PALS Act

Mr. President, I rise today to introduce the bipartisan ``Protecting Access to Lifesaving Screenings Act,'' which would protect access to annual mammograms by ensuring breast cancer screenings are covered through insurance for women starting at age 40.

With the exception of skin cancers, breast cancer continues to be the most common cancer in American women and second leading cause of cancer death in women behind lung cancer. According to the American Cancer Society, in 2021, about 281,550 new cases of invasive breast cancer will be diagnosed in women and about 43,600 women will die from breast cancer.

Fortunately, we're seeing the death rate for breast cancer go down with a decrease of 1 percent per year from 2013 to 2018. According to the American Cancer Society, this has been largely credited to earlier diagnosis of breast cancer through screening and patient awareness, in addition to improvements that have been achieved in breast cancer treatments.

Mammography has been the best test we have at finding breast cancer early, providing a better chance of survival after diagnosis. According to the Kaiser Family Foundation, women with insurance coverage are more likely to report having had a mammogram in the past two years compared to uninsured women. But while regular breast cancer screenings have helped tremendously in the early detection of breast cancer, health insurance coverage of these screenings for women in their forties is at risk.

While leading medical groups, including the American College of Obstetricians and Gynecologists, the American Cancer Society, and the American College of Radiology support women having no-cost access to breast cancer screenings starting at age 40, the actual decision of coverage is typically determined using recommendations by an independent volunteer panel known as the U.S. Preventive Services Task Force (USPSTF).

Unfortunately, when USPSTF updated its breast screening guidelines in 2015 to recommend that women should start mammography screenings at age 50, health coverage without cost sharing was put in jeopardy for women in their 40s.

The ``Protecting Access to Lifesaving Screenings Act'' was first introduced shortly thereafter to postpone these recommendations that would have limited coverage for breast cancer screening. Congress has subsequently acted to extend this moratorium several times since then, most recently passing an extension in December 2020 that is set to expire January 1, 2023.

The benefits of screenings are clear, and we need to ensure that women in their forties continue to have coverage for, and access to, these screenings. To that end, we are reintroducing the ``Protecting Access to Lifesaving Screening Act'' to further protect access to mammography screenings that are covered at no cost to patients ages 40- 49. If passed, the current moratorium on USPSTF breast cancer screening guidelines would be extended through 2028.

According to the Centers for Disease Control and Prevention, the total number of breast cancer screening tests received by women through CDC's National Breast and Cervical Cancer Early Detection Program declined by 87% during April 2020 as compared with the previous 5-year averages for that month. This decline is attributed to reduced routine medical visits due to COVID-19. Consequences of these prolonged delays in screening include delayed diagnoses, poor health consequences, and an increase in cancer disparities among women already experiencing health inequities. Further removing barriers to screening by ensuring patients are covered at no cost will be crucial as the public begins to resume routine preventive health services.

I am honored to be joined by Senators Blackburn and Shaheen in introducing this legislation. I am also very grateful for supporters of this bill, including the American College of Obstetricians and Gynecologists, American College of Radiology, American Women Unite for Breast Cancer Screening, Black Women's Health Imperative, Breast Care of Washington, Check for a Lump, DenseBreast-Info, FORCE: Facing Our Risk of Cancer Empowered, Living Beyond Breast Cancer, Men Supporting Women With Cancer, National Association of Nurse Practitioners in Women's Health, National Black Nurses Association, National Consortium of Breast Centers, National Hispanic Medical Association, National Medical Association, Prevent Cancer Foundation, Servicewomen's Action Network, Sharsheret, Society of Breast Imaging, Society of Breast Imaging, Susan G. Komen and the Tigerlily Foundation.

I urge my colleagues to join us in protecting access to lifesaving screenings by supporting the passage of this bill.

Thank you Mr. President, and I yield the floor.

Mr. President, I rise today to introduce the bipartisan ``Protecting Access to Lifesaving Screenings Act,'' which would protect access to annual mammograms by ensuring breast cancer screenings are covered through insurance for women starting at age 40.

With the exception of skin cancers, breast cancer continues to be the most common cancer in American women and second leading cause of cancer death in women behind lung cancer. According to the American Cancer Society, in 2021, about 281,550 new cases of invasive breast cancer will be diagnosed in women and about 43,600 women will die from breast cancer.

Fortunately, we're seeing the death rate for breast cancer go down with a decrease of 1 percent per year from 2013 to 2018. According to the American Cancer Society, this has been largely credited to earlier diagnosis of breast cancer through screening and patient awareness, in addition to improvements that have been achieved in breast cancer treatments.

Mammography has been the best test we have at finding breast cancer early, providing a better chance of survival after diagnosis. According to the Kaiser Family Foundation, women with insurance coverage are more likely to report having had a mammogram in the past two years compared to uninsured women. But while regular breast cancer screenings have helped tremendously in the early detection of breast cancer, health insurance coverage of these screenings for women in their forties is at risk.

While leading medical groups, including the American College of Obstetricians and Gynecologists, the American Cancer Society, and the American College of Radiology support women having no-cost access to breast cancer screenings starting at age 40, the actual decision of coverage is typically determined using recommendations by an independent volunteer panel known as the U.S. Preventive Services Task Force (USPSTF).

Unfortunately, when USPSTF updated its breast screening guidelines in 2015 to recommend that women should start mammography screenings at age 50, health coverage without cost sharing was put in jeopardy for women in their 40s.

The ``Protecting Access to Lifesaving Screenings Act'' was first introduced shortly thereafter to postpone these recommendations that would have limited coverage for breast cancer screening. Congress has subsequently acted to extend this moratorium several times since then, most recently passing an extension in December 2020 that is set to expire January 1, 2023.

The benefits of screenings are clear, and we need to ensure that women in their forties continue to have coverage for, and access to, these screenings. To that end, we are reintroducing the ``Protecting Access to Lifesaving Screening Act'' to further protect access to mammography screenings that are covered at no cost to patients ages 40- 49. If passed, the current moratorium on USPSTF breast cancer screening guidelines would be extended through 2028.

According to the Centers for Disease Control and Prevention, the total number of breast cancer screening tests received by women through CDC's National Breast and Cervical Cancer Early Detection Program declined by 87% during April 2020 as compared with the previous 5-year averages for that month. This decline is attributed to reduced routine medical visits due to COVID-19. Consequences of these prolonged delays in screening include delayed diagnoses, poor health consequences, and an increase in cancer disparities among women already experiencing health inequities. Further removing barriers to screening by ensuring patients are covered at no cost will be crucial as the public begins to resume routine preventive health services.

I am honored to be joined by Senators Blackburn and Shaheen in introducing this legislation. I am also very grateful for supporters of this bill, including the American College of Obstetricians and Gynecologists, American College of Radiology, American Women Unite for Breast Cancer Screening, Black Women's Health Imperative, Breast Care of Washington, Check for a Lump, DenseBreast-Info, FORCE: Facing Our Risk of Cancer Empowered, Living Beyond Breast Cancer, Men Supporting Women With Cancer, National Association of Nurse Practitioners in Women's Health, National Black Nurses Association, National Consortium of Breast Centers, National Hispanic Medical Association, National Medical Association, Prevent Cancer Foundation, Servicewomen's Action Network, Sharsheret, Society of Breast Imaging, Society of Breast Imaging, Susan G. Komen and the Tigerlily Foundation.

I urge my colleagues to join us in protecting access to lifesaving screenings by supporting the passage of this bill.

Thank you Mr. President, and I yield the floor.

Mr. President, unfortunately, rates of suicide have risen to epidemic levels in the United States, with suicide now the tenth leading cause of death in the country. On average, there are 129 suicides every day, roughly one every eleven minutes, a staggering statistic. That is why I am pleased to be introducing the Suicide Prevention Lifeline Improvement Act with Senator Moran to help turn the tide on this increasingly dire situation.

This legislation would provide $568 million in new funding over five years for the National Suicide Prevention Lifeline, delivering an infusion of new funds to help improve call capacity, make improvements to the Lifeline, and make the switch to a new, easy-to-remember, three- digit number, 9-8-8. The Lifeline has long been underfunded, but we have worked on a bipartisan basis to more than double the funding over the last three years. However, much more is needed, and this new legislation will help build on these efforts to ensure that the Lifeline is able to answer the calls of those seeking help.

In 2019, 47,500 Americans lost their lives to suicide. That same year, there were 1.4 million suicide attempts. We must renew our efforts on suicide prevention. In 2004, working with my colleague, former Senator Gordon Smith of Oregon, we authored the Garrett Lee Smith Memorial Act. This law authorized new youth suicide prevention programs in honor of Senator's Smith son, who tragically died by suicide just a couple of weeks short of his 22nd birthday. For over a decade, these programs have funded college campus, state, and tribal efforts to prevent suicide among our youth and young adult populations, who are particularly at risk of suicide. During this time, youth suicide rates have decreased significantly in my home state of Rhode Island. However, nationwide, suicide rates have skyrocketed.

That is why we must renew our attention and focus on suicide prevention, including by increasing funding for, and improving access to, the National Suicide Prevention Lifeline. This effort is critical to ensuring that when people in crisis call looking for help, someone will be there on the

other end of the line to offer hope and counseling. Last Congress, I was able to work with my former colleague Senator Gardner, and Senators Baldwin and Moran on legislation to designate the Lifeline as an easy to remember, three-digit number, 988. This common-sense law will make it easier for people across the country to access the Lifeline when they really need it. I am glad that the bill was signed into law last year, paving the way for every state to implement the switch to 9-8-8 by July 2022. This upcoming deadline, however, makes it all the more important that we provide more funding for the Lifeline.

I am pleased to once again have the opportunity to partner with Senator Moran on suicide prevention efforts. I look forward to working together with our colleagues, as well as stakeholders supporting these efforts, to pass this critical legislation.