Mr. President, I commend Senator Murray for her strong leadership in restoring funds for the Healthy Communities Access Program to improve the delivery of care to the uninsured. The program provides…
Mr. President, I commend Senator Murray for her strong leadership in restoring funds for the Healthy Communities Access Program to improve the delivery of care to the uninsured. The program provides grants to coalitions of health providers to improve the coordination of care for the uninsured. Since its inception, we have seen an overwhelmingly positive response to the program. Through these grants, 150 communities have been able to increase care for the uninsured, reduce unnecessary health costs, and create innovative projects through collaboration and information-sharing. In Massachusetts, the Cambridge Health Alliance used its grant to launch an impressive outreach campaign to enroll 57,000 uninsured residents in a comprehensive and well-coordinated system of care. The Alliance has formed strong partnerships with local schools, law enforcement, and advocacy groups who work together to meet the needs of the most vulnerable members of the community.
The Healthy Communities Access Program embodies exactly the kind of innovative approach to improving the quality of health care that we need. Yet, despite its successes, the administration wants to zero out the program and the Omnibus Bill eliminates its funding. We should not allow the gains made in communities across the country to be lost because of this shortsightedness. I urge the Senate to approve this amendment and support our communities in this effective way to improve care for the uninsured.
Will the Senator yield for a moment? Does the Senator have the time?
I want to commend my friend from Rhode Island. As one of the authors of the S-CHIP Program, we gave the States an opportunity to use the money and then we provided, if they did not use the money, that States that were attempting to cover the children would have some access to it and then eventually it would go back to the Treasury.
We are finding out now that there are a number of States that are prepared to go ahead and insure these children. This program is so enormously important, because if you put it with the Medicaid Program, there is no real reason why any child in America isn't covered with some form of health insurance.
I commend the Senator from Rhode Island. This program was agreed to and accepted in a strong bipartisan way. As author, along with my friend from Utah, Senator Hatch, if we had just not provided this provision and let the States have a little more time to implement it, we would have a lot more children covered. This makes a great
deal of sense. It is focused and it is a successful program. The point the Senator from Rhode Island makes is that it will ensure that hundreds of thousands of more children will be protected with health insurance.
I thank the Senator.
What was the request?
Mr. President, I send an amendment to the desk.
Mr. President, I ask unanimous consent that reading of the amendment be dispensed with.
Mr. President, I yield myself 8 minutes.
Mr. President, this is a health amendment. It is related to the broad disparities that exist in health care in our society, which recently the President of the United States has recognized, and also our majority leader.
I will take a moment or two to demonstrate these very significant health disparities. This amendment is intended to support and expand some of the existing programs which are in effect and a number of which have been cut very deeply in this omnibus appropriations bill, to restore funding to the appropriations, and then also to meet some of the current needs.
Just very quickly, we have nearly one in four African Americans and one in three Hispanics who are uninsured compared to 16 percent of all Americans. The mortality rate for African Americans is 1.6 times higher than for Whites, a ratio that is actually identical to the ratio in 1950. That has not changed since 1950--the last 50 years. The African- American infant mortality rate is twice that of Whites. Diabetes afflicts Hispanics twice as much as Whites. Minorities are less likely to get heart medicines or cardiac surgery or even essential pain medications. African-American men suffer prostate cancer twice as often as White men.
This is the reality. And I could go on. There are very dramatic and significant disparities. Take, for example, the health disparities in HIV/AIDS. This chart shows the rate per 100,000 of the population. It is 81.9 among Black Americans, 34.7 among Hispanics, 9.4 among American Indians/Alaskans. And it is 8.4 among the White population. There is a tremendous disparity.
What we have seen is that the minority HIV/AIDS initiative faces a devastating cut in this omnibus bill. It is an 85-percent cut. Do we hear that? An 85-percent cut.
In 2002, there was $381 million available for the initiative. In the omnibus, it is $50 million. This amendment would put it at $540 million. It would take the $380 million and adjust it to the increased demands we are facing.
It is absolutely intolerable that we have seen this dramatic reduction in terms of outreach for services, for prescriptions, for caring among minority populations. I think it is one of the glaring deficiencies of this particular program.
Before continuing, I must make a brief comment on today's Washington Post article on the front page where they say the AIDS panel choice wrote of a ``gay plague''--a ``gay plague.'' ``Views of White House Commission Nominee Draw Criticism.''
I would have thought, with all the debate and discussion we have had here on the floor, going back to the debate and discussion on Ryan White, and how we have debated and discussed the NIH budget and other issues relating to minority health, that we could have moved beyond this kind of serious stereotype of characterizing those with HIV or AIDS as part of a ``gay plague.'' Most of us thought this country had gone well beyond that kind of horrible insensitivity. I believe this appointment should be withdrawn. It is an insult to gay Americans, to those who have worked so hard to treat people with AIDS with sensitivity and support.
Removing one individual is not enough. We must maintain and expand our commitment to deal with the disease. When it comes to AIDS in the minority community, this appropriations bill is missing in action.
This amendment also provides some assistance to the NIH Center on Minorities and Health Disparities to try to make sure that the center, which coordinates a national research agenda on minority health is going to be adequately funded.
It also provides a very small and modest increase in the HHS Office for Civil Rights. Many members of the minority community are being excluded from treatment, care, and attention. It is difficult to think that is the case, but that is happening all over this country. The HHS Office for Civil Rights has more than 1,000 complaints on its desk that are being unanswered. We provide a few million dollars, from $33 million up to $48 million, to be able to deal with this.
Finally, one of the most important provisions in all of this pertains to programs that are directed to try to help meet the deficiencies in training minority health professionals and support historically Black schools. I just want to point out that in the Clinton year of 2000, funding was $93 million; in 2001, it was $109 million; and in 2002, it was $115 million; but the Bush request for this year is $10 million-- $10 million.
There has been an increase in the revised omnibus, but it still shows a blatant and flagrant failure to understand the serious problem in the declining numbers of minority health professionals. These series of programs and the centers of excellence that enable many minorities to make it to schools of professional training--in nursing, dentistry, and medicine--those programs would have effectively been closed down. And the scholarship programs which have been available to minority students effectively would have been drastically reduced.
It does seem to me, after all we have heard in the debates over the period of the last 2 weeks, on issues of affirmative action, on issues of civil rights, that the one area on which we could all come together is these extraordinary disparities in health care that have been out there. These are the same disparities that have been around for the last 50 years and, under this omnibus bill, programs that help to alleviate the disparities are being cut back or abandoned in a very significant and important way.
This amendment restores those funds and adds additional funding to it to make sure we have realistic levels of assistance to reduce disparities. It does seem that even though we have had debates that have been divisive over recent times, on issues of affirmative action and other judicial issues, we as a Senate ought to be able to come together and say that whether you are going to get care and attention on a particular sickness or disease should not depend on the color of your skin. That is what is happening.
Mr. President, I yield myself 2 more minutes.
Mr. President, that is what is happening. In too many instances we are finding that those whose skin is not white are being denied medical care. They are being denied the services which are so essential to individuals to improve their kind of health conditions.
This is an area we can do something about. We will have broad debates on
other kinds of policy issues, but in terms of reducing the disparities and having support for the tried and true programs, this amendment will advance that cause. I hope we can accept it and move on.
Mr. President, I withhold the remainder of my time.
Mr. President, I suggest the absence of a quorum and the time to be applied equally.
Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.
Mr. President, how much time remains?
I have 5 minutes remaining?
I yield myself 2\1/2\ minutes.
Mr. President, I would like to call attention to the Labor-HHS appropriations conference report from FY 2002 on the Minority HIV/AIDS Initiative.
What it shows is the appropriations for HIV/AIDS health programs for FY 2002--$123 million for HRSA; $96 million for CDC; $7 million for SAMHSA/Center for Mental Health Services; $57 million for SAMHSA/Center for Substance Abuse Treatment; $38 million to the Center for Substance Abuse Prevention; $50 million for the Office of the Secretary; $9.7 million for the Office of Minority Health. That adds up to $381 million.
The Senate fiscal year 2003 omnibus appropriations lists $50 million for the Minority HIV/AIDS Initiative, Office of the Secretary. That is it. It is all listed in very considerable detail in this 2002 report. On the other hand, under this fiscal year 2003, minority HIV/AIDS has just the $50 million, Office of the Secretary.
This is extremely important. The 2002 conference report illustrates exactly where the funding has been directed and the support for it. That is completely missing in this proposal.
Our amendment addresses these issues and provides the kind of support which will make an important difference in reducing the disparities in health care in our society.
Having listened to so many who have spoken so often in the last several days on civil rights, there may be differences on one issue or another affecting civil rights, but we should all come together on this issue to address the disparities in health care which exist. We should go beyond our differences.
I reserve the remainder of my time.
Mr. President, I yield myself 1 additional minute.
What do these cuts mean? They mean 10,000 minority women and children, including HIV-infected pregnant women, will lose medical care under title IV of Ryan White; 11,000 minority patients in the hardest hit cities will lose lifesaving drugs and critical medical care through title I of Ryan White; another 5,000 minority patients will lose medical care funded through State governments under title II of Ryan White. These are just some of what will happen unless we make major changes in the omnibus appropriations bill, and my amendment does that.
I withhold my remaining time.
I have 2 minutes which I will use.
That is fine.
Would the Senator be good enough to repeat?
I thank the leaders.