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Quiet the storm brewing in health care

By Sen. Mark R. Warner (D-VA)

Even before the coronavirus outbreak began, a storm was brewing in our health care system. Under the Trump administration, the number of uninsured Americans has steadily increased from the record lows seen following the passage of the Affordable Care Act. Thanks to the administration’s efforts to undermine the health care law, combined with political resistance to Medicaid expansion in many states, the uninsured rate climbed up and up. According to new data from the CDC, nearly 31 million Americans lacked health insurance on the eve of the pandemic.

Then the coronavirus hit. Of the more than 40 million Americans out of work due to the pandemic, an estimated 27 million have also lost their health insurance. Today we face record rates of Americans lacking health insurance precisely when demands on our health care system are greatest. 

The consequences of this policy failure will be severe, and the damage will not just be felt by those uninsured Americans who contract coronavirus. This will hit state budgets, cash-strapped hospitals and American families — who will likely see the financial strain on our system reflected in higher insurance premiums.

Unfortunately, this is not even the worst-case scenario. Having failed twice to overturn the Affordable Care Act in Congress, the Trump administration is currently leading a lawsuit that would overturn the health care law in its entirety with no plan for replacement. The Supreme Court is expected to rule on the case this fall, precisely when public health experts warn we could face a second wave of COVID cases. If successful, the Trump administration lawsuit would dismantle health coverage for millions of Americans and protections for the millions more who have a pre-existing condition.

To be clear, this legal challenge to the health coverage and protections that millions of Americans rely on represents the entirety of the Trump administration’s plan to address the health coverage crisis we now face.

The administration should immediately withdraw this lawsuit that threatens to disrupt our entire health care system in the middle of a pandemic. But merely avoiding this impending disaster is not nearly enough. We need to dramatically and quickly expand coverage for those Americans out of work due to the coronavirus, as well as for those Americans who lacked insurance before the crisis began.

First, we must expand and strengthen Medicaid. More than 380,000 Virginians have already gained affordable coverage through our expansion of Medicaid. As unemployment increases, states will see a further influx of individuals eligible for Medicaid coverage. Congress should provide states with additional funding, tied to unemployment rates, to help address this influx. In addition, we should pass legislation I’ve introduced called the SAME Act, which would make sure states such as Virginia that were late to expand Medicaid get their fair share of federal funding. 

Second, Congress should help workers who have lost their employer-provided insurance regain that coverage through the COBRA program. To offset the high cost of paying for an employer-sponsored plan without employer support, the federal government should temporarily help cover the costs until it is safe for workers to return to work.

Third, the Trump administration must re-open the Affordable Care Act health care exchanges so uninsured individuals can immediately enroll in health care coverage. Congress should also enhance tax credits to help more Americans afford this marketplace coverage.

These are three ideas that can and should be enacted in the next round of coronavirus relief legislation. While the legislative solutions I’ve described are not a cure-all to structural problems in our health care system, they would quickly help millions of Americans regain coverage during this critical moment.

With unemployment and uninsured rates at record highs, the combined economic and health care crisis we face cannot be ignored. The solutions I’ve described would allow us to get millions of Americans covered as quickly as possible, using the tools that are already available. We should implement them before it is too late.

Mark Warner represents Virginia in the U.S. Senate.



This article was originally published in the Bluefield Daily Telegraph on 08/29/2019

TAZEWELL, Va. — Sen. Mark Warner, D-Va., made a dramatic entrance into the Back of the Dragon headquarters in Tazewell Wednesday afternoon.

Jamie Cartwright, who works at the headquarters, drove him in riding shotgun in her “slingshot.”

“This is pretty darn cool,” Warner said as he exited the three-wheel convertible. “Compared to my day job, if we could have kept on riding it would be much more fun.”

Warner made a stop in Tazewell on his seven-day trip across the commonwealth.

Standing in front of the Back of the Dragon’s own 15-ft. dragon installed recently beside the headquarters, he spoke to a crowd gathered for the visit.

Warner praised the two men, Larry Davidson and Danny Addison, whose vision and work created the Back of the Dragon concept and fought for a state designation of the 32-mile trip to Marion across three mountains on winding Rt. 16, which is now bringing tens of thousands of motorcyclists and sports car enthusiasts to the area.

They should be commended for helping bring people to the area and the tourism dollars that follow, he said. “As Larry was saying, it’s not about him, it’s about bringing the whole community together.”

The tourism industry is here to stay, he said, and “we’re not going to see some company come in and buy Back of the Dragon and ship it to China.”

Warner said he always enjoys seeing how Tazewell is growing.

“There have been challenges but I think you guys have turned the corner,” he said, adding that during his visits to the area when he was Governor he usually bought a check but it doesn’t work that way with the federal government where it’s much more difficult to get anything done.

“I would love to come here and give you a report on all the great positive things that are happening in Washington,” he said. “Let me give you that report.”

Then he stood silently. “All right, end of that report.”

“It is sometimes kind of frustrating,” Warner said, as elected officials in Washington spend too much trying to “run each other down” rather than working together to accomplish what is needed.

Warner touched on several topics and answered questions.

He said he is continuing to work on making sure Black Lung benefits won’t disappear and one reason is it’s still a problem for working miners and “we’ve seen an uptick” in cases.

The recent sudden layoffs when Blackjewel Mines went bankrupt, which impacted many miners in Southwest Virginia and left them without benefits or even a paycheck, demonstrated a situation that should not happen, he said.

“Workers should not be at the back of the line when a company goes under,” he said. “Bankruptcy laws need to change so employees come first, not at the back of the line (for money the company may owe debtors).”

Warner also said the federal government has made strides in fighting the opioid crisis, but “issues of addiction are not going away soon … We need to treat addiction as a health care issue.”

He said being a former addict should not impact a person’s ability to find a job.

“We need to make sure federal and state funding continues to be available (to fight drug addiction),” he said.

Other initiatives Warner said he is continuing to address include working with Sens. Joe Manchin (D-W.Va.) and Shelley Moore Capito (R-W.Va.) on making sure miners receive the benefits they deserve.

Manchin has led the way with this, he said, and all they want now is for Senate Majority Leader Mitch McConnell (R-Ky.) to allow a vote on the issue.

He also wants to fight outside election interference in American elections with stricter social media identifications and paper ballots as backups if there is a problem at polling stations.

Warner said he is not ready to support any of the candidates for the Democratic nomination for President in 2020.

“I’m going to wait for awhile and see how it shakes out,” he said. “I get worried with Mr. Trump how he disrespects the rule of law and what he is doing to our reputation around the country so I look forward to supporting the Democrat. But I get worried when either political party goes to the extreme.”

On his own possible aspirations for the job, he said this year was not a time for him to throw his hat into the ring.

“I think we need folks in the Senate to work with both parties and I didn’t feel like it was my time,” he said.

“We are very glad to have the Senator here today,” Davidson said. “We feel that’s a very positive factor that we can be recognized for all the hard work that we are doing and our goal is to make this the hub of the motorcycle and sports car communities not only in Southwest Virginia but in the Eastern United States.”

Mike Hymes, Tazewell County Southern District supervisor, said Warner is a long-time friend and he looks out for working people.

“Sen. Warner has always been a friend to Tazewell County and Southwest Virginia,” he said. “He understands working people and he understands the problems that coal miners have. He has always been able to reach across the aisles and get things done.”

Hymes said Warner demonstrated his frustration in Washington when everyone has to be on one team or another.

“He’s on our team,” he said. “We need to keep him on it.”

Eastern District Supervisor Charlie Stacy was on hand and said the visit is good for the area.

“We are tickled to have the Senator come down and see our Back of the Dragon display,” he said, referring to the giant dragon that has proven to be popular. “It’s been a wonderful tourist attraction. Every time I have been here you have people stopping and lining up for photos with the dragon. That’s exactly what we want. We want people coming to Tazewell County.”

Stacy said the Back of the Dragon trail continues to be a big draw to ride on “and we hope to bring more people here to ride on it.”

“It was great having Sen. Warner here with us to see all of the great economic development going on,” said A.J. Robinson, interim tourism director for Tazewell County. “Obviously, the Back of the Dragon brings a tremendous amount of motorcycles to our region and we are happy to have him here to show him what we are doing.”

Tazewell Town Manager Todd Day said it was a “wonderful event” and Warner has always been a friend to the region.

“He’s bringing some inspiration to the community,” he said.

“Anytime we get exposure for the Back of the Dragon or any our attractions in Southwest Virginia it’s a good thing for us, it’s a good thing for the community,” said David Woodard, executive director of the Heart of Appalachia Tourism Authority and chair of the Tazewell County School Board. “It’s also good for economic development.”

This article was originally published in the Daily Press on 07/17/2019


U.S. Sen. Mark R. Warner is, again, raising Cain over complications that have slowed construction of new veterans health centers in Virginia.

Two years have passed since Congress agreed to fund 28 veteran health facilities nationwide to address a deep backlog of patient wait times. 

Two facilities planned for veteran-rich Virginia, however, are some of the last on the list. 

It’s deeply unfair that Hampton Roads — a region that has given so much to the military — has been placed in the back of the line when it comes time for service members to receive care. 

Sen. Warner, D-Va., is demanding an expedited timeline for a facility planned for South Hampton Roads and another in Fredericksburg. 

The former facility will help ease the workload at the Hampton VA Medical Center, which had some of the longest wait times in the country in 2014. 

Once built, the South Hampton Roads center would include 155,000 square feet and offer primary and specialty care, plus day surgery and other services. 

Hampton VA staff have worked hard to change the way the facility approaches calls for services. Administrators are doing more to hire and retain health care staff while making operational adjustments that will, hopefully, reduce the center’s backlog. 

Yet, construction on the Southside center is being slowed by a tangled web of bureaucracy. 

The delay is due, in part, because of differences between Veterans Affairs, the U.S. General Services Administration and Congress concerning how the projects should be funded. 

The VA considers these projects as long-term leases, even if the ultimate goal is building new facilities. The Congressional Budget Office has said Congress should set aside larger sums of money for the projects upfront, rather than paying smaller amounts year by year. 

Sen. Warner and other lawmakers have tried negotiating a compromise that sets aside less money than recommended by the CBO in order to move the projects forward. 

A VA Office of Inspector General report released July 2 called for reforms in how the VA handles these projects. 

The report reviewed 24 VA projects authorized in 2014. So far, only two facilities are open, and it will take nearly two more years for the rest of the projects to come online. 

Neither the Hampton nor the Fredericksburg centers were included in the July 2 report because those were authorized in 2017, not 2014. However, recommendations about how to expedite the process in the report are considered applicable to the Virginia projects. 

And every person who cares about the military — especially the service members who are based in Hampton Roads — must be dissatisfied with how this process is unfolding. As lawmakers and administrators grapple in Washington, veterans in need of significant care are waiting without help. 

In December 2014, the Hampton VA had the longest wait time in the nation for primary care patients. 

The backlogs in Hampton Roads do not appear to be abating anytime soon, especially considering the veteran population is anticipated to grow nearly 22 percent from 2017 to 2027. 

The current state of affairs at the VA is clearly not working properly. 

Even veterans who appeal decisions involving disability benefits are facing a growing backlog that could exceed 1 million people within a decade. Without clear answers to the problem, veterans may have to wait an average of 8.5 years to have their appeals resolved. 

Walk around our region and doesn’t take too long to realize the military’s outsized presence here. 

Nearly 18 percent of Hampton Roads is comprised of veterans, according to the U.S. Census Bureau. That figure far outpaces any other region in Virginia and it is one of the densest populations of veterans anywhere in the country. 

We must become a priority. 

Sen. Warner has sent a letter to the Secretary of the Department of Veterans Affairs Robert Wilkie as well as the Administrator of the U.S. General Services Administration Emily W. Murphy, demanding the agencies present a plan to speed up the completion of these Virginia facilities. 

Consider contacting the VA at or GSA to let them know how important the service members and veterans are to Hampton Roads. 

Their well-being is a standard of how we treat this entire community. And the current state of affairs will not be accepted.

WASHINGTON, D.C. – U.S. Senators Mark Warner and Tim Kaine announced $2,703,156 in federal funding to support nursing education at James Madison University over the next four years. The funding will be used to recruit, admit, and retain students interested in pursuing nursing and working in underserved primary care environments in Page County.

“At a time when Virginia faces a shortage in nurses, this grant will play an important role in supporting students interested in nursing and placing these qualified individuals at primary care facilities in underserved areas,” the Senators said. “We’re thrilled that the Department of Health and Human Services and JMU have shown a commitment to this important endeavor.”

“This collaboration is a great example of our university’s mission in action, as we seek to apply the knowledge and skills learned in the classroom to the real-world challenges of our community partners outside the classroom,” said Jonathan Alger, President of James Madison University.

“The School of Nursing at James Madison University is excited to work with our clinical partners in Page County to develop a nursing workforce prepared to meet the needs of rural and underserved individuals. Our BSN nursing students will greatly benefit from the opportunity to practice in rural, primary care settings in Page County while impacting the needs of the community as well,” said Julie Sanford, Director and Professor of James Madison University’s School of Nursing.

“The GO Virginia Council for Region 8, covering 16 communities in the Shenandoah Valley, including Page County, has been keenly aware of and concerned about the growing demand for a skilled nursing workforce to support the evolving health care sector of our regional economy.  Today’s announcement for James Madison University will reap benefits for the entire region as our federal, state, and local partners come together with our university-based assets to address this critical need,” said George Pace, GO Virginia Region 8 Council Chairman.

The funding was awarded through the Department of Health and Human Services Nurse Education, Practice, Quality and Retention (NEPGQR) Program. The purpose of this grant program is to recruit and train nursing students to practice in community-based primary care teams.




WASHINGTON –U.S. Sen. Mark R. Warner (D-VA), a member of the Senate Finance Committee, voted to advance the Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018. The bipartisan legislation includes four bills written by Sen. Warner to address the opioid crisis by expanding the use of telehealth services to provide substance abuse treatment, and by improving data sharing on substance use disorders for state Medicaid programs. The HEAL Actwas passed out of committee on a bipartisan 27-0 vote and now awaits full consideration on the Senate floor.

“Opioid overdoses are now the leading cause of accidental death in Virginia, surpassing car accidents and gun violence. One of the main drivers of the opioid crisis is that too many people lack access to quality substance use disorder treatment,” said Sen. Warner.  “Expanding access to telehealth services could not only save lives but equip rural and underserved communities with better tools to fight this epidemic. Since Leader McConnell has announced plans to keep the Senate in session through the month of August, there should be plenty of opportunity for the Senate to take up and pass this important bipartisan bill to help address the opioid crisis.”

Sen. Warner noted in his opening remarks before that Committee that Virginia has suffered greatly from the opioid and addiction epidemic. In 2016, there were 1,460 deaths from overdoses, a 38 percent increase over 2015. Eighty percent of these deaths involved opioid use. (To download video of Sen. Warner’s opening statement, click here.)


About Sen. Warner’s bills:

Telehealth is the provision of health care services via telecommunications technologies, such as live video interactions, that make it easier for healthcare providers to treat patients no matter where they live. However, in order for a Medicare patient to receive reimbursement for substance use disorder treatment, individuals are obligated to receive care from a Medicare approved location known as an originating site. Oftentimes individuals who need treatment live out of reach from the originating site or those centers may be filled at capacity. That is why Sen. Warner, along with Sens. John Thune (R-SD), Ben Cardin (D-MD) and John Cornyn (R-TX), introduced the Expanding Telehealth Response to Ensure Addiction Treatment (eTREAT) Act to reduce the existing barriers to expand telehealth services for substance use disorder treatment. The text is available here.

Virginia is a national leader in telemedicine. The University of Virginia (UVA) Center for Telehealth was launched in 1994 and has since grown into a national model for the health industry. Since then, UVA and its network of 152 telemedicine partners have enabled more than 51,000 patient encounters across more than 60 specialties, saving Virginians roughly 16 million miles of travel. While the center was selected as one of 14 regional telehealth resource centers by the federal government, it still faces barriers to delivering care because outdated federal laws restricts Medicare’s coverage of telehealth services.

"The University of Virginia Health System and our Center for Telehealth commend Senator Warner for his leadership in addressing barriers that prevent patients from getting needed substance abuse treatment in a timely way by eliminating burdensome geographic originating site restrictions in Medicare.  The Expanding Telehealth Response to Ensure Addiction Treatment (eTREAT) Act of 2018 will allow telehealth-- demonstrated to be an effective tool to deliver health care-- to provide such evaluation and treatment services to greater numbers of patients nationwide,” said Dr. Karen Rheuban, Director of the UVA Center for Telehealth.

In addition, Sen. Warner’s three other bills aimed at expanding the use of telehealth services for Medicaid patients receiving substance use disorder treatment are also included in the HEAL Act.

The Medicaid Substance Use Disorder Treatment via Telehealth Act will make clear how federal Medicaid funds can be used for substance use disorder treatment through telehealth services. Specifically, the bill will require the Secretary of Health and Human Services (HHS) to issue guidance on the reimbursement options available to state Medicaid services and treatment of substance use disorder through telehealth. The text is available here.

In addition, the Telehealth for Children’s Access to Services and Treatment (TeleCAST) Act will help ensure children suffering from substance use disorder receive the assistance they need through telehealth services. The bill will require the Government Accountability Office (GAO) to evaluate the population of children who utilize Medicaid treatment for substance use disorder. In addition, the bill requires that the Centers for Medicare and Medicaid Services (CMS) produce a report on reducing barriers to using telehealth services and remote patient monitoring for pediatric populations under Medicaid. The text is available here.

In 2003, then-Gov. Warner expanded Medicaid coverage for telemedicine statewide, including evaluation and management visits, a range of individual psychotherapies, the full range of consultations, and some clinical services, including in cardiology and obstetrics. Coverage was also expanded to include non-physician providers. Among other benefits, the telehealth expansion allowed individuals in medically underserved and remote areas of Virginia to access quality specialty care that isn’t always available at home.

The final bill, the Opioid Addiction Treatment Programs Enhancement Act, will improve data collection on substance use disorder among Medicaid recipients. The bill will require the Secretary of Health and Human Services to publish comprehensive data on the CMS website regarding the prevalence of substance use disorder within the Medicaid beneficiary population and the services provided for treatment of substance use disorders under Medicaid. By receiving the most up-to-date information, states will be better equipped to combat the growing opioid epidemic by targeting their efforts in communities that need it the most. The text is available here

In the Senate, Sen. Warner has been working on ways to combat the opioid crisis that has had a devastating effect for communities in rural Southwest Virginia. In March, Sen. Warner voted in favor of the omnibus bill that provided a total of $3.3 billion in increased funding to combat the opioid crisis, including an increase of $2.8 billion in treatment, prevention and research for programs under the Department of Health and Human Services (HHS) to help communities across Virginia and the nation fight against the opioid epidemic. He has also passed into law bipartisan legislation to expand the use of federal telehealth services.