December '09 Nevada Government—U.S. Senator Harry Reid Column

Reid: Health Reform Is An Opportunity As Great As The Costs Of Inaction

December 9, 2009 – Washington, D.C. – Nevada Senator Harry Reid made the following remarks on the Senate floor this morning regarding The Patient Protection and Affordable Care Act. Below are his remarks as prepared for delivery:

“Much of this momentous health care debate revolves around numbers. We read them in reports, see them on charts and hear about them in speeches.

“The state of health care in this country is in such severe crisis that these numbers are often quite overwhelming.

“Today I want to talk about one number: The number 31. It has a special significance – especially today – along the course of this long, historic pursuit to make it possible for every American to afford good health.

“First, let’s discuss the future. The number 31 is a powerful reminder of both the great opportunity before and of the great costs of inaction – a tangible illustration of what we stand to gain and what we stand to lose.

“When we pass this bill, 31 million Americans who today have no health insurance whatsoever will at long last be able to afford it. That means they no longer will have to put off the surgery they desperately need, and they will be able to finally fill the prescription that today is too expensive to buy. It means 31 million more Americans will have a decent shot at a healthy life.

“But if we do not act – if we let misinformation confuse us, or let distractions divert us, or refuse to answer the American people’s call to action – many more will suffer. In Nevada, like in every state, health insurance costs continue to climb. If we don’t act, in just six years the typical Nevada family will spend more than 31 percent of its income on health care premiums. Almost a third of every Nevadan’s paycheck will go right to his or her health care company. That number is even higher on average throughout the country – but only if we do nothing.

“Second, let’s talk for a moment about the present. Right now, every 31 minutes, insurance companies cut off more than 300 Americans’ health coverage. Sometimes it’s because you’ve lost your job, and so you lose your health care along with it. Sometimes it’s because you’ve changed your job, but your health care doesn’t come with it. And sometimes, at the very moment you need your health care the most – the investment into which for years you have poured more and more money from every paycheck – a greedy health insurance company looks at your medical history and says, I’m sorry, we’re taking it away.

“Maybe you’ve had high cholesterol your whole life, had acne as a child or had a C-section as an adult – health insurance companies have used all of these reasons to drop someone’s coverage. Maybe you had minor surgery 10 years ago, or your mother had breast cancer, or your father had heart disease. We all know that, much like our Republican colleagues, insurance companies will use any excuse in the book to say ‘no.’

“But that statistic – that every 31 minutes in America, more than 300 people lose their health insurance coverage – what does it really mean? Imagine if the Senate Gallery above us was filled, every single one of the nearly 600 seats taken by a good American citizen who has health insurance. Imagine that each of them came in this morning to watch their government at work, and observed the proceedings here on the floor for an hour. Then each of them went on their way when that hour came to a close, but on their way out the door they were told that they no longer have health care. That’s what is happening right now in America – the wealthiest and greatest country the world has ever seen. Every 31 minutes, 300 more people lose their health coverage.

“Third, and finally, let’s talk about the past. Let’s put the historical moment upon us in the context of history.

“It was 31 years ago today that Senator Ted Kennedy gave one of the most profound and stirring speeches both of his remarkable life and in the history of our nation’s long health care debate.

“In that talk, he made an observation that rings just as true today as it did more than three decades ago. He said, quote, ‘One of the most shameful things about modern America is that in our unbelievably rich land, the quality of the health care available to many of our people is unbelievably poor, and the cost is unbelievably high.’

“He observed how out of control costs were back in 1978, and warned how quickly they would rise if we didn’t act. Well, we didn’t act, and in the past 31 years, health care costs have skyrocketed. The number of uninsured Americans has done the same. More bankruptcies than ever – three out of five – are because of medical expenses. The cost of prescription drugs has doubled in just the past decade, and far fewer small businesses can afford to cover their workers. And one more thing has happened: the resistance of the health insurance industry and Congressional Republicans to the change the American people demand has only become more tone deaf and more intense.

“If we don’t act this time, those terrible trends will only continue. Costs will go up and up, without end. More Americans who have health insurance today will lose it. More patients will die of diseases we know how to treat. And as the crisis spirals, insurance company executives will laugh all the way to the bank.

“Much of this health care debate revolves around numbers. But at its heart, it is about people.

“On December 9, 1978 – 31 years ago today – Senator Kennedy asked us to recognize that health care is, quote, ‘a basic right for all, not just an expensive privilege for the few.’

“A generation later, good health is still a luxury in this country. We are working day and night so that a generation from now, it won’t be.”

Reid: Republicans May Want To Do Nothing, But The American People Demand That We Act

December 7, 2009 – Washington, D.C. – Nevada Senator Harry Reid made the following remarks on the Senate floor this morning. Below are his remarks as prepared for delivery:

“There is nothing the American people want more than for us to act.

“They want us to stop greedy insurance companies from denying health care to the sick and taking away your coverage at the exact time you need it most. They want us to make it illegal for these multibillion-dollar companies to say, I’m sorry, your high cholesterol or heart disease or hay fever might hurt you, but it also hurts my bottom line – so you’re on your own.

“They want us to make sure they can get the tests they need to prevent diseases before they start. Women want to be able to afford the screenings that can catch breast cancer, and men want to be able to afford those that can catch prostate cancer.

“Seniors want to be able to afford their prescription drugs. They want to know their Medicare benefits will always be protected.

“The American people want us to make it possible for everyone to afford insurance. They know that until we do, those who do have it will keep paying extra to cover those who don’t.

“They want us to cut the waste and fraud out of the health care system so that everyone saves money.

“They want us to make sure they can choose their own doctors, their own hospitals and the health plan that’s right for them.

“And they want us to guarantee them they will be able to afford health care even if they lose or change their job.

“That’s why we’ve written a good bill that will make it possible for every single American to afford to stay healthy. It’s a bill that will make health insurance more affordable and health insurance companies more accountable. And it will do all this while reducing the deficit.

“Yet while the American people want us to act, our Republican colleagues in the Senate want nothing more than for us to do nothing.

“And that’s why Republicans have sounded a familiar cry: Slow down, stop everything and start over.

“As we have seen again and again, these Republicans like to pretend America’s health care crisis isn’t a problem. They choose to ignore the fact that unfair and unchecked insurance company policies are forcing the very people these Senators represent to lose their homes, file for bankruptcy and even die.

“I know this country has never had a place for those who hope for failure. So here’s whom I would rather listen to: the men and women in my state of Nevada who write me every day.

“They are hardworking people who play by the rules and don’t understand why their health insurance system doesn’t do the same. They write from the heart, and these are some of the stories they’ve shared:

“A woman named Lisa lives in Gardnerville, Nevada, with her two daughters, both of whom are in elementary school. The youngest suffers seizures and her teachers think she has a learning disability.

“Because of her family history, Lisa, the girls’ mom, is at high risk for cervical cancer. Though she is supposed to get an exam every three months, she goes just once a year to save money.

“When Lisa lost her job, she lost her health coverage. Now both Lisa and her daughter miss out on the tests and preventative medicine that could keep them healthy. Her long letter to me ended with a simple plea. It wasn’t, ‘Slow down, stop everything and start over.’ It was, ‘We want to go to the doctor.’

“Here’s another: Braden lives in Sparks, Nevada. He works 55-hour weeks to support his family, but it just barely pays the bills. It’s not enough to buy him health insurance.

“Braden owes a hospital $12,000 for a trip to the emergency room – the only place he could go without heath care.

“Braden is brave. In his letter, he doesn’t dread the debt he carries, or grumble about how hard he works. But he does have one fear – and it’s not that the Senate is doing its job. His fear is, as he wrote, ‘if I was seriously sick or injured, I would lose it all.’

“And here’s one more: Michelle is a 60-year-old woman from Fallon, Nevada. Like so many in my state, she moved to Nevada in the last 10 years. And like so many Americans who keep our economy going, she’s self-employed and has to find her own health insurance plan.

“But she only has two choices. One is a company that won’t give Michelle a policy because she takes three prescription medications – the insurance company only allows you to have two. So Michelle is stuck buying insurance from the other company, the only one that will sell her a plan.

“When Michelle moved to Nevada a few years ago, she picked the cheapest plan and her premium was $100 a month. Today that same plan costs her $264 a month – and that doesn’t include dental or vision insurance.

“Michelle doesn’t want us to do nothing. She demands that we act. In the meantime, Michelle wrote, she’s ‘waiting to be old enough for Medicare to afford the surgery my doctor says I need, as I know with my current policy it will cost more than I can afford.’ People should not have to count down the days until they are old enough to be healthy.

“These are real stories from real people with real problems. They aren’t written with a political objective in mind or a partisan axe to grind.

“They are written by people who know that insurance companies discriminate against their policyholders, but not based on party affiliation. They are written by citizens who know this crisis is bigger than politics, and too big to ignore. They are written by Americans who just want to be able to live a healthy life without going broke.

“My colleagues on the other side want us to slow down, stop everything and start over. But the course of our country goes in only one direction. We move forward. We make progress. And when citizens call on their leaders to make their lives better, we answer, and we act.”

Reid: Democrats’ Reform Bill Puts People Ahead Of Insurance Companies’ Profits

December 5, 2009 – Washington, D.C. – Nevada Senator Harry Reid made the following remarks on the Senate floor this morning. Below are his remarks as prepared for delivery:

“Yesterday, Friday, 14,000 more Americans lost their health insurance. Another 14,000 will lose their coverage today. It’ll happen again tomorrow, again on Monday and again the day after that.

“The American people don’t get weekends off from this injustice. Bankruptcy doesn’t keep bankers’ hours. The bills don’t go away just because it’s a Saturday; the pain doesn’t go away just because it’s a Sunday.

“And so our work continues this weekend – and it will continue until we give this nation’s citizens a health insurance system that works for them.

“Tens of millions of Americans – those with coverage and those without – know all too well that right now, our system is broken. They don’t need academic studies or congressional investigations or politicians’ speeches to tell them our health care is in critical condition. Every day, they live with it – and every day, some even die from it.

“Next year is just around the corner – just weeks away. And in the new year, a whole lot more Americans are about to learn just how broken our system is.

“You see, one of the largest private insurance companies in America made a lot of money last year – more than a billion dollars, in fact. Its chairman and CEO took home at least $100 million of that money himself.

“This health care company is going to make a healthy profit again this year. But its executives decided the profit they’re making isn’t quite big enough. So this multibillion-dollar company found a clever way to make sure next year’s bottom line is even bigger: it’s raising its rates.

“As you might expect, those higher premiums are going to be too expensive for many. How many? It could be as many as 650,000 people.

“That’s more than the entire populations of North Dakota, Vermont and Wyoming. It’s more than the entire populations of Baltimore and Boston and Denver and Seattle. How many people is this one company willing to drop? You could count every man, woman and child in Las Vegas and still have almost 100,000 people left over.

“But here’s the worst part: That shocking estimate comes directly from the president of the company himself. The means the company devised this strategy, crunched the numbers and saw how many American families it was going to hurt. Then the bosses shrugged their shoulders and decided to go ahead with it anyway.

“We would hardly stand idly by if every citizen of one of our states were left out in the cold. We wouldn’t ever consider doing nothing if every resident of one of our biggest cities were hung out to dry. But that’s the equivalent of what just one company is doing – just one of countless health insurance companies.

“Others may suggest such a system is just fine the way it is, but Democrats know they’re only deluding themselves.

“This summer, the junior Senator from South Carolina said that we just need to – quote – ‘get out of the way and allow the market to work.’ The market sure worked for insurance companies this year. The problem is it didn’t work for people.

“Then just last week, my distinguished counterpart, the Republican Leader, called the health care crisis ‘manufactured’ – his words, not mine. In one sense, he’s right: It was manufactured by greedy insurance companies like the one I mentioned earlier, companies that claim to be in the business of helping people stay healthy, but that raise families’ rates on a whim, with concern for nothing but their own executives’ personal bank accounts.

“The question before the United States Senate is how many more of our own citizens we will sentence to such a fate. How much longer will we look the other way while our neighbors suffer right in front of our eyes? How much more are we willing to charge those fortunate enough to have insurance in order to cover the many who have none? Right now, families with coverage spend at least $1,000 a year more than they would need to if uninsured Americans could go to a doctor instead of the emergency room.

“I ask my colleagues, How much longer will we enable the insurance companies to deny health care to the sick? And how much longer will we let these companies force thousands upon thousands of Americans into bankruptcy while they rake in millions and millions of dollars?

“That’s the reality. Opponents of progress have tried to drown out this truth with distortions, distractions and dishonesty. But as John Adams observed, facts are stubborn things.

“Here’s one of the most startling facts: Last year, 750,000 Americans filed bankruptcy. Seventy percent of them did so because of medical expenses – and 62 percent of those who filed bankruptcy because of medical expenses already carry insurance.

“In the year World War II ended, Harry Truman warned that so many of us were so vulnerable to what he called ‘the economic effects of sickness.’ In the 64 years since, it’s only gotten worse.

“Here are some more facts – facts about what our bill will do:

It will make sure nearly every American can afford quality health care. That means 94 percent of Americans as a result of this bill, and 98 percent when you include our seniors on Medicare.
It will not only protect those seniors’ Medicare, it will make it stronger.
It will make sure that more than 30 million Americans who do not now have health care will have it soon.
It will not add a dime to the deficit. Quite the opposite, in fact: We will cut the deficit by $130 billion in the first 10 years and by as much as three-quarters of a trillion dollars in the first 20.

“And we’re making this bill even stronger:

We made it better this week with an amendment that makes sure women can get the mammograms, check-ups and other preventive tests they need to stay healthy, and get them at no cost.
We made it better by reaffirming our commitment to seniors who rely on Medicare and Medicare Advantage, guaranteeing they will always get the care they need and the quality of life they deserve.
We made it better by ensuring that the money dedicated to the health care of America’s seniors and of people with disabilities should be used only for those precise purposes.
And today, we will continue to make it better with an amendment by Senator Lincoln of Arkansas that stops irresponsible tax breaks for millionaire health insurance executives and starts to use companies’ revenue to strengthen Medicare.

“The fact is that our bill will, in short, save lives, save money and save Medicare.

“We will make it possible for each and every American to afford to live a healthy life. We can’t afford not to.”

Reid: Democrats Committed To Fixing Medicare Advantage So Seniors Get More For Their Money Than Insurers Do

December 4, 2009 – Washington, D.C. – Nevada Senator Harry Reid released the following statement this afternoon in reaction to Senator Hatch’s proposed amendment to The Patient Protection and Affordable Care Act. The Hatch amendment would restore $120 billion of wasteful spending to the Medicare Advantage program:

“Senate Democrats want to fix Medicare Advantage and make sure that more money from that program goes to seniors’ benefits and less to insurance companies. It is unfortunate that Senate Republicans will not join with us to fix the inequities in Medicare Advantage. Their amendment is an early Christmas gift to insurers and a cold shoulder to our seniors.

“Senate Democrats will continue to show the American people that we’re serious about making reform work in a fiscally responsible way that puts money toward care instead of profit.”

MEDICARE ADVANTAGE LINES THE POCKETS OF INSURANCE COMPANIES

Medicare Advantage is Run by Private Insurance Companies. Medicare Advantage plans are run by private insurers who receive a monthly payment from Medicare to provide covered health benefits to Medicare-eligible individuals. This means that seniors participating in Medicare Advantage have left the traditional fee-for-service Medicare program. [CRS, 3/3/09]

GAO: In One Year, Private Medicare Advantage Plans Reaped Over $1 Billion in Extra Profits. In a recent report, the GAO found that private insurers that participate in Medicare Advantage spent less on beneficiaries than they projected in 2005. This lower spending created a windfall profit for these plans of over $1 billion. These additional profits were on top of the $35 billion in revenues these plans generated in the same year. Medicare Advantage plans are supposed to use the additional payments they receive from the government to provide their beneficiaries extra benefits; instead, too much of this money is going, not to seniors, but to big insurance company profits. [GAO, 6/24/08]

Medicare Advantage Costs More Than Traditional Medicare. The Medicare Payment Advisory Commission (MedPAC) found that in 2009, payments to private Medicare Advantage plans are 14 percent higher than the cost of insuring a beneficiary in traditional Medicare. That’s an increase from 2008, when private insurers received a 13 percent overpayment. Payments to Medicare Advantage plans are projected to cost $110 billion this year. MedPAC estimates that Medicare pays $12 billion more to provide Medicare beneficiaries with covered health benefits than it would cost to cover them in traditional Medicare and notes, “The Congressional Budget Office estimates the additional 10-year cost at more than $150 billion.” [MedPAC, 3/09; MedPAC, 6/09]

Medicare Advantage Has Increased Medicare Spending. The Government Accountability Office found that Medicare Advantage “health plans were originally envisioned in the 1980s as a potential source of Medicare savings, such plans have generally increased program spending.” [GAO, 2/08]

Medicare is Closer to Bankruptcy Because of Medicare Advantage Overpayments. These overpayments bring Medicare closer to bankruptcy. The Center for Medicare and Medicaid Services estimates that Medicare Advantage overpayments will reduce the period of time the Medicare Trust Fund is solvent by 17 months. [Center on Budget and Policy Priorities, 9/14/09]

All Medicare Beneficiaries and All Taxpayers Pay a Hidden Tax to Private Insurance Companies Running Medicare Advantage. The Chief Actuary at the Centers for Medicare and Medicaid Services (CMS) found that overpayments increase premiums for beneficiaries in traditional Medicare by more than $86 per year per couple. In addition to overpayments, CMS reports that Medicare Advantage plans had an improper payment rate of 10.6 percent, or $6.8 billion in 2006. [Center on Budget and Policy Priorities, 9/14/09; CMS, 11/17/08]

Medicare Advantage Can’t Deliver for Seniors Without “Massive Government Subsidies.” As Barbara Kennelly, President and CEO of the National Committee to Preserve Social Security and Medicare, recently wrote, “For decades the insurance industry has told Congress it could provide better health care for seniors while saving Medicare money. However, it has never happened…Privatized Medicare cannot deliver on its promise because without massive government subsidies to boost profits, the industry inevitably loses interest in providing coverage for America’s elderly.” [HuffingtonPost.com, 9/28/09]

AARP: “Up to the Insurance Companies” to Manage Reduction in Overpayments, “Entirely Within Their Realm to…Deliver Medicare Benefits at the Same Level They Do Now.” David Sloane, AARP senior vice president for government relations, recently stated that Medicare Advantage enrollees could easily see no change in benefits under competitive bidding. In responding to subsidy reductions likely to occur under competitive bidding, Sloane said, “It’s up to the insurance companies to decide how they want to manage. We believe it’s entirely within their realm to continue to deliver Medicare benefits at the same level they do now.” [Washington Post, 9/28/09]

HEALTH INSURANCE REFORM CREATES A MARKET FOR SENIORS’ BUSINESS

Health Insurance Reform Creates Competitive Bidding to Reduce Substantial Overpayments to Private Insurance Companies. Senate health insurance reform creates a competitive bidding structure for Medicare Advantage plans, allowing the market to set payment rates and ensuring that payments to private insurance companies reflect the actual cost of caring for seniors and saving billions of dollars. As the Wall Street Journal puts it, “The bill would force the insurers to bid competitively to run the plans, a change from current law.” This will ensure that private insurance companies participating in Medicare bring value to all Medicare beneficiaries and taxpayers. In addition, bonus payments will be available to plans that coordinate care for enrollees and demonstrate measurable quality. [Wall Street Journal, 9/24/09; Patient Protection and Affordable Care Act, accessed 12/1/09]

Medicare Advantage Enrollment Will Continue to Grow Under Competitive Bidding. CBO projects that, under current law, Medicare Advantage enrollment will increase from 10.6 million in 2009 to 13.9 million in 2019. Appearing before the Senate Finance Committee, CBO Director Douglas Elmendorf testified that, under the Chairman’s Mark, Medicare Advantage enrollment would be reduced by 20 percent in 2019, or 2.7 million beneficiaries. The CBO Director went on to say that “almost all” of this reduction results from Medicare beneficiaries not joining Medicare Advantage plans, and is not a result of beneficiaries leaving the plans. Comparing these numbers to CBO’s previously released enrollment estimate demonstrates that Medicare Advantage enrollment will be approximately 11.2 million 2019, a projected 5.7 percent increase over 2009 enrollment levels. [CBO, 5/18/09; CQ Transcript, 9/22/09]

Medicare Advantage Will Continue to be Offered in Existing Areas Under Competitive Bidding. CBO Director Douglas Elmendorf told the Senate Finance Committee that, “…the competitive bidding system would, in our judgment, keep the plans essentially the same place as they would be under current law…the competitive bidding process should enable these plans to continue operate (sic) where they are…” [CQ Transcript, 9/22/09]

Republican Senators Have Supported Competitive Bidding in Medicare Advantage. Eight Republican Senators have cosponsored legislation that includes a competitive bidding program for Medicare Advantage. Senators Alexander, Bunning, Burr, Chambliss, Graham, Inhofe, and Isakson are cosponsors of Senator Coburn’s Patients’ Choice Act (S. 1099). A description of the bill indicates that, “To promote competition among Medicare Advantage plans and to increase the quality of care furnished under such plans, this provision establishes a competitive bidding mechanism that will apply to these plans beginning in 2011.” [The Patients’ Choice Act, Section-by-Section, access 9/24/09]

Republicans Senators Are Now Abandoning Their Free Market Ideology to Keep Subsidies Flowing to the Private Insurance Industry. On many issues, Republicans demonstrate a strong adherence to free market ideology. When speaking of health insurance reform, Republicans have argued that we just need to “get out of the way and allow the market to work” and that what we, “need to do is unleash the marketplace that you've got.” But now, Senate Republicans claim concern over both the cuts to the Medicare Advantage program and the idea it would become competitive. [Congressional Record, 7/20/09; The News and Observer (NC), 8/28/09]

Reid, Ensign Host Promotion Of Las Vegas Soldier

December 3, 2009 – Washington, D.C. – Nevada Senators Harry Reid and John Ensign today hosted the promotion of Army Staff Sergeant and Nevada native Michael Spence to the rank of Sergeant First Class during their weekly “Welcome to Washington” breakfast with constituents.

“It is a pleasure to participate in the promotion one of Nevada’s own,” said Reid. “The Battle Born State has a long tradition of supporting the nation in a time of war and Sergeant Spence continues that tradition. We are grateful to Sergeant First Class Spence and his family for their service and sacrifice as a part of our armed services.”

“It was an honor and a privilege for me to share in this great moment for First Sergeant Michael Spence,” said Ensign. “This man and his family truly represent what it is to be Americans, and he will continue to serve our country as an American hero.”

Nevada Senators Harry Reid and John Ensign host the promotion of Sergeant First Class Michael Spence, a native of Las Vegas. Sen. Reid administers the Oath of Office.

Nevada Senators Harry Reid and John Ensign host the promotion of Sergeant First Class Michael Spence, a native of Las Vegas. SFC Spence is joined by his wife Karen Spence.

Reid Announces $2.5 Million In Energy Efficiency Rebates Headed To Nevada
Funds made available as part of Economic Recovery Act
December 3, 2009 – Washington, D.C. – Nevada Senator Harry Reid announced $2.5 million of economic recovery funding is headed to Nevada to give consumers rebates for buying Energy Star appliances. Energy Star appliances consume less energy than other appliances, which has helped consumers save $19 billion on utility bills in 2008 alone.

“In these tough economic times, I’m pleased that we’ve found another way to make it easier for consumers to save money,” Reid said. “These rebates will reward Nevadans who want to become more energy efficient and help them reduce their utility bills.”

Reid Statement On Cancellation Of Fema Exercise

December 3, 2009 – Washington, D.C. – Nevada Senator Harry Reid today made the following statement after the Federal Emergency Management Agency (FEMA) informed him of its decision to cancel its exercise that faced overwhelming opposition from the local business community.

“I thank the Department of Homeland Security for considering my letter to Secretary Napolitano and reaching the decision to cancel this exercise so quickly. At a time when Las Vegas is beginning to show signs of improvement, including the first increase in tourism in a year, an exercise of this magnitude would have created unnecessary anxiety and possibly undo our efforts to strengthen the engine of Nevada’s economy.

“I look forward to working with Secretary Napolitano and FEMA in the future to ensure our first responders have every resource and opportunity they need to prepare for, and respond to, such an event.”

Reid: Mikulski Amendment Makes It Easier For Women To Receive Preventive Care That Saves Lives And Saves Money

December 3, 2009 – Washington, D.C. – Nevada Senator Harry Reid released the following statement today after Senate passage of the Mikulski Amendment to the Patient Protection and Affordable Care Act:

“Today’s passage of the Mikulski amendment is a victory for millions of American women. This amendment improves coverage and affordability of women’s preventive health services by promoting comprehensive women’s preventive care and screenings at no additional cost. As I’ve said before, Senator Mikulski has long been a champion of improving women’s health services, and her work to develop this amendment continues that legacy.

“According to the American Cancer Society, almost half of Nevada women over age 40 did not get a mammogram or clinical breast exam in their most recent doctor’s visit. Senator Mikulski’s amendment makes it easier for our mothers, daughters, wives and sisters to receive this critical preventive care that saves lives and saves money.

“The addition of this amendment ensures that our bill preserves the doctor-patient relationship and protects patients’ ability to consult with their doctors on what services are best for them. Equally important, this amendment is fully paid for. We took important steps to strengthen our bill today.”