WASHINGTON – U.S. Sen. Mark R. Warner D-Va. and Senate Finance Committee Ranking Member Ron Wyden, D-Ore. called for the Trump administration to share its plan to prevent cyberattacks on rural hospitals following the largest health care cuts in American history in the Republican budget bill. 

“Trumpcare will harm the cybersecurity resiliency of rural and small hospitals just as this Administration has chosen to gut cybersecurity operations at HHS,” Wyden and Warner wrote. “As rural and small hospitals confront even lower operating margins due to Republican health care cuts, they will be less likely to prioritize spending on cybersecurity infrastructure. The lack of federal oversight and resources, coupled with historic cuts to Medicaid and the ACA, only serve to increase rural and small hospitals’ cybersecurity vulnerabilities.” 

The letter, sent to Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. and Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz, calls on the Administration to share its plans to help small and rural hospitals meet federal cybersecurity standards, as well as its plan to use the so-called “rural health transformation program” to fund cybersecurity improvements - a fund that is dwarfed by more than $1 trillion in cuts to Medicaid and the Affordable Care Act (ACA)  under Trumpcare. 

Hospitals, particularly smaller facilities and those in rural areas, are a prime target for cyber criminals. Hospitals are also very likely to pay a ransom in order to maintain the continuity of health care given the lack of nearby providers, especially emergency services and procedures, and their top priority is protecting the health and well-being of patients they serve.

Last year, Wyden and Warner introduced legislation to strengthen federal cybersecurity standards across the health care system. Independent analysis has confirmed that over 330 rural hospitals are at risk of deep financial hardship or even closure due to Trumpcare’s cuts to Medicaid, forcing facilities into impossible choices to stay open and continue serving their community.

The full letter is here.

A web version of this release is here.

WASHINGTON - Today, U.S. Sens. Mark R. Warner (D-VA) and Roger Marshall (R-KS) and U.S. Reps. Mike Kelly (PA-16), Suzan DelBene (WA-01), John Joyce, M.D. (PA-13), and Ami Bera, M.D. (CA-06), co-leads of the bipartisan Improving Seniors’ Timely Access to Care Act, released the following joint statement after an announcement Monday from U.S. Health & Human Services (HHS) Secretary Robert F. Kennedy, Jr. and Centers for Medicare and Medicaid (CMS) Administrator Dr. Mehmet Oz that pledges to ease the Medicare Advantage prior authorization process.

The pledge, which includes several provisions contained in their legislation, follows years of legislative progress led by Kelly and Congressional colleagues.

"We applaud these commitments, which aims to improve health care access for millions of Americans by easing the Medicare Advantage prior authorization process," the Members said. "We encourage our House and Senate colleagues to carry this momentum forward and to pass our life-changing legislation, the Improving Seniors’ Timely Access to Care Act, to ensure this progress becomes law."

Under the commitment, participating health plans would:

• Standardize electronic prior authorization submissions using Fast Healthcare Interoperability Resources (FHIR®)-based application programming interfaces.
• Reduce the volume of medical services subject to prior authorization by January 1, 2026.
• Honor existing authorizations during insurance transitions to ensure continuity of care.
• Enhance transparency and communication around authorization decisions and appeals.
• Expand real-time responses to minimize delays in care with real-time approvals for most requests by 2027.
• Ensure medical professionals review all clinical denials.
   

In May 2025, Sen. Warner reintroduced the Improving Seniors’ Timely Access to Care Act. Prior authorization is a tool used by health plans to reduce unnecessary care by requiring health care providers to get pre-approval for medical services. But it’s not without fault. The current system often results in unconfirmed faxes of a patient’s medical information or phone calls by clinicians which takes precious time away from delivering quality and timely care. Prior authorization continues to be the #1 administrative burden identified by health care providers, and three out of four Medicare Advantage enrollees are subject to unnecessary delays due to prior authorization. In recent years, the Office of the Inspector General at the U.S. Department of Health and Human Services (HHS) raised concerns after an audit revealed that Medicare Advantage plans ultimately approved 75% of requests that were originally denied. More recently, HHS OIG released a report finding that MA plans incorrectly denied beneficiaries’ access to services even though they met Medicare coverage rules.

Health plans, health care providers, and patients agree that the prior authorization process must be improved to better serve patients and reduce unnecessary administrative burdens for clinicians. In fact, leading health care organizations released a consensus statement to address some of the most pressing concerns associated with prior authorization.

Specifically, the legislation would:

• Establish an electronic prior authorization process for MA plans including a standardization for transactions and clinical attachments.
• Increase transparency around MA prior authorization requirements and its use.
• Clarify HHS’ authority to establish timeframes for e-prior authorization requests including   expedited determinations, real-time decisions for routinely approved items and services, and other prior authorization requests.
• Expand beneficiary protections to improve enrollee experiences and outcomes.
• Require HHS and other agencies to report to Congress on program integrity efforts and other ways to further improve the e-PA process.
• Previously, Rep. Kelly led similar legislation in the 118th Congress. The Improving Seniors’ Timely Access to Care Act unanimously passed the House in the 117th Congress and was cosponsored by a majority of members in the Senate and House of Representatives. 

Text of the bill can be found here and a section-by-section can be found here.

WASHINGTON – U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) today issued the following statement slamming congressional Republicans’ bill that would devastate rural communities across Virginia by gutting Medicaid and accelerating hospital closures:

“The big GOP plan is a direct threat to families in rural Virginia who rely on Medicaid to access care and keep their community hospitals open. This bill would strip health care from thousands of Virginians, gut funding for struggling rural hospitals, and undo decades of progress. Almost forty percent of kids in rural Virginia are covered by Medicaid. Without that lifeline, families would face impossible choices, and many local hospitals wouldn’t survive. For rural Virginia, this bill might mean the difference between a hospital that’s five minutes away and one that’s 50. It is a slap in the face to the health care workers, parents, and local leaders doing everything they can to keep their communities afloat. We refuse to stand by while Republicans gamble with Virginians’ lives.”

Small towns and rural areas in Virginia have the highest rates of Medicaid coverage. According to research by the Georgetown Center for Children and Families:

• 37.9 percent of children in Virginia’s small towns and rural areas rely on Medicaid/CHIP for their coverage, compared to 30 percent in metro/urban areas;
• Among Virginia adults younger than 65, 18.9 percent of those in small towns and rural areas get their coverage through Medicaid/CHIP, compared to 13.7 percent in metro areas; and
• Among seniors, 11.7 percent of those living in Virginia’s small towns and rural areas were covered by Medicaid, compared to 10.7 percent in metro/urban areas.

Nearly half – 47 percent – of rural births in the U.S. are covered by Medicaid, as are 65 percent of nursing home residents in rural counties.

Almost half of rural hospitals nationwide are already operating at a financial loss, according to the American Hospital Association. The GOP’s proposed Medicaid cuts would push already-struggling rural hospitals further toward financial collapse, particularly in areas like Southwest and Southside Virginia. Detailed data from the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill concluded that Republican health care cuts could place more than 300 rural hospitals across the U.S. – including six hospitals in Southwest and Southside Virginia – at disproportionate risk of closure, conversion, or service reductions.

Since the Affordable Care Act expanded Medicaid in Virginia, the uninsured rate has fallen dramatically, and rural hospitals have seen a critical infusion of funds to help keep their doors open. The GOP’s plan to give giant tax cuts to the ultra wealthy while slashing Medicaid and other investments threatens to reverse that trend.

Warner and Kaine have long championed Medicaid expansion and rural health infrastructure, including broadband-enabled telehealth services and rural hospital stabilization programs. They have pledged to fight the GOP plan as long as Republicans in Congress continue to insist on gutting vital programs in order to pay for tax breaks for the richest Americans, noting that the GOP bill would strip health insurance from more than 302,000 Virginians, cut SNAP benefits, raise energy costs for Virginia households, jeopardize more than 20,000 Virginia jobs, raise taxes on minimum wage workers while giving the richest 0.1% a $188,000 tax cut, make tax filing more expensive, and explode the deficit, among other devastating impacts to Virginia families.

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WASHINGTON – Today, U.S. Sens. Mark R. Warner and Tim Kaine (D-VA) issued the following statement after Republicans in the House of Representatives voted in the dead of night to approve legislation to cut taxes for the ultra-wealthy while slashing Medicaid and nutrition assistance, raising taxes on working families, and exploding the national debt:  

“This bill would do real harm to Virginia families, workers, and communities. It would raise taxes on working families and rip health care away from more than 262,000 people in Virginia in order to give tax breaks to Donald Trump and his billionaire friends. Virginians deserve better, and we will oppose this bill with everything we’ve got as it comes to the Senate. “

Warner and Kaine have been sounding the alarm about the effects of the GOP plan on Virginia if Republicans in Congress continue to insist on gutting vital programs in order to pay for tax breaks for the richest Americans, noting that the GOP bill would strip health insurance from more than 262,000 Virginians; rip nutrition assistance away from at least 204,000 Virginians, including children; raise energy costs for Virginia households; jeopardize more than 20,000 Virginia jobs; and raise taxes on minimum wage workers while giving the richest 0.1% a $188,000 tax cut.

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WASHINGTON –U.S. Sens. Mark Warner (D-VA) and Roger Marshall, M.D. (R-Kansas) today reintroduced the Improving Seniors’ Timely Access to Care Act – bipartisan, zero-cost legislation to improve access to care for seniors enrolled in Medicare Advantage (MA) plans. The bill focuses on streamlining the often cumbersome and time-consuming prior authorization process, ultimately allowing healthcare providers to spend more time on patient care rather than administrative burdens.

This legislation would help physicians better serve and improve care for the 32.8 million Americans.

“Our seniors deserve high-quality care delivered in a timely fashion. I am proud to introduce this legislation that takes commonsense steps to modernize the prior authorization process, cutting through red tape, streamlining approvals, and making sure our health care providers are focused on what really matters — supporting their patients,” Sen. Warner said.

“Prior authorization is the number one administrative burden facing physicians today across all specialties,” Sen. Marshall said. “As a physician, I understand the frustration this arbitrary process is causing health care practices across the country and the headaches it creates for our nurses. With the bipartisan, bicameral Improving Seniors’ Timely Access to Care Act, we will streamline prior authorization and help improve patient outcomes and access to quality care.”

Joining Sens. Warner and Marshall are U.S. Sens. Maggie Hassan (D-NH), John Fetterman (D-PA), Amy Klobuchar (D-MN), Bill Cassidy (R-LA), Shelley Moore Capito (R-WV), John Hickenlooper (D-CO), James Lankford (R-OK), Jeff Merkley (D-OR), Marsha Blackburn (R-TN), Cynthia Lummis (R-WY), Cindy Hyde-Smith (R-MS), Tim Kaine (D-VA), Jeanne Shaheen (D-NH), Mike Rounds (R-SD), Alex Padilla (D-CA), Bill Hagerty (R-TN), Andy Kim (D-NJ), John Boozman (R-AK), Dick Durbin (D-IL), John Cornyn (R-TX), Patty Murray (D-WA), Jerry Moran (R-KS), Kirsten Gillibrand (D-NY), Maria Cantwell (D-WA), Mazie Hirono (D-HI), Thom Tillis (R-NC), Cory Booker (D-NJ), Tina Smith (D-MN), Peter Welch (D-VT), Sheldon Whitehouse (D-RI), Ted Budd (R-NC), Catherine Cortez Masto (D-NV), Tim Sheehy (R-MT), Tammy Baldwin (D-WI), Pete Ricketts (R-NE), Richard Blumenthal (D-CT), Elizabeth Warren (D-MA), Tammy Duckworth (D-IL), John Hoeven (R-ND), Rick Scott (R-FL), Mark Kelly (D-AZ), Jacky Rosen (D-NV), Martin Heinrich (D-NM), Deb Fischer (R-NE) and Chris Coons (D-DE).

“Too often, seniors face unnecessarily complicated and burdensome prior authorization processes that can become a barrier to receiving care,” Sen. Hassan said. “This bipartisan legislation is a commonsense way to support seniors on Medicare Advantage in accessing care, and to help health care providers focus on their patients instead of paperwork.”

“Prior authorization places more importance on process than patients. As a doctor, I want that to change. Let’s make sure seniors are receiving timely care,” Sen. Cassidy said. 

“Too often, seniors have to wait to receive vital care because of administrative burdens like prior authorization. I’m proud to join my colleagues in introducing the Improving Seniors’ Timely Access to Care Act, which will streamline prior authorization and reduce unnecessary health care delays,” Sen. Capito said.

“Seniors across the Cowboy State rely on Medicare, but too often, bureaucratic red tape gets in the way of timely care,” Sen. Lummis said. “I am proud to join my colleagues across the aisle to streamline the prior authorization process and put patients over paperwork.”

“Excessive administrative burdens within the Medicare Advantage program means too many seniors receive delayed benefits, while our health care providers are overwhelmed by paperwork. The current system isn’t working well for anyone, and it’s time we take meaningful action to fix it. This commonsense legislation is a necessary step in the right direction,” Sen. Hyde-Smith said.

“Health care providers handling mountains of paperwork takes up valuable time and can unnecessarily delay older folks’ access to the crucial care they need,” Sen. Kaine said. “I’m proud to champion this bipartisan legislation to modernize and streamline health care processes to ensure that Americans covered by Medicare Advantage can more swiftly access care and empower health care providers to direct more of their time to their patients.”

“Quality, expedited medical care should always be within reach for seniors, and our providers deserve a system that helps them focus on delivering it,” Sen. Boozman said. “I’m pleased to join this bipartisan effort to end the inefficient process that delays Medicare Advantage beneficiaries’ evaluations and treatments while removing an unnecessary, bureaucratic burden on clinicians.”

“Doctors and health care providers are too often bogged down by unnecessary burdens, which can lead to delayed care and negative outcomes for patients,” Sen. Cornyn said. “By streamlining the prior authorization process under Medicare Advantage, this legislation would cut red tape, improve enrollee experiences, and ensure seniors receive the timely care they deserve.

“Improving the prior authorization process will help seniors have quicker access to the health care they need and remove administrative hurdles for physicians,” Sen. Moran said. “This legislation would make commonsense changes to better support thousands of seniors in Kansas and remove the red tape that is costing doctors and patients valuable time.”

“Senior citizens have spent their entire lives contributing to our communities, and they deserve every resource to support their health and well-being,” Sen. Gillibrand said. “The Improving Seniors’ Timely Access to Care Act will help cut through unnecessary red tape and ensure timely medical care is accessible to older Americans. Seniors should have reliable access to specialist care, mental health support, preventative services, and the treatments they need to live with dignity. I am proud to support this important legislation, and I pledge to continue fighting to expand access to quality, affordable, and timely health care for our seniors.” 

“Seniors with Medicare Advantage plans should not have to endure unnecessary delays when seeking medical treatment, and sometimes even life-saving care,” Sen. Hirono said. “This legislation will help to reduce these arbitrary waiting periods, streamlining prior authorization processes to ensure that health care providers can treat and care for their patients in an efficient manner.”

“North Carolina seniors shouldn’t face unnecessary delays when trying to access the care they need through Medicare Advantage,” Sen. Tillis said. “I’m proud to support this bipartisan, commonsense legislation that streamlines the prior authorization process, cuts red tape for providers, and ensures patients get timely access to treatment.”

U.S. Reps John Joyce, M.D. (R-PA-13), Mike Kelly (R-PA-16), Suzan DelBene (D-WA-01), and Ami Bera, M.D. (D-CA-06) introduced companion legislation in the House of Representatives.

This legislation is supported by the Better Medicare Alliance, Humana, and 138 other health care organizations.

“Prior authorization helps keep health care costs low and ensures seniors are getting the most appropriate care. But the process should be easier. The changes put forth in this legislation are long overdue and will help ensure seniors can get the care they need without delay,” Mary Beth Donahue, President and CEO of Better Medicare Alliance, said. “We are proud to support this bill and thank Senators Marshall and Warner, and Representatives Kelly, DelBene, Bera, and Joyce for their leadership. We look forward to continued work on this issue with Congress and the Administration.”

“Humana’s job is to ensure our members have access to high quality, affordable healthcare.  We support efforts in the House and Senate to move the Seniors’ Timely Access to Care Act forward quickly,” Jim Rechtin, Humana CEO, said. “It is a common-sense approach to making healthcare easier by modernizing the prior authorization process.”

Background:

• Prior authorization is a tool used by health plans to reduce unnecessary care by requiring health care providers to get pre-approval for medical services. However, the current system often results in multiple faxes or phone calls by clinicians, which takes precious time away from delivering care.
• Prior authorization continues to be the number-one administrative burden identified by health care providers, and nearly three out of four Medicare Advantage enrollees are subject to unnecessary delays due to the practice.
• The bill would codify and enhance elements of the Advancing Interoperability and Improving Prior Authorization Processes (e-PA) rule that was finalized by the Centers for Medicare & Medicaid Services (CMS) on January 17, 2024.
• Last Congress, the bill was supported by a super majority of members in the Senate (60) and a majority in the House (232), and was unanimously passed by the House in 2022.
• In 2018, the Office of the Inspector General at the U.S. Department of Health and Human Services (HHS) raised concerns after an audit revealed that Medicare Advantage plans ultimately approved 75% of requests that were originally denied.
• In 2022, the HHS Office of Inspector General released a report finding that MA plans incorrectly denied beneficiaries’ access to services even though they met Medicare coverage rules.

The Improving Seniors’ Timely Access to Care Act would:

• Establish an electronic prior authorization process for Medicare Advantage plans, including a standardization for transactions and clinical attachments.
• Increase transparency around Medicare Advantage prior authorization requirements and their use.
• Clarify HHS’ authority to establish timeframes for e-prior authorization requests, including expedited determinations, real-time decisions for routinely approved items and services, and other prior authorization requests.
• Expand beneficiary protections to improve enrollee experiences and outcomes.
• Require HHS and other agencies to report to Congress on program integrity efforts and other ways to further improve the e-prior authorization process.
• Result in a zero cost to American taxpayers.

The full text of the legislation can be found here.

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WASHINGTON – Today, U.S. Sens. Mark R. Warner (D-VA) and Marsha Blackburn (R-TN) introduced the Rural Patient Monitoring (RPM) Access Act to ensure Medicare patients in rural and underserved communities have access to remote physiologic monitoring services, which lower costs and improve access to care by using technology to collect and transmit patient health data to healthcare providers.

“Too often, patients are struggling to receive the medical care they need because of how difficult it is to see a doctor in person,” said Sen. Warner. “Remote monitoring services offer a life-saving solution, expanding care options and allowing individuals to regularly receive the medical consultations they need, all while lowering costs and hospital admissions. I’m proud to introduce the Rural Patient Monitoring Access Act to improve health care services for our seniors.”

“Medicare beneficiaries in rural and underserved areas often face serious barriers to health care, and they deserve better,” said Sen. Blackburn. “The Rural Patient Monitoring Access Act would ensure Tennessee Medicare patients have access to high-quality remote physiologic monitoring services to manage chronic conditions and help patients eliminate unnecessary hospital visits.”

U.S. Reps. David Kustoff (R-Tenn.), Mark Pocan (D-Wisc.), Troy Balderson (R-Ohio), and Don Davis (D-N.C.) introducing companion legislation in the House.

Rural Medicare patients face high rates of chronic conditions like heart failure, hypertension, and diabetes. In particular, Medicare patients living in rural areas have limited access to healthcare because of roadblocks like lack of transportation. Remote Physiologic Monitoring (RPM) helps patients manage chronic conditions and eliminates unnecessary hospital visits. A recent study of over 4,000 hypertension patients found that RPM decreased patients’ total monthly cost of care by more than 50%. Current lack of adequate Medicare reimbursement leads to not implementing RPM programs in rural areas, reducing access to cost-saving and patient-centered care.

Specifically, The Rural Patient Monitoring Access Act would ensure high-quality remote physiological monitoring services are established and maintained for Medicare beneficiaries in rural and underserved geographies; allow rural areas to provide RPM services at the national average rate; and decrease patients’ total monthly cost. Under the RPM Access Act:

• RPM providers must be capable of responding to data anomalies detected by the monitoring service;
• RPM providers must be capable of promptly transmitting captured vitals and treatment management notes to electronic health record of the supervising provider; and
• The Centers for Medicare & Medicaid Services may require providers of RPM to report data to the Secretary of Health and Human Services in order to facilitate the evaluation of cost savings generated to the Medicare program through the proliferation of remote physiologic monitoring services.

This legislation is supported by National Rural Health Association, American Association of Nurse Practitioners, HIMSS, American Telemedicine Association, Alliance for Connected Care, Ascension, LifePoint Health, Marshfield Clinic, SSM Health, the University of Virginia Center for Telehealth, and the Bipartisan Policy Center.

“Technology-enabled care is crucial to ensuring seniors in rural areas are able to safely manage their chronic conditions. Remote physiologic monitoring allows for chronic disease complications to be captured early – saving lives, reducing health care costs, and helping to mitigate common rural barriers such as longer distances to in-person treatment,” said Alan Morgan, CEO of National Rural Health Association.

“On behalf of HIMSS, we applaud Senators Blackburn and Warner, and Representatives Kustoff, Balderson, Pocan, and Davis for introducing the Rural Patient Monitoring (RPM) Access Act. Remote patient monitoring is a critical digital health tool that helps providers and patients work together to improve patient access and outcomes. We urge Congress to take action to advance the safe and effective use of RPM for millions of Medicare beneficiaries,” said Hal Wolf, President and CEO of HIMSS.

“Patients in rural and underserved communities deserve the same opportunity to manage their health as those in more resourced areas. At Lifepoint, we’ve seen firsthand how high-quality remote patient monitoring can help bridge long-standing access gaps and drive meaningful clinical improvement, especially for chronic conditions like hypertension and diabetes. This bill is an important step forward in ensuring fair reimbursement for rural providers, empowering them to deliver high-quality, proactive care to the patients who need it most,” said Dr. Chris Frost, Chief Medical Officer and Chief Quality Officer at Lifepoint Health.

“We are proud to support the Rural Patient Monitoring Access Act, which will help to ensure rural practitioners can provide remote physiologic monitoring services. RPM supports coordinated chronic disease management and acute and chronic disease risk reduction, while improving health outcomes helping patients remain healthy at home,” said Michael Richards, System Vice President at SSM Health.

“The Alliance for Connected Care applauds Senators Blackburn and Warner for their leadership to ensure rural patients have access to high-quality, innovative patient-centered care. Remote patient monitoring has a huge potential to empower rural seniors with technology to better take accountability for their own health,” said Chris Adamec, Executive Director of The Alliance for Connected Care.

“This proposed legislation will incentivize healthcare systems in rural areas to establish remote monitoring programs and ensure sustainability of existing programs. We are grateful for Sen. Warner and Sen. Blackburn’s leadership on this issue. Remote monitoring has been shown to improve outcomes and ultimately lower the cost of care,” said Karen Rheuban, MD, Director of the University of Virginia Center for Telehealth.

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA), joined by U.S. Sens. Tim Kaine (D-VA), John Fetterman (D-PA), and Bernie Sanders (I-VT), wrote to Health and Human Services Secretary Robert F. Kennedy Jr. pushing back on his decision to gut the National Institute of Occupational Safety and Health (NIOSH), firing nearly 900 employees. Recent reporting has indicated that these firings include all employees tasked with protecting the health and safety of coal miners.

“According to reports, HHS is laying off approximately 873 employees, or two-thirds, of the National Institute for Occupational Safety and Health (NIOSH), part of the Centers for Disease Control and Prevention (CDC),” the senators wrote. “According to a notification provided to AFGE Local 1969, whose federal employee members are being impacted, all employees working on mining safety and health in NIOSH’s Spokane, WA and Pittsburgh, PA, offices are being let go. ,  The NIOSH Pittsburgh Mining Research Division focuses on coal miner safety, and the Spokane Mining Research Division specializes in hard rock mining, and are the two main research hubs for NIOSH’s Mining Research Program. Additionally, reports indicate more than 185 NIOSH employees are being laid off from its Morgantown, WV, office, who also work to protect miner health, among other occupational safety and health activities.”

The senators also highlighted the immediate impacts of this move, explaining that mining communities are already being left without key health services.

They continued, “We also have heard from those who work directly with our miner constituents in these communities that the Enhanced Coal Workers’ Health Surveillance Program is also being decimated. This program provides direct screening services via a mobile medical unit to miners at no cost. NIOSH also supports clinic sites where screening is done, so miners can understand if they are developing black lung or another condition and be as healthy as possible for themselves and their families.”

In their letter, the senators demanded answers from Secretary Kennedy, questioning how these crucial services will continue with a significantly reduced workforce. The senators requested a written response to the following:

1.  How many HHS employees who work in offices that work on mining health and safety have been fired, put on administrative leave, accepted the deferred resignation program offer, or accepted the VERA/VSIP offer since January 20, 2025? Provide a complete breakdown by agency and position. For each category of employee at each agency, provide information on GS level and veteran status, and clearly state the justification for termination. Include employees who have since been reinstated or placed on administrative leave, noting that change in status. Please provide the latest data available.
2. How many HHS employees remain who work on mining health and safety? Please provide a complete breakdown by agency and position.
3. How many additional employees who work in offices that work on mining health and safety do you intend to fire following the announcement made on March 27, 2025?
4. Provide all analyses conducted prior to the reorganization and firings of HHS employees who work in offices that focus on mining safety and health to determine the immediate and long-term impact these firings will have on programs and activities that those employees are tasked with administering. In particular, provide all analyses relating to 1) ensuring statutory obligations will be met, and 2) the Coal Workers’ Health Surveillance Program.

A copy of letter is available here and text is below.

Dear Secretary Kennedy:

We write today with alarming concern about reports that nearly the entire workforce that works to improve the health of miners was laid off and the office that oversees this work was eliminated. We urge you to reverse course immediately and ensure the Department of Health and Human Services (HHS) continues its important work in our states to protect and serve our constituents.

According to reports, HHS is laying off approximately 873 employees, or two-thirds, of the National Institute for Occupational Safety and Health (NIOSH), part of the Centers for Disease Control and Prevention (CDC).  According to a notification provided to AFGE Local 1969, whose federal employee members are being impacted, all employees working on mining safety and health in NIOSH’s Spokane, WA and Pittsburgh, PA, offices are being let go. ,  The NIOSH Pittsburgh Mining Research Division focuses on coal miner safety, and the Spokane Mining Research Division specializes in hard rock mining, and are the two main research hubs for NIOSH’s Mining Research Program. Additionally, reports indicate more than 185 NIOSH employees are being laid off from its Morgantown, WV, office, who also work to protect miner health, among other occupational safety and health activities. 

We also have heard from those who work directly with our miner constituents in these communities that the Enhanced Coal Workers’ Health Surveillance Program is also being decimated. This program provides direct screening services via a mobile medical unit to miners at no cost. NIOSH also supports clinic sites where screening is done, so miners can understand if they are developing black lung or another condition and be as healthy as possible for themselves and their families.

Never has there been a more critical time to do this work. A 2023 study conducted jointly by researchers at NIOSH and at the University of Illinois Chicago found that coal miners in central Appalachia—Virginia, West Virginia, and Kentucky—were eight times more likely to die from respiratory diseases like chronic obstructive pulmonary disease (COPD) and black lung than American men who are not miners.  Our constituents are getting more severe disease at younger ages in recent decades, and we might never had known that without the expertise of NIOSH’s work on coal miner health.

We require more than a fact sheet indicating these duties will be reorganized into an Administration for a Healthy America given the extensive cuts to personnel. In order for us to better understand how the same amount of work can be done with hundreds fewer individuals, please provide responses to the following questions by April 9, 2025:

1. How many HHS employees who work in offices that work on mining health and safety have been fired, put on administrative leave, accepted the deferred resignation program offer, or accepted the VERA/VSIP offer since January 20, 2025? Provide a complete breakdown by agency and position. For each category of employee at each agency, provide information on GS level and veteran status, and clearly state the justification for termination. Include employees who have since been reinstated or placed on administrative leave, noting that change in status. Please provide the latest data available.
2. How many HHS employees remain who work on mining health and safety? Please provide a complete breakdown by agency and position.
3. How many additional employees who work in offices that work on mining health and safety do you intend to fire following the announcement made on March 27, 2025?
4. Provide all analyses conducted prior to the reorganization and firings of HHS employees who work in offices that focus on mining safety and health to determine the immediate and long-term impact these firings will have on programs and activities that those employees are tasked with administering. In particular, provide all analyses relating to 1) ensuring statutory obligations will be met, and 2) the Coal Workers’ Health Surveillance Program.

Art Miller, an expert in mine air quality who has been working for NIOSH since 1996 and for its predecessor before this, was part of the Spokane-area firings. He noted that no one else does this kind of research and that “every worker in this country deserves to go home safe.”  We agree, and urge you to reverse these cuts before it’s too late.

Sincerely,

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WASHINGTON – U.S. Sens. Mark R. Warner, a member of the Senate Finance Committee, and Tim Kaine, a member of the Senate Health, Education, Labor and Pensions (HELP) Committee, (both D-VA), joined a bipartisan group of 27 of their Senate colleagues in introducing the Accelerating Kids’ Access to Care Act, legislation that would allow previously-vetted health care providers to enroll as participating providers in Medicaid programs across state lines to treat children with complex medical needs.

“Specialized care is crucial when treating complex medical issues, especially for children, but too often bureaucratic red tape interferes in treatment for patients with out-of-state Medicaid coverage,” said Sen. Warner. “I’m proud to introduce this bipartisan legislation that will eliminate redundancies for health care professionals and ensure that kids are getting the care they need, when they need it.”

“Ensuring that sick kids have access to the specialized care they need is critical,” said Sen. Kaine. “This bill will allow health care providers who have already demonstrated quality care to avoid redundant screening processes and care for children who have out-of-state Medicaid coverage. I am proud to be joining a bipartisan group of colleagues in introducing this important legislation to reduce delays in kids’ access to care.”

Under the Accelerating Kids’ Access to Care Act, state Medicaid programs would be required to create a process for qualifying out-of-state providers to enroll as providers in multiple states to treat children with complex medical conditions. To qualify for this accelerated process, a health care provider must have previously been screened by Medicare or by the state Medicaid program, as well as pose a limited risk of fraud or waste as determined by the state Medicaid program or federal Centers for Medicare & Medicaid Services.

Sens. Warner and Kaine have long supported efforts to improve health care access for children. In 2014, the senators introduced the Gabriella Miller Kids First Research Act, which established crucial federal funding for pediatric cancer research. Sens. Warner and Kaine introduced legislation to reauthorize this funding in 2021, ultimately securing its reauthorization in the Senate by a unanimous vote in December 2024 in the final hours of the 118th Congress.

A link to the text of the bill can be found here.

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WASHINGTON – Today, U.S. Sens. Mark R. Warner (D-VA) and John Boozman (R-AR) introduced legislation to renew and expand the Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program, a Department of Veterans Affairs (VA)-administered program that provides essential funding for mental health outreach in veteran communities. The Fox Grant Program was created through a Warner- and Boozman-led bill, passed as part of the broader Commander John Scott Hannon Veterans Mental Health Care Improvement Act, and it has distributed millions in grants to community and veteran service organizations (VSOs), as well as mental health providers across the country. Without further intervention, the program is scheduled to sunset later this year.

“Veterans put an enormous amount on the line to serve our nation, and we owe them the best benefits available when they come home – including robust mental health resources,” said Sen. Warner. “For the past several years, the Staff Sergeant Fox Grant Program has played an invaluable role getting organizations already doing life-saving mental health outreach more support, including many incredible organizations in Virginia. We cannot back down on our commitment to preventing suicide in veteran communities – it’s time for us to extend and expand this essential grant program.”

“Veterans who struggle with mental health have responded well to support provided by those they know and trust,” said Sen. Boozman. “When our former servicemembers have access to assistance within their own communities, from organizations with demonstrated ability to build strong relationships and foster hope, they are less likely to take their own lives. Reauthorizing funding for this life-saving initiative is part of the commitment we made to fulfilling what was promised to our veterans struggling to carry the invisible weight of their mental and physical sacrifice.”

Suicide is the 12^th-leading cause of death for veterans, and the 2^nd-leading cause for veterans under 45. Over 131,000 veterans have died by suicide since 2001, withveterans being 72% more likely than the civilian population to die by suicide. Since its original passage, the Fox Grant Program has worked to end this crisis by distributing hundreds of millions in funding to organizations that provide critical, frontline mental health services to veterans. In 2024 alone, Virginia organizations received $4.5 million from these grants. The program honors Veteran Parker Gordon Fox, a veteran and former sniper instructor at the U.S. Army Infantry School at Ft. Benning, GA. SSG Fox died by suicide on July 21, 2020 at the age of 25.

Specifically, this reauthorization of the Fox Grant Program would:

• Reauthorize the Fox Grant Program until Sept. 30, 2028.
• Increase the total authorized funding for the grant program from $174 million to $285 million.
• Expand the maximum potential award from $750,000 to $1.25 million.
• Direct the VA to collect additional measures and metrics on performance to better serve veterans.
• Require annual briefings for VA medical personnel to improve awareness of the program, and coordination with providers.

The legislation has strong support from Veterans of Foreign Wars and Blue Star Families.

“The Veterans of Foreign Wars (VFW) strongly supports the bipartisan legislation introduced by Senators Warner and Boozman to reauthorize and expand the Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program,” said Joy Craig, Associate Director of Service Member Affairs with the VFW’s National Legislative Service. “Veteran suicide remains a national crisis, and increasing the maximum grant amount while improving oversight and coordination will help ensure life-saving resources reach those in need. The VFW has long advocated for community-based solutions, and this legislation strengthens critical partnerships between the VA and local organizations working to prevent suicide. We urge Congress to swiftly pass this bill and reaffirm its commitment to those who have sacrificed for our nation.” 

"The SSG Fox Suicide Prevention Grant Program is a lifeline for Veterans and military families facing the invisible wounds of service,” said Kathy Roth-Douquet, CEO, Blue Star Families. “Blue Star Families has seen firsthand the impact of these critical resources—support that saves lives and strengthens communities. This program ensures that Veterans and their loved ones get the help they need before a crisis turns tragic. We are proud to support its reauthorization and urge Congress to continue investing in solutions that honor the service and sacrifice of those who’ve given so much for our country."   

Full text of the legislation can be found here.

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WASHINGTON – Today, U.S. Sens. Mark R Warner and Tim Kaine (both D-VA) led 20 of their colleagues in writing a letter to U.S. Department of Health and Human Services Acting Secretary Dorothy A. Fink, M.D. regarding reports that Health Resources and Services Administration (HRSA) grantees, including community health centers, are experiencing significant delays in accessing funding. The senators also expressed concerns about restrictions on regular communications between HRSA and grantees. These issues come after an Office of Management and Budget (OMB) memo that suspended all federal grant and loan funding. The memo has since been rescinded following pressure from the senators, other Democrats in Congress, and the public, but many grantees that rely on federal funding are still experiencing confusion and uncertainty, and have received little to no guidance from the Trump Administration about their funding.

There are 31 Federally Qualified Health Centers with over 200 locations—a majority of which serve rural areas with limited access to medical care—in Virginia. Due to the funding freeze, several centers within the Capital Area Health Network closed earlier this week. Kaine and Warner met with Virginia community health centers earlier this week.

“We are writing to express serious concerns regarding reports that Health Resources and Services Administration (HRSA) grantees, such as Community Health Centers (health centers), continue to experience significant delays in accessing funding to support services, as well as restrictions on regular communications with agency staff as a result of the Trump Administration’s January 20, 2025 executive orders to pause external communication from federal agencies, and subsequent memorandum directing all federal departments and agencies to freeze all financial assistance.” wrote the members.

The members continued, “While nearly 70 percent of health center revenue comes from payments from Medicaid, Medicare, commercial insurance, and self-pay patients, health centers rely on their regular federal grant funding to meet payroll obligations and keep their doors open. Beginning in late January, health centers started reporting issues accessing the Payment Management System (PMS) – getting “locked out”, being denied funding they had been awarded, and experiencing long delays in funding being released. As a result, health centers across the country are experiencing panic, unsure how to pay their staff and keep their doors open.”

“Despite a judge’s order blocking the funding freeze, we are troubled by reports that health centers are unable to access funding duly appropriated by Congress through the PMS. To compound this issue, our offices have heard troubling reports that since the Trump Administration’s executive orders and funding freeze, funding that has already been appropriated and directed by Congress is still being restricted, and standing webinars, briefings, and meetings are being cancelled at the last minute,” they wrote. “Health centers are receiving little communication regarding these cancellations and changes, and the communication they have received from HRSA has been unclear, directing actions that may conflict with current court orders.”

“Two-thirds of Virginia’s community health centers are located in the rural areas of our Commonwealth,” said Tracy Douglas, CEO of the Virginia Community Healthcare Association. “For countless hardworking individuals and families in these regions, these health centers are not just a place for medical care—they are a lifeline. People rely on them to stay healthy so they can work, care for their families, and live full, productive lives. It is absolutely imperative that we ensure the continued operation of these vital health centers to protect the well-being of our communities and our nation.”

In addition to Kaine and Warner, the letter is signed by U.S. Senators Richard Blumenthal (D-CT), Lisa Blunt Rochester (D-DE), Chris Coons (D-CT), John Hickenlooper (D-CO), Angus King (I-ME), Ben Ray Luján (D-NM), Jeff Merkley (D-OR), Jack Reed (D-RI), Bernie Sanders (I-VT), Rev. Raphael Warnock (D-GA), Elizabeth Warren (D-MA), Peter Welch (D-VT), and Ron Wyden (D-OR). The letter is also signed by U.S. Representatives Bobby Scott (D-VA-02), Gerry Connolly (D-VA-11), Don Beyer (D-VA-08), Jennifer McClellan (D-VA-04), Eugene Vindman (D-VA-07), Suhas Subramanyam (D-VA-10), and Sarah McBride (D-DE-At-Large).

The full text of the letter is available here and below.

Dear Acting Secretary Fink,

We are writing to express serious concerns regarding reports that Health Resources and Services Administration (HRSA) grantees, such as Community Health Centers (health centers), continue to experience significant delays in accessing funding to support services, as well as restrictions on regular communications with agency staff as a result of the Trump Administration’s January 20, 2025 executive orders to pause external communication from federal agencies, and subsequent memorandum directing all federal departments and agencies to freeze all financial assistance.

Community Health Centers provide high-quality primary and preventive care, dental care, behavioral health and substance use disorder services, and low-cost prescription drugs to more than 32 million Americans annually, serving one in five rural Americans and one in three people living in poverty. Nationally, more than 1,400 health centers operate over 15,000 service sites across every state and Territory, employing more than 500,000 individuals and generating nearly $85 billion in economic output.

Despite the critical role health centers play in addressing health inequities, many centers struggle to keep up with the growing demand for services and rising costs to deliver high-quality care in their communities. While nearly 70 percent of health center revenue comes from payments from Medicaid, Medicare, commercial insurance, and self-pay patients, health centers rely on their regular federal grant funding to meet payroll obligations and keep their doors open. Beginning in late January, health centers started reporting issues accessing the Payment Management System (PMS) – getting “locked out”, being denied funding they had been awarded, and experiencing long delays in funding being released. As a result, health centers across the country are experiencing panic, unsure how to pay their staff and keep their doors open. Due to delays in funding, health centers have reported:

• “We have put off signing a contract to replace our mammography machine, which has reached end of life, because of this freeze and the uncertainty.”
• “I'm also now getting providers asking if they should be looking for a new job. Without any understanding and guidance, I'm pretty limited with how much I can actually assure them to do other than tighten our belts…”
• “Any services that are directly funded by federal funds will be placed on hold…”
• “We had to use all reserves in 2024. We will not make payroll or any other payments next week without access to this federal funding. Staff will be dismissed without access to federal funds.”
• “If everything stays the same…the best guess is that we could be fully operational for six months.”
• “We have the ability to sustain current or full operations for 60 days…Outreach and case management staff…would be in the first wave of layoffs. Unfortunately, those positions rely on federal support as they are typically not reimbursable through third-party payors. In a short period of time, this has had a profound impact on our staff. [Staff are] concerned that we will lose valuable staff members as they are concerned about the stability of the organization.”
• “We will step back on hiring and likely implement hiring pause unless this is resolved quickly.”
• “We have enough in reserve to cover two payroll periods.”
• “The pause in grant funding would create a deficit for us...We would likely need to start reducing staff and healthcare services to the…patients we serve…within the next couple of weeks if the freeze persists.”

As safety net providers operating on razor-thin margins, health centers need certainty to provide care in underserved communities. In Virginia alone, ongoing delays in accessing funding have caused health centers to close their doors and cancel patient appointments. When health centers close, people with chronic conditions miss appointments, pregnant women miss prenatal visits, and behavioral health services are interrupted, worsening outcomes and increasing costs to the entire health care system.

Despite a judge’s order blocking the funding freeze, we are troubled by reports that health centers are unable to access funding duly appropriated by Congress through the PMS. To compound this issue, our offices have heard troubling reports that since the Trump Administration’s executive orders and funding freeze, funding that has already been appropriated and directed by Congress is still being restricted, and standing webinars, briefings, and meetings are being cancelled at the last minute. Health centers are receiving little communication regarding these cancellations and changes, and the communication they have received from HRSA has been unclear, directing actions that may conflict with current court orders.

We request that you provide answers to the following questions in writing no later than Wednesday, February 12, 2025.

1. How many health centers have draw-down requests pending in the PMS?
1. How has that number changed, daily, since January 27, 2025?
2. What is the average wait time from submission of a draw-down request to disbursement of funds prior to January 27, 2025 and after January 27, 2025?
2. How many health center draw-down requests have been denied since January 27, 2025?
1. What is the rationale for these denials?
3. What is the exact timeline for ensuring the PMS is fully operational and disbursing all pending health center draw-down requests?
4. What specific authority and under which executive action did HRSA or the Department of Health and Human Services use to restrict health center access to the PMS and funding that they had been previously awarded?
5. Please provide a list of regular standing calls or meetings between HRSA staff and HRSA grantees that have been cancelled since January 20, 2025. Please include the following:
1. A description of the grantees impacted, including the type of grantees and number of grantees.
2. Whether funds appropriated by Congress for the purpose of the grant are being withheld from being awarded to the grantees.
6. Please provide a list of webinars, briefings, information sessions, and trainings that have been cancelled since January 20, 2025. Please include the following:
1. A description of the purpose of each webinar, briefing, information session, or training.
2. Whether or not the webinar, briefing, information session, or training is required by statute and if so, provide the corresponding citation.

Sincerely,

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WASHINGTON — Today, U.S. Sens. Mark R. Warner, a member of the Senate Finance Committee, and Tim Kaine, a member of the Senate Health, Education, Labor and Pensions Committee, (both D-VA) joined a group of Senate colleagues in reintroducing the Health Care Affordability Act, legislation to lower health care costs for millions of Americans and make permanent the current enhanced premium tax credits (PTCs) for Health Insurance Marketplace coverage. The PTCs were created in the Affordable Care Act and previously enhanced under the American Rescue Plan Act and the Inflation Reduction Act but are set to expire at the end of this year, increasing health insurance costs for over 20 million Americans. The Health Care Affordability Act would make the enhanced PTCs permanent, ensuring that these Americans don’t face sudden cost increases or leave almost 3.8 million Americans each year without coverage at all. Without this extension, out-of-pocket premium payments across the Commonwealth are projected to increase as much as 33%, according to the Virginia State Corporation Commission.

“For years, the ACA premium tax credits have lowered health care costs and increased access to insurance for Virginians and their families,” said the senators. “And through the American Rescue Plan Act and the Inflation Reduction Act, we further lowered costs for American families. But without action, these enhanced tax credits will expire. We are proud to introduce this legislation that will ensure more than 20 million Americans don’t face unfair cost increases at the end of the year.”

Sens. Warner and Kaine have long fought to lower health care costs and increase accessibility for all Americans.

In addition to Sens. Warner and Kaine, the bill is sponsored by U.S. Sens. Jeanne Shaheen (D-NH), Tammy Baldwin (D-WI), Chuck Schumer (D-NY), Ron Wyden (D-OR), Richard Blumenthal (D-CT), Angus King (I-ME), Maggie Hassan (D-NH), Peter Welch (D-VT), Chris Coons (D-DE), Elizabeth Warren (D-MA), Dick Durbin (D-IL), Patty Murray (D-WA), Raphael Warnock (D-GA), Kirsten Gillibrand (D-NY), Jack Reed (D-RI), Tammy Duckworth (D-IL), Chris Van Hollen (D-MD), Catherine Cortez Masto (D-NV), Brian Schatz (D-HI), Alex Padilla (D-CA), Tina Smith (D-MN), Amy Klobuchar (D-MN), Jacky Rosen (D-NV), Mark Kelly (D-AZ), Cory Booker (D-NJ), Sheldon Whitehouse (D-RI), Jeff Merkley (D-OR), Adam Schiff (D-CA), Ed Markey (D-MA), Ben Ray Luján (D-NM), Mazie Hirono (D-HI), Michael Bennet (D-CO), John Hickenlooper (D-CO), Gary Peters (D-MI), John Fetterman (D-PA), Martin Heinrich (D-NM), Andy Kim (D-NJ) and Elissa Slotkin (D-MI).

In the House of Representatives, the legislation is sponsored by U.S. Rep. Lauren Underwood (D-IL-14).

Full text of the bill is available here.

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WASHINGTON –  Today, U.S. Sens. Mark R. Warner and Tim Kaine, a former fair housing lawyer, (both D-VA) announced $1,450,000 in federal funding to address lead-based paint hazards in homes across Virginia. Many older homes still have lead-based paint on walls, which is dangerous when it peels and chips. Young children are most susceptible to lead poisoning and can face long-term developmental delays if exposed. The funding is part of the U.S. Department of Housing and Urban Development’s (HUD) Lead Hazard Reduction Grant Program, which provides federal funding to identify and control lead-based paint hazards in eligible homes.

“Lead poisoning can pose long-term health issues for those exposed,” the senators said. “This funding will help to protect Virginians from lead-based hazards and help ensure they have safe housing.”

The funding is broken down as follows:

• $750,000 for the City of Roanoke.
• $700,000 for the Commonwealth of Virginia. This funding will be distributed across Virginia by the Virginia Department of Housing and Community Development’s Lead Hazard Reduction Program.

Sens. Warner and Kaine have long advocated for safe, affordable housing for Virginia families. This funding builds on the $11.6 million in federal funding the senators announced in October to address this issue. Earlier this year, the senators announced over $98 million in federal funding for affordable housing, community development, and homelessness assistance and over $55 million in federal funding for improvements to affordable housing across the Commonwealth. 

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