporate income tax. Nor are they held to the same demanding ship construction and operating standards imposed on U.S.-flag vessel operators. Foreign cruise lines are also free from the need to comply with many U.S. labor and environmental protection laws, and U.S. health, safety, and sanitation laws do not apply to the foreign ships. The legislation I am introducing today is designed to level the playing field between the U.S. cruise industry and the international cruise industry. For example, it provides that a shipyard will pay taxes on the construction or overhaul of a cruise ship of 20,000 gross tons or greater only after the delivery of the ship. Under my bill, a U.S. company operating a cruise ship of 20,000 grt and greater may depreciate that vessel over a five-year period rather than the current 10-year depreciation period. The bill would also repeal the $2,500 business tax deduction limit for a convention on a cruise ship to provide a tax deduction limit equal to that provided to conventions held at shore-side hotels. The measure would authorize a 20 percent tax credit for fuel operating costs associated with environmentally clean gas turbine engines manufactured in the U.S., and also allows use of investment of Capital Construction Funds to include not only the non-contiguous trades, but also the domestic point-to- point trades and ``cruises to nowhere''. Mr. President, I truly believe that this legislation would help jumpstart the domestic cruise trade, benefit U.S. workers and companies, and promote economic growth in our ports. I strongly urge my colleagues to join me in a strong show of support for this effort.

Ms. SNOWE

Ms. SNOWE. Mr. President, today I am reintroducing legislation that would establish a Northern Border States Council on United States- Canada trade. The purpose of this Council is to oversee cross-border trade with our Nation's largest trading partner--an action that I believe is long overdue and should be considered. The Council will serve as an early warning system to alert State and Federal trade officials to problems in cross-border traffic and trade from the very people who are dealing with trade problems. The Council will enable the United States to more effectively administer the trade policy with Canada by applying the wealth of insight, knowledge and expertise of people who reside not only in my State of Maine, but also in the other northern border States, on this critical policy issue. Within the U.S. Government we already have the Department of Commerce and a U.S. Trade Representative, both Federal entities, responsible for our larger, national U.S. trade interests. But the fact is that too often such entities fail to give full consideration to the interests of the northern States that share a border with Canada, the longest demilitarized border between two nations anywhere in the world. The Northern Border States Council will provide State trade officials with a mechanism to share information about cross-border traffic and trade. The Council will also advise the Congress, the President, the U.S. Trade Representative, the Secretary of Commerce, and other Federal and State trade officials on United States-Canada trade policies, practices, and problems. Canada is our largest and most important trading partner. It is by far the top purchaser of U.S. export goods and services, as it is the largest source of U.S. imports. In 1999, total two-way merchandise commerce was $365 billion--that's $1 billion a day. With an economy one-tenth the size of our own, Canada's economic health depends on maintaining close trade ties with the United States. While Canada accounts for about one-fifth of U.S. exports and imports, the United States is the source of two-thirds of Canada's imports and provides the market with fully three-quarters of all of Canada's exports. The United States and Canada have the largest bilateral trade relationship in the world, a relationship that is remarkable not only for its strength and general health, but also for the intensity of the trade and border problems that do frequently develop--as we have seen in recent years with actual farmer border blockades in some border states because of the unfairness of agricultural trade policies. Over the last decade, Canada and the United States have signed two major trade agreements--the United States-Canada Free Trade Agreement in 1989, and the North American Free Trade Agreement, or NAFTA, in 1993. They also negotiated the 1996 US-Canada Softwood Lumber Agreement, which will expire two months from now, on March 31. Even though some of us in Congress urged the last Administration on more than one occasion to negotiate a process with Canadian officials to work for a fairer alternative, nothing was attempted on a government to government basis. Notwithstanding these trade accords, numerous disagreements have caused trade negotiators to shuttle back and forth between Washington and Ottawa for solutions to problems for grain trade, wheat imports, animal trade, and joint cooperation on Biotechnology. Most of the more well-known trade disputes with Canada have involved agricultural commodities such as durum wheat, peanut butter, dairy products, and poultry products, and these disputes, of course, have impacted more than just the northern border States. Each and every day, an enormous quantity of trade and traffic crosses the United States- Canada border. There are literally thousands of businesses, large and small, that rely on this cross-border traffic and trade for their livelihood. My own State of Maine has had a long-running dispute with Canada over that nation's unfair policies in support of its potato industry. Specifically, Canada protects its domestic potato growers from United States competition through a system of nontariff trade barriers, such as setting container size limitations and a prohibition on bulk shipments from the United States. I might add that there has still not been any movement towards solutions for these problems, even though I have been given promises every year that trade problems with Canada would be a top priority for discussion. This bulk import prohibition effectively blocks United States potato imports into Canada and was one topic of discussion during a 1997 International Trade Commission investigations hearing, where I testified on behalf of the Maine potato growers. The ITC followed up with a report stating that Canadian regulations do restrict imports of bulk shipments of fresh potatoes for processing or repacking, and that the U.S. maintains no such restrictions. These bulk shipment restrictions continue, and, at the same time, Canada also artificially enhances the competitiveness of its product through domestic subsidies for its potato growers. Another trade dispute with Canada, specifically with the province of New Brunswick, originally served as the inspiration for this legislation. In July 1993, Canadian federal customs officials began stopping Canadians returning from Maine and collecting from them the 11-percent New Brunswick Provincial Sales Tax, [PST] on goods purchased in Maine. Canadian Customs Officers had already been collecting the Canadian federal sales tax all across the United States-Canada border. The collection of the New Brunswick PST was specifically targeted against goods purchased in Maine--not on goods purchased in any of the other provinces bordering New Brunswick. After months of imploring the U.S. Trade Representative to do something about the imposition of the unfairly administered tax, then Ambassador Kantor agreed that the New Brunswick PST was a violation of NAFTA, and that the United States would include the PST issue in the NAFTA dispute settlement process. But despite this explicit assurance, the issue was not, in fact, brought before NAFTA's dispute settlement process, prompting Congress in 1996, to include an amendment I offered to immigration reform legislation calling for the U.S. Trade Representative to take this action without further delay. But, it took three years for a resolution, and even then, the resolution was not crafted by the USTR. Throughout the early months of the PST dispute, we in the state of Maine had enormous difficulty convincing our Federal trade officials that the PST was in fact an international trade dispute that warranted their attention and action. We had no way of knowing whether problems similar to the PST dispute existed elsewhere along the United States- Canada border, or whether it was a more localized problem. If a body like the Northern Border States Council had existed when the collection of the PST began, it could have immediately started investigating the issue to determine its impact and would have made recommendations as to how to deal with it. The long-standing pattern of unsuccessful negotiations is alarming. In short, the Northern Border States Council will serve as the eyes and ears of our States that share a border with Canada, and who are most vulnerable to fluctuations in cross-border trade and traffic. The Council will be a tool for Federal and State trade officials to use in monitoring cross-border trade. It will help ensure that national trade policy regarding America's largest trading partner will be developed and implemented with an eye towards the unique opportunities and burdens present to the northern border states. The Northern Border States Council will be an advisory body, not a regulatory one. Its fundamental purpose will be to determine the nature and cause of cross-border trade issues or disputes, and to recommend how to resolve them. The duties and responsibilities of the Council will include, but not be limited to, providing advice and policy recommendations on such matters as taxation and the regulation of cross-border wholesale and retail trade in goods and services; taxation, regulation and subsidization of food, agricultural, energy, and forest-products commodities; and the potential for Federal and State/provincial laws and regulations, including customs and immigration regulations, to act as nontariff barriers to trade. As an advisory body, the Council will review and comment on all Federal and/or State reports, studies, and practices concerning United States-Canada trade, with particular emphasis on all reports from the dispute settlement panels established under NAFTA. These Council reviews will be conducted upon the request of the United States Trade Representative, the Secretary of Commerce, a Member of Congress from any Council State, or the Governor of a Council State. If the Council determines that the origin of a cross-border trade dispute resides with Canada, the Council would determine, to the best of its ability, if the source of the dispute is the Canadian Federal Government or a Canadian Provincial government. The goal of this legislation is not to create another Federal trade bureaucracy. The Council will be made up of individuals nominated by the Governors and approved by the Secretary of Commerce. Each northern border State will have two members on the Council. The Council members will be unpaid, and serve a 2-year term. The Northern Border States Council on United States-Canada Trade will not solve all of our trade problems with Canada. But it will ensure that the voices and views of our northern border States are heard in Washington by our Federal trade officials. For too long their voices have been ignored, and the northern border States have had to suffer severe economic consequences at various times because of it. This legislation will bring our States into their rightful position as full partners for issues that affect cross-border trade and traffic with our country's largest trading partner. I urge my colleagues to join me in supporting this important legislation. I ask unanimous consent that the text of the bill be printed in the Record.