I share the concerns of many women in Nevada who worry about how they can access quality health care, advance in the workplace, and support their families. We must continue to address the needs of half of Nevada's residents, or the more than one million women who call the Silver State home. Since entering the Senate, I have launched several initiatives to expand opportunities and open doors for Nevada women.

Fighting for Better Health Care

Women in Nevada and across the country rank health care as their primary concern, but spiraling health care costs are making it harder for women to buy health insurance and afford their medical costs. Over 180,000 women in Nevada lack any insurance coverage, many of whom either cannot afford the out-of-pocket expenses or whose employer does not offer health plans. Among workers, women are less likely than men to be eligible for and to participate in their employer's health plan, in part because they are more likely to work part-time, have lower incomes, and rely more on spousal coverage. Being uninsured contributes to poorer health outcomes for women because they are considerably more likely to postpone care than their insured counterparts and often forego important preventive services such as mammograms and Pap tests.

I am working to help address these challenges with commonsense legislation like the Affordable Health Care Act (S. 16), which will modernize the health care infrastructure, improve the quality of patient care, and make the health care system more efficient and cost-effective. This legislation is especially important for Nevada women because it will increase health coverage for expectant mothers and provide coverage to all children -- including the 108,000 uninsured children in Nevada. I have also worked to end the practice of "drive-through deliveries" by helping to pass the Newborns' and Mothers' Health Protection Act. This law requires health plans to cover a minimum hospital stay for a mother following the birth of a child. The Affordable Health Care Act also affirms my commitment to protect the Medicaid program. Though Medicaid serves 160,000 people throughout Nevada, this program is crucial to women of childbearing age in particular because it is the primary provider of necessary prenatal care for pregnant women with modest incomes and covers nearly 40 percent of all births in the United States.

Every woman deserves good health care, but too many are going without health insurance. For the women in Nevada and across the country who already have health coverage, I am committed to protecting the hard-won state health care guarantees that they depend on. Nevada women can be assured that I will continue to use my leadership in the U.S. Senate to make women's health a priority on the national agenda.

Eliminating Health Disparities

Though all Americans deserve quality medical care, women have unique health care needs that deserve unique treatment. In 2005, I introduced the Prevention First Act (S. 20), legislation that would help to reduce the staggering rate of unintended pregnancy in our nation and improve access to women's health care. 

The Prevention First Act includes common-ground, common-sense policies. It makes family planning services more accessible to low-income women. It improves awareness and understanding of emergency contraception, a poorly understood yet highly effective form of contraception.  It ensures that government-funded sex education programs provide medically-accurate information about contraception. 
This comprehensive measure also includes the Equity in Prescription and Contraception Coverage Act (EPICC), bipartisan legislation that I have long championed that would require insurance plans that provide coverage for prescription drugs to provide the same coverage for prescription contraceptives. Women of reproductive age pay 68 percent more in out-of-pocket medical expenses than men, largely due to their reproductive health-care needs. EPICC will take a significant step toward eliminating this inequality in prescription and contraceptive coverage that unfairly impacts women.

I am also committed to ensuring that medical research on women-specific diseases receives the funding and the focus they merit. When I first began my work as a member of the Senate Appropriations Committee, I was dismayed to find that such diseases had been shortchanged when it came to research funds. Having made it my mission to remedy this inequality, I have sought to increase research at the National Institutes of Health (NIH) and Centers for Disease Control (CDC) for a broad range of illnesses that disproportionately affect women.

While certain illnesses afflict both men and women, they affect women differently. For example, women are more likely than men to suffer a second heart attack. We must continue to fund research to better understand how illnesses affect women and to learn more about diseases that are unique to women.

Breast cancer is one disease that disproportionately affects Nevada women. Each year in Nevada alone, more than a thousand women will be diagnosed with the disease. I strongly support the national breast and cervical cancer screening program, which is run by the Centers for Disease Control and operates as Women's Health Connection in our state. This national program is tremendously successful, with more than 4.6 million screening examinations provided in all 50 states and over 17,000 breast cancers, 61,000 precancerous cervical lesions, and 1,100 cervical cancers detected as a result.

Unfortunately, because these women are uninsured, they often do not have the resources to get treatment for the cancer. In order to help solve this problem, I cosponsored The Breast and Cervical Cancer Treatment Act. This law ensures that women who are screened under the CDC's screening program can receive treatment for breast or cervical cancer. As a result, Nevada women diagnosed through Women's Health Connection are eligible for health coverage through Medicaid until the treatment and follow-up visits are completed.

While this law helps women who have already been diagnosed with breast cancer, it is important to also look at what factors lead to the disease in the first place. I have long championed legislation, The Breast Cancer Environmental Research Act of 2005 (S. 757), which would fund research to study the role of the environment in the development of breast cancer.  This legislation moved one step closer to passage when it was approved by the Senate Health, Education, Labor and Pensions Committee on June 28, 2006.  I will continue to work for the swift passage of this legislation by the full Senate.

Helping Women Support Their Families

Women are typically the primary health care providers and health decision-makers for their families. Two-thirds of all women are alone responsible for health care decisions within their family and more than 80 percent have sole or shared responsibility for financial decisions regarding their family's health. Women are also the primary care givers for ill or family members with disabilities. Of the estimated 15 percent of Americans who are informal care givers, an estimated 72 percent are women -- many of them sandwiched between caring for an ailing relative and caring for their own children.

Their choice to serve as caregivers is a generous yet difficult one, and I am working to ease the burden they carry for their loved ones. For example, I have supported establishing tax credits and other support programs for elderly and disabled individuals in need of long-term care and their caregivers. I also helped pass the Family and Medical Leave Act, which has allowed millions of parents to take up to 12 weeks of unpaid leave for a birth, adoption, or serious illness of a child or their own parents, while continuing to receive health benefits during their leave of absence.

Making Work Pay

Women deserve equal pay for equal work. Unfortunately, the average woman was paid 76 cents for every dollar her male counterpart was paid. Even after accounting for differences in education and the amount of time in the work force, women's pay still lags far behind men who are doing the same or similar work. That is why I support the Paycheck Fairness Act (S. 841), which seeks to strengthen enforcement of the Equal Pay Act and toughen its remedy provisions.

It is also critical that we raise the minimum wage, which has remained stagnant at $5.15 per hour since 1997. Over time, inflation has steadily eroded the purchasing power of the minimum wage, so that it is now 25 percent lower than it was in 1997. Women comprise nearly two-thirds of minimum wage earners - many of whom are often the sole support for their families. If we want to reward hard work and help ensure the livelihoods of millions of families throughout the country, we must raise the minimum wage through legislation like the Fair Wage, Competition, and Investment Act of 2005 (S. 14). This bill will increase the minimum wage to $7.25 over two years.

Protecting Women at Home and Abroad

We must support the rights of women both at home and abroad. I have sponsored legislation to permanently reverse the global gag rule, a misguided policy that denies funding to groups that promote women's health and reduces the rate of unintended pregnancies by educating women about family planning methods. I also have been a strong supporter of funding for the United Nations Population Fund (UNPFA), an international organization that provides life-saving reproductive health services, works to prevent female genital mutilation, fights the spread of AIDS, and reduces maternal mortality rates.

We also must demonstrate our support for the women of Afghanistan and Iraq by providing humanitarian relief and basic education for them. I am working with my colleagues in the Senate to ensure that women are included in the rebuilding of Afghanistan and Iraq.

Ending Domestic Violence

Throughout my career in Congress, I have supported domestic violence prevention programs, as well as programs to provide services to the victims of domestic violence. I cosponsored the Violence Against Women Act (VAWA), the landmark law that significantly expanded the federal government's commitment to eliminating violence against women, and was pleased to support its reauthorization a second time last year. The Violence Against Women and Department of Justice Reauthorization Act of 2005 was signed into law (Public Law 109-162) on January 5, 2006.

As a senior member of the Senate Appropriations Committee, I continually work to increase funds for domestic violence prevention programs.  I also recognize the unique needs of our state’s population.  That is why I have obtained earmarks to provide specific services for victims in Nevada, and why I will continue to support innovative programs to help rapidly growing communities and to aid victims in both rural and urban settings.  In the FY2006 Commerce-Justice-Science Appropriations Bill, I secured:

• $75,000 for SAFE House Domestic Violence Shelter’s Elderly Project:  This will help protect seniors from domestic violence abuse and provide services to those who have become victims of domestic violence.
• $20,000 Douglas County Sexual Assault Response Team (SART):  This funding will be used to purchase the equipment necessary so that the special nurses can complete a sexual assault exam. 

I also worked to pass the Victims of Abuse Access to Health Care Reform Act to prevent insurance companies from denying coverage to domestic violence victims. As a senior member of Senate Appropriations Committee, I am committed to increasing funding for domestic violence prevention programs, including Battered Women Shelters and Services, Grants to Combat Violence Against Women, and Victims of Crime Act programs.

Protecting Title IX

I support Title IX, which prohibits discrimination on the basis of gender in federally-assisted education programs or activities, and have opposed recent attempts to dismantle this program. The public perception of Title IX revolves around its application to athletics, yet this landmark law applies to every area of gender-based discrimination in an educational setting. Title IX has been instrumental in promoting sports equality for female athletes at high schools and colleges around the nation. Achieving equal opportunity for women in intercollegiate sports, however, remains an ongoing challenge. We need to level the playing field and continue opening up athletics to more women.

Upholding Women's Rights

One of the most important constitutional obligations of a United States Senator is to provide "advice and consent" with respect to a President's judicial nominations. I take this duty very seriously and will continue to oppose judicial candidates who have demonstrated a tendency to let ideology interfere with their ability to render impartial justice. We must ensure that federal judges respect the rights of women and will protect the progress we have made towards ending gender discrimination.

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