Quality Health Care for All Nevadans

I want to make quality, affordable health care available to every Nevadan by cutting costs, improving quality, and expanding access. I am also committed to protecting Nevadans from existing and emerging threats to health by funding research on diseases and preparing the nation for a potential pandemic. This website provides a few examples of how I am working to achieve these goals.

Prescription Drugs

The cost of health care is just too high - especially the cost of prescription drugs. We have to make sure Nevadans can afford good health care, including the medicine they need.
Spiraling health care costs not only make it harder for families to buy health insurance and seniors to afford their prescriptions. Soaring costs also weaken our economy by burdening small businesses and making American manufacturers less competitive. I am committed to addressing the rising cost of health care with commonsense measures that will provide relief to businesses and to Nevada's families.

Make Prescription Drugs More Affordable

The United States is the largest market for pharmaceuticals in the world, yet American consumers pay the highest prices for brand-name drugs. I believe that we should have access to the lower drug prices available on the world market. I am a cosponsor of the Affordable Health Care Act (S. 16), which would legalize the safe importation of FDA-approved drugs from other industrialized countries like Canada while still ensuring that only safe medicines are brought into the United States.

I often hear from seniors who are particularly hit hard by high drug prices. I am committed to making their medicines more affordable by allowing Medicare to use the power of its 42 million beneficiaries to negotiate bulk discounts. Currently, there is a prohibition on Medicare from using its bargaining power to achieve lower drug prices. I am a cosponsor of legislation, the Meeting Our Responsibility to Medicare Beneficiaries Act (S. 18), to repeal this ban.

Improve and Strengthen Medicare

The 2003 Medicare Prescription Drug Bill (P.L. 108-173) created a number of problems for our seniors. While I have long supported adding prescription drug coverage under Medicare, I opposed the final version of this bill for many reasons. Not only does it contain huge giveaways to special interest HMOs and drug companies, it created a new drug program that is deeply flawed and unnecessarily complicated.

Nonetheless, the law passed and is being implemented, so I am committed to helping Nevadans take advantage of the new drug benefit in every way possible. Our seniors and people with disabilities should come before special interests, and legislation I cosponsored takes the first steps to improving the Medicare program to reflect those priorities. This bill, the Meeting Our Responsibility to Medicare Beneficiaries Act (S. 18), will lower the cost of prescription drugs, eliminate the $10 billion slush fund for HMOs and invest that money to lower Part B premiums, and ensure that retirees can keep the good drug coverage they have now.

Expanding Coverage

Every Nevadan deserves good health care, but too many are going without health insurance. We have to expand coverage and remove other barriers to health care.

Expand Health Coverage to More Nevadans

Health care costs increase for everyone as the number of Americans without health care coverage rises. The uninsured are more likely to forego cost-effective preventive treatments and to seek care in an emergency room where it is more expensive. More importantly, they do so at potentially great harm to their health. Rising health care costs and our rate of uninsurance therefore pose serious risks not only to individuals, but also to our country's economic well-being.

Clearly, we must ensure that Nevadans -- regardless of income, age, employment, or health status -- can access, afford, and maintain quality health insurance coverage. The Affordable Health Care Act will make significant steps toward this goal by providing coverage to all children, increasing coverage for expectant mothers, and helping small employers cover their workers. Furthermore, real solutions should constrain underlying health care costs, lower prescription drug costs and administrative expenses, and realize the cost-saving potential of information technology and care coordination. These are some of the measures also included in the Affordable Health Care Act.

Provide Small Businesses Relief

Although every sector of our economy is affected by the high cost of health care, many small businesses are increasingly struggling to provide health insurance to their employees. Many employers are pressured to pass additional health care costs onto their insured workers, while some are cutting health care benefits altogether.

I am committed to finding solutions that will work for small employers and their employees, while maintaining important consumer protections. For instance, legislation I cosponsored this year, the Small Employers Health Benefits Program Act, will provide small businesses relief by offering the same kind of coverage options that Members of Congress enjoy.

Protect Medicaid

I am committed to protecting the federal-state partnership that sustains the Medicaid program, which provides access to necessary, affordable, and quality medical care for 40 million Americans, including 160,000 Nevadans. Despite its vital role in our health care system, Medicaid's future is threatened by proposals to severely cut its federal funding and to enact drastic changes that would undermine the program's mission. I fought to protect Medicaid against these proposed spending cuts earlier this year and will continue to oppose similar proposals in the future.

Cover All Children

I am determined to pass legislation to cover all children as a first step to ensuring that all Americans have access to affordable health care coverage. For example, many parents would become insured if they - like their children - were able to enroll in Medicaid or the State Children's Health Insurance Program (SCHIP). I support legislation that would allow states to provide health coverage to uninsured parents who have children eligible for Medicaid and SCHIP.

Eliminate Health Care Barriers for Persons with Disabilities

I am working to enact legislation that would allow families of children who have disabilities to purchase Medicaid coverage for their children. Many children with significant disabilities do not have access to comprehensive health services because their insurance does not cover the care they need. Their parents often forgo better jobs in order to remain eligible for coverage of these services under Medicaid.

In addition, I fought to pass the Ticket to Work and Work Incentives Improvement Act, which allows individuals with disabilities to have great access to Medicaid or Medicare coverage when they go to work. Previously, people with disabilities would become ineligible for Medicaid or Medicare if they worked, forcing a choice between health care and employment.

End Insurance Discrimination Against Women

Women of reproductive age pay 68 percent more in out-of-pocket medical expenses than men, largely due to their reproductive health-care needs. I am the sponsor of bipartisan legislation, the Equity in Prescription and Contraception Coverage Act of 2005 (S. 1214), that require private insurance plans that provide coverage for prescription drugs to provide the same coverage for prescription contraceptives.

This legislation to ensure equity and fairness in contraception coverage is also a critical component of legislation that I introduced last year, the Prevention First Act (S. 20). The Prevention First Act will improve women's health, increase Nevadans' access to family planning services, and reduce the number of unintended pregnancies -- all while saving scarce public health dollars.

Increase Access to Mental Health Care

Mental illnesses are just as real as physical illnesses and deserve to be treated as such. That is why I will continue to fight for full parity with respect to health insurance coverage for mental illnesses. Given Nevada's tremendous population growth and a statewide suicide rate that is consistently among the nation's highest, it is increasingly critical to improve our mental health care system.

These efforts should include suicide intervention and prevention strategies because the need for them is so great in Nevada. As part of this endeavor, I led the first effort to create and implement a national strategy for suicide prevention. In 2004, I played a key role in securing the passage of the Garrett Lee Smith Memorial Act to support the planning, implementation, and evaluation of statewide youth suicide early intervention and prevention strategies. The bill, which was signed into law on October 21, 2004, also authorizes funds for campus mental and behavioral health service centers -- including $400,000 recently secured for Nevada.

Build Our Health Care Infrastructure

Nevadans should not have to travel far away to receive the high quality health care they deserve and need. Not only have I been working to improve rural Nevadans' access to health care, I worked to secure millions of dollars of federal support to improve the health care infrastructure in our state so we may meet the increasing needs of our growing population.

Funding Research

Our nation's major commitment to health research will likely bring stunning new treatments for cancer, deadly diseases, chronic conditions, and other ailments. I am committed to making the investments necessary to sustain the pace of current research and to spur on new advances.

More Money to Combat Diseases

Throughout my career in the Senate, I have used my position on the Senate Appropriations Committee to fund biomedical research through the annual Labor-Health and Human Services-Education appropriations bill. I have worked to double our national medical research budget, directing federal funds to the flagship centers of health like the National Institutes of Health and the Centers for Disease Control. This investment will lead to immeasurable contributions in the fight against a number of serious illnesses, including cancer, diabetes, Alzheimer's, and Parkinson's.

Unfortunately, the President's Fiscal Year 2007 budget proposal would cut funding for both the NIH and CDC. At a time when we are the verge of major new breakthroughs and the burden of chronic disease continues to grow, we should not be shortchanging promising medical research and disease prevention initiatives. Moreover, the President's budget would make substantial cuts to vital health, education, and labor programs, while calling for continued budget deficits for years to come.  In my view, this fiscally irresponsible budget proposal represents the wrong priorities for our nation and we can do better. I am committed to ensuring a final budget that reflects our nation's values and puts the everyday people of Nevada and America first.

Stem Cell Research

Stem cell research has the potential to lead to treatments and cures for many debilitating diseases, including Parkinson's Disease, spinal cord injuries, heart disease, and diabetes. Since embryonic stem cells have the ability to develop into virtually any cell in the body, they may offer unprecedented opportunities to treat a wide range of medical conditions for which there are few or no cures.

On May 24, 2005, a bipartisan majority in the House of Representatives approved the Stem Cell Research Enhancement Act (H.R. 810). Since then, I have been pressing for the Senate to embrace the same spirit of bipartisanship and pass this legislation (H.R. 810). On July 28, I tried to pass these two important bills in the Senate, but my efforts were blocked by the majority party.

Every day the Senate delays floor consideration of the House-passed Stem Cell Research Enhancement Act (H.R. 810) is another day we deny hope to millions of Americans and people throughout the world who suffer from Parkinson's disease, spinal cord injuries, heart disease, and diabetes, to name only a few. I am committed to seeing the Stem Cell Research Enhancement Act (H.R. 810) enacted into law so that federally-funded researchers can realize the potential of stem cell research.

ALS Registry Act

On June 30, 2005, I introduced the ALS Registry Act to improve our understanding of amyotrophic lateral sclerosis (ALS) and help determine its causes. My bill will establish a single, national ALS patient registry at the Centers for Disease Control, thus centralizing existing data and facilitating the collection of new information about the epidemiological and demographic factors associated with ALS. I am working hard to see this national registry established because it will significantly enhance the nation's efforts to ultimately cure ALS.

Breast Cancer and Environmental Research Act

For several years now, I have worked to pass bipartisan legislation, The Breast Cancer and Environmental Research Act, which will give scientists the tools and resources they need to better understand any link between breast cancer and environmental factors. To date, there has been only a limited research investment to study the role of the environment in the development of breast cancer. This bill would dedicate $30 million annually for five years, so that promising research opportunities are not missed.  The 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.

Inflammatory Bowel Disease Research Act

Crohn's disease and ulcerative colitis, collectively known as inflammatory bowel disease, are chronic disorders of the gastrointestinal tract that represent a major cause of morbidity from digestive illness and have a devastating impact on patients and families. I sponsored bipartisan legislation, the Inflammatory Bowel Disease Research Act (S. 1930), to expand federal research on IBD and direct the Centers for Disease Control to provide a comprehensive approach to addressing the burden of this debilitating disease in the United States. By increasing our investment in these areas, my bill will offer hope to millions of Americans who suffer from IBD and save millions of dollars in net health care expenditures through reduced hospitalizations and surgeries.

Protecting Public Health

It is vital to make the investments necessary for this nation and the world to prepare for and respond to emerging threats against public health, including a potential avian flu pandemic. In order to help Nevadans lead healthy and productive lives, we should also support preventative health and successful aging.

Pandemic Flu

Public health experts are warning that an avian influenza outbreak could cause the next flu pandemic. While it is impossible to predict when or if the avian flu will cause a pandemic, public health experts believe that we will face at least one pandemic in this century. The human and economic costs of a pandemic could have dramatic and far-reaching consequences on every sector of our society and our economy. That is why we must act to prepare and protect our nation against the threat of an influenza pandemic.

I am the author of the Pandemic Preparedness and Response Act (S. 1821), which would prepare and protect Americans from a potential flu pandemic. I also worked to pass an amendment offered by Senator Harkin (S. Amdt. 2283 to H.R. 3010) that would provide an almost $8 billion in emergency funds for pandemic preparedness activities. I was disappointed when Congress passed and President Bush approved only $3.8 billion of this $8 billion for pandemic preparedness last year.  As I result, earlier this year, I supported including an additional $2.3 billion for pandemic preparedness in the Senate version of the Emergency Supplemental Appropriations bill (H.R. 4939).  I am pleased that this additional funding was finalized when the bill was signed into law (Public Law 109-234) on June 15, 2006.

These funds are needed to: improve global surveillance, stockpile enough antivirals to treat the majority of the population, double our investment in our country's vaccine infrastructure, improve state and local public health infrastructure, and improve education and outreach to health care providers, businesses, and the public. I will continue these efforts to do everything possible to prepare and protect the American people from the pandemic threat.

Coordinated Environmental Health Network Act

In April 2001, I held a field hearing of the Senate Environmental and Public Works Committee Fallon, Nevada. The purpose of this hearing was to investigate why a number of children in this small community had been diagnosed with Acute Lymphoblastic Leukemia.

In response to the Fallon hearing, I introduced legislation to establish a national network to track and correlate chronic diseases and environmental exposure. The bill would also create a public health rapid response capability to help small communities like Fallon respond to  high incidences of disease. The lack of such a tracking and response system was a focal point of testimony at the hearing.

I recently reintroduced this legislation, the Coordinated Environmental Health Network Act (S. 1442), with Senator Clinton (D-NY). The Coordinated Environmental Health Network Act will help put in place a system to finding answers to these horrible questions and to preventing public health crises before they occur. I have also worked to secure over $100 million for a number of states, including Nevada, to begin the process of establishing tracking and response programs called for in this legislation.

White House Conference on Aging

The White House Conference on Aging (WHCoA), which convenes every 10 years with the mission to help lawmakers understand the important issues facing senior citizens, was last held in December 2005. I am pleased to have appointed a fellow Nevadan, Tom Gallagher, to the WHCoA's Policy Committee. On June 14, 2006, the Policy Committee voted to approve the Final Report of the 2005 White House Conference on Aging, and the report will soon be transmitted to the President, Congress and the WHCoaA Delegates. I look forward to this report, as well as my continued collaboration with Tom and other Nevadans in order to help our seniors lead healthy, independent, and satisfying lives.

More Doctors for Seniors

Our nation is not yet prepared to meet the challenges associated with care for the elderly. In the U.S. today, there is a shortage of geriatricians, doctors specially trained to recognize and treat the complex health problems of the elderly.

I support encouraging more doctors to become certified in geriatrics through loan forgiveness programs. Since Medicare plays a significant role in most seniors' health care, I am working to improve Medicare reimbursement for geriatricians to account for the extra time required to effectively treat the elderly. I also support legislation that would allow Medicare to cover geriatric assessments for seniors with complex health needs. Greater access to geriatric care will become increasingly important as Nevada's senior population continues to rapidly increase.

Improving Quality

Improving the quality of patient care is a vitally important goal shared by both patients and health care professionals. I am committed to legislation that puts patients first, while supporting the efforts of Nevada's health care professionals to provide the highest quality care.

Protect Patients from Insurance Bureaucrats

Doctors, not insurance companies, should make medical decisions. I support a strong Patients' Bill of Rights that would ensure that all Americans have timely access to the emergency care, specialists, clinical trials and the prescription medications they need. Patients must come before profits.

Eliminate Disparities in Health Care

Everyone deserves equal treatment in health care. The elimination of racial and ethnic health disparities can and should be a priority for our nation because the health of every community is enhanced when we work to promote health care equality for everyone, regardless of race or ethnicity.

So that we may begin to close the health care divide, I am a cosponsor of the Health Care Equality and Accountability Act (S. 1580). This legislation will help to expand the health care safety net, combat diseases that disproportionately affect racial and ethnic minorities, and eliminate barriers to health care experienced by people with limited English proficiency. The bill will also help to ensure that our public health workforce reflects, understands, and respects the backgrounds, experiences, and perspectives of the people it serves.

Modernize Health Care

If we are serious about preventing medical errors, reducing health care costs and improving the quality of health care in our nation, then we must invest in modernizing our health care system by improving the use of health information technology (IT). 

The federal government's estimate is that the nation would save $140 billion each year from proper health IT use.  These savings from health IT could cut the cost of a family's insurance policy by over $700.

The Wired for Health Care Quality Act (S. 1418) would improve the use of life-saving health information technology in hospitals and doctors’ offices across the country.  This would help to prevent medical errors, reduce health care costs, and improve the overall quality of patient care. The legislation would also work to ensure strong privacy protections for the security and confidentiality of private medical information. The Wired for Health Care Quality Act passed the Senate in November 2005 and now awaits further action in the House of Representatives.

Prevent Medical Errors

The Institute of Medicine has estimated that between 44,000 and 98,000 people die each year in hospitals as a result of medical errors. I supported the passage of legislation, the Patient Safety and Quality Improvement Act of 2005 (Public Law 109-41), that is designed to reduce the incidence of these errors. This new law establishes a new national system for voluntarily reporting events that may adversely affect patient safety and authorizes grant programs to improve the quality of patient care.

Support Nevada's Health Care Workforce

Nevada's doctors deserve a Medicare reimbursement system that fairly and accurately reflects the costs of serving beneficiaries. I also support closing loopholes found under the McCarran-Ferguson Act (Public Law 79-15), which contribute to malpractice premiums higher than what would be achieved through true competition. In addition, I have cosponsored past legislation that would allow hospitals and doctors, especially doctors in high-risk specialties, to claim a tax credit for part of their malpractice premiums.

Because Nevada is facing a nursing shortage, I will also continue to support the comprehensive Title VIII nursing education and workforce programs. These Title VIII programs merit funding because they help to encourage bright students to join the nursing profession, keep the current workforce strong, and open doors to advanced education. We also need to ensure that working conditions -- such as needlestick laws, staffing ratios, and mandatory overtime rules -- support our nurses' desire to provide the highest quality care possible.

Looking Forward to the Future

With the rise in both quantity of years and quality of life, Nevadans now face the rewarding challenge of making those extra years of life healthy and productive. Advancements in medical technology and the increasing role individuals are taking in their own wellness will afford more opportunities for quality health care than ever before. By improving our health care system, we can ensure that these opportunities are available to all. We are living longer, better lives, and by preparing for the future, we can ensure the best years are yet to come.

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