Authored by Senator Barbara Mikulski (D-MD), this amendment to the Patient Protection and Affordable Care Act would require all health plans to cover comprehensive women’s preventative care and screenings – and to cover these recommended services at no cost to women.
The Senate passed the Mikulski amendment on December 3, 2009 by a vote of 61 to 39. I am proud to be a co-sponsor of this amendment, and I am pleased to share with you this transcript of my speech that appeared in the Congressional Record. You can also view the video from my floor speech at http://boxer.authoring.senate.gov/en/press/videos/12012009.cfm
Sincerely,
Barbara Boxer
United States Senator
Barbara Boxer
United States Senator
Senator Boxer's Congressional Record Statement on the Mikulski Amendment
December 1, 2009
MRS. BOXER. Mr. President, I am proud to support the Mikulski-Harkin-Boxer amendment to improve preventive health coverage for women.
The Mikulski amendment addresses this critical issue by requiring that all health plans cover comprehensive women’s preventive care and screenings -- and cover these recommended services at little or no cost to women.
These health care services include annual mammograms for women at age 40, pregnancy and postpartum depression screenings, screenings for domestic violence, annual women’s health screenings, and family planning services.
The preventive services covered under this amendment would be determined by the Health Resources and Services Administration to meet the unique preventive health needs of women.
HRSA is an agency within the Department of Health and Human Services. HHS Secretary Kathleen Sebelius has already said that “Mammograms have always been an important life-saving tool in the fight against breast cancer and they still are today.” The Secretary made clear that recommendations by the U.S. Preventive Services Task Force “do not set federal policy and they don’t determine what services are covered by the federal government.”
This is not the first time that experts have disagreed about this issue. I have been in this battle before, with Senator Mikulski, who called a hearing with all of the women Senators in 1994 where I insisted that routine mammograms for women over 40 must be covered.
And thank goodness we fought back then, and in 1997 and in 2002 when this issue was raised again and again. Since 1991, the death rate from breast cancer has been reduced by over 20 percent.
According to a 2007 Partnership for Prevention report, 3,700 additional lives would be saved each year if we increased to 90 percent the portion of women age 40 and older who have been screened for breast cancer in the past 2 years.
The most recent data show us that approximately 17 percent of breast cancer deaths occurred in women who were diagnosed in their forties.
That is why the American Cancer Society continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40.
Mammograms are still the most effective and valuable tool for decreasing suffering and death from breast cancer.
The Mikulski amendment will ensure women are able to get access to this and other lifesaving preventive services at no cost.
The underlying bill introduced by Senator Reid already requires that preventive services recommended by the U.S. Preventive Services Task Force be covered at little to no cost. These recommendations already include some women’s preventive services such as osteoporosis screenings.
But they do not include certain recommendations that many women’s health advocates and medical professionals believe are critically important, such as screenings for ovarian cancer – a disease that will claim the lives of nearly 15,000 women this year. We know that when ovarian cancer is diagnosed early, more than 93 percent of women survive longer than 5 years.
Women are often the decision makers for their families when it comes to health care. But women too often put the health needs of their family members and their children ahead of their own.
By passing this amendment, we are saving the lives of countless mothers, daughters, grandmothers and sisters who would otherwise forgo preventative health care because of high copays and expensive deductibles.
I would like to share with my colleagues a story from a doctor in my home state of California, William Leininger, that drives home the importance of this amendment:
“In my last year of residency, I cared for a mother of two who had been treated for cervical cancer when she was 23. At that time, she was covered by her husband’s insurance, but it was an abusive relationship, and she lost her health insurance when they divorced.
For the next five years, she had no health insurance and never received follow-up care (which would have revealed that her cancer had returned). She eventually remarried and regained health insurance, but by the time she came back to see me, her cancer had spread.
She had two children from her previous marriage—her driving motivation during her last rounds of palliative care was to survive long enough to ensure that her abusive ex-husband wouldn’t gain custody of her kids after her death. She succeeded. She was 28 when she died.”
That is not a story that should be told in the richest nation in the world.
The Mikulski amendment addresses this critical issue by requiring that all health plans cover comprehensive women’s preventive care and screenings -- and cover these recommended services at little or no cost to women.
These health care services include annual mammograms for women at age 40, pregnancy and postpartum depression screenings, screenings for domestic violence, annual women’s health screenings, and family planning services.
The preventive services covered under this amendment would be determined by the Health Resources and Services Administration to meet the unique preventive health needs of women.
HRSA is an agency within the Department of Health and Human Services. HHS Secretary Kathleen Sebelius has already said that “Mammograms have always been an important life-saving tool in the fight against breast cancer and they still are today.” The Secretary made clear that recommendations by the U.S. Preventive Services Task Force “do not set federal policy and they don’t determine what services are covered by the federal government.”
This is not the first time that experts have disagreed about this issue. I have been in this battle before, with Senator Mikulski, who called a hearing with all of the women Senators in 1994 where I insisted that routine mammograms for women over 40 must be covered.
And thank goodness we fought back then, and in 1997 and in 2002 when this issue was raised again and again. Since 1991, the death rate from breast cancer has been reduced by over 20 percent.
According to a 2007 Partnership for Prevention report, 3,700 additional lives would be saved each year if we increased to 90 percent the portion of women age 40 and older who have been screened for breast cancer in the past 2 years.
The most recent data show us that approximately 17 percent of breast cancer deaths occurred in women who were diagnosed in their forties.
That is why the American Cancer Society continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40.
Mammograms are still the most effective and valuable tool for decreasing suffering and death from breast cancer.
The Mikulski amendment will ensure women are able to get access to this and other lifesaving preventive services at no cost.
The underlying bill introduced by Senator Reid already requires that preventive services recommended by the U.S. Preventive Services Task Force be covered at little to no cost. These recommendations already include some women’s preventive services such as osteoporosis screenings.
But they do not include certain recommendations that many women’s health advocates and medical professionals believe are critically important, such as screenings for ovarian cancer – a disease that will claim the lives of nearly 15,000 women this year. We know that when ovarian cancer is diagnosed early, more than 93 percent of women survive longer than 5 years.
Women are often the decision makers for their families when it comes to health care. But women too often put the health needs of their family members and their children ahead of their own.
By passing this amendment, we are saving the lives of countless mothers, daughters, grandmothers and sisters who would otherwise forgo preventative health care because of high copays and expensive deductibles.
I would like to share with my colleagues a story from a doctor in my home state of California, William Leininger, that drives home the importance of this amendment:
“In my last year of residency, I cared for a mother of two who had been treated for cervical cancer when she was 23. At that time, she was covered by her husband’s insurance, but it was an abusive relationship, and she lost her health insurance when they divorced.
For the next five years, she had no health insurance and never received follow-up care (which would have revealed that her cancer had returned). She eventually remarried and regained health insurance, but by the time she came back to see me, her cancer had spread.
She had two children from her previous marriage—her driving motivation during her last rounds of palliative care was to survive long enough to ensure that her abusive ex-husband wouldn’t gain custody of her kids after her death. She succeeded. She was 28 when she died.”
That is not a story that should be told in the richest nation in the world.
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