Voluntary Support for Reservists and National Guard Members Act

Mr. President, today I introduce the Community-Based Health Care Retraining Act, which would amend the Workforce Investment Act to help communities with both significant job losses and shortages in the health care professions create programs to retrain displaced workers for high-demand health care jobs. I have introduced similar legislation in the past to help workers who are displaced from the manufacturing and service sectors.

In light of the state of our economy and the tremendous increase in unemployment across this country, I have tried to broaden the bill to cover workers from all sectors. According to the Department of Labor, in the last year the number of unemployed people in the United States has increased by 6 million. In April alone, private sector employment fell by 539,000, bringing the unemployment rate to 8.9 percent. In my home State of Wisconsin, the unemployment rate is up to 8.8 percent.

In Wisconsin, we have seen the loss of many manufacturing jobs, including at the idled General Motors automobile assembly plant in my hometown of Janesville, and in Kenosha, where Chrysler recently announced that the Kenosha Chrysler plant will cease production in 2010. But these large factories are just the tip of the iceberg. Some small manufacturing businesses are also going out of business in communities around Wisconsin, and others are struggling to survive.

In addition, the economic troubles in the last few years have permeated other industries besides manufacturing, including construction, business, and also the retail industry.

The people in my State are facing tough economic challenges, but they are meeting them head-on. Wisconsin has a determined workforce that is a tremendous asset as we look to rebuild this economy. These talented, hard-working people are ready, willing, and able to work, and Congress should be doing more to help connect them with jobs in growing industries.

That is exactly what I am proposing to do as I introduce this Community-Based Health Care Retraining Act. This bill will help more dislocated workers find jobs in the growing health care industry. My bill would create $25 million in grants to help workforce development boards in our communities identify health care job openings and train people for these positions. This bill is also paid for, so it won't increase the deficit. This bill is a small step toward two critically important goals: helping the hard-working Americans whose jobs have disappeared and providing all Americans with the health care they deserve.

The Community-Based Health Care Retraining Act puts control in the hands of the local communities. It allows local workforce development boards to partner with institutions of higher education and other community leaders to design programs that can retrain dislocated workers for jobs in the health care industry. Allowing the local workforce boards and their partners to apply for the grant funds and design the programs means that each community can use the funds differently to address the specific needs it faces. Particularly in such challenging economic times, I think a one-size-fits-all approach will not work; communities know best about the resources they need to run an efficient program. I believe the Federal programs should be flexible enough to allow partnerships to tailor the programs to meet the needs of individual communities.

For years, despite limited resources and increases in demand for their services, our workforce development boards have worked tirelessly to retrain workers for new employment. These boards are a tremendous asset for local economies, bringing together members of the labor, business, education, and other communities to ensure that the boards are doing their best to provide the most valuable services and training. In Wisconsin, workforce development boards are leading the way in finding innovative solutions to retraining workers for new careers on shoestring budgets. I look forward to the long overdue reauthorization of the Workforce Investment Act this year and to the opportunity to provide better support for these boards.

I wish to take this time to commend the leaders of these boards in Wisconsin and across the country for their dedication and hard work. Workforce development agencies in Wisconsin have already been training people for health care jobs. But in these difficult times, we have to do more to support our communities in these efforts. We must do our best to ensure that communities across the country have the resources they need to help employ more dislocated workers.

As we face the challenge of helping Americans who lose jobs, we must look to industries that continue to grow and demand more workers. As many of my colleagues know, there is, in fact, a real shortage of health care workers in the United States. Congress continues to fund programs that address nursing shortages and recently provided stimulus funds for health care retraining, but we need to develop longer term and wider ranging programs. Shortages of health care professionals of all sorts pose a real threat to the health of our communities by impacting access to timely, high-quality health care.

As Congress looks forward to reforming our Nation's health care system, we must also ensure that there are enough trained professionals to provide services. According to the Bureau of Labor Statistics, we are going to need an additional 700,000 nursing aides, home health aides, and other health professionals in long-term care before the year 2016.

This bill will help provide communities with the resources they need to run retraining programs for the health professions.

Partnerships funded by the legislation will be able to use these funds for a variety of purposes, including for implementing training programs, providing tuition assistance, providing transportation assistance, and also to increase capacity for existing training programs that are already working but could use more resources.

We must ensure we are doing what we can to train laid-off Americans into fields such as health care that continue to demand more workers, and this Community-Based Health Care Retraining Act takes a small but important step toward that goal.

Mr. President, I ask unanimous consent that the text of the bill and a list of supporters be printed in the Record.

Mr. President, I rise today to express my support for the Confidence in Long-Term Care Insurance Act of 2009. With America aging at an unprecedented rate, and with the high and rising costs of caring for a loved one, the financing of long-term care must be addressed if we are going to get health care costs under control. I am proud to be an original cosponsor of this bill. I wish to also thank my colleague Senator Wyden for his leadership on addressing the financing of long- term care.

We all know that long-term care is expensive. The cost of an average nursing home is nearly $75,000 per year. However, according to the Congressional Research Service, most Americans do not realize that neither Medicare nor Medicaid will cover these costs unless their household savings are nearly eliminated. States share the responsibility of providing Medicaid funding for long-term care with the federal government, and are also looking for ways to reduce their expenses. As of today, 43 states are in the process of launching ``Partnership'' programs, which provide incentives to consumers who purchase private long-term care insurance. But in the rush to ease the burden of long-term care costs on state budgets, we fear that some key concerns are being overlooked.

We have a duty to make sure these policies, which may span many decades, are financially viable. Several long-term care insurance providers have applied for TARP funds in recent months, raising questions about their solvency. In addition, many insurance companies have been raising their policyholders' monthly premiums, which can be devastating for older persons who are living on a fixed income. Many Americans living on modest or fixed incomes, who have held policies for many years, have seen premium rates double when a company encounters financial difficulties. For such consumers, the choices are stark and very limited: they can either dig deeper and pay the increased premiums, or let their policy lapse, leaving them with no coverage if they ever need care.

Last year, I was joined by several Senate and House colleagues in releasing a GAO report on whether adequate consumer protections are in place for those who purchase long-term care insurance. The report found that rate increases are common throughout the industry, and that consumer protections are uneven. While some states have adopted requirements that keep rates relatively stable, some have not, leaving consumers unprotected.

The Confidence in Long-Term Care Insurance Act takes several important steps to ensure that premiums increases are kept at a minimum, insurance agents receive adequate training, and that complaints and appeals are addressed in a timely manner. We should also make it easier for consumers to accurately compare policies from different insurance carriers, particularly with regard to what benefits are covered and whether the plan offers inflation protection. States should also have to approve materials used to market Partnership policies. The Confidence in Long-Term Care Insurance Act will institute many of these needed improvements.

In closing, I urge my colleagues to support the Confidence in Long- Term Care Insurance Act of 2009. It is estimated that two out of three Americans who reach the age of 65 will need long-term care services and supports at some point to assist them with day-to-day activities, and enable them to maintain a high-quality, independent life. Long-term care insurance is an appropriate product for many who wish to plan for a secure retirement. But we must guarantee that consumers have adequate information and protections, and that premiums won't skyrocket down the road. I thank Senator Wyden for his commitment to ensuring we address the important issue of long-term care financing. I look forward to working with my colleagues to enact the legislation we are introducing today.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I rise today to introduce the Preserving Patient Access to Primary Care Act of 2009, together with my colleagues from Maine, Senator Susan Collins, and from Rhode Island, Senator Sheldon Whitehouse. As we set about the urgently important business of health care reform, we will be hearing a lot about the uninsured. But there is another urgent problem in our health care system: the underserved. We must address both problems as we set about reforming the health care system.

It does you little good to have health care insurance if the nearest primary care physician is hundreds of miles away.

This bipartisan proposal sets out a multifaceted approach to supporting and expanding our primary care workforce as well as enhancing the coordination of care within our health care system. I am grateful for the input and collaboration of key health-care stakeholders in Washington state that has helped make this legislation possible. In my state, we know it is possible to both increase health care quality while also lowering costs, all within an integrated system that places a priority on expanding our primary care workforce and protecting patients' relationships with their doctors.

A dramatic increase in the primary care physician workforce will be needed. My legislation not only addresses the needs of those individuals to whom health insurance coverage will be extended but also of those who are currently insured but who live in areas underserved by our current health care system.

I believe we can address this problem by adopting long overdue reforms to improve pay levels for primary care providers while also taking measures to ensure an adequate primary care workforce, particularly in rural areas. As more Americans gain health care coverage, the experts estimate there will be a shortage of 46,000 primary care physicians available to care for the influx of patients by the year 2025. As the need grows, the number of medical students choosing primary care is rapidly dwindling.

Detailed studies from the Center for Evaluative Clinical Sciences at Dartmouth and the Commonwealth Fund found that populations with ready access to primary care physicians realize improved health outcomes, reduced mortality, lower utilization of health care resources, and lower overall costs of care. Yet despite what we know, all across this country, we are failing to realize the benefits of primary care and

a system of having a primary care physician coordinate a patient's health care needs. This bill includes several key provisions aimed at achieving a high quality, more comprehensive integrated health system.

Specific provisions include: scholarship and loan repayment opportunities for primary care providers who serve in areas with critical shortages of primary care services. New residency positions for primary care with a focus on more opportunities to train in ambulatory care settings--including community in health centers. Increased reimbursements for primary care providers. Medicare payments for care coordination services, and bonus payments to providers who serve as integrated patient-centered medical homes. Improved access to primary care for seniors by eliminating copayments for preventives care services in Medicare.

I look forward to working with my colleagues in the Senate to ensure we make the necessary investments in our primary care workforce. Mr. President, I ask unanimous consent that the text of the bill and letters of support be printed in the Record.

Mr President, I rise today to introduce legislation to help reduce the financial burden placed on our Reserve and National Guard troops and their families. More than a quarter of a million have deployed in support of operations in Iraq and Afghanistan, and we must make it a priority to honor their service at home.

Nevada alone has more than three thousand Guards men and women, and a thousand Reservists--many of whom work full-time jobs when they are not on active duty. Since September 11th, our National Guard and Reserve Troops have significantly increased their deployments beyond what had been forecasted, advertised or expected. They have continued their engagements around the globe while still responding to historic callouts in support of disaster relief.

In our Democracy, we enjoy the luxury of an all-volunteer military force. Yet in volunteering, many of our Citizen-Soldiers are financially penalized for their service. Far too frequently, when a Service Member is mobilized in service to their state or our nation, they suffer a financial burden in the reduced pay received while mobilized. A National Guard medic might earn much less while he or she is deployed in Afghanistan than they did working a full-time job in a Nevada hospital. This legislation gives American taxpayers the option of contributing money to help our military families to make up for wages lost during a deployment.

The bill I am introducing today allows Americans to designate all or a portion of their income tax refunds to the Reserve Income Replacement Program. The Program is a compensation that must be paid to all eligible Service Members when they incur a loss in monthly income as a result of a mobilization. The funds that volunteers donate will be transferred from the Treasury Department to this program, which was developed specifically to provide payments to eligible members of the National Guard and Reserve who are involuntary serving on active-duty and who are experiencing a monthly active-duty income differential of more than $50. In 2007, the IRS issued 106 million refunds that totaled $246 billion with the average refund coming in at $2,342. Even a small percentage of this amount could make a significant difference in the lives of these reservist and National Guard families.

The financial stress of deployments during a recession has placed enormous pressures on our National Guard and Reserve Service Members and their families. Many of these members are returning from war only to find their businesses facing extreme difficulty. This bill would not only assist the Guard with monetary resources, but it would also rightfully focus more attention on the financial struggles that our brave and dedicated citizen Soldiers and Airmen undertake in defense of our country. With this legislation, we can show them that their service is not taken for granted.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr President, I rise today to introduce legislation to help reduce the financial burden placed on our Reserve and National Guard troops and their families. More than a quarter of a million have deployed in support of operations in Iraq and Afghanistan, and we must make it a priority to honor their service at home.

Nevada alone has more than three thousand Guards men and women, and a thousand Reservists--many of whom work full-time jobs when they are not on active duty. Since September 11th, our National Guard and Reserve Troops have significantly increased their deployments beyond what had been forecasted, advertised or expected. They have continued their engagements around the globe while still responding to historic callouts in support of disaster relief.

In our Democracy, we enjoy the luxury of an all-volunteer military force. Yet in volunteering, many of our Citizen-Soldiers are financially penalized for their service. Far too frequently, when a Service Member is mobilized in service to their state or our nation, they suffer a financial burden in the reduced pay received while mobilized. A National Guard medic might earn much less while he or she is deployed in Afghanistan than they did working a full-time job in a Nevada hospital. This legislation gives American taxpayers the option of contributing money to help our military families to make up for wages lost during a deployment.

The bill I am introducing today allows Americans to designate all or a portion of their income tax refunds to the Reserve Income Replacement Program. The Program is a compensation that must be paid to all eligible Service Members when they incur a loss in monthly income as a result of a mobilization. The funds that volunteers donate will be transferred from the Treasury Department to this program, which was developed specifically to provide payments to eligible members of the National Guard and Reserve who are involuntary serving on active-duty and who are experiencing a monthly active-duty income differential of more than $50. In 2007, the IRS issued 106 million refunds that totaled $246 billion with the average refund coming in at $2,342. Even a small percentage of this amount could make a significant difference in the lives of these reservist and National Guard families.

The financial stress of deployments during a recession has placed enormous pressures on our National Guard and Reserve Service Members and their families. Many of these members are returning from war only to find their businesses facing extreme difficulty. This bill would not only assist the Guard with monetary resources, but it would also rightfully focus more attention on the financial struggles that our brave and dedicated citizen Soldiers and Airmen undertake in defense of our country. With this legislation, we can show them that their service is not taken for granted.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.