More than one million women call the Silver State home. Since entering the Senate, I have worked on their behalf to improve women's health care, strengthen their legal and civil protections, and fight for equal opportunities in the classroom and in the workplace.

Fighting for Better Health Care
Every woman deserves good health care, but over 200,000 women in Nevada lack any health coverage. 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. Unfortunately, being uninsured contributes to poorer health outcomes for women because they are considerably more likely to postpone care than their insured counterparts. They also often forego important preventive services like mammograms and Pap tests. At the same time, even those with coverage may find themselves struggling to pay their medical bills in today's health care system.

There is a growing sense among Nevadans, women and men alike, that real solutions for the nation's health care system are long past due. As the national debate on health care moves forward, I will continue working toward the goal of all Americans having affordable, quality health care coverage. For the women in Nevada and across the country who already have it, I am committed to preserving the hard-won guarantees on which they depend. For example, I worked to end the practice of "drive-through deliveries" by helping to pass the Newborns' and Mothers' Health Protection Act, which requires health plans to cover a minimum hospital stay for a mother following the birth of a child.

I am fighting to protect Medicaid and the Children's Health Insurance Program (CHIP) as well. Medicaid is especially crucial to women of childbearing age because it is the primary provider of necessary prenatal care for pregnant women with modest incomes. In fact, Medicaid covers nearly 40 percent of all births in the United States. However, despite its vital role in our health care system, Medicaid is repeatedly threatened by proposals to severely cut its federal funding and to enact drastic changes that would weaken the program. I fought to protect Medicaid against these spending cuts in previous years, and I will continue to oppose similar proposals in the future.

Many women in our state also count on Nevada's CHIP, called Nevada Check Up, to provide their children with health coverage that they would otherwise go without. Under a special agreement with the federal government, our state can now also use federal CHIP funds to cover pregnant women with high financial need. Extending coverage to this population not only ensures that more Nevadans can get needed medical care, it also increases the likelihood that more children will stay insured. As the 110th Congress worked on legislation to reauthorize the 1997 law that created CHIP, one of my priorities was, in fact, to support the efforts in our state and across the country to cover more expectant and new mothers.

I was disappointed when last year, President Bush vetoed two strong bills (H.R. 976 and H.R. 3963) that Congress passed with overwhelming, bipartisan support to extend and improve CHIP. Both bills included provisions that would have given the states another option to expand coverage to low-income pregnant women, in addition to their current ones. Although we had to enact a temporary extension through March 2009 as a result of the President's vetoes, I look forward to soon revisiting this issue in order to enact a strong reauthorization bill – a bill includes improvements for pregnant women and new mothers.

Putting Prevention First
Though all Americans deserve quality health care, women have unique health care needs that deserve unique treatment. That is why I introduced the Prevention First Act, legislation that will improve women’s health and reduce the rate of unintended pregnancy -- all while saving scarce public health dollars.

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 also ensures that government-funded sex education programs provide medically-accurate information about contraception. 

In addition, this comprehensive measure includes the Equity in Prescription and Contraception Coverage Act (EPICC), bipartisan legislation that I have long championed. EPICC 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 health care coverage that unfairly impacts women.

Eliminating Health Disparities
Funding promising medical research on women-specific diseases is also high on my health care agenda. When I first entered the Senate, I was dismayed to find that research funding for such diseases had been shortchanged. While certain illnesses cut across gender lines, they affect women differently or in higher proportion than men. For example, women are more likely than men to suffer a second heart attack. I will continue to support funding for more research at the National Institutes of Health (NIH) and Centers for Disease Control (CDC) to study how illnesses affect women and to learn more about the illnesses that disproportionately affect women.

Breast cancer is one such disease that takes a devastating toll on Nevada's women, with over 1,600 women diagnosed in our state each year. I am the lead sponsor of the Breast Cancer Environmental Research Act (S. 579), which will boost research on the role of the environment in the development of breast cancer and also establish a national research strategy. I will continue to work for the swift passage of this legislation in the 110th Congress. At the same time, I will continue to support federally-funded programs that ensure access to lifesaving screenings and treatment, such as Nevada Women's Health Connection. Also known as the National Breast and Cervical Cancer Early Detection Program, this program has been tremendously successful across the country. This program has provided 6.9 million screening examinations in all 50 states, with more than 29,000 breast cancers and 1,800 cervical cancers detected as a result.

Unfortunately, because these women are uninsured, they often do not have the resources to get treatment for their cancer. To help solve this problem, I cosponsored the Breast and Cervical Cancer Treatment Act to allow women who are diagnosed under the screening program to receive needed care. As a result, Nevada women diagnosed through Women's Health Connection are eligible for Medicaid coverage until their treatment and follow-up visits are completed.

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 responsible for health care decisions within their family and even more have sole or shared responsibility for financial decisions regarding their family's health. Women are also often the primary caregivers for ill or family members with disabilities.

I am working to ease this serious burden that they carry for their loved ones. For example, I 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 is still paid only 77 to 81 cents for every dollar her male counterpart is 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 am an original cosponsor of the Paycheck Fairness Act (S. 766), legislation that will better help prevent, regulate, and reduce pay discrimination for women across the country.

In the first session of the 110th Congress, I also proudly helped increase the federal minimum wage for the first time in 10 years, giving millions of women a pay raise in 2007. As too many Nevadans know all too well, the cost of housing, food, gasoline, and other expenses has increased since the minimum wage was last adjusted. This issue is particularly significant for women, as they comprise nearly two-thirds of workers who make less than the current federal minimum wage. Many are often the sole support for their families.

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 reduce the rate of unintended pregnancies by educating women about family planning methods. I also have been a strong supporter of 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 HIV/AIDS, and helps mothers safely undergo childbirth.

Additionally, we 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 federal programs designed to prevent domestic violence and help its victims, including the Battered Women Shelter and Services program, Grants to Combat Violence Against Women, and Victims of Crime Act programs. I also cosponsored the Violence Against Women Act (VAWA), the landmark law that significantly expanded the federal government's commitment to eliminating violence against women. Among other provisions, VAWA provides federal funding to local and federal law enforcement officers, prosecutors, and advocates for prosecuting crimes, addressing victims’ needs, educating the public, and otherwise preventing sexual and relationship violence. 

Protecting Title IX
I strongly support Title IX, which prohibits discrimination on the basis of gender in federally-assisted education programs or activities. 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.