Snoqualmie Pass Land Conveyance Act

Let me thank my distinguished colleague from Cleveland, Ohio, the chairwoman of the Ethics Committee, and as well the first African American woman, only African American woman on the Ways and Means Committee. These two distinctive positions are so important, one, for the health of this body, the Ethics Committee, and two, for the great city that she represents. And I might compete with her, she has the Cleveland Clinic; I have the Texas Medical Center. And I know that we have had the opportunity to work with each other, and I want to thank her for what I think is an enormously important Special Order.

I want to begin, as many of my colleagues have begun, and I want to acknowledge the chairwoman of the Congressional Black Caucus, Congresswoman Kilpatrick, for the importance of putting a face on the issue of disparities in health care.

In doing that, I'm reminded of the language in the beginning of the Constitution that the Founding Fathers organized to create a more perfect Union. But as they struck out on faith to establish this fledgling United States of America, only 13 colonies, feeling the redcoats breathing down their backs, afraid that at any moment this very fragile government might be toppled, they had enough courage to declare some words that I believe, if this Congress would use it as a moral compass, these issues of Congresswoman Stephanie Tubbs Jones would be very clear, and those are the words of the Declaration of Independence that said we all are created equal with certain inalienable rights; the right to pursue life, liberty and the pursuit of happiness. We are all created equal with certain inalienable rights; the rights of life, liberty and the pursuit of happiness.

Clearly, health care is intimately involved in life and the pursuit of happiness. And so in actuality, the Founding Fathers put down a marker of what kind of Nation they wanted this to be. Tragically, over the last years, when our good friends were involved, many of the serious issues of health care were diminished in terms of care and funding. And so it is important that we stand here tonight to be able to lay down the challenge and the charge that we are here to fix it up. We are here to make it right. We are here to correct some of the ills, governmental ills, budgetary ills that have caused health care to be diminished.

And let me cite some important statistics that represent the districts of individuals in this body coming from the south, coming from the midwest, coming from the far west, next to Texas, and parts of the mountain area.

The cost of the war in one district is costing $1 million. And out of that waste of money in the Iraq war, we would be able to provide people with health care: 336,000 adults and 527,000 children, plus, with health care.

Another district, the war is costing them $1.2 million, plus. We would be able to provide 420,000 people with health care if that war was ended, 758,000 children.

Another district, the war is costing them $1.1 million--755,000 people would be able to have health care and 633,000 children. Another district, $812,000 it's costing them, and we would be able to provide 310,000 adults with health care, and children, 502,000.

So, we can already see that we would be able to provide thousands, hundreds of thousands of Americans with health care and hundreds of thousands of children with health care if we, first of all, brought our troops home and ended the Iraq war.

Now, why should we be concerned with that? And the Congressional Black Caucus has gone on the record on questions of disparities in health care. And I might say that this whole issue of disparities is not just an issue of race; it's an issue of dealing with economics. It is the kind of health care that poor people are able to manage to get versus those who are covered, who have means. Some people have means where they pay outright for the care. The Texas Medical Center, for example, has long-time hosted international patients who outright pay for good care. We don't have that luxury here in the United States for many of those who are struggling.

And I might give you just a real-life example, Mr. Speaker, having left my home district and had the challenge and the desire to visit constituents who were ailing. They are now surviving because they happen to be individuals who had the care and the sophistication of family members who could get them to a spot that would, in fact, determine what was the final need of their care. Mr. Speaker, they had a disastrous cancerous organ that was not initially found, and they could have died. But because they had the means, they were able to go through test after test, and one expensive test that is rarely given, an MRI, was able to find that cancerous organ, their life has been saved. Another person with a severe injury or severe disease was able to be cared for and is in the best of care because of means. They live today. But that is not the case in the question of disparities on economics, what you make, and also on race.

I'm very glad to be part of the CBC effort and Health Task Force to focus on ensuring that the Ryan White CARE Act is passed with language that emphasizes minority HIV organizations.

I believe in fixing health care disparities on the ground. I have organized a series of testing activities or actions to engage the community in being tested. Our first effort with a church, 245 persons were tested. And our message is that HIV testing is not a one-shot deal. Just recently, a good friend, Representative Borris Miles, was able to get 7,000, or thousands of persons tested, possibly 7,000 persons, for HIV. We are going to launch another effort of testing and a campaign that says ``HIV testing is not a one-shot deal.''

I am a strong supporter of believing in the Health Centers Renewal Act of 2006. For the time that I have been here, I have emphasized that we have not enough community-based health clinics that were privately owned in neighborhoods accessible to grandmothers and young mothers with children. And we have worked hard to ensure that more community health centers come to Houston, Texas.

I'm proud that in my own congressional district we've opened one in Fifth Ward. We've opened two that are under the auspices of the Martin Luther King Community Center that I worked with and kept their doors open with a $400,000 grant from HHS in the early years of my congressional career. This is a stopgap to the disparities in health care, allowing those in the community to have immediate access to health care.

Then, of course, one of the largest, if I might use the term, Mr. Speaker, ``elephants'' in the room, is the question of obesity in America. As the cochair of the Congressional Children's Caucus, we have worked on the issue of obesity in children. I was very proud to join Congressman Donald Payne for a very thoughtful, forward-thinking session on obesity in New Jersey, and providing remarks dealing with the question of obesity in our children. And it is a disparity in health care as it relates to Hispanic and African American children who are victimized, if you will, in large numbers by the lack of nutritious food that generates an overweight child. That turns into hypertension as an adult, type II diabetes, coronary heart disease, stroke, gallbladder disease, asthma, bronchitis, sleep apnea, and other respiratory diseases.

There are also increases in overweight among children and teens. For

children age 2 to 5, the prevalence of overweight increased from 5 percent to 13 percent; 6 to 11 years, prevalence increased from 6.5 percent to 18.8 percent; and for age 12 to 19 years, 5 percent to 17.4 percent.

We're working to ensure in the agricultural reauthorization bill that's coming forward that school lunches and school breakfasts are nutritious. That has to be for those children who are poor and are dependent upon those meals as sometimes their only meal.

I passed legislation that involved the creation of an Office of Minority Populations that still stands today, and the idea is to keep the question of disparities in health care before Health and Human Services regardless of who the Secretary is. We can do better in this Congress.

And there are issues dealing with our veterans. I'm very pleased that my VISTA bill was marked up in the veterans which provides added resources for visually impaired veterans in order to assist them in the care of those who are impaired by their recent, if you will, deployment to Iraq and those who are veterans who have suffered injury or have lost their sight.

But we come now to the issue of the SCHIP, which is in the process of being reauthorized. And the difficulty, of course, is that we need to emphasize the crucialness of SCHIP in the Nation and in our States. I believe that the work of the Congressional Black Caucus and all of us in our respective States is a telling answer to health care for children who are at a certain economic level.

Tragically, the State of Texas, after the passage of the 1997 budget resolution which created SCHIP, was one of those States that turned back $400 million because they could not enroll the children. As we move forward, I want to make sure that we move forward on the package that will cover 6 million children. I would like to see us go up to 9 million, but I think we need to look at process. I hope that we do not privatize and make this a market-based program so that people can stuff their pockets with money.

This should be a program that goes directly to these families. Any State that fails to enroll should be penalized by the State's having to refund their own tax dollars, not the money sent for the children. Let us not penalize the children, but let us cause those States to pay fines for their inertia and their inability to enroll these children. I hope that we will have that kind of reform.

Let me close by suggesting that we have an enormous road to take on health care. I am gratified that I hear more African Americans and Hispanics and others of a certain economic level who are prone to these disparities in health care talking about eating right, talking about an intake of less red meat. For those who are on the ranches, and I am from Texas, a good steak is a good thing to have. But to focus on vegetables, and some people have become vegetarians and are drinking water. These are elements that can encourage good health care.

For those of us who have our schedule here in Washington, D.C., a little walking, a little exercise would be good as well. We should probably look at ourselves in the mirror and try to improve our own health status. We have the capability and capacity if and when some health matter would come to our attention, that is a personal matter, but we must speak for the millions of Americans, 44 million, that are uninsured, that do not have access to health care. I do believe that it is time to move for universal access to health care.

So as we move in the 110th Congress and complete this session, I would say to all of my colleagues, be reminded of the Declaration of Independence; we all are created equal with certain inalienable rights of life, liberty and the pursuit of happiness. Health care has to be a constitutional issue and a right for Americans.

Certainly for the least of those we must stand ready to provide them with a strong and forceful statement and action on health care in America. We should have the SCHIP passed without hindrance and without a market-based approach. We should pass universal access to health care so that all Americans, all Americans, can have the ability to be blessed with the virtues of the pursuit of happiness and have good health care.

Mr. Speaker, let me thank my colleague for yielding. Might I also suggest that we have our marching orders at this point, that we will not take a ``no'' on passage of the SCHIP out of this House. We want to see universal access to health care come to the floor.

On the disparity question, I am looking forward to the Congressional Black Caucus and the Tri-Caucus health disparity bill being made in regular order and being brought to this floor as soon as possible.

Mr. Speaker, we must save lives. We must.

Mr. Speaker, I rise in support of Special Order to recognize the importance of closing the racial and ethnic health disparities in this country. It is crucial that we continue to bring awareness to the many health concerns facing minority communities and to acknowledge that we need to find solutions to address these concerns. My colleagues in the Congressional Black Caucus and I understand the very difficult challenges facing us in the form of huge health disparities among our community and other minority communities. We will continue to seek solutions to those challenges. It is imperative for us to improve the prospects for living long and healthy lives and fostering an ethic of wellness in African-American and other minority communities. I wish to pay special tribute to my colleague, Congresswoman Donna Christensen, the Chair of the CBC Health Braintrust, for leading the Congressional Black Caucus in its efforts to bring attention to the health challenges facing minority communities. I thank all of my CBC colleagues who have been toiling in the vineyards for years developing effective public policies and securing the resources needed to eradicate racial and gender disparities in health and wellness.

Let me focus these brief remarks on what I believe are three of the greatest impediments to the health and wellness of the African-American community and other minority communities. The first challenge is to provide everyone access to healthcare. This includes supporting the reauthorization and expansion of the State Children's Heath Insurance Program (SCHIP) so that all of our children who need health insurance will receive it. The second challenge is combating the scourge of HIV/ AIDS. The third challenge is to reverse the dangerous trend of increasing obesity in juveniles and young adults.

differential access may lead to disparities in quality; support for

healthcare legislation--h.r. 676

Across this great Nation the health disparities between minority and majority populations are staggering. Most major diseases--diabetes, heart disease, prostate cancer, HIV/AIDS, low-birth weight babies--all hit minority communities harder. As minorities, we constantly have had to endure decreased access to care, and often of lesser quality care, than do members of the majority race in America.

h.r. 676, ``the united states national health insurance act''

Earlier this year, I was proud to be an original cosponsor of H.R. 676, ``The United States National Health Insurance Act.'' This Act would allow for every American to receive heath insurance. You, the American people called for universal health care, as it was one of the most prominent issues for Americans in the 2006 election.

The need for a high-quality, accessible and affordable health care system has never been more urgent. There are currently 47 million uninsured Americans, 8 million of whom are children. Another 50 million are underinsured. Although the U.S. spends twice as much on health care per capita as countries with universal coverage, the World Health Organization ranks us 37th in overall health system performance. Major American corporations such as General Motors bear the brunt of an outdated health care system because they are at a competitive disadvantage relative to their international counterparts who pay less for health care. A Harvard study found that almost half of all bankruptcies are partially or fully related to health care bills.

Our plan, H.R. 676, ``The United States National Health Insurance Act,'' guarantees every resident of the United States access to a full range of medically necessary services, including primary care, prescription drugs, mental health care and long term care. The role of the government would be limited to collecting revenues and disbursing payments; care would continue to be delivered privately. Patients could continue to use the same hospital, physician or health clinic from which they currently receive services. H.R. 676 is supported by over 210 labor unions and more than 100 grassroots groups across the country. The former editor of the New England Journal of Medicine, two former U.S. Surgeons General and 14,000 physicians support national health insurance.

health equity and accountability act of 2007

I also strongly support the Health Equity and Accountability Act of 2007, an important bill that my colleague Congresswoman Donna Christensen has crafted to address the health disparities we face in our community. This bill will provide for:

Creation of Regional Minority Centers of Excellence Programs in medically underserved regions of the country

Creation of Health Information Technology Zones

Data Collection and Analysis Grants for Historically Black Colleges and Universities, Hispanic Services Institutions, and Tribal Colleges and Universities, and Asian American and Pacific Islander-serving institutions with accredited public health, health policy or health services research programs

Reauthorization of the National Center for Minority Health and Health Disparities

Expansion of funding the Minority AIDS Initiative ($610 million)

Grants for Racial and Ethnic Approaches to Community Health

Access to programs and activities and establishes support center to those with limited English proficiency and ensures antidiscrimination provisions and sets standards for these services, such as hiring bilingual staff and informing patients of their rights in their primary language.

Federal agencies that carry out health related activities are mandated to adopt a guidance model on language services.

The Secretary is required to conduct a demonstration project in no less than 30 states or territories showing the impact of costs and health outcomes to those with limited English proficiency.

Grants to improve healthcare for those with communities with low functional literacy.

The preparation and publication of a report that describes government efforts to provide access to culturally and linguistically appropriate healthcare services including an evaluation of activities and an explanation of best practices and models.

DHHS will be responsible for submitting a report on health workforce diversity with descriptions of any grant support provided for workforce diversity initiatives.

Establishment of a technical clearinghouse for health workforce diversity with statistical information, model health workforce programs, admissions policies, etc.

Evaluation of workforce diversity initiatives, data collection and reporting by health professional schools, and supporting institutions committed to workforce diversity.

Providing career development for scientists and researchers and for those non-research health professionals.

Provide cultural competence training for health care professionals.

To increase the number of individuals from disadvantaged backgrounds in health professions by enhancing their academic skills and supporting them in training.

Examination of providers and the delivery of culturally and linguistically appropriate services in geographic areas

Makes public the data collected and analyzed.

Grants to eligible institutions to conduct and coordinate research on the built environment and its influence on individual and population- based health.

Such a bill will go a long way in providing for the healthcare needs of minorities and will help to narrow the health disparity gap.

There is no reason why this country should continue down a dreadfully deleterious road of denying healthcare to any citizen of this country who needs it. Many of the health conditions, such as diabetes, obesity, kidney failure, cancer, hypertension and HIV/AIDS, the prevalence of which plagues our community the most, could be curtailed or even prevented if everyone had access to health insurance. I will continue to fight hard for the most effective policy measures that aim to narrow the racial health disparity gap.

It is a misconception that minority healthcare is just about helping minorities. Keeping Americans healthy ensures that children can stay in school and that their parents can go to work. It ensures that our emergency rooms are not glutted. It ensures that our hospitals are not wasting time and money chasing the uninsured with massive bills they cannot afford to pay anyway. Keeping Americans healthy ensures that all of our friends, neighbors, and loved ones can have longer, more productive lives to contribute to our communities and to our economy.

We all pay the cost of leaving people in America without health coverage. We cannot afford to pay that high cost any longer. The time for health equality is now. We need to work to improve access to care for people, in general, but there are also areas where more specific interventions are necessary.

I have worked to improve awareness on prostate cancer, and have worked with MD Anderson to help start clinics in Houston that will open access to quality affordable prostate screening and care. I have worked with Hepatitis C advocates in Houston, and across the Nation, to spread the word that Hep C is a silent killer that is cutting down our minority communities and our veterans. There is so much misinformation out there about Hep C. I am pushing the Government Accountability Office to do a full report on the Hep C problem so that we can work to stop this epidemic.

There is also a significant shortage of minority doctors, dentists, and health professionals of all sorts; a shortage that contributes significantly to quality healthcare access. It has been shown that people tend to seek care from people who look like them, and share similar backgrounds. So, the lack of diversity is not just a civil rights issue, it is an issue of health access. We need to boost minority enrollment in health professional programs.

Success will require young people to redouble their efforts to pursue their scholarly pursuits with a renewed commitment to health and medical research. I am very bullish on academic achievement. That is one reason why I was so interested in securing increased funding for science, technology, engineering, and mathematics education and research.

There are so many areas in which we need to work together and address the critical needs of the people who are being left out of our health care system. Putting energy and resources into decreasing health disparities is a solid investment, one that will reduce unnecessary suffering, and make our workforce and our society stronger. I pledge to you that I will continue to do my part. By your presence here today, I have no doubt you will continue to do yours. And together, we will see the eradication of serious health inequalities in our lifetimes.

We must ensure that all Americans have access to healthcare. Access to healthcare is an important prerequisite to obtaining quality care. Some access barriers, whether perceived or actual, can result in adverse health outcomes. Patients may perceive barriers to delay seeking needed care, resulting in presentation of illness at a later, less treatable stage of illness. For example, a usual source of care can serve as a navigator to the healthcare system and an advocate to obtain needed evidence-based preventive and health care services. Of the major measures of access, the lack of health insurance has significant consequences. Avoidable hospitalizations are a good example of the link between access and disparities in quality of care. These hospitalizations may reflect, in part, the adequacy of primary care. When health care needs are not met by the primary health care system, rates of avoidable admissions may rise. Many racial and ethnic minorities and individuals of lower socioeconomic status are less likely to have a usual source of care. As a result:

Hispanics and people of lower socioeconomic status are more likely to report unmet health care needs.

While most of the population has health insurance, racial and ethnic minorities are less likely to report health insurance compared with whites. Lower income persons are also less likely to report insurance compared with higher income persons.

Higher rates of avoidable admissions by blacks and lower socioeconomic position persons may be explained, in part, by lower receipt of routine care by these populations.

Many of these circumstances are the direct result of lack of heathcare coverage.

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

Mr. Speaker, I thank the Speaker for the opportunity to serve as moderator for this special designated time for recognition under Special Orders for celebration of health care, and, in particular, the uninsured.

Tonight I have several colleagues who will be joining me to speak on different topics with respect to health care issues affecting minority communities. Just to give you a brief summary of some of the topics we will touch on, obviously reauthorization of SCHIP, language access, obesity, diabetes, cancer, tobacco, HIV and AIDS, health professions, community health workers, environmental health and Medicaid citizenship.

Mr. Speaker, tonight I rise to recognize National Minority Health Month. This week is Covering the Uninsured Week. Tonight you are going to hear from some of my colleagues representing the Congressional Black Caucus, the Congressional Hispanic Caucus and the Congressional Asian Pacific Islander Caucus and their efforts to improve health care in our communities.

Did you know that life expectancy and overall health have improved in recent years for large numbers of Americans due to an increase in and focus on preventive medicine and new advances in medical technology? However, not all Americans are faring that well, particularly communities of color, which continue to suffer from significant disparities in overall rate of disease incidence, prevalence, morbidity, mortality and survival rates in the population, as compared to the health status of the general population.

The National Minority Health Month was launched in an effort to eliminate health disparities and to improve health status of minority populations across the country. This month was created in response to Healthy People 2010, a set of comprehensive health objectives established by the U.S. Department of Health and Human Services. Disparities continue to persist, and we must eliminate health disparities by identifying significant opportunities to improve health care.

There are disparities in the burden of illness and death experienced by African Americans, Hispanic Americans, Asian Americans, Pacific Islanders, and American Indian and Alaskan Natives as compared to the U.S. population as a whole.

I am pleased to once again be working with my colleagues in the Congressional Black Caucus, the Hispanic Caucus, and the Congressional Asian Pacific Islander Caucus to develop a comprehensive tri-caucus health disparities bill. Our bill will address the importance of language access, health professions, training, data collection and health coverage for immigrants. Our colleagues in the Senate are also working on a disparities bill, and I hope that they too will pass legislation that will truly save the lives of millions of minorities. We must do more to better the health of our population, which includes all communities of color.

With that, I want to just briefly touch on this issue of the uninsured. Today marks the start of the fifth year of Covering the Uninsured Week. Although the United States has one of the best health care systems in the world, not everyone has the means to access our health care system. The number of uninsured people affects us all and is a national problem that needs a national solution.

We all know that lack of health insurance results in reduced access to care. Access can be defined as the ability to get to health services, receive service at the right time, and obtain the appropriate services necessary to promote the best health outcomes possible.

Reduced access could mean that someone is less likely to have regular sources of care, less likely to receive preventive services and more likely to use emergency departments as primary sources of care. The long-term consequences of reduced access to care include lower quality of life, higher mortality rates and the decline of the population's overall health.

Despite the growth of our economy, the number of uninsured persons continues to increase. In 2005, more than 44 million people were uninsured, and of that number, 14 million were Latinos.

The cost of private health insurance continues to rise astronomically, and we hear that every single day when we go back home to our districts. Health insurance premiums continue to rise by double- digit rates each year, and over 80 percent of the uninsured come from working families, people who are working and getting a paycheck. While two-thirds of uninsured children are eligible for public programs such as Medicaid and the SCHIP program, most are still uninsured.

These adults also are low-income populations who are not eligible for public programs but have incomes below 200 percent of the Federal poverty level. This group is composed predominantly of parents and childless adults who work but may have difficulty in obtaining and affording coverage. Due to the low Medicaid eligibility level for parents, many uninsured parents have children who qualify for public coverage but do not qualify, themselves, as parents. What an irony.

Members of racial and ethnic minority groups make up a large number, a disproportionate share, of the uninsured population. The uninsured rate for Latinos was 33 percent in 2005, 20 percent for African Americans and 18 percent for Asians and 30 percent for Native Americans. They lack health care coverage.

In addition to impacting health and the finances of the uninsured themselves, the lack of health care coverage has had repercussions for all of us in America. Many hospitals, as you know, are currently struggling under the strain of providing uncompensated emergency care to uninsured individuals.

In my own district in California, community health centers bear the brunt of responsibility for treating the uninsured. These community health centers are often the first place that the uninsured turn to when seeking health care services. These community health centers are a vital part of our health care safety net.

Poor health leads to poor financial status, and a never-ending cycle of low socioeconomic status often leads to poor health. The core values for a strong and secure America should include the right to universal access to affordable, high-quality health care for all.

In a country that prides itself on equality, it is evident that our health

care system is broken when people suffer from a lack of access to health insurance and to quality care. We must make health care services affordable and provide quality through linguistically and culturally competent services for all Americans. That must be our national priority.

I want to refer myself to the State Children's Health Insurance program, known by many as SCHIP, which covers currently 6 million children, building on Medicaid's coverage of 28 million children. However, statistically speaking, 9 million children remain uninsured.

Over the past decade, SCHIP and Medicaid together have reduced the uninsured rate among low-income children by one-third. We know that uninsured children are more likely to receive cost-effective preventive services and are healthier, which leads to greater success in school and life. Although programs such as SCHIP and Medicaid have decreased the number of uninsured children, the lack of funding and outreach efforts have left millions of those children ineligible without any coverage. Reducing disparities in children's access to health care is extremely important and should be one of our biggest priorities here in Congress.

For example, uninsured African American and Latino children are less likely to have a personal doctor and are more likely to forego needed medical care than any other group of uninsured children. More than half of insured African American children, 51 percent, and insured Latino children, 50 percent, are covered by Medicaid and SCHIP. Nearly 95 percent of eligible but uninsured children live in families with incomes below 200 percent of the Federal poverty level, which is $33,200 for a family of three, and over 40 percent of this population is Latino.

Enrollment in SCHIP has proven to reduce disparities in access to health care services as well as reducing the coverage gap for minority children. More than 80 percent of African American children and 70 percent of uninsured Latino children appear to be eligible for this public coverage, but currently are not enrolled.

Additional funding for SCHIP, as you know, is necessary for the coverage of all uninsured. SCHIP plays a critical role for children of color. After SCHIP was created back in 1997, the percent of uninsured children steadily declined from a high of 15.4 percent in 1998 to a low of 10 percent in 2004, and for racial and ethnic minorities the decline was remarkable. In 1998, roughly 30 percent of Latino children, 20 percent of African American, and 18 percent of Asian Pacific Islander children were uninsured. In 2004, those numbers had dropped to about 21 percent, 12 percent and 8 percent respectively.

In addition to reducing the coverage gap for minority children, SCHIP enrollment has helped to reduce disparities in access to health care services. For example, a study of children enrolled in New York's SCHIP program for one year found an almost complete elimination of these disparities and the number of children with unmet health care needs decreased. A study from California's SCHIP population confirmed those results as well. Across racial and ethnic groups, SCHIP enrollment was associated with a significant reduction in disparities and access to needed care.

We need adequate SCHIP reauthorization. Currently there is insufficient Federal funding for SCHIP to cover the children currently enrolled. We need additional money to cover them and to expand coverage to uninsured children who are eligible.

In order to expand health coverage for minority children, we also need to address the underlying barriers to enrollment in Medicaid and SCHIP that minorities are more likely to face; as an example, the distrust of government and a health care system where language may not be spoken adequately to the different groups that are affected. And misinformation about eligibility rules is often complicating the process for many who don't understand the paperwork.

Enrollment strategies targeted to minority communities, including the use of community health workers, known as promotoras, could help guide families through the enrollment process and have been proven to increase enrollment and reduce disparities. We must improve outreach efforts and simplify enrollment in order to reach the millions of unenrolled children from communities of color who are eligible for Medicaid and the SCHIP program. This year, with the reauthorization of SCHIP, this is an opportunity for us to address racial and ethnic disparities in children's access to health care. I hope that we can work together with our colleagues across the aisle to begin the debate and see that we reauthorize these programs that are so vitally needed.

I am very pleased this evening to have one of my colleagues, the gentlewoman from Guam, who has chaired the Congressional Asian Pacific Islander Caucus Task Force on Health who has joined me this evening. She has been a pioneer on health care access and will give us, I am sure, very informative data regarding the problems that are faced currently in the Asian Pacific Islander community. I welcome her this evening.

I gladly yield to the gentlewoman.

I thank the gentlewoman from Guam, and I would like to at this time thank her for her hard work and deliberations in the past few years as a strong member of the tri-caucus working on health care issues. I know she is going to continue to lead and be a voice for those underrepresented communities.

I would like to now recognize a very special individual who is Chair of our Subcommittee on Health on Energy and Commerce, but also plays a very important role in representing the Native Americans in our great country and that is the gentleman from New Jersey (Mr. Pallone).

I thank the gentleman from New Jersey for his kind words and knowledge and always helping Members to better organize their messages, particularly when it comes to health care and the need to improve access for all people in our great country.

As the gentleman says, the fact is that we are undergoing a change where our populations are exploding, our minority populations have increased, and we don't see more services provided, one of which is the Native American population. I have a significant Native American population in L.A. County and there is one center available for them. It is just horrifying to think that people have to travel so many counties just to get there. Lord help them if they have an episode of some sort, that they get there in time to receive the necessary care. To know that this is not a priority with the administration is very alarming. We need to prioritize this issue.

I again want to recognize my colleague from Guam to talk about some other very pressing health care issues that affect not just Asian Pacific Islanders but these other minority populations. So I would yield to her.

Mr. Speaker, I thank the gentlewoman for joining us this evening and representing the caucus so well, the Asian Pacific Islander Caucus, and demonstrating a willingness to work across the aisle and in a coalition so that we can better improve access to health care for all underrepresented groups.

I want to talk very briefly before I recognize one of our other colleagues who has joined us here from the Congressional Black Caucus, Sheila Jackson-Lee.

I want to talk about diabetes because diabetes, in my opinion, is one of the major chronic illnesses. It does not just affect ethnic minority or underrepresented groups, but many, many people in our country.

One of the goals that I mentioned earlier of the Healthy People 2010 program, a campaign underway, by the way, by the Department of Health and Human Services, is to reduce the disease and economic burden of diabetes and to improve the quality of life for all people who have or are at risk of getting diabetes.

Diabetes, as you know, is a chronic disease affecting both children, Type I, and adults, Type II. The number of people with diabetes has increased steadily in the past decade, and the increase has occurred within certain racial and ethnic groups.

Today, approximately 20.8 million Americans have diabetes, and of these people, an estimated 6.2 million individuals have not even been diagnosed. According to the Centers for Disease Control and Prevention, another 54 million people have pre-diabetes.

Complications of diabetes include heart disease, stroke, blindness, kidney

failure, dental disease, pregnancy complications and amputations. These are very serious illnesses, and diabetes is now the sixth leading cause of death in the United States and costs the Nation over $132 billion per year in direct and indirect costs.

Diabetes, as you know, is the leading cause of nontraumatic amputations, and about 150 amputations per day are due to diabetes.

Two million Latinos have been diagnosed with diabetes, and Latinos are 1.5 times more likely to have diabetes than whites, on the average, and many children with Type II diabetes are Latino or African American.

Reducing the incidence of diabetes and thus reducing racial and ethnic disparities involves diet and lifestyle changes. However, strategies to manage the disease and prevent the disease also need to be culturally sensitive and targeted to specific populations.

The number of overweight minority children has increased in recent years, and more of them are being diagnosed with adult-type diabetes. It is estimated that now at least 40,000 children now have Type II diabetes, which is the type of diabetes associated with adult obesity.

Regular diets of low-cost, high-calorie fast food and sodas, in addition to inadequate daily physical activity, have contributed to the prevalence of diabetes. Health education, as you know, is extremely important, and we need to teach people how to prevent diabetes because it is preventable. For people who already have diabetes, we need to teach them how to manage that disease.

In order to prevent or delay complications and early death from diabetes, patients need to understand the disease, take charge of blood glucose management, comfortably talk to their provider about diabetes care, and have access to equipment, supplies and prescriptions. Cultural competence and access to health care play a very large role in preventing deaths due to diabetes.

Sixty percent of my district, as you know, is Latino, and I have seen firsthand the community clinics that have helped my constituents who are diagnosed with this deadly but preventable disease. A large proportion of the people who visit these clinics in my district are uninsured. When I see the packed waiting rooms, I understand how hard it is to manage this chronic illness. Even with appointments, people can have waiting times of several hours, resulting in loss of work.

A 2005 Commonwealth Fund study of public hospitals also found that African American and Latino patients were less likely than their white counterparts to have well-controlled diabetes, and uninsured patients received even less care. Public hospitals serve a high number of patients at high risk for not receiving access to needed health care. In the study, about two out of five patients with diabetes were uninsured, and two-thirds were members of racial and ethnic minority groups, and up to two-thirds of patients primarily spoke a language other than English.

Insurance status and race influences health care use and outcomes for diabetes patients. Uninsured patients have the worst diabetes control, and 33 percent do not have their condition under control now, which is almost double the rate for Medicare patients.

The routine costs for managing diabetes, to test and control glucose levels, can reach hundreds of dollars per month. Uninsured patients have difficulties paying for equipment to effectively manage their treatment. Consequently, the higher prevalence of diabetes and the inability to manage diabetes leads to more diabetes-related deaths in communities of color.

This is just one example of how social determinants impact our health care status, and I wanted to draw your attention to that.

This evening we have been joined by two members of the Congressional Black Caucus, and I would first like to recognize the gentlewoman from Texas (Ms. Jackson-Lee). Thank you for joining us this evening.

I thank the gentlewoman from Texas for joining us this evening.

Before I conclude with our discussion on the uninsured and celebrating, actually, a call to action, a call to action

for all people of color and all Americans, that we have a balanced health care system that serves all of us, one last item I would like to bring up, before I recognize the gentlewoman from the Virgin Islands for the last 5 minutes is to talk a little bit about one of the biggest killers in our community, and it is about tobacco. Each year tobacco use kills more than 400,000 Americans and costs our country more than $96 billion in health care costs.

According to the Centers for Disease Control and Prevention, tobacco use by pregnant women alone costs at least $400 million per year due to complications such as low birth weight, premature birth and sudden infant death syndrome. Every day, 1,000 kids become regular smokers, one-third of whom will die prematurely as a result. Smoking is responsible for 87 percent of lung cancer deaths in the U.S.

Tobacco-related cancers are disproportionately higher among low- income and ethnic-minority communities. Because these groups have been repeatedly targeted by the tobacco industry, they unfairly carry a greater weight of the health and economic burden tobacco has in our country. For communities of color, tobacco addiction brings a disproportionate amount of death and disease to communities with low rates of health insurance coverage. Lung cancer is the leading cause of cancer among Latino men and second leading cause of death among Latinas.

Approximately 25,000 Latinos will die from smoking-related illnesses this year, surpassing all other causes of cancer. Each year, approximately 45,000 African Americans die from smoking-caused illness.

Native American adults have the highest tobacco use rates for all major ethnic groups. The prevalence of smoking is 37.5 percent among Native American, 26.7 among African American, and 24 percent among white men. This year it is expected that the rate of lung and cancer deaths for white males will be 73.8 per 100,000, while for African Americans it will be 98.4 per 100,000. Tobacco use is an important risk factor for coronary heart disease, the leading cause of death among Latinos.

Unfortunately, tobacco companies have increased their marketing to our minority communities, and I have seen advertisements in magazines popular with Latino youth. RJ Reynolds is running ads for Kool cigarettes with images that appeal to Latinos.

I recently learned that the Kool Mixx campaign focused its marketing images around music and hip-hop, which appeals to African American and Latino youth. The Kool Mixx campaign included 14 music concerts around the country and a DJ competition, as well as a special theme park with cartons displayed on them.

In addition, the tobacco company placed advertisements in publications popular with Latino youth, like this one here, including ``Latina'' and ``Cosmopolitan en Espanol.'' The ads include slogans like: ``It's about pursuing your ambitions and staying connected to your roots.'' To reach everybody in our community, they not only use attractive Latino models, but they also make sure ads are in English and Spanish.

The cigarette companies have focused on African American populations as well. One company created a line of cigarette flavors like Caribbean Chill and Mocha Taboo and used images of African Americans to promote their cigarettes. This targeted marketing is having an impact on the rates that we are seeing, higher number of people smoking. In 2005, 22 percent of Latino high school students smoked, a 19 percent increase over 2003, when the smoking rate was down to 18 percent.

Smoking continues to be a huge public health risk for us, and we must not tolerate it in our communities. We have to stand up to these big corporations and say, enough advertising, let's speak the truth, let's talk about prevention, let's talk about awareness, let's talk about alternative lifestyles so we can have healthier communities.

I am pleased that we were able to entertain this discussion on the uninsured, the celebration of Uninsured Week and to talk about the disparities that exist in our communities and communities of color.

I am pleased to give the remainder of my time to the distinguished woman from the Virgin Islands, who is chairperson of the task force for the Black Caucus, the Congressional Black Caucus.

Mr. Speaker, I move to suspend the rules and pass the Senate bill (S. 2739) to authorize certain programs and activities in the Department of the Interior, the Forest Service, and the Department of Energy, to implement further the Act approving the Covenant to Establish a Commonwealth of the Northern Mariana Islands in Political Union with the United States of America, to amend the Compact of Free Association Amendments Act of 2003, and for other purposes.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and include extraneous material on the resolution under consideration.

Mr. Speaker, I am pleased to call up this legislation which is comprised of 61 separate measures that were already considered by this body, packaged by the Senate, and sent back to us for further and final consideration. This is a bipartisan package, almost evenly split between bills sponsored by Democrats and Republicans.

Further, I would note that 57 of the measures included in this package originated in the Committee on Natural Resources. In this regard, I salute the committee's Chairs who worked so hard on this legislation:

Raul Grijalva, chairman of the Subcommittee on National Parks, Forests and Public Lands; Grace Napolitano, chairwoman of the Subcommittee on Water and Power, and Donna Christensen, chairwoman of the Subcommittee on Insular Affairs.

In this body, these three Members did all of the heavy lifting, the hearings, the managing of the individual bills on the floor, the listening from other Members of this body that helped to make the package we are considering today possible.

The pending measures include new protections for wilderness, national parks, historic sites and trails, and precious water resources from sea to shining sea.

I will not speak to each and every provision of this legislation today but would like to highlight two in particular.

This bill will finally designate the long-awaited Wild Sky Wilderness in Washington State, championed by our colleague, Rick Larsen. As I noted last week when the House considered wilderness legislation for my home State of West Virginia, to be in a wilderness area is truly a humbling experience. To be part of designating the wilderness is even more humbling because wilderness is an effort to retain the landscape as God created it. And as with God's good graces, we are working toward designating new wilderness areas in West Virginia today.

Let this be the next-to-last action, other than the President's signature, on establishing the Wild Sky Wilderness in the State of Washington.

The other measure I would like to highlight would finally bring badly needed immigration, national security and labor protections for the Commonwealth of the Northern Mariana Islands. Further, this legislation would also grant a nonvoting delegate to the U.S. House of Representatives to the Northern Mariana Islands.

For too long, abuses took place in the CNMI, and for too long remedial legislation was held hostage in this body. Let this legislation bring forth a new dawn, the start of a new era with a delegate to this body, that the people of the CNMI's voices be heard.

Again, I want to thank the gentlelady from the Virgin Islands, the chairman of the Subcommittee on Insular Affairs, Dr. Donna Christensen, for her great work on this matter.

There are other issues of note in this bill. It would expand parks in Maine, Massachusetts, North Carolina, Washington and Idaho. It would improve visitor transportation options at Denali National Park and Acadia National Park. And it would expand and increase the authorization for the National Underground Railroad Network to Freedom. Three new national heritage areas and nine existing areas will receive Federal assistance under this measure. Seven other areas will be examined as possible new park units.

This bill would also authorize Federal participation in new and expanded water recycling projects around the west, projects which will provide an estimated 52,600 acre-feet of water annually in an area experiencing severe drought.

It's a good bill, Mr. Speaker. I urge all Members to vote for this package.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield 3 minutes to a senior member of our Committee on Natural Resources, Mr. DeFazio from Oregon.

Mr. Speaker, I have already commended her profusely, but I want to once again thank the chairwoman of our Subcommittee on Insular Affairs, Donna Christensen, from the Virgin Islands for the hard work and long hours that she has put in on this legislation. I now yield her 3 minutes.

Mr. Speaker, I want to yield 2 minutes to another of our subcommittee chairwomen who has put in long hours and very hard work on this legislation, the chairwoman of the Subcommittee on Fisheries, Wildlife and Oceans (Ms. Bordallo).

Mr. Speaker, I yield 2 minutes to a member of our Committee on Natural Resources, the gentleman from Washington (Mr. Inslee).

(Mr. INSLEE asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I have commended this gentleman in my opening remarks because he truly has worked hard over a number of years for a major part of this package. It is a highlight of the package, and I yield 2 minutes to the gentleman from Washington (Mr. Larsen) to explain it.

Mr. Speaker, a simple response to the gentleman who just spoke. There's no eminent domain authority whatsoever granted in this legislation.

Mr. Speaker, I yield 2 minutes to the gentleman from Connecticut, a very valued Member that has worked hard on this bill and has done a superb job, and I want to commend Mr. Courtney for his leadership and work on this legislation.

I am prepared to close on this side, Mr. Speaker.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, as I mentioned in my opening remarks, this is 60-some pieces of legislation in this bill, and it may not be perfect, but it's the nature of the beast, as the process is. Of the 60-some measures in this legislation, 57 that went through our committee on

Natural Resources were pretty well examined. They weren't just thrown into this bill without any consideration whatsoever. Either in this Congress or the previous Congress, these bills have had hearings on them. I mentioned the subcommittee process that worked its will in our Committee on Natural Resources. So this bill has had pretty careful scrutiny.

I'd like to conclude by commending the majority leader of the other body, Mr. Reid. He has called me on this legislation. It passed through the other body after a tortuous process. The final vote over there was 91-4. I also want to commend the Chairman of the Energy and Natural Resources Committee on the other side, Mr. Bingaman, for his work and his tenacity.

Again, I commend my ranking member, the gentleman from Alaska (Mr. Young) and the subcommittee ranking member, Mr. Bishop, and the staffs on both sides of our committee on Natural Resources for the long hours that they have put in on this legislation. It is indeed, as the process goes, an excellent piece of legislation, and I am very proud and highly commend it to my colleagues for passage and on to the President for his signature.

Mr. UDALL of Colorado, Mr. Speaker, I rise in support of this Senate- passed bill, and urge that it be passed and sent to the President for signing into law.

It gathers into one omnibus measure some 60 bills--dealing with various public land, national park, water, and territorial issues--that have already been passed by the House but on which the Senate has not taken separate action. To expedite their consideration, Senator Bingaman, the Chairman of the other body's Committee on Energy and Natural Resources, gathered them into one package after most if not all of them had been favorably reported by that committee and been pending on the Senate calendar for some time. Each part of the package is important, but I want to highlight three.

produced water legislation

Section 514, entitled ``More Water, More Energy, Less Waste,'' is based on my bill, H.R. 902, the ``More Water and More Energy Act,'' which passed the House last year.

Its purpose is to facilitate the use of water produced in connection with development of energy resources for irrigation and other uses in ways that will not adversely affect water quality or the environment.

I think there is a possibility that it can help change an energy- industry problem into an opportunity, not just for oil and gas producers but for everyone else who would benefit from increased supplies of useable water. And especially in the arid west, that covers everyone--not least our hard-pressed ranchers and farmers.

The focus of the section is the underground water extracted in connection with development of energy sources like oil, natural gas or coalbed methane. It would do two things:

First, it would direct the Bureau of Reclamation and the USGS to identify the obstacles to greater use of produced water and how those obstacles could be reduced or eliminated without adversely affecting water quality or the environment.

Second, it would provide for Federal help in building pilot plants to demonstrate ways to treat produced water to make it suitable for irrigation or other uses, again without adversely affecting water quality or the environment. At least one of these pilot plants would be in each of the States in the Upper Basin of the Colorado River--that is, Colorado, New Mexico, Utah, and Wyoming--and at least one would be in one of the States in the Colorado River's lower basin--Arizona, California, and Nevada. This is to assure that, together, the plants would demonstrate techniques applicable to a variety of geologic and other conditions. The Federal Government could pay up to half the cost of building each plant, but no more than $1 million for any one plant. No Federal funds could be used for operating the plants.

The extent of the potential benefits was shown by the testimony of Mr. David Templet at a hearing on the similar bill of mine the House considered in the 109th Congress.

Testifying on behalf of the Domestic Petroleum Council and several other groups, including the Colorado Oil & Gas Association, he noted that produced water is the most abundant byproduct associated with the production of oil and gas, with about 18 billion barrels being generated by onshore wells in 1995. And he pointed out that if only an additional 1 percent of that total could be put to beneficial use, the result would be to make over 75 billion gallons annually available for use for irrigation or other agriculture, municipal purposes, or to benefit fish and wildlife.

Now, remember that in the west we usually measure water by the acre- foot--the amount that would cover an acre to the depth of one foot--and an acre-foot is about 328,560 gallons, so an additional 75 billion gallons is more than 230,000 acre feet--more water, indeed.

And at the same time making produced water available for surface uses, instead of just reinjecting it into the subsurface, can help increase the production of oil and gas.

At the hearing, this was illustrated by the testimony of Dr. David Stewart, a registered professional engineer from Colorado. He cited the example of an oil field in California from which an estimated additional 150 million barrels of oil could be recovered if water were removed from the subsurface reservoir. And he pointed out that where oil recovery is thermally enhanced, a reduced amount of underground water means less steam--and so less cost--is needed to recover the oil.

The potential for having both more water and more energy is also illustrated by the example of a project near Wellington, Colorado, that treats produced water as a new water resource. I had the opportunity to visit it last year, and found it very interesting. An oil company is embarking on the project to increase oil production while a separate company will purchase the produced water to supplement existing supplies, eventually allowing the town of Wellington and other water users in the area to have increased water for drinking and other purposes.

In view of its potential for leading to both ``more water'' and ``more energy'' as well as ``less waste,'' I was pleased but not surprised that the Administration, through the Interior Department, has testified that it ``agrees that the goals of the bill are commendable and the needs that could be addressed are real.'' So, I welcome the fact that the Senate has followed the lead of the House in approving this legislation, and I look forward to its enactment.

platte river recovery implementation legislation

Section 515 of this Senate-passed bill is also based on a bill (H.R. 1462) I introduced last year. It will authorize the Interior Department to participate in the implementation of the Platte River Recovery Implementation Program for Endangered Species in the Central and Lower Platte River Basin.

As I said when the House debated that bill, I consider myself fortunate to have the honor of introducing it, and am gratified that it was cosponsored by my Colorado colleagues, Representatives DeGette, Salazar, and Perlmutter, as well as the entire House delegations of our neighboring States of Wyoming and Nebraska.

Its purpose is to continue a cooperative effort involving the Federal Government and the States of Colorado, Nebraska, and Wyoming (and other entities and groups) aimed at recovery of endangered species in ways that will not involve the creation of Federal water rights or requiring the grant of water rights to Federal entities. It is the result of 14 years of negotiations that culminated in 2006 when the Governors of Colorado, Wyoming, and Nebraska joined Secretary Kempthorne in signing the agreement.

The program is modeled after a somewhat similar program for the recovery of several endangered species of fish in the upper basin of the Colorado River. I have strongly supported that program because it has enabled us in Colorado and other participating States to meet the requirements of the Endangered Species Act while allowing continued development and use of water for other purposes as well. While such arrangements are not easy to work out, I think doing so is far better than alternative approaches that are more likely to be marked by conflicts or litigation. So, I think all concerned in the negotiation of this important agreement are to be congratulated.

The Program has three main elements--(1) increasing stream flows in the central Platte River during relevant periods through retiming and water conservation/supply projects; (2) enhancing, restoring and protecting habitat lands for the target bird species; and (3) accommodating certain new water related activities. Its purpose is to benefit three endangered species (interior least tern, whooping crane, and pallid sturgeon) and one threatened species (piping plover) referred to as the ``target species.'' The Federal Government is to pay half the cost, for which the total authorization would be $157.14 million plus any needed inflation adjustments. Implementation of the Program will mitigate the adverse impacts of certain new water related activities through the implementation of state and federal depletions plans. This will allow continued growth and water development to occur in the Platte River basin along with improving conditions for the target species.

The legislation is important for Colorado and our neighbors in Wyoming and Nebraska. I am glad that the Senate has approved it and look forward to its becoming law.

Northern Marianas Legislation

Finally, Mr. Speaker, I want to note that Title VII of the bill before us includes important provisions related to the Commonwealth of the Northern Mariana Islands, or CNMI.

Subtitle A of that Title responds to longstanding Federal concerns regarding immigration, labor, and law enforcement in the CNMI.

Its enactment will bring completion, at long last, to more than a decade of congressional and executive branch efforts to extend the U.S. immigration laws to the CNMI including the establishment of Federal border control as anticipated by the 1976 covenant agreement between the CNMI and the United States.

And Subtitle B will enable the citizens of the CNMI--who have been U.S. citizens and members of the U.S. family for over 20 years--to elect a Delegate to the House of Representatives, a necessary step if we are to keep faith with our Nation's founding principle of representative government.

The CNMI, a U.S. Territory located in the western Pacific Ocean, is an archipelago comprised of fourteen islands. The majority of CNMI's population lives on three of the most southern islands: its capital Saipan, Rota, and Tinian. At the end of World War II, along with most of the other islands in the Micronesian region, they were included in a United Nations Strategic Trust Territory administered by the United States. In the early 1970's, the Northern Marianas sought greater self- government, and in 1975 submitted a ``Covenant'' proposal to the U.S. for final approval. After favorable consideration by Congress, that Covenant, which established the Commonwealth of the Northern Mariana Islands in political union with the United States, was signed into law in 1976 by President Gerald Ford.

During the negotiations over the Covenant, island officials expressed concern about possible adverse effects on their culture and economic development that could come from application of certain U.S. laws. In response, the Marianas government was given temporary responsibility for determining minimum wage laws, immigration standards, and an income tax system.

Beginning in the late 1980s, the CNMI focused on developing a garment industry and used its local control of immigration policy to allow for the recruitment and importation of foreign guest workers. But there were increasing reports of abuses.

For example, after visiting the islands in July, 1997, the U.S. Commission on Immigration Reform reported it had found problems ``ranging from bureaucratic inefficiencies to labor abuses to an unsustainable economic, social and political system that is antithetical to most American values,'' including exploitation of foreign workers with retaliation against protesters, suppression of basic freedoms, and flagrant abuses of household workers, agricultural workers, and bar girls. The Commission said the CNMI's guest-worker policy had created major policy problems and resulted in a two-class system where the majority of workers were denied political and social rights.

That and similar reports prompted efforts to achieve reforms through Federal legislation, and both the George H. W. Bush Administration and the Clinton Administration were concerned about repeated allegations that foreign guest workers were being mistreated and exploited. Both Administrations supported addressing the problem through legal reforms.

I have long supported those reforms. In 1999--my first year as a Representative from Colorado--I joined as a cosponsor of a bill a bill entitled the ``United States-Commonwealth of the Northern Marianas Human Dignity Act'' to bar use of the ``Made in the USA'' label on textiles produced in the CNMI unless they were produced in plants that conformed with American labor laws, including those aimed at protecting health and safety and guarding against exploitation.

And ever since, I have supported similar legislation, including the bill (H.R. 3079, the ``Northern Mariana Islands Immigration, Security, and Labor Act'') which passed the House last year and which is the basis for Subtitle A of Title VII of the bill before us today.

I did so, in part, because in September, 1999, the Committee on Resources (as it was then named) held an oversight hearing regarding the enforcement of federal laws and the use of federal funds in the CNMI at which officials of the Interior Department and the Departments of Justice and Labor, testified that reform legislation was needed.

As the witness from the Justice Department put it, ``in order to control crime in the CNMI, the U.S. government must be able to prevent criminals from gaining unlimited access to the islands. We cannot expect to stop the flow of drugs, or guns, or trafficking in women and forced prostitution, unless we keep out the people who we know are already committing these crimes'' and ``the only way to fight effectively the larger crime problem on the CNMI is to apply the Act as it is applied in other U.S. jurisdictions with appropriate transitional phase-in provisions to prevent avoidable adverse impacts on the economy.'' And the witness from the Labor Department told our committee that ``there are extremely serious, pervasive, and stubbornly persist[ing] immigration, labor, and human rights problems in the Commonwealth of the Northern Marianas'' which ``derive from systematic, structural weaknesses in the legal framework in the Commonwealth and any solution to these problems demands a comprehensive, structural solution.''

In short, in the words of the witness from the Interior Department, ``current Federal law is insufficient to correct the continuing inadequacies caused by CNMI immigration and labor policy'' and ``the need to apply . . . Federal immigration, wage, and trade standards is inescapable.''

Unfortunately Mr. Speaker, while responsible Federal officials saw the need as inescapable, for too long Congress did not act to meet that need. In part, that was because those responsible for some of the worse abuses had friends in powerful positions here in the House of Representatives.

That evidently was why the then-leadership of the House refused to even allow the House to debate a reform bill (S. 1052 of the 106th Congress) sponsored by the Republican Senator who chaired the Committee on Energy and Natural Resources that passed the Senate without dissent in 2000.

Instead of being brought to the House floor, like this bill, that measure was bottled up in the Resources Committee and Jack Abramoff, the lobbyist who represented some of its most important opponents, reportedly informed his clients that ``We erected a roadblock in the House to stop the bill from moving.''

But now that roadblock is gone, and today we can write an end to that sad chapter by approving reforms that have been delayed far too long.

Mr. Speaker, this is a good bill that deserves enactment, and I urge the House to approve it.

I yield back the balance of my time.

Mr. Speaker, I rise today in strong support of H. Con. Res. 35 supporting the goals and ideals of National Black HIV/AIDS Awareness. Established in February 2000, National Black HIV/ AIDS Awareness and Information Day, NBHAAD, is an annual observance day that was created to raise awareness among African-Americans about HIV/ AIDS and its devastating impact on African-American communities.

There is no question that we must continue to mount a massive campaign to support the mission of National Black HIV/AIDS Awareness Day, NBHAAD to build the capacity and increase awareness, participation and support for HIV prevention, care and treatment among African- Americans. February 7, 2007 marks the seventh year of this annual event. The day is part of a national mobilization effort to get African-Americans to learn more about the threat posed by the disease, get tested, get treated and make a commitment to fight HIV/AIDS. For this day and everyday forward we must raise our voices to volumes that can be heard across the globe. Unfortunately, for too long we have settled for surviving our tragic losses in silence. But listen to these screaming statistics:

According to CDC estimates, at the end of 2005, African-Americans accounted for 44 percent of all individuals living with AIDS--188,000.

In 2005, African-Americans accounted for nearly 50 percent of all new HIV infections, despite representing only about 12.3 percent of the population, according to the 2000 Census.

In 2005, African-American women represented 66 percent of all new HIV/AIDS cases among women, and were 25 times more likely to be infected than White women.

CDC estimates that 73 percent of all children born to HIV infected mothers in 2004 were African-American.

With an estimated 38.6 million people worldwide living with HIV at the end of 2005, and more than 25 million people having died of AIDS since 1981, NBHAAD serves to remind everyone that action makes a difference in the fight against HIV/AIDS. Let there be no mistake; we are here to acknowledge that AIDS is a deadly enemy against which we must join all our forces to fight and eliminate.

Though I stand here today in recognition of National Black HIV/AIDS Awareness Day, Americans should be reminded that HIV/AIDS does not discriminate. With an estimated 1,039,000 to 1,185,000 HIV-positive individuals living in the U.S., and approximately 40,000 new infections occurring every year, the U.S., like other nations around the world is deeply affected by HIV/AIDS.

Mr. Speaker, there is no doubt that AIDS is devastating the African- American community. As of February 2006, African-Americans represented only 13 percent of the U.S. population, but accounted for 40 percent of the 944,306 AIDS cases diagnosed since the start of the epidemic and approximately half, 49 percent of the 42,514 cases diagnosed in 2004 alone. African-Americans also account for half of new HIV/AIDS diagnoses in the 35 States/areas with confidential name-based reporting.

The AIDS case rate per 100,000 population among African-American adults/adolescents was nearly 10.2 times that of Whites in 2004. African-Americans accounted for 55 percent of deaths due to HIV in 2002 and their survival time after an AIDS diagnosis is lower on average than it is for other racial/ethnic groups. HIV was the third leading cause of death for African-Americans, ages 25-34, in 2002 compared to the sixth leading cause of death for Whites and Latinos in this age group.

African-American women and children have been disproportionately victimized by this deadly disease. African-American women account for the majority of new AIDS cases among women--67 percent in 2004; White women account for 17 percent and Latinas 15 percent. Among African- Americans, African-American women represent more than a third, 36 percent of AIDS cases diagnosed in 2004. Although African-American teens, ages 13-19, represent only 15 percent of U.S. teenagers, they accounted for 66 percent of new AIDS cases reported among teens in 2003. We must continue to forge a tough fight to reverse all of these costly trends.

Mr. Speaker, combating this crisis will take a team effort. All of us--researchers, legislators, clergy, community organizers and activists and others--must work tirelessly to find solutions and to help so that our work will bring forth a wealth of wisdom that creates a climate of compassionate care and healing.

Let us go forth as warriors, renewed in our commitment to stand in solidarity with everyone who has been affected by HIV and AIDS, and let us be encouraged in our efforts to comfort the afflicted and confront the passiveness of so many who contribute to the spread of this deadly disease; and let us be

emboldened to speak out in our own communities so that silence may no more mask the ringing alarms of rapidly rising infection rates.

I hope that our inner human spirits will move us to a place and time where we no longer turn our heads and close our eyes to those communities who need our help the most. We must find the strength to look past our fears and find compassion to create a world where no man, woman or child is confronted with the perils of this current AIDS crisis.

Mr. Speaker, I strongly support the goal of NBHAAD to motivate African-Americans to get tested and know their HIV status; get educated about the transmission modes of HIV/AIDS; get involved in their local community; and get treated if they are currently living with HIV or are newly diagnosed.

Let me take this moment to recognize a major inspiration for NBHAAD, Mr. Louis E. Harris, 1947-2003, who passed away in January 2003 due to complications with bladder cancer. Mr. Harris served as the executive director of Concerned Black Men, Inc. of Philadelphia during NBHAAD's conception. His work and dedication will be missed along with his kind and warm words of encouragement. It is hoped that NBHAAD will continue to build the capacity of community based organizations, CBOs, as well as community stake holders to increase awareness, prevent HIV and get those who need treatment into care. I applaud the efforts of NBHAAD advocates to:

1. Increase reporting of accurate up-to-date statistics on the HIV and AIDS epidemic among Blacks by electronic and print media, radio and television stations;

2. Increase collaboration and sharing of resources at the national and local levels;

3. Increase resources and support including capacity building assistance for health departments, community based organizations and stakeholders serving Black communities; and

4. Increase the number of Blacks at high risk for acquiring HIV that receive HIV counseling, testing and other HIV prevention, treatment and care services.

Observance of this day provides an opportunity for governments, national AIDS programs, churches, community organizations and individuals to demonstrate the importance of the fight against HIV/ AIDS. Though funding for research is an important key to tackling the tragic devastation of HIV/AIDS in our communities, I realize that providing funding for research alone is simply not sufficient to eradicate the high rates of HIV/AIDS cases within the African-American community. We must also provide funding for prevention and education.

Billions and billions of private and Federal dollars have been poured into drug research and development to treat and ``manage'' infections, but the complex life cycle and insane mutation rates of HIV strains have made these efforts futile in the fight to remove HIV/AIDS as a global public health threat. Though the drugs we currently have are effective in managing infections and reducing mortality by slowing the progression to AIDS in an individual, they do little to reduce disease prevalence and prevent new infections.

A thousand drugs that ``manage'' infection will not suffice. We can make and market drugs until we have 42 million individually tailored treatments, but so long as a quarter of those infected remain detached from the importance of testing, we have no chance of ending or even ``managing'' the pandemic. Currently, the only cure we have for HIV/ AIDS is prevention. While we must continue efforts to develop advanced treatment options, it is crucial that those efforts are accompanied by dramatic increases in public health education and prevention measures.

During my time in office, I have fully and eagerly supported all legislation that has given increased attention to HIV/AIDS, including the Ryan White CARE Act, which is currently slated to receive about $2.2 billion in funding for FY2007. I have supported legislation to reauthorize funding for community health centers--H.R. 5573, Health Centers Renewal Act of 2006--including the Montrose and Fourth Ward clinics right here in Houston, as well as supported legislation to provide more nurses for the poor urban communities in which many of these centers are located--H.R. 1285, Nursing Relief Act for Disadvantaged Areas. I have also supported and introduced legislation aimed to better educate our children--H.R. 2553, Responsible Education About Life Act in 2006) and eliminate health disparities--H.R. 3561, Healthcare Equality and Accountability Act and the Good Medicine Cultural Competency Act in 2003, H.R. 90. And I will continue to endorse and push for similar legislation.

Twenty-five years from now, I hope that we will not be discussing data on prevalence and mortality, but rather how our sustained efforts at elimination have come into fruition. But if we are ever to have that discussion, there are a number of actions that we must take right now. We must continue research on treatments and antiretroviral therapies, as well as pursue a cure. And we absolutely have to ensure that everyone who needs treatment receives it. In order to do this, we have to increase awareness of testing, access to testing, and the accuracy of testing. How can we stop this pandemic if we are unable to track it?

We must also increase funding for local health departments and community health clinics, as well as fully fund the Ryan White CARE Act. Lastly, but perhaps most importantly, it is imperative that we work to increase funding for HIV prevention and education, so that our children will be equipped with sufficient and appropriate knowledge of this growing threat within our communities, especially within our Black communities and among Black women. If Blacks are 11 times as likely to acquire infection, then we need to make 11 times the effort to educate. And we need to apply similar efforts in every community until HIV/AIDS becomes a memory. If not, our friends and family will be memories instead.

I would like to take a moment to applaud the enormous efforts of community volunteers from churches and other organizations which have done commendable work across our Nation. I think everyone can learn something from their selflessness and their will to serve their communities. We need more people to follow their lead. We do not have time for excuses or hesitation. We have the passion and dedication, and we are securing more and more resources. It is up to us to get the resources where they are needed. I know a lot of people don't want to take things seriously until it hits home; until a brother or a sister or a son or a daughter falls victim to our blithe and ignorance. We cannot afford nor do we want to bear that cost; however, if we continue to sit by and wait for the next person to act, we may all have brothers and sisters and sons and daughters with HIV/AIDS.

We need to be proactive and act with unprecedented urgency. Now is not the time to get comfortable. If you feel like you're getting comfortable, just remember that there is a face to every number, to every statistic. This is not a hypothetical or theoretical or metaphysical phenomenon. There are no imaginary numbers in this equation; only real people. And I am confident that we can protect and save real people with increased efforts.

I will continue work tirelessly to keep the spotlight on this dark disease that is devastating many people in the African-American community, United States and around the world. My hope is that all of our efforts will lead to the elimination of HIV and AIDS not just from the African-American community but from every community. I urge my colleagues to support H. Con. Res. 35 supporting the goals of National Black HIV/AIDS Awareness Day.

Mr. Speaker, I want to thank my colleague and good friend, Hilda Solis, for bringing this forum together.

Tonight I come to the floor to take part in a very important dialogue about National Health Month that has been organized, as I said earlier, by my colleague from California, Congresswoman Hilda Solis. Congresswoman Solis' leadership in the area of minority health disparities, particularly with regard to environmental health factors, is strong and it has raised awareness of these issues on Capitol Hill.

I thank her for yielding me the time, and I commend her for her efforts, along with those of the members of the Congressional Hispanic Caucus, the Congressional Black Caucus, and my colleagues in the Congressional Asian Pacific American Caucus, in ensuring that minority health disparities are on the national agenda.

I am here tonight as the Chair of the Congressional Asian Pacific American Caucus Health Task Force to recognize April as National Minority Health Month. Designated in 2001, National Minority Health Month is sponsored by the National Minority Quality Forum, an organization dedicated to addressing and eliminating the disparity in care, treatment, and access faced by racial and ethnic minority populations.

The National Minority Quality Forum has been a leader in addressing these disparities and since 2004 has hosted a national summit each year to address these issues. Because the fourth annual summit began today in Washington, D.C., this is an opportune time to bring further awareness of the increasing need to address health disparities. It is very important that within this dialogue surrounding minority health disparities, that the needs of Asian American and Pacific Islanders are included. Asian Americans and Pacific Islanders face a number of hurdles towards receiving adequate health care stemming from linguistic and cultural challenges, and a lack of data collection.

Based on the following statistics, the health care disparities in the Asian American and Pacific Islander community become readily apparent, according to the President's Advisory Commission on Asian American and Pacific Islanders.

Ms. Solis covered in detail the lack of insurance coverage. I am here to give statistics on the diseases prevalent among minorities.

Asian American and Pacific Islander women have the lowest rate of cancer screening compared to other ethnic groups. Asian Americans and Pacific Islanders make up over half of the cases of chronic hepatitis B. Asian Americans and Pacific Islanders make up 20 percent of all cases of tuberculosis; and Vietnamese Americans are 13 times more likely to die of liver cancer than Caucasians.

There are many diseases and illnesses that disproportionately affect communities of color, ranging from HIV/AIDS to diabetes. Hepatitis B, which disproportionately affects the Asian American and Pacific Islander community, is often overlooked.

Today as we recognize National Minority Health Month, I would like to take this opportunity to raise awareness about this deadly disease. Hepatitis B is an infection caused by the

hepatitis B virus. Usually, people infected with the disease do not show early symptoms. But if left undetected, it may lead to cirrhosis of the liver, liver failure, and liver cancer. The statistics regarding hepatitis B are alarming. According to the Asian and Pacific Islander American Health Forum, one in 10 Asian Americans and Pacific Islanders are chronically infected with hepatitis B.

And of all those infected with hepatitis B in the United States, 50 percent are Asian Americans and Pacific Islanders, and liver cancer is the leading cause of death for Laotian American men in California.

The promising thing with hepatitis B is there is a three-shot vaccination series that can prevent hepatitis B and its dire consequences. Unfortunately, only one in 10 Asian American and Pacific Islander children have received the vaccination series. So with the proper education, outreach, and funding, I hope that we can address the killer disease within the Asian-American and Pacific Islander community, increase the vaccination rate, address the need for early detection and monitoring, and improve the quality of life for the people and families that live with hepatitis B.

Additionally, I hope we take this opportunity during National Minority Health Month to strengthen data collection and dissemination that will lead to improved access to health care for all racial and ethnic minority communities across the United States.

Again, as the Chair of the Health Care Task Force for the Congressional Asian Pacific American Caucus, I want to thank my colleague, Ms. Solis, for organizing tonight's Special Order speech on the occasion of National Minority Health Month and for the purposes of generating greater attention and raising awareness to the disparities in access to quality health care that our minority communities face and that deserve to be eliminated.

Mr. Speaker, I thank the gentlewoman from California (Ms. Solis) for organizing this forum, and I would also like to thank my colleague from New Jersey (Mr. Pallone) who joined us on the floor tonight to discuss this very important issue.

I am to cover cancer, and today is a very sad day for the House of Representatives. We have lost a dear colleague to cancer, and this is the second cancer-related passing this year in the House of Representatives.

Cancer is the second most common cause of death in the United States and accounts for one out of every four deaths. Unfortunately, health disparities in cancer continue to persist. Minority groups face unique problems and concerns about cancer, including higher rates of developing some cancers and barriers to early detection.

In 2001, the National Cancer Institute formed the Center to Reduce Cancer Health Disparities. In 2005, the center launched a new program to reduce cancer deaths among minority and underserved populations through $95 million in grants that funded community-based projects in geographically and culturally diverse areas of our country.

Dr. Harold Freeman, a leader in reducing cancer health disparities, and former surgeon at Harlem Hospital, said that cancer disparities are attributable to three interacting factors: first, low socioeconomic status; second, culture; and third, social injustice.

Low socioeconomic status and lack of health insurance lead to disparities. Lack of coverage prevents many Americans from receiving optimal health care. Frequently, people are not getting screened and treated because they feel they cannot afford to pay for a test if they are uninsured. The same populations also express concern that if they are diagnosed with cancer they will not be able to get the care they need.

Culture also plays a role. Some Native American tribes do not use the word ``cancer.'' When asked why they cannot discuss this disease, they say that in their culture, if they say the word ``cancer,'' it will bring disease to all of their families.

It is necessary to understand the cultural beliefs of different populations when talking about diseases. According to Dr. Freeman, much of the disparity in cancer outcomes is a result of the cancer type, the time of diagnosis, and the continuity of cancer care, not the disease itself.

Screening and early detection are extremely important to avoiding cancer-related deaths. Many deaths from breast, colon and cervical cancer could be prevented by increased usage of established screening tests.

Although white and African American women aged 40 and older had the same prevalence of mammography use, other racial and ethnic groups of women were less likely to have had a mammogram. The lowest prevalence of mammography use occurred among women who lacked health insurance and by immigrant women who lived in the United States for less than 10 years.

The incidence of some cancers is much higher in communities of color. For example, African American men are at least 50 percent more likely to develop prostate cancer than men of any other racial or ethnic group in the United States.

Latino males have the third highest incidence rate for prostate cancer after African Americans and whites. Death rates for Latino males reveal that they have the third highest death rates from prostate and colon and rectal cancer after African Americans and whites.

Asian Pacific Islander males have the third highest rate for lung and bronchus cancer and colon and rectal cancer.

Cervical cancer occurs most often in Latinas; the incidence rate is more than twice the rate for non-Latina white women. Among Latinas in the United States, cervical cancer ranks as the fourth most common type of cancer.

Although African American women are less likely to develop breast cancer than other women, those who do are about twice as likely to die from it.

Consequently, programs such as the National Breast and Cervical Cancer Early Detection Program are essential for low-income, uninsured and underserved women.

Although breast cancer is the leading cause of cancer death for Latina women, cancer screening rates are lower for Latinas.

Providing culturally appropriate health education and health services is so essential to preventing and treating cancer.

Again, I want to thank Congresswoman Solis for providing and organizing this forum.