[Congressional Record Volume 163, Number 207 (Tuesday, December 19, 2017)]
[Senate]
[Pages S8145-S8146]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
HEALTHCARE
Ms. CANTWELL. Madam President, I wish to call attention to several
urgent and bipartisan health programs that Congress must renew without
further delay.
The Republican majority has spent much of this year trying to pass
partisan healthcare and tax legislation. As a result, they have
neglected to extend numerous uncontroversial healthcare programs,
threatening these programs' very existence and causing needless chaos
and uncertainty.
It is past time that the Republican-controlled Congress extend these
programs to provide healthcare access and certainty to millions of
Americans.
First, I would like to address the Children's Health Insurance
Program, CHIP. CHIP is a bipartisan healthcare success story. Enacted
20 years ago, thanks to the leadership of Senate Finance Committee
Chairman Orrin Hatch and the late Senator Ted Kennedy, CHIP brings
affordable health coverage to children in families who are not eligible
for Medicaid but struggle to afford private insurance.
Washington's successful CHIP program, Apple Health for Kids, covers
about 60,000 children. Through CHIP, parents get peace of mind, and
States and the Federal Government pitch in to share the cost.
CHIP means affordable healthcare for 9 million children. On average,
a family of four pays $158 per year in premiums and deductibles for
each CHIP-enrolled child. The same family would likely pay more than
$1,000 in annual out-of-pocket costs on a commercial insurance plan,
even after counting available financial help. That is a difference of
more than $800 per year for millions of families across the country and
represents real affordability.
Because of CHIP, children have a medical home. In fact, more than 90
percent of Washington children with CHIP coverage visited a primary
care
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provider at least once in 2014, the most recent year in which data were
available. CHIP also provides kids with benefits that are often more
comprehensive than those offered in the commercial insurance market,
including immunizations, periodic screenings, hearing exams, and dental
care. We know that prevention and early detection are key to reducing
the burden of disease and health costs. CHIP emphasizes these early
interventions during the critical early years of a child's life,
helping kids grow up to be healthy, productive, and successful adults.
Yet, despite CHIP's near-universal popularity and lack of partisan
controversy, this Congress has allowed CHIP to go unfunded since
October 1, 2017. This long and unprecedented lapse threatens CHIP's
very survival. Already, it has thrown States, including Washington,
into crippling uncertainty and administrative disruption. Some States
have been forced to send letters to CHIP families informing them that
their coverage will end. Moreover, if Congress fails to extend CHIP, my
State will be on the hook for hundreds of millions of dollars to make
up for Congress's failure to act.
Next, I would like to highlight the urgent need to reauthorize
funding to community health centers.
Community health centers are a bedrock of the healthcare safety net
and are the preferred medical home for tens of millions of working
Americans. Washington's 26 community health centers serve 1 million
people in every corner of my State, from Spokane to Seattle, Omak to
Port Angeles.
Community health centers are a lean and efficient healthcare delivery
model, focusing on primary care, prevention, case management and social
services for their patients. They are also good for the economy,
supporting more than 9,000 jobs and $1 billion in annual economic
output in my State alone.
The Community Health Center Fund, which comprises the majority of
these health centers' Federal funds, expired on October 1, 2017. As a
result, community health centers in my State are at risk of having to
turn off the lights and turn away patients. Already, the expiration of
the Community Health Center Fund has threatened these centers' ability
to retain and hire nurses and doctors and make financial arrangements
for the coming year.
The Community Health Center Fund was enacted in 2010 so that millions
of newly covered Americans would have a medical home. The fund is doing
just that. Moreover, the Community Health Center Fund was extended with
strong bipartisan support in 2015, when an overwhelming majority of the
House and Senate, myself included, supported its extension as part of
the Medicare and CHIP Reauthorization Act, MACRA. It is past time for
Congress to extend this program without delay.
In addition, Federal funds have been allowed to expire for a number
of additional but equally important health programs. All enjoy a
history of strong bipartisan support. These programs include the
Maternal, Infant, and Early Childhood Home Visiting Program, the
Special Diabetes Program, the Teaching Health Center Program, and
certain Medicare provisions.
The Maternal, Infant, and Early Childhood Home Visiting--MIECHV--
Program is an evidence-based grant that is helping States and Tribes
improve early childhood and maternal health. MIECHV-funded home
visiting programs, which are voluntary, have benefited 1,650 Washington
families in 15 counties and have reduced in half the likelihood of
child abuse and neglect. MIECHV is a prime example of evidence-driven
policymaking that is improving the health and well-being of vulnerable
mothers and children. It is also strongly bipartisan. Unfortunately,
MIECHV's Federal funding expired on October 1, 2017.
The Special Diabetes Program and the Special Diabetes Program for
Indians are modest investments with a proven track record of combatting
diabetes. As a senior member of the Senate Diabetes Caucus, I recognize
that diabetes is a leading cause of death and a major driver of
healthcare costs. In particular, the Special Diabetes Program for
Indians supports 27 community-driven grant programs in Washington's
Tribal communities, helping Tribal members prevent, diagnose, and
manage this condition through lifestyle changes, counseling, and
treatment.
The Teaching Health Center Program is also a small investment with a
big return. Teaching Health Center funds are currently being used to
train 722 primary care medical residents in 27 States and the District
of Columbia. Data show that many physicians eventually practice close
to where they train, and the Teaching Health Center Program is training
physicians where they are needed most. In Spokane, Toppenish, Tacoma,
Yakima, and Auburn, Teaching Health Centers are training a new
generation of safety-net physicians to serve those most in need. While
the Teaching Health Center Program has received a short-term extension,
its funding will expire on January 1, 2018, if Congress does not act.
Lastly, several temporary Medicare provisions have expired and must
be renewed. These provisions help rural Medicare patients get hospital,
ambulance, and home health services where they live. Additional
Medicare ``extenders'' prevent essential services like physical therapy
from being arbitrarily capped for Medicare patients. Extending these
provisions is important to preserving healthcare access in rural
Washington State and empowering our healthcare delivery system to
continue to improve and innovate.
The programs I have highlighted and many more are vital to my
constituents, my State's economy, and our healthcare delivery system.
They are also strongly bipartisan. I call on my Republican colleagues
to work with us in a good-faith negotiation to extend these programs
immediately.
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