Your Washington Desk:
This week, the Senate debated and passed H.R.3547, the omnibus appropriations legislation. The Senate approved the bill by a vote of 72 to 26. The House passed H.R. 3647 on Wednesday by a vote of 359 to 67.
I voted for the omnibus appropriations bill because it contained several key provisions that are critically important to Georgians and the economic future of our state. In addition, the spending levels in this bill will not add to our deficit.
This package includes language that will help us make progress with Georgia’s number one economic development project – the Savannah Harbor Expansion Project. This appropriations bill, combined with the upcoming adoption of the conference report on the Water Resources Development Act, will ensure that the Savannah harbor is expanded and that Georgia remains preeminent in the import-export business of America.
I’m also pleased that this bill prevents cuts to benefits for military widows and widowers as well as for disabled veterans that were set to take place in 2015. Our brave men and women who have served in our armed forces and their families should not have to disproportionally bear the burden of our country’s fiscal challenges, and I will continue to work to ensure that all of our military retirees are protected from unfair cuts to their benefits.
While this bill is not perfect, it is a step in the right direction toward getting Congress back in the business of budgeting and appropriating, rather than continuing the pattern of last-minute showdowns on short-term patches.
Unemployment Insurance Extension
Also this week, the Senate continued work on S.1845, the Emergency Unemployment Compensation Extension Act, after cloture on the motion to proceed was agreed to by a vote of 60 to 37 last week. I voted against this procedural vote on unemployment insurance last week because I am concerned by the $6.4 billion cost of this bill.
In 2008, Congress created an emergency unemployment compensation program to provide a temporary extension of benefits for long-term unemployed workers who have exhausted up to 26 weeks of state-sponsored benefits. Since 2008, Congress has voted 11 times to extend the Unemployment Compensation Act. Following last week’s vote, I vowed to work with my colleagues to find a way to pay for this legislation and to include amendments that provide workforce training for unemployed Americans.
On Thursday, I, along with U.S. Senators Dean Heller, R-Nev., Susan Collins, R-Maine, Rob Portman, R-Ohio, Kelly Ayotte, R-N.H., Dan Coats, R-Ind., Lisa Murkowski, R-Alaska, and John Hoeven, R-N.D., introduced the Responsible Unemployment Compensation Extension Act of 2014, S.1931. This legislation would fully pay for an extension of unemployment insurance benefits for three months. The bill also repeals recent cuts in the military retiree cost-of-living adjustment included in December’s budget agreement.
I was proud to join several of my Senate Republican colleagues in introducing this legislation to continue our efforts to pay for an extension of unemployment insurance and to protect our military from cuts to their retirement. Over the past several weeks, we have–in good faith–offered several solutions with our latest proposal incorporating the Majority Leader’s ideas. It’s unfortunate that the Majority Leader rejected outright our proposal and is putting politics above good policy for the American people.
The legislation fully offsets the three-month extension by spreading savings proposed by the Majority across the current 10-year budget window. This legislation exempts Medicare providers from further cuts and includes specific language to ensure that sequestration of defense resources is not increased; reduces weeks of eligibility for emergency unemployment tiers 1 and 2, which reduces total state and federal unemployment from 73 weeks to 57 weeks; eliminates overlapping payments for unemployment insurance benefits and Social Security disability benefits.
Bipartisan, Bicameral Medicare Reforms Seek to Improve Care and Lower Costs
On Wednesday, I joined with U.S. Senator Ron Wyden, D-Ore., and U.S. Representatives Erik Paulsen, R-Minn., and Peter Welch, D-Vt., to introduce bipartisan, bicameral legislation aimed at providing better care at lower cost for the millions of Medicare beneficiaries with multiple chronic conditions.
The Better Care, Lower Cost Act seeks to improve care coordination for beneficiaries with multiple chronic conditions, the most-expensive and fastest-growing portion of the Medicare population. The legislation would expand the use of multidisciplinary health teams to keep patients as healthy as possible in their homes and communities.
According to Centers for Medicare and Medicaid Services, 68 percent of Medicare enrollees have multiple chronic conditions, and account for 93 percent of Medicare spending. Additionally, 98 percent of costly hospital readmissions involved beneficiaries with multiple chronic conditions.
I believe that the best and most innovative solutions come from the private sector and people on the ground, and my hope is that the Better Care, Lower Cost Act will unleash the creativity of the medical community to develop ways to provide better care at a lower cost. I’m proud to join Sen. Wyden in introducing this legislation, which addresses our health care system’s challenge of managing chronic medical conditions by allowing patients to voluntarily enroll in a program that incentivizes health care providers to invest in prevention and keeping patients healthy. This legislation is critical to the future of Medicare and our health care system.
The legislation creates the “Better Care Program,” allowing health plans and groups of providers to form “Better Care Plans” or “Better Care Practices,” (BCPs) respectively. This program would be voluntary and open to Medicare enrollees suffering with chronic illnesses. Participating plans and practices would receive newly calculated risk-adjusted, capitated payments rewarding better health outcomes for enrolled beneficiaries.
BCPs would be allowed to focus and specialize in chronic care delivery and management. Under current law, the so-called “attribution rule” strictly limits the ability of provider-led organizations to reach out to sicker patients and provide them with the highest-quality, integrated chronic care services.
Existing integrated care delivery models are largely limited to the Pacific Northwest, Midwest and Northeast, leaving millions of Medicare enrollees without access to this more-effective and cost-efficient model of care. In these areas, the legislation provides opportunities to go further.
In rural or underserved areas where integrated delivery models may not be as prevalent, the legislation provides a direct focus to so-called ‘hot spots’ where there is a high prevalence of chronic disease. Further, the bill would encourage the expansion of telemedicine health IT, and ensure that health providers in underserved areas could practice at the top of their licenses.
Additionally, the bill would encourage medical schools to focus on team-based care as well as geriatrics and chronic disease management.
The legislation has already attracted a wide range of interest and support from the National Coalition on Heath Care, the Council for Affordable Health Coverage, Amedisys, and numerous health systems.
What’s on Tap?
Next week, the Senate is in recess. When the Senate returns on Jan. 27, we are expected to consider legislation that would delay federal flood insurance rate increases for four years. The Homeowner Flood Insurance Affordability Act would protect millions of homeowners from facing huge flood insurance premium rate hikes and require FEMA to complete an affordability study and propose real solutions to address affordability issues before any flood insurance premiums can be raised in the future.
Sincerely,
Johnny Isakson
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