WASHINGTON – U.S. Sen. Mark R. Warner today introduced bipartisan legislation, co-sponsored by Sens. Shelley Moore Capito (R-WV), Tim Kaine (D-VA), Joe Manchin (D-WV), Bob Casey (D-PA) and Sherrod Brown (D-OH), to boost participation in federal programs that detect and treat black lung disease among coal miners.

According to a recent study published in the American Journal of Public Health, cases of black lung are at a 25-year high in Appalachian coal mining states, with as many as one in five underground coal miners in the region having evidence of black lung. In order to address this worsening public health crisis, Sen. Warner has filed an amendment to the defense, labor, health and education spending package currently under consideration on the floor of the U.S. Senate aiming to improve the participation rate of coal miners in federal health surveillance programs that detect and treat black lung. Specifically, the amendment requires the National Institute for Occupational Safety and Health to submit a report to Congress on ways to boost outreach efforts to increase participation in the Coal Workers’ Health Surveillance Program (CWHSP) and to identify barriers that deter miners with black lung from accessing treatment. CWHSP is a national program that offers free health screening services to coal miners, including chest X-rays, lung function testing, respiratory health assessment questionnaires, and extended health surveillance. However, the current national participation rate in CWHSP is approximately 35 percent among active miners and even lower among retirees.

“Black lung is a deadly disease, but the earlier it’s detected, the better the outcomes are. Underground coal miners help keep the heat and the lights on, but often at a significant cost to their own health. By improving outreach efforts, we can make sure that more miners are getting screened so we can catch cases of black lung early, and make sure that they can get the treatment they need,” said Sen. Warner.

“West Virginia coal miners have worked tirelessly for decades to keep industries and communities in this country moving,”Sen. Capito said. “These resources dedicated to the early detection of black lung could be life-saving for thousands of hardworking West Virginians. Amazing work is being done in this area by the National Institute for Occupational Safety and Health’s Respiratory Health Division in Morgantown, and I am honored to help that work continue and provide assistance to those who have given so much to our state.” 

“Virginia’s coal miners have worked for decades, often at the expense of their own health, to keep the country’s lights on, and we owe it to them to ensure they’re aware of their options to access black lung detection and treatment resources,”said Sen. Kaine.

“Coal miners sacrifice a lot to keep our lights on, heat our homes, and power our businesses, including their own health. Black lung cases are at a 25-year high and with today’s technology and our knowledge of this disease, that is simply unacceptable. Our amendment will make sure more miners participate in early detection so we can catch it and treat it quicker. The health and safety of our miners should always be our number one priority and I will be fighting for this amendment to be included in the final spending bill,” Sen. Manchin said.

“No worker should have to sacrifice their health and safety on the job to provide for their family,” said Sen. Casey. “Black lung claims too many lives but the earlier it’s detected the better chance individuals have fighting its impact. We owe it to our nation’s miners to put in place policies that help detect and prevent this fatal disease.”  

“Ohio miners put their health at risk to power our country. Finding ways to increase outreach and miner participation in the screenings that help prevent and manage conditions like black lung is the least we can do,” said Sen. Brown.

“Eliminating barriers to participation in the Coal Worker’s Health Surveillance Program is a strong first step towards improving the health and wellness of active and retired coal miners in the Commonwealth of Virginia. This amendment will assist Congress in determining how to improve the Program, thereby enabling it to best serve miners. The amendment could also lead to better participation in the Surveillance Program, help save lives, improve early identification of black lung, and ultimately improve health outcomes for current and future health center patients throughout the Commonwealth of Virginia. We support this amendment to H.R. 6157 and encourage its inclusion in the final version of the appropriations package,” said Rick Shinn, Virginia Community Healthcare Association, Director of Government Affairs.

“The NIOSH Coal Workers’ Health Surveillance Program is vital to the detection of Black Lung Disease. Ensuring Program access to as many active and non-active coal miners as possible will help miners be aware of their health status, reduce continued exposure to harmful dust, and seek treatment as early as possible. This amendment will assist Congress in determining how to improve the Program, thereby enabling it to best serve miners,” said James L. Werth, Jr., PhD, Stone Mountain Health Services, Black Lung Program Director.

Sen. Warner has been a strong advocate for coal miners and their families. In 2017, Sen. Warner reintroduced the Black Lung Benefits Improvement Act to ensure black lung claims are processed fairly and quickly, and he has pushed for more funding for black lung health clinics in Virginia. In December, he joined several of his colleagues in urging Secretary of Labor Alexander Acosta to keep the Respirable Dust Rule to protect mine safety and miners health. Last year, Sen. Warner successfully fought to permanently protect more than 10,000 retired coal miners and their families in Virginia who were in danger of losing their health benefits. He has also introduced the American Miners Pension Act, which would protect the pensions of more than 7,000 retired Virginia coal miners who are in danger of losing their benefits if the 1974 UMWA Pension Plan becomes insolvent.

Text of Sen. Warner’s amendment is available here.

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WASHINGTON – Today U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) announced that the Appalachian Regional Commission (ARC) has approved $500,000 in grant funding for St. Mary’s Health Wagon, a non-profit organization that provides health services to underserved individuals. The funding will be used to construct a new healthcare clinic in Clintwood, Va. that is expected to serve 3,500 uninsured and underinsured patients annually.

“Every year, the Health Wagon helps thousands of Virginians get access to healthcare they otherwise could not afford. As Governors and as Senators, we have been proud to support the important work of the Health Wagon. Worthy projects such as this clinic are why we have fought so hard in Washington to protect funding for the Appalachian Regional Commission. This new facility in Dickenson County will allow the Health Wagon to continue providing health, vision and dental services to underserved patients in Southwest Virginia,” said the Senators. 

“We are so pleased that ARC chose to fund a much-needed construction grant for a brand-new stationary free health clinic in Dickenson County, the county where St. Mary’s Health Wagon began almost forty years ago. The Health Wagon is the region’s only free clinic, serving Lee, Scott, Wise, Dickenson, Buchanan and Russell Counties and is a medical home to over 10,000 patients. The new free clinic will be located in Clintwood, Virginia, and will bring a variety of new innovative patient resources and economic benefits such as medical tourism and new jobs to the region.  The new clinic will have dedicated optometry, dental, ultrasound and x-ray suites,” said Dr. Teresa Tyson, Health Wagon Executive Director.

The current Health Wagon clinic in Clintwood has only two exam rooms, limiting the ability of physicians to accommodate patient needs. Construction of the new 5,000-square foot clinic will provide additional exam rooms for medical, dental, and vision care services, as well as administrative offices and spaces for x-ray, pharmacy, laboratory and telehealth use. Governor McAuliffe recommended funding for this project at the end of tenure, which has now been formally approved by ARC.

ARC project grants are awarded to local and state government entities and non-profits. The ARC funds are then matched by local funding sources. In addition to the ARC funds, local sources will provide $730,600, bringing the total project funding to more than $1.2 million. Since its inception in 1965, ARC has generated over 300,000 jobs and $10 billion for the 25 million Americans living in Appalachia. ARC has provided funding and support for job-creating community projects across the 13 Appalachian states, producing an average of $204 million in annual earnings for a region often challenged by economic underdevelopment. President Trump’s 2018 budget proposed eliminating the program entirely. Warner and Kaine have continued to vote to fully fund ARC.

As Governors, Warner and Kaine both advocated for additional funding for the Health Wagon, a partner in the annual Remote Area Medical (RAM) clinic that provides dental care, exams and treatment at no cost.

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(Washington, D.C.) – Today, the Office of Inspector General of the Department of Health and Human Services (HHS)announced it would conduct a comprehensive review of the Office of Refugee Resettlement’s (ORR) Unaccompanied Alien Children (UAC) program after Senator Patty Murray (D-WA), ranking member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, Senator Dick Durbin (D-IL), and 39 other Senate Democrats sent a letter to the Office of Inspector General requesting they look into the issue. The request for an investigation follows weeks of uncertainty about the Health Department’s ability to appropriately care for children placed in its custody as a result of President Trump’s family separation policy, as well as the Department’s lack of clarity around plans to reunite children and parents.   

“We write to request a comprehensive review of the operations of the Department of Health and Human Services (HHS) Office of Refugee Resettlement’s (ORR) Unaccompanied Alien Children (UAC) program, particularly focused on how the Office has approached and responded to President Trump’s family separation policy. We are alarmed by the uncertainty and pain inflicted on thousands of families arriving at the U.S. border, particularly the mental and physical harm inflicted on immigrant children and their parents by this policy, and we are deeply troubled by recent reports of maltreatment of children while under ORR custody. While we are encouraged by the announcement of recent efforts to prioritize family reunification, we also have significant questions about how the Department is working to accomplish this goal. It is equally important that we understand what measures, if any, HHS undertook to prioritize the health, safety, and wellbeing of children in its custody as it implemented the family separation policy, both before and after President Trump’s June 20 Executive Order to reverse the policy,” wrote Senator Murray.

The letter was signed by Senators Patty Murray (D-WA), Dick Durbin (D-IL), Dianne Feinstein (D-CA), Ron Wyden (D-OR), Tom Udall (D-NM), Elizabeth Warren (D-MA), Edward Markey (D-MA), Patrick Leahy (D-VT), Catherine Cortez Masto (D-NV), Martin Heinrich (D-NM), Tina Smith (D-MN), Cory Booker (D-NJ), Tammy Duckworth (D-IL), Angus King (I-ME), Jeanne Shaheen (D-NH), Sheldon Whitehouse (D-RI), Richard Blumenthal (D-CT), Maria Cantwell (D-WA), Bernie Sanders (I-VT), Tammy Baldwin (D-WI), Chris Coons (D-DE), Amy Klobuchar (D-MN), Tim Kaine (D-VA), Brian Schatz (D-HI), Chris Van Hollen (D-MD), Maggie Hassan (D-NH), Michael Bennet (D-CO), Bill Nelson (D-FL), Kamala Harris (D-CA), Chris Murphy (D-CT), Mazie Hirono (D-HI), Jack Reed (D-RI), Kirsten Gillibrand (D-NY), Bob Casey (D-PA), Robert Menendez (D-NJ), Jeff Merkley (D-OR), Gary Peters (D-MI), Debbie Stabenow (D-MI), Sherrod Brown (D-OH), Mark Warner (D-VA), and Tom Carper (D-DE).

The full text of the letter is below and the PDF can be found HERE.

June 27, 2018

The Honorable Daniel R. Levinson

Office of Inspector General

Department of Health and Human Services

330 Independence Avenue, SW

Washington, DC 20201

Dear Inspector General Levinson:

            We write to request a comprehensive review of the operations of the Department of Health and Human Services (HHS) Office of Refugee Resettlement’s (ORR) Unaccompanied Alien Children (UAC) program, particularly focused on how the Office has approached and responded to President Trump’s family separation policy. We are alarmed by the uncertainty and pain inflicted on thousands of families arriving at the U.S. border, particularly the mental and physical harm inflicted on immigrant children and their parents by this policy, and we are deeply troubled by recent reports of maltreatment of children while under ORR custody. While we are encouraged by the announcement of recent efforts to prioritize family reunification, we also have significant questions about how the Department is working to accomplish this goal. It is equally important that we understand what measures, if any, HHS undertook to prioritize the health, safety, and wellbeing of children in its custody as it implemented the family separation policy, both before and after President Trump’s June 20 Executive Order to reverse the policy.

            Under President Trump’s family separation policy, thousands of children who arrived in this country with their parents were placed in ORR custody while their parents were detained separately awaiting immigration proceedings.  On June 20, 2018, President Trump signed an Executive Order purportedly to reverse the policy, but the path forward to execute the Order remains unclear.  The Executive Order instructs the Secretary of Defense to provide “facilities available for the housing and care of alien families.”  Later on June 20, the Department of Defense (DoD) issued a memo announcing that HHS had asked whether DoD has the ability to house up to 20,000 children at military installations between July and December 2018, in order to accommodate  HHS’s need to rapidly increase its capacity.[1]  As HHS addresses an increased number of children in its custody at HHS-contracted UAC program facilities, it is unclear what steps are being taken to ensure that HHS contractors and facilities are meeting established standards for ensuring the safety and wellbeing of children in their care—including meeting requirements related to background checks, inspections, qualifications, training, and licensure.

Recent press reports have also detailed concerning allegations of abuse of children in HHS-contracted UAC program facilities, raising concerns about the Department’s oversight of the UAC program, especially as it seeks to ramp up capacity.[2]  One report from a Virginia facility described aggressive and routine use of physical force to restrain children.[3]  Another story from a Texas site recounted coerced use of numerous psychotropic drugs on children, including through forced injections and medications disguised as vitamins.[4]  These allegations are deeply worrisome and merit intense scrutiny of the quality of care in HHS-contracted UAC program facilities, particularly as the Administration is separating and detaining more and more children. 

The forced separation of immigrant children from their parents is a serious, traumatizing event that should never have occurred. Forced separation can over-activate the body’s stress-response system, creating a constant “fight-or-flight” mode that can disrupt a child’s brain chemistry and create potentially long-term or lifelong health consequences as documented in the Centers for Disease Control and Prevention’s (CDC) Adverse Childhood Experiences (ACEs) study.[5]^,[6]  As the Department responsible for children’s health and wellbeing, HHS should be dedicating resources to ensuring children are receiving the medical and mental health care they need.  HHS has the tools to measure capacity in its facilities and to assess the potential needs of children in their custody.  Yet, we remain concerned about whether the Department is ensuring children receive the care they need and whether the services and treatments they receive are trauma-informed and evidence-based. 

To better understand HHS’s efforts to implement the family separation policy and the June 20 Executive Order, we ask that you conduct an investigation of the UAC Program and address the following questions:

1.     What processes does HHS employ to assess the needs of children in the UAC program, including the capacity needed at HHS-contracted UAC program facilities and their ability to provide needed services for children of all ages and medical needs?

a.      Did those processes change when President Trump’s family separation policy was implemented?

b.     Did those processes change after President Trump signed his June 20 Executive Order?

c.      What steps did the Department take to prepare for the arrival of children separated from their parents at the U.S. border?  Was notice provided to HHS ORR in advance of President Trump’s family separation policy to allow the agency to plan for the increase in UACs in its custody?

d.     Was notice provided to HHS ORR in advance of President Trump’s June 20 Executive Order to allow for HHS ORR to establish policies, train employees and contractors, and plan for family reunification consistent with federal law and court orders? 

e.      Were additional program or contracting staff tasked to ORR in response to the expected increase in UACs?

2.     What steps did the Department take to prepare for reunification of the separated children with their parents consistent with federal law and court orders? 

a.      What specific steps has the Department taken to coordinate, with the Department of Homeland Security (DHS) on the reunification of children in its custody with parents in DHS’ custody? Please provide a list of procedures detailing inter-agency coordination between the Department and DHS to reunify separated families.

3.     Was the Department adequately prepared to care for separated children, including by providing the range of necessary, age appropriate, medical and mental health services needed in a traumatized population of children, and to reunify families consistent with federal law and court orders?

a.      Were additional medical or mental health staff tasked to ORR in response to the expected increase in UACs?

b.     Does ORR have adequate staff to oversee and support the medical and mental health needs of traumatized children in the UAC program?

c.      What steps did the Department take to ensure evidence-based trauma-informed services were provided to separated children?  Did HHS ORR consult with any other units or programs within HHS that have expertise in the medical and mental health needs of traumatized children?

d.     Did HHS ORR consult with any non-governmental entities with expertise in the medical and mental health needs of traumatized children?

e.      Did HHS ORR medical staff provide guidance to HHS-contracted UAC program facilities regarding the use of psychotropic medications? Was any such guidance sufficient?

4.     How did the Department ensure UACs had adequate access to qualified mental health professionals? 

5.     How does the Department assess the qualifications of contracted providers to deliver adequate medical and mental health care to children in their custody?  Did the Department take additional steps to ensure proper oversight of the quality of care that is provided to separated children, particularly in light of the trauma experienced when separated from their parent(s)?

6.     Prior to awarding new contracts to operate facilities under the UAC program, what steps does HHS ORR take to determine if the operator or facility has past allegations of abuse or neglect, including under any program under state law?

7.     Press reports indicate that HHS is currently in the process of exploring opportunities to expand capacity of the UAC program. 

a.      What was the timeline of actions taken by HHS to assess capacity of the UAC program? 

b.     What information was HHS relying on to make expansion decisions? 

c.      Who was making decisions about when and how such expansions would occur? 

8.     There continues to be significant confusion across the federal government regarding implementation of President Trump’s family separation policy and of the June 20 Executive Order.  

a.      How have HHS staff and HHS-contracted UAC program facilities received direction about implementation of Administration policies? 

b.     Is that direction coming from within HHS?  If not, is it coming from other federal departments or from the White House?

c.      What information has HHS staff provided to HHS-contracted facilities about implementation of Administration policies?

d.     What was the timeline for communication to HHS-contracted UAC program facilities on family reunification procedures that are consistent with federal law and court orders?

9.     How is HHS ensuring that its contractors and facilities meet established standards for ensuring the safety and wellbeing of children in their care and after placement with a sponsor, including background checks, inspections, qualifications, training, and licensure?

10.  How does HHS investigate and address allegations of mistreatment, abuse, or neglect of children at HHS-contracted facilities in the UAC program? 

a.      Are these measures adequate to ensure the health, safety, and wellbeing of children in the Department’s custody?

b.     Were there any instances of leaving children in the physical care of a HHS-contracted UAC program facility that had an allegation of mistreatment, abuse or neglect of children? If so, for how long? 

c.      Under what conditions would HHS end a contract with a facility with substantiated allegations of abuse? Has HHS followed such protocols?

Thank you for your attention to this important matter, and we look forward to reviewing the findings from your investigation. 

Sincerely,

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WASHINGTON – U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) released the following statement after Virginia Governor Ralph Northam signed into law the state budget that expands Medicaid:

“After years of working on this issue that affects families across the Commonwealth, we are thrilled that hundreds of thousands of Virginians who currently lack basic health care coverage will finally have some peace of mind. Today’s historic signing shows a good faith effort by legislators to provide health insurance for Virginians who need it the most.  We are grateful for the tireless work Governor Northam and the leaders of the General Assembly have shown to ensure the stability and well-being of hardworking families. We are ready to assist the Governor and his administration as Virginia begins the process of full expansion.” 

Virginia is now one of 33 states across the country that have expanded Medicaid. Up to 400,000 low-income adults in Virginia will now be eligible for Medicaid health coverage.

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WASHINGTON – U.S. Sen. Mark R. Warner (D-VA), a former Governor and a current member of the Senate Finance Committee, released the following statement after the Virginia Senate voted to expand the Medicaid program under the Affordable Care Act (ACA) 

“I’m thrilled that the Virginia Senate has decided partisan politics should no longer stand in the way of thousands of Virginia families getting the healthcare they need. I look forward to the House of Delegates soon doing the same.  

“Governor Northam and supporters of Medicaid expansion should be proud of this bipartisan achievement, but the real winners here are the hardworking Virginians who will finally have healthcare for their families.” 

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WASHINGTON — Today, U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) sent a letter to U.S. Secretary of Health and Human Services (HHS) Alex Azar, urging him to take swift action to stabilize the insurance marketplace. On May 4, the majority of health insurers filed initial rates with the Virginia Bureau of Insurance proposing to raise premiums between 15 and 64 percent in 2019 – a move that could impact more than 400,000 Virginians who purchase their health care coverage through the individual marketplace. 

“We are concerned that these substantial rate increases will negatively impact hundreds of thousands of individuals in Virginia that purchase their plans on the health insurance marketplace,” wrote the Senators. “Additionally, we are disappointed to know that these increased costs are largely a result of policies the U.S. Department of Health and Human Services (HHS) and Republicans in Congress have pursued and implemented.”

In 2017, the Trump Administration ended cost sharing reduction payments under the Affordable Care Act, a move that subsequently destabilized the individual marketplace and increased premiums for people who do not receive financial assistance on the marketplace.  Since then, Congressional Republicans and the Administration have taken several steps to undermine the success of the Affordable Care Act, including repealing the individualmandate and expanding the availability of short-term health plans that don’t cover many basic health care costs such as prescription drugs, maternity care, or preventive health services. According to experts, expanding the availability of these plans – which don’t protect consumers from discrimination on the basis of age, gender, or pre-existing conditions – will draw younger and healthier consumers out of the health care marketplaces and further raise premiums for individuals who depend on the individual market to purchase their health care coverage.   

In filing their proposed rates for 2019 with the Virginia Bureau of Insurance, insurers directly cited the elimination of cost-sharing reductions, the expansion of short-term plans, and the elimination of the individual mandate to justify double-digit rate increases.  

“Double digit premium increases are not only unacceptable, they are also avoidable. We are committed to work with you to take proactive steps to lower premiums in Virginia and across the country. This would include prioritizing proposals that would establish a federal reinsurance program and continuing cost sharing reduction payments while adopting policies to hold harmless those people who do get financial help in the marketplace,” the Senators told Sec. Azar. “We also would encourage you to revise your recently proposed rule to expand the use of short term limited duration plans. Finally, we urge you to reverse recent policies to shorten the annual open enrollment period, slash funding for consumer outreach and assistance, and other efforts to undermine consumer protections. Without these important changes it is likely Virginians and other Americans will continue to experience significant premium increases in the future.”

In addition, according to a study by Medicare's chief actuary that was released on Tuesday, President Trump’s plan to expand short-term health insurance policies will drive up federal spending by $1.2 billion next year and by a total of $38.7 billion over 10 years – significantly more than the Trump Administration’s original estimates.

Sens. Warner and Kaine previously raised similar concerns in a public statement after Virginia insurers filed their initial rates for 2019.

The full text of today’s letter can be found below and here.

Honorable Alexander M. Azar II

Secretary

U.S. Department of Health & Human Services

200 Independence Avenue, S.W.

Washington, D.C. 20201 

Dear Secretary Azar,

We write to you regarding the 2019 proposed premium rates in Virginia. The majority of insurers filed proposed rates with the Virginia Bureau of Insurance earlier this month that propose to increase premium rates for plans on the health insurance marketplace between 15 and 64 percent in 2019. We are concerned that these substantial rate increases will negatively impact hundreds of thousands of individuals in Virginia that purchase their plans on the health insurance marketplace. Additionally, we are disappointed to know that these increased costs are largely a result of policies the U.S. Department of Health and Human Services (HHS) and Republicans in Congress have pursued and implemented.

Virginia insurers have directly cited actions by HHS to eliminate cost sharing reduction payments, which increased premiums for those who don’t get financial help in the marketplace, and a recently proposed rule to expand the use of short term limited duration (STLD) plans when explaining the justification for their substantial rate increases. In addition, insurers have stated that premiums were further increased when Republicans in Congress and President Trump passed legislation repealing the individual shared responsibility provision. Together, these changes have made it more difficult – and in some cases impossible – for many Virginians to afford their health care premiums.

Doctors, hospitals, patient organizations and the medical community have raised concerns that the actions listed above will result in patients paying more money for less care. They have the potential to disproportionally hurt older Americans and individuals with pre-existing conditions by making it more difficult for them and other Virginians to get affordable plans that cover basic benefits such as hospitalization, behavioral health, prescription drugs, and maternity care. The Urban Institute estimated that the impact on premiums due to expanded STLD policies and the loss of the individual shared responsibility provision is 19 percent, while, the non-partisan Congressional Budget Office projects that repeal of the ACA’s individual shared responsibility provision alone will increase individual market premiums by 10 percent in 2019.

Double digit premium increases are not only unacceptable, they are also avoidable. We are committed to work with you to take proactive steps to lower premiums in Virginia and across the country. This would include prioritizing proposals that would establish a federal reinsurance program and continuing cost sharing reduction payments while adopting policies to hold harmless those people who do get financial help in the marketplace. We also would encourage you to revise your recently proposed rule to expand the use of short term limited duration plans. Finally, we urge you to reverse recent policies to shorten the annual open enrollment period, slash funding for consumer outreach and assistance, and other efforts to undermine consumer protections. Without these important changes it is likely Virginians and other Americans will continue to experience significant premium increases in the future.

We are willing to work with you on the steps listed above and other proposals that will stabilize the health insurance marketplace and reduce premiums for enrollees. We simply ask that you work with us, rather than against us, to achieve the important and shared goal of ensuring affordable and accessible health care coverage for Virginians. Thank you for your consideration of our letter and we look forward to your response.

Sincerely,

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WASHINGTON, D.C. — U.S. Senators Mark R. Warner and Tim Kaine released the following statement after insurers filed initial rates that would lead to major premium increases for Virginians in 2019:

“These proposed price increases are a painful consequence of the Trump Administration’s efforts to sabotage the health insurance market and dismantle the Affordable Care Act. After a series of unsuccessful attempts to repeal the ACA, President Trump and Republicans in Congress settled for taking actions that will increase premium costs for American families, something even Trump’s former HHS Secretary admitted this week. Now, their irresponsible games are hurting Virginians by making it harder for families to afford health care. We hope our colleagues will take this seriously and pass bipartisan legislation to stabilize the market and make sure Virginians have affordable options for health insurance in 2019.” 

Over 400,000 Virginians rely on the individual marketplace for health insurance coverage.

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Washington, D.C. – In a letter to the U.S. Senate Committee on Appropriations and the Subcommittee on Labor, Health and Human Services, and Education, U.S. Senators Susan Collins (R-ME), Mark Warner (D-VA), and Ed Markey (D-MA) requested an increase in funding for Alzheimer’s disease research as they work to set appropriations levels for fiscal year 2019.  Senator Collins is the founder of the Congressional Task Force on Alzheimer's disease and co-chairs the group with Senators Warner, Markey, and Pat Toomey (R-PA).    

“Alzheimer's disease and other dementias pose a grave threat to the health of our people and to the fiscal well-being of our nation,” Senators Collins, Warner, and Markey wrote.  “Nearly 6 million Americans are living with Alzheimer's today, a number that is projected to increase to approximately 14 million by 2050.  Alzheimer's and other dementias cost our nation an estimated $277 billion a year, including $186 billion in costs to Medicare and Medicaid.” 

“While the challenges posed by Alzheimer's are substantial, continued breakthroughs in science and therapy could help achieve the national goal of preventing and effectively treating Alzheimer's disease by 2025… [W]e urge you to continue making Alzheimer's disease research at the NIH a priority so that we can ramp up to the level necessary to achieve the 2025 goal set by the National Plan,” the Senators continued.  “We…also urge you to provide appropriate support to Alzheimer's disease and dementia initiatives through the Administration for Community Living (ACL) and the Centers for Disease Control and Prevention (CDC) that seek to support family caregivers of persons with Alzheimer's disease and other dementias and to expand awareness and understanding of this disease.” 

In 2011, Senator Collins authored the National Alzheimer’s Project Act (NAPA), with then-Senator Evan Bayh (D-IN).  NAPA convened a panel of experts, who determined that $2 billion per year in research funding is needed to achieve our goal of preventing and treating Alzheimer’s by the year 2025.  Senator Collins helped to secure $1.8 billion—an increase of $414 million—for Alzheimer’s research in the fiscal year 2018 funding bill, which brings us within reach of the $2 billion goal.

Senators Collins, Warner, and Markey’s letter was signed by a total of 38 Senators: Jim Inhofe (R-OK), Tammy Baldwin (D-WI), Mike Crapo (R-ID), Chris Murphy (D-CT), Roger Wicker (R-MS), Jeanne Shaheen (D-NH), John Kennedy (R-LA), Kirsten Gillibrand (D-NY), James Risch (R-ID), Dianne Feinstein (D-CA), Todd Young (R-IN), Tom Carper (D-DE), John Hoeven (R-ND), Sheldon Whitehouse (D-RI), Martin Heinrich (D-NM), Sherrod Brown (D-OH), Michael Bennet (D-CO), Elizabeth Warren (D-MA), Mazie Hirono (D-HI), Chris Van Hollen (D-MD),  Richard Blumenthal (D-CT), Cory Booker (D-NJ), Bill Nelson (D-FL), Debbie Stabenow (D-MI), Chris Coons (D-DE), Tammy Duckworth (D-IL), Bob Menendez (D-NJ), Jack Reed (D-RI), Gary Peters (D-MI), Amy Klobuchar (D-MN), Catherine Cortez Masto (D-NV), Angus King (I-ME), Bob Casey (D-PA), Ben Cardin (D-MD), and Tim Kaine (D-VA).

To view a signed PDF of the letter, click HERE.

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WASHINGTON — Today, a package of bipartisan healthcare provisions introduced by U.S. Sen. Mark R. Warner (D-VA), a member of the Senate Finance Committee, were included in a funding bill passed by Congress and signed by the President. Among the five bipartisan legislative proposals is the CHRONIC Care Act, legislation aimed at improving health outcomes for Medicare beneficiaries living with chronic conditions.

“It is no surprise that this package of cost-effective, evidence-based proposals received broad bipartisan support,” said Sen. Warner. “These commonsense fixes will streamline the way Medicare patients living with chronic conditions receive care, helping those with diabetes or renal disease access high quality and affordable healthcare services.” 

Bipartisan legislation passed by Congress today includes: 

• Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act – This bill will permanently reauthorize and strengthen Medicare Advantage Special Needs plans to ensure that Medicare beneficiaries with chronic conditions or other significant health needs have continued access to quality care that is tailored to their personal needs. It also expands telehealth services offered through different providers of care that will benefit seniors in rural areas and increase access to primary care services and telestroke care. In addition, it extends the proven “independence at home” model that allows seniors to receive care from primary care teams, thereby decreasing hospital readmissions and allowing seniors with multiple chronic conditions to receive care in their own home.
• Medicare Home Infusion Therapy Access Act – This bill will create a transitional reimbursement for Medicare home infusion services. While legislation sponsored by Sen. Warner to restructure the way Medicare beneficiaries who need intravenous medication receive their infusion treatments from the comfort of their home has already passed Congress, this bill properly aligns the change in payments with the new benefit, avoiding a four-year gap during which patients would have challenges securing these life-saving treatments. Companion legislation was introduced in the House of Representatives.
• Dialysis Access Improvement Act – This bill will allow dialysis providers to seek outside accreditation from organizations approved by the Centers for Medicare and Medicaid Services (CMS) to participate in the Medicare program, streamlining the accreditation process for dialysis facilities and improving access for Medicare patients with end-stage renal disease (ESRD). Companion legislation was introduced in the House of Representatives.
• Protecting Access to Diabetes Supplies Act – The bill will strengthen patient protections included in the Medicare National Mail Order program for Diabetic Testing Supplies (DTS), ensuring that Medicare beneficiaries are able to continue accessing familiar diabetes supplies and test systems through DTS. Companion legislation was introduced in the House of Representatives. 
• Medicare Orthotics and Prosthetics Improvement Act – This bill will apply accreditation and other standards for orthotics and prosthetics, such as prosthetic limbs, under Medicare, helping to guarantee access to quality products for beneficiaries. Companion legislation was introduced in the House of Representatives.

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WASHINGTON — U.S. Sen. Mark R. Warner (D-VA), Co-Chair of the Senate Alzheimer’s Task Force, joined Co-Chair Sen. Susan Collins (R-ME) and a bipartisan group of colleagues in a letter to President Trump requesting an increase in funding for Alzheimer’s research in his fiscal year (FY) 2019 budget request.

“Alzheimer’s is one of our nation’s leading causes of death and it is the only one of our nation’s deadliest diseases without an effective means of prevention, treatment, or cure,” the senators wrote.  “If nothing is done to change the trajectory of Alzheimer’s, the number of Americans afflicted with the disease is expected to more than triple by 2050.”

In addition to Sens. Warner and Collins, the letter was also signed by Sens. Amy Klobuchar (D-MN), Thom Tillis (R-NC), Sheldon Whitehouse (D-RI), John Hoeven (R-ND), Richard Blumenthal (D-CT), John Boozman (R-AR), Ed Markey (D-MA), Roger Wicker (R-MS), Todd Young (R-IN), Chris Van Hollen (D-MD), Angus King (I-ME), and Bob Casey (D-PA).

“Federal funding for Alzheimer’s research is a wise investment,” the senators continued.  “We urge you to support efforts to meet the research investment objective set forth in the National Plan by boosting the current investment in Alzheimer’s research in the fiscal year 2019 budget request.”

Sen. Warner has been a longstanding advocate in Congress for improving access and quality of medical care for some of our country’s most vulnerable patients. Last year, he introduced bipartisan legislation designed to give people with advanced illness, such as Alzheimer’s disease, new tools to plan for their care and empower them to have those choices honored.

A PDF copy of the letter is available here. Full text can be found below.

The President 
The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500

Dear Mr. President:

Alzheimer’s is a devastating disease that exacts a tremendous personal and economic toll on the individual, the family, and our society.  In addition to the human suffering it causes, Alzheimer’s is our nation’s most expensive disease, costing the United States more than $259 billion a year, including $175 billion in costs to Medicare and Medicaid.  These costs will skyrocket as the baby boom generation ages.

Alzheimer’s is also one of our nation’s leading causes of death.  It is the only one of our nation’s deadliest diseases without an effective means of prevention, treatment, or cure.  

If nothing is done to change the trajectory of Alzheimer’s, the number of Americans afflicted with the disease is expected to more than triple by 2050.  Already our nation’s costliest disease, Alzheimer’s is projected to cost our country up to $1.1 trillion by 2050. 

At a time when the United States is spending more than $200 billion a year to care for Alzheimer’s patients, we are spending less than two thirds of one percent of that amount on research.  Although we have made progress in increasing funding, Alzheimer’s research funding remains disproportionately low compared to its human and economic toll.  Indeed, similarly deadly diseases receive annual funding of $2 billion, $3 billion, and even $6 billion for research, which has paid dividends.  Given the tremendous human and economic price of this devastating disease, we can do more for Alzheimer’s. 

Investments in research for other diseases have yielded tremendous results: patients have access to new treatments, and death rates for some diseases are decreasing.  Yet, at the same time, mortality due to Alzheimer’s is escalating dramatically.  Fortunately, there is promising research that holds hope for Alzheimer’s patients and their families.  The research community is poised to make important advances through clinical trials and investigating new therapeutic targets, but adequate funding is critical to advance this research. 

The National Plan to Address Alzheimer’s Disease, which was authorized by the bipartisan 2010 National Alzheimer’s Project Act, has as its primary goal to “prevent and effectively treat Alzheimer’s disease by 2025.”  To meet that goal, the Chairman of the Advisory Council created by the legislation says that we will need to devote $2 billion a year to Alzheimer’s research.  The Consolidated Appropriations Act of 2017 took a major step forward by providing a $428 million increase for Alzheimer’s disease including Alzheimer’s Disease Related Dementias research funding, the largest increase for Alzheimer’s research funding in history.  Congress has recently taken additional steps to fight Alzheimer's with the enactment of the 21st Century Cures Act, which provides additional funding for the BRAIN Initiative and creates the breakthrough EUREKA prize competition to address pressing diseases, including Alzheimer's.  These are critical achievements, but we need to do more.    

Federal funding for Alzheimer’s research is a wise investment.  We urge you to support efforts to meet the research investment objective set forth in the National Plan by boosting the current investment in Alzheimer’s research in the fiscal year 2019 budget request.

We remain committed to finding a way to prevent and effectively treat Alzheimer’s by 2025, and we look forward to working with you to meet that goal.

Sincerely,

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Washington, D.C. – Today, U.S. Senators Joe Manchin (D-WV), Sherrod Brown (D-OH), Tim Kaine (D-VA), Mark Warner (D-VA) and Bob Casey (D-PA) sent a letter to the Secretary of the Department of Labor (DOL), Alexander Acosta, urging him to keep the Respirable Dust Rule to protect mine safety and miners health. This letter comes after the rule was included in the Unified Agenda for re-examination. 

The Senators said in part: “Given this increase in black lung disease and the devastating impact that this disease has on coal miners and their families, we believe that it is critical that we maintain this rule. Claims that the Respirable Dust Rule is unnecessary, imposes a costly burden, or provides little to no benefit to society ignore the fact that it can take up to a decade or longer for simple black lung disease to develop.

“We are also keenly aware that the rate of black lung disease fell after Congress passed the Coal Act of 1969 and that comprehensive evidence that this rule has been effective will not be fully available until 2026 at the earliest. We should not abandon our coal miners three short years after the rule went into effect.”

Read the full letter below or click here:

Dear Secretary Acosta, 

On December 14, 2017, the Office of Information and Regulatory Affairs (OIRA) published its fall Unified Agenda and Regulatory Plan, a semiannual list of federal regulatory and deregulatory actions.  We write to express our concerns regarding the decision to list several rules under the purview of the Mine Safety Health Administration (MSHA) for re-examination in the Unified Agenda.  These rules are meant to protect the health and safety of our nation’s coal miners.  

The Trump Administration has made clear its commitment to reducing regulatory burdens. We agree that unnecessary, outdated, or duplicative regulations should be examined for elimination or modification.  However, we believe that worker safety is of the utmost importance and we unequivocally oppose rolling back the Respirable Dust Rule (“the rule”) which is meant to protect the safety, health, and – in effect – the livelihood of our coal miners.  

In particular, the rule, which took effect in 2014, was promulgated by MSHA in an effort to reduce occupational lung diseases - namely coal workers pneumoconiosis (CWP), commonly known as “black lung disease”.   Black lung disease is a common but preventable disease that has plagued coal miners in Appalachia for decades.  The impacts of black lung disease are debilitating and, in the most serious cases, fatal.  

In 2010, the Secretary of Labor, acting under the authority of the Federal Mine Safety Health Act of 1977, proposed the rule.  The rule lowers the acceptable threshold for concentrations of respirable coal mine dust with the goal of making the air that miners breathe in coal mines less toxic.  The final rule decreased the dust limits from 2.0 milligrams per cubic meter to an improved level of 1.5 milligrams per cubic meter.   

Unfortunately, recent research, most notably a report from the National Institute of Occupational Safety and Health (NIOSH), has indicated the prevalence of black lung in Appalachian coalfields is worse than previously thought.  Furthermore, black lung clinics in Appalachia report that younger coal miners are being diagnosed with the disease at increasing rates.   

Given this increase in black lung disease and the devastating impact that this disease has on coal miners and their families, we believe that it is critical that we maintain this rule. Claims that the Respirable Dust Rule is unnecessary, imposes a costly burden, or provides little to no benefit to society ignore the fact that it can take up to a decade or longer for simple black lung disease to develop. 

We are also keenly aware that the rate of black lung disease fell after Congress passed the Coal Act of 1969 and that comprehensive evidence that this rule has been effective will not be fully available until 2026 at the earliest. We should not abandon our coal miners three short years after the rule went into effect. 

In short, we believe in worker safety first and foremost.  MSHA’s mission is a critical one for the safety and health of our nation’s miners and the Respirable Dust Rule is vital to ensuring that MSHA succeeds in that mission.   We urge you to retain the Respirable Dust Rule and prevent the unnecessary erosion of vital mine safety and health standards.

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