The Administration strongly supports the provisions of H.R. 4386
that would allow States to provide full Medicaid benefits to uninsured
women whose cancers are detected through a certain federally funded
screening program. This proposal, which was included in the President's
FY 2001 Budget, would help States eliminate the barriers low-income
women face to getting treatment for breast or cervical cancer.
The Administration has no objection to House passage of H.R. 4386,
but will work with the Senate to address a number of concerns with
provisions of the bill relating to condom labeling and human
papillomavirus (HPV) screening programs.
Many of the provisions of H.R. 4386 concerning HPV will strengthen
public health efforts to prevent HPV infection. Unfortunately, the
provisions of the bill requiring labeling of condoms and providing
information on condom effectiveness in all informational
materials related to condoms or sexually transmitted diseases (STDs)
will be problematic and potentially counterproductive to prevention
The Administration supports the goal of better informing the public
about HPV and the fact that the use of condoms may not fully prevent HPV
transmission. Public education, however, should be conducted in a manner
to increase awareness about the issue while not confusing the public
about when condoms are effective. It is well-documented that condoms are
an effective method of preventing transmission of HIV and other STDs. In
addition, requiring that information on condom effectiveness be provided
on all STD informational materials could be confusing and
contrary to the intent of the materials (e.g., materials related to
"abstinence only" education).
The goal of HPV prevention efforts should be educating Americans
about enhancing their ability to protect and preserve their health in a
way that does not confuse them about means of protecting themselves from
other STDs such as HIV.
H.R. 4386 would increase direct spending; therefore, it is subject to
the pay-as-you-go requirement of the Omnibus Budget and Reconciliation
Act of 1990. The bill's provisions allowing Medicaid treatment for
breast or cervical cancer would increase direct spending by $15 million
in FY 2001 and a total of $220 million during FYs 2001-2005. The bill
does not contain provisions to offset the increased direct spending.
Therefore, if the bill were enacted, its net budget costs could
contribute to a sequester of mandatory programs. The Administration
supports the Medicaid benefit provisions of the bill and will work with
the Congress to avoid a sequester.