Health Care Coverage
With the Patient Protection and Affordable Care Act signed into law by President Obama, more than a half million Nevadans are now a step closer to quality, affordable health care. Tens of thousands of Nevada small businesses are a step closer to getting critical relief to support health care for their employees.  More than 200,000 Nevada seniors are a step closer to a stronger Medicare program that puts money back in their pockets instead of padding insurer profits.  This story can be told all over America, and it represents the real impact of health reform. 

This historic legislation will help families that can’t afford insurance, individuals facing discrimination for pre-existing conditions and small businesses that have been unable to offer health benefits to their employees. It will provide consumers with more protection and more choice, and ensure that medical decisions are made by patients and doctors, not insurance companies.  In addition, this legislation combined with the Health Care and Education Reconciliation Act will also reduce the federal deficit by $143 billion in the first ten years it is law.

I was proud to lead the passage of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act.  For more information on how health insurance reform will benefit Nevada, please click here.

Children’s Health Insurance Program (Nevada Check Up)
The time to chart a new course for the nation’s health care system is upon us.  Since the beginning of the 111th Congress, we have made great strides towards significant health care reform, and have already reauthorized and improved the successful Children’s Health Insurance Program, known as Nevada Check Up.

I am pleased to report the Children’s Health Insurance Program Reauthorization Act was signed by President Obama on February 4th, 2009 (P.L. 111-3).  This long overdue reauthorization ensures health care for thousands of children across Nevada whose parents earn too much for Medicaid, but not enough to afford private insurance.  Thanks to the recent expansion, an additional 4.1 million low-income children across the country will now have access to quality health coverage.  

Medicare
Seniors and people with disabilities know the value of the Medicare program, which is why I am proud the health care reform legislation we passed in Congress will strengthen and extend Medicare's solvency.  For more information on how health insurance reform with benefit Nevada's seniors and the Medicare program, please click here.

In the last Congress, I led the way to overriding a Presidential veto of improvements to the program.  This legislation ensured that physicians did not experience severe cuts to reimbursement that could have jeopardized access to care for Nevada’s seniors.  I was also successful in including a provision to assure mental health parity in the program.  This key package also included improvements to preventive care for beneficiaries, continued access to therapy services, and other key program and provider provisions.  In the next Congress, I will continue to fight for stronger benefits, fair reimbursement to providers, improvements to the drug program, and the wise use of taxpayer and beneficiary resources.

Small Businesses
Although every sector of our economy is affected by the high cost of health care, small businesses often suffer from these costs more acutely. Many employers have been forced to pass additional health care costs onto their workers, and others have had to cut health care benefits altogether. I am committed to finding solutions that will work for both small employers and their employees while maintaining important consumer protections. As we proceed with reforming our health care system, I am continuing to pursue solutions in the 110th Congress that will address the needs of Nevada's small employers.

Medicaid
The Medicaid program provides access to necessary, affordable, and quality medical care to 160,000 Nevadans. Despite its vital role in our health care system, Medicaid's future has been repeatedly threatened by proposals to severely cut its federal funding and to impose changes that would undermine the program's mission. I fought to protect Medicaid against these spending cuts in previous years, and was successful in blocking several administrative efforts to cut funding to Nevada’s program and providers.  I will continue to fight for this important program and the seniors, children, and people with disabilities that it serves.

End Insurance Discrimination Against Women
Women of reproductive age pay 68 percent more in out-of-pocket medical expenses than men, largely due to their reproductive health-care needs. Legislation that I have long supported, the Equity in Prescription and Contraception Coverage Act, would require private insurance plans that provide coverage for prescription drugs to provide the same coverage for prescription contraceptives.

This legislation to ensure equity and fairness in contraception coverage is also a critical component of the Prevention First Act (S. 21). The Prevention First Act will improve women's health, increase Nevadans' access to family planning services, and reduce the number of unintended pregnancies -- all while saving scarce public health dollars.

Increase Access to Mental Health Care
Mental illnesses are just as real as physical illnesses and deserve to be treated as such. That is why the enactment of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 is an important victory for all those who are affected by mental illnesses. This legislation is the culmination of many years of work to build on and strengthen the 1996 mental health parity act. It will ensure that plans covering mental health services cannot provide different financial requirements or treatment limitations than they would for medical or surgical benefits When this law is fully implemented, 113 million people across the country will have the right to non-discriminatory mental health coverage, including the 800,000 individuals in Nevada who are enrolled in self-funded plans and cannot be assisted by our State parity law. .

Prescription Drug Safety
In September 2007, I worked to enact the Food and Drug Administration Revitalization Act (Public Law 110-85), which extends the legal authority for the Food and Drug Administration (FDA) programs for approving prescription drugs and medical devices. While this new law will improve prescription drug and food safety for all Americans, it also will improve programs focused just on our children. These improvements represent a victory for consumers and patients who depend on our nation's system for ensuring that life-saving drugs and devices come to market in a timely and safe way.  

Protecting Americans from Genetic Discrimination
I supported legislation, which is now law (PL 110-28), that will establish strong protections against discrimination based on genetic information in health insurance and employment.  As a result, patients can receive the best possible medical treatments without having to fear that genetic information will be used against them by their insurers or by their employers.  This law will also allow researchers to pursue the promise of genetic research by ensuring the confidentiality of genetic information by participants in clinical trials.  It will enable all Americans to take full advantage of potentially life-saving genetic testing, and will pave the way for full realization of the promise of personalized medicine.

Strengthen our Health Care Safety Net
I supported legislation, which is now law, that reauthorizes and strengthens three important programs:  the Community Health Centers program, the National Health Service Corps, and the Rural Health Care Programs.  These programs provide a safety net that provides millions of Americans, including over 70,000 Nevadans, access to critical health care services each year.

Improving Access to Cancer Screenings
I supported legislation that was recently enacted (P.L. 110-18) which increases funding for the program to subsidize mammography exams, pap tests, and other screening exams.  The law will allow states to spend grant money on outreach programs to underserved women who may not otherwise know about the program.

FMAP increase
Over the past year, the United States has experienced an unparalleled economic crisis, and I understand what a devastating impact the economic downturn has had on Nevada.  To compound these problems, several states, including Nevada, saw significant budgetary shortfalls, which have unfortunately resulted in dangerously drastic funding cuts to health insurance coverage and treatment programs.

To offset these budget cuts, I am pleased that at the federal level, we have worked very hard to increase temporarily the federal medical assistance percentage (FMAP) as included in the American Recovery and Reinvestment Act of 2009 (P.L. 111-5).  The goal was to enable states to maintain their Medicaid services, and I am pleased that we were able to provide an increase to every state while also targeting additional funds to the states most in need like ours.  Nevada will receive more than $450 million in additional funding as a result, which is the largest percentage increase of any state in the Federal Medical Assistance Program.  It is my continued hope that the FMAP increase will provide funding for our state to revisit planned cuts to programs that Nevadans need most. 

Health Care Reform
In America today, concerns about health care are rightly at the forefront of the national consciousness.  Many Nevadans are far too familiar with the hardships caused by rising costs,  inadequate or lack of coverage. 

Amid this health care crisis, I believe that there is a great opportunity for Congress, the Obama Administration, the private sector, and other stakeholders, to work together to come up with a solution.  We should protect what works, and improve what doesn’t.  If you like what you have, you should be able to keep it.  The solution we develop should ensure quality, affordable health care coverage for all Americans, regardless of their age, income, employment, or health status.  I want to increase choices for consumers and make sure that no one comes between patients and their doctors.

 I am pleased that we have already made significant improvements to our healthcare system.  For example, in February we passed an expansion and extension of the vital Children’s Health Insurance Program (P.L. 111-3).  This legislation will expand coverage to an additional 4.1 million low-income children across our country. I am also pleased that as a result of the American Recovery and Reinvestment Act of 2009 (P.L. 111-5), billions of dollars have been allocated for health information technology, research and development, and prevention and wellness programs.  In addition, the federal matching payments for state Medicaid programs have been increased, and a temporary subsidy for COBRA premiums has been implemented to help ease the burden for hard working families affected by the economic crisis. 

I sincerely appreciate all of the ideas and personal stories that I have received from Nevadans regarding our troubled health care system.  I welcome any feedback or information you may wish to share about your experiences while Congress addresses health care.

Cobra
I am deeply concerned about Nevada’s economy, and I know that increased medical costs and expensive insurance plans can place a great deal of stress on a family.  Coupled with a recent job loss, loss of insurance and unexpected medical expenses can send a family’s financial future spiraling out of control.  The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires most employers with group health plans to offer employees the opportunity to continue their coverage under their employer’s plan if their coverage is cut off or suspended due to a layoff, or other qualifying change in their employment status.  I know that many Nevadans who have recently become unemployed are troubled by the steeply rising premiums for their COBRA insurance coverage.  That is why I am pleased that a premium subsidy for COBRA recipients was included in the ARRA of 2009.

This provision creates a 65% subsidy for health insurance premiums under COBRA for up to nine months for workers and their families who have been involuntarily terminated between September 1st, 2009 and December 31st, 2009.  However, individuals who have access to group health insurance, are eligible for Medicare, or whose yearly individual income exceeds $125,000, or couples who’s income exceeds $250,000, are not eligible for the subsidy.  If you have questions regarding your COBRA subsidy, concerns with your eligibility, or would like to file an appeal, you may contact the United States Department of Labor to speak to a benefits advisor: Toll-free #:1-866-444-3272  www.dol.gov/cobra