[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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