Protecting Public Safety and Sacred Sites from the Utah Prairie Dog Act of 2011

Mr. President, I am proud to once again introduce legislation addressing the health care disparities in racial and ethnic minority communities, the Health Equity and Accountability Act of 2012. I would like to thank my cosponsor, Senator Inouye, along with a number of our colleagues in the House of Representatives, for all their support and contributions to this important legislation, and for raising awareness of this widespread problem.

While there are glaring health disparities based on racial and ethnic identity alone, they are further exacerbated by factors such as socioeconomics, geography, and sexual orientation and identity. Although the exact causes for the current state of health disparities in our country may be debatable, it is undeniable that ethnic, racial, geographic, and other minorities across the United States are plagued by disproportionately high rates of disease and experience a diminished quality of health care. Statistics paint a disturbing picture of minority health, consistently showing higher rates of illness and death for members of minority and marginalized groups.

For instance, HIV/AIDS has had a devastating impact on minorities in the U.S. In 2009, ethnic minorities accounted for over 70 percent of newly diagnosed cases of HIV. That year, nine out of ten babies born with HIV belonged to minority groups. The Office of Minority Health reported that, compared to Caucasians, Hispanic individuals are 3 times more likely to be diagnosed with AIDS; Native Americans are 1.4 times more likely; and Native Hawaiians and Pacific Islanders are 2.4 times more likely to be diagnosed with AIDS.

Cancer is the number one killer of Asian American Pacific Islanders and the second leading cause of death for most other racial and ethnic minorities in the United States. Cancer also affects African Americans at particularly alarming rates and has a disproportionate prevalence in the population of Hispanic women, who are 1.6 times more likely to be diagnosed with cervical cancer than non-Hispanic women. In addition, Native Americans are twice as likely as non-Hispanic whites to develop stomach or liver cancer.

The infant mortality rates for African Americans are one-and-a-half to 3 times higher than the rates for infants born to women of other races and ethnicities. Hispanic individuals are three times more likely to be diagnosed with AIDS than Caucasian individuals. As our nation continues to struggle with obesity, trends show increasingly high rates of obesity in minority groups, with young Mexican-American men under the age of 20 experiencing obesity at a rate of 25 percent of the population, while white men of the same age have a rate of just 15 percent.

Circulatory diseases are a growing problem in the Pacific region. These diseases not only lower patients' quality of life, but they are also very costly. Data from the Agency for Healthcare Research and Quality shows that eliminating preventable hospitalizations that are associated with lower incomes would save $6.7 billion in health care costs each year. However, the numbers alone do not capture the full extent of health disparities since there are additional issues with data collection and multiple factors often contribute to deaths.

In 2005, I introduced a similar piece of legislation, S. 1580, because many of the indigenous and ethnic minority communities across the United States and its territories lacked essential access to health care and suffered from certain key diseases at disproportionately high rates. The bill I am introducing today addresses many of the same issues and also takes into account the strong advances made by the Patient Protection and Affordable Care Act. In 2008, the landmark health care reform legislation laid the foundation to start reducing some of those health disparities. Senator Inouye and I are introducing this legislation today to build on the work of the Affordable Care Act, and to advance the national discussion on how we can better achieve health equity.

While the Affordable Care Act expanded care in diverse communities across the country, such as Asian Americans, Native Hawaiians, and Pacific Islanders, it is important that we take further steps to ensure that all Americans, regardless of racial, ethnic, socioeconomic, physical, and geographic circumstances, have affordable access to high- quality health care. Because the causes of health care disparities are wide-ranging, the scope of this bill must be equally encompassing. Therefore, my bill focuses on two main strategies: first, encouraging research on diseases and conditions that disproportionately impact minority individuals; and second, improving access to effective care for minority communities.

We must make it easier to identify existing disparities through comprehensive data collection, ensure workforce diversity, target diseases that disproportionately affect minorities, and make culturally and linguistically appropriate health care services available to all.

We need more comprehensive data on the most significant health care problems experienced by minority individuals and the factors that play a role in how these diseases affect different communities. The more we know about the way populations are affected by disease, the better prepared health care professionals will be to create strategies to both treat and prevent each high-impact disease in specific communities. My bill will help to accomplish this by strengthening both data collection and the reporting of health data.

To complement our efforts in data collection, we must also target disease awareness education and effective preventative services towards communities with large populations of ethnic and racial minorities at high risk for certain diseases. Community-based programs as well as comprehensive disease-specific programs already in place are helping to ensure that the health needs of minority communities are being met. My legislation would revitalize efforts in community health and preventive services, which are the most cost-effective ways of providing care.

This bill builds upon the Affordable Care Act's historic investment in prevention and calls for resources to target communities striving to overcome negative social factors. This bill encourages these investments and focuses on preventing fatal diseases, which could save thousands of lives each year and lower health care costs.

Although prevention plays a critical role in finding ways to close disparities, we also have to invest in research to develop better treatment plans for diseases that disproportionately affect indigenous, racial, and ethnic minorities, and to ensure that currently underserved communities have access to care. My bill proposes focused approaches to combat a variety of diseases and conditions, including heart disease, cancer, diabetes, and HIV/

AIDS, which have a disparate impact on racial and ethnic minorities. This legislation also helps to provide affordable and culturally appropriate access to care in several ways.

My bill, the Health Equity and Accountability Act of 2012, includes proposals to remove significant barriers to health care coverage and access and maximize the positive impact of federal investments in health care in minority communities. For example, it would re-establish Medicaid eligibility for citizens of the Compact of Free Association nations living in the United States. This would greatly ease the financial burden on States like Hawaii and Arkansas, which have been forced to absorb the costs of providing health and social services, education, and public safety for Compact migrants in accordance with unfunded Federal mandates since 1996.

My bill would also make health care more affordable and improve access by providing a 100 percent Federal Medicaid Assistance Percentage, FMAP, for Native Hawaiians who receive health care from Federally Qualified Health Centers or the Native Hawaiian Health Care System. The increased FMAP will ensure that Native Hawaiians have access to the essential health services provided by community health centers and the Native Hawaiian Health Care System. These provisions would provide treatment for Native Hawaiians that is similar to that already provided to Native Alaskans through the Indian Health Service or tribal organizations.

This legislation will make it easier for minorities with cultural and language barriers to improve their health outcomes by enhancing language access services, making health literacy a priority in patient care, and making sure there is culturally competent care in the health care delivery system. My bill will support professionals who are well- equipped to provide quality health care that is culturally and linguistically appropriate. As a part of this effort, this legislation creates training opportunities for willing and competent minority candidates to enter the health care workforce.

The Health Equity and Accountability Act also seeks to ensure that communities of color benefit from the rapid advances in health information technology, or health IT. It also encourages new investments in health IT infrastructure, which will serve as the foundation for improving the quality, effectiveness, and efficiency for all Americans in our future health care system. Improvements in health IT and health IT infrastructure will also make it possible for rural communities to access mobile health services and other treatment and diagnostics that were previously unavailable.

Another vital service that my bill seeks to make more accessible is mental health care. The Affordable Care Act fundamentally improved services for individuals with mental health and addiction disorders. Despite the improvements, mental health treatment remains underutilized, especially by minorities, due to social stigma and cultural resistance. To develop access and encourage treatment, my bill incorporates culturally competent strategies to address mental and behavioral health problems affecting minority communities and authorizes investment in researching and treating these serious conditions.

However, we cannot simply put these provisions in place and believe that they will eliminate all health disparities. We must have accountability and regular evaluation of these programs to ensure they are being carried out as they were intended, and that they are meeting their goals. To that end, my bill strengthens oversight by the Department of Health and Human Services, requiring the Department to make regular scheduled reports to Congress on the impact of these initiatives to ensure that they are continuing to reduce health disparities.

April is National Minority Health Month, and as we work diligently to transform health care in America, it is essential that we strive to eliminate the health disparities that affect our minority groups. This bill would significantly improve the quality of life for indigenous people, ethnic and racial minorities, as well as other marginalized groups. I encourage my colleagues to support this legislation, and begin an open dialogue on how we can close the gap in health care across the country.

Mr. President, I am pleased to introduce the Helium Stewardship Act of 2012, along with my cosponsors, Senators Barrasso, Wyden, and Enzi. This bipartisan bill addresses the need for ongoing stewardship of the nation's helium reserve in Amarillo, Texas. The helium reserve is not only a domestic treasure, but it also provides nearly 30 percent of the world's helium.

Helium is a commodity that is frequently overlooked and often only considered when you are going to the florist to purchase party balloons for your child's birthday party. I want to take a moment and highlight the importance of this commodity, as well as the importance of the U.S. helium reserve in the world's helium market.

Helium is critical to a wide range of industrial, scientific, and medical markets, including medical devices such as MRIs, industrial welding, high tech manufacturing of microchips and fiber optic cables, manufacturing magnets for wind turbines, space exploration at NASA, and other important scientific research that is conducted at national laboratories like those in my State.

The current sales and management structure for the helium reserve is distorting the private helium market and threatening helium supplies for Federal medical and scientific research, and other private commercial applications. The low government sales price is also a barrier to the development of private sources of helium. But more importantly, if Congress does not act, the helium program will disappear altogether in less than three years, leaving our hospitals, national labs, domestic manufacturers, and helium producers high and dry.

This bipartisan bill will address these issues by authorizing prudent helium sales and management beyond 2015 and securing private access to Federal supplies. It will also allow for the continued repayment of the national debt by selling helium at fair market prices--providing a good return on investment to the American taxpayer. This will bolster the private helium sector, and help to create long-term jobs in this American resource sector, as well as ensure the continued success of domestic manufacturers that utilize helium in their manufacturing process.

Finally, this bill will ensure secure access to helium for our national labs, scientific researchers, NASA, medical institutions, and universities, who rely on helium to push the boundaries of science and technology here in the USA. In particular, as the reserve is sold off, a 15 year supply of helium will be set aside exclusively for Federal researchers to guarantee continuity of our research programs as we transition to purely private sources of helium.

The bill is based on stakeholder input of the National Academies of Science, Bureau of Land Management staff, scientific researchers, high- tech manufacturers, and the private helium industry to address the most pressing problems facing Federal helium users and the helium industry today.

I would like to conclude by taking a moment to acknowledge the exceptional efforts of Dr. Marcius Extavour who was the AAAS Science policy fellow and physicist working on the Energy and Natural Resources Committee last year. He worked diligently to help craft this important piece of legislation and I thank him for his efforts.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I rise today to introduce the Columbine- Hondo Wilderness Act which will designate approximately 45,000 acres in the Sangre de Cristo Mountains in northern New Mexico as wilderness. I am pleased that my colleague, Senator Tom Udall, is a cosponsor of this legislation.

Located in the Carson National Forest in Taos County, the Columbine- Hondo is one of the last remaining segments of this high alpine ecosystem to receive permanent wilderness protection. The concept of wilderness has deep roots and a long history in the Carson National Forest. For example, in the early 1900s, Aldo Leopold, known as the father of wilderness, spent his early career in the Forest Service in the Carson where he quickly reached the post of Forest Supervisor. There is no doubt that he spent much time traveling through this landscape that likely helped cultivate his thoughts on the importance of wilderness.

Leopold's concept of wilderness evolved over time and heavily influenced policy makers and the growing conservation community. He wrote, ``Wilderness is the raw material out of which man has hammered the artifact called civilization. . . . To the laborer in the sweat of his labor, the raw stuff on his anvil is an adversary to be conquered. So was wilderness an adversary to the pioneer. But to the laborer in repose, able for the moment to cast a philosophical eye on his world, that same raw stuff is something to be loved and cherished, because it gives definition and meaning to his life.'' One person who shared that definition and meaning with Aldo Leopold was former New Mexico Senator Clinton P. Anderson. In fact, due in large part to the conversations he had with Leopold forty years earlier, Senator Anderson led the effort in Congress to pass the Wilderness Act of 1964.

In that 1964 Act, the Wheeler Peak Wilderness became the first wilderness area in the Carson National Forest, which lies just south of the Columbine-Hondo area. Shortly thereafter in 1970, the Taos Pueblo- Blue Lake Wilderness, adjacent to Wheeler Peak, was established, further demonstrating that the idea of wilderness is a valuable concept to Indian tribes wishing to protect their most sacred sites for future generations. Another decade had to pass before Congress protected additional lands in New Mexico as wilderness in 1980, including the Latir Peak Wilderness, north of the Columbine-Hondo. In that same Act, the Columbine-Hondo was designated as a Wilderness Study Area to allow Congress further time to review the merits of designating this area as wilderness.

Aldo Leopold laments in A Sand County Almanac that progress in conservation is slow--a fact that hasn't changed much in modern times. ``Despite nearly a century of propaganda,'' he wrote, ``conservation still proceeds at a snail's pace.'' In this context, it is unfortunately not surprising that it has taken Congress over 30 years to review the merits of the Columbine-Hondo Wilderness Study Area.

But the time to permanently protect the Columbine-Hondo is now before us. After many years of hard work by local community leaders, a nearly unanimous consensus has formed in support of protecting this landscape as wilderness. This is due to the longstanding recognition by the surrounding communities and their residents of the benefits that wilderness provides them. The mountains provide communities with clean air and act as a watershed, providing them with fresh and clean water. Sportsmen benefit from the protection of quality habitat that will ensure the elk, deer, and antelope found in the mountains and the fish in the mountain streams will continue to thrive. Communities like the Towns of Taos and Red River and the Villages of Questa and Taos Ski Valley can find economic benefits by attracting visitors seeking opportunities for solitude and quiet recreation, including hiking, birding, horseback riding, and even the occasional llama trekking. And community members can create job opportunities through outfitting and other service industries to assist residents and visitors alike explore these gateways to a more primitive era.

Wilderness also ensures that the way of life of many local ranchers will remain protected from threats like mining or disruptive off-road vehicle use. Local mountain biking coalitions have also recognized that a balance can be reached to protect wilderness values while making practical and common sense boundary adjustments that will help promote sustainable mountain biking opportunities in the region.

During my tenure in the Senate, it has been relatively uncommon to find such overwhelming support for the establishment of a new wilderness area. I commend the dedication and perseverance exhibited by the many local wilderness advocates who have devoted many years to see this effort come to fruition. Without their help, it may have taken another decade before Congress addressed this long outstanding matter. Congress has had 32 years now to review the designation of the Columbine-Hondo Wilderness. With such broad support having been developed, I urge my colleagues to support this initiative to protect this area without further delay.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, Senator McCain and I are introducing, by request, the Administration's proposed National Defense Authorization Act for fiscal year 2013. As is the case with any bill that is introduced by request, we introduce this bill for the purpose of placing the administration's proposals before Congress and the public without expressing our own views on the substance of these proposals. As Chairman and Ranking Member of the Armed Services Committee, we look forward to giving the administration's requested legislation our most careful review and thoughtful consideration.