LIHEAP and Community Health Centers

Floor Speech

LIHEAP AND COMMUNITY HEALTH CENTERS -- (Senate - June 26, 2008)

Mr. SANDERS. Mr. President, on Tuesday, I introduced S. 3186, the Warm in Winter and Cool in Summer Act. This bill would provide $2.53 billion in emergency funding for the Low-Income Home Energy Assistance Program, commonly known as LIHEAP.

I take this opportunity to thank the majority leader for completing the rule XIV process of placing this bill directly on the Senate calendar yesterday. I also want to express my deep appreciation to him for his goal of moving this legislation forward within the next month. I think there is widespread support, in a nonpartisan way, for this legislation, which impacts people when the weather gets hot and it impacts people when the weather gets cold.

This bipartisan bill is being cosponsored by Senators Leahy, Snowe, Brown, Sununu, Cardin, Coleman, Kerry, Collins, Kennedy, and Smith and I expect that the numbers of Senators from both sides of the aisle who will be supporting it will only grow. The bottom line here is pretty simple, and that is: With the cost of energy soaring, we have many millions of Americans wondering next winter how they are going to be able to stay warm, and we have got to expand LIHEAP funding to match the inflationary costs of home heating fuel.

For those people living in warm weather States, what we understand right now is that electricity rates are also soaring. There are many Americans--elderly people, lower income people--who are unable to afford the increasingly high cost of electricity. They run the danger of seeing their electricity cut off. When the weather gets 110 degrees and the electricity gets cut off, and you are a senior citizen or you are a person who is frail or who is ill, you have a problem dealing with heat problems.

So I hope and expect there will be widespread support for this legislation. Once again, I thank the leader for putting this on the rule XIV process.

I also want to say a few words about the Medicare package that was approved overwhelmingly in the House on Tuesday, and which we expect, hopefully, to take up here shortly. This bill is nearly identical to the bill put forth on the floor last week by Finance Committee Chairman Baucus, and I thank the chairman for his commitment and his effort in putting together this excellent piece of legislation.

There is a lot in this bill, but there is one particular section I want to focus on, and that is the section pertaining to Medicare payments to community health centers.

Specifically, this bill provides for a much needed increase in the cap on Medicare payments to community health centers, and also requires a GAO study to determine whether the current structure for Medicare payments to community health centers provides adequate compensation for the care provided. I believe it does not.

According to the National Association of Community Health Centers, the artificially low cap on Medicare payments costs community health centers $50 million annually--money that could be used to provide primary care access to thousands more of our Nation's seniors. An overwhelming majority of community health centers--a full 75 percent--now lose money--they lose money--treating Medicare beneficiaries. An inadequate and arbitrary payment system jeopardizes the ability of community health centers to continue to provide necessary primary care to the 1.5 million Medicare beneficiaries who are seen at community health centers each year, many of who live in the most isolated and medically underserved regions of this country.

Let me say a word on community health centers, because I am a very strong advocate of that program. The truth is that in the midst of the disintegrating health care system, one of the major crises we are facing is in primary health care access. All over America, especially in rural areas, millions and millions of people simply cannot get access to a doctor, to a nurse, to a dentist, to people who will help them deal with their day-to-day health problems. The insanity of continuing that situation, that lack of health care access, means people will simply get sicker. They are going to go to the emergency room and they will end up in the hospital at far greater expense and a lot more human suffering.

I happen to believe this country has to join the rest of the industrialized world and establish a national health care program which guarantees health care to every man, woman, and child. I think at a time when we spend twice as much per person on health care as any other nation and have 47 million people uninsured and see our social indices, in terms of infant mortality or longevity, much worse than many other countries, I think we should finally conclude there is something fundamentally wrong with our health care system.

Health care should be a right of all people. We should do it in a cost-effective way. The function of health care should not be to make insurance companies rich or make drug companies rich but should be to provide quality health care to every man, woman, and child.

In the midst of all that, while we try to take on the insurance companies and all their lobbyists and while we try to take on the drug companies and all their lobbyists and advertising and campaign contributions, there is one simple thing we can do, where I suspect there is going to be tripartisan support, and that is substantially increase the funding for community health centers. In that regard, I thank Senator Kennedy and Senator Enzi for a very strong authorization package that came out of the Health, Education, Labor Committee. I thank Senator Harkin and Senator Specter for their support in giving us a reasonable increase in appropriations funding. But we have a long way to go.

The simple truth is--and this is a point that should be understood by all Members--if we spend as a nation $2 or $3 billion more on community health centers, do you know what? We could provide primary health care access to every man, woman, and child. That is about 1 week of the war in Iraq. So you have war in Iraq, 1 week; or $2 billion or $3 billion building hundreds of community health centers, providing primary health care, dental care, mental health counseling, low-cost prescription drugs, to every man, woman, and child.

In the course of the coming months and years, I will be fighting for that $2 or $3 billion. It certainly is not going to solve all our health care problems, but by providing a place where any American--whether you are insured, uninsured, Medicare, Medicaid--regardless of your income you can walk in and get high-quality primary health care--wow, that is a huge step forward in this country.

In order to make sure these community health centers function, we have to do something else. Do you know what we have to do? We have to graduate doctors and nurses. We are living at a time when we are not graduating from medical school enough doctors or enough nurses or enough dentists. We have to work on that. One of the ways we work on that is to significantly increase funding for the Health Services Corps, a program which provides debt forgiveness and scholarships for those willing to serve in underserved medical areas.

There is a lot of work to be done. I think we are making some progress on the Medicare bill coming before us. The day has to come when all our people, by right, have primary health care access and access to health care.

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