Ensuring that everyone can see a doctor when they need one is one
of the most serious challenges facing our state and our country. It is
critical that as we work to expand access and push for affordability,
that we also maintain quality, cultivate innovation, and ensure that
safety standards are met. As a member of the Health, Education, Labor,
and Pensions (HELP) Committee, I have focused on these priorities and
pushed for legislation and funding that will improve access to quality
health care, particularly for children and residents of rural and
underserved areas.
Children’s Health Insurance Program
No child should be forced to go without health care because
their parents can’t afford insurance. That’s why I have been a strong
supporter of the Children’s Health Insurance Program, which helps
ensure families can afford to go to the doctor. I was an original
cosponsor of the legislation enacted in 1997. And in 2007, I
supported and pushed repeatedly for passage when the bill was up for
renewal, or reauthorization.
In 2009, after multiple attempts, I was happy to help pass a
renewed CHIP bill. This bill extends health insurance coverage to
almost 10 million children – up from the 6 million children currently
covered.
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Expanding Health Care Access in Underserved
Regions
Too many Washingtonians lack access to a regular doctor,
either because they don’t have insurance or because of a shortage of
adequate health care providers. We can see the impact in overcrowded
hospital emergency rooms across our state. I have worked hard to help
make health care more accessible. As a member of both the Budget and
Appropriations committees, for example, I have continually fought for
increased funding for the Community Health Centers and National Health
Service Corps, which help increase health care access to medically
underserved populations.
Other examples of my work to increase access include:
- The Community Coalitions for Access and
Quality Improvement Act of 2007 – I introduced this bill to
create a national network of local community health care access
coalitions to help ensure all residents of a geographic area can
get a broad range of coordinated, high-quality health care
services without having to rely on the Emergency Room. This
legislation was included in the health care reform law, the Affordable Care Act.
- Health Care Safety Net Act – In
2007, I cosponsored and helped pass the Health Care
Safety Net Act. The bill reauthorizes the Community Health
Centers, which work to increase health care access to medically
underserved populations.
- Health Care Safety Net Authorization Act
– In 2002, I helped draft and pass this bill, which provided a
comprehensive plan to expand telehealth, in part by establishing Centers
of Excellence to help providers expand the use of cameras,
computers, and high-speed Internet to connect doctors with
patients who are miles away.
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Lack of Insurance
Studies estimate that as many as one in 11 Washingtonians
does not have health insurance, and around the country, the number of
uninsured continues to rise. Without health insurance, access to
health care services is almost impossible. The result is that we face a
startling disparity: we are one of the richest countries in the
world, yet an increasing number of people are unable to afford health
care. I have worked to try to bridge that gap by introducing and
supporting legislation and funding for programs, including:
-
The
Affordable Care Act—Health care reform will ensure that Americans have access
to quality, affordable health care.
Those who are not offered insurance by their employer, or that coverage
is unaffordable, will be able to purchase insurance through a new market place
called the Exchange. In addition, those
individuals may be eligible to receive premium tax credits and cost-sharing
assistance to purchase this coverage through the Exchange. - More
- Children’s Health Insurance – The
so-called CHIP renewal, or reauthorization, would help ensure
millions more families can afford to go to the doctor. I was an
original cosponsor of the legislation enacted in 1997. And in
2007, I supported and pushed repeatedly for reauthorization. The
reauthorization would have extended coverage from the 6 million
children currently covered to almost 10 million children.
- Trauma Care – In 2007, I introduced the
National Trauma Center Stabilization Act, to provide federal grants for
trauma care centers across the nation. Nationally, many trauma
centers are struggling and even closing their doors because of the
increased costs of providing health care and uncompensated charity
care. My bill would protect our trauma centers and reauthorize,
strengthen, and modernize the Trauma Center Grant Program. This
legislation was included in the health care reform law, the Affordable Care Act.
- Community and Migrant Health Centers –
I have been a strong supporter of Community and Migrant Health
Centers which provide preventive and primary health care services
in underserved communities. I worked to reauthorize the program as
well as provide additional funding.
- Community Health Centers and the Community
Health Access Program – Both of these programs are vital
to our communities because they provide a health care safety net
for the most vulnerable members of our society, and I have long
fought for more federal investment.
- Medicaid – As a member of the
Senate HELP Committee and the Labor Health and Human Services
Appropriations subcommittee, I have worked to increase the Federal
Medicaid match and secure increased Medicaid funds for Washington
state. I was also supportive of
expanding Medicaid access through the health care reform law, the
Affordable Care Act.
- Preventive Care and Childhood Immunizations
– Preventive care should be a critical part of our health care
system. Yet uninsured and underinsured families often don’t have
the ability to take proactive steps to help their kids stay
healthy. I believe our federal health care programs should
emphasize preventive care for all people – particularly children.
That’s why I was an original cosponsor of the Children’s Health
Insurance Program in 1997 and strongly supported its
reauthorization in 2007 and its expansion in 2009, and it’s why I
have worked hard to support childhood immunization programs.
———————————————————
Shortage of Nurses and Other Health Professionals
Our country is currently facing a critical shortage of
nurses and other health care professionals, and the problem is only
expected to get more severe as the population ages. The shortage is
increasing the burden on our already strained health care system.
Affordable health care will not be possible unless we ensure
people have doctors, nurses, and other health care professionals to
provide it. Addressing this serious problem has been one of my
priorities as a member of the Senate HELP, Budget, and Appropriations
committees.
In an effort to understand the scope of the problem in
Washington state, and to get ideas for how the federal government can be
a better partner, I have held a number of roundtables throughout the
state to discuss the causes and impacts of the health care worker
shortage and what can be done about it. I have also secured funding
for multiple demonstration projects in Washington state to survey
20,000 Washington nurses about retention issues. And I have worked on a
number of bills to help address this issue, such as:
The
Affordable Care Act -- As we work to ensure quality, affordable health
care coverage for all Americans, we must make sure there are enough
qualified professionals to provide that care. That is why I was honored to write a
strong workforce title in the Health, Education, Labor, and Pensions
Committee health care reform bill, which was the basis of the workforce
section in the final law. This
Title boosts our economy with investment in the training, recruitment and
retention of health care workers – creating jobs and ensuring care to keep
our larger American workforce healthy and productive. [Link to
health care reform resource center.]
- The
Affordable Care Act - As we work to ensure quality, affordable health
care coverage for all Americans, we must make sure there are enough
qualified professionals to provide that care. That is why I was honored to write a
strong workforce title in the Health, Education, Labor, and Pensions
Committee health care reform bill, which was the basis of the workforce
section in the final law. This
Title boosts our economy with investment in the training, recruitment and
retention of health care workers – creating jobs and ensuring care to keep
our larger American workforce healthy and productive. - More
- Health Care Safety Net Act of 2007 –
I was an original co-sponsor of this bill to reauthorize the
National Health Service Corps programs, which help increase health
care access to medically underserved populations.
- Allied Health Reinvestment Act –
Allied health professions are clinical health care professionals who are
distinct from medicine and nursing, such as medical assistants,
occupational and physical therapists, and pharmacists. I was an
original cosponsor of this bill, which would take a number of
steps to promote and support allied health professions.
- Nurse Reinvestment Act – Signed
into law in 2002, this law provides increased scholarships,
faculty improvements, and the best practices to retain nurses.
- National Nurse Service Corps – I
have been a longtime supporter of this program, which provides
scholarships and loans to nursing students as well as grants to
boost nurse retention.
- National Health Service Corps –
Like the Nurse Service Corps, I have been proud to support the
Health Service Corps, which helps place medical professionals in
areas where they are needed most. Additionally, the Corps’
“Scholars Program” identifies and sponsors future health care
providers.
- Title VII and VIII Health Professions
– As a member of both the Budget and Appropriations committees, I have
worked hard to secure funding for Title VII and VIII Health
Professions. This funding supports the training of nurses and
other primary care medical personnel, and it helps encourage
health professionals to practice in medically underserved areas.
- Children’s Hospitals Graduate Medical
Education Program – I was proud to help secure $301
million in the fiscal year 2008 Omnibus Appropriations bill for
this program, which supports the training of pediatric and other
residents in graduate medical education programs.
———————————————————
Lack of Access – Fewer Doctors Accepting Medicare
Over the past few years, many physicians in Washington state
have made the difficult decision to reassess whether they will treat
Medicare patients. Some have decided to turn away new Medicare
patients, while others have dropped Medicare patients altogether.
Their decisions are due, in large part, to the amount they are
reimbursed by the federal government for treating Medicare recipients.
Medicare law specifies a formula for calculating the annual update in
payments for physicians’ services, and beginning in 2002, the updates
actually resulted in payment cuts.
In Washington state, Medicare reimbursement rates currently
penalize patients and providers. The reimbursement system is based on
an outdated reimbursement scale generated from cost of living, patient
utilization, and health care costs among states. Washington has a
tradition of efficient health care and healthy seniors, therefore
health care costs are much lower in Washington than in other states.
As a result, doctors and providers are reimbursed at a dramatically
lower rate, and many Medicare providers have moved to states with
higher reimbursement rates.
We desperately need to change the way physicians are paid.
If we don’t, physicians and Medicare beneficiaries across the country
will continue to be adversely impacted. In the Senate, I have been an
advocate for our doctors by fighting against Medicare physician payment
cuts. My work includes:
- Medicare Improvements for Patients and
Providers Act of 2008 – As a member of the Democratic
Leadership, I worked with my colleagues to help pass the Medicare
Improvements for Patients and Providers Act of 2008, which postponed an
impending physician reimbursement rate cut for 18 months and
increased physician payment by 1.1 percent for 2009.
- 2007 Medicare-CHIP Extender Package
– I supported the 2007 Medicare-CHIP Extender Package, which
stopped a scheduled 10 percent rate cut and replaced it with a 0.5
percent increase through June 30, 2008.
- MediFair Act – In 2002, I
introduced the MediFair Act for the first time, and I have
introduced it in every Congress since because we need to ensure that
no state receives less than the national average of Medicare
reimbursement rates. The bill would also substantially
increase rates for providers in Washington state.
More
———————————————————
Mental Health
Access to mental health care is as important as access to
physical health care. Yet our health care system hasn’t recognized
that fact. Too many Americans have sought mental health care, only to
be burdened by high deductibles and co-payments. In the Senate, I’ve
fought to ensure more Americans can get access to mental health care.
For example, I supported and worked to strengthen the Mental Health
Parity Act, which became law in 2008. This important new law sets a
federal standard that will make mental health care coverage more
equitable, accessible, and affordable.
In addition, I supported and helped pass the Medicare
Improvements for Patients and Providers Act of 2008, which lowers
co-payments for seniors’ mental health services.
———————————————————
Rural Health
Access to health care is a problem in many rural
communities, either because there aren’t enough doctors or because
appropriate care isn’t available nearby. As a Senator from a large,
rural state, one of my goals has been to improve health care in rural
communities by both expanding access and improving the quality of care.
My work includes:
- The
Affordable Care Act— The health care reform law will lower health care
costs and offer greater health care choices for rural Americans. - More
- Craig Thomas Rural Hospital and Provider
Equity Act of 2007 – I was an original cosponsor on this
bill to create a fund for small-town hospitals, boost payments to
rural ambulance units, and fix Medicare payments for rural providers.
- Medicare Improvements for Patients and
Providers Act of 2008 – This legislation, which became law in
July 2008, contains many provisions that are particularly
beneficial to rural areas, such as increasing payments to sole
community and critical-access hospitals, increasing Medicare
payments for ground ambulance services in rural areas, and
extending the minimum payment adjustments for physicians in rural
areas.
- Health Care Safety Net Act of 2007 –
I am a cosponsor of this bill to improve health care access,
particularly in rural areas. This bill includes a
reauthorization of the Community Health Centers and the National
Health Service Corp programs, both of which work to increase
health care access to medically underserved populations. The
National Health Service Corps provides scholarships and loan
repayments for doctors, nurses and other health professionals who
commit to practice in medically underserved areas.
Community Health Centers provide family-oriented primary and
preventive health care services for people living in rural and urban
medically underserved communities. I have also worked to
increase appropriations for these valuable programs.