Ensuring that everyone can see a doctor when they need one is one of the most serious challenges facing our state and our country. Senator Murray believes it is critical that as we work to expand access and push for affordability, that we also maintain quality, cultivate innovation, and ensure that safety standards are met. As a member of the Health, Education, Labor, and Pensions (HELP) Committee, Senator Murray has focused on these priorities and pushed for legislation and funding that will improve access to quality health care, particularly for children and residents of rural and underserved areas.
Children’s Health Insurance Program
Senator Murray believes that no child should be forced to go without health care because their parents cannot afford insurance. That is why she has been and continues to be a strong supporter of the Children’s Health Insurance Program, which helps ensure families can afford to go to the doctor. Senator Murray was an original cosponsor of the legislation enacted in 1997. And in 2007, Senator Murray supported and pushed repeatedly for passage when the bill was up for renewal, or reauthorization. In 2009, after multiple attempts, Senator Murray helped pass a renewed CHIP bill. This bill extends health insurance coverage to almost 10 million children – up from the 6 million children currently covered.
Expanding Health Care Access in Underserved Regions
Too many Washingtonians lack access to a regular doctor, either because they do not have insurance or because of a shortage of adequate health care providers. Senator Murray has worked hard to help make health care more accessible. As a member of both the Budget and Appropriations committees, for example, she has continually fought for increased funding for the Community Health Centers and National Health Service Corps, which help increase health care access to medically underserved populations.
Other examples of Senator Murray’s work to increase access include:
- The Community Coalitions for Access and Quality Improvement Act of 2007 – Senator Murray introduced this bill to create a national network of local community health care access coalitions to help ensure all residents of a geographic area can get a broad range of coordinated, high-quality health care services without having to rely on the Emergency Room. This legislation was included in the health care reform law, the Affordable Care Act.
- Health Care Safety Net Act – In 2007, Senator Murray cosponsored and helped pass the Health Care Safety Net Act. The bill reauthorizes the Community Health Centers, which work to increase health care access to medically underserved populations.
- Health Care Safety Net Authorization Act – In 2002, Senator Murray helped draft and pass this bill, which provided a comprehensive plan to expand telehealth, in part by establishing Centers of Excellence to help providers expand the use of cameras, computers, and high-speed Internet to connect doctors with patients who are miles away.
Lack of Insurance
Studies estimate that as many as one in 11 Washingtonians does not have health insurance, and around the country, the number of uninsured continues to rise. Without health insurance, access to health care services is almost impossible. Senator Murray has worked to address this issue by introducing and supporting legislation and funding for programs, including:
- The Affordable Care Act—Health care reform will ensure that Americans have access to quality, affordable health care. Those who are not offered insurance by their employer, or that coverage is unaffordable, will be able to purchase insurance through a new market place called the Exchange. In addition, those individuals may be eligible to receive premium tax credits and cost-sharing assistance to purchase this coverage through the Exchange. - More
- Children’s Health Insurance – The so-called CHIP renewal, or reauthorization, would help ensure millions more families can afford to go to the doctor. Senator Murray was an original cosponsor of the legislation enacted in 1997. And in 2007, Senator Murray supported and pushed repeatedly for reauthorization. The reauthorization would have extended coverage from the 6 million children currently covered to almost 10 million children.
- Trauma Care – In 2007, Senator Murray introduced the National Trauma Center Stabilization Act, to provide federal grants for trauma care centers across the nation. Nationally, many trauma centers are struggling and even closing their doors because of the increased costs of providing health care and uncompensated charity care. This bill would protect trauma centers and reauthorize, strengthen, and modernize the Trauma Center Grant Program. This legislation was included in the health care reform law, the Affordable Care Act.
- Community and Migrant Health Centers – Senator Murray has been a strong supporter of Community and Migrant Health Centers which provide preventive and primary health care services in underserved communities. Senator Murray worked to reauthorize the program as well as provide additional funding.
- Community Health Centers and the Community Health Access Program – Senator Murray believes that both of these programs are vital to communities because they provide a health care safety net for the most vulnerable members of our society, and she has long fought for more federal investment.
- Medicaid – As a member of the Senate HELP Committee and the Labor Health and Human Services Appropriations subcommittee, Senator Murray has worked to increase the Federal Medicaid match and secure increased Medicaid funds for Washington state. Senator Murray was also supportive of expanding Medicaid access through the health care reform law, the Affordable Care Act.
- Preventive Care and Childhood Immunizations – Senator Murray believes preventive care should be a critical part of the health care system. Yet uninsured and underinsured families often do not have the ability to take proactive steps to help their kids stay healthy. Senator Murray believes federal health care programs should emphasize preventive care for all people – particularly children. That’s why she was an original cosponsor of the Children’s Health Insurance Program in 1997 and strongly supported its reauthorization in 2007 and its expansion in 2009, and it is why Senator Murray has worked hard to support childhood immunization programs.
Shortage of Nurses and Other Health Professionals
America currently faces a critical shortage of nurses and other health care professionals, and the problem is only expected to get more severe as the population ages. The shortage is increasing the burden on an already strained health care system. Senator Murray believes affordable health care will not be possible unless we ensure people have doctors, nurses, and other health care professionals to provide it. Addressing this serious problem has been one of her priorities as a member of the Senate HELP, Budget, and Appropriations committees.
In an effort to understand the scope of the problem in Washington state, and to get ideas for how the federal government can be a better partner, Senator Murray has held a number of roundtables throughout the state to discuss the causes and impacts of the health care worker shortage and what can be done about it. Senator Murray has also secured funding for multiple demonstration projects in Washington state to survey 20,000 Washington nurses about retention issues. And she have worked on a number of bills to help address this issue, such as:
- The Affordable Care Act – Senator Murray believes that as we work to ensure quality, affordable health care coverage for all Americans, we must make sure there are enough qualified professionals to provide that care. That is why Senator Murray was honored to write a strong workforce title in the Health, Education, Labor, and Pensions Committee health care reform bill, which was the basis of the workforce section in the final law. This Title boosts the economy with investment in the training, recruitment and retention of health care workers – creating jobs and ensuring care to keep the larger American workforce healthy and productive. - More
- Health Care Safety Net Act of 2007 – Senator Murray was an original co-sponsor of this bill to reauthorize the National Health Service Corps programs, which help increase health care access to medically underserved populations.
- Allied Health Reinvestment Act – Allied health professions are clinical health care professionals who are distinct from medicine and nursing, such as medical assistants, occupational and physical therapists, and pharmacists. Senator Murray was an original cosponsor of this bill, which would take a number of steps to promote and support allied health professions.
- Nurse Reinvestment Act – Signed into law in 2002, this law provides increased scholarships, faculty improvements, and the best practices to retain nurses.
- National Nurse Service Corps – Senator Murray has been a longtime supporter of this program, which provides scholarships and loans to nursing students as well as grants to boost nurse retention.
- National Health Service Corps – Like the Nurse Service Corps, Senator Murray has been proud to support the Health Service Corps, which helps place medical professionals in areas where they are needed most. Additionally, the Corps’ “Scholars Program” identifies and sponsors future health care providers.
- Title VII and VIII Health Professions – As a member of both the Budget and Appropriations committees, Senator Murray has worked hard to secure funding for Title VII and VIII Health Professions. This funding supports the training of nurses and other primary care medical personnel, and it helps encourage health professionals to practice in medically underserved areas.
- Children’s Hospitals Graduate Medical Education Program – As a member of the Appropriations Committee, I am proud to continue to help secure funding for this program, which supports the training of pediatric and other residents in graduate medical education programs.
Lack of Access – Fewer Doctors Accepting Medicare
Over the past few years, many physicians in Washington state have made the difficult decision to reassess whether they will treat Medicare patients. Some have decided to turn away new Medicare patients, while others have dropped Medicare patients altogether. Their decisions are due, in large part, to the amount they are reimbursed by the federal government for treating Medicare recipients. Medicare law specifies a formula for calculating the annual update in payments for physicians’ services, and beginning in 2002, the updates actually resulted in payment cuts.
In Washington state, Medicare reimbursement rates currently penalize patients and providers. The reimbursement system is based on an outdated reimbursement scale generated from cost of living, patient utilization, and health care costs among states. Washington has a tradition of efficient health care and healthy seniors, therefore health care costs are much lower in Washington than in other states. As a result, doctors and providers are reimbursed at a dramatically lower rate, and many Medicare providers have moved to states with higher reimbursement rates.
Senator Murray believes there needs to be a change in the way physicians are paid or physicians and Medicare beneficiaries across the country will continue to be adversely impacted. In the Senate, Senator Murray continues to be a strong advocate for our doctors by fighting against Medicare physician payment cuts.
Access to mental health care is as important as access to physical health care. Yet the current health care system has not recognized that fact. Too many Americans have sought mental health care, only to be burdened by high deductibles and co-payments. In the Senate, Senator Murray has fought to ensure more Americans can get access to mental health care. For example, she supported and worked to strengthen the Mental Health Parity Act, which became law in 2008. This important new law sets a federal standard that will make mental health care coverage more equitable, accessible, and affordable. In addition, Senator Murray supported and helped pass the Medicare Improvements for Patients and Providers Act of 2008, which lowers co-payments for seniors’ mental health services.
Access to health care is a problem in many rural communities, either because there aren’t enough doctors or because appropriate care isn’t available nearby. As a Senator from a large, rural state, one of Senator Murray’s goals has been to improve health care in rural communities by both expanding access and improving the quality of care. Her work includes:
- The Affordable Care Act— The health care reform law will lower health care costs and offer greater health care choices for rural Americans. - More
- Craig Thomas Rural Hospital and Provider Equity Act of 2007 – Senator Murray was an original cosponsor on this bill to create a fund for small-town hospitals, boost payments to rural ambulance units, and fix Medicare payments for rural providers.
- Medicare Improvements for Patients and Providers Act of 2008 – This legislation, which became law in July 2008, contains many provisions that are particularly beneficial to rural areas, such as increasing payments to sole community and critical-access hospitals, increasing Medicare payments for ground ambulance services in rural areas, and extending the minimum payment adjustments for physicians in rural areas.
- Health Care Safety Net Act of 2007 – Senator Murray is a cosponsor of this bill to improve health care access, particularly in rural areas. This bill includes a reauthorization of the Community Health Centers and the National Health Service Corp programs, both of which work to increase health care access to medically underserved populations. The National Health Service Corps provides scholarships and loan repayments for doctors, nurses and other health professionals who commit to practice in medically underserved areas. Community Health Centers provide family-oriented primary and preventive health care services for people living in rural and urban medically underserved communities. Senator Murray have also worked to increase appropriations for these valuable programs.